Lisa Haddad | PubMed Health

PubMed2005

Celiac disease presenting as a paraneoplastic syndrome in a patient with synchronous endometrial and ovarian cancers.

OBJECTIVE: Celiac disease is characterized by gluten intolerance and commonly manifests with unexplained diarrhea, abdominal distention and weight loss. Infrequently, patients present with vague, non-specific symptoms which often delay diagnosis and treatment. CASE: A 52-year-old female with a history of synchronous endometrial and ovarian cancers, previously treated with surgical resection, staging and pelvic irradiation, presented with progressive paresthesias in her extremities. Extent of disease work-up was unremarkable. Neurologic evaluation suggested celiac disease which was later proven by duodenal biopsy. CONCLUSION: The development of new or worsening neurologic symptoms in the cancer patient requires a thorough evaluation especially to exclude metastatic disease and/or paraneoplastic syndromes. Once neoplastic processes are excluded, celiac disease should be considered in the differential diagnosis of patients with unexplained neurologic dysfunction.

Celiac Disease↗

PubMed2004

Cognitive impairment associated with toxigenic fungal exposure: a replication and extension of previous findings.

In this study, neuropsychological data and symptom reports from 31 individuals exposed to toxic mold were examined. Most participants were found to have reduced cognitive functioning in multiple domains, with memory and executive functions the most commonly affected areas. Rates of dysfunction were significantly greater than chance on more than half of the tests. Number of cognitive impairments was found to be related to depression, although few neuropsychological test scores were correlated with depression. Results also indicated that symptom report of the mold-exposed participants was not significantly different from that of matched groups of 65 persons with mild traumatic brain injury (TBI) and 26 individuals with moderate TBI. The mold-exposed participants reported significantly more symptoms than 47 people with no disability. This study adds to a growing body of literature (e.g., Baldo, Ahmad, & Ruff, 2002; Gordon, Johanning, & Haddad, 1999) relating exposure to mycotoxins to cognitive dysfunction.

Adult↗

PubMed2000

Sexual dysfunction after traumatic brain injury.

Objective: The frequency of self reported sexual difficulties was examined in a group of 322 individuals with traumatic brain injury (TBI) ($N = 193$ men; 129 women) and contrasted with reports of sexual difficulties in 264 individuals without disability (152 men; 112 women) residing in the community. Physiological, physical, and body images problems impacting sexual functioning were examined individually and then summed into a sexual dysfunction score. Mood, quality of life, health status and presence of an endocrine disorder were examined as predictors of sexual difficulties post TBI. Study design: In this retrospective study, data about sexual difficulties were analyzed separately for men and women with TBI and without disability. ANOVAs with post hoc analysis for continuous variables, chi-square analyses for categorical variables, and ANCOVAs for predictors of sexual difficulties were utilized. Results: When contrasted to individuals without disability, individuals with TBI reported more frequent: (1) physiological difficulties influencing their energy for sex, sex drive, ability to initiate sexual activities and achieve orgasm; (2) physical difficulties influencing body positioning, body movement and sensation, and (3) body image difficulties influencing feelings of attractive and comfort with having a partner view one's body during sexual activity. Additional gender specific TBI findings were observed. In comparison to gender matched groups without disability, men with TBI reported less frequent involvement in sexual activity and relationships, and more frequent difficulties in sustaining an erection; women with TBI reported more frequent difficulties in sexual arousal, pain with sex, masturbation and vaginal lubrication. While groups differed in core demographic variables, age was the only demographic variable that was related to reports of sexual difficulties in individuals with TBI and men without disability. Age at onset and severity of injury were negatively related to reports of sexual difficulties in individuals with TBI. In men with TBI and without disability, the most sensitive predictor of sexual dysfunction was level of depression. For women without disability, an endocrine disorder was the most sensitive predictor of sexual dysfunction. For women with TBI, an endocrine disorder and level depression combined were the most sensitive predictors of sexual difficulties. Conclusion: Individuals post TBI report frequent physiological, physical and body images difficulties which negatively impact sexual activity and interest. For men post TBI, predictors of sexual difficulties included age at interview, age at injury, and having milder injuries, however, depression was the most sensitive predictor of sexual dysfunctions. For women post TBI, predictors of their sexual difficulties included age at injury and having milder injuries, however, depression and an endocrine disorder combined were the most sensitive predictors of sexual dysfunction. Implications of this study include the need for broad-based assessment of sexual dysfunction, and the implementation of treatment studies to enhance sexual functioning post TBI.

Journal Article↗