PubMed Health⌕ Search

Biomedical subjects

S Riggio

Publications and source records attributed to S Riggio.

At least 19 recordsLinked to original sources
PubMed2001

Disulfiram-ethanol induced delirium.

OBJECTIVE: To report a case of delirium, without major autonomic symptoms, as the primary manifestation of concomitant use of alcohol while taking disulfiram. CASE SUMMARY: A 50-year-old white woman with a history of bipolar disorder, type I, and alcohol dependence being treated with disulfiram was admitted to an inpatient psychiatric unit with a three- to four-day history of a change in mental status, including deficits in orientation, concentration, and visual hallucinations. Significant finding on review of systems included the spurious report of a 9.1-kg weight loss. Tachycardia and nonfocal neurologic signs on physical examination were also noted. Extensive metabolic, infectious, and neurologic work-up revealed no abnormalities that alone could explain the patient's acute confusional state. It was subsequently discovered that the patient had imbibed alcohol on at least two separate occasions while taking disulfiram prior to her change in mental status and that a similar, although shorter, experience had occurred previously. DISCUSSION: This is the first case, to the authors' knowledge, that describes an acute confusional state as the primary manifestation of a patient taking alcohol while being prescribed disulfiram as aversive therapy for alcohol abuse. Possible pathophysiologic mechanisms for delirium as a complication of alcohol ingestion while taking disulfiram include disturbances in various neuroendocrine axes, neurotransmitter systems, and metabolic derangements. Other reports of possible neuropsychiatric complications of disulfiram therapy are also reviewed. CONCLUSIONS: The differential diagnosis for the presentation of delirium in a patient known to be undergoing aversive therapy for alcohol dependence with disulfiram should include nonadherence to alcohol abstinence.

Alcohol Deterrents↗
PubMed1996

Mucormycosis after bone marrow transplantation: report of four cases in thalassemia and review of the literature.

We report four cases of mucormycosis that occurred among 711 patients who underwent BMT for thalassemia, and review 18 additional cases among BMT recipients that were reported in the English-language literature. All these patients were polytransfused and were in advanced phase of disease with severe acquired hemochromatosis. The sites of infection were sinonasal, rhinocerebral-pulmonary, pulmonary and pulmonary-central nervous system. Mucormycosis was the primary cause of death in three of four patients. Two infections were detected within the first 100 days after BMT. Only one of the four patients had partial resolution of sinonasal mucormycosis following aggressive antifungal therapy combined with hyperbaric oxygen treatment.

Adolescent↗
PubMed1994

Psychogenic seizures.

Psychogenic seizures are nonepileptic events that are varied in their clinical presentations. These events can be psychiatric or physiologic in their origin and can occur concomitantly in patients with epileptic seizure disorders. The diagnosis often requires laboratory and electrophysiologic investigation; however, historical, clinical, and laboratory findings can aid in making the diagnosis.

Emergency Service, Hospital↗
PubMed1993

Refractory status epilepticus in adults.

The management of status epilepticus has improved over the past 20 years, resulting in a substantial decrease in the associated morbidity and mortality. Patients who have seizures that are refractory to initial pharmacologic interventions tend to have significant underlying toxic, metabolic, structural, or infectious disorders, and therefore management of refractory status epilepticus must focus on stabilization and on identification and correction of seizure etiology. Regardless of etiology, the faster the seizures are brought under control, the better the prognosis. Risk of central nervous system injury increases after 30 minutes of seizure activity, and therefore efforts should focus on controlling the abnormal electrical discharges at the earliest time possible, preferably within one hour. Benzodiazepines, phenytoin, and phenobarbital remain the most commonly used first- and second-line anticonvulsants, have proven effective in cases of status epilepticus, and should be administered within the first 45 minutes of management. For refractory status epilepticus, pentobarbital anesthesia is evolving as an effective and recommended treatment modality and should be instituted immediately after phenytoin and phenobarbital loading. The role of other anticonvulsants remains to be investigated in controlled clinical trials.

Anticonvulsants↗
PubMed1992

Interictal EEG topography of frontal lobe epilepsy.

Ictal localization of seizure discharges in the frontal lobe is difficult and not easily resolved by simple translation of techniques that have proved useful for localization within the temporal lobe. There is need for improved interictal localization of functional abnormalities within the frontal lobe utilizing CET and other methods of functional localization including magnetoencephalography, cerebral blood flow, and cerebral metabolism. It is likely that improved localization within the frontal lobe and clarification of clinical syndromes of frontal epilepsy will be obtained through the use of a combination of these interictal methods, aided by the results of intracranial ictal recording and surgical extirpation (7a,b,10a,b,15a-c).

Adult↗
PubMed1991

Emergency department approach to managing seizures in pregnancy.

Seizures in pregnancy pose risks for both the mother and the fetus and must be managed aggressively. Antiepileptic drugs have some teratogenic potential, but the risks are not as profound as reported in earlier literature. There is definitely less risk to the fetus from anticonvulsant exposure than from uncontrolled seizures. The evaluation of a pregnant woman with new-onset seizures is the same as for the nonpregnant patient, including head computed tomography with appropriate abdominal shielding. Status epilepticus management is based on IV benzodiazepines, phenytoin, or phenobarbital. Good fetal outcome is dependent on rapid seizure control. Management of eclampsia is controversial. There is little evidence that magnesium sulfate has anticonvulsant properties, and its use as such will probably decline steadily in the future. At present, it is reasonable to manage eclamptic seizures in the same way that status epilepticus is managed.

Eclampsia↗
PubMed1988

Cephalic tetanus: a case report and review of the literature.

Cephalic tetanus is a rare form of tetanus defined as trismus plus paralysis of one or more cranial nerves. The most frequently involved cranial nerve is the seventh. It accounts for 1 to 3% of the total number of reported cases of tetanus and has a mortality of 15 to 30%. The incubation period is 1 to 14 days, and approximately two thirds of cases progress to generalized tetanus. The mechanism of the paralysis is not completely understood. Treatment involves debridement of wounds, administration of penicillin and tetanus immune-globulin, aggressive supportive care, and initiation of active immunization.

Facial Injuries↗
PubMed1987

[Saint's triad. Statistico-epidemiologic research and case contribution].

The results are reported of a systematic research conducted on 684 patients subjected to radiological examinations for the purpose of identifying the three pathologies that constitute Saint's triad in an attempt to contribute to the assessment of its real incidence. The investigation revealed 7 cases of Saint's triad (1.02%) and 86 cases of bifocal associations; 59 cholelithiasis + diverticulosis, 17 cholelithiasis + Hiatus hernia; 10 diverticulosis + hernia. The incidence of the triad was 4 times higher than expected as was revealed by a simple statistical calculation.

Age Factors↗
PubMed1987

Lymphocytic adenohypophysitis causing pituitary mass.

Lymphocytic infiltration of the anterior pituitary is a rare complication of pregnancy, which has been reported in 18 cases. Symptoms begin in the last trimester or soon after delivery. Radiologically, an expanding mass in the sella may result in suprasellar extension. We studied a case in which there was CT evidence of a pituitary mass 2 weeks postpartum, and biopsy confirmed the diagnosis.

Adult↗
PubMed1984

[Malformations of the fetal urinary tract of surgical significance. Diagnosis on the basis of pre- and post-natal imagings].

Out of the 29 cases of fetal urinary tract anomalies detected by sonography, the authors report on the 17 cases with potentially correctable malformations. A critical analysis of the diagnostic contribution offered by the radiologic and sonographic studies is presented. The role of ultrasound examination in the choice of a suitable investigation strategy is emphasized, underlining the importance of an accurate approach to avoid diagnostic errors and unuseful procedures. The indications for fetal and neonatal antegrade pyelography are discussed.

Female↗
PubMed1984

[The lung of the severely premature infant: radiologic aspects].

The iatrogenic pulmonary complications (interstitial emphysema, pneumothorax, atelectasis, broncho-pulmonary dysplasia) in 87 premature infants (less than 32 weeks gestational age, birth weight less than 1500 g) are analyzed. Also the predictive value of the radiologic pattern of the lung of the premature infant as seen at birth is evaluated (predictive value versus survival beyond the fifth day and versus the possible need of assisted ventilation).

Bronchopulmonary Dysplasia↗