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Neuropsychological impairment following inorganic arsenic exposure.

A 50-year-old chemical engineer, routinely screened for occupational arsenic exposure, was admitted with a delirium for which no known etiology was found. Elevated levels of arsenic were found in the urine and hair. The patient received chelation treatment with British anti-Lewisite; substantial amounts of arsenic were excreted and the toxic encephalopathy improved gradually over the 8-month follow-up period. The patient was tested at 6 weeks, 4 months, and 8 months postdelirium with a battery of neuropsychological tasks. The pattern of results showed verbal learning and memory to be severely impaired while tests of general intellectual abilities and language remained unaffected. Follow-up examinations with no subsequent reexposure revealed improvements on specific cognitive tasks. It is unclear whether recovery of cortical functions occurred or if compensatory strategies were developed. It is proposed that a subacute exposure to arsenic may have contributed to the neuropsychological deficits.

Arsenic↗

[A meningioma associated with AVM: a case report].

This paper reports a case of meningioma associated with AVM. A 67 years old lady showed transient rt. lower hemiparesis with severe headache, nausea and consciousness disorder. Bilateral carotid angiogram and CT scan revealed lt. convexity meningioma and AVM. Lt MCA and ACA entered into the AVM from which several draining vessels entered into the deep venous system. These two lesions were removed by one stage. It is quite rare that cerebral tumor associates with intracranial AVM. Only two cases of meningioma associated with AVM have been reported.

Aged↗

[Delayed encephalopathy].

A specific clinical course of light covered craniocerebral traumas patients, corresponding to 2 per cent of all clinically treated craniocerebral traumata. Twilight states and transient neurological and ophthalmological symptoms characterise the clinical picture. The prompt reversibility of the symptoms indicates a functional damage requiring a differential-diagnostic consideration of morphological sequelae of traumas, for which instrumental diagnostics and, if required, surgical consequences are necessary.

Accidental Falls↗

[Scorpionism complicated by transient blindness. Apropos of a case].

A six years old child, string by a Leiurus quinquestriatus scorpion (Buthidae fam), got, 15 hours after having been string, consciousness disorders and convulsions within a feverish context. The general status recovered rapidly, but disorders of upper functions and a total blindness both occurred. The latter disappeared in few weeks time; central disorders improved progressively while a pyramidal syndrome appeared. No satisfactory explanation was given of such phenomena.

Blindness↗

[The role of respiratory physiotherapy in an intensive care unit].

In an intensive care unit an important role is assigned to respiratory physiotherapy. Its principal task is efficacious toilet of the bronchi by fluidifying the secretions, promoting their ungluing from the respiratory tree and facilitating their evacuation by cough or by aspiration with a catheter or bronchoscope. The technique comprises the inhalation of a secretolytic (e.g. Bisolvon, NaCl 9%) and, in the case of asthma, bronchospasmolytic (e.g. Ventoline) aerosol followed by breathing exercises. The other objectives of physiotherapy are to ensure a better distribution of inspired air, increase failing ventilation, ameliorate disturbed gas exchange, relax the contracted respiratory muscles and prevent bronchiolar collapse in emphysema during expiration. The field of application of respiratory physiotherapy is large; its purpose is prophylactic and therapeutic. The method is prophylactic in all patients confined to bed, where there is a risk of bronchial obstruction or ventilatory failure, especially in those with severe operation, traumatism or consciousness disorder. Physiotherapy has a therapeutic role in several, principally broncho-pulmonary diseases, such as asthma, obstructive emphysema, pneumonia, bronchiectasis, pulmonary abscess, atelectasis, and pulmonary and pleural fibrosis. Myocardial infarction and pulmonary embolism in the acute state, acute pulmonary edema, pneumothorax and pulmonary hemorrhage are contraindications for physiotherapy. If the method is to be effective the intensive care unit should have a specialized physiotherapist attached to it working there on a daily basis.

Bronchodilator Agents↗

The neuroleptic malignant syndrome.

The neuroleptic malignant syndrome (NMS) is an evidently underdiagnosed but potentially lethal consequence of treatment with potent neuroleptics. The author presents a detailed review of the clinical characteristics and differential diagnosis of the NMS as described in the world literature. Further studies of the incidence, etiology and pathogenesis of the NMS may enhance knowledge of neuroleptic pharmacology and produce more effective means of prevention and treatment.

Antipsychotic Agents↗

The neuroleptic malignant syndrome.

The neuroleptic malignant syndrome is an uncommon, potentially fatal, adverse reaction to major tranquillisers. Prompt diagnosis, cessation of medication and supportive medical care are essential in management.

Antipsychotic Agents↗