Presse Med
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Case Reports
[Thyreotoxic periodic paralysis. A cause of pseudo-paralysing hypokalemia that should not be ignored in Caucasians].
Despite its rare occurrence in Caucasians, thyreotoxic periodic paralysis should be evoked in young male Caucasians presenting with episodes of pseudo-paralytic hypokalemia. ⋯ In Caucasians, sporadic acute paralysis with hypokalemia requires testing for hyperthyroidism. Though it is well know that hypokalemia results from potassium intracellular shift, the underlying mechanism remains poorly elucidated. Treatment includes potassium administration with caution and/or beta blockers but the specific treatment is that of hyperthyroidism.
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Review Comparative Study
[Serotonin reuptake inhibitors in depression of Alzheimer's disease and other dementias].
RATIONALE IN ALZHEIMER'S DISEASE: Selective serotonine uptake inhibitors (SSRI) have demonstrated their effectiveness for symptomatic treatment of depression, as well as for behavioral and psychological disorders in dementia patients, particularly in Alzheimer's disease. ⋯ SSRI are particularly well tolerated, particularly in comparison with tricyclic antidepressants. Nausea and vomiting may be a problem in old demented patients. Safety studies have shown that tolerance is not modified in patients with Alzheimer's disease. DRUG INTERACTIONS AND PHARMACOKINETICS: Fluoxetine and paroxetine have an inhibiting effect on metabolism of cholinesterase inhibitors which should be avoided. The compounds have a short half-life and non-active metabolites should be preferred. TRAZODONE: Studies conducted in patients with Alzheimer's disease, mixed type dementia, or fronto-temporal dementia have shown the efficacy of trazodone for diverse types of symptoms: sadness, emotional disorders, irritability, fear, psychomotor instability, delirant ideas. Efficacy of SSRI in patients with Lewy body dementia remains to be confirmed.
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Vibrio vulnificus proliferates during the summer in salt water where it infects the crustaceans. Expression of its pathogenicity depends on the underlying condition and mode of contamination. ⋯ Even the most severe forms of V. vulnificus infections may be cured with early and well adapted anti-infectious treatment.
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Diarrhea occurs in 2 to 70% of tube-fed patients, depending on their disease (with an increased risk in critically ill patients) and on the definition of diarrhea used. ⋯ Treatment of the cause is only valid when it has been identified. Symptomatic treatment principally combines compensation for water and electrolyte loss and drugs that slow down the transit. Prevention associates the regulation of the administration rate and the fight against Clostridium difficile. Restoration of the colonic microflora appears the key to success and some prebiotics and probiotics have demonstrated preventive effects. Further research in this direction is warranted.