A case of bilateral posterior vitreous detachment after electroconvulsive therapy (ECT) has been reported previously in the literature. There is not enough evidence about ocular side effects of this treatment. The literature supports a slight increase in intraocular pressure (IOP), although no ocular complications have been reported in normal, glaucomatous or postsurgical eyes. In this case report, we describe a 73-year-old female patient suffering a recurrent depressive disorder, who was admitted to acute psychiatric unit because a treatment-resistant major depressive episode (after an adequate trial of antidepressant drugs and transcranial magnetic stimulation) and clinical suspicion of visual delusions by her reference psychiatrist. The nonpsychiatric history consisted of hypertension, glaucoma and ulcerative colitis in treatment with azathioprine and mesalazine. After a careful examination in the emergency room, we consulted to ophthalmologist because miodesopsias and glaucoma history. The IOP was normal, but a bilateral posterior vitreous detachment (PVD) was identified. Because this entity is not an absolute contraindication for ECT, and there is scarce evidence, we informed the patient and her family. After that, and through informed consent, we decided to undergo ECT. After fourteen sessions, the patient could be discharged because significant clinical benefit and no ocular complications. Outpatient continuation ECT was indicated.ConclusionsECT can be a safe treatment choice in cases of PVD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Oscillatory response of cellular tissues has been observed in multiple embryogenetic developmental stages. The source of these oscillations has been attributed to imbalance of instabilities in the chemo-mechanical signalling and delayed cell activity. Although the relation of these oscillations with further drastic tissue deformation remains uncertain, it is apparent that intracellular remodelling events seem to drive the viscoelastic properties and the measured pulsatile deformations.We here resort to a viscoelastic model that is based on a variable restlength of the cell. We include a delay between the measured elastic strain and the evolution of the rest-length which dynamically adapts to the cell strain. This law is not only able to reproduce the relaxation phenomena observed in embryonic tissues in vitro and in vivo, but also to give rise to oscillatory cell responses. We analyse the stability of the resulting oscillations on minimal systems with two cells, and also on planar or out of plane deformation modes of monolayers. We conclude that in all cases, the stability decreases with an increasing delay or with the ability to adapt in a faster manner.
High altitude exposure reduces the oxygen tension in ambient air. The resultant hypoxia induces oxidative stress and causes vasoconstriction of the blood vessels within the pulmonary vasculature that can result in pulmonary hypertension. Previously we found that high altitude gestation deregulated Ca2+ spark activity in fetal pulmonary arteries, which is due to local ryanodine receptor (RyR) activation. These Ca2+ sparks are thought to be coupled to vasodilatory pathways and are important to vasodilation at birth, Furthermore, RyR activity is affected by the redox-status of the protein. Thus, the elevated oxidative stress in pulmonary arteries due to high altitude exposure may underlie the dysregulation in Ca2+ spark activity. We hypothesized that high altitude mediated long term hypoxia alters the impact of oxidative stress on Ca2+ spark activity. This hypothesis was examined in pulmonary arterial (PA) myocytes from low altitude (335m) and high altitude acclimatized fetal sheep (~3,800m for <100 days). Intracellular Ca2+ sparks were recorded within the myocytes of smooth muscle cells using line-scan confocal imaging of the Ca2+ indicator Fluo-4. Oxidative stress was elevated with acute exposure to tert-butyl H2O2 (TbH2O2) or reduced with the antioxidant N-Acetyl-Cysteine (NAC). Ca2+ spark activity and spatial-temporal properties were analyzed with automated custom designed software (SparkLab). Increased oxidative stress with TbH2O2 failed to influence Ca2+ spark activity independent of altitude. Interestingly, NAC preferentially reduced Ca2+ spark activity in myocytes of normoxic pulmonary arteries. These data suggest that RyR activity and resultant Ca2+ sparks in high altitude fetal sheep are resistant to acute changes in cellular redox status. NIH R01HL155295 and R01HL149608, NSF Grant MRI-DBI 0923559 and the Loma Linda University School of Medicine This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
Even though the scientific evidence supports the benefits of bariatric surgery, its indications and contraindications must be continually revised in order to avoid psychiatric complications. Substance use is more common in patients subjected to bariatric surgery than in the general population. There are reports of increased incidence of alcohol abuse in patients after bariatric surgery.ObjectiveTo review the available evidence, after treat the case of a 50-year-old man with addiction history whose addictive behaviour worsened after undergoing bariatric surgery, with decreased tolerance to alcohol effect and increase of the intake, as well as changes in the graduation of alcohol used (including antiseptic). As a result, a dangerous revolving door that led him to repeated admissions, including Intensive Care Unit.ResultsThe case is consistent with the literature that suggests that there is an increased risk of later alcohol-related problems after bariatric surgery. This risk is higher several years post surgery, in patients with previous history of problems related to alcohol, young, men, and Roux-en-Y Gastric Bypass procedure.ConclusionsThe indications for bariatric surgery should thoroughly consider the history of addiction, an adequate assessment of the patient's mental status and psychoeducation about the possible psychiatric side effects, in order to develop preventive strategies.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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