A 68-year-old man was admitted to the hospital because of auditory and visual hallucinations and persecutory delusions. Twenty years ago, he was diagnosed with chronic subdural hematoma after hitting his head, and he had been cured. Ten years earlier, he had visited a neurologist for gait instability and hearing impairment. Axial T2-weighted magnetic resonance imaging (MRI) scans revealed a rim of hypointensity around the cerebrum, brain stem and cerebellum. CSF analysis showed xanthochromia, an increased number of red blood cells and elevated iron and ferritin levels. The diagnosis of SSNS was made. His first experience of hallucination and delusion occurred at age 65 after moving to another city. After the move, he complained that neighbors were intentionally making loud noises, had bugged their home, changed their TV screen to red color and turned down his air conditioner. As the symptoms escalated in the following 3 years, he caused disturbances in the neighborhood and was taken to the hospital by his wife. On admission he showed auditory hallucinations and persecutory delusions. Physical examination showed tremor in upper limbs, dysarthria, complete hearing loss, and visual impairment. Laboratory tests and electroencephalography showed no significant abnormalities. MRI scans showed abnormal temporal cerebral and cerebellar atrophy in addition to the findings of 10 years ago. Single photon emission computed tomography showed mild low perfusion in the left frontal and the left temporal cerebral cortex and preserved perfusion in the other cerebral cortex, which indicated that the diagnosis of Alzheimer's disease was unlikely. Psychological tests showed mild cognitive impairment with the Mini Mental State Examination 20-23 points (indicating poor calculation and recall). The patient's Beck Depression Inventory II score was 14 and Hamilton Depression Scale score was 9, indicating an absence of severe depression. After admission, risperidone was started and increased to 5 mg/ day over 12 days. After 12 days he rarely hallucinated, and gradually stopped talking about delusions. On the 17th day he was discharged. At follow up, 23 days later, he showed neither hallucination nor delusion.In view of its pathology, SSNS can present with a variety of psychiatric symptoms, as occurred in this case. Iron is the cofactor for tyrosine hydroxylase, the late limiting enzyme in the synthesis of dopamine.3 The excessive iron may cause the overproduction of dopamine and lead to psychotic symptoms. A serotonin dopamine antagonist was effective in alleviating the psychotic symptoms. During differential diagnosis of psychotic patients, SSNS should be considered as a contributing factor, because the psychotic symptoms of SSNS can be sensitive to treatment with antipsychotic drugs, although the physical symptoms are progressive. 1 We report here three cases of schizophrenia improved by switching to blonanserin.Case 1 was a 30-year-old male college student with paranoid schizophrenia, strong delusions of being observed, and auditory ...
To investigate the photoreception that controls daily oscillations at the periphery in insects, we decapitated larvae of the silkworm Bombyx mori (Lepidoptera: Bombycidae) by ligature, and observed rhythms in their peripheral tissues under several light conditions. We measured the mRNA expression of period (per) and timeless (tim), which are homologues of Drosophila clock genes that function in the core oscillator of the circadian clock system. The expression of both per and tim significantly changed in the midgut, Malpighian tubules and silk glands of decapitated larvae exposed to photophase and scotophase that were reversed from the original daily light–dark cycle under which the larvae were housed. Under constant darkness, the daily expression of tim mRNA persisted for at least one cycle in the midgut and silk gland. In addition, an appropriate light stimulus under constant darkness induced a significant phase shift in the endogenous timing system (probably a circadian clock) that determined peak levels of tim mRNA expression in the midgut and silk glands of decapitated larvae. Since light regulated the gene expression rhythm in peripheral tissues of decapitated silkworm larvae, neither the brain nor eyes were essential for photoreception to control daily oscillations in these tissues. Thus, peripheral tissues in insects might directly use light even at the larval stage.
The aim of this study was to investigate the dementia provision for elderly cancer patients in designated regional cancer centers. A survey was mailed to 389 designated regional cancer centers from February to June, 2015. A total of 188 facilities responded (response rate: 48.3%). 5.3% of the respondents used two manuals (on basic dementia care and the behavioral and psychological symptoms of dementia) to check whether these centers were following appropriate measures. About 50% of the respondents performed dementia assessments by the primary care team. 29.3% of the respondents maintained the system of the education and training of dementia care. Therefore, dementia provision for elderly cancer patients in designated regional cancer centers needs to improve the education of dementia care.Palliat Care Res 2017; 12 (1) : 116-24
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.