Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.072
Filtrar
1.
A A Pract ; 15(11): e01547, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34807869

RESUMO

Hiccups are a common phenomenon experienced by many people and are usually short-lived with spontaneous resolution of symptoms. Certain anesthetic medications have been associated with the development of hiccups, though the underlying pathophysiology and reflex arcs remain poorly understood. We describe a patient who developed hiccups lasting 9 days following an orthopedic surgery and again developed hiccups during a subsequent surgery after only having received midazolam; flumazenil administration led to sustained cessation of his hiccup symptoms immediately.


Assuntos
Soluço , Flumazenil/uso terapêutico , Soluço/induzido quimicamente , Soluço/tratamento farmacológico , Humanos , Midazolam/efeitos adversos
2.
Tidsskr Nor Laegeforen ; 141(2021-14)2021 10 12.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-34641651

RESUMO

BACKGROUND: Neuromyelitis optica is an inflammatory syndrome of the central nervous system, associated with anti-aquaporin-4 IgG antibodies. It is associated with severe neurological symptoms and risk of permanent neurological disability. The diagnosis can be established on the basis of clinical core characteristics of neuromyelitis optica, together with serological testing for anti-aquaporin-4 IgG antibodies and magnetic resonance imaging of the central nervous system. CASE PRESENTATION: We describe the case of a young woman presenting with obstipation, persistent nausea, vomiting and hiccups. The initial diagnostic workup confirmed obstipation, but did not find any underlying gastrointestinal pathology that could explain her persistent symptoms. Her condition deteriorated, she was unable to eat or drink without inducing vomiting, and eventually she received parenteral nutrition. Further diagnostic workup included magnetic resonance imaging of the brain, which revealed a T2-hyperintense lesion in the medulla oblongata, more specifically in the area postrema. Neurological and neuroradiological assessment led to a tentative clinical diagnosis of neuromyelitis optica spectrum disorder with a well-described, but rare, presentation: the area postrema syndrome. The diagnosis was confirmed by serological testing for anti-aquaporin-4 IgG antibodies. She was successfully treated with methylprednisolone with complete remission of symptoms. Patients with neuromyelitis optica spectrum disorders frequently experience relapses of the disease if untreated, and she was therefore treated with rituximab to prevent future relapses. INTERPRETATION: This case is a reminder that common gastrointestinal symptoms may be caused by diseases of the central nervous system.


Assuntos
Soluço , Feminino , Soluço/etiologia , Humanos , Náusea/etiologia , Vômito/etiologia
3.
Bol Med Hosp Infant Mex ; 78(5): 485-488, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34571523

RESUMO

Background: Spontaneous pneumomediastinum is the presence of free air in the mediastinum that does not occur from direct thoracic or esophageal trauma. It is a very rare condition usually related to patients with asthma, respiratory infections, or foreign body aspiration. Only a few cases are reported to be associated with severe reflux events. Case report: We present the case of a 10-year-old female with spontaneous pneumomediastinum extending to the neck secondary to severe and persistent hiccups, with no history of asthma, trauma, surgery, acute infection, foreign body aspiration, and intense exercise with Vasalva. Conclusions: The irritation of the distal third of the esophagus produced severe and persistent episodes of hiccups that increased the intrathoracic pressure, which in turn triggered the pneumomediastinum by Macklin effect. The diagnosis is made with imaging studies. The treatment is conservative with resolution of the clinical picture between five and seven days after hospitalization.


Assuntos
Asma , Soluço , Enfisema Mediastínico , Enfisema Subcutâneo , Criança , Feminino , Soluço/etiologia , Soluço/terapia , Humanos , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/terapia
4.
Artigo em Inglês | MEDLINE | ID: mdl-34378765

RESUMO

Hiccups are involuntary, spasmodic contractions of the diaphragm and intercostal muscles and can be classified as acute (< 48 h), persistent (48 h to a month) or intractable (> 1 month). A previously healthy 29-year-old man sought the Emergency Department with flu-like symptoms and a two-day history of persistent hiccups. His physical examination was otherwise unremarkable and vital signs were within normal limits. An unenhanced computed tomography scan of the chest showed small focal ground-glass opacities scattered throughout 25% of the lungs. A COVID-19 test was positive. Chlorpromazine was prescribed for the hiccups with improvement over 10 h. The patient was discharged home on the same day without hiccups and no other complications.


Assuntos
COVID-19 , Soluço , Adulto , Soluço/etiologia , Humanos , Masculino , SARS-CoV-2 , Tomografia Computadorizada por Raios X
5.
Clin Neuropharmacol ; 44(5): 186-188, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34238784

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) is a systemic illness that implies neurological features and complications. Persistent (>48 hours) hiccups (ie, singultus or hiccoughs) have been recently described as a rare presentation of COVID-19. Even when considered benign, the frequency and duration of hiccup spells can be burdensome and sometimes difficult to treat. CASE PRESENTATION: We report the case of a 62-year-old man known by the treating physicians for vascular cognitive impairment, who consulted for progressive persistent hiccups that commenced 5 days earlier, about 24 hours after testing positive for the severe acute respiratory syndrome coronavirus 2 by real-time reverse transcription polymerase chain reaction. The patient could barely sleep because the hiccups reached the highest rate of 47 per minute in a spell lasting almost 72 hours. The patient initially received levomepromazine 25 mg by mouth, but sedation and delirium impeded the continuation of treatment, which only reduced the frequency of the hiccup spells by about 25%. Afterward, the patient was offered levosulpiride 25 mg thrice a day by mouth, resulting in a steady reduction in the hiccups rate, as well as the duration and daily frequency of spells, which disappeared after 3 days of levosulpiride treatment. COVID-19 pneumonia was moderate by chest computed tomography scan imaging and biomarkers, meriting continuous oxygen therapy, dexamethasone 6 mg once a day by mouth for 10 days, and enoxaparin 40 mg once a day, subcutaneously, for 7 days (due to elevated D-dimer serum concentration). Oxygen therapy was gradually withdrawn after 12 days. CONCLUSIONS: Oral levosulpiride is a suitable option in persistent hiccups that occur in patients with COVID-19 pneumonia. To our knowledge, this is the fourth published case of persistent hiccups as a clinical feature of COVID-19.


Assuntos
COVID-19/complicações , Disfunção Cognitiva/complicações , Soluço/etiologia , Sulpirida/análogos & derivados , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/diagnóstico por imagem , Disfunção Cognitiva/diagnóstico por imagem , Soluço/diagnóstico por imagem , Soluço/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Sulpirida/uso terapêutico
6.
BMJ Case Rep ; 14(7)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34285021

RESUMO

Persistent hiccups has not been reported previously with suprahepatic inferior vena cava (IVC) stenting. Persistent hiccups after palliative oesophageal stenting has been reported. We present a case of a 41-year-old male patient diagnosed with primary Budd-Chiari syndrome who underwent IVC stenting for suprahepatic IVC stenosis. Patient developed transient hiccups post procedure which settled immediately with medications. Patient developed a recurrence of symptoms after a year due to stent migration which led to redo stenting. Post-procedure, the patient developed persistent hiccups which could not be controlled by physiological methods or chlorpromazine and needed baclofen at a dose of 10 mg three times a day. The patient has been symptom-free for the past 2 years. Persistent hiccups may present as a rare complication of suprahepatic IVC stenting due to extrinsic phrenic nerve compression or by direct irritation of the diaphragm. Baclofen has been effective in terminating persistent hiccups in our case.


Assuntos
Síndrome de Budd-Chiari , Soluço , Adulto , Constrição Patológica , Soluço/etiologia , Humanos , Masculino , Stents/efeitos adversos , Veia Cava Inferior/diagnóstico por imagem
7.
Trop Doct ; 51(4): 601-602, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34152226

RESUMO

Herpes simplex virus-1 (HSV-1) oesophagitis as an aetiology of persistent hiccough is a rarity in immunocompetent hosts and entails an exhaustive diagnostic work-up, since it does not present with any of the typical oesophagitis symptoms. Our patient presented with persistent hiccoughs that were resistant to treatment with baclofen. Oesophagogastroduodenoscopy with biopsy confirmed the diagnosis of HSV-1 oesophagitis. The hiccough subsided within 48 h of aciclovir therapy.


Assuntos
Esofagite , Herpesvirus Humano 1 , Soluço , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Esofagite/diagnóstico , Esofagite/tratamento farmacológico , Humanos
9.
A A Pract ; 15(5): e01452, 2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-33999910

RESUMO

Increased intra-abdominal pressure (IAP) following large abdominal surgeries can lead to postoperative complications, including wound dehiscence and surgical reoperation. Numerous factors can contribute to increased postoperative IAP, and intractable hiccups have been implicated as a culprit. Different treatment modalities have been widely used with variable success in addressing intractable hiccups. Here, we present a case in which postoperative hiccups leading to wound dehiscence and reoperation were successfully treated with an indwelling phrenic nerve catheter. Following placement, a significant reduction in hiccup severity and frequency was noted, improving the patient's quality of postoperative course and preventing further surgical intervention.


Assuntos
Anestesia por Condução , Soluço , Soluço/prevenção & controle , Humanos , Nervo Frênico , Complicações Pós-Operatórias
10.
J Integr Neurosci ; 20(1): 247-254, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33834710

RESUMO

The hiccup (Latin singultus) is an involuntary periodic contraction of the diaphragm followed by glottic closure, which can be a rare side effect of aripiprazole. In contrast to the structurally closely related aripiprazole, brexpiprazole was not associated with this particular adverse drug reaction. Having two very similar drugs that differ in their ability to induce hiccups represents a unique opportunity to gain insight into the receptors involved in the pathophysiology of the symptom and differences in clinical effects between aripiprazole and brexpiprazole. The overlap between maneuvers used to terminate paroxysmal supraventricular tachycardia and those employed to terminate bouts of hiccups suggests that activation of efferent vagal fibers can be therapeutic in both instances. Recent work seems to support a pivotal role for serotonin receptors in such vagal activation. It is unlikely that a unique receptor-drug interaction could explain the different effects of the examined drugs on hiccup. The different effect is most likely the consequence of several smaller effects at more than one receptor. Brexpiprazole is a highly affine (potent) α2C antagonist and, therefore, also an indirect 5-HT1A agonist. In contrast, aripiprazole is a partial 5-HT1A agonist (weak antagonist) and an HT3 antagonist. Activation of 5-HT1A receptors enhances vagal activity while HT3 blockade reduces it. Vagus nerve activation is therapeutic for hiccups. A definitive answer continues to be elusive.


Assuntos
Aripiprazol/farmacologia , Soluço/induzido quimicamente , Neurotransmissores/farmacologia , Quinolonas/farmacologia , Tiofenos/farmacologia , Aripiprazol/efeitos adversos , Aripiprazol/farmacocinética , Humanos , Neurotransmissores/efeitos adversos , Neurotransmissores/farmacocinética , Quinolonas/efeitos adversos , Quinolonas/farmacocinética , Tiofenos/efeitos adversos , Tiofenos/farmacocinética
11.
Medicine (Baltimore) ; 100(8): e24879, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33663115

RESUMO

BACKGROUND: Persistent and intractable hiccups are a common clinical symptom that cause considerable physical pain to patients and severely damage their quality of lives. An increasing number of studies have demonstrated that acupuncture applied at acupoints dominated by Cuanzhu (BL2) can be used as one of the nonpharmacological therapies for controlling intractable hiccups. However, there is insufficient evidence evaluating the safety and effectiveness of those interventions. Therefore, this study is intended to conduct a systematic review and meta-analysis to provide evidence for a further study investigating alternative treatment options for persistent and intractable hiccups. METHODS AND ANALYSIS: Randomized controlled trials (RCTs) of adult patients aged >18 years who meet the criteria for intractable hiccup diagnosis will be included, regardless of gender, nationality, and education level. Eight electronic databases will be searched, including 4 Chinese databases (CNKI, SinoMed, Wanfang Database, and Chinese Scientific Journal Database), 4 English databases (Web of Science, Medline, Embase, and Cochrane Library), from their date of establishment to September 2020. Two independent reviewers will evaluate the title summary for each RCT. Disagreements will be discussed with a third commentator. Data integration, heterogeneity analysis, subgroup analysis, and sensitivity analysis, will be performed using R-3.3.2 software. The RevMan 5.3 software will be used for the meta-analysis, and the "risk of bias" assessment will be conducted based on the methodological quality of the included trials recommended by the Cochrane Handbook 5.1. The quality evaluation of this study will be completed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS: This study will summarize all the selected trials aimed at estimating the effectiveness, as well as safety, of applying acupuncture at acupoints dominated by Cuanzhu (BL2) to persistent and intractable hiccups. CONCLUSIONS: This systematic review will provide evidence to assess the validity and safety of applying acupuncture at acupoints dominated by Cuanzhu (BL2) for persistent and intractable hiccups, which may provide clinicians with more choices in the treatment of this disease. PROSPERO REGISTRATION NUMBER: CRD42020114900.


Assuntos
Terapia por Acupuntura/métodos , Soluço/terapia , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto
12.
J Pain Symptom Manage ; 62(3): e85-e90, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33587996

RESUMO

CONTEXT: Hiccups are a symptom in cancer patients but it's less researched. OBJECTIVES: The aimed to determine of prevalence of hiccups and treatment approach used in hiccup management in cancer patients receiving chemotherapy for nursing care. METHODS: This study used a descriptive cross-sectional design with self-reported questionnaires and was conducted from November 2018-May 2019 in Turkey. For collection of the data, a Patient Information Form (sociodemographic and disease characteristics), and a Hiccups Evaluation Form were used for the patients. RESULTS: Hiccups were observed in 37 (23%) of the 160 patients who met the criteria for inclusion in the study. The great majority of the patients suffering from hiccups were male (65.9%) and the type of cancer in the majority of these patients was gastrointestinal cancer (54.1%). It was determined that the duration of hiccups in 83.8% of patients observed with hiccups was between 0 and 48 hours, that the average severity of their hiccups was 3.81 ± 2.25 (0-10), and that hiccups in 59.5% of these patients was of low severity. It was found that only 10.8% of patients suffering from hiccups used pharmacological methods for relief and that 27% used nonpharmacological methods. CONCLUSION: The results of the study showed that over one-fifth of cancer patients suffered from hiccups. This situation reveals that hiccups are an important symptom that needs to be carefully emphasised in oncology practice.


Assuntos
Soluço , Neoplasias , Estudos Transversais , Feminino , Soluço/induzido quimicamente , Soluço/epidemiologia , Humanos , Masculino , Neoplasias/tratamento farmacológico , Neoplasias/epidemiologia , Turquia/epidemiologia
15.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431481

RESUMO

A 19-year-old man was admitted with a 2-week history of continuous cough along with a day history of acute onset unsteadiness and hiccups. Given the current pandemic, he was initially suspected to have COVID-19, however he tested negative on two occasions. Subsequent brain magnetic resonance imaging (MRI)confirmed a small left acute and subacute lateral medullary infarction with chest X-ray suggesting aspiration pneumonia with right lower lobe collapse. This is a distinctive case of posterior circulation stroke presenting with a new continuous cough in this era of COVID-19 pandemic. We anticipate based on MRI findings that his persistent cough was likely due to silent aspiration from dysphagia because of the subacute medullary infarction. It is therefore imperative that healthcare workers evaluate people who present with new continuous cough thoroughly to exclude any other sinister pathology. We should also be familiar with the possible presentations of posterior circulation stroke in this pandemic era.


Assuntos
COVID-19/diagnóstico , Tosse/fisiopatologia , Soluço/fisiopatologia , Síndrome Medular Lateral/diagnóstico por imagem , Pneumonia Aspirativa/diagnóstico por imagem , Transtornos das Sensações/fisiopatologia , Vertigem/fisiopatologia , Tosse/etiologia , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética , Soluço/etiologia , Humanos , Síndrome Medular Lateral/complicações , Síndrome Medular Lateral/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Pneumonia Aspirativa/etiologia , Equilíbrio Postural , SARS-CoV-2 , Transtornos das Sensações/etiologia , Vertigem/etiologia , Adulto Jovem
16.
J Neuroimmunol ; 352: 577488, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33498007

RESUMO

Neuromyelitis optica spectrum disorder (NMOSD) is not defined as a classical paraneoplastic neurological syndrome, however there are growing evidences that NMOSD may be rarely associated with cancer. Older (>45 years old) male patients with longitudinally extensive transverse myelitis (LETM) or patients with "area postrema" syndrome (intractable vomiting and hiccups) at onset are at higher risk for neoplasm-associated NMOSD. We report the case of 79-years old man who developed, a month after radiotherapy for prostatic adenocarcinoma, an area postrema syndrome rapidly followed by a LETM involving the whole spinal cord (from C2 to the conus). Aquaporin-4-IgG antibodies were positive in serum.


Assuntos
Adenocarcinoma/complicações , Neuromielite Óptica/etiologia , Síndromes Paraneoplásicas/etiologia , Neoplasias da Próstata/complicações , Idoso , Aquaporina 4/imunologia , Autoanticorpos/imunologia , Autoantígenos/imunologia , Soluço/etiologia , Humanos , Masculino , Mielite Transversa/etiologia , Vômito/etiologia
17.
J Nat Med ; 75(1): 105-115, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33084985

RESUMO

Persimmon Calyx is a crude drug derived from the persistent calyx of mature fruit of Diospyros kaki Thunberg (Ebenaceae) and is used for the treatment of intractable hiccups. Although there are several reports on the isolation of constituents from Persimmon Calyx, its active constituents have not been elucidated. In this study, by focusing on the medicinal part of Persimmon Calyx, calyx on mature fruit of D. kaki, we examined the changes in the extraction amounts of 3 cultivars of D. kaki ('Hiratanenashi', 'Jiro', and 'Tonewase') to identify and quantify seasonally variable constituents during the maturation process by analysing their chemical compositions. We found that the extraction weight of the calyx, fruit of persimmons, and total tannin content in calyxes were significantly increased during maturation. Lupeol (1), betulinic acid (2), pomolic acid (3), ursolic acid (4), ß-sitosterol (5), rotungenic acid (6), barbinervic acid (7), catechin (8), gallocatechin (9), and sucrose (10) were identified in the calyx of D. kaki. Compounds 1, 6, and 7 were isolated from Persimmon Calyx for the first time. Moreover, the isolated compounds (1-7) and their analogue (oleanolic acid) were quantitatively analysed, and the results showed that the amounts of 4 and oleanolic acid were reduced during maturation, whereas that of 2, 3, 6, and 7 were increased.


Assuntos
Diospyros/química , Soluço/tratamento farmacológico
19.
Respir Investig ; 59(2): 263-265, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33309013

RESUMO

BACKGROUND: Hiccups are involuntary diaphragmatic muscle contractions with early glottis closure terminating inspiration. They are classified into two types: acute (<48 hours) and persistent (>48 hours). COVID-19 is the defining health crisis of our generation. Although there are common symptoms of the disease (e.g. fever, cough), several atypical presentations have appeared as the pandemic has evolved. Here, we present a patient with COVID-19 presenting with fever, sore throat, and persistent hiccups. METHODS AND RESULTS: A 48-year-old man presented to the hospital with a seven-day history of persistent hiccups, fever, and sore throat. Physical examination was unremarkable and abdominal ultrasound showed gaseous abdominal distension. Laboratory values were remarkable for elevated C-reactive protein, ferritin, and lactate dehydrogenase levels. Computed tomography of the chest showed bilateral subpleural areas of ground-glass attenuation and crazy-paving pattern. A COVID-19 test was positive, and hydroxychloroquine, oseltamivir, baclofen, and symptomatic treatment were initiated. The hiccups improved, and the patient was discharged home after ten days. CONCLUSION: Physicians should maintain a high level of suspicion and be aware of atypical presentations of COVID-19.


Assuntos
COVID-19/complicações , COVID-19/diagnóstico , Soluço/etiologia , Baclofeno/uso terapêutico , Biomarcadores/sangue , COVID-19/terapia , Teste para COVID-19 , Febre/etiologia , Soluço/terapia , Humanos , Hidroxicloroquina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Oseltamivir/uso terapêutico , Faringite/etiologia , Doenças Raras , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia
20.
Top Stroke Rehabil ; 28(6): 475-480, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33073739

RESUMO

BACKGROUND: Persistent and intractable hiccups have a major impact on quality of life and can be a barrier to stroke rehabilitation. The first-line treatment for intractable hiccups, chlorpromazine, can have sedating effects, which may negatively affect rehabilitation participation. Gabapentin has been reported in several cases to be effective in hiccup treatment in both the general and post-stroke populations. OBJECTIVE: To describe the use of gabapentin for treatment of persistent or intractable hiccups in post-stroke patients. METHODS: Four cases were identified by clinicians for a retrospective review. A literature review was concurrently conducted. RESULTS: This case series presents four patients with improvement or resolution of intractable hiccups on gabapentin in a stroke rehabilitation setting. Therapeutic dose ranged from 100 mg TID to 400 mg BID. Treatment duration ranged from 2 days to 5.5 weeks. Adjuncts were used in three of the cases. A potential side effect was worsened confusion in one case. CONCLUSION: Evidence on the use of gabapentin for persistent or intractable hiccups is limited. This case series expands on the current literature by examining and comparing the current literature to our cases and exploring issues related to dosing, titration, side effects, and adjuncts to gabapentin.


Assuntos
Soluço , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Gabapentina , Soluço/tratamento farmacológico , Soluço/etiologia , Humanos , Qualidade de Vida , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...