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Retronasal Olfaction
Published in Alan R. Hirsch, Nutrition and Sensation, 2023
Jason J. Gruss, Alan R. Hirsch
However, there is another feature to hunger that has also been studied. In some people, appetite can be decreased to a level where dangerous weight loss occurs. Patients with diseases such as cancer, and elderly patients with diminished sense of smell and taste are two examples. In these populations decreased appetite can lead to significant medical problems.
100 MCQs from Dr. David Browne and Colleagues
Published in David Browne, Selena Morgan Pillay, Guy Molyneaux, Brenda Wright, Bangaru Raju, Ijaz Hussein, Mohamed Ali Ahmed, Michael Reilly, MCQs for the New MRCPsych Paper A, 2017
Dr Karen Fleming, Dr Michael Kenewali, Dr Manas Sarkar, Dr Daniel White
Decreased appetite is common but usually transient. Nervousness and insomnia are the most common adverse reactions reported with methylphenidate. They are usually controlled by reducing dosage and omitting the drug in the afternoon or evening. Central nervous system adverse effects are dizziness, drowsiness, headache and dyskinesia. Other side effects include hyperactivity, convulsions, muscle cramps, choreo-athetoid movements, tics (exacerbation of pre-existing tics) and Tourette’s syndrome. Psychotic episodes, including hallucinations, which subsided when methylphenidate was discontinued, have been reported. Although a definite causal relationship has not been established, isolated cases of transient depressed mood as well as symptoms of visual disturbances on rare occasions have been described. Difficulties with accommodation and blurring of vision have also been noted. (28, pp 1002–3)
Health Consequences of Marijuana Use
Published in John Brick, Handbook of the Medical Consequences of Alcohol and Drug Abuse, 2012
Alan J. Budney, Brent A. Moore, Ryan Vandrey
Withdrawal has generally been deemed a more robust indicator of dependence than tolerance. Early nonhuman studies of cessation of THC administration provided evidence of a withdrawal response, but the effects were mild and inconsistent (Beardsley, Balster, and Harris, 1986; Kaymakcalan, 1973). Early studies with humans in residential laboratories also found evidence of withdrawal (Georgotas and Zeidenberg, 1979; Jones and Benowitz, 1976; Mendelson et al., 1984; Nowlan and Cohen, 1977). Common symptoms included decreased appetite, irritability, restlessness, sleep difficulties, and uncooperativeness. These effects were characterized as mild, transient, and without serious medical complications, and thus considered clinically insignificant when compared with the dramatic medical and physiological symptoms associated with severe opiate or alcohol withdrawal.
A critical evaluation of fenfluramine hydrochloride for the treatment of Dravet syndrome
Published in Expert Review of Neurotherapeutics, 2022
An-Sofie Schoonjans, Berten Ceulemans
Fenfluramine is generally well tolerated. The main adverse effect is a decreased appetite, sometimes associated with weight loss. This effect is more pronounced in combination with topiramate (an ASM often used in DS patients), which also has an anorectic effect. However, it is rarely necessary to lower the dose or stop the treatment due to side-effects. Both in the international extension phase III study (232 patients, treatment duration up to 634 days) and in our Belgian cohort (31 patients, treatment duration up to 32 years), no valvular heart disease or pulmonary hypertension was seen. Use of a low dose (maximum daily dose 27 mg per day or 17 mg in combination with STP) and avoidance of products that enhance the effect of fenfluramine (like phentermine) probably protect patients for the development of cardiovascular side-effects. Nevertheless, careful cardiovascular follow-up is mandatory.
Current practices and barriers in gastrostomy indication in amyotrophic lateral sclerosis: a survey of ALS care teams in The Netherlands
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2022
Remko M. Van Eenennaam, Willeke J. Kruithof, Esther T. Kruitwagen-Van Reenen, Leonard H. van den Berg, Johanna M.A. Visser-Meily, Anita Beelen
Respondents agree on the most important, primary clinical indicators for gastrostomy (i.e. malnutrition/weight loss, dysphagia, prolonged and effortful meals, recurrent chest infections, insufficient intake of liquids, low vital capacity). Decreased appetite, increased dependency on others, and hypermetabolism were mentioned less frequently despite research showing their association with weight loss, altered nutritional state through lower energy intake or increased energy needs, or decision-making on gastrostomy (3, 22,23). The lack of consensus on cutoff values/criteria for clinical indicators of gastrostomy found in our survey is in agreement with findings from earlier surveys in England and Canada (11, 24) and is reflected in ALS guidelines (4–8). This stresses the need for a more evidence-based indication.
Smoothened receptor inhibitor vismodegib for the treatment of basal cell carcinoma: a retrospective analysis of efficacy and side effects
Published in Journal of Dermatological Treatment, 2020
András Bánvölgyi, Pálma Anker, Kende Lőrincz, Norbert Kiss, Dalma Márton, Luca Fésűs, Nóra Gyöngyösi, Norbert Wikonkál
The management of alopecia for female patients was mainly a prescription for topical estradiol and prednisolone lotion without considerable effect. After the discontinuation of vismodegib therapy, we observed hair regrowth in all cases. In case of grade 2 and 3 muscle cramps, the combination of tizanidine and amlodipine, found mostly in the literature, did not result in marked improvement, tizanidine and tolperisone together only moderately relieved muscle cramps. Grade 1 muscle cramps were alleviated with magnesium and calcium supplementation. For the management of decreased appetite and weight loss, oral nutrition supplementation was introduced. Although weight loss initially slowed down, the treatment had to be discontinued in two patients due to further weight loss. For dysgeusia, specific treatment could not be applied; however, dietary guidelines were followed to alleviate food intake.