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Chronic Fatigue Syndrome: Limbic Encephalopathy in a Dysregulated Neuroimmune Network
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
I used to think that alcoholics could not get CFS, since it was difficult to make the diagnosis in a patient who did not have alcohol intolerance of some sort. This rule is not hard and fast, however, since I have a few recovering alcoholics in my practice. Drug seeking behavior is not frequently seen, either. Most patients in whom I would diagnose drug dependence also have borderline personality disorder. Sociopathy is quite rare, as is attention deficit disorder with hyperactivity. I hypothesize that these conditions have a completely different anatomic substrate than the limbic encephalopathy of CFS.
Acne, rosacea and similar disorders
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
The acute episodes of inflammation can be calmed with systemic tetracycline, erythromycin or metronidazole, using the full antibacterial dosage until the condition improves and then a dose sufficient to maintain improvement. Initial improvement usually occurs within the first 3–4 weeks of treatment. It would be typical for a patient to start tetracycline 250 mg 6-hourly for 3 weeks and then receive the drug three times daily for a further 3 or 4 weeks. At that time, reduction to twice-daily dosage would be made and maintained until stopping (perhaps at 10–12 weeks) did not result in the appearance of further papules. Minocycline or doxycycline 50 mg once or twice per day is more convenient. Erythromycin is also effective and the same dose regimen applies as for tetracycline. Clarithromycin has also been reported to be effective. Metronidazole is not often given because of its side effect profile. It has a disulfiram-like effect, causing alcohol intolerance. Other side effects include nausea and blood dyscrasias.
Malignant Wounds
Published in Margaret O’Connor, Sanchia Aranda, Susie Wilkinson, Palliative Care Nursing, 2018
Antibiotic therapy can be effective, as this will kill the bacteria thought to be responsible for odour production (Newman, Allwood & Oakes 1989). The most commonly used treatment is metronidazole. It can be given systemically, but side-effects such as nausea, neuropathy, and alcohol intolerance can diminish patient acceptability (Hampton 1996). In addition, a lack of blood supply to the malignant wound can reduce the antibiotic’s effectiveness (Thomas et al. 1998a). It is more practical and effective to use a topical preparation of metronidazole gel (Metrotop, Anabact) (Gilchrist 1999; Cutting 1998; Bower et al. 1992; Ashford et al. 1984). This gel is applied directly onto the wound once daily for 5–7 days, but might need to be repeated often to keep odour under control. The gel should be spread over the whole of the wound bed if the wound is flat, or it can be used to fill shallow cavities. For deeper cavities the gel can be used to coat a cavity-filling dressing (Moody 1998).
Evaluating case diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): toward an empirical case definition
Published in Disability and Rehabilitation, 2023
Karl E. Conroy, Mohammed F. Islam, Leonard A. Jason
The preliminary EFA yielded a six-factor solution. The following items were dropped from the analysis due to low factor loadings: need to nap daily, sensitivity to lights, losing or gaining weight without trying, sensitivity to noise, muscle weakness, some smells, foods, medications, or chemicals make you feel sick, bladder problems, night sweats, muscle twitches, joint pain, no appetite, muscle pain, loss of depth perception, and sleep all day/stay awake all night. The item alcohol intolerance was dropped due to a low factor loading and a low communality score (<0.20). Sufficient inter-item correlations were observed from the correlation matrix. Moreover, multicollinearity was not observed (>0.80). Bartlett's test of sphericity for the correlation matrix was significant (χ2 (741)=45577.56, p< 0.001) and the Kaiser–Meyer–Olkin measure of sampling adequacy (KMO = 0.953) also indicated that the matrix was appropriate for EFA.
Unwanted Sex Due to Intoxication among Australians Aged 16–69 Years
Published in The Journal of Sex Research, 2021
Allison Carter, Christy Newman, Richard de Visser, Anna Yeung, Chris Rissel, Andrew Grulich, Bridget Haire, Deborah Bateson, Cathy Vaughn, Kevin McGeechan, Basil Donovan, Juliet Richters, Rebecca Guy
Interestingly, though, heavy drinking was independently associated with unwanted intoxicated sex in women only in our study. Past research has found that women who are heavy drinkers are more likely to report that sex feels easier with alcohol, and to regret sex and partner choice after drinking (Connor et al., 2015; Mallett et al., 2006). An advantage of drawing on assemblage theory to interpret these results is that it provides a framework for thinking about how biological, psychological, and social-relational forces may work together to increase this likelihood for women but not men, such as lower alcohol intolerance (Moinuddin et al., 2016), sexual scripts (Farris et al., 2010, 2008; Lindgren et al., 2008), and rape myths (Webster et al., 2018). Conversely, the associations seen with injection drug use and smoking behavior in men, which is inversely related to socio-economic status in Australia (Siahpush, 2004; White, 2003), have not been previously documented.
Optimizing non-opioid pain control after implant-based breast reconstruction: a review of the literature and proposed pain control algorithm
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Jeremie D. Oliver, Rebecca Knackstedt, James Gatherwright
Non-steroidal anti-inflammatory (NSAID) medications have been used as adjuvant pain control medications for most enhanced recovery protocols. Despite previous concerns regarding increased bleeding risk, multiple studies have failed to demonstrate a causative link [23,38]. Main contraindications to NSAID pharmacotherapy would include patients with a history of peptic ulcer disease, gastrointestinal bleeding, alcohol intolerance, renal impairment, or cerebrovascular bleeding (see algorithm, Figure 2). In addition to NSAID therapy, acetaminophen has been suggested as a helpful and safe adjunct to perioperative pain management protocols in breast reconstruction. Acetaminophen use, compared to placebo, has been shown to significantly reduce postoperative pain in surgical patients, both on its own, as well as in combination at various dosages with NSAIDs, lending additional evidence to support the concept of multimodal analgesia protocols [8,9].