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Laryngeal Dystonia, New Approaches for Direct Botulinum Toxin Administration
Luis Javier López Del Val,
José Miguel Sebastián Cortes,
Elena Bellosta Diago,
Sonia Santos Lasaosa,
Paúl Ricardo Vinueza Buitron,
Yolanda Lois Ortega,
Héctor Valles Varea,
Elena López García
Issue:
Volume 7, Issue 3, September 2019
Pages:
52-56
Received:
27 June 2019
Accepted:
12 August 2019
Published:
29 August 2019
Abstract: To describe our experience in the treatment of laryngeal dystonia (in abduction and adduction), with special emphasis given to the technical aspects (approach procedure, dosage and type of botulinum toxin type A used), as well as treatment response and possible side effects. We conducted a cross-sectional descriptive study of a sample of patients with laryngeal dystonia treated by means of transoral administration of onabotulinumtoxinA or incobotulinumtoxinA over a period of 10 years (2007-2017). Data collected include demographic and clinical variables, treatment response (based on a self-rating scale), the duration of treatment and the appearance of side effects. Sample size: 15 patients (11 women; mean age: 44.06 years) with laryngeal dystonia (mean time since onset of 40 months; 12 patients with dystonia in adduction) and 174 administrations (92% incobotulinumtoxinA; average dosage of 5 U in each vocal cord). The procedure took an average of 11.7 minutes to perform. Response was good in 31% of the procedures and very good in 57.5%. Side effects were recorded in 14.4% of the procedures, although always mild and transitory, with a predominance of dysphagia and dysphonia. In our experience, transoral administration of botulinum toxin type A to treat laryngeal dystonia has proved to be a simple, quick, effective and safe technique.
Abstract: To describe our experience in the treatment of laryngeal dystonia (in abduction and adduction), with special emphasis given to the technical aspects (approach procedure, dosage and type of botulinum toxin type A used), as well as treatment response and possible side effects. We conducted a cross-sectional descriptive study of a sample of patients w...
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Psychiatry of Radicalization and Terrorism in the Lone Wolf, Children, and Women: An E-ethnographic Approach for Analysis
Carlo Lazzari,
Abdul Nusair,
Marco Rabottini
Issue:
Volume 7, Issue 3, September 2019
Pages:
57-68
Received:
10 August 2019
Accepted:
27 August 2019
Published:
10 September 2019
Abstract: Radicalization is a global event affecting different countries and present in different historical contexts. Psychiatrists can help in the analysis of radicalization in individuals who operate autonomously from more radicalized groups. These lone actors or lone wolves are more difficult to spot as there is no unique identification because they operate as self-determined women or men. A focus of the current study is on the radicalization of children and women. The use of ethnographic research also using Internet sources has provided satisfactory results in the analysis of radicalization while reducing the risk and difficulties of approaching a sample population (terrorists, lone wolves, and radical groups) that, most of the time, is remote, dangerous and concealed to public scrutiny. Emphasis is also provided to the stages of development of radicalized thought and how radicalization can be understood in terms of cognitive and social development of the lone-wolf terrorist. The authors also explore how a radicalized leader can lever on the vulnerability of some individuals to radicalize them. Besides, the authors approach radicalized thought also as a logical fallacy and as a sign of dualistic thinking. Hence, a mix of cognitive, logical, and psychiatric triggers is analyzed in their potential to radicalize.
Abstract: Radicalization is a global event affecting different countries and present in different historical contexts. Psychiatrists can help in the analysis of radicalization in individuals who operate autonomously from more radicalized groups. These lone actors or lone wolves are more difficult to spot as there is no unique identification because they oper...
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Anais Nin: An Incest Between a Father and a Daughter
Issue:
Volume 7, Issue 3, September 2019
Pages:
69-73
Received:
7 August 2019
Accepted:
4 September 2019
Published:
19 September 2019
Abstract: In 1933, Anais Nin thirty years old, meets again with her beloved father, the pianist and composer Joachin Nin. She did not see him since the age of eleven when he left his family for a mistress. She then started to write a diary. I want to show that you can make links and interpret the material and associations of her diary like the material of a psychoanalysis or a psychotherapy. When they meet again, he behaves like an incestual father telling her his love affairs and his sexual life with her mother. Then he relates to her an incestuous dream with her and acts like a lover until the consummate incest. She seems to consent but feels guilty, between fear and desire, and disgust. She will complain of intense heart beats, death anxiety and loss of joy. Through her Journal of Incest (1932-1934) and her Youth Journal (1914-1919), I will try to understand how such an incest can happen. The father is an incestuous father who has no taboo of the incest, does not recognize the difference between generations, does not respect the body intimacy of his daughter and treat her like a narcissistic object. He fluctuates between psychosis without symptoms and narcissistic perversion. Anais has a hysterical personality, with separation anxiety, psychosomatic and pervert symptoms. This patchwork evokes a borderline state. She acts sometimes like a narcissistic pervert.
Abstract: In 1933, Anais Nin thirty years old, meets again with her beloved father, the pianist and composer Joachin Nin. She did not see him since the age of eleven when he left his family for a mistress. She then started to write a diary. I want to show that you can make links and interpret the material and associations of her diary like the material of a ...
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A Pilot Study of a Medical Cannabis - Opioid Reduction Program
Issue:
Volume 7, Issue 3, September 2019
Pages:
74-77
Received:
20 December 2018
Accepted:
6 September 2019
Published:
20 September 2019
Abstract: Many chronic pain patients are prescribed opioids at doses exceeding the current Guideline. Tapering the dose can be difficult, as patients fear a return to a state of overwhelming pain. Several factors can increase the likelihood of success: the patient’s readiness for change, psychological support, pharmacological support and careful monitoring. This pilot study addressed these four factors. Six hundred patients took part. Each was taking daily opioid doses ranging from 90-240 mg morphine equivalent dose (MED). All indicated they were prepared to reduce their opioid dose. Over a six-month period, opioid doses were tapered according to individual needs, usually 10% every 1-2 weeks. Psychological support was provided through a freely available web-based mental health and wellness tool. Medical cannabis provided pharmacological support at the rate of 0.5g/day for each 10% reduction in opioid dose, as needed. Physicians monitored patients regularly according to each patient’s needs. After 6 months, 156 patients (26%) had ceased taking opioids. An additional 329 patients (55%) had reduced their opioid use by an average of 30%. One hundred fourteen patients (19%) neither increased nor decreased their opioid use. The one patient whose opioid dose was increased had poorly controlled pain and an aggravated pain condition. The success of this medical cannabis – opioid reduction program in a large proportion of patients is grounds for further investigation.
Abstract: Many chronic pain patients are prescribed opioids at doses exceeding the current Guideline. Tapering the dose can be difficult, as patients fear a return to a state of overwhelming pain. Several factors can increase the likelihood of success: the patient’s readiness for change, psychological support, pharmacological support and careful monitoring. ...
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