ABSTRACT
OBJECTIVES: We report a fatal case of neuroleptic malignant-like syndrome, which occurred as a consequence of paralytic bowel in a 72-year-old woman on treatment with antiparkinson medication. CASE DESCRIPTION: Contrast enhanced computerized tomography of the chest and abdomen demonstrated the presence of paralytic bowel. RESULTS: The patient died. CONCLUSIONS: Physicians involved in the treatment of patients affected by Parkinson's disease should take into consideration the possibility of dopaminergic drug malabsorption due to paralytic bowel as a possible cause of neuroleptic malignant-like syndrome. LEARNING POINTS: Clinical features of neuroleptic malignant-like syndrome (NMLS) in parkinsonian patients are similar to those of neuroleptic malignant syndrome (NMS), which is a potentially fatal condition associated with the withdrawal of antipsychotic medication.Paralytic bowel is a condition frequently impairing medication absorption in the absence of modifications to the normal daily intake of antiparkinson drugs.The present case report describes the fatal outcome of NMLS following paralytic bowel in a parkinsonian patient on levodopa and amantadine therapy.
ABSTRACT
Acute low back pain (LBP) is the fifth most common reason for physician visits and about nine out of ten adults experience back pain at some point in their life. In a large number of patients LBP is associated with disc herniation (DH). Recently, oxygen-ozone (O2O3) therapy has been used successfully in the treatment of LBP, reducing pain after the failure of other conservative treatments. The aim of this study was to assess the effects of O2O3 therapy in back pain rehabilitation, comparing three groups of patients suffering from chronic back pain associated with DH submitted to three different treatments: intramuscular O2O3 infiltrations, global postural An observational retrospective/horizontal study to compare oxygen-ozone therapy and/or global postural re-education in complicated chronic low back pain re-education (GPR), or a combination of the two (O2O3+GPR). The data show that pain severity before treatment was significantly lower in the patients treated with GPR alone (VAS score 7.4) than in the O2O3+GPR patients (VAS score 8.5) and the O2O3 patients (VAS score 8.6). At the end of treatment, pain severity was lower in the O2O3 patients than in the GPR-alone patients. After some years of follow-up only the difference between O2O3+GPR and GPR-alone remained significant.
