ABSTRACT
Body packing is the term used to describe the ingestion of illicit substances for transport across control lines. Where the diagnosis of body packing is made independently in the ED, the issue of reporting the case to law enforcement officials poses a difficult scenario given the legal obligations of patient confidentiality. We describe a case of a body packer brought into the ED and subsequently reported to the police. The conflicts between patient confidentiality versus statutory exceptions to confidentiality along with case law regarding this scenario are discussed.
Subject(s)
Confidentiality/legislation & jurisprudence , Crime/legislation & jurisprudence , Drug and Narcotic Control/legislation & jurisprudence , Mandatory Reporting , Narcotics , Adult , Australia , Emergency Service, Hospital , Humans , MaleABSTRACT
According to the American Psychiatric Association, the risk for complications related to the electroconvulsive therapy (ECT) treatment of patients with cerebrovascular malformations is small. The literature contains a number of case studies presenting the uneventful treatment of patients with cerebral aneurysms with ECT. However, there is a paucity of cases presenting ECT in the context of a cerebral venous angioma. In this article, we present 2 cases of patients treated with ECT who were found to have documented venous angiomas. This is followed with a brief review of the literature.
Subject(s)
Central Nervous System Venous Angioma/complications , Electroconvulsive Therapy , Adult , Aged , Bipolar Disorder/complications , Bipolar Disorder/pathology , Bipolar Disorder/therapy , Central Nervous System Venous Angioma/pathology , Depressive Disorder, Major/complications , Depressive Disorder, Major/pathology , Depressive Disorder, Major/therapy , Female , Humans , Male , Stress Disorders, Post-Traumatic/complications , Stress Disorders, Post-Traumatic/pathology , Stress Disorders, Post-Traumatic/therapyABSTRACT
OBJECTIVE: These case reports examine the potential efficacy and safety of ziprasidone for the treatment of agitation or psychosis in dementia. METHOD: The authors performed a retrospective chart review of three patients with DSM-IV diagnoses of dementia, treated with ziprasidone for agitation/psychosis on an academic psychiatric inpatient unit in 2002-2003. In addition, these three case reports are supplemented by a clinical report of the first outpatient with DSM-IV diagnosis of dementia completing a prospective open-label six-week study in 2004 evaluating the use of oral ziprasidone for agitation/psychosis in dementia. Qualitative descriptions of clinical improvement provide outcome data for these case reports. RESULTS: Four patients with dementia with agitation/psychosis experienced marked behavioral improvement after receiving oral doses of ziprasidone (20-160 mg/day), without any evidence of problematic cardiac or other side-effects. Two of the four patients had final EKGs and both of these patients demonstrated no change of QTc interval after administration of ziprasidone. CONCLUSIONS: These case reports suggest that oral ziprasidone may be an effective and safe medication for the treatment of agitation or psychosis in patients with dementia.
