Valacyclovir and Acyclovir Neurotoxicity With Status Epilepticus

We present the case of a 52-year-old man with hypertension, diastolic congestive heart failure, end-stage renal disease on hemodialysis 3 times a week and a remote history of a hemorrhagic stroke who presented to the emergency department with a vesicular rash on his left arm. The rash was observed to be in a dermatomal distribution, and a diagnosis of herpes zoster was made. The patient was discharged home on valacyclovir 1 g 3 times a day for a duration of 7 days. The patient took 2 doses of valacyclovir before presenting to the hospital again with irritability and hallucinations. Over the next several days, the patient's neurologic status declined and he became disoriented and increasingly somnolent. Because of a concern for varicella zoster virus (VZV) or herpes simplex virus (HSV) meningoencephalitis, acyclovir was initiated intravenously at 600 mg (10 mg/kg) for every 12 hours. Computed tomography and magnetic resonance imaging of the brain failed to reveal an acute process. Electroencephalogram was interpreted as seizure activity versus metabolic encephalopathy. Lumbar puncture was not suggestive for meningitis, subarachnoid hemorrhage, or HSV/VZV infection. The patient subsequently had a witnessed seizure during dialysis and was felt to have status epilepticus due to acyclovir and valacyclovir neurotoxicity. The patient underwent daily hemodialysis for removal of the drug and eventually made a full neurologic recovery. Our case highlights that acyclovir neurotoxicity c...
Source: American Journal of Therapeutics - Category: Drugs & Pharmacology Tags: Case Reports Source Type: research

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Abstract Polymorphisms in the LPA gene have been associated with aortic valve calcification (AVC). There are wide differences in the allelic frequencies, Lp(a) levels, and the association with AVC among ethnic groups. The aim of this study was to determine the association of the LPA gene polymorphisms with Lp(a) levels and risk of developing AVC, in Mexican-Mestizos population. Six LPA polymorphisms (rs10455872, rs7765803, rs6907156, rs1321195, rs12212807 and rs6919346) were genotyped by TaqMan assays in 1,265 individuals without premature coronary artery disease. The presence of AVC was determined by computed tomography. ...
Source: Genetics and Molecular Biology - Category: Genetics & Stem Cells Source Type: research
Publication date: November 2019Source: European Urology Supplements, Volume 18, Issue 10Author(s): R. Rodrigues Fonseca, R. Lains Mota, I. Peyroteo, A. Bilé Silva, J.C. Santos, F. Alpoim Lopes, A. Covita, A. Canhoto, P. Monteiro, R. Nogueira, L. Abranches Monteiro
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Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
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Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Conclusions In 10-km road races, injury rates are low compared with longer races in similar weather conditions. Common medical issues can be managed with basic resources in the on-site medical tent. Green flag start race conditions may not predict race safety with regard to exertional heat stroke risk. There were no deaths in nearly 100,000 finishers.
Source: Medicine and Science in Sports and Exercise - Category: Sports Medicine Tags: CLINICAL SCIENCES Source Type: research
Conclusions Accelerometer-determined MVPA may provide more consistent risk estimates for incident diabetes than self-reported MVPA.
Source: Medicine and Science in Sports and Exercise - Category: Sports Medicine Tags: EPIDEMIOLOGY Source Type: research
Publication date: Available online 14 November 2019Source: European Journal of RadiologyAuthor(s): Akira Nishiyama, Naoko Kawata, Hajime Yokota, Toshihiko Sugiura, Yosuke Matsumura, Takashi Higashide, Takuro Horikoshi, Shigeto Oda, Koichiro Tatsumi, Takashi UnoABSTRACTPurposeAcute respiratory distress syndrome (ARDS) is an acute inflammatory lung injury that frequently shows fatal outcomes. As radiographic predictive factors, some reports have focused on the region of ill-aerated lung, but none have focused on well-aerated lung. Our objective was to evaluate the relationship between computed tomography (CT) volume of the w...
Source: European Journal of Radiology - Category: Radiology Source Type: research
Publication date: Available online 13 November 2019Source: Academic RadiologyAuthor(s): Masaaki Hori
Source: Academic Radiology - Category: Radiology Source Type: research
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Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
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Source: Journal of Orthopaedic Translation - Category: Orthopaedics Source Type: research
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