This article reports 2 cases of urinary retention in Alzheimer's disease with agitation treated by acupuncture. Based on patients' clinical symptoms, the etiology and pathogenesis were determined, and acupuncture was applied to Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), and bilateral Ciliao (BL32), Zhongliao (BL33), Fengchi (GB20), Taiyang (EX-HN5), etc. to regulate the mind and promote water metabolism. The positive and negative electrodes of the SDZ-Ⅴ type electroacupuncture device were attached to ipsilateral Ciliao (BL32), Zhongliao (BL33) respectively, with continuous wave, at the frequency of 15 Hz, and the current of 3 to 10 mA, depending on patients' tolerance. The needles were retained for 20 min. The treatment was delivered once every other day, 3 interventions a week and 12 interventions as 1 course. Both patients reported the micturition desire after 1 intervention with acupuncture and the catheter was removed on the same day. The urination was ameliorated without dysuresia after 1-2 courses of treatment, and the agitated behavior was alleviated. It can be the reference for the clinical treatment of urinary retention in patients with Alzheimer's disease with agitation.
Humans ; Alzheimer Disease/psychology* ; Acupuncture Therapy ; Urinary Retention/etiology* ; Male ; Female ; Aged ; Acupuncture Points ; Psychomotor Agitation/complications*

A 7-year-old girl was admitted to the hospital with rapidly progressive vision loss. Since 1 year of age, she had exhibited developmental delay accompanied by visual impairment and neutropenia. Combined with genetic testing and molecular pathogenicity analysis, she was diagnosed with Cohen syndrome (CS) caused by compound heterozygous variants in VPS13B (c.6940+1G>T and c.2911C>T). The c.6940+1G>T variant resulted in exon 38 skipping, leading to a frameshift and premature termination. Reverse transcription quantitative polymerase chain reaction revealed significantly reduced VPS13B gene expression (P<0.05). Bioinformatic analysis suggested that both variants likely produce truncated proteins. This case highlights that integrating clinical features with molecular pathogenicity assessment (DNA, RNA, and protein analysis) can improve early diagnostic accuracy for CS.
Humans ; Female ; Child ; Vesicular Transport Proteins/genetics* ; Developmental Disabilities/etiology* ; Muscle Hypotonia/etiology* ; Myopia/etiology* ; Heterozygote ; Intellectual Disability/etiology* ; Microcephaly/etiology* ; Obesity/genetics* ; Growth Disorders/etiology* ; Retinal Degeneration/genetics* ; Psychomotor Disorders/genetics* ; Fingers/abnormalities*

Child ; Humans ; Carbohydrate Metabolism, Inborn Errors ; Microcephaly ; Psychomotor Disorders ; Seizures

This study summarizes the clinical thinking of acupuncture for snoring based on "disharmony qi leads to restlessness". According to the pathological characteristics of qi stagnation and blood stasis, phlegm dampness and internal obstruction in snoring patients, combined with the etiology, pathogenesis and location of the disease, the innovative viewpoint of "disharmony qi leads to restlessness" is proposed. It is believed that the key to snoring treatment lies in "regulating qi ". In clinical practice, acupuncture can directly regulate the qi of the disease's location, regulate the qi of the organs and viscera, and regulate the qi of the meridians to achieve overall regulation of the body's internal and external qi, smooth circulation of qi and blood, and ultimately achieve the therapeutic goal of harmonizing qi, stopping snoring, and improving sleep quality.
Humans ; Qi ; Snoring/therapy* ; Psychomotor Agitation ; Acupuncture Therapy ; Meridians

OBJECTIVE: To explore the genetic basis for a child with ocular anomaly, microcephaly, growth retardation and intrauterine growth restriction. METHODS: The patient underwent ophthalmologic examinations including anterior segment photography, fundus color photography, and fundus fluorescein angiography. The patient and her parents were subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing and bioinformatic analysis. RESULTS: The patient was found to have bilateral persistent pupillary membrane and coloboma of inferior iris, in addition with macular dysplasia and radial pigmentation near the hemal arch of the temporal retina. She was found to have carried compound heterozygous missense variants of the PHGDH gene, namely c.196G>A and c.1177G>A, which were respectively inherited from her father and mother. Bioinformatic analysis suggested both variants to be pathogenic. CONCLUSION The patient was diagnosed with phosphoglycerate dehydrogenase deficiency. Above finding has enriched the phenotypic spectrum of the disease with ocular manifestations.
Carbohydrate Metabolism, Inborn Errors/genetics* ; Child ; Coloboma ; Female ; Humans ; Microcephaly/genetics* ; Mutation ; Phenotype ; Phosphoglycerate Dehydrogenase/genetics* ; Psychomotor Disorders/genetics* ; Seizures/genetics* ; Whole Exome Sequencing

BACKGROUND: Previous studies have suggested that screen time (ST) has a negative effect on children's emotional and behavioral health, but there are few longitudinal studies that have been conducted with infants and toddlers. This study sought to examine the effect of ST in early childhood on emotional and behavioral problems in children aged 4 years, based on a birth cohort study in China. METHODS: A total of 2492 children aged 4 years were enrolled in this study. The parents and guardians of each child completed a questionnaire that included items eliciting information on children's birth information, socio-demographic information at baseline, and ST at each follow-up. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) at 4 years of age. Multivariate logistic analysis was used to explore the effects of ST on emotional and behavioral problems. RESULTS: The percentages of children with ST > 0 h/day at age 0.5 years, ST > 2 h/day at age 2.5 years, and ST > 2 h/day at age 4 years were 45.7, 55.5, and 34.5% respectively. The prevalence of emotional and behavioral problems was 10.8%. ST at 6 months was a risk factor for emotional symptoms and hyperactivity at the age of 4 years. ST at age 2.5 years was a risk factor for hyperactivity at the age of 4 years. However, ST at age 4 years was a risk factor for total difficulties, conduct problems, peer problems, hyperactivity, and prosocial behavior. CONCLUSIONS Higher ST exposure at early childhood is associated with later emotional and behavioral problems. In particular, sustained high ST exposure is a risk factor for behavioral problems. These findings suggested the importance of controlling ST to prevent the occurrence of emotional and behavioral problems in the early years.
Altruism ; Child, Preschool ; China/epidemiology* ; Cohort Studies ; Emotions ; Female ; Humans ; Male ; Prevalence ; Problem Behavior/psychology* ; Psychomotor Agitation/psychology* ; Screen Time

BACKGROUND AND PURPOSE: Shift work disrupts the body's circadian rhythms and increases the risk of health problems. Despite evidence of neuropsychological disturbances in shift workers (SW), the brain functional status as measured by brain perfusion in chronic shift work has not been evaluated previously. We investigated the regional cerebral blood flow (rCBF) in SW using perfusion MRI (pMRI) and evaluated the relationships between altered rCBF and sleep, mood, psychometric measures, and quality of life. METHODS: Fifteen rotational SW and 15 day workers (DW) were enrolled. The participants were all female nurses working at a university-affiliated hospital. During 2 weeks of actigraphy they underwent pMRI scanning and psychometric testing on the last day immediately after working. Demographic characteristics, insomnia, daytime sleepiness, and mood were compared between the groups. RESULTS: The participants were aged 35.3±2.9 years (mean±SD) and had been performing their current work for more than 2 years. The demographic characteristics did not differ between SW and DW, but the levels of insomnia, anxiety, depression, and hyperactivity-restlessness in psychometric measures were higher in SW than in DW. Cerebral perfusion in SW was significantly decreased in the cuneus, fusiform/parahippocampal gyri, and cerebellum of the right hemisphere, while it was increased in the inferior occipital gyrus of the left hemisphere. Perfusion changes in SW were significantly correlated with depression and insomnia severity. The onset and duration irregularity of sleep among SW were related to insomnia, mood, hyperactivity/ restlessness, and quality of life. CONCLUSIONS: SW experience considerably more insomnia and mood disturbances than do DW, and this is significantly related to perfusion changes in multiple brain areas.
Actigraphy ; Anxiety ; Brain ; Cerebellum ; Cerebrovascular Circulation ; Circadian Rhythm ; Depression ; Female ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Occipital Lobe ; Perfusion ; Psychometrics ; Psychomotor Agitation ; Quality of Life ; Sleep Initiation and Maintenance Disorders

Going back to basics prior to mentioning the use of antipsychotics in patients with pain, the International Association for the Study of Pain (IASP) definition of pain can be summarized as an unpleasant experience, composed of sensory experience caused by actual tissue damage and/or emotional experience caused by potential tissue damage. Less used than antidepressants, antipsychotics have also been used for treating this unpleasant experience as adjuvant analgesics without sufficient evidence from research. Because recently developed atypical antipsychotics reduce the adverse reactions of extrapyramidal symptoms, such as acute dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia caused by typical antipsychotics, they are expected to be used more frequently in various painful conditions, while increasing the risk of metabolic syndromes (weight gain, diabetes, and dyslipidemia). Various antipsychotics have different neurotransmitter receptor affinities for dopamine (D), 5-hydroxytryptamine (5-HT), adrenergic (α), histamine (H), and muscarinic (M) receptors. Atypical antipsychotics antagonize transient, weak D₂ receptor bindings with strong binding to the 5-HT(2A) receptor, while typical antipsychotics block long-lasting, tight D₂ receptor binding. On the contrary, antidepressants in the field of pain management also block the reuptake of similar receptors, mainly on the 5-HT and, next, on the norepinephrine, but rarely on the D receptors. Antipsychotics have been used for treating positive symptoms, such as delusion, hallucination, disorganized thought and behavior, perception disturbance, and inappropriate emotion, rather than the negative, cognitive, and affective symptoms of psychosis. Therefore, an antipsychotic may be prescribed in pain patients with positive symptoms of psychosis during or after controlling all sensory components.
Affective Symptoms ; Analgesics ; Antidepressive Agents ; Antipsychotic Agents ; Delusions ; Dopamine ; Drug-Related Side Effects and Adverse Reactions ; Dystonia ; Hallucinations ; Histamine ; Humans ; Movement Disorders ; Norepinephrine ; Pain Management ; Prolactin ; Psychomotor Agitation ; Psychotic Disorders ; Receptor, Serotonin, 5-HT2A ; Receptors, Neurotransmitter ; Serotonin ; Weight Gain

PURPOSE: The purpose of this study is to identify the effects of aromatherapy on agitation in patients with dementia using a meta-analysis and systemic literature review. METHODS: The EMBASE, CINAHL, MEDLINE, and other databases were searched up to November 2017. RESULTS: Of 419 publications identified, 12 met inclusion criteria, and 9 studies were used to estimate the effect size of aromatherapy. A total of 837 participants across all studies were included. The commonly applied methods were massage (50%), type of oil lavender (75%), and instrument Cohen-Mansfield Agitation Inventory (75%). A medium effect size of aromatherapy on agitation was identified (d=−0.56, I2=65.0%, p=.001). The massage group has lower effect size than the other group (d=−0.98, I2=0.0%, p=.001). CONCLUSION: Aromatherapy appears to be effective in improving agitation in patients with dementia. However, further studies for home-dwelling patients with dementia and with different types of aroma oil should be conducted in the future. In addition, research with well-designed are needed to assess the effects or aromatherapy on agitation.
Aromatherapy ; Dementia ; Dihydroergotamine ; Humans ; Lavandula ; Massage ; Psychomotor Agitation

No abstract available.
Gait Apraxia ; Gait