OBJECTIVE To compare the effect of individual educational visits versus group visits using academic detailing to discuss prescribing of highly anticholinergic antidepressants in elderly people. DESIGN Randomised controlled trial with three arms (individual visits, group visits, and a control arm). SETTING Southwest Netherlands. PARTICIPANTS 190 general practitioners and 37 pharmacists org...

1. Manivel S, Prasad R, Jacob R. Anesthetic management of a child with Klippel-Feil syndrome in the radiology suite. Paediatr Anaesth. 2005;15:171--2. 2. Cakmakkaya OS, Kaya G, Altintas F, et al. Anesthetic management of a child with Arnold-Chiari malformation and Klippel-Feil syndrome. Paediatr Anaesth. 2006;16:355--6. 3. Subramanyam R, Cudilo EM, Hossain MM, et al. To pretreat or not to pretr...

UNLABELLED INTRODUCTION Unilateral hyperhidrosis can be a neurological manifestation of irritations of the central or peripheral nervous system. CASE PRESENTATION We present the case of a 67-year-old German man who had hyperhidrosis of his right upper body quadrant (including face, arm, and chest) following intrathoracic surgery of a left-sided pleural lipoma. CONCLUSION An isolated unil...

BACKGROUND Older people are commonly prescribed multiple medications, including medications with anticholinergic effects. Polypharmacy and anticholinergic medications may be risk factors for the development of delirium. METHODS Patients from a medical admission unit who were over 70, with DSM-IV diagnosed delirium and patients without delirium, were investigated. Number of drugs prescribed on...

It is well documented that the antipsychotic medications, i.e., the pheno-thiazines and butyrophenones, offer considerable risk of permanent injury to the liver, skin, cornea, bone marrow, heart, and especially to the nervous system. Tardive dyskinesia, a prolonged and sometimes permanent extrapyramidal syndrome, has been reported in up to 50 percent of patients over age 60 who have been treate...

BACKGROUND The prescribing cascade model involves the misinterpretation of an adverse reaction to 1 drug and the subsequent, potentially inappropriate prescription of a second drug. We present a new example of the prescribing cascade involving cholinesterase inhibitors and anticholinergic drugs used to manage urinary incontinence. METHODS A population-based retrospective cohort study was carr...

Central giant cell granuloma is a benign, aggressive neoplasm composed of multinucleated giant cells that almost exclusively occurs in the jaws though extra-gnathic incidence is rare.Multifocal CGCGs of the jaws are very rare and suggestive of systemic diseases such as hyperparathyroidism,an inherited syndrome such as Noonan-like multiple giant cell lesion syndrome or other disorders.Very few c...

Anticholinergic drugs are frequently used in psychiatry for the prophylaxis and treatment of extrapiramidal symptoms caused by neuroleptics. Abuse of anticholinergic agents has been reported in patients with psychotic disorders, on treatment with neuroleptics, and polysubstance use disorders. We are reporting the case of a patient who presented with hypoactive delirium as a consequence of biper...