Severe accidental colchicine poisoning by the autumn crocus: A case of successful treatment

AbstractBackgroundThe common garden plant autumn crocus contains colchicine and its derivatives. Colchicine poisoning causes abdominal cramps and diarrhea within hours. Several days later, multiorgan failure, pancytopenia, and cardiovascular collapse occur.1,2 Severe colchicine poisoning is associated with high mortality.Case reportA 63-year-old woman who accidentally ingested an autumn crocus, which contained ∼0.38 mg colchicine, had severe vomiting and was taken to an emergency center. She presented with symptoms of gastroenterocolitis within 1 hour of ingestion, and bone marrow hypoplasia with pancytopenia developed on the 3rd day after ingestion. We continued administration of granulocyte colony-stimulating factor (300 μg) for 5 days until we confirmed that the patient's white blood cell count was increasing. Also, there was focal and segmental intestinal ischemia and some cakes of charcoal remained in the intestinal tract. Therefore, we presumed that nonocclusive mesenteric ischemia was caused by hypotension with severe dehydration, although pseudo-obstruction due to the activated charcoal may have been a contributing factor. We were able to promptly intervene to treat paralytic ileus and gastrointestinal edema before anticipated worsening of abdominal compartment syndrome, by conducting open peritoneal drainage. Despite severe poisoning, our patient survived with intensive care. Conclusion: Colchicine intoxication may lead to a sudden and extreme critical course. Therefore, as there is no means to predict prognosis from initial severity of symptoms at onset, we suggest that all patients suspected of colchicine intoxication should be managed in hospital with continuous vital sign monitoring and frequent laboratory testing for at least a few days after ingestion

Predictors of successful long-term weight loss maintenance: a two-year follow-up

Abstract Background Weight regain is a common problem following weight loss intervention, with most people who seek treatment for obesity able to lose weight, but few able to sustain the changes in behavior required to prevent subsequent weight regain. The identification of factors that predict which patients will successfully maintain weight loss or who are at risk of weight regain after weight loss intervention is necessary to improve the current weight maintenance strategies. The aim of the present study is identify factors associated with successful weight loss maintenance by women with overweight or obesity who completed group cognitive behavioral treatment (CBT) for weight loss. Methods Ninety women with overweight or obesity completed a 7-month weight loss intervention. The data of 86 who completed follow-up surveys 12 and 24 months after the end of the treatment was analyzed. Depression, anxiety, binge eating, food addiction, and eating behaviors were assessed before and after the weight loss intervention. Participants who lost at least 10% of their initial weight during the weight loss intervention and had maintained the loss at the month 24 follow-up were defined as successful. Results The intervention was successful for 27 participants (31.3%) and unsuccessful for 59 (68.6%). Multiple logistic regression analysis extracted larger weight reduction during the weight loss intervention, a lower disinhibition score, and a low food addiction score at the end of the weight loss intervention as associated with successful weight loss maintenance. Conclusion The results suggest that larger weight reduction during the weight loss intervention and lower levels of disinhibition and food addiction at the end of the weight loss intervention predicted successful weight loss maintenance. Trial registration Trial registry name: Development and validation of effective treatments of weight loss and weight-loss maintenance using cognitive behavioral therapy for obese patients. Registration ID: UMIN000006803 Registered 1 January 2012. URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R00000805

Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss

Objective: To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. Methods: 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. Results: 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Conclusion: Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women

Additional file 2: Table S2. of Inhibition of emotional needs and emotional wellbeing predict disease progression of chronic hepatitis C patients: an 8-year prospective study

Baseline associations between the FACIT scales and physical factors. (DOCX 16 kb

Additional file 1 of Inadequate care and excessive overprotection during childhood are associated with the presence of diabetes mellitus in adulthood in a general Japanese population: a cross-sectional analysis from the Hisayama Study

Additional file 1: Supplemental Table S1. Parental care and overprotection scores for all participants according to age group. Supplemental Table S2. Combination of paternal and maternal parenting styles. Supplemental Table S3. Association of the score of parental care and overprotection with the presence of diabetes after including the participants with a single parent. Supplemental Table S4. Characteristics of included and excluded subjects

Additional file 3: Table S3. of Perceived inadequate care and excessive overprotection during childhood are associated with greater risk of sleep disturbance in adulthood: the Hisayama Study

Characteristics of participants and non-participants. (DOCX 15 kb