Urticaria Successfully Treated with Mindfulness and Nutraceutical Supplements

The study is to describe a patient with urticarial lesions which was successfully treated with mindfulness and nutraceuticals.A 20-year-old female patient with an unmarked past medical history presented with diffuse pruritic urticarial lesions associated with breathless and severe fatigue,lasting for 5 months.The lesions covered all body,except palms and plants.Hospitalized for three days,she received dexamethasone,promethazine,and subcutaneous adrenalin and discharged with fexofenadine,prednisone,and ranitidine.Mindfulness and relaxation practice were instructed and some nutraceuticals.After two months,she returned asymptomatic,without any new episodes of urticaria or fatigue.Most of the chronic urticaria patients are treated with antihistamines and/or steroids.This case illustrates an alternative holistic approach,combining mindfulness and relaxation practices with nutraceuticals.This alternative therapeutical strategy should be explored by back to back comparison to the conventional pharmaceutical approach.

Suicide risk in systemic lupus erythematosus:A narrative review

Introduction:Despite the medical and scientific advances,the disease’s restrictions and the perception of personal and social losses related to its course reinforce fear and generate intense suffering in lupus patients.Psychiatric comorbidities,especially major depressive episodes,are highly prevalent during systemic lupus erythematosus.Among them,suicide is a behavior that is much more common than we believe.Objective:To perform a narrative review on suicidal behavior associated with systemic erythematosus lupus(SLE).Results:Studies have shown an increased risk of suicide among patients with chronic diseases and psychiatric disorders,especially depression.However,suicide cannot be attributed only to a higher prevalence of depression and other mental illnesses.Therefore,it is necessary to learn more about the suicide risk factors present in patients with lupus to work on secondary prevention and avoid the premature loss of lives and the additional suffering of families and surrounding communities.The coordination between the studies on suicidal behavior and its intricate network of individual and sociocultural factors and the studies on this multisystem autoimmune disease with a broad manifestation spectrum,lupus,creates new and essential field research.Conclusions:Non-psychiatrist office-based physicians,health clinics,or wards dedicated to the treatment of SLE should recognize and handle the suicide risk factors on their patients to reduce the suffering caused by this disease.

Presarcopenia and chronic cough due to chronic obstructive pulmonary disease successfully treated with nutraceutical supplements and physical exercise

Objective:To describe a patient with presarcopenia and chronic cough secondary to chronic obstructive pulmonary disease(COPD)successfully treated with supplements and physical exercise.Case report:A 75-year-old female patient with a positive past medical history of systemic hypertension,dyslipidemia,heart arrhythmia,and smoking during 20 years evolved with chronic cough due to a chronic obstructive pulmonary disease diagnosed ten years ago.She came to our private clinic due to low weight,low energy.Her weight was 44.8 kg,her height 1.57 m,body mass index of 18.18 kg/m^(2).Laboratory tests showed SDHEA 76.3,vitamin D of 15.6 ng/ml(nr:>30 ng/ml),C-reactive protein(CRP)of 55 mg/ml.Computed tomography showed bronchiectasis.She had an skeletal muscle mass index of 5.0 kg/m^(2)(nr:>5.5 kg/m^(2))by DXA.A diagnosis of presarcopenia was determined based on DXA evaluation with low muscle mass but normal gait speed handgrip strength.We suggested to the patient to increase physical exercise and prescribed a supplement formula.After five months,she returned asymptomatic,without cough,marked improvement of fatigue,increased energy levels,and weight increased to 50 kg,BMI of 20.28 kg/m^(2).Laboratory tests showed SDHEA to 140,vitamin D3 to 64.5 ng/ml,reduced CRP reduced to 5 mg/dl,and amlodipine was excluded due to better blood pressure control.Currently,two years later,the patient continues without cough and has dyspnea only with high efforts,without fatigue,and her weight is 52 kg and BMI 21.1 kg/m^(2).She also reduced her conventional treatment for COPD,using only a bronchodilator on-demand,without topical corticoids.Conclusions:This case illustrates an interesting case of a patient with presarcopenia and chronic cough,refractory to conventional approach,successfully treated with a combination of nutraceuticals and physical exercises.