Introduction:Studies have shown that narcolepsy patients may present with low serum acylcarnitine levels, demonstrating a dysfunctional beta fatty acid oxidation pathway in these patients. Objective: Evaluate the therapeutic efficacy of L-carnitine as a treatment for narcolepsy patients. Methods: This study runned in form of systematic review. The terms used for the search: ("narcolepsy"[MeSH Terms] OR "narcolepsy"[All Fields]) AND ("carnitine"[MeSH Terms] OR "carnitine"[All Fields] OR "l carnitine"[All Fields]). Were included all surveys published until January 2021, with the diagnosis of narcolepsy, that performed drug treatment with I-carnitine. The clinical endpoints of interest were: excessive daytime sleepiness, dissociative REM sleep manifestations: cataplexy, sleep paralysis, hypnagogic hallucinations, and early REM sleep (REM sleep naps, SOREMP). Results: L-carnitine was found to be well-tolerated and without side effects in all surveys, at dosages ranging from 500 to 510 mg/day. Newborns did not present complications during delivery. Conclusion: This study corroborates the efficacy and good tolerability of L-carnitine therapy as a treatment for patients with narcolepsy, including during pregnancy.
Intussusception is the invagination of a bowel segment into another immediately adjacent, causing obstruction, and the etiology can be benign, malignant, or idiopathic. The diagnosis may be obtained by ultrasound scans, or computed tomography imaging that can detect characteristics findings. Small bowel obstruction due to intussusception of inverted Meckel's diverticulum is a rare condition that usually constitutes a challenging diagnosis in adulthood. The surgical management in adults is often performed by en bloc resection without reduction attempts. We report a case of CASE REPORTS a middle-aged man with acute intestinal obstruction due to an ileo-ileal intussusception of inverted Meckel's diverticulum with a lipoma that was managed by laparoscopy. Worthy of note is the very scarce number of case reports on this exceeding uncommon association.
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