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贪食症bulimia

山东精神医学 1988年第1期 70-71页

作者：矫汉勤山东省精神病医院

贫食症是以反复暴食为特征,伴有精神和躯体症状,常见社会上层阶级年轻女性,本症国内报道不多,国外较为常见,在国外女大学生中患病率尤高(KaplanAS)。暴食后多有自我引吐,滥服泻剂,情绪抑郁,甚至自杀。病因尚不清楚,可能与下丘脑功能障... 详细信息

贫食症是以反复暴食为特征,伴有精神和躯体症状,常见社会上层阶级年轻女性,本症国内报道不多,国外较为常见,在国外女大学生中患病率尤高(KaplanAS)。暴食后多有自我引吐,滥服泻剂,情绪抑郁,甚至自杀。病因尚不清楚,可能与下丘脑功能障碍有关,无特殊治疗。

关键词：贪食症 bulimia 丘脑功能障碍神经性厌食躯体症状情感性疾病重型抑郁症上层阶级进食障碍抗抑郁剂

Gastrojejunostomy for pyloric stenosis after acute gastric dilatation due to overeating

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World Journal of Gastroenterology 2015年第5期21卷 1670-1674页

作者： Akiharu Kimura Norihiro Masuda Norihiro Haga Tomokazu Ito Kichirou Otsuka Jyunko Takita Hitoshi Satomura Yuji Kumakura Hiroyuki Kato Hiroyuki Kuwano Department of Surgery Utsunomiya National HospitalTochigi 329-1193Japan Department of General Surgical Science Gunma UniversityGraduate School of MedicineMaebashiGunma 371-8511Japan Department of Surgery I Dokkyo Medical UniversityTochigi 321-0293Japan

A 34-year-old woman presented at our hospital withabdominal distention due to *** gastric dilatation was *** patient was hospitalized,and nasogastric decompression was *** hospitalization day 3,she developed shock,and her respiratory state deteriorated,requiring intubation and mechanical *** decompression contributed to the improvement in her clinical *** was discharged 3 mo after *** outpatient follow-up,her dietary intake decreased,and her body weight gradually decreased by 14 *** upper gastrointestinal series and endoscopy revealed pyloric stenosis; therefore,we performed gastrojejunostomy 18 mo after her initial *** patient was discharged from the hospital with no postoperative *** necrosis and perforation due to overeating-induced gastric dilatation are life-threatening *** intervention may be required if delayed pyloric stenosis occurs after conservative *** report a case of pyloric stenosis due to overeating-induced gastric dilatation treated by gastrojejunostomy 18 mo after the initial presentation.

关键词： Acute gastric dilatation bulimia Pyloric stenosis

Association between resting energy expenditure, psychopathology and HPA-axis in eating disorders

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World Journal of Clinical Cases 2014年第7期2卷 257-264页

作者： Giovanni Castellini Walter Castellani Lorenzo Lelli Carolina Lo Sauro Carla Dini Lisa Lazzeretti Lorenza Bencini Edoardo Mannucci Valdo Ricca Department of Neuroscience PsychologyDrug Research and Child HealthUniversity of Florence50134 FirenzeItaly Department of Respiratory Physiopathology Palagi Hospital50134 FirenzeItaly Department of Health Science University of Florence50134 FirenzeItaly Nutrition Service University of Florence50134 FirenzeItaly Non Invasive Cardiology Department of Heart and VesselsUniversity of Florence50134 FirenzeItaly

AIM: To investigate the complex relationships between resting energy expenditure(REE), eating psychopathology, and Hypothalamus Pituitary Adrenal axis functioning in patients with eating disorders. METHODS: The study was designed as a crosssectional survey, and it was planned by the Clinic for Eating Disorders of the University of Florence(Italy). The protocol was approved by the Ethics Committee of the Institution. Twenty two anorexia nervosa and twenty one bulimia Nervosa patients were assessed by means of a clinical interview and the structured clini-cal interview for diagnostic and statistical manual of mental disorders, fourth edition. Eating attitudes and behaviour were specifically investigated by means of the eating disorder examination questionnaire(EDE-Q). Patients were also evaluated by means of the symptom checklist(SCL 90-R), REE was measured by means of indirect calorimetry, and blood cortisol morning levels were evaluated. RESULTS: Both anorexia nervosa and bulimia nervosa patients showed a reduced REE as compared with predicted REE. Body mass index(BMI) was positively associated with resting energy expenditure in Bulimics, whereas a strong, negative association between BMI and REE was observed in Anorectics. The pattern of associations between variables supported a mediation model, where shape concern accounted for variations in REE and cortisol levels(mediator), and variations in the mediator significantly accounted for variations in REE. When these associations where taken into account together, the relationship between shape concern and REE was no longer significant, whereas the association between cortisol levels and REE retained its significance, showing strong evidence for a single, dominant mediator. Anorectics and Bulimics showed an opposite pattern of association between BMI and REE. In Anorectics only, a higher REE was associated with a more severe eating disorder specific psychopathology, and cortisol levels represent a possible mediating

关键词： Anorexia nervosa bulimia nervosa Cortisol Psychopathology Resting energy expenditure

Eating disorders and psychosis: Seven hypotheses

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World Journal of Psychiatry 2014年第4期4卷 112-119页

作者： Mary V Seeman Department of Psychiatry University of Toronto Toronto Ontario M5S 1A8 Canada

Psychotic disorders and eating disorders sometimes occur in the same person, and sometimes, but not always, at the same time. This can cause diagnostic confusion and uncertainty about treatment. This paper examines seven ways in which symptoms of both conditions can co-exist. The literature on this topic consists to a large extent of case reports, so that firm conclusions cannot be drawn from their examination. There is no consistent sequence in the co-occurrence of the two conditions-eating disorders sometimes precede, and sometimes follow the onset of psychosis. The advent of the psychosis, and sometimes the treatment of the psychosis can cure the eating disorder, but it can sometimes aggravate it. Psychosis is not necessarily a mark of severity in the course of an eating disorder, and food refusal can occur independent of severity in psychotic illness, but it can be a cause of death. There is some genetic association and some overlap of physiologic, cognitive and brain structure deficits in the two types of disorder. The connection between the two, however, remains speculative. The area of comorbidity and overlapping symptoms in psychiatry requires more research. Clinical recommendations include attentionto the different individual ways in which these two disparate conditions often overlap.

关键词： Psychosis Anorexia bulimia Eating disorder Comorbidity

Disordered eating behaviors in type 1 diabetic patients

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World Journal of Diabetes 2011年第11期2卷 189-195页

作者： Alejandra Larraaga Ricardo V García-Mayor María F Docet Eating Disorders Unit University Hospital of Vigo Nutrition Section University Hospital of Vigo

Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially diff icult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following compo- nents: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight andshape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.

关键词： Anorexia nervosa bulimia nervosa Eating disorders not otherwise specified Disordered eating behaviors Type 1 diabetes

Endoscopic retrieval of a duodenal perforating teaspoon

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World Journal of Gastrointestinal Endoscopy 2013年第4期5卷 186-188页

作者： Ivo Bokoski Andrea Tringali Rosario Landi Pietro Familiari Anna Chiara Iolanda Contini Claudio Pintus Guido Costamagna Digestive Endoscopy Unit Catholic University of Rome Pediatrics Department Catholic University of Rome Digestive Endoscopy Unit Catholic University of Rome

Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal of foreign bodies larger than 10 cm has not yet been described. We present the case of a 16 years old bulimic girl that swallowed a 12 cm long teaspoon in order to provoke vomiting. The teaspoon perforated the duodenum. However, it was removed during gastroscopy and the site of perforation was closed endoscopically. This particular case shows the importance of endoscopy for retrieval of large foreign bodies, and the possibility to endoscopically close a perforated duodenal wall.

关键词： Foreign body ingestion Upper endoscopy Bowel perforation bulimia