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Anorexia nervosa:outpatient treatment and medical management

World Journal of Psychiatry 2022年第4期12卷 558-579页

作者： Stein Frostad Mette Bentz Department of Mental Health Research Division of PsychiatryHaukeland University HospitalBergen 5021Norway Child and Adolescent Mental Health Centre Capital Region of DenmarkUniversity of CopenhagenCopenhagen 2400Denmark

Anorexia nervosa(AN)is a disabling,costly and potentially deadly *** failure and relapse are common after completing treatment,and a substantial proportion of patients develop severe and enduring *** time from AN debut to the treatment initiation is normally unreasonably *** the past 20 years there has been empirical support for the efficacy of several treatments for ***,outpatient treatment with family-based therapy or individual psychotherapy is associated with good outcomes for a substantial proportion of *** intervention improves outcomes and should be a priority for all *** treatment is usually the best format for early intervention,and it has been demonstrated that even patients with severe or extreme AN can be treated as outpatients if they are medically *** care is more disruptive,more costly,and usually has a longer waiting list than does outpatient *** decision as to whether to proceed with outpatient treatment or to transfer the patient for inpatient therapy may be *** core aim of this opinion review is to provide the knowledge base needed for performing safe outpatient treatment of *** scientific essentials for outpatient treatment are described,including how to assess and manage the medical risks of AN and how to decide when transition to inpatient care is *** following aspects are discussed:early intervention,outpatient treatment of AN,including outpatient psychotherapy for severe and extreme AN,how to determine when outpatient treatment is safe,and when transfer to inpatient healthcare is *** treatments,ethical issues and outstanding research questions are also addressed.

关键词： Anorexia nervosa outpatient treatment Medical management outpatient psychotherapy Inpatient healthcare

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outpatient hybrid endoscopic submucosal dissection with SOUTEN for early gastric cancer,followed by endoscopic suturing of the mucosal defect:A case report

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世界胃肠外科杂志:英文版(电子版) 2023年第8期15卷 1831-1837页

作者： Renma Ito Kazuhiro Miwa Yutaka Matano Internal Medicine Komatsu Municipal HospitalKomatsu 923-0961Japan

BACKGROUND Although endoscopic submucosal dissection(ESD)is becoming more common for early gastric cancer,it requires more advanced techniques and a longer treatment duration than endoscopic mucosal *** ESD using a multifunctional snare(SOUTEN)has been reported to be effective for colorectal lesions,as it can reduce treatment *** suturing of post-ESD mucosal defects has been reported to reduce the incidence of ESD-related *** SUMMARY This study reports outpatient hybrid ESD for early gastric cancer using SOUTEN,followed by endoscopic suturing of post-ESD mucosal defects in an 86-year-old *** referral for ESD,a 10-mm flat,depressed lesion was found on the posterior wall of the gastric antrum,the depth of which was expected to be *** his history of delirium,we performed outpatient endoscopic *** procedure used was hybrid ESD using SOUTEN to reduce the duration of treatment and endoscopic suturing of post-ESD mucosal ESD defects to reduce *** procedure time was 62 min and the lesion was completely resected based on histopathological examination,with no reported postoperative *** This safe and useful procedure may be especially important for outpatient endoscopic treatment.

关键词： outpatient treatment Hybrid endoscopic submucosal dissection Multifunctional snare Early gastric cancer Endoscopic suturing Case report

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