scholarly journals Complications of Emergency Refeeding in Anorexia Nervosa: Case series and review

2011 ◽  
Vol 10 (2) ◽  
pp. 69-76
Author(s):  
G J Webb ◽  
◽  
K Smith ◽  
F Thursby-Pelham ◽  
T Smith ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Case Series ◽  
Refeeding Syndrome ◽  
High Prevalence

The refeeding syndrome is common among patients with anorexia nervosa. It may be lethal and has many manifestations. We report a case series of 14 anorexic patients admitted for feeding to a single British centre. There was a high prevalence of the refeeding syndrome, with three cases requiring higher dependency unit support and one death. We present a review of the refeeding syndrome in anorectics and highlight our impression that infection among such patients may be serious and under-recognised.

scholarly journals Eating Disorders in Schizophrenia: Implications for Research and Management

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Youssef Kouidrat ◽  
Ali Amad ◽  
Jean-Daniel Lalau ◽  
Gwenole Loas
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Binge Eating ◽  
Case Series ◽  
Psychotic Symptoms ◽  
Patient Centered ◽  
Night Eating ◽  
Binge Eating Disorders ◽  
High Prevalence ◽  
Centered Care

Objective.Despite evidence from case series, the comorbidity of eating disorders (EDs) with schizophrenia is poorly understood. This review aimed to assess the epidemiological and clinical characteristics of EDs in schizophrenia patients and to examine whether the management of EDs can be improved.Methods.A qualitative review of the published literature was performed using the following terms: “schizophrenia” in association with “eating disorders,” “anorexia nervosa,” “bulimia nervosa,” “binge eating disorder,” or “night eating syndrome.”Results.According to our literature review, there is a high prevalence of comorbidity between schizophrenia and EDs. EDs may occur together with or independent of psychotic symptoms in these patients. Binge eating disorders and night eating syndromes are frequently found in patients with schizophrenia, with a prevalence of approximately 10%. Anorexia nervosa seems to affect between 1 and 4% of schizophrenia patients. Psychopathological and neurobiological mechanisms, including effects of antipsychotic drugs, should be more extensively explored.Conclusions.The comorbidity of EDs in schizophrenia remains relatively unexplored. The clearest message of this review is the importance of screening for and assessment of comorbid EDs in schizophrenia patients. The management of EDs in schizophrenia requires a multidisciplinary approach to attain maximized health outcomes. For clinical practice, we propose some recommendations regarding patient-centered care.

Editorial

2011 ◽  
Vol 10 (2) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Anorexia Nervosa ◽  
Case Series ◽  
Good News ◽  
Close Monitoring ◽  
Refeeding Syndrome ◽  
Great Opportunity ◽  
Acute Medicine ◽  
The Past ◽  
High Dependency ◽  
The Impact

Welcome to the first summer edition of Acute Medicine which became a ‘quarterly’ journal this year. Some readers may be relieved to have survived the passing of spring, with Bank Holidays and a Royal wedding bringing the challenges of 7 day working into sharp focus. There have been times in the past when it felt like acute medicine was the only in-patient speciality with its ‘finger in the dyke’ during holiday periods. The recent e-mail traffic on this issue suggests that greater planning and support from other hospital specialities may have helped limit the impact of the lost ‘working days’ in April. It certainly felt much better than Christmas – perhaps the good weather also helped! Weekend and out-of-hours working are likely to be key areas for acute medicine over coming years. As numbers of trainees obtaining CCTs rises we have a great opportunity to bid for greater consultant numbers; this should enable us to extend the hours of consultant-led acute medical care on AMUs across the UK while maintaining a work-life balance – and our sanity! The interface with specialities on the AMU is another area which has been creating discussion over recent months. A workshop at the Edinburgh SAM meeting last autumn spawned a plenary session on this subject at the spring meeting in Bristol. Two articles in this edition provide different perspectives on this problem. Charlotte Cannon describes the service in Swindon where patients on the AMU remain under the care of the acute medical team; Jo Southgate’s model in Norwich involves much earlier involvement by speciality teams, facilitated by much larger numbers of speciality consultants. Both models have their merits and have been developed to deal with the specific local challenges; earlier involvement of speciality teams may improve continuity of care for those who remain in hospital, but this may be at the expense of delays to treatment and discharge decisions for those who do not. Readers may find the experiences described in these papers helpful in developing their own services. Patients with anorexia nervosa commonly present on the acute medical take and can be difficult to manage. The case series and review published in this edition may help acute physicians to understand better how to prevent, identify and manage refeeding syndrome in these patients. This potentially fatal condition appears to be particularly common where malnutrition relates to anorexia nervosa, affecting 13 of 14 patients in this series despite very careful control of nutritional intake. Three patients required high dependency care. The need for close monitoring of electrolyte levels and raised awareness of the serious nature of the condition appear to be the key messages from this paper. Finally, a piece of good news for aspiring authors who may be considering submission to Acute Medicine. The journal was recently approved for listing on MEDLINE, and articles will now be archived on-line on PubMed. This is a great step forward and I hope will lead to a further increase in the number of high quality submissions we receive. I would like to pass on my thanks to all of those who have been involved in making the journal a success over the past 10 years and helping to take us up to this new level. We remain particularly keen to publish more AMU-based research articles, and those describing completed audit cycles which demonstrate improved practice – so please keep them coming!

scholarly journals Readiness and motivation to change in the treatment of adults with anorexia nervosa: a case series

2014 ◽  
Vol 2 (S1) ◽  
Author(s):  
Olivia Carter ◽  
Susan Byrne ◽  
Karina Allen ◽  
Anthea Fursland
Keyword(s):  
Anorexia Nervosa ◽  
Case Series ◽  
Motivation To Change

OP004 MYOCARDIAL DYSFUNCTION ASSOCIATED WITH REFEEDING SYNDROME (RS) IN SEVERELY MALNOURISHED ANOREXIA NERVOSA (AN) PATIENTS

2011 ◽  
Vol 6 (1) ◽  
pp. 2
Author(s):  
M.G. Hanachi-Guidoum ◽  
A. Kimmoun ◽  
A. Fayssoil ◽  
M. Antona ◽  
J.C. Melchior ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Myocardial Dysfunction ◽  
Refeeding Syndrome

Radiographs of 366 removed limb lengthening nails reveal differences in bone abnormalities between different nail types

2021 ◽  
pp. 1-5
Author(s):  
Christopher A. Iobst ◽  
Markus Winther Frost ◽  
Jan Duedal Rölfing ◽  
Ole Rahbek ◽  
Anirejuoritse Bafor ◽  
...  
Keyword(s):  
Case Series ◽  
Limb Lengthening ◽  
Retrospective Case ◽  
High Prevalence ◽  
Nail Insertion ◽  
Radiological Changes ◽  
Low Prevalence ◽  
Nail Removal ◽  
Mean Time ◽  
Bone Abnormalities

Aims Limb lengthening nails have largely replaced external fixation in limb lengthening and reconstructive surgery. However, the adverse events and high prevalence of radiological changes recently noted with the STRYDE lengthening nail have raised concerns about the use of internal lengthening nails. The aim of this study was to compare the prevalence of radiological bone abnormalities between STRYDE, PRECICE, and FITBONE nails prior to nail removal. Methods This was a retrospective case series from three centres. Patients were included if they had either of the three limb lengthening nails (STYDE, PRECICE, or FITBONE) removed. Standard orthogonal radiographs immediately prior to nail removal were examined for bone abnormalities at the junction of the telescoping nail parts. Results In total, 306 patients (168 male, 138 female) had 366 limb lengthening nails removed. The mean time from nail insertion to radiological evaluation was 434 days (36 to 3,015). Overall, 77% of STRYDE nails (20/26) had bone abnormalities at the interface compared with only 2% of FITBONE (4/242) and 1% of PRECICE nails (1/98; p < 0.001). Focal osteolysis in conjunction with periosteal reaction at the telescoping interface was only observed in STRYDE nails. Conclusion Bone abnormalities at the interface of telescoping nail parts were seen in the majority of STRYDE nails, but only very rarely with FITBONE or PRECICE nails. We conclude that the low prevalence of radiological changes at the junctional interface of 242 FITBONE and 98 PRECICE nails at the time of nail removal does not warrant clinical concerns.

Perinatal Pulmonary Hemorrhage: A Retrospective Autopsy Case Series

2020 ◽  
Vol 23 (4) ◽  
pp. 267-273
Author(s):  
Indu Agarwal ◽  
Linda M Ernst
Keyword(s):  
Pulmonary Hypoplasia ◽  
Case Series ◽  
Pulmonary Hemorrhage ◽  
Vascular Pathology ◽  
Placental Pathology ◽  
Autopsy Case ◽  
Inclusion Criteria ◽  
High Prevalence ◽  
Hematoxylin And Eosin ◽  
Pathology Reports

Perinatal pulmonary hemorrhage (PH) is a condition characterized by blood loss via the respiratory tract with an approximate incidence of 0.1% in all newborns. The histologic characteristics of the lung in PH are not well characterized, and we hypothesized that pulmonary maldevelopment such as pulmonary hypoplasia may contribute to PH. In addition, we sought to find any correlations with placental pathology. Retrospective study of fetal and neonatal autopsies with diagnosis of PH was performed between the years from 2009 to 2015. Autopsy reports, placental pathology reports, and hematoxylin and eosin sections of the lung were reviewed. Of the 17 cases which were identified meeting inclusion criteria, PH ranged from mild (<5% in each lung) to severe (>75% in both lungs). PH involved >50% of both lungs in 6 cases. Pulmonary hypoplasia was designated in 7 of 17 (41.17%) cases with PH. Pulmonary hypoplasia and/or persistence of intra-acinar arterioles was seen in 13 of 17 (76.4%) cases. No specific placental pathology was seen universally in the cases of PH, but either maternal or fetal vascular malperfusion was noted in 14 of 17 (82%) cases. Our data suggest a high prevalence of pulmonary maldevelopment, such as pulmonary hypoplasia and persistence of intra-acinar arterioles, in cases with PH. Although no specific placental pathology is seen in PH, maternal and fetal vascular pathology is common.

Diagnosis of lung cancer: a necropsy-based study of 128 cases (1997–2016)

2020 ◽  
pp. 030089162094966
Author(s):  
Pietro Gino Barbieri ◽  
Dario Mirabelli
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Case Series ◽  
The Elderly ◽  
Positive Finding ◽  
Chest Computed Tomography ◽  
Pleural Plaques ◽  
High Prevalence ◽  
Diagnosis Of Lung Cancer ◽  
Clinical Records

Background: The diagnosis of lung cancer (LC) may be difficult to make in the elderly. We report on the diagnostic elements available in life in an LC necropsy case series of asbestos-exposed workers and describe the frequency of non-neoplastic asbestos-related diseases as biological exposure indices. Methods: We reviewed pathologic and clinical records of an unselected series of autopsies (1997–2016) in patients with LC employed in the Monfalcone shipyards. We assessed the consistency with autopsy results of diagnoses based on, respectively, radiologic, cytologic, and histologic findings. Results: Data on 128 autopsy-confirmed LC cases were available; in life, 119 had been diagnosed as LC. Among these, 49 had histologic confirmation of diagnosis (17 with immunophenotyping); histology had been negative in 4. Cytology had been the main positive finding and the basis for diagnosis in 24 cases, but had been negative in 13. Chest computed tomography had been the basis for diagnosis in 45; in 18 cases, it had been negative. Nine patients had received a diagnosis different from LC, among whom 4 had been suspected to have malignant pleural mesothelioma by chest computed tomography. Pleural plaques were found in 124 and histologic asbestosis in 46 cases. Conclusions: Autopsies confirmed all LC diagnoses received in life, including 46 that would have been considered only possible LC based on clinical workup. The overall survival in this case series was poor. The high prevalence of pleural plaques and asbestosis suggest severity of asbestos exposures.

scholarly journals Avoiding deaths in hospital from anorexia nervosa: the MARSIPAN project

2012 ◽  
Vol 36 (3) ◽  
pp. 109-113 ◽  
Author(s):  
Paul Robinson
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Adult Patients ◽  
Refeeding Syndrome ◽  
The Family ◽  
Key Issues ◽  
Medical Teams ◽  
Medical Wards

SummaryThe MARSIPAN (MAnagement of Really SIck Patients with Anorexia Nervosa) project was established in response to reports of patients admitted to medical wards and proving refractory to treatment, sometimes dying on the ward. Psychiatrists, physicians and other clinicians in nutrition and eating disorders were brought together to discuss key issues in the assessment and management of such patients. The resulting guidance report, which applies to adult patients over 18, addresses: assessment of risk, where to treat the patient, specialist support for medical teams, key elements of treatment, namely (a) safe refeeding to avoid refeeding syndrome and underfeeding syndrome, (b) management of problematic behaviours, (c) support for the family, and (d) transfer to a specialist eating disorder unit when appropriate and possible.

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