Anorexia nervosa--diagnosis, aetiology, and treatment.

The aetiology, assessment and treatment of anorexia nervosa are reviewed in the light of the classical accounts of Morton, Lasègue and Gull. The core symptoms are deliberate weight loss, disturbed body image and amenorrhoea, and complications may include cardiac failure, electrolyte disturbances, hypothermia and osteoporosis. Common clinical findings are described. Disturbed brain serotonin activity is implicated in the aetiology of anorexia nervosa, but there is little support for the use of pharmacological treatments. Psychological theories of aetiology are discussed with reference to Bruch, Crisp, Palazzoli and Minuchin: the common theme is the reaction of the patient and her family to the physical and social changes of puberty. Individual and/or family psychotherapy is seen as central to the treatment of anorexia nervosa, and the relevant clinical research is reviewed. The roles of general practitioners, general psychiatrists and eating disorder specialists are discussed in the light of recent consensus treatment guidelines.     

Severe acute respiratory syndrome: a preliminary review

Severe acute respiratory syndrome (SARS) is a new disease of unknown aetiology and probably a new strain of coronavirus is thought to be responsible for the disease. After originating from south-east China it has spread to several countries across the world. Patients of SARS suffer from fever with cough and dyspnoea. The virus spreads by droplet to nearby contacts and has high tendency to spread to the healthcare providers. Since the aetiology is not yet clear exact treatment is not yet defined and hence prevention is of utmost importance.     

Management of leg ulcers

Leg ulcer is a leading cause of morbidity among older subjects, especially women in the Western world. About 400 years BC, Hippocrates wrote, "In case of an ulcer, it is not expedient to stand, especially if the ulcer be situated on the leg". Hippocrates himself had a leg ulcer. The best treatment of any leg ulcer depends upon the accurate diagnosis and the underlying aetiology. The majority of leg ulcers are due to venous disease and/or arterial disease, but the treatment of the underlying cause is far more important than the choice of dressing. The aetiology, pathogenesis, treatment, and the future trends in the management of the leg ulcers are discussed in this review.     

原发性骨质疏松骨折治疗探讨

目的　探讨原发性骨质疏松骨折的治疗方法。方法　对 138例原发性骨质疏松骨折 ,在治疗骨折的同时采用联合用药 ,中西医结合用药及脉冲电磁场进行病因学治疗。结果　 138例中 134例获得 8～ 36个月 ,平均 13.5个月的随访 ,按优、良、可、差疗效评定标准 ,优 4 8例 ,良 6 2例 ,可 14例 ,差 6例 ,优良率 85.1% ,另 4例半年后死于其它疾病。结论　原性骨质疏松性骨折必须在进行骨折治疗的同时 ,进行骨质疏松病因学的治疗 ,二者结合才能收到较好的疗效     

Angiokeratoma corporis diffusum: the evolution of a disease entity.

The clinical features, diagnosis management, aetiology and inheritance of angiokeratoma corporis diffusum (Fabry''s disease) are discussed and the literature reviewed. The treatment and knowledge generally of this rare condition have not greatly improved in 75 years.     

Epstein - Barr virus Pneumonitis

Epstein-Barr virus is an unusual pathogen in the aetiology of alveolitis. We describe a case of Epstein-Barr virus induced pneumonitis and its successful treatment with Aciclovir.     

Focal epithelial hyperplasia (Heck's disease) in a Sudanese girl: case report

Focal epithelial hyperplasia is a rare oral mucosal condition with ethnic and familial patterns of prevalence. The exact aetiology is unknown, but a viral aetiology was suggested. The condition does not require any treatment and will regress spontaneously. A recent report considered the condition one of the oral manifestations of HIV infection. The present case report is on focal epithelial hyperplasia affecting a 9 year old Sudanese girl. The case is discussed with special emphasis on the importance of a correct diagnosis.     

Appendix abscess in a femoral hernial sac �� case report and review of the literature

The case of an appendix abscess situated in a rightsided femoral hernial sac is reported. The aetiology, diagnosis and treatment of this rare condition are discussed.     

围生期心肌病的病因学研究进展

围生期心肌病是一种特发性、妊娠相关的的心肌病,多发生于妊娠晚期至产后5个月期间,以左室收缩功能减低并引起心力衰竭为主要表现,是导致妊娠妇女死亡的重要原因,发病率有明显升高趋势,目前病因和发病机制尚不清楚。本文较系统地综述了围生期心肌病的病因学研究进展,以期为临床诊治提供帮助。     

心脏性猝死的研究进展

心脏性猝死是威胁人类生命的一大杀手,发生率较高.该文从流行病学、病因、发病机制及防治等方面对心脏性猝死的研究进展作一综述.     

Treatment for morbid obesity

There is no single unifying theory to explain the aetiology of obesity but several environmental factors, such as decreased physical activity and increased fat intake may contribute to its development in genetically predisposed individuals. Dietary and pharmacological treatments of morbid obesity have been proven to be unsuccessful. Modern surgical treatments have been shown to be effective in achieving significant weight loss with consequent reduction in morbidity. Despite the fact that surgical treatment of morbid obesity is the only therapeutic form that has stood the test of time, it still remains a crisis-driven form of therapy in the UK. It is probable that a better understanding of the aetiology and physiology of obesity may lead to the development of an effective pharmacological treatment of obesity in the future. However, until then, surgical treatment of morbid obesity should be considered as an effective and efficient way of treatment in selected cases.


     

Acute herniation through a posterolateral diaphragmatic (Bochdalek) hernia in an adult

Acute herniation through a posterolateral diaphragmatic defect is rare. A case is presented in which herniation took place after the sudden inversion of a 16-year old youth. Its aetiology, presentation, diagnosis and treatment are discussed.     

Heparin-associated priapism.

A patient who developed priapism 7 hr after stopping an intravenous heparin infusion is described. Abnormal spontaneous platelet aggregation was demonstrated whilst on heparin treatment and is thought to play a role in the aetiology of heparin induced priapism.     

Triple-vessel mesenteric ischaemia presenting with gastric ulceration

We present an unusual presentation of chronic mesenteric ischaemia in a patient with recurrent gastric ulceration that highlights both the importance of recognition of ischaemia as a possible aetiology in those refractory to conventional treatment and the success of percutaneous transluminal mesenteric angioplasty in these cases.     

Hypertrophic osteoarthropathy: two unusual causes.

Two patients with hypertrophic osteoarthropathy of unusual aetiology are described. The first patient developed the condition in association with oesophageal carcinoma and the second as a complication of active pulmonary tuberculosis. In the second case, substantial resorption of new bone was seen following treatment.     

百忧解治疗痉挛性斜颈的效果和机理探讨

目的探讨百忧解治疗痉挛性斜颈的疗效和机理.方法分析6例痉挛性斜颈的治疗过程.结果6例病人应用百忧解治疗均有效果.结论百忧解治疗痉挛性斜颈是有效的,其发病可能与5-羟色胺浓度降低有关.     

Hepatic abscess and cystic fibrosis

Extrapulmonary infection is rare in cystic fibrosis. We describe two adult patients with cystic fibrosis whose course was complicated by the development of liver abscesses. The possible aetiology of these abscesses is discussed and the diagnosis, treatment and prognosis of pyogenic hepatic abscess is briefly reviewed.     

Hyperostosis of anterior cervical vertebrae: a rare cause of dysphagia

Recently, we treated two cases of dysphagia as a result of anterior cervical osteophytes. The cases were the result of two different aetiologies. Referral was delayed in one case because a general practitioner was under the impression that the condition was untreatable. The aetiology, diagnosis and treatment are discussed.     

Aetiology, diagnosis and management of haemospermia: a review

OBJECTIVE: To provide an overview of the aetiology, investigations and the various treatment methods currently available in the management of haemospermia. DATA SOURCE: Review of literature was effected through medline and index medicus search of major published indexed journals and books. DATA SELECTION: Published data on haemospermia, hemospermia, haematospermia and semen over the last five decades (1967-2007) were utilised. DATA EXTRACTION: Abstracts of selected articles were read and analysed to determine their possible contribution and relevance to this article. DATA SYNTHESIS: All relevant articles were reviewed in full and contribution extracted for this review as necessary. CONCLUSION: Haemospermia (haematospermia) is a relatively frequent, distressing and frightening symptom in sexually active men. It is usually a benign self-limiting condition resolving within several weeks except for the few with underlying aetiology including prostate malignancy and idiopathic. Patients presenting with haemospermia should have a detailed medical history, physical examillation including blood pressure measurement, genital and digital rectal examination. Persistent and recurrent haemospermia is best investigated by TRUS, CT, MRI, urethrocystoscopy, and biopsy and histological confirmation of malignancies. Specific treatment depends on the underlying pathological cause but often involves only minimal investigations and simple reassurance.     

From genomic databases to translation: a call to action

The rapid rise of international collaborative science has enabled access to genomic data. In this article, it is argued that to move beyond mapping genomic variation to understanding its role in complex disease aetiology and treatment will require extending data sharing for the purposes of clinical research translation and implementation.