World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Eating Disorders

Abstract

Objectives. The treatment of eating disorders is a complex process that relies not only on the use of psychotropic drugs but should include also nutritional counselling, psychotherapy and the treatment of the medical complications, where they are present. In this review recommendations for the pharmacological treatment of eating disorders (anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED)) are presented, based on the available literature. Methods. The guidelines for the pharmacological treatment of eating disorders are based on studies published between 1977 and 2010. A search of the literature included: anorexia nervosa bulimia nervosa, eating disorder and binge eating disorder. Many compounds have been studied in the therapy of eating disorders (AN: antidepressants (TCA, SSRIs), antipsychotics, antihistaminics, prokinetic agents, zinc, Lithium, naltrexone, human growth hormone, cannabis, clonidine and tube feeding; BN: antidepressants (TCA, SSRIs, RIMA, NRI, other AD), antiepileptics, odansetron, d-fenfluramine Lithium, naltrexone, methylphenidate and light therapy; BED: antidepressants (TCA, SSRIs, SNRIs, NRI), antiepileptics, baclofen, orlistat, d-fenfluramine, naltrexone). Results. In AN 20 randomized controlled trials (RCT) could be identified. For zinc supplementation there is a grade B evidence for AN. For olanzapine there is a category grade B evidence for weight gain. For the other atypical antipsychotics there is grade C evidence. In BN 36 RCT could be identified. For tricyclic antidepressants a grade A evidence exists with a moderate-risk-benefit ratio. For fluoxetine a category grade A evidence exists with a good risk-benefit ratio. For topiramate a grade 2 recommendation can be made. In BED 26 RCT could be identified. For the SSRI sertraline and the antiepileptic topiramate a grade A evidence exists, with different recommendation grades. Conclusions. Additional research is needed for the improvement of the treatment of eating disorders. Especially for anorexia nervosa there is a need for further pharmacological treatment strategies.     

Bichat guidelines for the clinical management of brucellosis and bioterrorism-related brucellosis

Interest in Brucella species as a biological weapon stems from the fact that airborne transmission of the agent is possible. It is highly contagious and enters through mucous membranes such as the conjunctiva, oropharynx, respiratory tract and skin abrasions. It has been estimated that 10-100 organisms only are sufficient to constitute an infectious aerosol dose for humans. Signs and symptoms are similar in patients whatever the route of transmission and are mostly non-specific. Symptoms of patients infected by aerosol are indistinguishable from those of patients infected by other routes. Regimens containing doxycycline plus streptomycin or doxycycline plus rifampin are effective for most forms of brucellosis. Isolation of patients is not necessary. Trimethoprim-sulfamethoxazole and fluoroquinolones also have good results against Brucella, but are associated with high relapse rates when used as monotherapy. The combination of ofloxacin plus rifampicin is associated with good results. Even if there is little evidence to support its utility for post-exposure prophylaxis, doxycycline plus rifampicin is recommended for 3 to 6 weeks.     

茶树籽对钉螺生殖腺和肝脏的影响

目的 :了解钉螺组织经茶树籽处理的影响。方法 :应用电镜技术观察处理后的钉螺肝脏及生殖腺组织的超微结构。结果 :钉螺在茶树籽作用 2 4 h后 ,肝内细胞受损。雄性生殖细胞有凝固性及溶解性变化 ;成熟精子细胞膜肿胀与内部结构分离 ,线粒体鞘呈现凝集型 ,支持细胞可见凝固性改变 ,且彼此断裂并与生殖细胞分离。雌性钉螺生殖腺可见卵细胞肿胀 ,严重时滤泡细胞有破裂 ,卵细胞膜则可丧失完整性。结论 :茶树籽能损伤钉螺的生殖腺和肝脏。     

DNA探针用于中华按蚊和嗜人按蚊的分类研究

本项研究首次报道了我国中华按蚊和嗜人按蚊DNA基因库的建立,并从中华按蚊DNA基因库中筛选出一特异的DNA片段,以此为DNA探针,分别与中华按蚊DNA和嗜人按蚊DNA进行斑点杂交试验,其结果证明该DNA探针可与任何发育期的中华按蚊DNA杂交而不与嗜人按蚊DNA杂交,该探针敏感性高,可检测出7.5ng的中华按蚊DNA,大约相当于1个蚊虫总DNA的1/150,可用于区别中华按蚊和嗜人按蚊。     

Practice parameters for the identification and testing of patients at risk for dominantly inherited colorectal cancer--supporting documentation

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient. Prepared By The Standards Task Force The American Society of Colon and Rectal Surgeons     

日本血吸虫大陆株副肌球蛋白部分基因克隆

目的 :克隆日本血吸虫大陆株副肌球蛋白部分基因。方法 :用 PCR方法根据已发表日本血吸虫菲律宾株副肌球蛋白基因部分核苷酸序列扩增大陆株副肌球蛋白基因。结果 :获得一日本血吸虫大陆株 72 0 bp基因克隆。结论 :经核苷酸序列分析证实 ,本克隆基因与菲律宾株基因核苷酸同源性为 99.0 3%。     

阿苯达唑对感染仓鼠的美洲钩虫幼虫及虫卵的作用

感染美洲钩虫成虫的仓鼠口服阿苯达唑７５或１５０ｍｇ／ｋｇ的有效率为８３．８％和１００％。治前３ｄ，２个治疗组每鼠每ｇ粪便培养的幼虫数为２９７１６±３２９９和２８２５６±１１８，对照组的为８８２８±２６５９。治后３ｄ，治疗组的粪便培养未查见幼虫，而对照组的为９０６６±７４１６。此外，受治２组的培养粪便残渣用饱和盐水漂浮虫卵时，无或仅查见几个变性虫卵。仓鼠于感染第３期幼虫后３、７或１４ｄ口服１剂阿苯达唑１５０或３００ｍｇ／ｋｇ时，粪便虫卵阳性率为０－９．１％，减虫率为９６．８－１００％。     

溴乙酰胺对枝小丽螺的毒杀作用

实验室和现场试验,溴乙酰胺对中华双腔吸虫和胰阔盘吸虫的第一中间宿主枝小丽螺(Ganesella virgo)具有良好的毒杀作用。现场用0.5和1g/m~2的剂量喷洒,枝小丽螺的死亡率分别为74.7～84.7％和84.8～95.7％。有关该药对家畜和牧草的毒性问题有待进一步试验。