Acculturation and eating disorders in Asian and Caucasian Australian adolescent girls

The present study aimed to compare the attitudes and psychopathology of eating disorders between Asian and Caucasian adolescent girls; and investigate the relationship between acculturation and the attitudes and psychopathology of eating disorders in subgroups of Asian girls. Two groups of non-clinical adolescent girls in Perth, Western Australia, were compared using a survey method. There were 17 Asian and 25 Caucasian adolescent girls, aged 14-17 drawn from private high schools in Perth who were screened using the Eating Attitudes Test (EAT-26), the Eating Disorders Inventory (EDI-2), and an acculturation index. The psychopathology scores for eating disorders of the Asian group were significantly higher than that of the Caucasian group in terms of total EDI-2 score, Interpersonal Distrust, Maturity Fears, Impulse Regulation and Social Insecurity subscales. Eating attitudes measured by Dieting subscale of the EAT-26 was significantly different. Within the Asian group, the less acculturated girls had higher scores on the EAT-26 and the EDI-2 than the more acculturated. Less acculturated Asian girls appeared to have unhealthier attitudes and psychopathology toward eating.     

Dupuytren's disease risk factors

Dupuytren's is a common problem, but little is known about its aetiology. We have undertaken a large case-control study to assess and quantify the relative contributions of diabetes and epilepsy as risk factors for Dupuytren's in the community. Cases were patients with a diagnosis of Dupuytren's disease and, for each, two controls were individually matched by age, sex, and general practice. Our dataset included 821 cases and 1,642 controls. Five hundred and eighty-eight (72%) of the cases were men. The mean age at diagnosis was 62 (range 24-97) years. Diabetes was a significant risk factor for Dupuytren's disease (OR=1.75) and there was an increased risk for medicinally treated diabetes (metformin--OR=3.56; sulphonylureas--OR=1.75) and particularly insulin controlled (OR=4.38) rather than diet-controlled diabetes. Epilepsy (OR=1.12) and anti-epileptic medications were not associated with Dupuytren's disease. Ascertainment bias in previous studies may explain the reported association with epilepsy.     

Primary aorto/iliac-enteric fistula-report of 6 new cases

The management of patients with vascular-enteric fistulas remains a challenging diagnostic and therapeutic problem for the vascular surgeon. Although fortunately quite a rare cause of gastrointestinal bleeding, reported mortality and amputation rates are very high. Fistulas between major vascular structures and the gastrointestinal tract are classified as either primary or secondary. Primary fistulas occur most commonly between an aortic aneurysm and the distal duodenum, while secondary fistulas occur following erosion of prosthetic material into the bowel following aortic reconstruction. The authors report 6 new cases of primary aortoenteric fistula: A malignant aortoenteric fistula in a patient with advanced metastatic squamous cell carcinoma involving the infrarenal aorta and duodenum, 4 cases of primary aortoenteric fistulas in patients with abdominal aortic aneurysms, and 1 iliac-enteric fistula secondary to a common iliac aneurysm. The diagnosis is often difficult to make, and although it was considered in 4 patients preoperatively, the diagnosis was not made until the time of laparotomy in all of these patients. Three patients were treated with an in-situ vascular graft, 2 others had the distal abdominal aorta oversewn and axillobilateral femoral bypass performed, and in the case involving the malignancy, the patient underwent primary aortic repair owing to the extent of the tumor process prohibiting aortic reconstruction. Three patients had primary closure of the intestine performed, and 3 required bowel resection and primary anastomosis. The overall 30-day mortality rate was 50% as 3 patients died in the early postoperative period and the remaining 3 patients survived to be discharged from hospital. One patient (17%) required bilateral above-knee amputations. Treatment of patients with vascular-enteric fistulas is a difficult problem, often associated with delayed diagnosis and high morbidity and mortality rates. Successful surgical management can be achieved with primary closure of the intestinal tract and an in-situ vascular graft or extraanatomic bypass.     

Spontaneous involution of pilocytic astrocytoma in a patient without neurofibromatosis type 1: case report

Serial magnetic resonance imaging findings are described in a patient with a sporadically occurring pilocytic astrocytoma that underwent spontaneous regression over 6 years. To the authors' knowledge, this is the first report in which spontaneous involution of a pilocytic astrocytoma not associated with neurofibromatosis type 1 has been described. A literature review regarding sporadic and syndrome-associated pilocytic astrocytoma was undertaken, with particular reference to treatment and natural history.