The role of the family physician in eating disorders

The steady increase in Eating Disorders (ED) during the last three decades has raised increasing concern over the early diagnosis and treatment of this disease. Due to the multi-factorial etiology of ED, treatment is complex, prolonged, and demands a team approach. Family physicians are often approached first for consultation following the patient's initial physical complaints. For this reason, the general practitioner can play a critical role in the early diagnosis and treatment of these disorders. By asking the appropriate questions and providing relevant information, the family physician (FP) may be able to refer the patient to treatment necessary for recovery, as well as assist in this process. Because the family physician typically has previous acquaintance with the patient and her family, he or she may be of considerable import to creating a therapeutic liaison and support framework with the professional team. This article will discuss the potential involvement and significance of the family physician in the successful diagnosis, prevention, and treatment of ED. The importance of the FP in the decision for hospitalization, referral, and follow-up is emphasized, as well as the pivotal role of the FP as a multi-disciplinary team coordinator.     

Dermis fat graft. Use of surgical reconstruction of the cavities]

Dermis fat graft is a surgical technique that is nowadays well accepted for the reconstruction of the orbital cavities. The authors report the results and the follow-up of 17 dermis fat grafts carried out at the Reims Hospital between March 1(st), 1987 and December 31(st)1999. They explain the modalities of the technique, its major indications and the possible complications. At Reims, the dermis fat graft is mainly done to resolve intraorbital implant extrusions.     

Hepatoprotective and anti-inflammatory effects of a traditional medicinal plant of Chile, Peumus boldus

Dried hydro-alcoholic extract of Peumus boldus (Monimiaceae) has been evaluated for hepatoprotective, choleretic and anti-inflammatory effects in mice and rats, in order to validate or to invalidate traditional therapeutic indications. This extract exerted a significant hepatoprotection of tert-butyl hydroperoxide-induced hepatotoxicity in isolated rat hepatocytes (in vitro technique) by reducing the lipid peroxidation and the enzymatic leakage of LDH; this in vitro efficacy was reinforced by a significant hepatoprotection on CCl4-induced hepatotoxicity in mice (in vivo technique), the plant extract reducing the enzymatic leakage of ALAT. Boldine, the main alkaloid of P. boldus appears to be implicated in this hepatoprotective activity. Choleretic effects, often mentioned in traditional indications, have not been confirmed in rats. Finally, significant and dose-dependent anti-inflammatory effects were obtained on an acute inflammatory process (carrageenan-induced edema test in rats). Boldine does not appear to be involved in such properties.     

Nail biopsy--why, when, where, how?

The technique and significance of nail biopsies with regard to mycotic and bacterial infections, onychopathy associated with cutaneous and systemic diseases, and benign and malignant ungual neoplasms is discussed.