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Content available remote Necrotizing pulmonary aspergillosis caused by anorexic syndrome - a case report
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EN
The patient presented is a 44-year-old female treated for cavitary changes in the lung apexes. Due to suspected tuberculosis, treatment began with anti-tuberculosis (AT) drugs, despite negative sputum smears for acid-fast bacilli. During hospitalization, the patient was febrile (up to 38°C), hypotensive, extremely cachectic (32 kg), had a dry cough, increased nitrogen products, hypokalemia and anemia. Because of poor response to the applied AT therapy, bronchoscopic tests were repeated and spores of aspergillus fungus were discovered in the pathohistological findings of transbronchial lung biopsy. The appropriate treatment with amphotericin B and voriconazole was initiated. A psychiatric opinion was requested because we suspected that the patient suffered from the anorexic syndrome (anorexia nervosa). This diagnosis was confirmed by a psychiatrist; her psychiatric treatment began simultaneously with the treatment in our facility. Anorexia was the cause of the cachexia, immunodeficiency and invasive pulmonary aspergillosis. The disorder was not recognized before the manifestation of the somatic disorder. There is little data in the available literature on the association between these two diseases.
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Content available Anorexia nervosa: A literature review
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EN
Introduction: Anorexia nervosa is a food intake disorder characterized by acute weight loss that it could cause severe psychosomatic problems. Purpose: To present the data and information as well as the treatment related to Anorexia nervosa. Materials and methods: The study material consisted of reviewed articles on the topic found in Greek and globally accepted electronic databases, Pubmed, Scopus, Medline, Google Scholar, regarding the effects of Anorexia nervosa on health and its treatment. Results: Initial symptoms of Anorexia nervosa and Bulimia Nervosa may be characterised by body-related negative interpretation bias, distorted body image and pronounced body dissatisfaction. Anorexic patients refuse to eat with their family or in public places. They lose weight by drastically reducing their total food intake, with a disproportionate reduction in the amount of meals containing carbohydrates and fats. The term Anorexia is unfortunate, because a decrease in appetite does not occur. Patients are constantly hungry and they are constantly thinking about food, but they refuse it. An indication of their way of thinking is that they often collect recipes or prepare complex meals for others. Conclusions: Anorexia nervosa is a disease that connects the physical with the mental dimension of health. A person's disharmonious relationship with oneself, which may have its roots in a dysfunctional family context or in a demanding and competitive social environment, finds the way to be manifested through the individual's reflection on food.
PL
W pracy przedstawiono rys historyczny oraz ewolucję kryteriów diagnostycznych jadłowstrętu psychicznego. Temat świadomego ograniczania ilości spożywanego jedzenia rozpoczyna opis z 895 roku i dotyczy wieśniaczki o imieniu Friderada, następnie opisano przykłady głodzenia się w okresie średniowiecza opierając się na „żywotach świętych” oraz opisach „cudownych panien”. Pierwszego usystematyzowanego opisu objawów anoreksji we współczesnym rozumieniu tego zaburzenia dokonał angielski lekarz Richard Morton w 1687 roku. Następnie w historii anoreksji pojawiają się tak wielkie postacie jak Lasegue i Gull, którzy stworzyli wspólną listę objawów psychopato- logicznych charakterystycznych dla tego zaburzenia. W latach 70. XX w. Gerald Russell przedstawił pierwsze kryteria diagnostyczne jadłowstrętu psychicznego, natomiast jedną z pierwszych współczesnych klasyfikacji anoreksji zaproponował w 1976 roku Feighner i wsp. (współpracownicy). Na tej podstawie Amerykańskie Towarzystwo Psychiatryczne (APA - American PsychiatricAssociation) w 1980 roku zweryfikowało kryteria anoreksji psychicznej i przedstawiło je w klasyfikacji DSM-III w 1982 roku, dokonując późniejszych aktualizacji. W Polsce obowiązują kryteria zaproponowane przez Światową Organizację Zdrowia (World Health Organization, WHO), które zostały ujęte w Międzynarodowej Klasyfikacji Chorób i Zaburzeń Psychicznych (International Statistical Classification of Diseases and RelatedHealthProblems, ICD-10) i obowiązują od 1996 roku.
EN
This essay shows the history and evolution of diagnostic criteria about anorexia nervosa. The description begins in 895 with peasant woman named Friderada and refers to deliberate reduction of quantity food that is consumed. The next thing that is referred is examples of starvation people in Middle Ages based on hagiography and the description of “miraculous maiden”. The first person who did fully description of the symptoms of anorexia nervosa in contemporary meaning and that was effective systematized was English doctor Richard Morton in 1687. Next figures who was very important in history of anorexia was Lasegue and Gull who created mutual list of psychopathological symptoms that was typical for this disorder. In 70's Gerald Russell presented first diagnostics criteria about anorexia nervosa, but in 1976 Feighner and his associates did one the first contemporary classification about this disorder. Based on this, in 1980 the American Psychiatric Association verified the criteria about anorexia nervosa and in 1982 presented it with classification DSM-III (with many up- dates).Here, in Poland take effect the criteria that was suggested by World Health Organization. It was included in International Statistical Classification of Diseases and Related Health Problems, ICD-10 and has been operative since 1996.
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