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Chylothorax is an uncommon pleural effusion characterized by the presence of chyle in the pleural space. Malignancy, trauma, and infections such as tuberculosis and filariasis can result in chylothorax. The chyle is an odourless and white liquid; however, around 50% of chylothorax is not milky (serosanguineous) and 10% of chylothorax is idiopathic which can pose a diagnostic dilemma. We propose a systematic approach which includes pleural fluid triglycerides and cholesterol for all undiagnosed pleural effusion. The case highlights the diagnostic dilemma as well as therapeutic challenges.
Research has identified factors specific to exercise in eating disorder patients such as affect regulation and compulsivity. Existing measures of exercise behaviour which were not originally designed for eating disorder patients may not adequately assess these factors. The aim of this systematic review is to identify and assess the psychometric properties of all self-report measures of exercise designed to be used with eating disorder patients.
A systematic review was conducted following the PRISMA guidelines. MedLine, Scopus and PsycINFO were systematically searched. A total of 12 studies examining two measures, the Exercise and Eating Disorders and the Compulsive Exercise Test, met inclusion criteria.
Validation studies showed promising results for both tests and established internal consistency, concurrent and convergent validity, and construct validity. The factor structure of the Compulsive Exercise Test was not confirmed in the majority of the studies included in this review, while there are only two studies conducting factor analysis on the Exercise and Eating Disorders.
The two measures identified by this systematic review represent the current research on measures of compulsive exercise for eating disorder patients. Further research is needed to confirm a factor structure and validate both the Compulsive Exercise Test and the Exercise and Eating Disorders in more diverse clinical samples.
The two measures identified by this systematic review represent the current research on measures of compulsive exercise for eating disorder patients. Further research is needed to confirm a factor structure and validate both the Compulsive Exercise Test and the Exercise and Eating Disorders in more diverse clinical samples.
Routine supplementation of thiamine in patients with restrictive eating disorders prior to initiation of nutritional rehabilitation, is an example of a clinical guideline based on expert opinion rather than evidence-based recommendations. This study investigates whether adolescents hospitalised with a restrictive eating disorder commenced on a higher caloric refeeding regimen, present with or develop thiamine deficiency during their admission.
An eighteen month retrospective audit of 119 consecutive admissions for nutritional rehabilitation was conducted on patients admitted with an eating disorder in a large tertiary teaching hospital in Western Sydney. Data from paper-based and electronic medical records were collected. Baseline and weekly blood thiamine levels were documented, as well as patient demographic information including admission weight, age, length of stay, percentage median body mass index, weight change throughout admission and caloric prescription.
Sixty admissions met inclusion criteriahe most vulnerable group.
Nutritional management of 60 malnourished adolescents hospitalised with an eating disorder was conducted safely with the provision of only 10 mg thiamine in a multivitamin daily, and no additional thiamine supplementation. The high caloric refeeding protocol, inclusive of a daily multivitamin, provided adequate thiamine to prevent thiamine deficiency. PND-1186 in vivo Further research should examine thiamine requirements in an exclusive severely malnourished population to assess the need for thiamine replacement in the most vulnerable group.The above article from Clinical Case Reports, published online on 3 April 2020 in Wiley Online Library as Early View (https//onlinelibrary.wiley.com/doi/full/10.1002/ccr3.2825), has been retracted by agreement between Dr Masoud Garshasbi, the Editor-in-Chief and John Wiley and Sons Ltd. The retraction has been agreed because the article has been submitted and approved for publication by Dr. Omid Daneshjoo without consent in any form from the named co-authors and Dr. Masoud Garshasbi. Reference Daneshjoo O, Ebrahimi P, Salehi LB, Pizzuti A, Garshasbi M. Identification of a novel RUNX2 gene mutation and early diagnosis of CCD in a cleidocranial dysplasia suspected Iranian family (2020). Clin Case Rep. 2020;1-8.Stair-specific FTSD in the lower limb is very rare. Most patients show dystonic posture when walking downstairs rather than upstairs.The pathophysiological mechanism of resting tremor in Parkinson's disease remains obscure. Spinal/peripheral mechanisms may modulate oscillatory activity from central origin, thereby changing amplitude and frequency of tremor in Parkinson's disease.The inverted appendix or appendiceal stump is a rare finding that may be identified at colonoscopy. This may cause diagnostic confusion and be misinterpreted as a polyp with a risk of peritonitis if excised endoscopically.Thymic hyperplasia is a common finding among newborns, but cyst formation might produce mediastinal symptoms. Lethal outcome is reported when accompanied by massive intrathoracic hemorrhage. The clinical picture in our case was characterized from profuse multiple hemorrhagic foci and respiratory distress syndrome, with an unclear role of the thymic cyst.A detailed medical history is vital in the correct interpretation of medical images Peer-to-peer feedback and a thorough medical history can help avoid diagnostic pitfalls and unnecessary therapy.Respiratory complaints alone or in association with musculoskeletal complaints can be the predominant presenting feature of antisynthetase syndrome. Therefore, antibodies to cellular antigens should be evaluated in such clinical settings.Young patient exhibiting lumbar pain accompanied by severe kyphoscoliosis-hemivertebra of the thoracolumbar spine; a rare etiology with difficult surgical treatment.
