Treatment of hereditary angioneurotic oedema with methandienone

The Turkish journal of pediatrics

Anorexia and bulimia nervosa are common in western civilized countries. They are among the psychiatric disorders in that they are often accompanied by a variety of life-threatening physical abnormalities. These patients need a close follow-up of the pediatrician in collaboration with the psychiatrist since the changes in bodily functions affect the psychiatric therapy. The challenge to the physician is to use the traditional tools of medicine to diagnose and treat these physical abnormalities using careful medical history, a complete physical examination and appropriate laboratory testing. Peripheral edema is seen as a physical finding in anorexia nervosa (AN) and it is not rare. The estimated frequency is up to 20% among adolescent patients. Peripheral edema in this setting can be easily confused as weight gain. There are five possible mechanisms for its occurrence: hypoproteinemia, electrolyte imbalance, hormonal changes, rapid refeedings, and abuse of laxative, diuretics and diet...

Therapeutics and Clinical Risk Management, 2011

Background: We have demonstrated that anorexia nervosa is underpinned by overwhelming adrenal sympathetic activity which abolishes the neural sympathetic branch of the peripheral autonomic nervous system. This physiological disorder is responsible for gastrointestinal hypomotility, hyperglycemia, raised systolic blood pressure, raised heart rate, and other neuroendocrine disorders. Therefore, we prescribed neuropharmacological therapy to reverse this central and autonomic nervous system disorder, in order to normalize the clinical and neuroendocrine profile. Methods: The study included 22 female patients with anorexia nervosa (10 restricted type, 12 binge-eating type) who received three months of treatment with amantadine 100 mg/day. We measured blood pressure, heart rate, and circulating neurotransmitters, (noradrenaline, adrenaline, dopamine, platelet serotonin, free plasma serotonin) during supine resting, one minute of orthostasis, and a five-minute exercise test before and after one, two, and three months of treatment with amantadine, a drug which abrogates adrenal sympathetic activity by acting at the C1(Ad) medullary nuclei responsible for this branch of the peripheral sympathetic activity. Results: We found the amantadine abolished symptoms of anorexia nervosa from the first oral dose onwards. Normalization of autonomic and cardiovascular parameters was demonstrated within the early days of therapy. Abrupt and sustained increases in the plasma noradrenaline:adrenaline ratio and disappearance of abnormal plasma glucose elevation were registered throughout the three-month duration of the trial. Significant and sustained increases in body weight were documented in all cases. No relapses were observed. Conclusion: We have confirmed our previously published findings showing that the anorexia nervosa syndrome depends on the hypomotility of the gastrointestinal tract plus hyperglycemia, both of which are triggered by adrenal sympathetic hyperactivity. The above neuroendocrine plus neuroautonomic and clinical disorders which underpinned anorexia nervosa were abruptly suppressed since the first oral dose of amantadine, a drug able to revert the C1(Ad) over A5(NA) pontomedullary predominance responsible for adrenal and neural sympathetic activity, respectively.

Expert Opinion on Pharmacotherapy, 2004

Currently, no medications are approved by the FDA for the treatment of anorexia nervosa (AN). However, there are several promising pharmacological targets. Treatment includes a weight restoration and a weight maintenance phase and different pharmacological treatments may be useful in one phase, but not the other. Although cyproheptadine has some modest benefit during the weight restoration phase, it is not widely used. Fluoxetine administered during the weight maintenance phase decreases relapse rate. The medications currently being most widely studied are the atypical antipsychotics, particularly olanzapine. Emerging evidence suggests that some AN patients have psychotic symptoms that may respond to antipsychotic agents. There are promising case reports and open-label studies of the atypical antipsychotics, but as yet, no randomised, placebo-controlled, double-blind studies have been reported. Additional novel treatment approaches are urgently needed for this group of severely ill patients who have a high premature mortality rate.

Physiology & Behavior, 2007

The hypothesis that eating disorders are caused by an antecedent mental disorder, presently believed to be an obsessive compulsive disorder, has been clinically implemented during many years but has not improved treatment outcome. Alternatively, eating disorders are eating disorders and the symptoms of anorexic patients and probably bulimic patients as well, are epiphenomena which emerge as a consequence of starvation. This hypothesis is supported by the observations of the effects of a 6 month long period of semi-starvation on healthy human volunteers, which demonstrated not only the emergence of psychiatric symptoms but also the reduction in eating rate which is typical of anorexia nervosa patients. On this framework training anorexic patients how to eat may be a useful intervention. We report that anorexic patients, either with a body mass index b 14 or N 15.5 display the same pattern of eating behavior, with a low level of intake, a slow eating rate and a high level of satiety. They also have the same, high level of psychiatric symptoms, including obsessive compulsive symptoms. Training patients to eat more food at a progressively higher rate reverses these symptoms and patients remain free of symptoms during an extended period of follow-up. It is suggested that the pattern of eating behavior mediates between the starved condition and the psychopathology of anorexia nervosa.

Journal of Psychiatric Research, 1999

Anorexia nervosa is a syndrome of unknown etiology[ It is associated with multiple endocrine abnormalities[ Hypothalamic monoamines "especially serotonin#\ neuropeptides "especially neuropeptide Y and cholecystokinin# and leptin are involved in the regulation of human appetite\ and in several ways they are changed in anorexia nervosa[ However\ it remains to be clari_ed whether the altered appetite regulation is secondary or etiologic[ Increased secretion of corticotropin!releasing hormone and proopiomelanocortin seems to be secondary to starvation\ however\ there is evidence that it may maintain and intensify anorexia\ excessive physical activity and amenorrhea[ Hypothalamic amenorrhea\ which is a diagnostic criterion in anorexia nervosa\ is not solely related to the low body weight and exercise[ Growth hormone resistance with low production of insulin!like growth factor I and high growth hormone secretion re~ect the nutritional deprivation[ The nutritional therapy of patients with anorexia nervosa might be improved by administering an anabolic agent such as growth hormone or insulin!like growth factor I[ So far none of the endocrine abnormalities have proved to be primary\ however\ there is increasing evidence that some of these might participate in a vicious circle[ Þ 0888 Elsevier Science Ltd[ All rights reserved[

Journal of Neural Transmission, 1976

Based on a review of the pathophysiology of the major symptoms of anorexia nervosa, it was suggested that increased activity of dopamine at central dopamine receptors plays a role in the pathophysiology of this disorder. Although dopamine receptor site hypersensitivity, or synthesis, of a false transmitter could account for this, a defect in negative feedback control mechanisms is more consistent with the known characteristics of anorexia nervosa. The possible role of pure dopamine antagonists in symptomatic treatment and of dopamine agonists in reversing this disorder was discussed.

Journal of eating disorders, 2015

Inherent to anorexia nervosa and bulimia nervosa are a plethora of medical complications which correlate with the severity of weight loss or the frequency and mode of purging. Yet, the encouraging fact is that most of these medical complications are treatable and reversible with definitive care and cessation of the eating-disordered behaviours. Herein, these treatments are described for both the medical complications of anorexia nervosa and those which are a result of bulimia nervosa.

Medical Hypotheses, 2018

BMJ, 1960

BELL'S PALSY Bhrrmi ________________________________________________________________________MEDICAL JOUiRNAL Current views on the pathological processes involved are presented and the value of electrodiagnostic tests is discussed. No clear evidence emerges from this series to prove the value of facial-nerve decompression, and there is a strong case for a large-scale clinical investigation to evaluate this and other methods of treatment.

Cités nouvelles, villes des marges : Fondations, formes urbaines, espaces ruraux et frontières de l’archaïsme à l’Empire, 2023

The aim of this work is to study the topography and religious landscape of Valentia and its ager, between the time of its foundation in 138 BC and the 3rd century AD I will rely on epigraphic and archaeological documentation to determine which gods were honoured in the city and on its territory, with a particular emphasis on public religion. Keywords: Epigraphy, Archaeology, Roman religion, Roman Spain, Roman colony