Paucisymptomatic pulmonary and right ear tuberculosis in young woman suffering from anorexia and bulimia nervosa

Pulmonary complications of eating disorders: a literature review

The medical complications of eating disorders (EDs) have been described in the literature; however, the pulmonary system has historically been described as relatively spared from the ravages of eating disorders and thus neglected in the literature. Here we review the pulmonary complications that have been described in the literature, including the effects of starvation on the lungs of nutritionally deprived animals and patients with anorexia nervosa. There is clear evidence of weakness of respiratory muscles with starvation in both groups. However, there is discordance in the literature as to whether starvation results in "nutritional emphysema," and if so, by what mechanism and at what degree of malnutrition it develops. We also explore the growing concern for the risk of non-tuberculosis mycobacterium infection as well as risk for pneumomediastinum and pneumothorax in patients with restrictive EDs. From the limited literature, it is clear the lungs, in fact, are not spared and that further research is needed to fully understand the full extent of pulmonary complications instigated by EDs.

Pseudoaneurysm of the aortic root following aortic valve endocarditis - a case with 2 rare life - threatening complications

Infective endocarditis can have peri-annular spread and involve the valvular annulus and adjacent cardiac structures, leading to tissue necrosis and peri-annular abscess. This process may cause pseudoaneurysm formation and other rare and potentially life-threatening complications, so their identification and correct diagnosis are crucial.

We describe a case of an 81-year-old woman, with a history of aortic valve replacement and worsening of symptoms, that presents at the imaging a pseudoaneurysm of the aortic root complicated at the same time by 2 life-threatening conditions: fistulization in the Right Ventricular Outflow Tract (RVOT) and the compression of Right Coronary Artery (RCA).

This case underlines the importance of imaging, especially Coronary Computed Tomography Angiography (CCTA), in the diagnosis and follow-up of infective endocarditis and its complications, especially in a patient not eligible for surgery.

Coping strategies and stress-induced natural killer cell redistribution in women with eating disorders

BACKGROUND

Patients with eating disorders (ED) are very sensitive and responsive to psychosocial stress. Stress response includes changes in immune cell distribution and may be modulated by the capability to cope with stressors. Thus, the present study sought to analyze the association between coping strategies and immune response (natural killer [NK] cell redistribution following psychosocial stress) in patients with anorexia nervosa (AN) and bulimia nervosa (BN) and healthy controls (HC).

METHOD

Twenty-four AN patients, 29 BN patients, and 58 HC were studied. A multidimensional assessment tool, the COPE Inventory, was used to assess coping strategies. The number of NK cells was quantified in peripheral blood before and after the application of the Trier Social Stress Test (TSST). Potentially mediating variables, such as weight status, severity of eating pathology, depression, anxiety, and impulsivity were controlled.

RESULTS

The three groups differed in intensity and direction of cell redistribution: The TSST was followed in BN patients by a significant decrease in the number of NK cells, whereas HC displayed a moderate decrease and AN a clear increase. Specific correlations between coping strategies and NK cell mobilization were found, especially in BN patients (positive for "planning" and negative for "substance abuse").

CONCLUSION

Recognition and subsequent modification of the dysfunctional coping strategies used by patients with ED could contribute to improving their immune status, strengthening their resilience and increasing their ability to overcome the disease.