Medical hypotheses
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Post-spinal hypotension at cesarean section appears difficult to prevent, despite the three obligatory so-called preventative measures. So far, literature data provide no compelling evidence that expectations have been met in this regard. A critical appraisal of volume preload, ephedrine prophylaxis and left lateral supine position shows that the preventative measures should be re-evaluated. New avenues should be explored aiming at a better prevention and decrease in both the prevalence and magnitude of post-spinal hypotension at cesarean section.
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The comorbidity of eating disorders and reflex sympathetic dystrophy syndrome in the same patients raises the possibility of a common pathway for both conditions. Reflex sympathetic dystrophy syndrome may be manifesting itself in those individuals who have sympathetic overdrive. Microtrauma, often induced by compulsive exercise, and depression may be contributory factors. It is recommended that: patients with eating disorders who develop pain in an extremity should be investigated for possible reflex sympathetic dystrophy syndrome; patients with reflex sympathetic dystrophy syndrome should be discouraged from dieting, and eating disorders should be suspected if they begin to lose weight or are already malnourished.