European journal of internal medicine
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Eur. J. Intern. Med. · Jan 2009
Prevalence and clinical determinants of low bone mineral density in anorexia nervosa.
To determine the prevalence of low bone mass in anorexia nervosa (AN) and the association with clinical parameters. ⋯ We conclude that low BMD is frequent in AN. The best indicator of low BMD appeared to be the lowest reported BMI ever.
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Rhabdomyolysis is a syndrome of skeletal muscle cell damage that leads to the release of toxic intracellular material into the systemic circulation. The pathogenesis of rhabdomyolysis is based on an increase in free ionized calcium in the cytoplasm. Its main complications include (a) acute renal failure, which is triggered by renal vasoconstriction and ischemia, (b) myoglobin cast formation in the distal convoluted tubules, and (c) direct renal toxic effect of myoglobin on the epithelial cells of proximal convoluted tubules. ⋯ The concomitant electrolyte and metabolic disorders should also be treated appropriately; hemodialysis should be considered when life-threatening hyperkalemia and metabolic acidosis exist. In the case of compartmental syndrome, it is important to monitor the intra-compartmental pressure and to perform fasciotomy, if required. When diagnosed early and if the appropriate treatment is initiated promptly, the complications of rhabdomyolysis are preventable and the syndrome has a good prognosis.
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Eur. J. Intern. Med. · Dec 2008
Persistent dyspnea complaints at long-term follow-up after an episode of acute pulmonary embolism: results of a questionnaire.
There is a lack of information on long term complications of patients with pulmonary embolism (PE), including chronic complaints of dyspnea. ⋯ A large percentage of patients with prior PE have persistent complaints of dyspnea at long term follow-up. The majority of them developed new or worsened dyspnea after the thrombo-embolic event. In comparison to a control population without a medical history of VTE, PE patients were overall significantly more dyspnoeic. An explanation for this phenomenon needs to be studied in further functional work-up of these patients.