"Muscle Pics", a new body-checking behavior in muscle dysmorphia?

BACKGROUND AND AIMS: The internalization of ideal hypermuscular body and pro-muscularity media's influence have shown their importance in muscle dysmorphia development. The aim of the current study is to have a better understanding of links between specific body checking behaviors and muscle dysmorphia in social network context. METHODS: In total, 342 students practicing weightlifting at the university gym in Bordeaux answered to a survey with sociodemographic information and body checking symptoms including taking specific selfies of muscles and muscularity "Muscle Pics" and the MDDI (Muscle Dysmorphic Disorder Inventory). RESULTS: Muscle dysmorphia was prevalent in 18.7% of our population (64 students). We observed that muscle dysmorphia was correlated to "Muscle Pics", "Follow-up", "Message", "Selfie", and gym mirror checking with significant results (P<0.01). Also, « Muscle Pics ¼ were linked to APEDs use, pro-muscularity websites, fitness model comparison and gym mirror checking (P<0.01). For muscle dysmorphia, "Muscle Pics" have strong predictive results (OR=5.10, P=0.000) and (OR=4.08, P=0.000) for adjusted. "Follow up" (OR=4.76, P=0.000) and (OR=3.83, P=0.000) for adjusted, "Muscle Pics Selfie" (OR=11.20, P=0.000) and (OR=11.55, P=0.000) for adjusted, "Muscle Pics Message" (OR=4.49, P=0.001) and (OR=5.78, P=0.001) for adjusted. CONCLUSION: "Muscle Pics" showed several links with muscle dysmorphia for global score "drive for size", "functional impairment" but not for "appearance intolerance" dimension. Pro-muscularity websites, fitness model comparisons and gym mirror checking are linked to muscle dysmorphia and "Muscle Pics". Future research on "Muscle Pics" will help to provide a better understanding of muscle dysmorphia and its link with pro-muscularity influence websites.

Muscle dysmorphia from an addictive perspective: Validation of the Addiction to Body Image Inventory (ABII).

OBJECTIVES: Muscle dysmorphia (MD) is a disorder affecting mainly men and is characterized by significant dissatisfaction with muscles. The idea that MD could represent an addiction has been theoretically discussed, but no empirical data are available. Based on Foster et al. (2015) framework, the Addiction to Body Image Inventory (ABII) was developed. This study aims to validate the ABII and to evaluate its capacity to capture MD severity. METHODS: A first community sample of 466 participants was recruited and completed the ABII and questionnaires on MD and body esteem. A second sample of 47 men at risk of MD was recruited mostly in gyms and completed the ABII and questionnaires on MD, eating and psychological symptoms. RESULTS: With the community sample, the results showed that the ABII had a valid factorial structure, good internal consistency, and good convergent validity. With the sample of men at risk of MD, the results showed that the ABII had good convergent validity with MD and eating symptoms but not with psychological symptoms. The results of a regression model showed that the ABII explained 12% of the MD variance. CONCLUSIONS: This study brings the first measure of addiction to body image and suggests that MD must be understood as a complex phenomenon including eating symptoms and addictive tendencies.

Atypical eye lesion in a human immunodeficiency virus-positive patient.

AIDS-related Kaposi sarcoma (KS), nowadays known to be an angioproliferative disease, occurs in several clinical-epidemiological forms, all of which are associated with infection by human herpesvirus-8. KS can affect the eye, with the bulbar conjunctiva and lacrimal gland being rare sites of occurrence. We present a case of AIDS-related KS of the conjunctiva and also discuss recent literature.

Simultaneous bilateral percutaneous nephrolithotomy: Effectiveness and safety. / Nefrolitotomía percutánea bilateral simultánea: Eficacia y seguridad".

OBJECTIVES: To evaluate the effectiveness and safety of simultaneous bilateral percutaneous nephrolithotomy performed in patients affected with bilateral renal calculi. MATERIALS AND METHODS: This is a prospective study from September 2012 to November 2016. Patients diagnosed of bilateral kidney stones with abdominal CT scan were included. Surgical technique prone position, renal puncture guided by fluoroscopy and tract dilation up to 24Ch. We reviewed demographic and stone characteristics, stone free rate, clinical success, complications and follow-up. RESULTS: During the study period, 732 percutaneous nephrolithotomies were performed. Eighteen patients were included (36 renal units, 2.5%), 13 men and 5 women, with a median age of 58 years and an interquartile range (IQR) of 40-66. Median stone burden was 228mm2 (IQR 134-389); median operative time, 150minutes (IQR 97-180); and median hospital stay, 5 days (IQR 5-15). Stone free rate was 80%. Residual calculi were encountered in 8 renal units (22.2%) and required other complementary techniques for their complete tesolution 4 external shockwave lithotripsies, one open ureterolithotomy, 2 ureteroscopies and one second look. Major complications included 4 cases of severe hemorrhage managed with angiographic embolization. The median follow-up was 36 months (range 26-46). CONCLUSIONS: Simultaneous bilateral percutaneous nephrolithotomy is an effective and safe procedure in patients affected with bilateral renal calculi. It is a surgical challenge that should be performed in selected patients and in centers with experience.

[Our experience in high-flow priapism due to uni-or bilateral arterio-lacunar fistula]. / Nuestra experiencia en el priapismo de alto flujo por fístula arterio-lacunar uni y bilateral.

OBJECTIVE: To present our experience in both uni-and bilateral priapism, highlighting good results obtained with supraselective embolisation. MATERIAL AND METHODS: We present 5 cases of high-flow priapism secondary to perineal trauma, with a mean age of 31 years (24-43 years). The mean time to presentation from the moment of the trauma was 18, 6 days (1-60 days). Diagnosis was confirmed through gasometry of the corpora cavernosa, penile Doppler ultrasound (2 cases) and selective arteriography of the pudendal artery. In all cases treatment was by supralective embolisation with gelatin sponge. In the two bilateral cases, embolisation was performed in the same act. RESULTS: In the short-term was a recovery of flaccidity and in the long-term (3-4 months) a recovery of erection with no fibrotic sequelae of the corpora cavernosa. CONCLUSIONS: Embolisation of the lacerated artery, in a single procedure in cases of bilateral lacerations, provides excellent results.

High-flow priapism as a complication of a veno-occlusive priapism: two case reports.

The presentation of two cases of veno-occlusive priapism, in patients of 36 and 58 years, in whom the different medical and surgical techniques employed, failed. The suspicion that high-flow priapism had been provoked by said surgical intervention was confirmed by bilateral arteriographs of the pudendal artery. The treatment, selective embolisation of the affected cavernosal artery with reabsorbable material, led to a rapid return of penile detumescence.

[Congenital portosystemic shunt. The Abernethy malformation]. / Shunt porto cava congénito. Malformación de Abernethy.

BACKGROUND: Congenital portosystemic shunt (CEPS) is a rare condition that was first reported by John Abernethy in 1793. Two types of CEPS are described: type I (side to end anastomosis) or congenital absence of the portal vein, and type II (side to side anastomosis) with portal vein supply partially conserved. Type I CEPS is usually seen in girls and associates multiple malformations as polysplenia, malrotation, and cardiac anomalies. Type II is even rarer with no sex preference and no malformations associated. Hepatic encephalopathy is a common complication of both types in adulthood. Liver transplantation is the only effective treatment for symptomatic type I CEPS. A therapeutic approach for type II could be surgical closure of the shunt. OBJECTIVE: To analyse our experience in diagnosis and management of portosystemic shunts. METHODS: We report 4 cases of CEPS (3 type I and 1 type II) diagnosed between January-1997 and March-2005 in our department. RESULTS: We present 4 patients with ages at diagnosis ranging from 0 to 28 months, 3 type I CEPS (2 boys and 1 girl) and 1 boy type II. The type I girl was prenatally diagnosed at 12 weeks of gestation. Initial clinical signs in type 1 boys were splenomegaly and hypersplenism, both with normal pondo-statural growth. No polysplenia or cardiac anomalies were assessed. One of them presented mild developmental delay, dismorphic features and facial telangiectasias. He had normal coagulation tests with chronic hepatic dysfunction (high transaminases) and regenerative nodular lesions were seen by imaging techniques. The other type I patient had hypoprothrombinemia, tendency to capillary bleeding (haematomas and epistaxis) with preserved liver function. Both patients have developed mild portal hypertension and present steatosis signs at liver biopsy. The type I girl presents a 21 trisomy and associates a cardiac anomaly (interauricular communication). Her hepatic function test are normal but liver calcifications can be seen by ultrasound. Type II child associates hypospadias but he has no clinical sigh or symptom related to the shunt. In our three cases diagnosis was suggested by conventional and Doppler ultrasound and confirmed by angio-resonance imaging. All our patients are included in a meticulous clinical and radiological follow-up with no need of surgical treatment for the shunt until now. CONCLUSIONS: Although diagnosis of these malformations could be casual we have to think about CEPS in children presenting unspecific liver disease. Magnetic angio-resonance imaging is actually the best diagnosis methods for CEPS. These patients have a high risk for developing hepatic encephalopathy and portal hypertension, so a careful follow-up is required although surgery is not usually needed until adulthood.

[Cutaneous haemangioma associated with a hepatic haemangioma and neurofibromatosis type 1 (NF1)]. / Hemangioma cutáneo asociado a hemangioma hepático y a neurofibromatosis tipo 1 (NF1).

OBJECTIVE: To present a girl with cutaneous cavernous hemangioma associated with hemangioma of the liver and neurofibromatosis type 1 (NF1). PATIENTS AND METHODS: A 3 year old girl showed cutaneous cavernous hemangioma on the right hypochondral region and numerous caf au lait spots. She was studied with abdominal echography and abdominal and thoracic magnetic resonance (MR) as well as with cerebral MR angiography. RESULTS: Both image studies, echography and MR, revealed a mass 2 x 2 cm of hemangiomatous type in the upper zone of the liver, near the external cutaneous cavernous hemangioma. Echographical follow up showed a progressive diminution of the hepatic hemangioma size. At 2 1/2 years of age a voluminous thoracic tumor extending between aorta and sternon very difficult of being removed was found. CONCLUSION: Hemangioma of the liver appears to be related with cutaneous cavernous hemangioma as a finding of the syndrome of Pascual Castroviejo II. Furthermore, the patient has NF1 which has not been previously related with the cutaneous and/or the liver pathology.

[Corynebacterium pseudodiphtheriticum pneumonia in a patient diagnosed with HIV infection]. / Neumonía por Corynebacterium pseudodiphtheriticum en paciente diagnosticado de infección por VIH.

Corynebacterium pseudodiphteriticum is a diphteromorphic bacterium, previously described as pathogenic in very few cases. We present the case of a patient diagnosed of infection by the human immunodeficiency virus (HIV), who developed pneumonia probably caused by Corynebacterium pseudodiphtheriticum and who had a good response to the initial empirical therapy with cephotaxime. We reviewed the literature on patients with diagnosis of HIV infection, acquired immunodeficiency syndrome (AIDS) and AIDS-related complex and we found just one case of this corynebacterium acting as pathogenic and causing a pulmonary abscess.

[Cyclosporine in inflammatory bowel disease]. / Ciclosporina A en la enfermedad inflamatoria intestinal.

Inflammatory Bowel Disease (IBD), as Ulcerative Colitis (UC) as well as Crohn's Disease (CD), can appear as severe outbreak resistant to steroid treatment. These cases require surgery or immunosupressive therapy (mercaptopurine or azathioprine). Cyclosporine A (CYA) is a selective, reversible immunosupressor of the T helper lymphocites, used in the treatment of organ transplants and in certain autoimmune diseases. CYA is not a first line therapy for IBD. In spite of the positive results obtained in some uncontrolled studies, only one randomized trial has shown the superiority of CYA over the placebo in the treatment of UC and avoided colectomy in one third of the patients with the severe form of this disease. It can also contribute to the healing of resistault CD fistulaes. The potential toxicity of CYA and the few controlled clinical trials limit its use. However CYA needs to define its role in the treatment of IBD through II more controlled trials.

[Ocular toxoplasmosis in human immunodeficiency virus infected patients without concurrent central nervous system infection. Report of two cases]. / Toxoplasmosis ocular sin afectación del SNC en pacientes con infección por el VIH. Presentación de dos casos.

Ocular toxoplasmosis is an uncommon complication of acquired immunodeficiency syndrome (AIDS), and it is generally described associated with central nervous system (CNS) lesions. We describe two cases of ocular toxoplasmosis in human immunodeficiency virus (HIV) infected patients, without concurrent CNS infection. Both developed bilateral or unilateral choriorretinitis with favorable response to antitoxoplasma therapy. None of them presented toxoplasmosis of the CNS coexisting with ocular lesions. Ocular toxoplasmosis should be considered in HIV infected patients although no involvement of the CNS is found.

Possible azithromycin-associated hiccups.

OBJECTIVE: To report a case of persistent hiccups associated by azithromycin therapy. CASE SUMMARY: A 76-year-old man presented with persistent hiccups after beginning azithromycin for the treatment of pharyngitis. Hiccups were persistent and exhausting. Discontinuation of azithromycin and therapy with baclofen finally resolved hiccups. No organic cause of hiccups was identified despite extensive investigation. DISCUSSION: Pharmacotherapeutic agents have been uncommonly associated with hiccups. Corticosteroids (dexamethasone and methylprednisolone), benzodiazepines (midazolam) and general anaesthesia have been the specific agents mentioned most frequently in the literature as being associated with the development of hiccups. Few cases of drug-induced hiccups have been reported related to macrolide antimicrobials. Using the Naranjo adverse effect reaction probability scale this event could be classified as possible (score 5 points), mostly because of the close temporal sequence, previous reports on this reaction with other macrolides and the absence of any alternative explanation for hiccups. Our hypothesis is that a vagal mechanism mediated by azithromycin could be the pathogenesis of hiccups in our patient. CONCLUSIONS: Diagnosis of drug-induced hiccups is difficult and often achieved only by a process of elimination. However, macrolide antimicrobials have been reported to be associated with hiccups and vagal mechanism could explain the development of this side-effect.