Eating disorders.

Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis. The main characteristic of these diseases is changed behavior in the nutrition, either as an intentional restriction of food, i.e. extreme dieting, or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are characteristic forms of compensatory behavior of patients with eating disorder. The most appropriate course of treatment is determined by evaluating the patient's health condition, associated with behavior and eating habits, the experience of one's own body, character traits of personality, and consequently the development and functioning of the individual. The final treatment plan is individual. Eating disorders are a growing medical problem even in this part of the world. Prevention should be planned in cooperation with different sectors so as to stop the epidemic of these diseases.

Mirizzi syndrome--two case reports and a short review of the literature.

The authors have analyzed the problem of Mirizzi syndrome (MS) and found in the literature that it was reported in 0.3% to 3% of patients undergoing cholecystectomy. Anatomic disorder, especially the presence of cholecystocholedochal fistula, increases the risk of bile duct injury during cholecystectomy, albeit more often during laparoscopic than laparotomic cholecystectomy. A comparative study was performed regarding the incidence of MS in two groups of patients: 332 patients in Zrenjanin in the year 2009, and 531 patients in Belgrade in the year 2005, with an incidence of MS found in 2 patients in Zrenjanin (0.63%) and 4 patients in Belgrade (0.75%). The incidence rate was 6% in Zrenjanin and 7.5% in Belgrade, but there was no statistically significant difference between the two groups. All patients with MS were diagnosed during the operative period using operative cholangiography. During preoperative diagnosis, patients underwent laboratory ultrasound examination, and those who were suspected of having an anatomic disorder underwent operative cholangiography, although patients today more often undergo choledochoscopy then cholangiography. MS according to classification by Csendes was found in all 6 patients undergoing operation.

Presence of different forms of compensatory behaviours among eating disordered patients.

INTRODUCTION: Eating disorders indicate unhealthy habits in nutrition and/or behaviour in the feeding and maintaining of body weight. The main characteristic of these diseases is changed behaviour in nutrition, either as an intentional restriction of food, namely extreme dieting or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are the forms of compensatory behaviour. OBJECTIVE: The purpose of the present research was to determine the presence of different inappropriate compensatory behaviours among eating disordered patients. METHODS: The experimental group included 35 female eating disordered patients of 23.02 +/- 3.46 years on average, with anorexia or bulimia nervosa. The control group consisted of 70 girls aged 23.1 +/- 3.0 years on average. Each participant completed a "24-hour Recall Questionnaire" and the "Eating Disorder Diagnostic Scale". RESULTS: A high statistically significant difference existed in the presence of all compensatory behaviours in the experimental and control group, regarding vomiting (chi2 = 40.6; p < 0.001), misuse of laxatives and diuretics (chi2 = 33.7; p < 0.001), extreme dieting (chi2 = 23.4; p < 0.001) and excessive exercising (chi2 = 27.1; p < 0.001). CONCLUSION: Eating disordered patients showed a significantly higher incidence of all evaluated forms of compensatory behaviour in comparison with the control group. This report confirms the presence of specific symptomatology of anorexia and bulimia patients.

[Richard Morton (1637-1698)--the distinguished physician of the 17th century].

Richard Morton was a distinguished physician of the 17th century. He was born in Suffolk, England, on July 30th 1637. Morton published three works but his landmark paper was "Phthisiologia, seu exercitationes de phthisi, tribus libris comprehensae" published in 1689, dedicated to William III. The book established his reputation at home and abroad lasting for over a century. Pulmonary tuberculosis was very frequent in the 17th century in England. He was the first physician ever to state that tubercles were always present in its pulmonary form. When we add to these momentous observations and their rational explanation the facts that he was the first physician to state categorically that tubercles are always present in phthisis, we must agree that Morton richly deserves his honoured place in the long list of those who have contributed to the solution of the problem of tuberculosis. Morton first described and gave conclusions of numerous today well known and already examined illnesses. In 1694 he gave first notes about the psychiatric illness which we today call "anorexia nervosa", calling it "nervous consumption". His chapters on treatment are long and contain a sound basis of common sense as indicated by his instructions on general management. He stresses the need for an adequate diet, an environment free from fog and smoke, and the desirability of ensuring a moderate amount of exercise. All Morton's therapeutic dicta are in their humanity and thoughtful care in striking contrast to the regimen of copious bleeding and semi-starvation inflicted by the later generation of physicians. Confirmation of his achievements and his teaching can be found in today's medical practice.