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Baumann ChristophCorresponding author University of Wuerzburg, Medical Faculty, Josef-Schneider-Straße 2, Würzburg, Germany
Objective: To assess the effect of different treatment approaches on the course of anorexia nervosa (AN) over time. Methods: The subjects were 27 hospitalized AN patients. In our retrospective analysis we compared weight gain in two groups. While one group was treated with a standard oral refeeding protocol (historical control) through January 2013 (N=16), the second group (highly standardized refeeding protocol) received a high energy liquid nutrition and nutritional supplements including omega-3 fatty acids (N=11). Results: On admission, the two groups were comparable in terms of height, weight, age and heart rate. At the end of our monitoring time frame of 25 days, weight gain was 121.4% higher in the highly standardized refeeding protocol group than in the historical control group (66.5 ±52.4 vs 147.3 ±55.7 grams/day; t-Test p=0.004; CI95%: 29.3-132.2). A carbohydrate rich diet clearly improved weight gain if high energy liquid nutrition was replaced by the diet according the patient’s own wishes. About 45% of our patients stated they were vegetarians at admission. However, we could not identify a vegetarian diet as a statistically significant negative prognostic factor for weight gain. Conclusion: The highly standardized refeeding protocol seems to be helpful in malnourished AN patients to improve weight gain without enhancing the risk of a refeeding syndrome. However, further studies with greater number of patients are needed to confirm the effectiveness of our standardized treatment protocol.
Giardino S. Neri F.Corresponding author Centre of Rare Diseases of the Sicilian Region, University of Catania, Italy
Superior mesenteric artery syndrome 1234 is a rare disorder characterised by a compression of the duodenum because of the reduced angle between the aorta and superior mesenteric artery. The disease is clinically characterised by abdominal pain, lack of appetite, vomiting and anorexia; some of these symptoms also characterise eating disorders. We report a case of a young female patient presenting with abdominal pain, loss of appetite and chronic loss of weight which led to misdiagnosis of anorexia nervosa; ultrasound with echo color Doppler methodology has subsequently allowed the correct diagnosis.