Introduction
Trichobezoar is a rare entity that primarily occurs as a complication of psychiatric disorders, most often in adolescent and young females suffering from trichotillomania (TTM) and ...trichophagia. In many cases, children with TTM unwillingly admit hair pulling, deny ingesting hair and often feel ashamed of their disease and try to hide it.
Objectives
Our main aim was to present an uncommon complication of TTM and trichophagia and to point out the importance of early diagnosis and prevention of complications of the disorder. Furthermore, we describe the role of a child’s psychological features and family dynamics in etiopathogenesis of TTM, as well as comorbidities and specific clinical presentation.
Methods
Case report.
Results
An 11-year-old girl was admitted to the pediatric department due to abdominal pain. After detailed pediatric differential diagnosis, trichobezoar was diagnosed and she was treated surgically. While she did not deny ingesting her hair, three months after surgery (TTM was dermatologically verified from the beginning of the treatment) she mentioned focused hair pulling for the first time. During individual cognitive behavioral psychotherapy the following was recognized in the patient: perfectionism traits, inhibition in expressing emotions, elements of depression, anxiety. During family psychotherapy elements of alexithymia were observed.
Conclusions
Cooperation among medical experts (pediatrician, dermatologist, child psychiatrist, pediatric surgeon etc.) and awareness of this disorder is important for recognizing it at an early stage and starting the treatment, especially considering habit-forming mechanism, psychiatric comorbidity, emotional distress and preventing other complications including trichobezoars.
Keywords
adolescents, trichobezoar, trichophagia, trichotillomania
Disclosure of Interest
None Declared
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal).
This article has been retracted at the ...request of the Editor-in-Chief. The article is a duplicate of a paper that has already been published in JOM, volume 28 (2013), 175–185, https://bib.irb.hr/datoteka/684767.Iodine_Orthomolecular_Momcilovic.pdf. One of the conditions of submission of a paper for publication is that authors declare explicitly that the paper has not been previously published and is not under consideration for publication elsewhere. As such this article represents a misuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.
Considerable number of intellectual disabled people experience some form of disruptive behavior. Antipsychotics are the most common treatment for these behaviors. Numerous patients were efficiently ...treated with thioridazine, recently withdrawn. The authors describe a case series of "thioridazine responders" treated with olanzapine. Thirty three patients with severe intellectual disability were recruited. All patients were assessed for seven types of disruptive behavior on five point scale. Patients with severe behavior disturbances were included in treatment. The time points of assessment were at day 0, 30, 60 and 180. Twenty one patient accomplished inclusion criteria. A significant decrease occurred at day 30 for all types of behavior. Total score, self injurious behavior, compulsive and destructive behavior showed further decrease at day 60 and became stable until the end of study. Olanzapine appears to be efficacious in the treatment of disruptive behavior in the intellectually disabled and could be substitute for thioridazine treatment.
Selenium (Se) is essential trace element in human nutrition. The aim of this study was to assess selenium nutritional status by analyzing Se frequency distribution in the long-term biological ...indicator tissue of hair (H∙Se) and in the short-term biological indicator tissue of whole blood (WB∙Se). Hair selenium was analyzed in 1073 apparently healthy adult Croats (339 ♂ and 734 ♀) and the whole blood selenium was analyzed in a random subsample of 91 ♂ and 143 ♀. Samples were analyzed by the ICP-MS at the Center for Biotic Medicine, Moscow, Russia. There were no significant gender dependent difference in the selenium adequate linear reference range which was (µg∙g1) for H∙Se 0.078–0.701 and for WB∙Se 0.120–0.200, respectively. Hair selenium concentrations below 0.078 and 0.120 for WB∙Se indicate selenium deficiency. The estimated upper adequate selenium limits for H∙Se and WB∙Se are set at 0.701 and 0.200 µg∙g1, respectively. The linear segment of the generated H∙Se logistic distribution sigmoid curve is considered to represent adequate Se intake range. This adequate selenium intake segment can be itself partitioned by a 60:30:10 percentage ratio into Sparsely adequate (♀ 0.078–0.405, ♂ 0.1740.474), Adequate (Optimal) (♀ 0.4050.573, ♂ 0.474–0.608), and Ample adequate segment (♀ 0.5730.623, ♂ 0.608–0.709). These reference dose data are essential for continuous monitoring of the selenium nutritional status and selenium supplementation medication The noninvasive selenium status assessment is especially important when dealing with a vulnerable segments of human population like pregnant and lactating women, and their infants. The Median Derivatives Bioassay provides a new public health asset for general medical practice.
We reviewed again the significance of the stable gastric pentadecapeptide BPC 157 as a likely mediator of Robert’s stomach cytoprotection/adaptive cytoprotection and organoprotection and as novel ...mediator of Selye’s stress coping response to reestablish homeostasis. Specific points of BPC 157 therapy and the original concept of Robert’s cytoprotection/adaptive cytoprotection/organoprotection are discussed, including the beneficial effects of BPC 157. First, BPC 157 protects stomach cells and maintains gastric integrity against various noxious agents (Robert’s killing cell by contact) and is continuously present in the gastric mucosa and gastric juice. Additionally, BPC 157 protects against the adverse effects of alcohol and nonsteroidal anti-inflammatory drugs on the gastric epithelium and other epithelia, that is, skin, liver, pancreas, heart (organoprotection), and brain, thereby suggesting its use in wound healing. Additionally, BPC 157 counteracts gastric endothelial injury that precedes and induces damage to the gastric epithelium and generalizes “gastric endothelial protection” to protection of the endothelium of other vessels (thrombosis, prolonged bleeding, and thrombocytopenia). BPC 157 also has an effect on blood vessels, resulting in vessel recruitment that circumvents vessel occlusion and the development of additional shunting and rapid bypass loops to rapidly reestablish the integrity of blood flow (ischemic/reperfusion colitis, duodenal lesions, cecal perforation, and inferior vena caval occlusion). Lastly, BPC 157 counteracts tumor cachexia, muscle wasting, and increases in pro-inflammatory/procachectic cytokines, such as interleukin-6 and tumor necrosis factor-α, and significantly corrects deranged muscle proliferation and myogenesis through changes in the expression of FoxO3a, p-AKT, p-mTOR, and p-GSK-3β (mitigating cancer cachexia). (Gut Liver 2020;14:153-167)
We reviewed again the significance of the stable gastric pentadecapeptide BPC 157 as a likely mediator of Robert’s stomach cytoprotection/adaptive cytoprotection and organoprotection and as novel ...mediator of Selye’s stress coping response to reestablish homeostasis. Specific points of BPC 157 therapy and the original concept of Robert’s cytoprotection/adaptive cytoprotection/organoprotection are discussed, including the beneficial effects of BPC 157. First, BPC 157 protects stomach cells and maintains gastric integrity against various noxious agents (Robert’s killing cell by contact) and is continuously present in the gastric mucosa and gastric juice. Additionally, BPC 157 protects against the adverse effects of alcohol and nonsteroidal anti-inflammatory drugs on the gastric epithelium and other epithelia, that is, skin, liver, pancreas, heart (organoprotection), and brain, thereby suggesting its use in wound healing. Additionally, BPC 157 counteracts gastric endothelial injury that precedes and induces damage to the gastric epithelium and generalizes “gastric endothelial protection” to protection of the endothelium of other vessels (thrombosis, prolonged bleeding, and thrombocytopenia). BPC 157 also has an effect on blood vessels, resulting in vessel recruitment that circumvents vessel occlusion and the development of additional shunting and rapid bypass loops to rapidly reestablish the integrity of blood flow (ischemic/reperfusion colitis, duodenal lesions, cecal perforation, and inferior vena caval occlusion). Lastly, BPC 157 counteracts tumor cachexia, muscle wasting, and increases in pro-inflammatory/procachectic cytokines, such as interleukin-6 and tumor necrosis factor-α, and significantly corrects deranged muscle proliferation and myogenesis through changes in the expression of FoxO3a, p-AKT, p-mTOR, and p-GSK-3β (mitigating cancer cachexia). (Gut Liver 2020;14:153-167)
