António Roma Torres

Organic psychosis due to hypoparathyroidism in an older adult: a case report

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Os heróis, vítimas e vilões: discursos sobre a anorexia nervosa

Este artigo apresenta uma revisao da literatura sobre os discursos dominantes sobre a anorexia nervosa da Idade Media a actualidade. Coloca em destaque os herois, viloes e vitimas, culminando num olhar sistemico-familiar. Se durante seculos predominaram narrativas individuais de heroinas santas, posteriormente, na era do pensamento medico, estas heroinas passaram a vitimas de uma doenca mental. Mais tarde, com os movimentos da anti-psiquiatria e da terapia familiar, emergem novas narrativas com mais protagonistas: os familiares. Se, primeiramente, as familias sao retratadas como vilas, dadas as suas influencias nocivas, nas ultimas decadas as familias sao ilustradas como sistemas vitimas do impacto da doenca. Na actualidade, surgem narrativas de familias competentes, capazes de superar o problema. Este artigo termina refletindo sobre esta multiplicidade de leituras e suas implicacoes.

Arthroscopic reduction and fixation of a lateral inverted osteochondral fracture of the talus (‘LIFT’)

Some ankle sprains hide important lesions beyond the classic lateral ligament complex injuries. The lateral inverted osteochondral fracture of the talus (LIFT) represents a rare osteochondral lesion, whose diagnosis relies on a high clinical suspicion followed by correct image study interpretation. We present a successful arthroscopic fixation of a LIFT lesion in a 45-year-old active man. At 8 months follow-up, the patient was pain free and able to return to his daily activities without limitation. The imagiological study showed osteochondral fragment consolidation with no signs of hardware failure. This midterm results reassemble the need for early diagnosis and correct treatment to achieve a good outcome in these complex and rare osteochondral lesions.

Anorexia nervosa and dialysis: we have no time when the body is so damaged!

Anorexia nervosa remains challenging to treat and difficult to prevent. Nearly 5% of affected individuals die of this disease and 20% develop a chronic eating disorder. Anorexia nervosa may be associated with several medical complications of varying severity, including dysfunction of the renal system. Though there are some reports of renal failure in patients with anorexia nervosa, few reports are available concerning patients who required maintenance dialysis. We report a case of a patient with long-term untreated anorexia nervosa-binge eating/purging type who started psychiatric treatment when in a life-threatening situation (renal failure requiring dialysis), with unsuccessful weight recovery while on dialysis and died of septicaemia. The mechanisms that seem to be involved in the development of end-stage renal disease in this patient and the challenges associated with her treatment are reviewed. Patients with anorexia nervosa should be carefully monitored to discover the subtle manifestations of early renal failure.