OBJECTIVE: Although trichobezoars are well described in the surgical literature, there is relatively little in the psychiatric literature on them. This study aims to focus the attention of readers on trichobezoars by means of a case report and an overview of the literature. METHOD: We present a case of a patient with trichotillomania and a trichobezoar, including psychiatric management. We also briefly review the relevant literature. RESULTS: Hair-pulling significantly improved in response to treatment with the selective serotonin reuptake inhibitor fluoxetine and supportive psychotherapy. CONCLUSIONS: The medical and psychiatric sequelae of trichotillomania should not be underestimated. Pharmacotherapy may be play a useful role in some patients with this disorder.

Trichobezoars in trichotillomania: case report and literature overview.

OBJECTIVE. Effective treatment of acute lobar nephronia (ALN) can prevent its progression to renal abscess. The goal of this prospective study was to compare the treatment efficacy for pediatric patients who had ALN with a 3- vs 2-week intravenous plus oral antimicrobial-therapy regimen. METHODS. Patients who were suspected of having an upper urinary tract infection underwent a systematic scheme of ultrasonographic and computed tomographic (CT) evaluation for ALN diagnosis. Patients with positive CT findings were enrolled and randomly allocated with serial entry for either a total 2-week or a 3-week antibiotic treatment regimen. Antibiotics were changed from an intravenous form to an oral form 2 to 3 days after defervescence of fever. Follow-up clinical evaluations and urine-culture analyses were performed 3 to 7 days after cessation of antibiotic treatment. Patients with persistent infection or relapse were considered as treatment failures. RESULTs. A total of 80 patients with ALN were enrolled. Forty-one patients were treated with a 2-week antimicrobial protocol, and the other 39 patients were treated with a 3-week course. Seven treatment failures, 1 persistent infection, and 6 infection relapses were identified, all of which were in the 2-week treatment group. Prolonged fever before admission and positive Escherichia coli growth (>105 colony-forming units per mL) in urine culture were noted as risk factors for treatment failure. All treatment failures were managed successfully with an additional 10-day antibiotic course. CONCLUSION. A total of 3 weeks of intravenous and oral antibiotic therapy tailored to the pathogen noted in cultures should be the treatment of choice for pediatric patients with ALN.

Effective Duration of Antimicrobial Therapy for the Treatment of Acute Lobar Nephronia

Background.Correct identification of acute lobar nephronia (ALN) is necessary to prevent progression to renal abscess. The goal of this retrospective study was to determine whether the sonographic finding of severe nephromegaly (i.e. renal length greater than mean + 3 sd) is a preselection criterion

Effective ultrasonographic predictor for the diagnosis of acute lobar nephronia.

Hair pulling has been reported in humans, six different non-human primate species, mice, guineapigs, rabbits, sheep and muskox, dogs and cats. This behaviour seems to occur only in subjects who are confined in an artificial environment. It has been classified as a mental disorder in humans, as a behavioural pathology in animals. The hair is not only pulled but also, in most species, ingested. Hair pulling can be both self-directed and partner-directed, contains elements of aggression, manifests more often in females than in males, is associated with psychogenic distress, and resists treatment. Research data collected from affected animals are probably not normative, hence scientifically unreliable. The preemptive correction of husbandry deficiencies causing long-term stress may prevent the development of this bizarre behaviour in healthy subjects.

http://lan.sagepub.com/content/39/4/361.full.pdf

Hair pulling: a review

Acute bacterial nephritis: A clinicoradiologic correlation based on computed tomography

https://www.ajkd.org/article/S0272-6386(88)80172-0/pdf

Acute Focal Bacterial Nephritis

CT diagnosis of a gastric trichobezoar.

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Acute Focal Bacterial Nephritis

CT diagnosis of a gastric trichobezoar.