American Journal of Medical and Clinical Research & Reviews

The Various Faces of Bulimia

2025-09-20T07:05:25+03:00

Bulimia is an eating disorder characterized by binge eating episodes followed by compensatory behaviors, such as self-induced vomiting, use of laxatives or diuretics, fasting, and excessive exercise. Although people with bulimia often maintain close to normal weight, they suffer from great concern about body shape and impaired self-esteem. The disorder usually appears in adolescence, affecting mainly women, and can be related to social pressures, family inheritance, and emotional conflicts. From a neuropsychic point of view, the ventromedian nucleus of the hypothalamus is associated with satiety, while the lateral zones regulate hunger. Alterations in these centers can lead to both anorexia and bulimia, indicating the complexity of the biological and psychological bases of the disease. In addition to physiological factors, bulimia is interpreted as a way of dealing with anxieties, emotional dissatisfactions, and unconscious conflicts. Food can take on different meanings: a substitute for love, an expression of affection or aggressiveness, a symbol of security, a form of protection against rejection, or even a mechanism of self-destruction (thanatism). Clinical cases illustrate how the relationship with food can reflect affective deficiencies, family tensions and difficulties in love bonds. Thus, bulimia and obesity are not only issues of dysregulated appetite, but multifactorial phenomena that combine biological, psychological, and social aspects. Food, in addition to nourishing, can become a defense, compensation or means of expression of internal and relational conflicts.

Denosumab for the Prevention of Skeletal-Related Events in Breast Cancer Bone Metastasis: A Literature Review

2025-09-20T06:39:14+03:00

Background: Breast cancer is the leading cause of cancer-related mortality among women worldwide, with more than 90% of these deaths attributed to metastases ^[1]. Among patients with metastatic breast cancer, approximately 65% to 75% develop bone metastases ^[1,2].These metastases are responsible for serious skeletal-related events (pain, pathological fractures, spinal cord compression, hypercalcaemia). RANKL inhibitors, particularly denosumab (Xgeva®), represent a major therapeutic option in preventing bone complications related to these metastases. We therefore aim to conduct a literature review to evaluate the efficacy and safety of denosumab (Xgeva®) in the prevention of skeletal complications in patients with breast cancer and bone metastases.

Methods: A literature review was conducted using PubMed and MEDLINE databases from 2014 to 2025. The keywords used were « breast cancer », « denosumab » and « bone metastases ». A total of 140 articles were initially identified. After screening the abstracts, 31 articles were selected for full-text review, and 20 were finally included in the analysis.

Results /Discussion: This review demonstrated that denosumab (Xgeva®) significantly delays the onset of the first skeletal-related event in patients with breast cancer and bone metastases, reducing the risk by 14% to 24%^[3–6]. Denosumab also significantly lowers the incidence of fractures in both premenopausal and postmenopausal women^[3,7,8]. Compared to zoledronic acid, it reduces this risk by 23%^[9]. Regarding bone pain, treatment with denosumab significantly delays the onset or worsening of pain in patients with moderate to severe pain^[4,10,11], with a 17% risk reduction (p = 0.003)^[10] . Denosumab also appears to reduce the risk of spinal cord compression ^[4,8,13] . According to Charles L., the probability of spinal cord compression under denosumab is estimated at 8 per 10000 per month, and 2 per 1000 over three months (9). Similarly, Stopeck et al. reported a probability of 0.06% (0.0006)^[7] .

Conclusion: Denosumab (Xgeva®) is considered a reference treatment strategy for preventing bone complications related to bone metastases in breast cancer by delaying serious skeletal events such as pathological fractures and spinal cord compression. Careful monitoring is essential to manage potential side effects, including osteonecrosis of the jaw and hypocalcaemia.

Enhanced Modified Burow’s Flap Reconstruction Following Oncoplastic Excision of a Giant Atypical Adenomyoepithelioma Mimicking Breast Cancer

2025-09-20T06:53:09+03:00