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Cooper J, Ryder O, Barry S. Undergraduate perspectives of the awareness, diagnosis and management of patients with eating disorders. Br Dent J 2024; 236:894-899. [PMID: 38877260 DOI: 10.1038/s41415-024-7459-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/22/2023] [Accepted: 01/07/2024] [Indexed: 06/16/2024]
Abstract
Introduction Patients with eating disorders (EDs) may present with potentially life-threatening complications due to missed and late diagnoses. Dentists can play a fundamental role in the early identification and signposting of patients with suspected EDs.Aims To investigate the awareness of final-year dental students of the aetiology, diagnosis and management of EDs.Methods An anonymous electronic questionnaire was distributed to final-year dental students at the University of Manchester. Respondents reported their knowledge, confidence and education related to the management of patients with EDs.Results Over 50% of students felt they had an above average awareness of the clinical signs and oral manifestations of EDs. The majority of students lacked confidence in discussing a suspected ED diagnosis with patients (75%) and referring them to appropriate services (71%). Additionally, 58% were not confident in planning treatment for and treating a patient with an ED. In total, 100% of students reported that they would benefit from further teaching related to the management of patients with EDs.Conclusion Participants highlighted the need for further teaching related to the diagnosis and management of patients with EDs. This study supports the development of an educational resource of undergraduate dental students.
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Affiliation(s)
- Jessica Cooper
- University Dental Hospital of Manchester, Manchester, UK; University of Manchester, Manchester, UK.
| | | | - Siobhan Barry
- University Dental Hospital of Manchester, Manchester, UK; University of Manchester, Manchester, UK
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Nasrullah MH, Haider MJ, Arif M, Zahid MN, Iftikhar S, Mahmood S, Akhtar M, Bin Ilyas MA. Eating Disorders and Disordered Eating Behaviors Among Undergraduate Students in Pakistan as Measured by Eating Disorder Examination Questionnaire (EDE-Q). Cureus 2024; 16:e59158. [PMID: 38803725 PMCID: PMC11129612 DOI: 10.7759/cureus.59158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 05/29/2024] Open
Abstract
Objectives Eating disorders (ED) are an emerging public health issue globally, especially in young adults studying at the undergraduate level. This study aims to assess the frequency of eating disorders, their types, and disordered eating behaviors among such students. Moreover, it aims to identify factors like weight concern, shape concern, eating concern, and restraint, along with assessing the shifting trend of BMI impact on eating disorders using a standardized Eating Disorder Examination Questionnaire (EDE-Q). Methods In this cross-sectional study, 400 undergraduate students (aged 18-25) from four public universities participated from July 2022 to November 2023. Data was collected using the Eating Disorder Examination Questionnaire (EDE-Q). The frequency of eating disorders was computed using SPSS version 27. Results Among the participants, 21.75% (n=84) were identified as having a score surpassing the clinical cut-off. This group comprised 5.5% males (n=22) and 16% females (n=64). The highest prevalence among the four subscales was observed in the Shape Concern subscale (10.5%). Objective binge episodes (19.3%) emerged as the most notable disordered eating attitude. Atypical anorexia nervosa accounted for 13.8% of different eating disorders, while disordered eating was noted in 19.5% (n=78) of individuals. Discussion This study offers critical insights into eating disorders among Pakistan undergraduate students, utilizing the EDE-Q 6.0. Disordered eating behaviors, particularly shape concern and objective binge eating, exhibit significant correlations with these disorders. Weight dissatisfaction emerges as a prominent predictor, suggesting societal influence. The study also reveals a moderate correlation between BMI and eating disorders, challenging conventional assumptions. Furthermore, a changing trend in the prevalence of eating disorders is observed among the male population.
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Affiliation(s)
| | | | - Maria Arif
- Community Medicine, Allama Iqbal Medical College, Lahore, PAK
| | | | - Sana Iftikhar
- Community Health Sciences, Allama Iqbal Medical College, Lahore, PAK
| | - Shahid Mahmood
- Community Medicine, Allama Iqbal Medical College, Lahore, PAK
| | - Mehwish Akhtar
- Community Medicine, Allama Iqbal Medical College, Lahore, PAK
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Yu S, Zhang Y, Shen C, Shao F. Efficacy of pharmacotherapies for bulimia nervosa: a systematic review and meta-analysis. BMC Pharmacol Toxicol 2023; 24:72. [PMID: 38042827 PMCID: PMC10693702 DOI: 10.1186/s40360-023-00713-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023] Open
Abstract
OBJECTIVE The main purpose was to evaluate the efficacy and tolerability of different medications used to treat bulimia nervosa (BN). METHODS Randomized controlled trials (RCTs) were identified from published sources through searches in PubMed, Cochrane Library, Web of Science, and Embase from inception to November 2022. Primary outcomes were changes in the frequency of binge eating episodes and vomiting episodes from baseline to endpoint. Secondary outcomes were differences in the improvement of scores in depressive symptoms, tolerability (dropout due to adverse events) and weight change. RESULTS The literature search ultimately included 11 drugs, 33 studies and 6 types of drugs, 8 trials with TCAs (imipramine, desipramine), 14 with SSRIs (fluoxetine, citalopram and fluvoxamine), 6 with MAOIs (phenelzine, moclobemide and brofaromine), 3 with antiepileptic drugs (topiramate), 1 with mood stabilizers (lithium), and 1 with amphetamine-type appetite suppressant (fenfluramine). The reduction in binge eating episodes was more likely due to these drugs than the placebo, and the SMD was -0.4 (95% CI -0.61 ~ -0.19); the changes in the frequency of vomiting episodes (SMD = -0.16, 95% CI -0.3 ~ -0.03); weight (WMD = -3.05, 95% CI -5.97 ~ -0.13); and depressive symptoms (SMD = -0.32, 95% CI -0.51 ~ -0.13). However, no significant difference was found in dropout due to adverse events (RR = 1.66, 95% CI 1.14 ~ 2.41). CONCLUSIONS This meta-analysis indicates that most pharmacotherapies decreased the frequency of binge-eating and vomiting episodes, body weight, and depressive symptoms in BN patients, but the efficacy was not significant. In each drug the efficacy is different, treating different aspects, different symptoms to improve the clinical performance of bulimia nervosa.
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Affiliation(s)
- Sijie Yu
- Center for Rehabilitation Medicine, Department of Psychiatry, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
- The Second Clinical Medical College of Zhejiang, Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Yuhan Zhang
- The Second Clinical Medical College of Zhejiang, Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Chongkai Shen
- Hangzhou Xiaoshan No 2 People's Hospital, Hangzhou, Zhejiang, China
| | - Fei Shao
- Center for Rehabilitation Medicine, Department of Psychiatry, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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4
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Wang J, Tang L, Wang M, Wu G, Li W, Wang Y, Wang X, Wang H, Yang Z, Li Z, Chen Q, Zhang P, Wang Z. Fronto-temporal dysfunction in appetitive regulation of bulimia nervosa with affective disorders: A regional homogeneity and remote connectivity pattern analysis. J Affect Disord 2023; 340:280-289. [PMID: 37553018 DOI: 10.1016/j.jad.2023.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/03/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE The aim of this study was to assess brain functional alterations in BN patients with affective disorders and their association with maladaptive eating behaviors. METHODS A total of 42 BN patients with affective disorders (anxiety and depression) and 47 healthy controls (HCs) were enrolled in this study. The resting-state fMRI data were analyzed for functional changes as indicated by regional homogeneity based on Kendall's coefficient of concordance (KCC-ReHo) and seed-based functional connectivity (FC). A principal component analysis (PCA) model was used to identify the commonalities within the behavioral questionnaires from the BN group. RESULTS Patients in the BN group showed decreased ReHo in the bilateral middle frontal gyrus (MFG) and right supramarginal gyrus (SMG). Additionally, the BN group showed increased FC between the left MFG and the right inferior temporal gyrus (ITG); decreased FC between the right MFG and the bilateral insula and the left middle temporal gyrus (MTG); and decreased FC between the right SMG and the left superior temporal gyrus (STG) and right inferior frontal gyrus (IFG). In the FC-behavior association analysis, the second principal component (PC2) was negatively correlated with FC between the left MFG and the right ITG. CONCLUSION Based on a brain functional analysis (ReHo and FC), this study revealed significant aberrant changes in the frontal-temporal regions of BN patients with affective disorders. These regions, which serve as fronto-temporal circuitry, are associated with restraint and emotional eating behaviors. Our findings shed new light on the neural mechanisms underlying the condition.
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Affiliation(s)
- Jiani Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lirong Tang
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Miao Wang
- Chinese Institute for Brain Research, Beijing, China
| | - Guowei Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Weihua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yiling Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuemei Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Hao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhanjiang Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
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Wang JN, Wang M, Wu GW, Li WH, Lv ZL, Chen Q, Yang ZH, Li XH, Wang ZC, Li ZJ, Zhang P, Tang LR. Uncovering neural pathways underlying bulimia nervosa: resting-state neural connectivity disruptions correlate with maladaptive eating behaviors. Eat Weight Disord 2023; 28:91. [PMID: 37899387 PMCID: PMC10613592 DOI: 10.1007/s40519-023-01617-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 10/18/2023] [Indexed: 10/31/2023] Open
Abstract
PURPOSE Bulimia nervosa (BN) is characterized by recurrent binge-eating episodes and inappropriate compensatory behaviors. This study investigated alterations in resting-state surface-based neural activity in BN patients and explored correlations between brain activity and eating behavior. METHODS A total of 26 BN patients and 28 healthy controls were enrolled. Indirect measurement of cerebral cortical activity and functional connectivity (FC) analyses were performed in Surfstat. A principal component analysis (PCA) model was used to capture the commonalities within the behavioral questionnaires from the BN group. RESULTS Compared with the healthy control group, the BN group showed decreased surface-based two-dimensional regional homogeneity in the right superior parietal lobule (SPL). Additionally, the BN group showed decreased FC between the right SPL and the bilateral lingual gyrus and increased FC between the right SPL and the left caudate nucleus and right putamen. In the FC-behavior association analysis, the second principal component (PC2) was negatively correlated with FC between the right SPL and the left caudate nucleus. The third principal component (PC3) was negatively correlated with FC between the right SPL and the left lingual gyrus and positively correlated with FC between the right SPL and the right lingual gyrus. CONCLUSION We revealed that the right SPL undergoes reorganization with respect to specific brain regions at the whole-brain level in BN. In addition, our results suggest a correlation between brain reorganization and maladaptive eating behavior. These findings may provide useful information to better understand the neural mechanisms of BN. LEVEL OF EVIDENCE V, descriptive study.
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Affiliation(s)
- Jia-Ni Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Miao Wang
- Chinese Institute for Brain Research, Beijing, China
| | - Guo-Wei Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wei-Hua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Zi-Ling Lv
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, No. 5 Ankang Hutong, Xicheng District, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Zheng-Han Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Xiao-Hong Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, No. 5 Ankang Hutong, Xicheng District, Beijing, China
| | - Zhen-Chang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Zhan-Jiang Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China.
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, No. 5 Ankang Hutong, Xicheng District, Beijing, China.
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China.
| | - Li-Rong Tang
- Beijing Anding Hospital, Capital Medical University, Beijing, China.
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, No. 5 Ankang Hutong, Xicheng District, Beijing, China.
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Gulakar TL, Comert GN, Karaman E, Cakan U, Ozel GS, Ahmet SO. Effect of simulated gastric acid on aesthetical restorative CAD-CAM materials' microhardness and flexural strength. Niger J Clin Pract 2023; 26:1505-1511. [PMID: 37929527 DOI: 10.4103/njcp.njcp_131_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Background Gastric acid, which is among erosive substances, gradually rises to the mouth in individuals with reflux and bulimia nervosa disorders, and this causes various effects on dental restorations. Aim The objective of this study is in vitro investigation of gastric acid's effect on flexural strength and hardness on aesthetic restorative computer-aided design and computer-aided manufacturing (CAD-CAM) materials. Materials and Methods For this study, four materials have been used, namely Enamic (Vita), Superfect Zir (Aidite) Zirconia, IPS e.max CAD (Ivoclar Vivadent), and Mark II (Vita). From these four different materials, 24 samples with 14 × 4 × 1 dimensions in rectangular prism form are used, which makes a total of 96 samples. One group was separated as the control group, while the rest was allowed to wait at 37°C, 5 ml gastric acid for 96 hours. Hardness value and flexural strengths were measured as pre-exposure and post-exposure to gastric acid. Results There is a statistically significant difference between the groups in terms of the amount of decrease in the mean hardness after exposure to gastric acid compared to pre-exposure values (p: 0,000; P < 0,05). There was no statistically significant difference between the groups in terms of the amount of decrease in the post-exposure average flexural strength compared to the pre-exposure value (p: 0.063; P > 0.05). There is a statistically significant difference between the groups in terms of the average flexural strength after exposure to the acid. Conclusions According to the data obtained, it was concluded that exposure to gastric acid affects the hardness and flexural strength properties of dental restorative ceramic materials.
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Affiliation(s)
- T L Gulakar
- Department of Prosthodontics, Graduate School of Health Sciences', Istanbul, Medipol University, Istanbul, Turkey
| | - G N Comert
- Department of Prosthodontics, Graduate School of Health Sciences', Istanbul, Medipol University, Istanbul, Turkey
| | - E Karaman
- Department of Prosthodontics, Graduate School of Health Sciences', Istanbul, Medipol University, Istanbul, Turkey
| | - U Cakan
- Department of Prosthodontics, Istanbul Medipol University, Istanbul, Turkey
| | - G S Ozel
- Department of Prosthodontics, Graduate School of Health Sciences', Istanbul, Medipol University, Istanbul, Turkey
| | - S O Ahmet
- Department of Prosthodontics, Graduate School of Health Sciences', Istanbul, Medipol University, Istanbul, Turkey
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7
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Argyrou A, Lappas AS, Bakaloudi DR, Tsekitsidi E, Mathioudaki E, Michou N, Polyzopoulou Z, Christodoulou N, Papazisis G, Chourdakis M, Samara MT. Pharmacotherapy compared to placebo for people with Bulimia Nervosa: A systematic review and meta-analysis. Psychiatry Res 2023; 327:115357. [PMID: 37562154 DOI: 10.1016/j.psychres.2023.115357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/15/2023] [Accepted: 07/21/2023] [Indexed: 08/12/2023]
Abstract
Bulimia Nervosa is a disorder with high rates of psychiatric and medical comorbidity and substantial societal costs. Cognitive Behavioural Therapy is considered the preferred treatment, but access can be problematic. Pharmacotherapy is more accessible but remains significantly underutilised. We aimed to assess the efficacy, tolerability, and safety of all available forms of pharmacotherapy for the treatment of bulimia nervosa. We conducted a comprehensive search of PubMed, EMBASE, CENTRAL, ClinicalTrials.gov, and reference lists of relevant articles up until April 2023. The primary outcomes were remission and binge frequency. 52 randomised controlled trials (RCTs) involving 3313 participants were included in the meta-analysis. Overall, no significant difference was observed between drugs and placebo in terms of remission; however, the available data were limited. Notably, drugs, particularly antidepressants, demonstrated a significant reduction in the frequency of binge episodes compared to placebo. Antidepressants were also found to be more effective than placebo in terms of treatment response and other clinically meaningful outcomes. An important limitation is that few RCTs were available for individual drugs. Our findings provide evidence supporting the increased utilisation of pharmacotherapy in clinical practice and underscore the need for further research involving larger populations and a broader range of outcomes.
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Affiliation(s)
- Aikaterini Argyrou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Andreas S Lappas
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larisa 41334, Greece; Department of Geriatric Liaison Psychiatry, Royal Gwent Hospital, Aneurin Bevan University Health Board, United Kingdom
| | - Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Eirini Tsekitsidi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Elissavet Mathioudaki
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Niki Michou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Zoi Polyzopoulou
- Department of Psychology, University of Western Macedonia, Florina 53100, Greece
| | - Nikos Christodoulou
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larisa 41334, Greece
| | - Georgios Papazisis
- Department of Clinical Pharmacology, Department of Medicine, School of Medicine, Faculty of Health Sciences, School of Health Sciences, Aristotle University, University Campus, Thessaloniki 54124, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Myrto T Samara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larisa 41334, Greece; Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich 81675, Germany.
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Merino D, Gérard AO, Destere A, Askenazy F, Dor E, Benoit M, Cherikh F, Drici MD. Iatrogenic triggers for anorexia nervosa and bulimia nervosa: A WHO safety database disproportionality analysis. Psychiatry Res 2023; 327:115415. [PMID: 37611327 DOI: 10.1016/j.psychres.2023.115415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/31/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
Eating disorders, characterized by abnormal eating, weight control behaviors or both include anorexia nervosa (AN) and bulimia nervosa (BN). We investigated their potential iatrogenic triggers, using real-world data from the WHO safety database (VigiBase®). VigiBase® was queried for all AN and BN reports. The reports were classified as `pediatric' or `adult' according to age. Disproportionality analyses relied on the Information Component (IC), in which a 95% confidence interval lower-end positivity was required to suspect a signal. Our queries yielded 309 AN and 499 BN reports. Isotretinoin was disproportionately reported in pediatric AN (IC 3.6; [2.6-4.3]), adult AN (IC 3.1; [1.7-4.0]), and pediatric BN (IC 3.9; [3.0-4.7]). Lamivudine (IC 4.2; [3.2-4.9]), nevirapine (IC 3.7; [2.6-4.6]), and zidovudine (IC 3.4; [2.0-4.3]) had the highest ICs in adult AN. AN was associated with isotretinoin, anticonvulsants in minors, and antiretroviral drugs in adults. In adults, BN was related to psychotropic and hormonally active drugs. Before treatment initiation, an anamnesis should seek out mental health conditions, allowing the identification of patients at risk of developing or relapsing into AN or BN. In addition to misuse, the hypothesis of iatrogenic triggers for AN and BN should also be considered.
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Affiliation(s)
- Diane Merino
- Department of Psychiatry, University Hospital of Nice, Nice, France; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France
| | - Alexandre Olivier Gérard
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France; Université Côte d'Azur Laboratory of Molecular Physio Medicine (LP2M), UMR 7370, CNRS, Nice, France
| | - Alexandre Destere
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France; Université Côte d'Azur, Inria, CNRS, Laboratoire J.A. Dieudonné, Maasai team, Nice, France
| | - Florence Askenazy
- Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval Nice, France; CoBTek Laboratory, Université Côte d'Azur, 06000 Nice, France
| | - Emmanuelle Dor
- Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval Nice, France; CoBTek Laboratory, Université Côte d'Azur, 06000 Nice, France
| | - Michel Benoit
- Department of Psychiatry, University Hospital of Nice, Nice, France
| | - Faredj Cherikh
- Department of Addiction, University Hospital of Nice, Nice, France
| | - Milou-Daniel Drici
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France.
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Chen Q, Wang M, Wu GW, Li WH, Ren XD, Wang YL, Wei X, Wang JN, Yang Z, Li XH, Li ZJ, Tang LR, Zhang P, Wang Z. Characteristics of white matter alterations along fibres in patients with bulimia nervosa: A combined voxelwise and tractography study. Eur J Neurosci 2023; 58:2874-2887. [PMID: 37423618 DOI: 10.1111/ejn.16077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/16/2023] [Accepted: 06/12/2023] [Indexed: 07/11/2023]
Abstract
Accumulating evidence supports the hypothesis that white matter (WM) abnormalities are involved in the pathophysiology of bulimia nervosa (BN); however, findings from in vivo neuroimaging studies have been inconsistent. We aimed to investigate the possible brain WM alterations, including WM volume and microstructure, in patients with BN. We recruited 43 BN patients and 31 healthy controls (HCs). All participants underwent structural and diffusion tensor imaging. Differences in WM volume and microstructure were evaluated using voxel-based morphometry, tract-based spatial statistics, and automated fibre quantification analysis. Compared with HCs, BN patients showed significantly decreased fractional anisotropy in the middle part of the corpus callosum (nodes 31-32) and increased mean diffusivity in the right cranial nerve V (CN V) (nodes 27-33 and nodes 55-88) and vertical occipital fasciculus (VOF) (nodes 58-85). Moreover, we found decreased axial diffusivity in the right inferior fronto-occipital fasciculus (node 67) and increased radial diffusivity in the CN V (nodes 22-34 and nodes 52-89) and left VOF (nodes 60-66 and nodes 81-85). Meanwhile, WM microstructural changes were correlated with patients' clinical manifestations. We did not find any significant differences in WM volume and the main WM fibre bundle properties between BN patients and HCs. Taken together, these findings provide that BN shows significant brain WM reorganization, but primarily in microstructure (part of WM fibre bundle), which is not sufficient to cause changes in WM volume. The automated fibre quantification analysis could be more sensitive to detect the subtle pathological changes in a point or segment of the WM fibre bundle.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Miao Wang
- Chinese Institute for Brain Research, Beijing, China
| | - Guo-Wei Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wei-Hua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Dan Ren
- Beijing Anding Hospital Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Yi-Ling Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jia-Ni Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Hong Li
- Beijing Anding Hospital Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Zhan-Jiang Li
- Beijing Anding Hospital Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Li-Rong Tang
- Beijing Anding Hospital Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Feng B, Harms J, Chen E, Gao P, Xu P, He Y. Current Discoveries and Future Implications of Eating Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6325. [PMID: 37510558 PMCID: PMC10379623 DOI: 10.3390/ijerph20146325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/20/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
Eating disorders (EDs) are characterized by severe disturbances in eating behaviors and can sometimes be fatal. Eating disorders are also associated with distressing thoughts and emotions. They can be severe conditions affecting physical, psychological, and social functions. Preoccupation with food, body weight, and shape may also play an important role in the regulation of eating disorders. Common eating disorders have three major types: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). In some cases, EDs can have serious consequences for an individual's physical and mental health. These disorders often develop during adolescence or early adulthood and affect both males and females, although they are more commonly diagnosed in young adult females. Treatment for EDs typically involves a combination of therapy, nutrition counseling, and medical care. In this narrative review, the authors summarized what is known of EDs and discussed the future directions that may be worth exploring in this emerging area.
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Affiliation(s)
- Bing Feng
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Jerney Harms
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
- Biology Department, Centenary College of Louisiana, Shreveport, LA 71104, USA
| | - Emily Chen
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Peiyu Gao
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Pingwen Xu
- The Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Yanlin He
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
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Puckett L. Renal and electrolyte complications in eating disorders: a comprehensive review. J Eat Disord 2023; 11:26. [PMID: 36803805 PMCID: PMC9942359 DOI: 10.1186/s40337-023-00751-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/06/2023] [Indexed: 02/22/2023] Open
Abstract
Eating disorders are psychiatric disorders with significant and widespread medical complications, including renal disorders. Renal disease is not uncommon in patients with eating disorders but is often unrecognized. It includes both acute renal injury and progression to chronic kidney disease requiring dialysis. Electrolyte abnormalities including hyponatremia, hypokalemia, and metabolic alkalosis are common in eating disorders and vary depending on whether patients engage in purging behaviors. Chronic hypokalemia due to purging in patients with anorexia nervosa-binge purge subtype or bulimia nervosa can lead to hypokalemic nephropathy and chronic kidney disease. Additional electrolyte derangements are seen during refeeding, including hypophosphatemia, hypokalemia, and hypomagnesemia. Patients can also develop Pseudo-Bartter's syndrome which leads to edema and rapid weight gain in patients who cease purging behavior. Clinicians and patients should be aware of these complications in order to provide education and early detection and prevention.
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Affiliation(s)
- Leah Puckett
- ACUTE Center for Eating Disorders and Severe Malnutrition Denver, Denver, CO, USA. .,Denver Health Medical Center, 723 Delaware Street, Fl. 3, Denver, CO, 80204, USA. .,University of Colorado School of Medicine Aurora, Aurora, CO, USA.
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Effects of gastric acid and mechanical toothbrushing in CAD-CAM restorative materials: Mechanical properties, surface topography, and biofilm adhesion. J Mech Behav Biomed Mater 2023; 138:105606. [PMID: 36525873 DOI: 10.1016/j.jmbbm.2022.105606] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate the effects of simulated gastric acid erosion combined with mechanical toothbrushing abrasion on the mechanical properties, surface topography, and biofilm adhesion of different CAD/CAM materials. MATERIAL AND METHODS Specimens of zirconia-reinforced lithium silicate glass-ceramic (ZLS), polymer-infiltrated ceramic network (PICN), feldspathic glass-ceramic (FE), and two nanoceramic resins (RK, RG), were submitted to the following challenges: erosion (E), abrasion (A), erosion combined with abrasion (E + A), or remained untreated (control - C). After challenges, flexural strength was evaluated, while microhardness (KHN) and surface roughness (Ra) were tested before and after treatments. The biofilm adhesion (Streptococcus mutans ATCC 700610, Streptococcus sanguinis ATCC 10556 e Candida albicans MYA 2876) was determined by the counting of colonies forming units per milliliters (UFC/mL) after erosive and abrasive challenges. RESULTS FE showed the lowest flexural strengths, while ZLS and RG exhibited the highest, while PICN and RK, had intermediate values. PICN, ZLS, and FE showed lower microhardness after E and E + A challenges than polymer-based materials (RG and RK). FE surface roughness increased after E and E + A challenges and after A and E + A challenges for RK. Biofilm formation after erosive/abrasive challenges was higher on ZLS than FE, RK, and RG, but no different than PICN. RK and RG exhibited the lowest biofilm formation among the groups. Furthermore, E + A challenges held significant changes in the surface of the materials, which were more severe on the surface of glass ceramics and hybrid materials. CONCLUSION Erosive challenges combined with abrasion negatively influenced the mechanical properties and surface topography of most CAD/CAM materials and increased the biofilm adhesion on ZLS. Besides, the severity of the damage is related to the type and composition of each material.
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Panariello F, Borgiani G, Bronte C, Cassero G, Montanari G, Falcieri M, Rugo MA, Trunfio O, De Ronchi D, Atti AR. Eating Disorders and Disturbed Eating Behaviors Underlying Body Weight Differences in Patients Affected by Endometriosis: Preliminary Results from an Italian Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1727. [PMID: 36767095 PMCID: PMC9914624 DOI: 10.3390/ijerph20031727] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to characterize the prevalence of eating disorders (EDs), disturbed eating behaviors (DEBs), and emotional eating attitudes (EEAs) among patients affected by endometriosis in order to understand a potential crosslink between this impacting gynecological disease and a Body Mass Index shift. A total of 30 patients were recruited at an endometriosis outpatient clinic in Bologna and were assessed by using standardized instruments and specific questionnaires for EDs, DEBs, and EEAs. Sociodemographic information and endometriosis clinical features and history information were collected by adopting a specific questionnaire. Retrospective reports of lifetime Body Mass Index (BMI) changes, current BMI, peak pain severity during the last menstrual period, and the average of pain intensity during the last intermenstrual period were used for a correlation with the mean score from eating-behavior scales' assessment. The preliminary results indicate that, although only 3.33% of endometriosis patients are affected by ED, statistically significant differences at the mean scores of DEBs and EEAs assessment scales were found by stratifying patients on the basis of BMI levels at risk for infertility and coronary heart disease and on the basis of moderate/severe pain levels. The enrichment of the sample size and the recruitment of the control group to complete the study enrollment will allow us to investigate more complex and strong correlation findings and to assess the prevalence of EDs among endometriosis patients.
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Affiliation(s)
- Fabio Panariello
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy
| | - Gianluca Borgiani
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy
| | - Concetta Bronte
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy
| | - Giovanni Cassero
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy
| | - Giulia Montanari
- Endometriosis and Pelvic Pain Outpatient Clinic (Regional Diagnostic and Therapeutic Path), Family Care Center (Local Heath Authority of Bologna, Department of Primary Care), 40123 Bologna, Italy
| | - Marcella Falcieri
- Endometriosis and Pelvic Pain Outpatient Clinic (Regional Diagnostic and Therapeutic Path), Family Care Center (Local Heath Authority of Bologna, Department of Primary Care), 40123 Bologna, Italy
| | | | - Ornella Trunfio
- Eating Disorder Clinic Residenza Gruber, 40141 Bologna, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy
| | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy
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Barakat S, Maguire S. Accessibility of Psychological Treatments for Bulimia Nervosa: A Review of Efficacy and Engagement in Online Self-Help Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010119. [PMID: 36612445 PMCID: PMC9819826 DOI: 10.3390/ijerph20010119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/30/2023]
Abstract
Bulimia nervosa is an eating disorder characterised by marked impairment to one's physical health and social functioning, as well as high rates of chronicity and comorbidity. This literature review aims to summarise existing academic research related to the symptom profile of BN, the costs and burden imposed by the illness, barriers to the receipt of care, and the evidence base for available psychological treatments. As a consequence of well-documented difficulties in accessing evidence-based treatments for eating disorders, efforts have been made towards developing innovative, diverse channels to deliver treatment, with several of these attempting to harness the potential of digital platforms. In response to the increasing number of trials investigating the utility of online treatments, this paper provides a critical review of previous attempts to examine digital interventions in the treatment of eating disorders. The results of a focused literature review are presented, including a detailed synthesis of a knowledgeable selection of high-quality articles with the aim of providing an update on the current state of research in the field. The results of the review highlight the potential for online self-help treatments to produce moderately sized reductions in core behavioural and cognitive symptoms of eating disorders. However, concern is raised regarding the methodological limitations of previous research in the field, as well as the high rates of dropout and poor adherence reported across most studies. The review suggests directions for future research, including the need to replicate previous findings using rigorous study design and methodology, as well as further investigation regarding the utility of clinician support and interactive digital features as potential mechanisms for offsetting low rates of engagement with online treatments.
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Affiliation(s)
- Sarah Barakat
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Camperdown 2050, Australia
- School of Psychology, University of Sydney, Camperdown 2050, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Camperdown 2050, Australia
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Abstract
BACKGROUND Delayed diagnosis, gaps in services and subsequent delays in specialist care and treatment lead to poorer health outcomes for individuals with eating disorders (EDs) and drive significant government healthcare expenditure. Given the significant disease burden associated with EDs, it is imperative that current implementation research is summarised to identify gaps in care and enable refinement for optimal patient outcomes. This review aimed to provide an updated synthesis on models of care for EDs in developed healthcare systems. METHODS This paper was conducted as part of a series of Rapid Reviews (RRs) to be published in a special series in the Journal of Eating Disorders. To provide a current and rigorous review, peer-reviewed articles published in the English language between 2009 and 2021 across three databases (ScienceDirect, PubMed and Ovid/Medline) were searched, with priority given to higher level evidence (e.g., meta-analyses, large population studies, Randomised Control Trials (RCTs)). The current review synthesises data from included studies investigating models of care for people with EDs. RESULTS Sixty-three studies (4.5% of the original RR) were identified, which included several diagnostic populations, the most common being Anorexia Nervosa (AN) (30.51%). Across EDs, specialist care was found to improve patient outcomes, with many patients effectively being treated in outpatient or day programs with multi-disciplinary teams, without the need for lengthy inpatient hospitalisation. Few studies investigated the interaction of different ED services (e.g., inpatient, community services, primary care), however stepped care models emerged as a promising approach to integrate ED services in a targeted and cost-effective way. Issues surrounding low treatment uptake, underdiagnosis, long waiting lists and limited hospital beds were also evident across services. CONCLUSION Findings suggested further research into alternatives to traditional inpatient care is needed, with partial and shorter 'hospitalisations' emerging as promising avenues. Additionally, to tackle ongoing resource issues and ensure timely detection and treatment of EDs, further research into novel alternatives, such as active waiting lists or a greater role for primary care clinicians is needed. This paper is part of a larger Rapid Review series carried out to guide Australia's National Eating Disorders Research and Translation Strategy 2021-2031. Rapid reviews aim to thoroughly summarise an area of research over a short time period, typically to help with policymaking in this area. This Rapid Review summarises the evidence relating to how we care for people with eating disorders in Western healthcare systems. Topics covered include inpatient/hospital care, residential care, day programs, outpatient/community care, and referral pathways. Findings suggested specialist eating disorder services may enhance detection, referral, and patient care. Stepped care models presented as a cost-effective approach which may help with linkage between different eating disorder services. There was a trend towards shorter hospital stays and approaches which allow for greater connection with the community, such as day programs. Evidence was also found of treatment delays, due to system issues (long waiting lists, lack of accurate assessment and diagnosis) and patient-related barriers (stigma, recognition). Upskilling and involving primary care clinicians in diagnosis and referral as part of a stepped care model may help to address some of these concerns. Further efforts to improve mental health literacy and de-stigmatise help-seeking for eating disorders are needed.
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Hu Y, Kang Q, Chen C, Guo L, Chen J. Increased plasma asprosin levels are associated with overeating and loss of control in drug-free bulimia nervosa. Eat Weight Disord 2022; 27:2783-2789. [PMID: 35768687 DOI: 10.1007/s40519-022-01431-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/08/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE Abnormalities in appetite hormones have been implicated in bulimia nervosa (BN). Orexigenic hormone asprosin has been reported to be associated with food intake and weight gain, but no relevant studies have yet been reported in BN. This study investigated asprosin concentrations and their association with eating disorder symptoms in patients with BN. METHODS This study recruited a total of 26 BN patients and 23 healthy controls (HC). Symptom severity for eating disorders, depression, and anxiety was determined by the Eating Disorder Examination Questionnaire 6.0, Beck Depression Inventory, Version 2, and Beck Anxiety Inventory, respectively. In addition, the study employed sandwich enzyme-linked immunoassay technology to determine plasma asprosin and glucose concentrations in all participants. RESULTS The results revealed that plasma asprosin concentrations were significantly higher in BN patients than in HC (P = 0.037), but the difference disappeared after adjusting for the covariate BMI (F = 2.685, P = 0.108). Correlation analysis showed that asprosin concentration was positively correlated with overeating (r = 0.451, P = 0.021) and eating loss of control (r = 0.483, P = 0.012) in BN patients. Linear regression analysis indicated that an increase in asprosin concentration was associated with an increase in the times of overeating (F = 6.303, P = 0.019, R2 = 0.208). Multiple linear regression showed that increases in asprosin concentration and BDI-II total score could explain the frequent eating loss of control (F = 5.766, P = 0.009, R2 = 0.334). CONCLUSIONS The present study is the first report of plasma asprosin concentration in BN patients and found that overeating and eating loss of control increased with the increase of asprosin concentration. Additionally, asprosin level and degree of depression may explain the frequency of loss of control. LEVEL OF EVIDENCE Level III: Evidence obtained from case-control studies.
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Affiliation(s)
- Yanran Hu
- Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Qing Kang
- Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Chen Chen
- Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Lei Guo
- Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Jue Chen
- Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China.
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Chiba FY, Chiba EK, Moimaz SAS, Matsushita DH, Garbin AJÍ, Garbin CAS. Malocclusion and its relationship with oral health-related quality of life in patients with eating disorders. Dental Press J Orthod 2022; 27:e2220305. [PMID: 35703616 PMCID: PMC9191855 DOI: 10.1590/2177-6709.27.2.e2220305.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/10/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence and severity of malocclusion and its impact on oral health-related quality of life (OHRQoL) and self-reported satisfaction of patients with anorexia and bulimia nervosa. METHODS The sample consisted of sixty women who attended a specialized mental health clinic of a Brazilian medical school. Participants were distributed into two groups: patients with anorexia and bulimia nervosa (ABN; n=30) and control patients without eating disorders (CN; n=30). The dental occlusion was evaluated by the Dental Aesthetic Index; the OHRQoL was assessed using the OHIP-14 questionnaire; and the self-reported satisfaction with the appearance of teeth, speech ability and chewing was obtained by interviews. RESULTS Severe and very severe malocclusion were observed in 26.67% and 46.67% of patients in the ABN group, respectively, while the CN group showed 80.00% of patients without abnormality/mild malocclusion. ABN group showed a higher proportion of patients (p < 0.05) with tooth loss, spacing in the region of incisors, maxillary misalignment, and mandibular misalignment in relation to CN group. ABN group presented lower (p< 0.05) OHRQoL and self-reported satisfaction with the appearance of teeth, speech ability and chewing, compared to the CN group. There was a significant positive correlation (p< 0.05) between the Dental Aesthetic Index and OHIP-14 scores in the ABN group. CONCLUSIONS The prevalence of severe malocclusion in ABN group was high, with a negative impact on OHRQoL and self-reported satisfaction with the chewing ability, speech ability and appearance of teeth.
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Affiliation(s)
- Fernando Yamamoto Chiba
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Erika Kiyoko Chiba
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Suzely Adas Saliba Moimaz
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Doris Hissako Matsushita
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Artênio José Ísper Garbin
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
| | - Cléa Adas Saliba Garbin
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia, Departamento de Odontologia Preventiva e Restauradora (Araçatuba/SP, Brazil)
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OĞUZ EG. The Prevalence and Related Factors of Eating Disorders and Eating Attitudes Among Balikesir University Students. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1002101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: Eating disorders are classified as psychiatric diseases that include deterioration in eating behaviors and attitudes and has negative effects on the physical and mental health of the individual. The main objective of the study is to elaborate the psychosocial and psychopathological factors related to eating disorders among university students.
Methods: We have enrolled 199 female and 201 male volunteer students at Balıkesir University Faculty of Medicine. Participants were evaluated with a semi-structured questionnaire prepared by our institution regarding clinical experience and available information sources and according to DSM-V diagnostic criteria. Eating Attitude Scale, Ortho-15 Scale, Maudsley Obsessive Compulsive Question List, Rosenberg Self-Esteem Scale and Body Perception Scale were administered to all participants. Individuals with previously known or concomitant dementia, delirium, mental retardation, psychotic disorder diagnosis, depression with psychotic symptoms, and bipolar depression were not included in the study.
Results: The OCD sub-dimension and cleaning sub-dimension differed significantly according to the gender variable (p
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Shobeiri P, Kalantari A, Teixeira AL, Rezaei N. Shedding light on biological sex differences and microbiota-gut-brain axis: a comprehensive review of its roles in neuropsychiatric disorders. Biol Sex Differ 2022; 13:12. [PMID: 35337376 PMCID: PMC8949832 DOI: 10.1186/s13293-022-00422-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/14/2022] [Indexed: 12/15/2022] Open
Abstract
Women and men are suggested to have differences in vulnerability to neuropsychiatric disorders, including major depressive disorder (MDD), generalized anxiety disorder (GAD), schizophrenia, eating disorders, including anorexia nervosa, and bulimia nervosa, neurodevelopmental disorders, such as autism spectrum disorder (ASD), and neurodegenerative disorders including Alzheimer’s disease, Parkinson’s disease. Genetic factors and sex hormones are apparently the main mediators of these differences. Recent evidence uncovers that reciprocal interactions between sex-related features (e.g., sex hormones and sex differences in the brain) and gut microbiota could play a role in the development of neuropsychiatric disorders via influencing the gut–brain axis. It is increasingly evident that sex–microbiota–brain interactions take part in the occurrence of neurologic and psychiatric disorders. Accordingly, integrating the existing evidence might help to enlighten the fundamental roles of these interactions in the pathogenesis of neuropsychiatric disorders. In addition, an increased understanding of the biological sex differences on the microbiota–brain may lead to advances in the treatment of neuropsychiatric disorders and increase the potential for precision medicine. This review discusses the effects of sex differences on the brain and gut microbiota and the putative underlying mechanisms of action. Additionally, we discuss the consequences of interactions between sex differences and gut microbiota on the emergence of particular neuropsychiatric disorders. The human microbiome is a unique set of organisms affecting health via the gut–brain axis. Neuropsychiatric disorders, eating disorders, neurodevelopmental disorders, and neurodegenerative disorders are regulated by the microbiota–gut–brain axis in a sex-specific manner. Understanding the role of the microbiota–gut–brain axis and its sex differences in various diseases can lead to better therapeutic methods.
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Affiliation(s)
- Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, 14194, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran
| | - Amirali Kalantari
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, 14194, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran. .,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Zimmer R, Methfessel I, Heiss L, Kovacs L, Papadopulos NA. Eating disorders: A neglected group of mental disorders in patients requesting aesthetic surgery. J Plast Reconstr Aesthet Surg 2021; 75:840-849. [PMID: 34799292 DOI: 10.1016/j.bjps.2021.09.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/03/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is a lack of data concerning the prevalence of eating disorders in patients requesting aesthetic surgery in spite of a large body of literature on the psychopathology of these patients. This may mostly be due to insufficient diagnostic assessment instruments. Therefore, the aim of this study was to determine the prevalence of eating disorders and their comorbidities in patients undergoing aesthetic surgery. METHODS The assessment of prevalence of the eating disorders as anorexia nervosa, bulimia nervosa and binge eating disorder as well as other mental disorders was performed with the Structured Clinical Interview for DSM-IV mental disorders (SCID), axis 1. RESULTS 212 patients (198 females, 14 males), requesting different types of aesthetic surgery, were included in this study. Eating disorders had a current prevalence of 8.0% (17/212) and a lifetime prevalence of 11.3% (24/212). Anorexia nervosa was predominantly found in patients with breast augmentation [current: 7.4% (2/27); lifetime: 11.1% (3/27)] and rhinoplasty [6.3 (1/16); 12.6% (2/16)]. Bulimia nervosa dominated in patients with liposuction [10% (3/30); 13.3% (4/30)] and binge eating disorder in patients with abdominoplasty [current/lifetime: 10.8% (4/37)]. Levels of significance (p ≤ 0.002) were reached for prevalence of the eating disorders in above mentioned types of surgery, when compared to prevalence data of the general population (two proportion Z test for SPSS). CONCLUSION Eating disorders are distributed according to a certain pattern in the different types of aesthetic surgery. Interestingly, the current prevalence of eating disorders (17/212) was comparable to that of body dysmorphic disorder (26/212).
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Affiliation(s)
- Reinhilde Zimmer
- Department of Psychiatry and Psychotherapy, University Hospital rechts der Isar, Munich Technical University, Ismaningerstrasse 22, 81675 Munich, Germany.
| | - Insa Methfessel
- Department of Psychiatry and Psychotherapy, University Hospital rechts der Isar, Munich Technical University, Ismaningerstrasse 22, 81675 Munich, Germany
| | - Linn Heiss
- Department of Psychiatry and Psychotherapy, University Hospital rechts der Isar, Munich Technical University, Ismaningerstrasse 22, 81675 Munich, Germany; Department of Plastic Surgery and Hand Surgery, University Hospital rechts der Isar, Munich Technical University, Ismaningerstrasse 22, 81675 Munich, Germany
| | - Laslo Kovacs
- Department of Plastic Surgery and Hand Surgery, University Hospital rechts der Isar, Munich Technical University, Ismaningerstrasse 22, 81675 Munich, Germany
| | - Nikolaos A Papadopulos
- Department of Plastic Surgery and Hand Surgery, University Hospital rechts der Isar, Munich Technical University, Ismaningerstrasse 22, 81675 Munich, Germany; Department of Plastic Surgery and Burns, Alexandroupoli University Hospital, Democritus University of Thrace, GR-68100 Alexandroupoli, Greece; School of Medicine, National and Kapodistrian University of Athens, GR-115 27 Athen Greece
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Effects of Simulated Gastric Acid Exposure on Surface Topography, Mechanical and Optical Features of Commercial CAD/CAM Ceramic Blocks. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11188703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Gastric acid exposure produces tooth structure demineralization and dental ceramic degradation. The most affected patients are those who suffer from gastroesophageal reflux disease, bulimia nervosa, and pregnant women with prolonged severe nausea. In order to protect this kind of patient, the purpose of this study was to determine whether simulated gastric acid exposure leads to microstructural changes in surface topography, hardness, color changes, and translucency of some ceramic materials, which are already on the market. Forty disks (Triluxe Forte, Cerasmart, Enamic and Empress CAD) were analyzed before and after immersion in simulated gastric acid juice, in terms of microhardness, surface roughness, translucency, and surface morphology using scanning electron microscopy. Color change was assessed by using a spectrophotometer based on CIELab parameters and the results showed that, after exposure, ∆Eab remained under the threshold of acceptability and perceptibility. In terms of microhardness, Cerasmart is the only material that did not undergo changes after immersion. SEM images illustrated observable changes surface topography after acid exposure for all the tested materials. In conclusion, Triluxe Forte suffered the most important changes after simulated gastric acid juice exposure, and Cerasmart proved to be the least affected material.
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Hanel V, Schalla MA, Stengel A. Irritable bowel syndrome and functional dyspepsia in patients with eating disorders - a systematic review. EUROPEAN EATING DISORDERS REVIEW 2021; 29:692-719. [PMID: 34086385 DOI: 10.1002/erv.2847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The prevalence of eating disorders is rising worldwide. The low body weight in anorexia nervosa as well as the increase in body mass index due to binge eating disorder are contributing to a strikingly high morbidity and mortality. In a similar pattern, the prevalence and burden of the disease of functional gastrointestinal disorders such as functional dyspepsia and irritable bowel syndrome is increasing. As gastrointestinal complaints are commonly reported by patients with eating disorders, the question arose whether there is a relationship between eating disorders and functional gastrointestinal disorders. METHODS To address the need to better understand the interplay between eating disorders and functional gastrointestinal disorders as well as factors that might influence this connection, the data bases Medline, Web of Science and Embase were systematically searched. RESULTS After removal of duplicates the search yielded 388 studies which were screened manually. As a result, 36 publications were selected for inclusion in this systematic review. CONCLUSION The occurrence of functional gastrointestinal disorders like irritable bowel syndrome and functional dyspepsia in patients with eating disorders is considerably high and often associated with psychological, hormonal and functional alterations. In the future, further research addressing the underlying mechanisms accounting for this relationship is required.
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Affiliation(s)
- Vivien Hanel
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Martha A Schalla
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Stengel
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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Atti AR, Mastellari T, Valente S, Speciani M, Panariello F, De Ronchi D. Compulsory treatments in eating disorders: a systematic review and meta-analysis. Eat Weight Disord 2021; 26:1037-1048. [PMID: 33099675 PMCID: PMC8062396 DOI: 10.1007/s40519-020-01031-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/24/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION The aims of this systematic review and meta-analysis are to provide a summary of the current literature concerning compulsory treatments in patients with eating disorders (ED) and to understand whether compulsorily and involuntarily treated patients differ in terms of baseline characteristics and treatment outcomes. METHODS Relevant articles were identified following the PRISMA guidelines by searching the following terms: "treatment refusal", "forced feeding", "compulsory/coercive/involuntary/forced treatment/admission", "eating disorders", "feeding and eating disorders", "anorexia nervosa", "bulimia nervosa". Research was restricted to articles concerning humans and published between 1975 and 2020 in English. RESULTS Out of 905 articles retrieved, nine were included for the analyses allowing the comparisons between 242 compulsorily and 738 voluntarily treated patients. Mean body mass index (BMI) was slightly lower in patients compelled to treatments. Mean illness duration, BMI at discharge and BMI variation showed no significant differences between the two groups. Average length of hospitalization was 3 weeks longer among compulsory-treated patients, but this did not result in a higher increase in BMI. No significant risk difference on mortality was estimated (three studies). CONCLUSIONS Compulsory treatments are usually intended for patients having worse baseline conditions than voluntary ones. Those patients are unlikely to engage in treatments without being compelled but, after the treatments, albeit with longer hospitalisations, they do achieve similar outcomes. Therefore, we can conclude that forcing patients to treatment is a conceivable option. LEVEL OF EVIDENCE Level I, systematic review and meta-analysis.
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Affiliation(s)
- Anna Rita Atti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
| | - Tomas Mastellari
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Stefano Valente
- Department of Mental Health, Local Health Authority of Bologna, Bologna, Italy
| | - Maurizio Speciani
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Fabio Panariello
- Department of Mental Health, Local Health Authority of Bologna, Bologna, Italy
| | - Diana De Ronchi
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
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Yang Y, Zhang S, Zhang X, Xu Y, Cheng J, Yang X. The Role of Diet, Eating Behavior, and Nutrition Intervention in Seasonal Affective Disorder: A Systematic Review. Front Psychol 2020; 11:1451. [PMID: 32903693 PMCID: PMC7438823 DOI: 10.3389/fpsyg.2020.01451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/29/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Seasonal affective disorder (SAD) is a biological and mood disorder with a seasonal pattern. Dietary intervention and nutritional status have been reported to affect SAD severity. The objective of this study was to systematically review the evidence of associations between SAD and diet, eating behavior, and nutrition intervention. Methods: We performed a comprehensive search of MEDLINE, EMBASE, Web of Science, and Google Scholar from inception up to July 1, 2019. Studies that examined diet and eating behaviors in SAD patients and tests of nutrition interventions for SAD were included. Two independent investigators extracted data based on study designs, participants, outcomes, exposures, and association measures. Results: Eleven studies were included: six studies examined distinctive dietary patterns and eating behaviors in SAD patients and five studies explored the efficacy of nutrition interventions for SAD. Vegetarianism and alcoholism were associated with higher SAD prevalence, but normal alcohol intake was not correlated with SAD severity. Compared with non-clinical subjects, SAD patients tended to consume significantly larger dinners and more evening snacks during weekdays and weekends and exhibit a higher frequency of binge eating, external eating, and emotional eating. Additionally, compared to healthy controls, SAD patients presented more cravings for starch-rich food and food with high fiber. However, neither the ingestion of carbohydrate-loaded meals nor Vitamin D/B12 supplementation showed benefit for SAD. Conclusion: Studies suggest that SAD patients may exhibit distinctive diet preferences and eating behaviors, but no current nutrition intervention has demonstrated efficacy for ameliorating SAD symptoms. Further evidence is needed from randomized controlled trials with larger sample sizes and longer durations.
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Affiliation(s)
- Yongde Yang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Zhang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xianping Zhang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yongjun Xu
- Wuhan East Body-Well Mental Hospital, Wuhan, China
| | - Junrui Cheng
- Friedman School of Nutrition and Policy, Tufts University, Boston, MA, United States
| | - Xue Yang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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Boutari C, Pappas PD, Mintziori G, Nigdelis MP, Athanasiadis L, Goulis DG, Mantzoros CS. The effect of underweight on female and male reproduction. Metabolism 2020; 107:154229. [PMID: 32289345 DOI: 10.1016/j.metabol.2020.154229] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/13/2022]
Abstract
Chronic energy deficiency can impair the hypothalamic-pituitary-gonadal (HPG) axis and lead to hypothalamic anovulation in underweight women. This review presents the syndromes related to underweight status that are associated with infertility, summarizes the underlying mechanisms, and reviews the available treatment options. Eating disorders, such as anorexia nervosa (AN), constitute the most common cause of infertility in underweight women, who, in addition, experience miscarriages, and sexual dysfunction. The relative energy deficiency in sports (RED-S; former terminology: athlete's triad) involves menstrual dysfunction due to low energy availability, which results in anovulation. Moreover, lipodystrophies, malnutrition, starvation, systematic illnesses (malignancies, endocrinopathies, infectious diseases, advanced chronic diseases, neurologic illnesses), and the utilization of drugs can cause excessive weight loss. They may result in fertility problems due to the loss of adipose tissue and the subsequent hormonal disturbances. Each of these conditions requires multidisciplinary management. Nutritional counseling should target the restoration of energy balance by increasing intake and reducing output. Medical treatment, recommended only for patients who did not respond to standard treatment, may include antipsychotics, antidepressants, or leptin administration. Finally, psychiatric treatment is considered an integral part of the standard treatment.
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Affiliation(s)
- Chrysoula Boutari
- Department of Medicine, Boston VA Healthcare System and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Panagiotis D Pappas
- Unit of Reproductive Endocrinology, 1(st) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Gesthimani Mintziori
- Unit of Reproductive Endocrinology, 1(st) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Meletios P Nigdelis
- Unit of Reproductive Endocrinology, 1(st) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Loukas Athanasiadis
- 3(rd) Department of Psychiatry, Medical School, Aristotle University of Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1(st) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Christos S Mantzoros
- Department of Medicine, Boston VA Healthcare System and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
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Alnasser M, Finkelman M, Papathanasiou A, Suzuki M, Ghaffari R, Ali A. Effect of acidic pH on surface roughness of esthetic dental materials. J Prosthet Dent 2019; 122:567.e1-567.e8. [PMID: 31699448 DOI: 10.1016/j.prosdent.2019.08.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022]
Abstract
STATEMENT OF PROBLEM Exposure to gastric acid in patients with bulimia nervosa and gastroesophageal reflux disease (GERD) causes demineralization of hard tooth structures. This chemical attack also causes the degradation of dental ceramics, which results in increased surface roughness and reduced strength. However, studies comparing the effect of acidic pH on resin matrix ceramic with other computer-aided design and computer-aided manufacturing (CAD-CAM) esthetic materials are lacking. PURPOSE The purpose of this in vitro study was to compare the surface roughness changes of different CAD-CAM restorative dental materials after exposure to acidic pH by using a 3D optical interferometer. MATERIAL AND METHODS Five esthetic CAD-CAM block materials, a leucite glass-ceramic (IPS Empress CAD), a zirconia (BruxZir Solid Zirconia), a resin matrix ceramic (VITA Enamic), a lithium disilicate glass-ceramic (IPS e.max CAD), and a feldspathic porcelain (VITABLOCS Mark II CAD) were tested. Eighteen specimens were sectioned from CAD-CAM blocks into 2-mm-thick rectangular plates and immersed in 10 mL of 5% hydrochloric acid (HCl) with (pH=2) at 37 °C for 45 and 91 hours. The surface roughness average (Ra) of the specimens was measured by using a 3D optical interferometer before the storage period (baseline), after 45 hours, and after 91 hours of exposure to HCl. Statistical analyses were performed with the Kruskal-Wallis test and the post hoc Dunn test with Bonferroni correction (α=.05). RESULTS Regarding the comparison of surface roughness changes at different periods of evaluation (baseline, 45 hours, 91 hours), there were no statistically significant differences for lithium disilicate (P=.063) or zirconia (P=.513). Leucite glass-ceramic, feldspathic porcelain, and the resin matrix ceramic demonstrated statistically significant differences (P<.001). For all tests that were statistically significant, greater surface roughness was found at the time point with the longer HCl exposure. Regarding the comparison of materials in terms of change in surface roughness between baseline to 45 hours and baseline to 91 hours, the Kruskal-Wallis test indicated a statistically significant difference among the materials in both cases (P<.001). Lithium disilicate and zirconia exhibited the least change in surface roughness among the 5 materials. CONCLUSIONS Leucite glass-ceramic, feldspathic porcelain, and resin matrix ceramic showed statistically significant increases in surface roughness when they were exposed to simulated gastric acid for 45 and 91 hours. Lithium disilicate and zirconia showed no statistically significant change in surface roughness after exposure to HCl for 45 and 91 hours.
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Affiliation(s)
- Muhsen Alnasser
- Resident, Advanced Graduate Education in Implantology, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass.
| | - Matthew Finkelman
- Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Aikaterini Papathanasiou
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Marcelo Suzuki
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Ruby Ghaffari
- Associate Professor, Department of Comprehensive Care, Tufts University School of Dental Medicine, Boston, Mass
| | - Ala Ali
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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Dooley-Hash S, Adams M, Walton MA, Blow FC, Cunningham RM. The prevalence and correlates of eating disorders in adult emergency department patients. Int J Eat Disord 2019; 52:1281-1290. [PMID: 31322755 PMCID: PMC7047774 DOI: 10.1002/eat.23140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/05/2019] [Accepted: 07/05/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study describes the prevalence of eating disorders among adult patients who present to the emergency department for medical care and examines the relationship between eating disorders, depression, and substance use disorders. METHOD Emergency department patients aged 21-65 years (n = 1,795) completed a computerized questionnaire that included validated screening tools for eating disorders, risky drinking behavior, other substance use, and depression. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, income, education), body mass index (BMI), risky drinking behavior, other substance use, and depression. RESULTS Nearly 16% (15.9%) of all patients screened positive for an eating disorder regardless of their reason for presenting to the emergency department. Patients who screened positive for an eating disorder were significantly more likely to have a BMI > 30 (odds ratio [OR] = 2.68, confidence interval [CI] = 1.98, 3.62, p < .001), to also screen positive for depression (OR = 3.19, CI = 2.28, 4.47, p < .001) and to be female (OR = 2.37, CI = 1.76, 3.19, p < .001). No differences in the prevalence of positive screens for eating disorders were seen across age or racial groups, level of education or income, or for any of the included substance use variables. DISCUSSION Eating disorders are common among adult emergency department patients and are associated with high rates of comorbid depression and higher BMI. Given the significant morbidity and mortality associated with eating disorders, targeted screening may be warranted in the emergency department setting.
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Affiliation(s)
- Suzanne Dooley-Hash
- department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
- The Center for Eating Disorders, Ann Arbor, Michigan
| | - Mackenzie Adams
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Maureen A. Walton
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan
| | - Frederic C. Blow
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Rebecca M. Cunningham
- department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan
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Caroleo M, Carbone EA, Greco M, Corigliano DM, Arcidiacono B, Fazia G, Rania M, Aloi M, Gallelli L, Segura-Garcia C, Foti DP, Brunetti A. Brain-Behavior-Immune Interaction: Serum Cytokines and Growth Factors in Patients with Eating Disorders at Extremes of the Body Mass Index (BMI) Spectrum. Nutrients 2019; 11:E1995. [PMID: 31450770 PMCID: PMC6770139 DOI: 10.3390/nu11091995] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
Abstract
Alterations of the immune system are known in eating disorders (EDs), however the importance of cytokine balance in this context has not been clarified. We compared cytokines and growth factors at opposite ends of BMI ranges, in 90 patients classified in relation to BMI, depressive and EDs comorbidities. Serum concentrations of interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) were determined by a biochip analyzer (Randox Labs). Differences were calculated through ANOVA. Possible predictors of higher cytokine levels were evaluated through regression analysis. IL-1α, IL-10, EGF, and IFN-γ were altered individuals with anorexia nervosa (AN) and binge eating disorder (BED). Night-eating was associated with IL-8 and EGF levels, IL-10 concentrations with post-dinner eating and negatively with sweet-eating, long fasting with higher IFN-γ levels. IL-2 increase was not linked to EDs, but to the interaction of depression and BMI. Altogether, for the first time, IL-1α, IL-10, EGF, and IFN-γ were shown to differ between AN and HCs, and between AN and individuals with obesity with or without BED. Only IL-2 was influenced by depression. Dysfunctional eating behaviors predicted abnormal concentrations of IL-10, EGF, IL-8 and IFN-γ.
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Affiliation(s)
- Mariarita Caroleo
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Elvira Anna Carbone
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Marta Greco
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | | | - Biagio Arcidiacono
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Gilda Fazia
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Marianna Rania
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Matteo Aloi
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Luca Gallelli
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy.
| | - Daniela Patrizia Foti
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Brunetti
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
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Chiba FY, Sumida DH, Moimaz SAS, Chaves Neto AH, Nakamune ACMS, Garbin AJI, Garbin CAS. Periodontal condition, changes in salivary biochemical parameters, and oral health-related quality of life in patients with anorexia and bulimia nervosa. J Periodontol 2019; 90:1423-1430. [PMID: 31361025 DOI: 10.1002/jper.19-0053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/02/2019] [Accepted: 05/20/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Anorexia and bulimia nervosa can have significant effects on oral health. Assessment of enzyme concentrations in saliva can be useful for obtaining information on molecular biomarkers for the prevention, monitoring, and diagnosis of oral diseases. This study investigated the periodontal condition, changes in salivary biochemical parameters, and oral health-related quality of life (OHRQoL) in patients with anorexia and bulimia nervosa. METHODS The study comprised 60 women patients who attended a Brazilian medical school. Participants were divided into two groups: patients with anorexia and bulimia nervosa (ABN; n = 30) and control patients (CN; n = 30). Oral clinical examinations were carried out to evaluate the periodontal condition by Community Periodontal Index, and interviews using the Oral Health Impact Profile (OHIP-14) were conducted to assess OHRQoL. Saliva samples were collected for the evaluation of salivary concentrations of total protein, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and thiobarbituric acid reactive substance (TBARS), and salivary flow rate. RESULTS Periodontal condition in the ABN group was significantly worse than that in the CN group. The ABN group showed significantly higher salivary concentrations of total protein, AST, ALT, and LDH than the CN group. There was no significant difference in the salivary concentrations of TBARS among the groups. The OHIP-14 score was higher in the ABN group than in the CN group. CONCLUSION Anorexia and bulimia nervosa are associated with poor periodontal condition, elevated salivary concentrations of total protein, AST, ALT, and LDH, decreased salivary flow rate and a significant adverse impact on OHRQoL.
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Affiliation(s)
- Fernando Y Chiba
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Doris H Sumida
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Suzely A S Moimaz
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Antônio H Chaves Neto
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Ana C M S Nakamune
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Artênio J I Garbin
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Cléa A S Garbin
- Department of Child and Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
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