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Colella G, Lo Giudice G, De Luca R, Troiano A, Lo Faro C, Santillo V, Tartaro G. Interventional sialendoscopy in parotidomegaly related to eating disorders. J Eat Disord 2021; 9:25. [PMID: 33597023 PMCID: PMC7890799 DOI: 10.1186/s40337-021-00378-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the viability and efficacy of sialendoscopy for the management of parotidomegaly related to eating disorders, 6 patients suffering from eating disorders and recurring symptoms of glandular swelling were followed up at the Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, AOU University of Campania "Luigi Vanvitelli". After the detection of the impaired gland through clinical and radiographical analysis, the diagnostic unit was introduced into the duct and was advanced in, reaching the ductal system. Plaques were washed out, any strictures were dilated both by hydrostatic pressure application and steroid solution injection directly in the fibrotic area. RESULTS Both glands resulted affected in 83% of patients. 11 parotid glands were explored and treated. Strictures were found in 2 glands (33%), sialectasis in 3 glands (50%), strictures and sialectasis together in 1 glands (17%). In 3 parotid glands (50%) Stenon's duct was affected, in two (33%) only secondary ducts, in 1 (17%) both. We reached symptomatic improvement in 5 patients (83%), reporting the spherical volume of the parotid region and pain reduction. CONCLUSIONS Our results demonstrate that sialendoscopy is a safe and effective therapeutic method to treat EDs salivary symptoms. Treating the underlining psychiatric pathology should be the primary goal in patient care to lower the possible recurrence rate and increase the successful outcome of this technique.
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Affiliation(s)
- Giuseppe Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Giorgio Lo Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", 80138, Naples, Italy.
| | - Roberto De Luca
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", 80138, Naples, Italy
| | - Antonio Troiano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", 80138, Naples, Italy
| | - Carmelo Lo Faro
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", 80138, Naples, Italy
| | - Vincenzo Santillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Gianpaolo Tartaro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
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Krukowska-Zaorska A, Kot K, Marek E, Dura W, Safranow K, Lipski M. Knowledge of Oral and Physical Manifestations of Anorexia Nervosa Among Polish Dentists: A Cross-Sectional Study. Front Psychiatry 2021; 12:751564. [PMID: 34777055 PMCID: PMC8578852 DOI: 10.3389/fpsyt.2021.751564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Anorexia nervosa is a psychosomatic disorder and is commonly associated with impaired oral health. Dentists can play a relevant role in the early diagnosis of anorexia nervosa. With the help of intra- and extraoral examinations and anamnesis, the dentist can detect characteristic signs and symptoms of this eating disorder. The purpose of this study was to determine the knowledge regarding the oral and physical manifestations of anorexia nervosa among general dental practitioners and specialist dentists of Poland. Material and Methods: A pretested online questionnaire consisting of a first part asking for the characteristics of the participant and a second part with 22 specific questions on their general knowledge of anorexia nervosa and knowledge of physical and oral manifestations of this eating disorder was used. Results: A total of 369 dentists completed the questionnaire. The Polish dentists in this study reported sufficient knowledge regarding anorexia nervosa. However, younger dentists and general dental practitioners had relatively lower knowledge scores than other groups. The dentists mainly had difficulties with the oral symptoms of anorexia nervosa. Conclusion: Despite Polish dentists having sufficient knowledge about anorexia nervosa in relation to the general symptoms of anorexia, there are deficits with regard to oral manifestations. Therefore, there is a need to increase continuing education in this field, which can improve early diagnosis of this disease by dental practitioners and referral to specialists for treatment.
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Affiliation(s)
- Agnieszka Krukowska-Zaorska
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna Kot
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Marek
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Włodzimierz Dura
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Szczecin, Poland
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Riedlinger C, Schmidt G, Weiland A, Stengel A, Giel KE, Zipfel S, Enck P, Mack I. Which Symptoms, Complaints and Complications of the Gastrointestinal Tract Occur in Patients With Eating Disorders? A Systematic Review and Quantitative Analysis. Front Psychiatry 2020; 11:195. [PMID: 32425816 PMCID: PMC7212454 DOI: 10.3389/fpsyt.2020.00195] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/27/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Eating disorders (ED) such as anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are often accompanied by a variety of psychological and physical comorbidities. Gastrointestinal (GI) symptoms are a classical feature in most patients with ED. The heterogeneity of studies on this topic is high, making it difficult to have a clear overview. The aim of this systematic review is therefore to provide an overview of subjectively and objectively measured differences and changes in the GI tract in patients with EDs, along with the occurrence of GI complications. METHODS A systematic literature search was conducted in PubMed, Web of Science, and Google Scholar to find all relevant studies examining GI problems in AN, BN, and BED. Quantitative analyses were performed for objective GI physiology measures where applicable. RESULTS The review differentiated between ED types and also between studies that report GI outcomes of ED in (i) human studies with an ED diagnosis excluding case reports that provide an overview of GI problems in ED and (ii) case reports with an ED diagnosis describing rare GI complications in ED. GI symptoms and impaired gastric transit times were frequent features of EDs with specific differences found for the ED types. During the time course of treatment, GI symptoms changed and/or improved but not completely. GI complications extended the range of GI problems observed, including a variety of serious complications such as gastric dilatation. CONCLUSIONS Problems of the GI tract are frequent in patients with ED and it is likely that they complicate therapy, especially in patients with AN. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42019100585.
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Affiliation(s)
- Caroline Riedlinger
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Competence Center for Eating Disorders (KOMET), Tübingen, Germany
| | - Greta Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Competence Center for Eating Disorders (KOMET), Tübingen, Germany
| | - Alisa Weiland
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Competence Center for Eating Disorders (KOMET), Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Competence Center for Eating Disorders (KOMET), Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Competence Center for Eating Disorders (KOMET), Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Competence Center for Eating Disorders (KOMET), Tübingen, Germany
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Competence Center for Eating Disorders (KOMET), Tübingen, Germany
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Competence Center for Eating Disorders (KOMET), Tübingen, Germany
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Planimetric correlation between the submandibular glands and the pancreas: a postmortem ductographic study. Anat Sci Int 2016; 93:114-118. [PMID: 27832478 DOI: 10.1007/s12565-016-0382-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/02/2016] [Indexed: 10/20/2022]
Abstract
The salivary glands and pancreas have comparable anatomic and antigenic properties and can share common pathogenetic mechanisms involving toxic or autoimmune processes. The aim of this study is to assess the correlation in size between the normal submandibular glands and the pancreas. The study was based on human autopsy specimens of the pancreas, neck and oral base from 22 adults, both sexes (mean age, 57.9 years). The pancreatic and submandibular ducts were injected with a contrast medium, and the area of the salivary and pancreatic glandular ductograms was measured with the aid of software for quantification of visual information. Samples of tissue from the salivary glands and the pancreas were studied by means of light microscopy. A high correlation was found between the planimetric size of the pancreas and the submandibular glands (correlation coefficient 0.497 and 0.699 for the right and the left gland, respectively). This ratio was close to 5:1. There were no significant differences in size for the left vs. right submandibular gland (p = 0.39). The ductograms were significantly larger in size in males than in females (p < 0.001). This study has proven a positive correlation in planimetric size between the normal submandibular glands and pancreas, a result that is expected to have possible clinical implications in the long-term follow-up of patients with chronic pancreatitis.
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Johansson AK, Norring C, Unell L, Johansson A. Eating disorders and biochemical composition of saliva: a retrospective matched case-control study. Eur J Oral Sci 2015; 123:158-64. [PMID: 25780814 PMCID: PMC6680160 DOI: 10.1111/eos.12179] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 12/02/2022]
Abstract
This study aimed to compare the biochemical composition of saliva from patients with eating disorders (EDs) with saliva from control subjects with no ED. All patients who initiated outpatient treatment in an ED clinic during a 12‐month period were invited to participate. Of the 65 patients who started treatment during the period, 54 (50 female patients/four male patients; mean age: 21.5 yr) agreed to participate. The controls were 54 sex‐ and age‐matched patients from a dental health clinic. All participants completed a questionnaire and underwent dental clinical examinations, including laboratory analyses of saliva. The proportion of subjects with unstimulated salivary hyposalivation was lower in the ED group and not correlated with intake of xerogenic drugs. Significant differences in the biochemical composition of saliva were found almost exclusively in the unstimulated state, with albumin, inorganic phosphate, aspartate aminotransferase (ASAT), chloride, magnesium, and total protein all being significantly higher in the ED group. Conditional logistic regression showed that higher ASAT and total protein concentrations were relatively good predictors of ED, with sensitivity and specificity of 65% and 67%, respectively. In conclusion, elevated salivary concentrations of ASAT and total protein may serve as indicators of ED as well as of disease severity. Future studies are needed to corroborate these initial findings.
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Affiliation(s)
- Ann-Katrin Johansson
- Department of Clinical Dentistry - Cariology, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Bowden DJ, Kilburn-Toppin F, Scoffings DJ. Radiology of eating disorders: a pictorial review. Radiographics 2013; 33:1171-93. [PMID: 23842978 DOI: 10.1148/rg.334125160] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Eating disorders are a major challenge for health professionals, with many patients receiving ineffective care due to underdiagnosis or poor compliance with treatment. The incidence of eating disorders is increasing worldwide, producing an increasing burden on healthcare systems, and they most often affect young patients, with significant long-term complications. The effects of long-term malnutrition manifest in almost every organ system, and many can be detected radiologically, even without overt clinical findings. Musculoskeletal complications including osteoporosis result in a high incidence of insufficiency fractures, with long-term implications for bone health and growth, while respiratory complications are often recognized late due to disordered physiologic responses to infection. Gastrointestinal complications are numerous and in extreme cases may result in fatal outcomes after acute gastric dilatation and rupture subsequent to binge eating. In patients with severely disordered eating, in particular anorexia nervosa, marked derangement of electrolyte levels may result in refeeding syndrome, which requires emergent management. Recognition of such complications is critical to effective patient care and requires radiologists to be aware of the spectrum of imaging abnormalities that may be seen. Since many patients are reluctant to disclose their underlying condition, radiologists also play a critical role in identifying previously undiagnosed eating disorders.
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Affiliation(s)
- David J Bowden
- Department of Radiology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Rd, Cambridge CB2 0QQ, England.
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Serum amylase in bulimia nervosa and purging disorder: differentiating the association with binge eating versus purging behavior. Physiol Behav 2011; 104:684-6. [PMID: 21781981 DOI: 10.1016/j.physbeh.2011.06.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 06/27/2011] [Accepted: 06/28/2011] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Elevated serum amylase levels in bulimia nervosa (BN), associated with increased salivary gland size and self-induced vomiting in some patients, provide a possible marker of symptom severity. The goal of this study was to assess whether serum hyperamylasemia in BN is more closely associated with binge eating episodes involving consumption of large amounts of food or with purging behavior. METHOD Participants included women with BN (n=26); women with "purging disorder" (PD), a subtype of EDNOS characterized by recurrent purging in the absence of objectively large binge eating episodes (n=14); and healthy non-eating disorder female controls (n=32). There were no significant differences in age or body mass index (BMI) across groups. The clinical groups reported similar frequency of self-induced vomiting behavior and were free of psychotropic medications. Serum samples were obtained after overnight fast and were assayed for alpha-amylase by enzymatic method. RESULTS Serum amylase levels were significantly elevated in BN (60.7±25.4 international units [IU]/liter, mean±sd) in comparison to PD (44.7±17.1 IU/L, p<.02) and to Controls (49.3±15.8, p<.05). CONCLUSION These findings provide evidence to suggest that it is recurrent binge eating involving large amounts of food, rather than self-induced vomiting, which contributes to elevated serum amylase values in BN.
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Gwee K, Teh A, Huang C. Acute superior mesenteric artery syndrome and pancreatitis in anorexia nervosa. Australas Psychiatry 2010; 18:523-6. [PMID: 20932197 DOI: 10.3109/10398562.2010.498885] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this paper is to describe the presentation and clinical management of a patient with anorexia nervosa complicated by superior mesenteric artery syndrome and pancreatitis, and discuss the association between these conditions. METHOD We present a case report and briefly review the relevant literature. RESULTS A 17-year-old girl with undiagnosed anorexia nervosa presented acutely with abdominal symptoms and vomiting. After numerous investigations, she was diagnosed with the rare condition of superior mesenteric artery syndrome and pancreatitis, leading to a prolonged hospital admission and management on both an acute medical/surgical ward and an eating disorders unit. CONCLUSIONS Anorexia nervosa has been associated with superior mesenteric artery syndrome and pancreatitis. Clinical awareness of these conditions can result in prompt diagnosis and optimal management of these patients.
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Affiliation(s)
- Karen Gwee
- Eating Disorders Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia
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Lundgren JD, Williams KB, Heitmann BL. Nocturnal eating predicts tooth loss among adults: results from the Danish MONICA study. Eat Behav 2010; 11:170-4. [PMID: 20434064 DOI: 10.1016/j.eatbeh.2010.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 02/02/2010] [Accepted: 02/19/2010] [Indexed: 10/19/2022]
Abstract
The relationship between nocturnal eating, such as that associated with night eating syndrome (NES), and oral health is unknown. This study sought to determine if nocturnal eating is related to tooth loss in a large, epidemiologic sample. Danes (N=2217; age range 30-60 years, M BMI [kg/m(2)]=25.9, % Male=50.1) enrolled in the Danish MONICA (MONItoring trends and determinants of CArdiovascular disease) were assessed on oral health, eating behavior, anthropometrics, general health, and demographic characteristics in both 1987/88 and 1993/94. We hypothesized that nocturnal eating at time one (1987/88) predicts number of missing teeth at time two (1993/94), when controlling for age, education, smoking status, body mass, carbohydrate intake, binge eating behavior, and diabetes diagnosis. A negative binomial model predicting number of missing teeth from nocturnal eating while controlling for covariates was conducted. Expected change in log count of missing teeth was significantly less for non-night eaters (p=.009), non-smokers (p=.001), non-diabetics (p=.001) and for each successive younger age group (p=.0001). Additionally, expected increase in log count of missing teeth was significantly greater for individuals with less than "high school diploma" education compared to those with the highest level of education (p=.0001). In sum, nocturnal eating contributes to tooth loss. Treatment providers should encourage good oral health care practices to reduce the risk of tooth loss associated with nocturnal eating.
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Affiliation(s)
- Jennifer D Lundgren
- Department of Psychology, University of Missouri-Kansas City, 4825 Troost Avenue, Ste. 124, Kansas City, MO 64110, United States.
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Price C, Schmidt MA, Adam EJ, Lacey H. Parotid gland enlargement in eating disorders: an insensitive sign? Eat Weight Disord 2008; 13:e79-83. [PMID: 19169067 DOI: 10.1007/bf03327509] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To study, using magnetic resonance imaging (MRI), the parotid glands of patients who self-induce vomiting and in particular to observe the effects of cessation of this behaviour. The morphological features and composition of enlarged parotid glands in this group, compared with normal controls, were also examined. METHOD MRI scans of the parotid glands were performed on 5 controls and 5 subjects with a purging form of eating disorder, at cessation of vomiting and 6 to 9 weeks later. RESULTS Parotid volumes are accurately measured using MRI. Enlarged parotids are not a consistent feature of subjects with eating disorders who self-induce vomiting. CONCLUSION Absence of salivary gland enlargement does not exclude significant vomiting behaviour and clinicians should remain alert to the possibility of undisclosed vomiting.
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Affiliation(s)
- C Price
- St. George's University of London, London, London, UK
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Dynesen AW, Bardow A, Petersson B, Nielsen LR, Nauntofte B. Salivary changes and dental erosion in bulimia nervosa. ACTA ACUST UNITED AC 2008; 106:696-707. [DOI: 10.1016/j.tripleo.2008.07.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Revised: 07/01/2008] [Accepted: 07/07/2008] [Indexed: 10/21/2022]
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Bozzato A, Burger P, Zenk J, Uter W, Iro H. Salivary gland biometry in female patients with eating disorders. Eur Arch Otorhinolaryngol 2008; 265:1095-102. [DOI: 10.1007/s00405-008-0598-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Accepted: 01/21/2008] [Indexed: 10/22/2022]
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Schmidt MA, Fraser KM. Two-point dixon fat–water separation: Improving reliability and accuracy in phase correction algorithms. J Magn Reson Imaging 2008; 27:1122-9. [DOI: 10.1002/jmri.21310] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Stimec B, Nikolic S, Rakocevic Z, Bulajic M. Symmetry of the submandibular glands in humans—a postmortem study assessing the linear morphometric parameters. ACTA ACUST UNITED AC 2006; 102:391-4. [PMID: 16920548 DOI: 10.1016/j.tripleo.2005.10.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Revised: 10/16/2005] [Accepted: 10/19/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND The analysis of morphometric right-left symmetry of the salivary glands is important for assessing unilateral changes discovered in these organs during diagnostic imaging. STUDY DESIGN A study was carried out on 18 adult human autopsy neck and maxillofacial specimens from both sexes (14 males, 4 females), with age range of 17 to 73 years (mean age 49.9 years). The submandibular duct was injected with contrast medium and images were made in two projection planes. RESULTS Morphometry performed using the obtained radiographs included: (a) caliber (mean proximal, middle, and distal = 1.73 mm, 1.82 mm, and 1.77 mm), (b) length (mean = 37.2 mm); (c) genu of the submandibular duct (mean = 114 degrees ); and (d) longitudinal and transverse diameters of the gland (mean = 44.1 mm and 25.9 mm). Comparison of these morphometric parameters between the right and the left glands revealed no statistically significant differences. CONCLUSION There is a high level of right-left symmetry in linear morphometric parameters of the submandibular gland.
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Affiliation(s)
- Bojan Stimec
- Institute for Anatomy, School of Medicine, University of Belgrade, Belgrade, Serbia and Montenegro.
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Schlienger JL, Luca F, Vinzio S. Pseudosyndrome de Gougerot-Sjögren et boulimie. Rev Med Interne 2006; 27:717-8. [PMID: 16766091 DOI: 10.1016/j.revmed.2006.04.010] [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: 02/10/2006] [Accepted: 04/28/2006] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Bilateral parotid enlargement are presenting features of some metabolic and systemic disease but also of chronic emesis. CASE RECORD A 24-year old woman consulted during three years many physicians asking for the treatment of a painless parotid swelling confusing with a Sjogren's syndrome. After an initial denial, the weight history, alteration of tooth wear and hypokaliemia conducted to admit a self inducing vomiting with bulimia nervosa. CONCLUSION Gender, young age, weight history, tooth alteration and electrolytic disorders are the main diagnostic tool of this dissimulated etiology of parotid swelling.
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Affiliation(s)
- J-L Schlienger
- Service de Médecine Interne et de Nutrition, Hôpital de Hautepierre, 67098 Strasbourg Cedex, France.
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Tanaka M, Nakahara T, Muranaga T, Kojima S, Yasuhara D, Ueno H, Nakazato M, Inui A. Ghrelin concentrations and cardiac vagal tone are decreased after pharmacologic and cognitive-behavioral treatment in patients with bulimia nervosa. Horm Behav 2006; 50:261-5. [PMID: 16643914 DOI: 10.1016/j.yhbeh.2006.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Revised: 02/03/2006] [Accepted: 03/17/2006] [Indexed: 01/23/2023]
Abstract
Patients with bulimia nervosa (BN) have bulimic and depressive symptoms, which have been associated with abnormalities in the neuroendocrine and vagal systems. Subjects included twenty-four female drug-free outpatients with BN that were selected from patients seeking treatment for eating behavior in our hospital along with twenty-five age-matched healthy females who served as controls. We investigated ghrelin and leptin levels, cardiac vagal tone and sympathovagal balance, frequency of sets of binge-eating and vomiting episodes per week and the Profile of Mood States (POMS) depression scale in BN before and after a 16-week administration of the serotonin selective reuptake inhibitor (SSRI) paroxetine combined with cognitive-behavioral therapy. Compared to controls, the BN group had higher ghrelin levels and resting cardiac vagal tone, and lower leptin levels and resting cardiac sympathovagal balance before treatment, although there was a significant difference between the two groups for the body mass index (BMI). The elevated ghrelin levels (301.7 +/- 18.9 pmol/l, mean +/- SEM vs. 202.8 +/- 15.6 pmol/l, P < 0.01), cardiac vagal tone (2246.4 +/- 335.5 ms(2) vs. 1128.5 +/- 193.3 ms(2), P < 0.01), frequency of sets of binge-eating and purging episodes and T scores for the POMS depression scale were all significantly decreased after treatment despite similar BMI, percent body fat and leptin levels. In close association with cardiac vagal function and ghrelin recoveries, abnormal eating behavior and depressive symptoms improved, indicating the usefulness of these indexes in the assessment of clinical condition and therapeutic efficacy in BN.
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Affiliation(s)
- Muneki Tanaka
- Department of Psychosomatic Medicine, Respiratory and Stress Care Center, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
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Abstract
This article is a review of the recent literature pertaining to the oral sequelae of eating disorders (EDs). Dentists are recognized as being some of the first health care professionals to whom a previously undiagnosed eating disorder patient (EDP) may present. However, despite the prevalence (up to 4 per cent) of such conditions in teenage girls and young adult females, there is relatively little published in the recent literature regarding the oral sequelae of EDs. This compares unfavourably with the attention given recently in the dental literature to conditions such as diabetes mellitus, which have a similar prevalence in the adult population. The incidence of EDs is increasing and it would be expected that dentists who treat patients in the affected age groups would encounter more individuals exhibiting EDs. Most of the reports in the literature concentrate on the obvious clinical features of dental destruction (perimolysis), parotid swelling and biochemical abnormalities particularly related to salivary and pancreatic amylase. However, there is no consistency in explanation of the oral phenomena and epiphenomena seen in EDs. Many EDPs are nutritionally challenged; there is a relative lack of information pertaining to non-dental, oral lesions associated with nutritional deficiencies.
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Affiliation(s)
- A M Frydrych
- School of Dentistry, The University of Western Australia, Nedlands.
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Tanaka M, Naruo T, Nagai N, Kuroki N, Shiiya T, Nakazato M, Matsukura S, Nozoe SI. Habitual binge/purge behavior influences circulating ghrelin levels in eating disorders. J Psychiatr Res 2003; 37:17-22. [PMID: 12482466 DOI: 10.1016/s0022-3956(02)00067-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Previous studies have reported that fasting plasma ghrelin concentrations play an important role in the pathophysiology of eating disorders. The purpose of this study was to examine the relationship between plasma ghrelin levels and frequency of abnormal eating behaviors, nutritional parameters in eating disorders. Fasting blood samples were obtained in 40 female anorexia nervosa (AN) patients, 21 restricting type (AN-R) and 19 binge-eating/purging type (AN-BP), in 31 bulimia nervosa (BN) patients, 18 purging type (BN-P) and 13 non-purging type (BN-NP), in 15 female healthy volunteers (control) before the initiation of active treatment. The fasting plasma ghrelin concentrations in all subjects were negatively correlated with nutritional parameters such as body mass index, percent body fat and serum cholinesterase concentration. The mean plasma ghrelin level in BN-P was higher than that in both BN-NP and controls despite similar nutritional parameters. The plasma ghrelin levels in both AN-R and AN-BP did not differ from BN-P despite difference of nutritional parameters. For both AN-BP and BN-P patients with habitual binge/purge behavior, there were significant correlations among plasma ghrelin values, frequencies of binge/purge cycles and serum amylase values. In BN-NP, there were no significant correlations among plasma ghrelin values, frequencies of binge-eating episodes and serum amylase values. These results suggest that habitual binge/purge behavior may have some influence on circulating plasma ghrelin levels in both BN-P and AN-BP. Habitual binge/purge cycles with vomiting as opposed to binge-eating episodes without vomiting may have a greater influence on fasting plasma ghrelin concentration in eating disorders.
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Affiliation(s)
- Muneki Tanaka
- Department of Psychosomatic Medicine, Kagoshima University Hospital, Faculty of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima-City 890-8520, Kagoshima, Japan.
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Mandel L, Surattanont F. Bilateral parotid swelling: a review. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:221-37. [PMID: 11925529 DOI: 10.1067/moe.2002.121163] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Louis Mandel
- Salivary Gland Center, Columbia University School of Dental and Oral Surgery, New York-Presbyterian Hospital, Columbia Campus, New York, NY 10032, USA
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Little JW. Eating disorders: dental implications. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:138-43. [PMID: 11862200 DOI: 10.1067/moe.2002.116598] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article presents updated information on the 2 major eating disorders, anorexia nervosa and bulimia nervosa. Both conditions are found primarily in women. The eating disorders have significant morbidity and mortality associated with them. Patients are vulnerable to sudden death from cardiac arrhythmias. Suicide is a concern in some patients. The etiology of the eating disorders is unknown, but genetic, cultural, and psychiatric factors appear to play a role. Medical management may involve hospitalization to stabilize the patient, behavior modification, drugs, and psychotherapy. The long-term outcome of treatment is unclear at this time. The role of the dentist as a "case finder" is discussed. Also, the role of the dentist in restoring the dental and oral tissues to a healthy state in patients with eating disorders is presented.
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Pilar Burkhardt Pérez M, Ruiz Villaverde R, Blasco Melguizo J, Naranjo Sintes R, Luis Martín Ruiz J. Respuesta de la hiperamilasemia dosis-dependiente tras un tratamiento con etretinato. ACTAS DERMO-SIFILIOGRAFICAS 2002. [DOI: 10.1016/s0001-7310(02)76644-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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