scholarly journals Depressions with eating disorders: clinical manifestations and therapy

2020 ◽  
Vol 12 (4) ◽  
pp. 49-56
Author(s):  
V. E. Medvedev ◽  
V. I. Frolova ◽  
E. V. Gushanskaya ◽  
Yu. S. Fofanova ◽  
S. E. Martynov ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Depressive Symptom ◽  
Rating Scale ◽  
Clinical Manifestations ◽  
Antidepressant Effect ◽  
Therapy Discontinuation ◽  
Comorbid Diagnosis ◽  
Clinical Presentations ◽  
Pathogenetic Therapy ◽  
Symptom Complex

Depression is a common comorbid diagnosis in patients with eating disorders (EDs). The development of pathogenetic therapy for depression with EDs is far from being completed.The objective of the psychopharmacotherapeutic study was to evaluate the efficacy and tolerability of melatonergic monotherapy with the antidepressant agomelatine (25–50 mg/day at night) for depressions with two ED variants: hyperphagic (n=32) and hypo- and aphagic (n=31) EDs.Patients and methods. The investigation enrolled patients of both sexes, aged 18 to 65 years. The investigators performed clinical psychopathological and experimental psychological studies, as well as psychometric examination using the 21-item Hamilton Depression Rating Scale (HDRS-21), the Clinical Global Impression (CGI), the Supplemental Hospital Offset Payment Program (SHOPP), the Dutch Eating Behavior Questionnaire (DEBQ), and statistical data processing.Results and discussion. There was a significant pronounced antidepressant effect of 6-week agomelatine therapy for depressions occurring with different ED variants both in the pattern of the depressive symptom complex and in that of concurrent with and preceding the latter. At the same time, the efficacy of the drug did not depend on the clinical presentations of the leading hypothymic syndrome, the variants of EDs, and the duration of actual depression. However, by the end of the study period, a larger effect was achieved in the therapy for depressions with the hyperphagic variant of EDs, as well as in patients with EDs manifesting in the pattern of depressive symptom complex. Agomelatine has a favorable tolerance profile. BMI tends to become normal in patients with different variants of EDs during the therapy. The adverse events are transient and/or unclear; they do not require therapy discontinuation.Conclusion. Agomelatine is an effective and relatively safe drug that can be recommended to treat depressions concurrent with EDs in therapeutic dosages for at least 6 weeks.

scholarly journals Relationship between neuropsychology, clinical traits, psychopathology and attitudes towards change in eating disorders

2020 ◽  
Author(s):  
Beatriz Mata-Saenz ◽  
Teresa Rodríguez-Cano ◽  
Victoria Eugenia Muñoz-Martínez ◽  
Luis Beato-Fernández
Keyword(s):  
Working Memory ◽  
Eating Disorders ◽  
Neuropsychological Tests ◽  
Rating Scale ◽  
Clinical Manifestations ◽  
Self Report ◽  
Psychiatric Status ◽  
Complex Figure ◽  
Quantitative Score ◽  
Figure Test

Abstract Background:Recent models try to find in eating disorders (ED) a relationship between the neuropsychological dimensions, the psychopathological disturbances and the clinical manifestations. Carrying out an investigation on neuropsychological aspects that may be related with an ED’s characteristic cognitive pattern could contribute to their possible influence towards therapeutic change. The main objective of this paper is to analyse the possible relationship between psychopathological and clinical variables with the neuropsychological characteristics of patients diagnosed with an ED and their possible influence on the attitude towards change. Methods:An observational analytical transversal study was done. Patients were outpatients referred during a 6-month period who signed informed consent. Seventy-four subjects were included. Clinical (Psychiatric Status Rating Scale modified) and neuropsychological tests (Letter Number Sequencing; Stroop’s test; Symbol and Digit Modalities Test; Rey-Osterrieth complex figure test) were administrated and psychopathological self-report questionnaires (Body Shape Questionnaire; Eating Disorders Inventory; The Bulimic Investigatory Test, Edinburgh; Beck’s depression inventory; State-Trait Anxiety Inventory; Dissociative Experiences Scale; Attitudes Towards Change in Eating Disorders Scale) were given (but 23 participants, 31.08%, did not give them back).Results:Nineteen patients (25,68%) were diagnosed with restrictive anorexia nervosa (AN), 19 (25,68%) purgative AN, 14 bulimia nervosa (18,92%), 9 binge eating disorder (12,16%) and 13 ED not otherwise specified (17,57%). There are not any significant differences between the diagnoses with regards to the score of neuropsychological tests. BMI was related to the majority of the neuropsychological scores. “Precontemplation” was related to time of copy (B=3.56; IC 95% (0.82-6.29), p<0,01) and time of memory (B=-2.31; IC 95% (-4.58-(-0.05)); p<0.05). “Contemplation” was related to time of copy (B=1.43; IC 95% (0.42-2.45); p<0.01) and index of style (B= -14.01; IC 95% (-24.98-(-3.04)); p<0.01). “Decision” was related to working memory (SpanLN), quantitative score of copy, index of order and index of style.Conclusions:Neuropsychological alterations could be summarized as the working memory is lowered and the interference is increased, which is associated with a more controlling and less flexible attitude, and scores in inhibitory care are lower. ROCFT shows a visoperceptive deficit in some patients.

Pathogenetic Therapy of Patients with Recurrent Genital Herpes

2020 ◽  
Vol 65 (5-6) ◽  
pp. 30-34
Author(s):  
L. L. Logvina ◽  
D. N. Bayram ◽  
Z. A. Kambachokova ◽  
F. V. Shavaeva ◽  
Z. S. Krymshokalova ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Blood Plasma ◽  
Genital Herpes ◽  
Antioxidant Defense ◽  
Clinical Manifestations ◽  
Complex Treatment ◽  
Herpesvirus Infection ◽  
Recurrent Genital Herpes ◽  
Complex Therapy ◽  
Pathogenetic Therapy

Evaluation of the effectiveness of aminophthalhydroside in the complex treatment of patients with recurrent genital herpes was carried out. The efficacy of the drug was assessed by clinical, biochemical, and immunological criteria. The inclusion of aminophthalhydrazide in the complex therapy of patients with recurrent herpesvirus infection led to an earlier relief of clinical manifestations of the disease, an increase in the relapse period, a decrease in lipid peroxidation products in the blood plasma, an increase in the content of antioxidant defense components, and correction of immunological disorders.

scholarly journals Clinical presentations and long term prognosis of childhood onset polyarteritis nodosa in single centre of Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Seon Lee ◽  
Joong-Gon Kim ◽  
Soyoung Lee
Keyword(s):  
Polyarteritis Nodosa ◽  
Clinical Manifestations ◽  
Long Term Outcomes ◽  
Childhood Onset ◽  
Laboratory Findings ◽  
Clinical Presentations ◽  
Long Term Prognosis ◽  
Digital Amputation

AbstractChildhood-onset polyarteritis nodosa (PAN) is a rare and systemic necrotising vasculitis in children affecting small- to medium-sized arteries. To date, there have been only a few reports because of its rarity. Thus, we aimed to investigate the clinical manifestations, laboratory findings, treatment, and long-term outcomes in patients with childhood-onset PAN and to evaluate the usefulness of the paediatric vasculitis activity score (PVAS). We retrospectively analysed the data of nine patients with childhood-onset PAN from March 2003 to February 2020. The median ages at symptom onset, diagnosis, and follow-up duration were 7.6 (3–17.5), 7.7 (3.5–17.6), and 7.0 (1.6–16.3) years, respectively. All patients had constitutional symptoms and skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. The median PVAS at diagnosis was 7 (range: 2–32). Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived, but three patients with high PVAS at diagnosis experienced irreversible sequelae, including intracranial haemorrhage and digital amputation. In conclusion, early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. This study suggests that high PVAS score at diagnosis may be associated with poor prognosis.

scholarly journals Autoimmune encephalitis in a South Asian population

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nilanka Wickramasinghe ◽  
Dhanushka Dasanayake ◽  
Neelika Malavige ◽  
Rajiva de Silva ◽  
Thashi Chang
Keyword(s):  
Sri Lanka ◽  
Psychiatric Symptoms ◽  
South Asians ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Autoimmune Encephalitis ◽  
Asian Population ◽  
South Asian Population ◽  
Clinical Presentations

Abstract Background Autoimmune encephalitis (AE) is now considered a main, potentially curable cause of encephalitis, but remains conspicuously underreported from South Asia. We studied the clinical characteristics in relation to their antibody status and outcomes of patients presenting with AE in Sri Lanka. Methods Patients admitting to government hospitals who were clinically suspected of AE by an on-site neurologist were prospectively recruited over a period of 12 months. Sera and cerebrospinal fluid were tested for NMDAR, AMPAR1, AMPAR2, LGI1, CASPR2, GABARB1/B2 antibodies (Ab) using commercial cell-based assays. Demographic, clinical and laboratory data were compiled into an investigator-administered proforma. Patients were reviewed at 1 year follow up either in person or via telephone. Results One-hundred and forty-two patients from 21 of 25 districts in Sri Lanka (median age = 20.5 years; range 1–86 years; females = 61.3%) were recruited. Of them, 65 (45.8%; median age = 19 years; range 1–86 years; females = 64.6%) fulfilled diagnostic criteria for probable NMDAR-antibody encephalitis (NMDARE) and 6 (4.2%; median age = 44 years; range 28–71 years; females = 83.3%) limbic encephalitis (LE). Abnormal behaviour (95.3%), seizures (81.5%) and movement disorders (69.2%) were the most frequent clinical manifestations of probable NMDARE. NMDAR-antibodies were detectable in 29 (44.6%) and not detectable in 36 in CSF of probable-NMDARE patients. Abnormal EEG was more frequent (p = 0.003) while a worse outcome (OR = 2.78; 95% CI = 0.88–9.09) and deaths (OR = 2.38; 95% CI = 0.67–8.33) were more likely in antibody-negative than antibody-positive probable-NMDARE. Most patients with LE had amnesia (50%) and/or confusion (100%) with agitation (83.3%) and seizures (100%) but none had detectable antibodies to any of the antigens tested. Conclusions NMDARE is the commonest type of AE among South Asians as is the case worldwide. Clinical presentations of NMDARAb-positive and NMDARAb-negative AE patients do not significantly differ but EEG may be a useful marker of an autoimmune basis for psychiatric symptoms.

scholarly journals Restrained eating in Lebanese adolescents: scale validation and correlates

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tracy Boulos Nakhoul ◽  
Anthony Mina ◽  
Michel Soufia ◽  
Sahar Obeid ◽  
Souheil Hallit
Keyword(s):  
Body Mass Index ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Body Dissatisfaction ◽  
Body Mass ◽  
Rating Scale ◽  
Activity Index ◽  
Arab Countries ◽  
Restrained Eating ◽  
Distress Scale

Abstract Background Restrained eating disorder is prevalent worldwide across both ethnic and different cultural groups, and most importantly within the adolescent population. Additionally, comorbidities of restrained eating present a large burden on both physical and mental health of individuals. Moreover, literature is relatively scarce in Arab countries regarding eating disorders, let alone restrained eating, and among adolescent populations; hence, the aim of this study was to (1) validate the Dutch Restrained Eating Scale in a sample of Lebanese adolescents and (2) assess factors correlated with restrained eating (RE), while taking body dissatisfaction as a moderator between body mass index (BMI) and RE. Methods This cross-sectional study, conducted between May and June 2020 during the lockdown period imposed by the Lebanese government, included 614 adolescents aged between 15 and 18 years from all Lebanese governorates (mean age of 16.66 ± 1.01 years). The scales used were: Dutch Restrained Eating Scale, body dissatisfaction subscale of the Eating Disorder Inventory-Second version, Rosenberg Self-Esteem Scale, Beirut Distress Scale (for psychological distress), Hamilton Anxiety Rating Scale and Patient Health Questionnaire (for depression). Results The factor analysis yielded a one-factor solution with Eigen values > 1 (variance explained = 59.65 %; αCronbach = 0.924). Female gender (B = 0.19), higher BMI (B = 0.49), higher physical activity index (B = 0.17), following a diet to lose weight (B = 0.26), starving oneself to lose weight (B = 0.13), more body dissatisfaction (B = 1.09), and higher stress (B = 0.18) were significantly associated with more RE, whereas taking medications to lose weight (B=-0.10) was significantly associated with less RE. The interaction body mass index (BMI) by body dissatisfaction was significantly associated with RE; in the group with low BMI, higher body dissatisfaction was significantly associated with more RE. Conclusions Our study showed that the Dutch Restrained Eating scale is an adapted and validated tool to be used among Lebanese adolescents and revealed factors associated with restrained eating in this population. Since restrained eating has been associated with many clinically-diagnosed eating disorders, the results of this study might serve as a first step towards the development of prevention strategies targeted towards promoting a healthy lifestyle in Lebanese adolescents.

Leptin Functioning in Eating Disorders

CNS Spectrums ◽  
2004 ◽  
Vol 9 (7) ◽  
pp. 523-529 ◽  
Author(s):  
Palmiero Monteleone ◽  
Antonio DiLieto ◽  
Eloisa Castaldo ◽  
Mario Maj
Keyword(s):  
Physical Activity ◽  
Eating Disorders ◽  
Body Weight ◽  
Eating Behaviors ◽  
Clinical Manifestations ◽  
Immune Functions ◽  
Abnormal Eating ◽  
The Brain

AbstractLeptin is an adipocyte-derived hormone, which is involved predominantly in the long-term regulation of body weight and energy balance by acting as a hunger suppressant signal to the brain. Leptin is also involved in the modulation of reproduction, immune function, physical activity, and some endogenous endocrine axes. Since anorexia nervosa (AN) and bulimia nervosa (BN) are characterized by abnormal eating behaviors, dysregulation of endogenous endocrine axes, alterations of reproductive and immune functions, and increased physical activity, extensive research has been carried out in the last decade in order to ascertain a role of this hormone in the pathophysiology of these syndromes. In this article, we review the available data on leptin physiology in patients with eating disorders. These data support the idea that leptin is not directly involved in the etiology of AN or BN. However, malnutrition-induced alterations in its physiology may contribute to the genesis and/or the maintenance of some clinical manifestations of AN and BN and may have an impact on the prognosis of AN.

scholarly journals Toxoplasmosis Outbreak Associated With Toxoplasma gondii-Contaminated Venison—High Attack Rate, Unusual Clinical Presentation, and Atypical Genotype

2020 ◽  
Author(s):  
Amy C Schumacher ◽  
Lina I Elbadawi ◽  
Traci DeSalvo ◽  
Anne Straily ◽  
Daniel Ajzenberg ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Wisconsin Department ◽  
Department Of Health ◽  
Clinical Presentations ◽  
Infection Source ◽  
Polymerase Chain ◽  
Acute Toxoplasmosis ◽  
Prior Infection

Abstract Background During 2017, in response to a physician’s report, the Wisconsin Department of Health Services, Division of Public Health, began investigating an outbreak of febrile illness among attendees of a retreat where never frozen, intentionally undercooked, locally harvested venison was served. Preliminary testing tentatively identified the illness as toxoplasmosis. Methods Confirmatory human serology panels and testing of the venison to confirm and categorize the presence and type of Toxoplasma gondii were completed by French and American national reference laboratories. All 12 retreat attendees were interviewed; medical records were reviewed. Results All attendees were male; median age was 51 years (range: 22–75). After a median incubation period of 7 days, 9 (82%) of 11 exposed persons experienced illness lasting a median of 12 days. All 9 sought outpatient healthcare for symptoms including fever, chills, sweats, and headache (100%) and ocular disturbances (33%). Testing confirmed the illness as toxoplasmosis and venison as the infection source. Multiple laboratory results were atypical for toxoplasmosis, including transaminitis (86%), lymphocytopenia (88%), thrombocytopenia (38%), and leukopenia (63%). One exposed but asymptomatic person was seronegative; the other had immunity from prior infection. The T. gondii strain was identified as closely related to an atypical genotype (haplogroup 12, polymerase chain reaction restriction fragment length polymorphism genotype 5) common in North American wildlife but with previously uncharacterized human clinical manifestations. Conclusions The T. gondii strain contaminating the venison might explain the unusual clinical presentations. In North America, clinicians and venison consumers should be aware of risk for severe or unusual presentations of acute toxoplasmosis after consuming undercooked game meat.

scholarly journals Coxitis in early axial spondyloarthritis

2019 ◽  
Vol 13 (4) ◽  
pp. 41-47 ◽  
Author(s):  
E. M. Agafonova ◽  
T. V. Dubinina ◽  
D. G. Rumyantseva ◽  
A. B. Demina ◽  
A. V. Smirnov ◽  
...  
Keyword(s):  
Disease Activity ◽  
Hip Joint ◽  
Joint Pain ◽  
Rating Scale ◽  
Axial Spondyloarthritis ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Joint Movement ◽  
Joint Injury

In Russia, coxitis is one of the most common extra-axial manifestations of ankylosing spondylitis (AS). However, many issues regarding its early diagnosis remain unresolved.Objective: to compare the clinical manifestations of coxitis with the data from an instrumental examination of CoRSAR cohort (Cohort of Early Axial Spondyloarthritis) patients.Patients and methods. Examinations were made in 175 patients (mean age, 28.2±5.7 years) diagnosed as having axial spondyloarthritis (axSpA) with inflammatory back pain lasting up to 5 years, which occurred at the age of ≤45 years. There was non-radiographic axSpA (nraxSpA) in 69 patients and AS in 106 patients. 87% of patients were HLA-B27-positive. The median disease duration was 23.8 [1–60] months; BASDAI was 3.3±1.94. Regardless of complaints, all the patients underwent hip X-ray and ultrasound studies and 54 more patients had magnetic resonance imaging (MRI).Results and discussion. The clinical signs of coxitis were present in 95 (54%) patients, of them 60% were diagnosed with AS and 40% had nraxSpA. According to the numerical pain rating scale (NPRS), the median hip joint pain was 4 [3; 7]. Limited joint movement was observed in 6 (3.4%) patients. The level of hip joint pain correlated with BASDAI (r=0.53) and ASDAS (r=0.30). The ultrasound signs of coxitis were detected in 42 (24%) patients; of them 26 (62%) had the clinical manifestations of hip joint injury, and such changes were absent in 16 patients. The patients with ultrasound signs of coxitis were noted to have a higher disease activity; peripheral arthritis and enthesitis were more common. According to MRI, coxitis was diagnosed in 39 (72%) of the 54 examinees, while the disease was asymptomatic in 10%.Conclusion. Different diagnostic methods used in patients with early axSpA could reveal coxitis in 33% of cases. The patients with coxitis show higher laboratory disease activity than those without hip joint injury. It is necessary to include MRI and ultrasound in the mandatory examination of patients with axSpA.

scholarly journals Comparative Analysis of Pediatric COVID-19 Infection in Southeast Asia, South Asia, Japan, and China

2021 ◽  
Author(s):  
Judith Ju Ming Wong ◽  
Qalab Abbas ◽  
Soo Lin Chuah ◽  
Ririe Fachrina Malisie ◽  
Kah Min Pon ◽  
...  
Keyword(s):  
Risk Factors ◽  
South Asia ◽  
Cultural Practices ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
World Health ◽  
Logistic Regression Models ◽  
Clinical Presentations ◽  
The Common ◽  
Health Organization

There is a scarcity of data regarding coronavirus disease 2019 (COVID-19) infection in children from southeast and south Asia. This study aims to identify risk factors for severe COVID-19 disease among children in the region. This is an observational study of children with COVID-19 infection in hospitals contributing data to the Pediatric Acute and Critical Care COVID-19 Registry of Asia. Laboratory-confirmed COVID-19 cases were included in this registry. The primary outcome was severity of COVID-19 infection as defined by the World Health Organization (WHO) (mild, moderate, severe, or critical). Epidemiology, clinical and laboratory features, and outcomes of children with COVID-19 are described. Univariate and multivariable logistic regression models were used to identify risk factors for severe/critical disease. A total of 260 COVID-19 cases from eight hospitals across seven countries (China, Japan, Singapore, Malaysia, Indonesia, India, and Pakistan) were included. The common clinical manifestations were similar across countries: fever (64%), cough (39%), and coryza (23%). Approximately 40% of children were asymptomatic, and overall mortality was 2.3%, with all deaths reported from India and Pakistan. Using the multivariable model, the infant age group, presence of comorbidities, and cough on presentation were associated with severe/critical COVID-19. This epidemiological study of pediatric COVID-19 infection demonstrated similar clinical presentations of COVID-19 in children across Asia. Risk factors for severe disease in children were age younger than 12 months, presence of comorbidities, and cough at presentation. Further studies are needed to determine whether differences in mortality are the result of genetic factors, cultural practices, or environmental exposures.

Eating Disorders in Males

2017 ◽  
pp. 309-326
Author(s):  
Tiffany A. Brown ◽  
Scott Griffiths ◽  
Stuart B. Murray
Keyword(s):  
Eating Disorders ◽  
Clinical Practice ◽  
Clinical Treatment ◽  
Treatment Approaches ◽  
Clinical Presentations ◽  
Male Eating Disorders ◽  
Assessment Measures ◽  
Males With Eating Disorders

Eating disorders have been traditionally thought of as female disorders, with males representing a rare and atypical minority of presentations. As a result, males with eating disorders have been uniquely stigmatized. However, contemporary evidence has illustrated an increasing prevalence of male eating disorders, although males continue to be underrepresented in treatment studies and often go undetected in clinical practice. This chapter provides an overview of the prevalence of eating disorders in males, highlights distinct differences in clinical presentations, and provides recommendations for tailoring clinical treatment approaches. It also describes useful clinical resources related to males and eating disorders, including useful assessment measures and website resources.

Sign in / Sign up

Export Citation Format

Share Document