Clinical Manifestations of Hypokalemia in Eating Disorders

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.

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Tokophobia: An Unsolved Dread of Childbirth

International Journal of Pharmaceutical Sciences Review and Research ◽

10.47583/ijpsrr.2021.v69i02.021 ◽

2021 ◽

Vol 69 (2) ◽

Author(s):

Sugreev Dwivedi Anuj ◽

Prity Raj Sinha ◽

Bhaskar Jyoti Borah ◽

Rahul Raj

Keyword(s):

Eating Disorders ◽

Psychiatric Disorder ◽

Clinical Manifestations ◽

Fear Of Childbirth ◽

Pregnancy And Childbirth ◽

The Relationship

Pregnancy is a life-changing event for every woman in her lifetime. In many women, due to various factors like psychology, environment, social, and etc., certain unwanted clinical manifestations arise which further develops into fear of pregnancy and childbirth. When a psychiatric disorder is associated with or exacerbated by breastfeeding, the topic requires expert experiences from several areas in medicine. This essay examines the relationship between pregnancy, depression, eating disorders, and irrational fear of childbirth, known altogether as tokophobia. Although literature in this area is scarce, an attempt is made to collect what is available and compile them together.

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Immunopathogenesis of cow’s milk allergy

Paediatrica Indonesiana ◽

10.14238/pi43.4.2003.111-6 ◽

2016 ◽

Vol 43 (4) ◽

pp. 111

Author(s):

Ariyanto Harsono

Keyword(s):

Eating Disorders ◽

Clinical Manifestations ◽

Psychosocial Problems ◽

Final Diagnosis ◽

Cow’S Milk Allergy ◽

Cow’S Milk ◽

Milk Allergy ◽

Cow's Milk ◽

Family Disruption ◽

Cow's Milk Allergy

Given the public’s increasing awareness of cow’smilk allergy and their frequent misperception thatvarious illness is caused by cow’s milk-induced aller-gic reactions, the physician must retain some skepti-cism throughout the evaluation and rely on objectivemeasures to arrive at the final diagnosis. Over diag-nosis of cow’s milk allergy has led to malnutrition,eating disorders, and psychosocial problems, as wellas family disruption, whereas under diagnosis leavesthe patient suffering unnecessarily and may result ingrowth failure and permanent physical impairments.The following discussion provides an immunologicalbasis of cow’s milk allergy in an attempt to improveour understanding in clinical manifestations, diagno-sis and management of the disease.

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Prevalence and clinical manifestations of eating disorders in Austrian adolescents with type-1 diabetes

Wiener klinische Wochenschrift ◽

10.1007/bf03041052 ◽

2004 ◽

Vol 116 (7-8) ◽

pp. 230-234 ◽

Cited By ~ 28

Author(s):

Vasileia Grylli ◽

Andrea Hafferl-Gattermayer ◽

Edith Schober ◽

Andreas Karwautz

Keyword(s):

Eating Disorders ◽

Type 1 Diabetes ◽

Clinical Manifestations

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Depressions with eating disorders: clinical manifestations and therapy

Neurology neuropsychiatry Psychosomatics ◽

10.14412/2074-2711-2020-4-49-56 ◽

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.

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

10.21203/rs.3.rs-21795/v1 ◽

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.

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Anorexia nervosa and purgative-type bulimia nervosa: a fundamental role of the dental surgeon in diagnosis and treatment

MedNEXT Journal of Medical and Health Sciences ◽

10.54448/mdnt21510 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Ana Maria Martins ◽

Isabella Oliveira Rodrigues ◽

Patrícia Garani Fernandes

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Literature Review ◽

Bulimia Nervosa ◽

Clinical Manifestations ◽

Erosive Wear ◽

Diagnosis And Treatment ◽

Rehabilitative Treatment ◽

To Come ◽

Salivary Substitutes

Introduction: In a world where appearance is considered above all by most people. It is in this unbridled search that some people end up acquiring eating disorders. Anorexia nervosa and purgative-type bulimia nervosa are diseases that are rarely taken into account in the first clinical assessment of the patient. Bulimia nervosa and Anorexia nervosa are eating disorder that causes serious physiological problems in the oral cavity, due to saliva calcification caused by frequent vomiting. Objective: it was to bring into discussion, through a literature review, the meticulous look that the dental surgeon must-have when performing the clinical examination and that he can be the first source in detecting signs of eating disorders and their clinical manifestations in the patient and so can forwards it to a multidisciplinary team for better diagnosis and treatment. Methods: This study followed an integrated literature review model and articles dating from 2001 to 2021 in English and Portuguese were selected. In virtual databases such as Scielo and PubMed. Results and Conclusion: The dental surgeon plays an important role in the team, controlling the development and progression of oral manifestations. Pass the oral hygiene guidelines, apply substances that can control the acids that are present in oral fluids; use salivary substitutes that can help reduce erosive wear. And always encourage this patient to come back for treatment. In extreme cases of damage to the dental structure, functional and anatomical, restorative or rehabilitative treatment is chosen. Recover form, function, esthetics and eliminate hypersensitivity and facilitate cleaning. The dental surgeon must be able to assess and diagnose the manifestations arising from eating disorders. Because it is the first professional to be able to detect and thus refer to a team of multi-professionals such as a psychologist, nutritionist, doctor and manage to perform the best possible treatment simultaneously and, through preventive and rehabilitative procedures, be able to return a better quality of life to the patient.

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Morphologic alteration in the muscles of patients with hypokalemic periodic paralysis or myopathy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100158650 ◽

1990 ◽

Vol 48 (3) ◽

pp. 222-223

Author(s):

T. Shimizu ◽

Y. Muranaka ◽

I. Ohta ◽

N. Honda

Keyword(s):

Clinical Manifestations ◽

Quadriceps Muscle ◽

Honeycomb Structure ◽

Periodic Paralysis ◽

Ultrastructural Changes ◽

Hypokalemic Periodic Paralysis ◽

Electron Microscopic ◽

Tubular Aggregates ◽

Hypokalemic Myopathy ◽

Transmission Electron

There have been many reports on ultrastructural alterations in muscles of hypokalemic periodic paralysis (hpp) and hypokalemic myopathy(hm). It is stressed in those reports that tubular structures such as tubular aggregates are usually to be found in hpp as a characteristic feature, but not in hm. We analyzed the histological differences between hpp and hm, comparing their clinical manifestations and morphologic changes in muscles. Materials analyzed were biopsied muscles from 18 patients which showed muscular symptoms due to hypokalemia. The muscle specimens were obtained by means of biopsy from quadriceps muscle and fixed with 2% glutaraldehyde (pH 7.4) and analyzed by ordinary method and modified Golgimethod. The ultrathin section were examined in JEOL 200CX transmission electron microscopy.Electron microscopic examinations disclosed dilated t-system and terminal cistern of sarcoplasmic reticulum (SR)(Fig 1), and an unique structure like “sixad” was occasionally observed in some specimens (Fig 2). Tubular aggregates (Fig 3) and honeycomb structure (Fig 4) were also common characteristic structures in all cases. These ultrastructural changes were common in both the hypokalemic periodic paralysis and the hypokalemic myopathy, regardless of the time of biopsy or the duration of hypokalemia suffered.

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