Background In light of growing concern over eating disorders among young athletes amid cultural and social pressures,this study aimed to assess the prevalence of orthorexia nervosa(ON)risk and evaluate body image perc...Background In light of growing concern over eating disorders among young athletes amid cultural and social pressures,this study aimed to assess the prevalence of orthorexia nervosa(ON)risk and evaluate body image perception and its predictive factors among young football players from Poland and Türkiye.Methods The study involved 171 players aged 15–18 years,recruited from football academies in Poland and Türkiye.The Polish and Turkish versions of the Body-Esteem Scale for Adolescents and Adults(BESAA)were administered to assess body image perception,while the Düsseldorf Orthorexia Scale(DOS)was used to measure ON risk.Anthropometric measurements were taken to calculate Body Mass Index(BMI),which was then referenced to centile charts to determine nutritional status.Results Results indicated that 13%of participants exhibited characteristics of ON,with an additional 26%classified as at elevated risk.Comparative analysis revealed no significant differences in ON prevalence between Polish and Turkish players(p=0.938)and no age-related differences(p=0.694).Among Polish players,a significant positive association emerged between BMI(relative to centile charts)and overall appearance evaluation(BE-Appearance)(p=0.008,partialη^(2)=0.10).This relationship was not observed in Turkish players.Moreover,analysis of ON risk predictors—including age,nationality,nutritional status,and body image—did not identify any single variable as a definitive predictor(all p-values>0.05),with a low predictive capacity(McFadden’s R^(2)=0.03).Conclusion The study revealed a significant risk of ON among young footballers with no clear predictors.展开更多
Adolescence is the age of all disturbances both physiological and psychological.This internal and external insight conflicts is often hard to be managed.Thus,some teens will be subjected to act more than others.They u...Adolescence is the age of all disturbances both physiological and psychological.This internal and external insight conflicts is often hard to be managed.Thus,some teens will be subjected to act more than others.They use their bodies to show deep suffering as well as confusion.Numerous pathological behaviors can appear due to this significant sensitiveness like escaping difficulties.One of the ways solving this hardness of understanding and resolving these disorders is the disturbance in the nutritional behavior.This paper would allow us to understand the subjective dimensions that incite acting by mental anorexia.We suggest that a lack in the reflexive function might be the main cause of the attitude.Thereby,teen’s mental anorexia would show mistreatment at early care,that would make them feel unable to be good mothers in the future.展开更多
Five new nervogenic acid derivatives（1-5） have been isolated from Liparis nervosa（Thunb.ex A.Murray） Lindl.Their structures were elucidated on the basis of extensive spectroscopic analysis,including 1D NMR,2D NMR,...Five new nervogenic acid derivatives（1-5） have been isolated from Liparis nervosa（Thunb.ex A.Murray） Lindl.Their structures were elucidated on the basis of extensive spectroscopic analysis,including 1D NMR,2D NMR,and HR-ESI-MS.展开更多
Three new pyrrolizidine alkaloids, nervosineⅦ（1）, nervosine Ⅷ（2） and nervosine IX （3） were isolated from the whole plant extract of Liparis nervosa. Their structures were elucidated by extensive spectroscopic ...Three new pyrrolizidine alkaloids, nervosineⅦ（1）, nervosine Ⅷ（2） and nervosine IX （3） were isolated from the whole plant extract of Liparis nervosa. Their structures were elucidated by extensive spectroscopic analyses （including 1 D, 2D NMR, and HR-ESI-MS） and chemical methods. Compounds 1-3 were evaluated for their cytotoxic activity against A549, MCF-7and H460 human cancer cell lines.展开更多
Objectives: To evaluate the long-term outcome of adolescents with anorexia nervosa and attempt to define prognostic factors for outcome. Methods: Transversal, descriptive epidemiological study with a strict methodolog...Objectives: To evaluate the long-term outcome of adolescents with anorexia nervosa and attempt to define prognostic factors for outcome. Methods: Transversal, descriptive epidemiological study with a strict methodology: minimum interval of 4 years since first admission, evaluation using clearly defined diagnostic criteria (EAT-40 self-evaluation, HSCL, global patient-driven self-evaluation and hetero evaluation: clinical interview and LECE). The 198 subjects are former adolescent anorexics treated at the Hôpital d’Enfants (Children’s Hospital) in Nancy (France). Results: Clinical evaluation of the 144 subjects traced showed positive outcome for 68.1%, intermediate outcome for 23.2% and poor outcome for 8.7%. 5 factors for a good prognosis were found (middle socioeconomic class of parents, no prior treatment, hospitalization > 1 month,展开更多
Orthorexia nervosa (ON) describes a fixation for proper nutrition and healthy foods that leads to die-tary restrictions and nutritional deficiencies over time. Given symptom overlap among ON, obsessive-compulsive diso...Orthorexia nervosa (ON) describes a fixation for proper nutrition and healthy foods that leads to die-tary restrictions and nutritional deficiencies over time. Given symptom overlap among ON, obsessive-compulsive disorder (OCD), and anorexia nervosa (AN), this study examines whether ON has a unique neuropsychological profile. Participants completed symptom checklists and neuropsychological tests chosen for their sensitivity to AN and OCD. Results showed that, across the full sample, ON is independently associated with self-reported weaknesses in Set-Shifting, Emotional Control, Self-Monitoring, and Working Memory. After controlling for AN and OCD variables, high- and low-ON groups differed in total correct trials on the Wisconsin Card Sorting Test. These areas of executive functioning, which are explained in the context of ON symptomatology, represent what would be considered the neuropsychological overlap among OCD and AN profiles.展开更多
Six ent-kaurene type diterpenoids were isolated from the leaves of Rabdosia nerwsa. Among them.ganer-vosin A and B are new compounds, the structures of which were elucidated as 1 and 2 respectively by spectral and che...Six ent-kaurene type diterpenoids were isolated from the leaves of Rabdosia nerwsa. Among them.ganer-vosin A and B are new compounds, the structures of which were elucidated as 1 and 2 respectively by spectral and chemical methods. The other four were identified as odonicin (3), novelrabdosin (4), nodosin (5) and shikokianal acetate (8). Compounds (1), (2), (5) and (8) have not been found in this herb previously.展开更多
AIM: To compare outcomes in anorexia nervosa(AN) in different treatment settings: inpatient, partial hospitalization and outpatient. METHODS: Completed and published in the English language, randomized controlled tria...AIM: To compare outcomes in anorexia nervosa(AN) in different treatment settings: inpatient, partial hospitalization and outpatient. METHODS: Completed and published in the English language, randomized controlled trials comparing treatment in two or more settings or comparing different lengths of inpatient stay, were identified by database searches using terms "anorexia nervosa" and "treatment" dated to July 2014. Trials were assessed for risk of bias and quality according to the Cochrane handbook by two authors(Madden S and Hay P) Data were extracted on trial quality, participant features and setting, main outcomes and attrition. RESULTS: Five studies were identified, two comparing inpatient treatment to outpatient treatment, one study comparing different lengths of inpatient treatment, one comparing inpatient treatment to day patient treatment and one comparing day patient treatment with outpatient treatment. There was no difference in treatment outcomes between the different treatment settings and different lengths of inpatient treatment. Both outpatient treatment and day patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was also cheaper than prolonged inpatient care for weight normalization also followed by evidence based outpatient care. CONCLUSION: There is preliminary support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting for anorexia nervosa.展开更多
Anorexia nervosa(AN) is a complex disorder with a strong genetic component. Comorbidities are frequent and there is substantial overlap with other disorders. The lack of understanding of the molecular and neuroanatomi...Anorexia nervosa(AN) is a complex disorder with a strong genetic component. Comorbidities are frequent and there is substantial overlap with other disorders. The lack of understanding of the molecular and neuroanatomical causes has made it difficult to develop effective treatments and it is often difficult to treat in clinical practice. Recent advances in genetics have changed our understanding of polygenic diseases,increasing the possibility of understanding better how molecular pathways are intertwined. This review synthetizes the current state of genetic research providing an overview of genome-wide association studies(GWAS) findings in AN as well as overlap with other disorders, traits, pathways, and imaging results. This paper also discusses the different putative global pathways that are contributing to the disease including the evidence for metabolic and psychiatric origin of the disease.展开更多
AIM To examine how self-reported and behavioural impulsivity are related in anorexia nervosa(AN).METHODS Twenty-four females with AN and 25 healthy controls(HC)participant in the study.Self-reported impulsivity was as...AIM To examine how self-reported and behavioural impulsivity are related in anorexia nervosa(AN).METHODS Twenty-four females with AN and 25 healthy controls(HC)participant in the study.Self-reported impulsivity was assessed with the Barratt Impulsiveness Scale(BIS-11).The scale yields three second-order factors:Attentional,motor and non-planning.Behavioural impulsivity was investigated with the continuous performance test(CPT),a computer-based task of sustained attention in which numbers are flashed briefly on screen and participants are required to click the mouse when the same number appears consecutively.The rate of commission and omission errors can be used a measure of behavioural imulsivity.RESULTS AN participants self-reported increased attentional[AN:20.67(3.64),HC:13.88(2.91),P=0.001]and reduced motor impulsivity[AN:11.55(2.28),HC:14.08(2.78),P=0.002].The rate of omission or commission errors on the CPT did not differ between groups(P>0.05).BIS-11 and CPT measures did not significantly correlate,but attentional impulsivity was related to negative mood states in AN(depression:r=0.52,P=0.010,anxiety:r=0.55,P=0.006,stress:r=0.57,P=0.004).CONCLUSION The discrepancy between self-reported and behavioural impulsivity are discussed in terms of perfectionism in AN.Furthermore,it is suggested that improving negative mood states may resolve this inconsistency in AN.展开更多
Objective: The purpose of this study was to elucidate clinical factors influencing quality of life (QOL) in anorexia nervosa (AN) patients. Methods: Twenty female patients with AN (median age = 30.0 years, quartile de...Objective: The purpose of this study was to elucidate clinical factors influencing quality of life (QOL) in anorexia nervosa (AN) patients. Methods: Twenty female patients with AN (median age = 30.0 years, quartile deviation = 6.8) and forty female healthy controls (HC) (median age = 30.0 years, quartile deviation = 8.6) participated in the study. QOL was assessed with the 36-Item Short Form Health Survey (SF-36) and social support was evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS). Clinical symptoms were evaluated with the Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D) and the Eating Disorder Inventory-2 (EDI-2). Results: Scores of the SF-36 Mental Component Summary (MCS) (U = 124.0, P U = 223.0, P = 0.006) and scores of total (U = 108.0, P < 0.0001) and subscales of the MSPSS were lower in AN group than HC group, and the SIGH-D score was higher (U = 46.0, P ρ = −0.565, P < 0.05) and subscales of the EDI-2 Interoceptive Confusion (ρ = −0.556, P ρ = −0.581, P ρ = −0.617, P < 0.05) were negatively correlated to MCS, and score of Interoceptive Confusion subscale showed a negative correlation to RCS (ρ = −0.672, P < 0.05). Moreover, stepwise regression analysis showed that the SIGH-D score was an independent predictor of MCS and Interoceptive Confusion score predicted RCS. Conclusion: These results suggest that among a variety of clinical symptoms and psychopathologies, depressive symptoms, poor emotional awareness and impaired sense of control are the most important influencing factors on AN patients’ QOL.展开更多
Prof.Min LI adopted acupoint catgut embedding at Zhōngwǎn(中脘CV12),Tiānshū(天枢ST25),Wèishū(胃俞BL21),Dàchángshū(大肠俞BL25),Zúsānlǐ(足三里ST36),Sānyīnjiāo(三阴交SP6),and Tàichōng...Prof.Min LI adopted acupoint catgut embedding at Zhōngwǎn(中脘CV12),Tiānshū(天枢ST25),Wèishū(胃俞BL21),Dàchángshū(大肠俞BL25),Zúsānlǐ(足三里ST36),Sānyīnjiāo(三阴交SP6),and Tàichōng(太冲LR3),and combined with auricular plaster therapy at Wèi(胃CO4),Dacháng(大肠CO7),Gān(肝CO12),Jiāogǎn(交感AH6 a),Nèifēnmì(内分泌CO18)for the treatment of 18 cases of bulimia nervosa(BN).The result was that 9 cases were clinically cured,6 cases improved,3 case ineffective,and the total effec-tive rate was 83.33%,no obvious adverse reactions.The therapeutic effect of acupoint catgut embedding combined with auricular plaster therapy for BN is good,without side effects.展开更多
Psychological treatment in anorexia nervosa(AN) is disheartening. Psychotherapy is the "treatment of choice" for adults though this recommendation is grounded on the absence of good quality clinical studies....Psychological treatment in anorexia nervosa(AN) is disheartening. Psychotherapy is the "treatment of choice" for adults though this recommendation is grounded on the absence of good quality clinical studies. This paper seeks to address the question of why improvements in the psychological treatment of AN have been thwarted, and why one of the best treatments available for adult patients is specialist supportive clinical management that has entered the stage through the backdoor of nonspecific supportive treatments originally serving as a placebo treatment assigned in randomized clinical trials to control for non-specific aspects of true psychosocial treatments. The possibility that most of the psychopathological features that characterise the AN symptoms profile could be best understood as the direct consequences of emaciation would enhance the utility of research with animal models for generating new hypothesis to improve AN treatment.展开更多
Purpose: To assess the prevalence of DSM-IV anorexia nervosa criteria, anorexia nervosa and subthreshold subgroups, and their incidence between the ages of 12 and 17 years using Cole’s international thinness cut-offs...Purpose: To assess the prevalence of DSM-IV anorexia nervosa criteria, anorexia nervosa and subthreshold subgroups, and their incidence between the ages of 12 and 17 years using Cole’s international thinness cut-offs, and to characterize these anorexic adolescents by parental socioeconomic status and whether or not they reported receiving treatment. Method: In all, a representative sample of 39,542 French adolescents (19,658 girls and 19,884 boys) was recruited in a cross-sectional study in 2008. Anorexia nervosa DSM-IV diagnosis was determined by a self-administered questionnaire. Results: Among females, 0.5% (n = 105) met criteria for anorexia nervosa between the ages of 12 and 17 years, whereas among males, the prevalence was 0.03% (n = 6). In females, the prevalence of sub-threshold anorexia nervosa was found to be between 1.2% (n = 216) and 3.3% (n = 618);more than 75% were of the restrictive subtype. The highest incidence of anorexia nervosa was at 16 years. There was also a greater prevalence of sub-threshold anorexia nervosa subgroups among subjects with high parental socioeconomic status. More than half of the female adolescents who met the anorexia nervosa criteria reported receiving treatment for their disorder, versus 23% to 40% of the adolescents in the sub-threshold subgroups (P sample of adolescents. Using Cole’s international thinness cut-off could improve international comparability among studies. Adolescents from the higher socioeconomic categories were more likely to be anorexic.展开更多
BACKGROUND Barrett’s esophagus is a known complication of long-standing gastroesophageal reflux disease,and it is a potential risk factor of developing esophageal adenocarcinoma.CASE SUMMARY Here,we present a case of...BACKGROUND Barrett’s esophagus is a known complication of long-standing gastroesophageal reflux disease,and it is a potential risk factor of developing esophageal adenocarcinoma.CASE SUMMARY Here,we present a case of a 47-year-old male patient referred to the gastroenterology clinic for upper endoscopy because he has a long-standing history of heartburn and vomiting after meals.On examination,he had characteristic findings of self-induced vomiting as abrasions and callosities on the dorsum of the right hand and dental erosions.A detailed history revealed that he had 17 years of binge eating with self-induced vomiting.His upper endoscopy showed gastroesophageal reflux grade D with salmon-red mucosal projections,and the biopsy revealed intestinal mucosal metaplasia.CONCLUSION This case emphasized the importance of considering upper endoscopy screening for Barrett’s esophagus in patients with eating disorders,especially those with self-induced vomiting,as in bulimia nervosa.展开更多
Anorexia nervosa(AN)is a disabling,costly and potentially deadly illness.Treatment failure and relapse are common after completing treatment,and a substantial proportion of patients develop severe and enduring AN.The ...Anorexia nervosa(AN)is a disabling,costly and potentially deadly illness.Treatment failure and relapse are common after completing treatment,and a substantial proportion of patients develop severe and enduring AN.The time from AN debut to the treatment initiation is normally unreasonably long.Over the past 20 years there has been empirical support for the efficacy of several treatments for AN.Moreover,outpatient treatment with family-based therapy or individual psychotherapy is associated with good outcomes for a substantial proportion of patients.Early intervention improves outcomes and should be a priority for all patients.Outpatient treatment is usually the best format for early intervention,and it has been demonstrated that even patients with severe or extreme AN can be treated as outpatients if they are medically stable.Inpatient care is more disruptive,more costly,and usually has a longer waiting list than does outpatient care.The decision as to whether to proceed with outpatient treatment or to transfer the patient for inpatient therapy may be difficult.The core aim of this opinion review is to provide the knowledge base needed for performing safe outpatient treatment of AN.The scientific essentials for outpatient treatment are described,including how to assess and manage the medical risks of AN and how to decide when transition to inpatient care is indicated.The following aspects are discussed:early intervention,outpatient treatment of AN,including outpatient psychotherapy for severe and extreme AN,how to determine when outpatient treatment is safe,and when transfer to inpatient healthcare is indicated.Emerging treatments,ethical issues and outstanding research questions are also addressed.展开更多
Objective: This review aims to describe the role of the hormone cholecystokinin (CCK) in the pathogenesis of bulimia nervosa (BN), the perpetuation of this illness and the possibility of its use as a target for future...Objective: This review aims to describe the role of the hormone cholecystokinin (CCK) in the pathogenesis of bulimia nervosa (BN), the perpetuation of this illness and the possibility of its use as a target for future therapeutic advances. Methods: Search for cholecystokinin AND bulimia nervosa in Pubmed Central, with no limits, identified 38 articles published up to the present date. Results: It is well established that CCK is altered in the pathogenesis of BN, and that its main role is in the perpetuation of the disorder rather than the cause of it. Discussion: Additional studies will be needed to further understand the mechanisms by which CCK regulates orexigenic pathways. If an orally active, longer acting analogue of CCK could be developed, it would be of significant interest as an appetite suppressant and a key adjuvant in the treatment of patients suffering from BN, particularly in refractory cases.展开更多
<strong>Background:</strong> The question of where to hospitalize extremely malnourished patients with anorexia nervosa (AN) is a real dilemma. On one hand, psychiatrists have to deal with severe medical c...<strong>Background:</strong> The question of where to hospitalize extremely malnourished patients with anorexia nervosa (AN) is a real dilemma. On one hand, psychiatrists have to deal with severe medical complications that are not within their competences and that justify hospitalization in an internal medicine ward. On the other hand, medical doctors have to face psychic decompensations that would justify admission to a psychiatric ward. In this context, we share our experience of management of severely malnourished AN adult patients in a transdisciplinary specialized eating disorders (ED) unit, referral center for AN associated with somatic severity. <strong>Method:</strong> First, we described the modalities of care proposed to patients with AN hospitalized in the medical unit. Intensive medical care, both somatic and psychiatric, are provided thanks to a transdisciplinary therapeutic program, where objectives are to: medically stabilize the patient, initiate progressive refeeding and start supportive psychotherapy before being transferred to a psychiatric ED unit. Secondly, we conducted a retrospective descriptive study that included all adult patients with AN admitted for the first time to the unit, between November 1997 and January 2014, for severe malnutrition and/or complications of the ED. Objective was to specify patients’ characteristics: demographic, nutritional status, history of ED, care pathway. <strong>Results: </strong>Among a cohort of 386 adult patients with AN (21 males and 365 females) admitted for the first time in the unit, mean age was 29.4 (±11.5) years, mean BMI was 12.7 (±2.2) kg/m<sup>2</sup>. Before being supported in the unit, 78.2% of patients had already been hospitalized in other hospitals. Mean length of stay was 35.2 days. Patients were clinically serious and unstable because of life-threatening somatic complications due to a low BMI. During hospital stay, a temporary transfer to medical intensive care unit was necessary for 25.6% of patients. Average patient weight gain was 0.777 kg per week and 81.9% of patients benefited from enteral nutrition.<strong> Conclusion: </strong>This specialized transdisciplinary unit where physician nutritionists and psychiatrists coordinate medical care together, allow a better understanding and management of extreme malnutrition associated with AN. Thanks to their expertise, care teams are less critical and less rejecting towards patients. Thus, therapeutic alliance could be optimized.展开更多
Introduction: Anorexia nervosa (AN) is a mental disorder whose features are deliberate weight loss, disordered body image, and intrusive overvalued fears of gaining weight. Long-term consequences of AN include endocri...Introduction: Anorexia nervosa (AN) is a mental disorder whose features are deliberate weight loss, disordered body image, and intrusive overvalued fears of gaining weight. Long-term consequences of AN include endocrine dysfunctions leading to secondary amenorrhea, bone loss and/or osteoporosis with an increased risk of bone fracture. Therefore young women with AN may develop a risk for bone fractures comparable to that of postmenopausal women. Methods: In this case report series Bone Mineral Density (BMD) was examined by Dual energy X-ray Absorptiometry (DXA) in 19 hospitalized patients with diagnosis of AN and prolonged amenorrhea. Results: All patients showed a lumbar/femoral bone loss or osteoporosis, with an increased fracture risk comparable to that of postmenopausal women. Conclusions: Our observation suggests that DXA evaluation of anorexic patients with prolonged amenorrhea would be helpful to prevent fracture risk in this population of patients. However, although DXA is almost routinely recommended in women over 65, it is not in young AN patients with prolonged amenorrhea.展开更多
文摘Background In light of growing concern over eating disorders among young athletes amid cultural and social pressures,this study aimed to assess the prevalence of orthorexia nervosa(ON)risk and evaluate body image perception and its predictive factors among young football players from Poland and Türkiye.Methods The study involved 171 players aged 15–18 years,recruited from football academies in Poland and Türkiye.The Polish and Turkish versions of the Body-Esteem Scale for Adolescents and Adults(BESAA)were administered to assess body image perception,while the Düsseldorf Orthorexia Scale(DOS)was used to measure ON risk.Anthropometric measurements were taken to calculate Body Mass Index(BMI),which was then referenced to centile charts to determine nutritional status.Results Results indicated that 13%of participants exhibited characteristics of ON,with an additional 26%classified as at elevated risk.Comparative analysis revealed no significant differences in ON prevalence between Polish and Turkish players(p=0.938)and no age-related differences(p=0.694).Among Polish players,a significant positive association emerged between BMI(relative to centile charts)and overall appearance evaluation(BE-Appearance)(p=0.008,partialη^(2)=0.10).This relationship was not observed in Turkish players.Moreover,analysis of ON risk predictors—including age,nationality,nutritional status,and body image—did not identify any single variable as a definitive predictor(all p-values>0.05),with a low predictive capacity(McFadden’s R^(2)=0.03).Conclusion The study revealed a significant risk of ON among young footballers with no clear predictors.
文摘Adolescence is the age of all disturbances both physiological and psychological.This internal and external insight conflicts is often hard to be managed.Thus,some teens will be subjected to act more than others.They use their bodies to show deep suffering as well as confusion.Numerous pathological behaviors can appear due to this significant sensitiveness like escaping difficulties.One of the ways solving this hardness of understanding and resolving these disorders is the disturbance in the nutritional behavior.This paper would allow us to understand the subjective dimensions that incite acting by mental anorexia.We suggest that a lack in the reflexive function might be the main cause of the attitude.Thereby,teen’s mental anorexia would show mistreatment at early care,that would make them feel unable to be good mothers in the future.
基金supported by the National Natural Science Foundation of China(Nos.21142004,31171695)the New Century Talents Scheme of the Ministry of Education(No. NCET-08-0820)+1 种基金Science and Technology Support Programs of Sichuan Province(No.2013SZ0083)the Fundamental Research Funds for Central Universities(Nos.SWJTU2010ZT09, SWJTU12CX048)
文摘Five new nervogenic acid derivatives（1-5） have been isolated from Liparis nervosa（Thunb.ex A.Murray） Lindl.Their structures were elucidated on the basis of extensive spectroscopic analysis,including 1D NMR,2D NMR,and HR-ESI-MS.
基金financially supported by the National Natural Science Foundation of China (Nos. 81402803, 31171695)the Science and Technology Support Programs of Sichuan Province (No. 2013SZ0083, 2015GZ0233)+2 种基金the Research Foundation for Educational Commission of Sichuan Province (No. 15TD0048)the Fundamental Research Funds for Central Universities (No. 2682014RC15)national undergraduate training programs for innovation and entrepreneurship (No. 201510613065)
文摘Three new pyrrolizidine alkaloids, nervosineⅦ（1）, nervosine Ⅷ（2） and nervosine IX （3） were isolated from the whole plant extract of Liparis nervosa. Their structures were elucidated by extensive spectroscopic analyses （including 1 D, 2D NMR, and HR-ESI-MS） and chemical methods. Compounds 1-3 were evaluated for their cytotoxic activity against A549, MCF-7and H460 human cancer cell lines.
文摘Objectives: To evaluate the long-term outcome of adolescents with anorexia nervosa and attempt to define prognostic factors for outcome. Methods: Transversal, descriptive epidemiological study with a strict methodology: minimum interval of 4 years since first admission, evaluation using clearly defined diagnostic criteria (EAT-40 self-evaluation, HSCL, global patient-driven self-evaluation and hetero evaluation: clinical interview and LECE). The 198 subjects are former adolescent anorexics treated at the Hôpital d’Enfants (Children’s Hospital) in Nancy (France). Results: Clinical evaluation of the 144 subjects traced showed positive outcome for 68.1%, intermediate outcome for 23.2% and poor outcome for 8.7%. 5 factors for a good prognosis were found (middle socioeconomic class of parents, no prior treatment, hospitalization > 1 month,
文摘Orthorexia nervosa (ON) describes a fixation for proper nutrition and healthy foods that leads to die-tary restrictions and nutritional deficiencies over time. Given symptom overlap among ON, obsessive-compulsive disorder (OCD), and anorexia nervosa (AN), this study examines whether ON has a unique neuropsychological profile. Participants completed symptom checklists and neuropsychological tests chosen for their sensitivity to AN and OCD. Results showed that, across the full sample, ON is independently associated with self-reported weaknesses in Set-Shifting, Emotional Control, Self-Monitoring, and Working Memory. After controlling for AN and OCD variables, high- and low-ON groups differed in total correct trials on the Wisconsin Card Sorting Test. These areas of executive functioning, which are explained in the context of ON symptomatology, represent what would be considered the neuropsychological overlap among OCD and AN profiles.
文摘Six ent-kaurene type diterpenoids were isolated from the leaves of Rabdosia nerwsa. Among them.ganer-vosin A and B are new compounds, the structures of which were elucidated as 1 and 2 respectively by spectral and chemical methods. The other four were identified as odonicin (3), novelrabdosin (4), nodosin (5) and shikokianal acetate (8). Compounds (1), (2), (5) and (8) have not been found in this herb previously.
基金Madden S and Touyz S have received consultancy fees from Shire Pharmaceuticals
文摘AIM: To compare outcomes in anorexia nervosa(AN) in different treatment settings: inpatient, partial hospitalization and outpatient. METHODS: Completed and published in the English language, randomized controlled trials comparing treatment in two or more settings or comparing different lengths of inpatient stay, were identified by database searches using terms "anorexia nervosa" and "treatment" dated to July 2014. Trials were assessed for risk of bias and quality according to the Cochrane handbook by two authors(Madden S and Hay P) Data were extracted on trial quality, participant features and setting, main outcomes and attrition. RESULTS: Five studies were identified, two comparing inpatient treatment to outpatient treatment, one study comparing different lengths of inpatient treatment, one comparing inpatient treatment to day patient treatment and one comparing day patient treatment with outpatient treatment. There was no difference in treatment outcomes between the different treatment settings and different lengths of inpatient treatment. Both outpatient treatment and day patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was also cheaper than prolonged inpatient care for weight normalization also followed by evidence based outpatient care. CONCLUSION: There is preliminary support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting for anorexia nervosa.
基金supported by the grant from Svenska S?llskapet f?r Medicinsk Forskning (SSMF)supported by the grant from Swedish Research Council (VR 2014-02812)。
文摘Anorexia nervosa(AN) is a complex disorder with a strong genetic component. Comorbidities are frequent and there is substantial overlap with other disorders. The lack of understanding of the molecular and neuroanatomical causes has made it difficult to develop effective treatments and it is often difficult to treat in clinical practice. Recent advances in genetics have changed our understanding of polygenic diseases,increasing the possibility of understanding better how molecular pathways are intertwined. This review synthetizes the current state of genetic research providing an overview of genome-wide association studies(GWAS) findings in AN as well as overlap with other disorders, traits, pathways, and imaging results. This paper also discusses the different putative global pathways that are contributing to the disease including the evidence for metabolic and psychiatric origin of the disease.
基金supported by the Jack Brockhoff Foundation(L.A.,S.R.,D.C.,A.P.,grant number:3410)the Dick and Pip Smith Foundation(A.P.,L.A.,S.R.,D.C.)+1 种基金an Australian Postgraduate Award(A.P.)the David Hay Memorial Fund Award(A.P.)
文摘AIM To examine how self-reported and behavioural impulsivity are related in anorexia nervosa(AN).METHODS Twenty-four females with AN and 25 healthy controls(HC)participant in the study.Self-reported impulsivity was assessed with the Barratt Impulsiveness Scale(BIS-11).The scale yields three second-order factors:Attentional,motor and non-planning.Behavioural impulsivity was investigated with the continuous performance test(CPT),a computer-based task of sustained attention in which numbers are flashed briefly on screen and participants are required to click the mouse when the same number appears consecutively.The rate of commission and omission errors can be used a measure of behavioural imulsivity.RESULTS AN participants self-reported increased attentional[AN:20.67(3.64),HC:13.88(2.91),P=0.001]and reduced motor impulsivity[AN:11.55(2.28),HC:14.08(2.78),P=0.002].The rate of omission or commission errors on the CPT did not differ between groups(P>0.05).BIS-11 and CPT measures did not significantly correlate,but attentional impulsivity was related to negative mood states in AN(depression:r=0.52,P=0.010,anxiety:r=0.55,P=0.006,stress:r=0.57,P=0.004).CONCLUSION The discrepancy between self-reported and behavioural impulsivity are discussed in terms of perfectionism in AN.Furthermore,it is suggested that improving negative mood states may resolve this inconsistency in AN.
文摘Objective: The purpose of this study was to elucidate clinical factors influencing quality of life (QOL) in anorexia nervosa (AN) patients. Methods: Twenty female patients with AN (median age = 30.0 years, quartile deviation = 6.8) and forty female healthy controls (HC) (median age = 30.0 years, quartile deviation = 8.6) participated in the study. QOL was assessed with the 36-Item Short Form Health Survey (SF-36) and social support was evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS). Clinical symptoms were evaluated with the Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D) and the Eating Disorder Inventory-2 (EDI-2). Results: Scores of the SF-36 Mental Component Summary (MCS) (U = 124.0, P U = 223.0, P = 0.006) and scores of total (U = 108.0, P < 0.0001) and subscales of the MSPSS were lower in AN group than HC group, and the SIGH-D score was higher (U = 46.0, P ρ = −0.565, P < 0.05) and subscales of the EDI-2 Interoceptive Confusion (ρ = −0.556, P ρ = −0.581, P ρ = −0.617, P < 0.05) were negatively correlated to MCS, and score of Interoceptive Confusion subscale showed a negative correlation to RCS (ρ = −0.672, P < 0.05). Moreover, stepwise regression analysis showed that the SIGH-D score was an independent predictor of MCS and Interoceptive Confusion score predicted RCS. Conclusion: These results suggest that among a variety of clinical symptoms and psychopathologies, depressive symptoms, poor emotional awareness and impaired sense of control are the most important influencing factors on AN patients’ QOL.
基金Supported by Guangdong Graduate Education Innovation Program:2017SFKC13。
文摘Prof.Min LI adopted acupoint catgut embedding at Zhōngwǎn(中脘CV12),Tiānshū(天枢ST25),Wèishū(胃俞BL21),Dàchángshū(大肠俞BL25),Zúsānlǐ(足三里ST36),Sānyīnjiāo(三阴交SP6),and Tàichōng(太冲LR3),and combined with auricular plaster therapy at Wèi(胃CO4),Dacháng(大肠CO7),Gān(肝CO12),Jiāogǎn(交感AH6 a),Nèifēnmì(内分泌CO18)for the treatment of 18 cases of bulimia nervosa(BN).The result was that 9 cases were clinically cured,6 cases improved,3 case ineffective,and the total effec-tive rate was 83.33%,no obvious adverse reactions.The therapeutic effect of acupoint catgut embedding combined with auricular plaster therapy for BN is good,without side effects.
基金Supported by The research budget of the Venres Clinicos Unit(University of Santiago de Compostela)
文摘Psychological treatment in anorexia nervosa(AN) is disheartening. Psychotherapy is the "treatment of choice" for adults though this recommendation is grounded on the absence of good quality clinical studies. This paper seeks to address the question of why improvements in the psychological treatment of AN have been thwarted, and why one of the best treatments available for adult patients is specialist supportive clinical management that has entered the stage through the backdoor of nonspecific supportive treatments originally serving as a placebo treatment assigned in randomized clinical trials to control for non-specific aspects of true psychosocial treatments. The possibility that most of the psychopathological features that characterise the AN symptoms profile could be best understood as the direct consequences of emaciation would enhance the utility of research with animal models for generating new hypothesis to improve AN treatment.
文摘Purpose: To assess the prevalence of DSM-IV anorexia nervosa criteria, anorexia nervosa and subthreshold subgroups, and their incidence between the ages of 12 and 17 years using Cole’s international thinness cut-offs, and to characterize these anorexic adolescents by parental socioeconomic status and whether or not they reported receiving treatment. Method: In all, a representative sample of 39,542 French adolescents (19,658 girls and 19,884 boys) was recruited in a cross-sectional study in 2008. Anorexia nervosa DSM-IV diagnosis was determined by a self-administered questionnaire. Results: Among females, 0.5% (n = 105) met criteria for anorexia nervosa between the ages of 12 and 17 years, whereas among males, the prevalence was 0.03% (n = 6). In females, the prevalence of sub-threshold anorexia nervosa was found to be between 1.2% (n = 216) and 3.3% (n = 618);more than 75% were of the restrictive subtype. The highest incidence of anorexia nervosa was at 16 years. There was also a greater prevalence of sub-threshold anorexia nervosa subgroups among subjects with high parental socioeconomic status. More than half of the female adolescents who met the anorexia nervosa criteria reported receiving treatment for their disorder, versus 23% to 40% of the adolescents in the sub-threshold subgroups (P sample of adolescents. Using Cole’s international thinness cut-off could improve international comparability among studies. Adolescents from the higher socioeconomic categories were more likely to be anorexic.
文摘BACKGROUND Barrett’s esophagus is a known complication of long-standing gastroesophageal reflux disease,and it is a potential risk factor of developing esophageal adenocarcinoma.CASE SUMMARY Here,we present a case of a 47-year-old male patient referred to the gastroenterology clinic for upper endoscopy because he has a long-standing history of heartburn and vomiting after meals.On examination,he had characteristic findings of self-induced vomiting as abrasions and callosities on the dorsum of the right hand and dental erosions.A detailed history revealed that he had 17 years of binge eating with self-induced vomiting.His upper endoscopy showed gastroesophageal reflux grade D with salmon-red mucosal projections,and the biopsy revealed intestinal mucosal metaplasia.CONCLUSION This case emphasized the importance of considering upper endoscopy screening for Barrett’s esophagus in patients with eating disorders,especially those with self-induced vomiting,as in bulimia nervosa.
文摘Anorexia nervosa(AN)is a disabling,costly and potentially deadly illness.Treatment failure and relapse are common after completing treatment,and a substantial proportion of patients develop severe and enduring AN.The time from AN debut to the treatment initiation is normally unreasonably long.Over the past 20 years there has been empirical support for the efficacy of several treatments for AN.Moreover,outpatient treatment with family-based therapy or individual psychotherapy is associated with good outcomes for a substantial proportion of patients.Early intervention improves outcomes and should be a priority for all patients.Outpatient treatment is usually the best format for early intervention,and it has been demonstrated that even patients with severe or extreme AN can be treated as outpatients if they are medically stable.Inpatient care is more disruptive,more costly,and usually has a longer waiting list than does outpatient care.The decision as to whether to proceed with outpatient treatment or to transfer the patient for inpatient therapy may be difficult.The core aim of this opinion review is to provide the knowledge base needed for performing safe outpatient treatment of AN.The scientific essentials for outpatient treatment are described,including how to assess and manage the medical risks of AN and how to decide when transition to inpatient care is indicated.The following aspects are discussed:early intervention,outpatient treatment of AN,including outpatient psychotherapy for severe and extreme AN,how to determine when outpatient treatment is safe,and when transfer to inpatient healthcare is indicated.Emerging treatments,ethical issues and outstanding research questions are also addressed.
文摘Objective: This review aims to describe the role of the hormone cholecystokinin (CCK) in the pathogenesis of bulimia nervosa (BN), the perpetuation of this illness and the possibility of its use as a target for future therapeutic advances. Methods: Search for cholecystokinin AND bulimia nervosa in Pubmed Central, with no limits, identified 38 articles published up to the present date. Results: It is well established that CCK is altered in the pathogenesis of BN, and that its main role is in the perpetuation of the disorder rather than the cause of it. Discussion: Additional studies will be needed to further understand the mechanisms by which CCK regulates orexigenic pathways. If an orally active, longer acting analogue of CCK could be developed, it would be of significant interest as an appetite suppressant and a key adjuvant in the treatment of patients suffering from BN, particularly in refractory cases.
文摘<strong>Background:</strong> The question of where to hospitalize extremely malnourished patients with anorexia nervosa (AN) is a real dilemma. On one hand, psychiatrists have to deal with severe medical complications that are not within their competences and that justify hospitalization in an internal medicine ward. On the other hand, medical doctors have to face psychic decompensations that would justify admission to a psychiatric ward. In this context, we share our experience of management of severely malnourished AN adult patients in a transdisciplinary specialized eating disorders (ED) unit, referral center for AN associated with somatic severity. <strong>Method:</strong> First, we described the modalities of care proposed to patients with AN hospitalized in the medical unit. Intensive medical care, both somatic and psychiatric, are provided thanks to a transdisciplinary therapeutic program, where objectives are to: medically stabilize the patient, initiate progressive refeeding and start supportive psychotherapy before being transferred to a psychiatric ED unit. Secondly, we conducted a retrospective descriptive study that included all adult patients with AN admitted for the first time to the unit, between November 1997 and January 2014, for severe malnutrition and/or complications of the ED. Objective was to specify patients’ characteristics: demographic, nutritional status, history of ED, care pathway. <strong>Results: </strong>Among a cohort of 386 adult patients with AN (21 males and 365 females) admitted for the first time in the unit, mean age was 29.4 (±11.5) years, mean BMI was 12.7 (±2.2) kg/m<sup>2</sup>. Before being supported in the unit, 78.2% of patients had already been hospitalized in other hospitals. Mean length of stay was 35.2 days. Patients were clinically serious and unstable because of life-threatening somatic complications due to a low BMI. During hospital stay, a temporary transfer to medical intensive care unit was necessary for 25.6% of patients. Average patient weight gain was 0.777 kg per week and 81.9% of patients benefited from enteral nutrition.<strong> Conclusion: </strong>This specialized transdisciplinary unit where physician nutritionists and psychiatrists coordinate medical care together, allow a better understanding and management of extreme malnutrition associated with AN. Thanks to their expertise, care teams are less critical and less rejecting towards patients. Thus, therapeutic alliance could be optimized.
文摘Introduction: Anorexia nervosa (AN) is a mental disorder whose features are deliberate weight loss, disordered body image, and intrusive overvalued fears of gaining weight. Long-term consequences of AN include endocrine dysfunctions leading to secondary amenorrhea, bone loss and/or osteoporosis with an increased risk of bone fracture. Therefore young women with AN may develop a risk for bone fractures comparable to that of postmenopausal women. Methods: In this case report series Bone Mineral Density (BMD) was examined by Dual energy X-ray Absorptiometry (DXA) in 19 hospitalized patients with diagnosis of AN and prolonged amenorrhea. Results: All patients showed a lumbar/femoral bone loss or osteoporosis, with an increased fracture risk comparable to that of postmenopausal women. Conclusions: Our observation suggests that DXA evaluation of anorexic patients with prolonged amenorrhea would be helpful to prevent fracture risk in this population of patients. However, although DXA is almost routinely recommended in women over 65, it is not in young AN patients with prolonged amenorrhea.
