Neuromodulation in eating disorders and obesity: A promising way of treatment?

Neuromodulation can affect the functioning of the central nervous system (CNS), and emotional/eating behavior is an exciting facet of that functioning. Therefore, it would be possible to offer an alternative (or complement) treatment to psychotropic medications and different psychological and nutritional approaches to both eating disorders (EDs) and obesity. Although there are a number of publications in these areas, a systematic review has not been conducted to date. Abstracts, letters, conference reports, dissertations, and reviews were excluded. Clinical trials and controlled human clinical trials were filtered and included in this study. Articles included were based on the population suffering from anorexia nervosa, bulimia nervosa, binge ED, overweight, and obesity. No restrictions were placed on the sample size. Only trials investigating the effect of neuromodulation by means of deep brain stimulation (DBS), transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS) were included. The following databases were used to conduct the search: MEDLINE/ PubMed, PsycINFO, PsycArticles, and Cochrane (Search Trials, CENTRAL). Study selection was performed following the PRISMA process (PRISMA 2009 Checklist). The total number of participants in all the trials was 562 (DBS, 25; tDCS, 138; TMS, 399; range, 3–90; median, 23.5). As a result, 50% of the studies had samples of between 14 and 38 participants. Neuromodulation in ED seems to have certain clinical potential, and therefore, this is a promising area for further research. Developments in ED neuromodulation will be linked to neuroimaging to identify potential stimulation targets and possible biomarkers of treatment response. To date, TMS and/or direct current stimulation (DCS) is not the first-line treatment yet, but it could become a preferred option of treatment in the future. Further studies should avoid small sample sizes and the use of different methodologies. Currently, neuromodulation techniques are in the experimental phase, and they are not an evidence-based treatment for ED

Impact of today's media on university student's body image in Pakistan: a conservative, developing country's perspective

<p>Abstract</p> <p>Background</p> <p>Living in a world greatly controlled by mass media makes it impossible to escape its pervading influence. As media in Pakistan has been free in the true sense of the word for only a few years, its impact on individuals is yet to be assessed. Our study aims to be the first to look at the effect media has on the body image of university students in a conservative, developing country like Pakistan. Also, we introduced the novel concept of body image dissatisfaction as being both negative and positive.</p> <p>Methods</p> <p>A cross-sectional study was conducted among 7 private universities over a period of two weeks in the city of Karachi, Pakistan's largest and most populous city. Convenience sampling was used to select both male and female undergraduate students aged between 18 and 25 and a sample size of 783 was calculated.</p> <p>Results</p> <p>Of the 784 final respondents, 376 (48%) were males and 408 (52%) females. The mean age of males was 20.77 (+/- 1.85) years and females was 20.38 (+/- 1.63) years. Out of these, 358 (45.6%) respondents had a positive BID (body image dissatisfaction) score while 426 (54.4%) had a negative BID score. Of the respondents who had positive BID scores, 93 (24.7%) were male and 265 (65.0%) were female. Of the respondents with a negative BID score, 283 (75.3%) were male and 143 (35.0%) were female. The results for BID vs. media exposure were similar in both high and low peer pressure groups. Low media exposure meant positive BID scores and vice versa in both groups (p < 0.0001) showing a statistically significant association between high media exposure and negative body image dissatisfaction. Finally, we looked at the association between gender and image dissatisfaction. Again a statistically significant association was found between positive body image dissatisfaction and female gender and negative body image dissatisfaction and male gender (p < 0.0001).</p> <p>Conclusions</p> <p>Our study confirmed the tendency of the media to have an overall negative effect on individuals' body image. A striking feature of our study, however, was the finding that negative body image dissatisfaction was found to be more prevalent in males as compared to females. Likewise, positive BID scores were more prevalent amongst females.</p

Identifying subtypes of patients with neovascular age-related macular degeneration by genotypic and cardiovascular risk characteristics

<p>Abstract</p> <p>Background</p> <p>One of the challenges in the interpretation of studies showing associations between environmental and genotypic data with disease outcomes such as neovascular age-related macular degeneration (AMD) is understanding the phenotypic heterogeneity within a patient population with regard to any risk factor associated with the condition. This is critical when considering the potential therapeutic response of patients to any drug developed to treat the condition. In the present study, we identify patient subtypes or clusters which could represent several different targets for treatment development, based on genetic pathways in AMD and cardiovascular pathology.</p> <p>Methods</p> <p>We identified a sample of patients with neovascular AMD, that in previous studies had been shown to be at elevated risk for the disease through environmental factors such as cigarette smoking and genetic variants including the complement factor H gene (<it>CFH</it>) on chromosome 1q25 and variants in the <it>ARMS2</it>/HtrA serine peptidase 1 (<it>HTRA1</it>) gene(s) on chromosome 10q26. We conducted a multivariate segmentation analysis of 253 of these patients utilizing available epidemiologic and genetic data.</p> <p>Results</p> <p>In a multivariate model, cigarette smoking failed to differentiate subtypes of patients. However, four meaningfully distinct clusters of patients were identified that were most strongly differentiated by their cardiovascular health status (histories of hypercholesterolemia and hypertension), and the alleles of <it>ARMS2</it>/<it>HTRA1 </it>rs1049331.</p> <p>Conclusions</p> <p>These results have significant personalized medicine implications for drug developers attempting to determine the effective size of the treatable neovascular AMD population. Patient subtypes or clusters may represent different targets for therapeutic development based on genetic pathways in AMD and cardiovascular pathology, and treatments developed that may elevate CV risk, may be ill advised for certain of the clusters identified.</p

Interactions between antihypertensive drugs and food Interacciones entre fármacos antihipertensivos y alimentos

Objective: A drug interaction is defined as any alteration, pharmacokinetics and/or pharmacodynamics, produced by different substances, other drug treatments, dietary factors and habits such as drinking and smoking. These interactions can affect the antihypertensive drugs, altering their therapeutic efficacy and causing toxic effects. The aim of this study was to conduct a review of available data about interactions between antihypertensive agents and food. Methods: The purpose of this review was to report an update of main findings with respect to the interactions between food and antihypertensive drugs by way of a search conducted in PubMed, which yielded a total of 236 articles initially. Results: After excluding different articles, which were not focusing on the specific objective, the main results refer to interactions between antihypertensive drugs and food (in general) as well as between antihypertensive agents and grapefruit juice. Discussion: Food may affect the bioavailability of antihypertensive drugs and this should be carefully considered. Advising patients to remove the grapefruit juice from their diet when treatment with these drugs seems to be the best recommendation. Given these interactions and the associated potential adverse effects the anamnesis must include detailed information about the specific eating habits of the patients.Objetivo: la interacción de medicamentos se define como cualquier alteración, farmacocinética y/o farmacodinámica, producida por diferentes sustancias, otros tratamientos, factores dietéticos y hábitos como beber y fumar. Estas interacciones pueden afectar a los fármacos antihipertensivos, alterando su eficacia terapéutica y causando efectos tóxicos. El objetivo de este estudio fue realizar una revisión de los datos disponibles acerca de las interacciones entre los fármacos antihipertensivos y los alimentos. Métodos: El objetivo de esta revisión fue proporcionar una puesta al día sobre los principales resultados con respecto a las interacciones entre alimentos y fármacos antihipertensivos mediante una búsqueda realizada en PubMed, que dio lugar inicialmente a un total de 236 artículos. Resultados: Tras la exclusión de diferentes artículos que no estaban centrados en el objetivo específico, los resultados principales se refieren a las interacciones entre los fármacos antiarrítmicos y alimentos en general y entre dichos fármacos y el zumo de pomelo. Discusión: Los alimentos pueden afectar a la biodisponibilidad de los fármacos antihipertensivos y ello debe ser considerado cuidadosamente. Advertir a los pacientes que supriman el zumo de pomelo en su dieta cuando están en tratamiento con estos fármacos parece la mejor recomendación. Dadas estas interacciones y sus potenciales efectos adversos, la anamnesis debe incluir información detallada sobre los hábitos alimentarios de los pacientes

Spanish version of the irrational food beliefs scale Versión Española de la escala de creencias irracionales sobre los alimentos

Objective: The aim of the study was to develop a Spanish adaptation of the Irrational Food Beliefs Scale (IFBS). This is important due not only to the scarcity and limitations of existing instruments in Spanish, but also to the potential of the IFBS in terms of studying the difficulties some people face in achieving healthy weight control. Methods: Subjects were 323 secondary-level and highschool students (12-20 years; 152 females, 171 males). In addition to the IFBS, we determined the body mass index and analysed the following variables: influence of the aesthetic body shape model, perceived stress, coping strategies, self-esteem and variables from the Eating Disorders Inventory-2. Results: The factor analysis yielded two factors corresponding to irrational and rational beliefs about food. The internal consistency (Cronbach's alpha coefficient) of the IFBS as a whole and of the irrational and rational subscales was 0.863, 0.881 and 0.779, respectively. The analysis of correlations with the abovementioned variables showed an adequate construct validity. Discussion: The Spanish version of the IFBS fulfils the psychometric requirements for a measure of irrational/rational food beliefs and shows adequate internal consistency and construct validity.Objetivo: El propósito del estudio fue adaptar la Irrational Food Beliefs Scale (IFBS) a la población española. La escasez y limitaciones de instrumentos similares en nuestra lengua y las posibilidades de la IFBS para estudiar las dificultades en el control de peso de manera saludable justifican el trabajo. Métodos: Fueron aceptados 323 estudiantes de educación secundaria y bachillerato (12-20 años; 152 mujeres, 171 hombres). Además de la IFBS, se determinó el índice de masa corporal y se analizaron las siguientes variables: influencia del modelo estético corporal, estrés percibido, estrategias de afrontamiento, autoestima y variables del Eating Disorders Inventory-2. Resultados: El análisis factorial sugirió dos factores que representan las creencias irracionales y racionales sobre los alimentos. La consistencia interna del IFBS y de sus subescalas (coeficiente alpha de Cronbach) fue de 0.881 y 0.779 para la subescala irracional y racional respectivamente. La IFBS presentó un a=0,863. El análisis de correlaciones con las variables mencionadas demostró una adecuada validez de constructo. Discusión: La IFBS, en su versión española, cubre los requisitos psicométricos para medir las creencias racionales-irracionales acerca de los alimentos, con una adecuada consistencia interna y validez de constructo

Neuromodulation in eating disorders and obesity: a promising way of treatment?

Ignacio J&aacute;uregui-Lobera,1 Jos&eacute; V Mart&iacute;nez-Qui&ntilde;ones2 1Department of Molecular Biology and Biochemical Engineering, University of Pablo de Olavide of Seville, Seville, Spain; 2Department of Neurosurgery, Mutua de Accidentes de Zaragoza (Servicio de Neurocirug&iacute;a), Zaragoza, Spain Abstract: Neuromodulation can affect the functioning of the central nervous system (CNS), and emotional/eating behavior is an exciting facet of that functioning. Therefore, it would be possible to offer an alternative (or complement) treatment to psychotropic medications and different psychological and nutritional approaches to both eating disorders (EDs) and obesity. Although there are a number of publications in these areas, a systematic review has not been conducted to date. Abstracts, letters, conference reports, dissertations, and reviews were excluded. Clinical trials and controlled human clinical trials were filtered and included in this study. Articles included were based on the population suffering from anorexia nervosa, bulimia nervosa, binge ED, overweight, and obesity. No restrictions were placed on the sample size. Only trials investigating the effect of neuromodulation by means of deep brain stimulation (DBS), transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS) were included. The following databases were used to conduct the search: MEDLINE/PubMed, PsycINFO, PsycArticles, and Cochrane (Search Trials, CENTRAL). Study selection was performed following the PRISMA process (PRISMA 2009 Checklist). The total number of participants in all the trials was 562 (DBS, 25; tDCS, 138; TMS, 399; range, 3&ndash;90; median, 23.5). As a result, 50% of the studies had samples of between 14 and 38 participants. Neuromodulation in ED seems to have certain clinical potential, and therefore, this is a promising area for further research. Developments in ED neuromodulation will be linked to neuroimaging to identify potential stimulation targets and possible biomarkers of treatment response. To date, TMS and/or direct current stimulation (DCS) is not the first-line treatment yet, but it could become a preferred option of treatment in the future. Further studies should avoid small sample sizes and the use of different methodologies. Currently, neuromodulation techniques are in the experimental phase, and they are not an evidence-based treatment for ED. Keywords: deep brain stimulation, transcranial direct current stimulation, transcranial magnetic stimulation, anorexia nervosa, bulimia nervosa, obesity&nbsp