Limbic-thalamo-cortical projections and reward-related circuitry integrity affects eating behavior: A longitudinal DTI study in adolescents with restrictive eating disorders.

Few studies have used diffusion tensor imaging (DTI) to investigate the micro-structural alterations of WM in patients with restrictive eating disorders (rED), and longitudinal data are lacking. Twelve patients with rED were scanned at diagnosis and after one year of family-based treatment, and compared to twenty-four healthy controls (HCs) through DTI analysis. A tract-based spatial statistics procedure was used to investigate diffusivity parameters: fractional anisotropy (FA) and mean, radial and axial diffusivities (MD, RD and AD, respectively). Reduced FA and increased RD were found in patients at baseline in the corpus callosum, corona radiata and posterior thalamic radiation compared with controls. However, no differences were found between follow-up patients and controls, suggesting a partial normalization of the diffusivity parameters. In patients, trends for a negative correlation were found between the baseline FA of the right anterior corona radiata and the Eating Disorder Examination Questionnaire total score, while a positive trend was found between the baseline FA in the splenium of corpus callosum and the weight loss occurred between maximal documented weight and time of admission. A positive trend for correlation was also found between baseline FA in the right anterior corona radiata and the decrease in the Obsessive-Compulsive Inventory Revised total score over time. Our results suggest that the integrity of the limbic-thalamo-cortical projections and the reward-related circuitry are important for cognitive control processes and reward responsiveness in regulating eating behavior

Changes and predictive value for treatment outcome of the compulsive exercise test (CET) during a family-based intervention for adolescents eating disorders

Abstract Background The aim of this study was to explore changes in the Compulsive Exercise Test (CET) following a family-based intervention in adolescents with restrictive eating disorders (ED). It was hypothesized that compulsive exercise would improve with successful intervention against the ED but also that a high level of compulsive exercise at presentation would be associated with a less favourable outcome. Method The CET, the Eating Disorders Examination-Questionnaire (EDE-Q), and body mass index were available for 170 adolescents at presentation and at a one-year follow-up. Treatment was a family-based intervention and included that all exercise was stopped at start of treatment. Recovery was defined as EDE-Q score < 2.0 or absence of an ED at an interview. Results Exercise for weight control and for avoiding low mood, which are related to ED cognitions, decreased in recovered patients. Exercise for improving mood did not change in either recovered or not recovered patients. The CET subscale scores at presentation did not independently predict recovery. Conclusion Compulsive exercise is one of several ED related behaviours which needs to be targeted at the start of treatment. With successful treatment it decreases in parallel with other ED related cognitions and behaviours but without a loss of the ability to enjoy exercise

Influence of premorbid BMI on clinical characteristics at presentation of adolescent girls with eating disorders

Background: Considering the prevalence of obesity in society it can be expected that some adolescents with an eating disorder (ED) start weight loss from an overweight and present at a near-normal weight. Presently, the influence of premorbid BMI on clinical characteristics of adolescent girls presenting with an ED has ben studied. Method: Premorbid growth charts were available for 275 postmenarcheal adolescent girls presenting with an ED (anorexia nervosa = 27, (subthreshold) bulimia nervosa = 9, restrictive EDNOS = 239). Initial assessment included measurement of weight and length, physical examination, blood sampling and administration of the Eating Disorder Examination-Questionnaire youth version (EDE-Q). Results: Despite greater weight loss girls with a high premorbid body mass index (BMI) had a higher BMI at presentation compared to those with a lower premorbid BMI. Although not underweight some presented with clinical and laboratory signs of starvation. These signs were related to not only low BMI but also to rapid and large weight loss. Their EDE-Q scores did not differ from those of girls who presented with an underweight. Conclusion: Girls with a restrictive ED and premorbid overweight may present with a near-normal BMI. They can nevertheless be medically compromised and have eating disturbed cognitions at the level of underweight girls. They should not be regarded as having a less severe ED but merit full assessment and a start of treatment

Recovery of premorbid BMI trajectory without overshoot during the first year of treatment of children with type 1 diabetes

OBJECTIVE: To study body mass index (BMI) changes and metabolic control in children and adolescents during the first year following the diagnosis of type 1 diabetes. RESEARCH DESIGN AND METHODS: 200 children and adolescents (<18 years) diagnosed with type 1 diabetes, started on multiple injection treatment and followed up for 1 year were studied with respect to metabolic control and weight change. Growth curves preceding the onset of diabetes were procured from the school health services. BMI was recalculated into BMI SD scores (BMISDS). RESULTS: Glycated hemoglobin (HbA1c) at 1 year was 6.7±1.3% (50±10 mmol/mol). HbA1c was positively correlated with daily insulin dose (R(2)=0.13; p<0.001), negatively correlated with age (R(2)=0.03; p<0.05) but not related to gender, BMISDS at 1 year, HbA1c at presentation, or ketoacidosis at presentation. Prior to the onset of diabetes, BMISDS was 0.41±1.20 and decreased to −0.63±1.25 at presentation. BMISDS at 1 year was 0.54±0.97 and not different from the premorbid value (p>0.05). In a multiple regression analysis, BMISDS at 1 year was directly proportional to and highly predicted by BMISDS prior to onset of diabetes (R(2)=0.57; p<0.001). BMISDS at 1 year was also inversely correlated with age (R(2)=0.03; p<0.001) but could not be predicted by gender, daily insulin dose, HbA1c at 1 year, HbA1c at presentation, or by ketoacidosis at presentation. CONCLUSIONS: During the first year of treatment of type 1 diabetes in children and adolescents, it is possible to achieve good metabolic control without excess weight gain

A comparison of clinical characteristics between adolescent males and females with eating disorders

Background: Eating disorders (ED) are serious disorders that have a negative impact on both the psychological and the physiological well-being of the afflicted. Despite the fact that ED affect both genders, males are often underrepresented in research and when included the sample sizes are often too small for separate analyses. Consequently we have an unclear and sometimes contradictory picture of the clinical characteristics of males with ED. The aim of the present study was to improve our understanding of the clinical features of adolescent males with eating disorders. Methods: We compared age at presentation, weight at presentation, history of significantly different premorbid weight and psychiatric (Attention Deficit Hyperactivity Disorder (ADHD)) and somatic comorbidity (celiac disease and diabetes) of 58 males to 606 females seeking medical care for eating disorders at the Children's Hospital in Uppsala, Sweden during the years 1999-2012. As all boys were diagnosed with either AN or Other Specified Feeding or Eating Disorder (OSFED) atypical AN, the age and weight comparisons were limited to those girls fulfilling the diagnostic criteria for AN or OSFED atypical AN. Results: There was no significant difference in age at presentation. Differences in weight at presentation and premorbid weight history were mixed. A significantly higher percentage of males had a history of a BMI greater than two standard deviations above the mean for their corresponding age group. As well, there was a higher prevalence of ADHD among the males whereas celiac disease and diabetes only was found among the females. Conclusions: A better understanding of the clinical characteristics of males with ED at presentation should improve our ability to identify males with ED and thereby aid in tailoring the best treatment alternatives

One-year outcome and incidence of anorexia nervosa and restrictive eating disorders among adolescent girls treated as out-patients in a family-based setting

Aims To study the 1-year outcome and to analyse predictors of outcome of a cohort of adolescent girls with anorexia nervosa (AN) or restrictive eating disorders not otherwise specified (EDNOSr) treated as out-patients in a family-based programme at a specialized eating disorder service. To calculate the incidence of anorexia nervosa among treatment-seeking girls younger than 18 in Uppsala County from 2004 to 2006. Methods A total of 168 female patients were offered treatment, and 141 were followed-up 1 year after starting treatment, 29 with AN and 112 with EDNOSr. Results Of the 29 girls who initially had AN, 6 (20%) had a good outcome and were free of any form of eating disorder at follow-up; only 1 (3%) had AN. Of the patients with EDNOSr, 54 (48%) had a good outcome and were free of eating disorders. Three (3%) had a poor outcome and had developed AN. The incidence of AN was 18/100,000 person-years in girls younger than 12 and 63/100,000 in girls younger than 18. Conclusion Restrictive eating disorders, including AN, in children and adolescents can be successfully treated in a family-based specialized out-patient service without in-patient care

Сбор и подготовка скважинной продукции

Предназначен для получения навыков выполнения расчетов при эксплуатации технологического оборудования систем сбора и подготовки продукции скважин нефтяных и газовых месторождений. Рассмотрены методики расчета состава продукции, потерь давления в трубопроводе при транспортировке сложных углеводородных систем. Представлены примеры решения задач, предложены варианты заданий для самостоятельного решения. Для студентов специальности 1-51 02 02 «Разработка и эксплуатация нефтяныхгазовых месторождений» дневной и заочной форм обучения

Family-based intervention in adolescent restrictive eating disorders : early treatment response and low weight suppression is associated with favourable one-year outcome

Background: Family-based treatments are first-line treatments for adolescents with restrictive eating disorders (ED) but have to be improved since outcome is poor for some. We have investigated the one-year outcome of a family-based intervention programme with defined and decisive interventions at the start of treatment. Method: Data pertaining 201 adolescents with restrictive ED with features of anorexia nervosa but not fulfilling the weight criterion starting treatment 2010-2015, had a wide range of body mass index (BMI) and of weight loss at presentation, and completed a one-year follow-up was analysed. Recovery from the ED was defined as an Eating Disorder Examination-questionnaire (EDE-Q) score &lt; 2.0 or as not fulfilling criteria for an ED at a clinical interview. Results: By EDE-Q 130 (65%) had recovered at 1 year and by clinical interview 106 (53%). According to the EDE-Q criterion recovery was independently associated with lower EDE-Q score at presentation, higher weight gain after 3 months of treatment and lower weight suppression at follow-up, weight suppression being defined as the difference between premorbid and current BMI. Not fulfilling criteria for an ED was associated with the same factors and also by higher BMI at presentation. Conclusion: The observations that low weight and high ED cognitions confer a poor prognosis but that rapid weight gain at the start of treatment predicts a better prognosis are presently extended to adolescents with restrictive ED with a wide range of BMI at presentation. High weight suppression at follow-up is associated with a poor prognosis and indicates the importance of taking premorbid BMI into account when setting weight targets for treatment

Correction: Limbic-thalamo-cortical projections and reward-related circuitry integrity affects eating behavior: A longitudinal DTI study in adolescents with restrictive eating disorders.

[This corrects the article DOI: 10.1371/journal.pone.0172129.]