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Objetivo: verificar a influência da pandemia de Covid-19 no risco de desenvolvimento de transtornos alimentares em mulheres. Metodologia: pesquisa quantitativa, com mulheres com acesso ao computador, a celular e à internet. A coleta de dados foi realizada a partir de um questionário on-line contendo 60 perguntas, com respostas fechadas, que visavam conhecer a sua relação com a alimentação. Foram verificados o consumo alimentar e o risco de desenvolvimento de anorexia nervosa (Eating Attitudes Test - EAT-26) e bulimia nervosa (Bulimic Investigatory Test, Edinburgh- BITE). Resultados: participaram da pesquisa 92 mulheres, sendo que 81,50% (n=75) referiram que ficaram em casa durante a pandemia. Sobre a ingestão de alimentos, 45,70% (n=42) relataram que consumiram diariamente frutas e hortaliças, 55,40% (n=51) ingeriram de 1 a 2 vezes/semana bolachas, salgadinhos, doces e guloseimas e 62,00% (n=57) consumiam embutidos pelo menos 1 vez/semana. Ainda, 18,50% (n=17) apresentaram risco para o desenvolvimento de anorexia nervosa e 83,60% (n=73) risco de bulimia nervosa. Entretanto, analisando se esse risco estava associado à pandemia, verificou-se que não houve diferença significativa entre o grupo que permaneceu em casa e o grupo que saiu para trabalhar (p > 0,05). Conclusão: portanto, grande parte das voluntárias apresentaram um risco de desenvolver algum transtorno alimentar, entretanto, não houve uma relação entre o possível risco de desenvolver transtornos alimentares influenciado pela pandemia.
Objective: to verify the influence of the Covid-19 pandemic on the risk of developing eating disorders in women. Methodology: quantitative research, with women with access to a computer, cell phone and internet. Data collection was carried out using an online questionnaire containing 60 questions, with closed answers, which aimed to understand their relationship with food. Food consumption Abstract and the risk of developing nervous anorexia (Eating Attitudes Test - EAT-26) and nervous bulimia (Bulimic Investigatory Test, Edinburgh - BITE) were verified. Results: 92 women participated in the research, with 81.50% (n=75) reporting that they stayed at home during the pandemic. Regarding food intake, 45.70% (n=42) reported that they consumed fruits and vegetables daily, 55.40% (n=51) ate cookies, snacks, sweets and sweets 1 to 2 times/week and 62, 00% (n=57) consumed sausages at least once/week. Furthermore, 18.50% (n=17) were at risk for developing nervous anorexia and 83.60% (n=73) were at risk for nervous bulimia. However, analyzing whether this risk was associated with the pandemic, it was found that there was no significant difference between the group that remained at home and the group that went out to work (p > 0.05). Conclusion: therefore, most of the volunteers presented a risk of developing an eating disorder, however, there was no relationship between the possible risk of developing eating disorders influenced by the pandemic.
الموضوعات
Humans , Female , Adult , Middle Agedالملخص
Abstract Objectives To provide a narrative review of the main eating disorders (ED), specifically focusing on children and adolescents. This review also aims to help the pediatrician identify, diagnose, and refer children and adolescents affected by this medical condition and inform them about the multidisciplinary treatment applied to these disorders. Data source The research was conducted in the Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (Medline) databases via PubMed and Embase. Consolidated Guidelines and Guidebooks in the area were also included in the review to support the discussion of ED treatment in childhood and adolescence. Data synthesis ED are psychiatric condition that usually begins in adolescence or young adulthood but can occur at any time of life, including in childhood, which has been increasingly frequent. Pediatricians are the first professionals to deal with the problem and, therefore, must be well trained in identifying and managing these disorders, which can be severe, and determine physical complications and quality of life of patients and their families. Conclusion ED has shown an increase in prevalence, as well as a reduction in the age of diagnosed patients, requiring adequate detection and referral by pediatricians. The treatment requires a specialized multidisciplinary team and is generally long-lasting for adequate recovery of affected individuals.
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Objetivo: Descrever a relação entre os principais transtornos alimentares e sua ocorrência em idosos, mostrando os impactos que estes distúrbios podem ocasionar na terceira idade, bem como relatar os principais desafios e dificuldades quanto ao diagnóstico e tratamento na prática clínica. Métodos: Trata-se de uma revisão narrativa, realizada durante julho de 2020 a setembro de 2023, utilizando-se bases de dados científicas tais como: Pubmed, Scopus, Web of Science, Scielo e Lilacs. Resultados: Foi possível constatar que os estudos envolvendo os transtornos alimentares em idosos ainda são mínimos, merecendo uma maior atenção a anemia, a bulimia e o transtorno de compulsão alimentar. Conclusão: Ressalta-se a necessidade de maiores estudos envolvendo a ocorrência de transtornos alimentares no público idoso. Devido à escassez de pesquisas nessa área, tem se tornado difícil oferecer abordagens eficazes de tratamento para o desenvolvimento e diagnóstico de transtornos alimentares nesse ciclo da vida.
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ObjectiveTo observe the clinical efficacy of modified Yigongsan combined with multi-enzyme tablets and bifidobacterium triple live powder on infantile anorexia with spleen-stomach Qi deficiency syndrome. MethodA total of 112 infantile patients anorexia with spleen-stomach Qi deficiency syndrome treated at Hebei Provincial Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were enrolled and divided into a control group and an observation group， with 56 cases in each group， according to a random number table. Children in the control group were treated with multi-enzyme tablets and Bifidobacterium triple live powder， while those in the observation group were treated with modified Yigongsan in addition to the treatment in the control group. During the study， one case dropped out in the control group and two cases dropped out in the observation group. The clinical efficacy of the two groups of children was compared， including changes in traditional Chinese medicine （TCM） syndrome scores （main symptoms， secondary symptoms， tongue， and pulse）， time to restore normal food intake， and increase in body weight. Changes in calcium， iron， zinc levels， hemoglobin， and albumin levels before and after treatment， as well as changes in gastrointestinal hormones such as gastrin and motilin， vasoactive intestinal peptide， somatostatin， neuropeptide Y， orexin， and leptin， were observed. The occurrence of adverse reactions in the two groups of children during the study was also recorded. ResultThe total effective rate of children in the control group after treatment was 85.19% （46/54）， while that in the observation group was 98.15% （53/54） （χ2 =5.939， P<0.05）. Compared with the control group， the time for food intake to return to normal in the observation group was shorter， and the increase in body weight was greater （P<0.05）. Compared with the results before treatment， the TCM syndrome scores （main symptoms， secondary symptoms， tongue， and pulse） in both groups of children significantly decreased， while the levels of calcium， iron， zinc， hemoglobin， albumin， gastrin， motilin， neuropeptide Y， and orexin increased， and the levels of vasoactive intestinal peptide， somatostatin， and leptin decreased （P< 0.01）. Compared with the control group after treatment， the improvement in the above indicators in the observation group was more significant （P<0.01）. The incidence of adverse reactions in the two groups of children during the treatment period was similar， and the difference was not statistically significant. ConclusionModified Yigongsan combined with multi-enzyme tablets and Bifidobacterium triple live powder is highly effective in treating infantile anorexia （spleen-stomach Qi deficiency syndrome）. After treatment， symptoms of the children were improved，appetite and food intake increased， gastrointestinal function was improved， body weight increased， and adverse reactions were few， indicating that the treatment was safe and reliable.
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Objective:To observe the therapeutic effect of vibrating the abdomen on anorexia model rats,as well as its effects on cholecystokinin octapeptide(CCK-8)and motilin(MTL)in the peripheral blood. Methods:Forty young rats were randomly divided into a normal group(n=10)and a modeling group(n=30).Rats in the normal group were fed common feed.The anorexia model was established by the etiological simulation method in the modeling group,and these rats were further randomly divided into a drug group,a vibrating abdomen group,and a model group 3 weeks after the anorexia model was induced,with 10 rats in each group.The drug group was given Jian Wei Xiao Shi Pian by intragastric administration at a dose of 0.72 g/(kg·bw)(0.72 g drug was dissolved in 10 mL purified water).The normal group and the model group were given purified water once a day in the morning.The vibrating abdomen group was treated with vibrating the abdomen once a day for 21 times.The body mass,food intake,serum CCK-8,MTL,gastrin(GAS),neurotensin(NT)levels,and the intestinal propulsion rate of rats in each group were measured. Results:Compared with the model group,the body mass,food intake,serum MTL and GAS levels,and the small intestine propulsion rate increased significantly,and the serum CCK-8 and NT levels,the gastric residual rate decreased significantly in the vibrating abdomen group and the drug group(P<0.05).There were no significant differences between the vibrating abdomen group and the drug group(P>0.05). Conclusion:Vibrating the abdomen increases the food intake and body mass of anorexia model rats,reduces the residue of gastric contents,improves the small intestine propulsion rate,and therefore has a good therapeutic effect on anorexia.The mechanism may be related to inhibiting the secretion of CCK-8 and NT in plasma and promoting the release of MTL and GAS in serum.
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ObjectiveTo explore the possible mechanism of pediatric tuina therapy in treating anorexia nervosa. MethodsTotally 120 children with anorexia nervosa were randomly divided into a tuina group and a medication group， with 60 cases in each group. Sixty healthy children undergoing physical examinations were recruited as the healthy control group. Children in the tuina group received traditional pediatric tuina therapy， while those in the medication group received orally chewed Jianwei Xiaoshi tablets. Each treatment course lasted for 7 days， with a 1-day interval between courses， and a total of 4 courses were administered. Before and after treatment， seven indicators including gastric motility frequency， gastric area， gastric area 30 minutes after drinking， anterior-posterior diameter and area during gastric fundus dilation， anterior-posterior diameter and area during gastric fundus contraction were measured using a color Doppler ultrasound diagnostic instrument in children from the healthy control group， tuina group， and medication group. Additionally， gastric emptying rate at 30 minutes， changes in anterior-posterior diameter and area during gastric fundus contraction， and changes in gastric area were compared. ResultsThis study ultimately included 60 healthy children in the control group， 59 children in the tuina group， and 51 children in the medication group. Compared with the control group at baseline， the gastric area and the anterior-posterior diameter and area during gastric fundus contraction increased， while the gastric emptying rate， gastric motility frequency， and changes in anterior-posterior diameter during gastric fundus contraction decreased in both the tuina group and medication group， with only a decrease in gastric area during gastric fundus contraction observed in the tuina group （P＜0.05）. Compared with baseline， after treatment， the gastric emptying rate， gastric motility frequency， and changes in anterior-posterior diameter and area during gastric fundus contraction increased in the tuina group， while the gastric area and area during gastric fundus contraction decreased 30 minutes after treatment； in the medication group， gastric motility frequency and changes in anterior-posterior diameter during gastric fundus contraction increased， while the area during gastric fundus contraction decreased （P＜0.05 or P＜0.01）. Compared with the medication group after treatment， the gastric area decreased 30 minutes after treatment， while the gastric emptying rate and gastric motility frequency increased （P＜0.05）. ConclusionThe possible mechanism of pediatric tuina therapy in treating anorexia nervosa is to promote gastric motility and gastric emptying， thereby improving gastrointestinal dysfunction in children.
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ABSTRACT Purpose: We aimed to evaluate retinal nerve fiber and choroidal layer alterations in adolescents with anorexia nervosa using spectral-domain optical coherence tomography. Methods: Thirty patients with anorexia nervosa and 30 healthy adolescents aged 12-18 years were included in this study. Their age, sex, body mass index, anorexia nervosa type, disease duration, and spectral-domain optical coherence tomography data were recorded. Results: Central macular thickness and retinal nerve fiber layer thickness in the temporal and inferior regions were significantly lesser in patients with anorexia than in healthy controls (p<0.05). Moreover, significant choroidal thinning around the foveal and subfoveal regions in patients with anorexia was observed (p<0.05). In addition, a statistically significant relation between the increase in disease duration and the thinning of the inferior retinal nerve fiber layer was detected (p<0.05). Conclusion: The retinal nerve fiber layer and choroidal layer thicknesses were lesser in patients with anorexia than in healthy controls. Screening for retinal indices might prevent the development of irreversible retinal pathologies in adolescents with anorexia nervosa. In addition, thinning of the retinal nerve fiber and choroidal layers could reflect structural or functional changes in the brain of adolescents with anorexia nervosa.
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RESUMO Objetivo Avaliar o consumo alimentar, comportamento de risco para transtornos alimentares e percepção da imagem corporal em adolescentes praticantes de judô. Métodos Estudo transversal com adolescentes judocas participantes da Federação Paranaense de Judô. Os dados foram coletados por meio de um questionário on-line, contendo os instrumentos Body Shape Questionnaire (BSQ) para avaliar percepção da imagem corporal, o Eating Attitudes Test (EAT-26) para identificar comportamentos de risco para transtornos alimentares e o Recordatório alimentar de 24 horas para análise da ingestão alimentar. A insatisfação com o peso corporal foi obtida pelo relato dos que gostariam de ganhar ou perder peso. Resultados Participaram 57 judocas de ambos os sexos, maioria sexo masculino (54,3%; n=31). Ausência de comportamento de risco para transtorno alimentar (63,1%; n=36) e insatisfação com a imagem corporal (75,4%; n=43) foram prevalentes entre os judocas. Entre os que apresentaram insatisfação com a imagem corporal (36,8%; n=14), observou-se que 9 (15,78%) também mostraram comportamento alimentar de risco para transtornos alimentares pelo teste EAT-26 (p=0,002). Houve associação entre insatisfação com o peso e comportamento de risco para TA (p=0,034), representado pelo EAT positivo para 26,31% (n=15) dos adolescentes. Identificou-se valores de ingestão alimentar insuficientes de energia e carboidratos, bem como consumo elevado de proteínas, e inadequação na ingestão para a maioria dos micronutrientes. Conclusão A maioria dos atletas não apresentou comportamento de risco para TA e estavam satisfeitos com sua imagem corporal. Diate da inadequação no consumo alimentar, destaca-se a importância das ações de educação alimentar e nutricional voltadas para este público.
ABSTRACT Objective To evaluate food consumption, risk behavior for eating disorders and perception of body image in adolescents who practice judo. Methods Cross-sectional study with adolescents practicing judo, participants of the Paraná Federation of Judo. For data collection, an online questionnaire was used, containing questions related to characterization and anthropometric data, the Body Shape Questionnaire (BSQ) instruments to assess body image perception, the Eating Attitudes Test (EAT-26) to identify behaviors risk factors for eating disorders and the 24-hour food recall to assess food intake. Dissatisfaction with body weight was obtained by reporting those who would like to gain or lose weight. Results 57 judokas of both sexes participated, mostly male (54.3%; n=31). Absence of risk behavior for eating disorders (63.1%; n=36) and dissatisfaction with body image (75.4%; n=43) were prevalent among judokas. Among the adolescents who were dissatisfied with their body image (36.8%; n=14), it was observed that 9 (15.78%) also showed risky eating behavior for eating disorders by the EAT-26 test (p=0.002). There was an association between dissatisfaction with weight and risk behavior for ED (p=0.034), represented by positive EAT for 26.31% (n=15) of adolescents. Insufficient food intake values of energy and carbohydrates, as well as high protein consumption, and inadequate intake for the largest of micronutrients were identified. Conclusion Most athletes did not present risk behavior for ED and were satisfied with their body image. Among those classified as dissatisfied with their body image, the degrees identified are mostly mild to moderate. The analysis of food consumption showed inadequacy for most of the nutrients evaluated, emphasizing the importance of food and nutrition education actions aimed at this public.
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L'anorexie est une pathologie du vide de sens, qui presente une défaillance au niveau des processus de la pensée, avec des implications directes au niveau de la construction identitaire. Le Rorschach a été utilise comme instrument d'évaluation du fonctionnement mental et comme méthode d'analyse des transformations psychiques. Martha est une adolescente de dix-sept ans, avec deux hospitalisations, avec un diagnostic d'anorexie. L'analyse du Rorschach à mettre en évidence deux mouvements psychiques: la présence d'une forte tension pulsionnelle, mobilisée face à l'atteinte ressentie dans la relation Moi-Autre; la dévitalisation du Moi, par un fort mouvement d'annulation du Moi. La compréhension de ces mouvements a permis une intervention thérapeutique dans le but de restaurer son Être, de consolider son identité et de permettre un ensemble de transformations psychiques qui permettent la subjectivation et la croissance mentale.
Resumos A anorexia é uma patologia do vazio do sentido, que apresenta uma falha ao nível dos processos do pensamento, com implicações diretas ao nível da construção da identidade. O Rorschach foi usado como um instrumento para aceder ao funcionamento mental e como um método de análise das transformações psíquicas. Martha é uma adolescente de dezessete anos, com duas internações, com um diagnóstico de anorexia. A análise de Rorschach permitiu destacar dois movimentos psíquicos: a presença de uma forte tensão pulsional, mobilizada perante o ataque sentido na relação Eu-Outro; a desvitalização do Eu, através de um movimento de uma forte anulação do próprio eu. A compreensão desses movimentos permitiu uma intervenção terapêutica com o objetivo de restaurar o seu Ser, consolidar sua identidade e permitir um conjunto de transformações psíquicas que possibilitam a subjetivação e o crescimento mental.
Anorexia is a pathology of the emptiness of meaning, which presents a failure at the level of thought processes, with direct implications in self-identity. Rorschach test was used as an instrument to assess mental functioning and as a method to analyze the psychic transformations. Martha is a 17-year-old adolescent, with two previous hospitalizations, diagnosed with anorexia. Through Rorschach test, it was possible to highlight two movements: the presence of a strong instinctual drive, mobilized in the face of the perceived attack in the Self-Other relationship; the devitalization of the Self, through a strong annulment of the self. The understanding of such movements enabled a therapeutic intervention aimed at restoring her Being, consolidating her identity and enabling a set of psychic transformations that allow for subjectivation and mental growth.
La anorexia es una patología del vacío de sentido, que presenta una falla al nivel de los procesos del pensamiento, con implicaciones directas en la construcción de la identidad. El Rorschach se utilizó como instrumento para evaluar el funcionamiento mental y como método de análisis de las transformaciones psíquicas. Martha es una adolescente de 17 anos, con dos hospitalizaciones y diagnóstico de anorexia. El análisis del Rorschach reveló dos movimientos psíquicos: la presencia de una fuerte tensión instintiva, movilizada frente al ataque sentido en la relación Yo-Otro; la desvitalización del Yo, mediante un fuerte movimiento de anulación del Yo. La comprensión de estos movimientos permitió aplicar una intervención terapéutica con el objetivo de restaurar el Ser de la paciente, consolidar su identidad y permitir un conjunto de transformaciones psíquicas que permitan la subjetivación y el crecimiento psíquico.
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ABSTRACT Objectives: to analyze films and documentaries about eating disorders from the last twenty years, identifying the way they approach the topic as well as their relevance for didactic use in teaching the health field. Methods: a descriptive study, whose data collection was carried out on the main streaming and video platforms, resulting in the survey of 60 media. Of these, only 25 had audio/subtitles in Portuguese (inclusion criteria). scientific relevance was analyzed considering psychopathological and epidemiological aspects of these disorders. A questionnaire about the plot, characters and descriptive data analysis were used. Results: most media were dramas about female teenagers who tried to conform to beauty stereotypes, whose symptoms portrayed converged with current medical diagnostic manuals. Conclusions: in practical terms, a classificatory list of 11 media was prepared that could be used as a teaching resource for teaching this topic in the health field.
RESUMEN Objetivos: analizar películas y documentales sobre trastornos alimentarios de los últimos veinte años, identificando la forma en que abordan el tema, así como su relevancia para su uso didáctico en la enseñanza del campo de la salud. Métodos: estudio descriptivo, cuya recolección de datos se realizó en las principales plataformas de streaming y video, dando como resultado la encuesta a 60 medios. De estos, sólo 25 tenían audio/subtítulos en portugués (criterios de inclusión). Se analizó la relevancia científica considerando aspectos psicopatológicos y epidemiológicos de estos trastornos. Se utilizó un cuestionario sobre la trama, los personajes y el análisis de datos descriptivos. Resultados: la mayoría de los medios fueron dramas sobre mujeres adolescentes que intentaban ajustarse a estereotipos de belleza, cuyos síntomas retratados convergían con los manuales de diagnóstico médico vigentes. Conclusiones: en términos prácticos, se elaboró un listado clasificatorio de 11 medios que podrían ser utilizados como recurso didáctico para la enseñanza de este tema en el campo de la salud.
RESUMO Objetivos: analisar filmes e documentários sobre transtornos alimentares dos últimos vinte anos, identificando o modo como abordam a temática, bem como sua pertinência para o uso didático no ensino do campo da saúde. Métodos: estudo descritivo, cuja coleta de dados foi realizada nas principais plataformas de streaming e vídeos, resultando no levantamento de 60 mídias. Dessas, apenas 25 tinham áudio/legenda em português (critério de inclusão). A pertinência científica foi analisada considerando aspectos psicopatológicos e epidemiológicos desses transtornos. Utilizaram-se um questionário sobre o enredo, as personagens e análise descritiva dos dados. Resultados: a maioria das mídias eram dramas sobre adolescentes do sexo feminino que tentavam adequar-se aos estereótipos de beleza, cujos sintomas retratados convergiam com os manuais de diagnósticos médicos atuais. Conclusões: em termos práticos, elaborou-se uma lista classificatória de 11 mídias que poderão ser utilizadas como recurso didático para o ensino desse tema no campo da saúde.
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Resumen Este trabajo propone realizar una revisión sistemática sobre las diferentes lecturas sobre la anorexia para describir las propuestas de abordaje en el psicoanálisis y sus perspectivas metodológicas. La revisión sistemática, según la Declaración PRISMA, se lleva a cabo en julio de 2022 y se seleccionan quince artículos científicos provenientes de siete bases de datos (REDIB, SCIELO, Dialnet, REDALYC, DOAJ, SNRD y Portal Regional en Salud Organización Panamericana de la Salud) que refieren a publicaciones en español entre 2022-2012 tomando como referencias las propuestas de la clínica psicoanalítica sobre la anorexia, en donde se concluye sobre las similitudes y diferencias en los abordajes de la temática desde el psicoanálisis sobre la consideración de la anorexia tanto a nivel teórico como clínico-terapéutico. Se podría pensar a la anorexia de hoy en día como la respuesta de algunos jóvenes histéricos a este imperativo: el sujeto insiste en afirmar su división subjetiva, rechazando al objeto que pretende colmarla. Se afana en albergar la nada, espacio del deseo puro.
Abstract This work proposes to carry out a systematic review on the different readings on anorexia to describe the proposals of approach in psychoanalysis and its methodological perspectives. The systematic review, according to the PRISMA Declaration, will be carried out in July 2022 and fifteen scientific articles will be selected from seven databases (REDIB, SCIELO, Dialnet, REDALYC, DOAJ, SNRD and Portal Regional en Salud Organización Panamericana de la Salud) that refer to publications in Spanish between 2022-2012 taking as references the proposals of the psychoanalytic clinic on anorexia, where it is concluded about the similarities and differences in the approaches to the subject from psychoanalysis on the consideration of anorexia both at a theoretical and clinical-therapeutic level. Today's anorexia could be thought of as the response of some hysterical young people to this imperative: the subject insists on affirming his subjective division, rejecting the object that tries to fill it. It strives to house nothingness, the space of pure desire.
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A teoria psicanalítica postula que as raízes emocionais dos transtornos alimentares (TAs) remontam à relação precoce mãe-filha. Este estudo qualitativo teve como objetivo investigar os significados atribuídos por mães de pacientes com anorexia e bulimia às experiências de gravidez, parto, puerpério e cuidados básicos oferecidos às filhas nos primeiros anos de vida. Participaram sete mães cujas filhas encontravam-se em seguimento em um serviço especializado para TAs. Os dados foram coletados por meio de entrevista aberta e organizados em categorias de acordo com a análise temática reflexiva. Os resultados foram discutidos à luz da Teoria do Amadurecimento Emocional de Winnicott. As experiências relacionadas à maternidade e aos cuidados maternos foram marcadas por frustrações e emoções negativas, com poucas recordações de vivências gratificantes advindas da assunção ao papel de mãe. São discutidas as repercussões emocionais da não elaboração de conflitos transgeracionais recebidos das gerações anteriores e transmitidos sem transformação pelas mães, o que contribui para inibir o amadurecimento emocional das filhas, guardando possível relação com a vulnerabilidade aos sintomas de TAs. (AU)
Psychoanalytic theory postulates that the emotional foundations of eating disorders (EDs) rest in the early mother-daughter relationship. This qualitative study aimed to investigate the meanings attributed by mothers of patients with anorexia and bulimia to the experiences of pregnancy, childbirth, puerperium, and basic care provided to their daughters in the first years of life. Participants included 7 mothers whose daughters were being treated in a specialized service for EDs. Data were collected by open interviews and organized into categories according to reflexive thematic analysis. Results were discussed in light of Winnicott's Theory of Human Maturation. The experiences related to motherhood and maternal care were marked by frustrations and negative emotions, with few memories of rewarding experiences with the assumption of the maternal role. The potential repercussions arising from the non-elaboration of intergenerational conflicts inherited and transmitted without transformation by mothers were discussed. These implications could potentially hinder the emotional maturation of daughters, establishing a close relation with the symptoms of EDs. (AU)
La teoría psicoanalítica postula que las bases emocionales de los trastornos alimentarios (TAs) descansan en la relación temprana madre-hija. Este estudio cualitativo tuvo como objetivo investigar los significados atribuidos por madres de pacientes con anorexia y bulimia a las vivencias del embarazo, parto, puerperio y cuidados básicos brindados a sus hijas en los primeros años de vida. Participaron siete madres cuyas hijas estaban siendo atendidas en un servicio especializado en TAs. Los datos fueron recolectados por entrevista abierta y organizados en categorías de acuerdo con el análisis temático reflexivo. Los resultados fueron discutidos a la luz de la Teoría del Desarrollo Emocional de Winnicott. Las experiencias relacionadas con la maternidad y el cuidado materno estuvieron marcadas por frustraciones y emociones negativas, con pocos recuerdos de experiencias gratificantes con la asunción del rol materno. Se discuten las posibles repercusiones de la no elaboración de conflictos transgeneracionales recibidos y transmitidos sin transformación por parte de las madres, lo que contribuye a inhibir la maduración emocional de las hijas, guardando una estrecha relación con los síntomas de los TAs. (AU)
الموضوعات
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Breast Feeding , Feeding and Eating Disorders , Socioeconomic Factors , Infant, Newborn , Pregnancy , Surveys and Questionnaires , Qualitative Research , Data Analysis , Infant , Mother-Child Relationsالملخص
Objetivo: Analizar las conductas alimentarias de riesgo, en relación al estado nutricional y actividad física en jóvenes adultos durante la pandemia COVID-19 en las comunas de Chillán y Chillán Viejo. Método: Diseño observacional y transversal. Se obtuvo una muestra de 184 adultos jóvenes de ambos sexos, que residían en dos comunas de la región de Ñuble (Chile) durante el periodo de confinamiento por la pandemia COVID-19. Se les aplicó un cuestionario de antecedentes personales y la escala SCOFF que evalúa el riesgo de trastornos de la conducta alimentaria (TCA). Resultados: Se encontró un 37,16% de riesgo para TCA (IC 95%: 30,23 - 44,63%). El riesgo de trastornos de la conducta alimentaria tuvo relación con las variables: actividad física (p = 0,01 análisis bivariante) y estado nutricional (p = 0,03, análisis ajustado). Conclusión: Se logró identificar una proporción superior a la registrada en la literatura y los factores asociados a TCA eran los que se esperaban encontrar.
Objective: To analyze risky eating behaviors in relation to nutritional status and physical activity in young adults during the COVID-19 pandemic in the communes of Chillán and Chillán Viejo. Methods: Observational and cross-sectional design. A sample of 184 young adults of both sexes, who lived in two communes in the Ñuble region (Chile) during the period of confinement due to COVID-19 pandemic, was obtained. A personal history questionnaire and the SCOFF scale that assesses the risk of eating behavior disorders (EDs) were applied. Results: A 37.16% risk for ED was found (95% CI: 30.23 - 44.63%). The risk of eating behavior disorders was related to the variables: physical activity (p=0.01 bivariate analysis) and nutritional status (p=0.03, adjusted analysis). Conclusion: It was possible to identify a higher proportion than that recorded in the literature and the factors associated with eating disorders were those that were expected to be found.
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Introduction: the evidence on the health problem-related prevalence of COVID-19 is an emergency. Case report: we present the case of a 28-year-old woman who had had a behavioral eating disorder (BED) since age 12. Her body mass index (BMI) was 13.6 kg/m2. She was hospitalized for a respiratory condition (bronchospasm) due to COVID-19, with supplementary oxygen at two liters. During her stay, she refused food and was started on standard enteral nutrition via a naso-gastric tube. She developed refeeding syndrome (RFS), which was managed with electrolytes, and her enteral diet was changed to a low-carbohydrate high-protein diet. She received psychological therapy through video calls, recovered, and was discharged to home. Discussion: refeeding complications increase when a high caloric rate is begun. The standard enteral formula has 54% carbohydrates, which contributes to the risk of developing RFS. The consequences of BED and COVID-19 are unknown, and it is likely to become more evident over time. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2626).
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Los trastornos de conducta alimentaria tienen efectos importantes sobre la salud oral destacándose entre estos por su alta prevalencia la anorexia y bulimia. Evaluar los efectos de la anorexia y bulimia sobre la periodontitis. Se realizó una búsqueda electrónica entre 2017 y 2021 en las bases datos Medline a través de Pubmed, Dentistry & Oral Sciences Source, Scopus, Springer y Biblioteca Virtual en Salud, donde con la estrategia de búsqueda "Anorexia OR Bulimia AND periodontal disease". Se recuperaron 101 registros potencialmente elegibles de los cuales luego de aplicar los criterios de elegibilidad se seleccionaron tres estudios de diseño observacional, cuyos resultados mostraron una asociación de la bulimia y anorexia con la incidencia de complicaciones orales en pacientes ambulatorios, donde la condición periodontal parece ser significativamente peor comparada con pacientes sanos emparejados por sexo y edad, siendo estos hallazgos de alta calidad metodológica o bajo riesgo de sesgo. La anorexia y la bulimia generan un alto impacto sobre la calidad de vida relacionada a la salud oral específicamente sobre el desarrollo de periodontitis. Sin embargo, se requieren de nuevos estudios que logren explicar en su totalidad esta posible relación.
Eating disorders have important effects on oral health, anorexia and bulimia standing out among them due to their high prevalence. To evaluate the effects of ano- rexia and bulimia on periodontitis. An electronic search was carried out between 2017 and 2021 in the Medline databases through Pubmed, Dentistry & Oral Sciences Source, Scopus, Springer and Virtual Health Library, where with the search strategy "Anorexia OR Bulimia AND periodontal disease". 101 potentially eligible records were retrieved from which, after applying the eligibility criteria, three observational design studies were selected, whose results showed an association of bulimia and anorexia with the incidence of oral complications in outpatients, where periodontal condition appears to be significantly worse compared to healthy patients matched for sex and age, these results being of high methodological quality or low risk of bias. Anorexia and bulimia have a high impact on health-related quality of life oral specifically on the development of periodontitis.However, it is required They want new studies that fully explain this possible relationship.
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Objetivo: avaliar os sintomas de transtornos alimentares em estudantes do Curso de Medicina do Centro Universitário Christus. Métodos: o estudo foi realizado com acadêmicos do quarto semestre do curso de Medicina. Utilizou-se um questionário sociodemográfico e antropométrico e os instrumentos Eating Atitudes Test (EAT-26); Binge Eating Scale (BES); e Sick Control One Stone Fat Food Questionnaire (SCOFF). Resultados: participaram do estudo 78 alunos, sendo 54 pessoas do sexo feminino (69,23%). A média de idade dos participantes foi de 22 (±4,7) anos, e o IMC médio foi de 24,33 (±4,11) kg/m2. Quanto ao SCOFF, 38,46% dos participantes apresentaram elevada probabilidade de transtorno alimentar, 14,10% apresentaram alto risco para desenvolverem transtornos alimentares segundo o EAT-26, e 12,82% apresentaram escores sugestivos de presença de compulsão alimentar moderada mediante o uso da BES. Conclusão: os transtornos alimentares e os comportamentos alimentares alterados foram identificados entre os acadêmicos de medicina. Assim, são necessárias intervenções de educação em saúde e de apoio psicológico para esta população, objetivando reduzir o risco de desenvolvimento de transtornos alimentares.
Objective: this study aimed to evaluate the symptoms of eating disorders in medical students at Centro Universitário Christus. Methods: the study was carried out with fourth-semester medical students. A sociodemographic and anthropometric questionnaire was used, the Eating Attitudes Test (EAT-26) instruments; Binge Eating Scale (BES); and Sick Control One Stone Fat Food Questionnaire (SCOFF). Results: 78 students participated in the study, 54 of whom were female (69.23%). The mean age of the participants was 22 (±4.7) years and the mean BMI was 24.33 (±4.11) kg/m2. As for the SCOFF, 38.46% of the participants had a high probability of having an eating disorder, 14.10% had a high risk of developing eating disorders according to the EAT-26, and 12.82% had scores suggestive of the presence of moderate binge eating using BES. Conclusion: eating disorders and altered eating behaviors were identified among medical students. Thus, health education and psychological support interventions are needed for this population, aiming to reduce the risk of developing eating disorders.
الموضوعات
Feeding Behavior , Anorexia Nervosa , Bulimia Nervosaالملخص
Objetivo: analisar a atuação da Enfermagem junto a pacientes com transtornos alimentares em filmes sobre o assunto. Método: trata-se de um estudo descritivo-exploratório desenvolvido a partir de dados secundários. Utilizaram-se a base de dados cinematográfica Internet Move Database e descritores em português e inglês, que foram: "anorexia", "bulimia" e/ou "transtornos alimentares". Adotaram-se como critérios de inclusão: criações audiovisuais produzidas entre 1998 e 2020; o conteúdo estar disponível nas plataformas de streaming elencadas; as criações terem áudio e/ou legendas em português; e o filme ter alguma cena com o profissional de Enfermagem. Seis mídias atenderam a esses critérios e foram analisadas a partir de um roteiro que investiga a abordagem da Enfermagem no tratamento dos transtornos alimentares. Para elencar a produção mais indicada para finalidade didática, foram considerados seis critérios objetivos. Resultados: a maioria dos enredos veiculou a Enfermagem de modo estereotipado e com pouca autonomia, além de atribuir uma postura de "mau" ou "bom ajudante do médico" a esses profissionais. Embora nenhum enredo tenha atendido a todos os critérios objetivos de maneira satisfatória, a produção audiovisual que correspondeu à maior parte dos critérios foi aquela indicada para a finalidade didática. Conclusão: as produções, de um modo geral, condizem mais com o modelo médico assistencialista, na qual o enfermeiro desenvolve ações de prevalência tecnicistas, de supervisão e desintegradas da equipe multiprofissional em detrimento do modelo biopsicossocial, o qual demanda raciocínio clínico, pensamento crítico e conhecimento científico fundamentado.(AU)
Objective: to analyze the performance of Nursing with patients with eating disorders in films about the subject. Method: this is a descriptive-exploratory study developed from secondary data. The film database Internet Move Database and descriptors in Portuguese and English were used, which were: "anorexia", "bulimia" and/or "eating disorders". The following inclusion criteria were adopted: audiovisual creations produced between 1998 and 2020; the content is available on the listed streaming platforms; the creations have audio and/or subtitles in Portuguese; and the film has a scene with the Nursing professional. Six media met these criteria and were analyzed based on a script that investigates Nursing's approach to the treatment of eating disorders. To list the most suitable production for didactic purposes, six objective criteria were considered. Results: most plots conveyed Nursing in a stereotyped way and with little autonomy, in addition to attributing a "bad" or "good doctor's helper" attitude to these professionals. Although no plot met all the objective criteria satisfactorily, the audiovisual production that met most of the criteria was the one indicated for didactic purposes. Conclusion: the productions, in general, are more in line with the medical care model, in which the nurse develops actions that are technical, supervisory, and disintegrated from the multidisciplinary team to the detriment of the biopsychosocial model, which demands clinical reasoning, critical thinking and grounded scientific knowledge.(AU)
Objetivo: analizar los cuidados de enfermería frente a pacientes con trastornos alimentarios en películas sobre el tema. Método: se trata de un estudio descriptivo-exploratorio desarrollado a partir de datos secundarios. Se utilizó la base de datos cinematográfica "Internet Move Database" y las palabras clave en portugués e inglés, las cuales fueron: "anorexia", "bulimia" y/o "trastornos alimentarios". Fueron adoptados los siguientes criterios de inclusión: creaciones audiovisuales producidas entre los años 1998 y 2020; el contenido estar disponible en las plataformas de streaming listadas; tener audio y/o subtítulos en portugués; y alguna escena con el profesional de Enfermería. Seis medios cumplieron estos criterios y fueron analizados a...(AU)
الموضوعات
Humans , Male , Female , Adult , Feeding and Eating Disorders/nursing , Nurse's Role/psychology , Nurse Practitionersالملخص
A new study in Cell from Ivan de Araujo and colleagues reported that intestinal GLP-1 acts on an inter-organ sympathetic neural circuit that induces appetite suppression. This study revealed that GLP-1， secreted by ileal L cells， sensing by intestinal myenteric layer intestinofugal neurons activated a sympatho-gastro-spinal-reticular-hypothalamic pathway involved in appetite suppression， linking stomach distention to craniofacial programs for food rejection. These molecularly indentified， delimited enteric circuits may be targeted to ameliorate the abdominal bloating and loss of appetite typical of gastric motility disorders.
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Objective:To evaluate the efficacy of self-made Xiaogan Tiaopi Kaiwei Decoction combined with conventional western medicine therapy in the treatment of infantile anorexia of spleen-stomach weakness.Methods:Randomized controlled trial. A total of 100 children with anorexia of spleen-stomach weakness ,who were treated in the First Clinical Medical College of Shaanxi University of Chinese Medicine between April 2020 and September 2021, were selected as the observation subjects in a prospective cohort study, and they were divided into two groups by the random number table method, with 50 in each group. The control group was given routine treatment, and the Traditional Chinese Medicine (TCM) group was given self-made Xiaogan Tiaopi Kaiwei Decoction on the basis of the control group. The TCM syndromes were scored before and after treatment. The levels of trace elements such as iron, zinc and calcium were detected by atomic spectrometer, the absorptivity of D-xylose was measured by colorimetry. The adverse events during treatment were recorded. After 6 months of follow-up, the height, weight and BMI were measured and recorded, and the clinical efficacy was assessed.Results:The total response rate was 96.0% (48/50) in the TCM group and that in the control group was 84.0% (42/50) ( χ2=4.00, P=0.046). The scores of decreased appetite, anorexia, sallow complexion, abdominal fullness and distention and shortness of breath and laziness to speak and total score in the TCM group after treatment were significantly lower than those in the control group ( t=12.47, 13.42, 14.19, 16.39, 9.15, 17.72, P<0.01). The levels of blood trace elements such as iron [(414.58 ± 57.52) mg/L vs. (350.85 ± 53.33) mg/L, t=5.75 ], zinc [(8.26 ± 1.55) mg/L vs. (7.64 ± 1.37) mg/L, t=2.12 ] and calcium [(77.26 ± 15.30) mg/L vs. (71.05±14.26) mg/L, t=2.10] and urine D-xylose absorption rate [(31.76±5.28) % vs. (27.97 ± 4.61) %, t=3.82 ] in the TCM group were significantly higher than those in the control group ( P<0.01 or P<0.05). During treatment, there was no serious adverse reaction in the TCM group and 1 case of nausea in the control group. There was no statistical significance in the incidence rate of adverse reactions between the two groups ( χ2=1.01, P=0.315). After follow-up, the weight in the TCM group was significantly higher than that of the control group ( t=2.17, P=0.032). Conclusion:Self-made Xiaogan Tiaopi Kaiwei Decoction combined with conventional western medicine therapy can relieve the clinical symptoms, promote the absorption of trace elements and improvement of spleen-stomach function, and enhance the long-term efficacy in the treatment of children with anorexia of spleen-stomach weakness, and it has no adverse reactions.
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Cancer anorexia/cachexia syndrome (cancer anorexia cachexia syndrome, CACS) is a common complication in advanced cancer patients, which is characterized by reduced feeding, sustained weight loss, general fatigue and weakness. CACS related symptoms make patients suffer from a series of adverse psychosocial effects, such as anxiety, pain and social isolation, thus bringing serious adverse effects on patients′ individuals, families and society. This paper reviewed the symptoms associated with CACS and their psychosocial effects, as well as the interventions related to adverse psychosocial effects, in order to provide theoretical reference for alleviating psychosocial distress and improving health-related quality of life of patients with CACS.