The role of dieting, psychopathological characteristics and maladaptive personality traits in Orthorexia Nervosa.

BACKGROUND: Pursuing a healthy diet is not a dysfunctional behavior, but dieting could be an important etiological factor for Orthorexia Nervosa (ON). The aim of this study was to investigate the role of diet in groups with high/low orthorexic tendencies. Moreover, some psychopathological characteristics associated with ON and maladaptive personality traits were investigated. METHODS: The sample consisted of three groups: two were on a diet and had high (HIGH-D; n = 52) or low (LOW-D; n = 41) orthorexic tendencies. The other was composed of people with high orthorexic tendencies not on a diet (HIGH; n = 40). Participants filled out self-report questionnaires to investigate orthorexic tendencies, eating disorders features, obsessive-compulsive symptoms, perfectionism, depressive/anxious symptomatology, and maladaptive personality traits. RESULTS: The HIGH-D group showed more orthorexic tendencies than the HIGH group. More maladaptive personality traits and anxiety symptoms have been highlighted in HIGH and HIGH-D groups. The HIGH group had more eating disorder characteristics than other groups. Only the HIGH-D group showed more depressive symptoms than the LOW-D group. CONCLUSIONS: The features of HIGH and LOW-D groups suggest that diet alone could not explain ON, even if it could be a possible factor related to ON. Therefore, people with high orthorexic tendencies, psychopathological features, and maladaptive personality traits could be in a prodromic condition for disordered eating habits and deserve clinical attention.

Orthorexia Nervosa: differences between clinical and non-clinical samples.

BACKGROUND: Orthorexia Nervosa (ON) is a construct characterized by behaviors, emotions, and beliefs on eating healthy food and excessive attention to diet; moreover, dieting has been considered a risk factor in ON symptoms development. The principal aim of this study was to investigate the differences in clinical and non-clinical groups most at risk of ON. Aspects that could be associated with ON (Eating Disorders [EDs], obsessive-compulsive symptomatology, perfectionistic traits, anxiety, depression, Body Mass Index [BMI]) were investigated in all groups. METHODS: The sample consisted of 329 adults belonging to four different groups. Three were on a diet: Anorexia/Bulimia Nervosa group (N = 90), Obesity/Binge Eating Disorder group (N = 54), Diet group (N = 91). The Control group consisted of people who were not following a diet (N = 94). Participants completed several self-administered questionnaires (EHQ-21, EDI-3, OCI-R, MPS, BAI, BDI-II) to assess ON-related features in different groups. RESULTS: Analyses highlighted higher orthorexic tendencies in Anorexia/Bulimia Nervosa, Obesity/BED, and Diet groups than in the Control group. Moreover, results have shown that in the AN/BN group, eating disorders symptomatology and a lower BMI were related to ON and that in Obesity/Binge Eating Disorder and Diet groups, perfectionism traits are associated with ON. CONCLUSION: Individuals who pursue a diet share some similarities with those who have an eating disorder regarding emotions, behaviors, and problems associated with orthorexic tendencies. Moreover, perfectionistic traits seem to predispose to higher ON tendencies. In general, these results confirm the ON as an aspect of the main eating disorders category.

Histopathological evidence of invasive gastric mucormycosis after transarterial chemoembolization and liver transplantation.

We describe a case of a 62-year-old diabetic woman with hepatocellular carcinoma due to chronic hepatitis B virus infection. Two weeks after orthotopic liver transplantation, endoscopy for massive upper gastrointestinal bleeding revealed a large necrotic area in the gastric fundus. The patient underwent emergency resection. Histopathologically, angioinvasive mold infection compatible with mucormycosis was diagnosed in a large area of necrosis, mimicking an atypically localized gastric ulcer. Foreign bodies originating from transarterial chemoembolization (TACE) performed 7 and 8 months earlier and 40 days before transplantation were identified in the submucosal tissue. The patient was treated with liposomal amphotericin B (LAB) for 5 weeks, followed by 7 weeks of posaconazole. Follow-up biopsies after 1 and 5 months confirmed successful treatment. Review of the radiological images of the TACE procedure showed that some of the TACE material had been diverted to the stomach via an accessory gastric branch originating from the left hepatic artery. TACE agents may be associated with chronic, refractory gastroduodenal ulcers. We hypothesize that the ischemic lesion was first colonized with presumed Mucorales mold and invasive growth was promoted by the posttransplantation immunosuppression. Careful exploration of extrahepatic collaterals during TACE may prevent this complication.

[Subacute lower back pain and acute kidney failure in a 47-year old man]. / Subakute lumbale Rückenschmerzen und akute Niereninsuffizienz bei einem 47-jährigen Mann.

A 47-year-old man presented with subacute, low back pain and increased creatinine levels. A CT scan showed an extrinsic, bilateral compression of the ureters by a retroperitoneal mass with pronounced uptake of 18F-fluorodeoxyglucose in positron emission tomography. Histological findings were consistent with the diagnosis of retroperitoneal fibrosis. Urological decompression was performed. The initiated corticosteroids led to a rapid clinical improvement and regression of the retroperitoneal mass. A relapse occurred after tapering of corticosteroids with a prompt response to increase of the dosage.

Theoretical study of charge recombination at the TiO2-electrolyte interface in dye sensitised solar cells.

The charge recombination reaction from the semiconductor (TiO(2)) conduction band to electron accepting electrolytes (I(2), I(2)(-), I(3)(-)) in dye-sensitised solar cells is investigated theoretically. The non-adiabatic theory of electron transfer has been adapted to compute the charge transfer rate measured in different experimental settings (namely with and without external illumination). In both cases we are able to provide an atomic level description of the charge recombination to the electrolyte (CRE), which is in good agreement with the experimental data available. The model employs a detailed density-functional theory (DFT) description of the semiconductor-electrolyte interface and the internal reorganization energy. A continuum dielectric model is used to evaluate the external component of the reorganization energy due to the solvent degrees of freedom. The intrinsic limitations of DFT are kept to a minimum by taking two key energetic parameters (the conduction band edge and the reaction energy) from the experiments. The proposed methodology correctly reproduces (i) the ratio between CRE rate to iodine and triiodide in dark, (ii) the absolute CRE rate to triiodide in dark, and (iii) the absolute CRE rate to I(2)(-) under illumination.

Inhibition of malate dehydrogenase by thyroxine and structurally related compounds.

The inhibition of pig heart mitochondrial malate dehydrogenase (L-malate: NAD+ oxidoreductase, EC 1.1.1.37) by the thyroxine and structurally related compounds was studied to resolve a longstanding question about the exact nature of the inhibition. Thyroxine, in freshly prepared solution, was found to be a "pure" competitive inhibitor relative to the nucleotide cofactor. Upon standing in diffuse daylight, solutions of thyroxine showed increased ability to inhibit the enzyme, presumably as a result of oxidation of enzyme sulfhydryl groups by free iodine that is released photochemically. This behavior probably accounts for earlier reports of irreversible inactivation by thyroxine. Comment is made on the implications of these findings to the mechanism of thyroid hormmone action.

Mechanism of inhibition of malate dehydrogenase by thyroxine derivatives and reactivation by antibodies: homogeneous enzyme immunoassay for thryroxine.

Pig heart mitochondrial malate dehydrogenase (L-malate:NAD+ oxidoreductase, EC 1.1.1.37) is about 90% inhibited upon labelling an average of two amino groups per subunit with an active ester of thyroxine. Inhibition is probably associated primarily with thyroxine binding to one specific group which is normally unreactive but becomes activated upon noncovalent binding of thyroxine derivatives to the enzyme. Enzyme inhibition is due to a decrease in the rate of association of NAD. Antibodies to thyroxine induce a slow conformational change with partial reversal of inhibition of more heavily labelled conjugates. The antibody-induced activation is not cooperative and does not require bivalent association of the antibody. Activation can be blocked by the presence of free thyroxine and is the basis for a clinically useful assay for serum thyroxine.

Infusion of donor-derived peripheral blood leukocytes after transplantation of cord blood progenitor cells can increase the graft-versus-leukaemia effect.

We describe the case of a child affected by acute lymphoblastic leukaemia who received adoptive immunotherapy after cord blood transplantation (CBT). The patient, transplanted in second relapse resistant to chemotherapy, still showed lung and costal leukaemic nodular lesions 2 months after CBT. For this reason, three infusions of donor peripheral blood leukocytes 1 x 10(7)/kg each were administered on days +60, +80 and +100. The procedure was well tolerated by both patient and donor, and a complete disappearance of the lung lesions was documented 2 months after the last infusion. The patient remains in continuous complete haematological remission 13 months after CBT. This experience suggests that adoptive immunotherapy may be safely employed after CBT in order to increase the contribution of immune-mediated anti-leukaemia effect.

Recent developments in computational proteomics.

The mapping of the human genome was completed earlier this year and efforts are underway to understand the role of gene products (i.e. proteins) in biological pathways and human disease and to exploit their functional roles to derive protein therapeutics and protein-based drugs. A key component to the next revolution in the 'post-genomic' era will be the increasingly widespread use of protein structure in rational experimental design. Improvements in quality, availability and utility of large-scale 3D and 4D protein structural information are enabling a revolution in rational design, having particular impact on drug discovery and optimization. New computational methodologies now yield modeled structures that are, in many cases, quantitatively comparable with crystal structures, at a fraction of the cost.

A simplified solid-phase immunofluorescence assay for measurement of serum immunoglobulins.

A simple 2-step solid-phase fluoroimmunoassay for the determination of serum immunoglobulins is described. The method employs a stabilized solid-phase immunoadsorbent consisting of antigen immobilized on a cellulose acetate/nitrate disc attached to a plastic StiQTM sampler. The polymeric disc serves both as a substrate for immobilization and as a highly uniform surface upon which very precise fluorescence determinations may be made. The assays rely upon the reaction of a precise and limiting amount of mono-specific fluorescent antibody with the specific antigen present in a test sample. Residual unreacted fluorescently labeled antibody is allowed to bind to the immunoadsorbent; non-specifically bound antibody is removed in a wash step. The amount of labeled antibody bound is inversely proportional to the amount of antigen present in the test sample. The fluorescence of the bound labeled antibody is measured using a FIAX surface-reading fluorometer. Comparison of this new procedure with the commercially available (4-step) FIAX assay, which requires generation of immunoadsorbent in situ, demonstrated excellent correlation between the two methods. The new 2-step procedure provides results in a much shorter period of time and requires one-half to one-eighth of the operator time required for the other available solid-phase fluoroimmunoassays.

A solid-phase fluoroimmunoassay for the quantitation of antibodies to Toxoplasma gondii.

A solid-phase fluoroimmunoassay (FIAX¿) for the detection and quantitation of human antibodies to Toxoplasma gondii is described. The method is a modification of the procedure of Walls and Barnhart [1] which differs from the earlier test in that it uses a dual rather than single surface StiQTM Sampler, having both an antigen and a control surface. Each sampler is carried through four steps: reaction with diluted serum, a buffer wash, reaction with FITC-labeled goat anti-human IgG, and a final buffer wash. The fluorescence of each surface is measured using a dedicated surface-reading fluorometer. Serum titers are interpolated from a standard curve. The antibody titers of 233 sera were determined by both the indirect immunofluorescent antibody (IFA) and the FIAX¿ assays. The titers determined by the two tests agreed within one four-fold dilution for 226 (97%) of the sera. For replicates (n = 21) of the sera with low, mid and high antibody titers the coefficients of variation were 13.6, 10.0, and 12.3% respectively.

Demonstration of both immunologically unique and common antigenic determinants in Dirofilaria immitis and Toxocara canis using monoclonal antibodies.

Using an ELISA system, the immunological cross-reactivity between D. immitis and T. canis has been, for the first time, examined on an individual clone-by-clone basis. This study offers a definitive demonstration of the presence of immunologically distinguishable species-specific non-crossreactive antigens and the presence of cross-reactive antigens in antigenic extracts obtained from adult D. immitis and T. canis.

A rare case of pancreatic lipoma.

During CT scanning, a pancreatic lipoma was diagnosed in a 70 year-old woman presenting with abdominal pain, elevated amylase and abnormal liver function tests. The patient underwent surgical excision of the lipoma located in the head of the pancreas. The postoperative course was uneventful. This is the third case of pancreatic lipoma described in the literature. It is a very rare neoplasm that should be included in the category of "non-ductal" tumors of the pancreas. The role of different diagnostic tools for the differential diagnosis of ductal pancreatic adenocarcinoma is discussed.

Progression from nodular to lymphangitic subcutaneous metastasis from clear cell endometrial carcinoma: CT findings.

Subcutaneous metastases from clear cell endometrial carcinoma are an uncommon event and tumor implantations are rarely found with diagnostic imaging techniques. The nodular form is the most frequent type of subcutaneous metastasis from genital system tumors, even though plaque-like and infiltrative forms have also been reported. We report the first case of subcutaneous metastasis from clear cell endometrial carcinoma whose progression from the early nodular to the lymphangitic infiltrative form was studied with computed tomography (CT). Differential diagnostic problems are discussed.

Accuracy of the smear technique in the cytological diagnosis of 650 lesions of the central nervous system.

The authors analyzed the results of 650 lesions of the central nervous system submitted to intraoperative cytological diagnosis by the smear technique. Cytological and paraffin section diagnoses were compared. The following statistical values were obtained: accuracy of 97.3%, sensitivity of 97.9%, specificity of 95%, positive predictive value of 99.1%, and negative predictive value of 89.6%. The authors comment on their main pitfalls using this cytological diagnostic procedure.

Blind megaureter with ipsilateral renal agenesis and mullerian anomaly: MR findings in a case.

The magnetic resonance imaging (MRI) of a patient with congenital blind megaureter and mullerian anomaly are presented. A retroperitoneal pelvic mass appeared as elongated tubular cystic structure spreading from parametrium to the adnexa and reaching the recto-sigma. On MRI, the mass was hyperintense on T1 and T2-weighted images and disappeared in STIR sequences. The mass with pseudo-intestinal structure, the retroperitoneal site, and the MRI sequences make the differential diagnosis.

Multiple nodular metastases in mesenteric panniculitis by uterine papillary serous adenocarcinoma (UPSC): CT appearance of a case.

Intra-abdominal panniculitis is a thickening of the mesentery of the small/large intestine due to infiltration of lipid-laden macrophages associated with a variable amount of fibrosis. This condition is rarely associated with malignant neoplasms. We report the computed tomography (CT) findings of a patient treated for uterine papillary serous adenocarcinoma (UPSC). She had mesenteric panniculitis where metastatic tumor nodules implanted. This was the only intraperitoneal recurrence. To our knowledge, no such finding has been reported in the gynecologic and radiologic literature to date. On CT images, the differential diagnosis is with cystic dilatations of mesenteric lymph vessels.

Primitive mucinous cystadenocarcinoma of the retroperitoneum. Case report and diagnostic considerations.

The combination of ultrasonography (US) and computed tomography (CT) proved useful in recognizing and defining the characteristics of a primitive mucinous cystadenocarcinoma of the retroperitoneum, a rare anatomopathological finding which consistently presents certain macroscopic features that help in the formulation of a diagnosis with imaging techniques.

Meningeal carcinomatosis in patient with esophagus adenocarcinoma.

Meningeal carcinomatosis (MC) is an uncommon from of metastasis of solid tumors. We reported a clinical case of a woman with esophagus adenocarcinoma that a few months after surgical operation, presented episodes of vomiting, nausea, hypertension, mental change, unconsiousness; A contrast-enhanced CT of the brain revealed an "area of enhancement in the caudate nucleus" and cerebrospinal fluid cytologic studies evidenced the presence of carcinomatous cells. The clinical state of the patient deteriorated and she died a few days later. Autopsy confirmed meningeal carcinomatosis without parenchymal involvement.

[Cerebrovascular diseases in patients aged 15 to 40 years: neuropathological findings in 47 cases]. / Doenças cerebrovasculares em pacientes entre 15 e 40 anos: achados neuropatológicos em 47 casos.

Cerebrovascular diseases in patients between 15 and 40 years old are not a frequent subject in Latin-American literature, especially when focusing on neuropathology. We analyzed 47 brains from necropsies performed from 1987 to 1997 and selected on a basis of age and the presence of vascular pathology. From the 47 analyzed brains, 26 belonged to females (55.3%). When distributed among age groups, 12.8% (n=6) affected patients from 15 to 20 yo, 51,1% (n=24) from 21 to 30 yo, 36,2% (n=17) from 31 to 40 yo. The underlying diseases were: cardiac and haemathologic (19.2%), pregnancy complications (12.76%), infections, diseases of blood vessels and neurological (10.1% each) amongst others. The neuropathological abnormalities included cerebral and/or cerebellar herniation (16%), cerebral edema (13.8%), subarachnoid hemorrhage (10%), recent cerebral infarction (9%), intraparenchymatous hemorrhage (8.14%), hypoxic-ischemic encephalopathy (3%) and other events such as Sneddon syndrome and Lupus vasculitis. These findings express that the cerebrovascular phenomena in this age group are unique and closely related with the underlying disease.