RESUMO
OBJECTIVE: Although some studies have shown cortisol nonsuppression following dexamethasone suppression test (DST) in current bulimia nervosa (BN), no study has looked at HPA axis abnormalities in behaviorally recovered BN patients. The purpose of this pilot study is to explore the role of current vs behaviorally recovered BN, as well as depression and childhood trauma in cortisol suppression in BN. METHODS: A 0.5 mg DST was performed on 21 patients with behaviorally recovered BN, 9 women with current BN and 14 controls. BN group also completed the Hamilton Depression Rating Scale and Childhood Trauma Questionnaire. RESULTS: There were no differences between the three groups in cortisol suppression, and BMI was not associated with cortisol levels following DST. Within the BN group, depression was significantly associated with afternoon cortisol nonsuppression (p=0.005). DISCUSSION: As researchers look for more accurate ways to identify biological phenotypes of BN, presence of comorbid depression may help explain differences in cortisol suppression.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Bulimia Nervosa/metabolismo , Bulimia Nervosa/psicologia , Depressão/metabolismo , Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipófise-Suprarrenal/metabolismo , Adolescente , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Dexametasona/farmacologia , Feminino , Glucocorticoides/farmacologia , Humanos , Hidrocortisona/análise , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Projetos Piloto , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Saliva/químicaRESUMO
Temporomandibular disorders (TMDs) are among the most controversial disorders in dentistry. Despite the publication of numerous theories, the origin of most TMDs is either unknown or is described as multifactorial. This article reviews the contribution of epidemiology to the understanding of TMDs, describes a classification system that emphasizes uniform criteria for diagnosis, and discusses current therapeutic considerations.
Assuntos
Transtornos da Articulação Temporomandibular , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Transtornos da Articulação Temporomandibular/classificação , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos da Articulação Temporomandibular/terapiaRESUMO
The clinician should recognize the importance of screening examinations for all patients seen in the dental office. The elements of a brief screening history and examination have been reviewed. In addition, the indications and elements of a comprehensive history and examination have been described. A discussion of current opinion on available diagnostic testing was also presented.
Assuntos
Dor Facial/etiologia , Transtornos da Articulação Temporomandibular/diagnóstico , Anestésicos Locais , Artrografia , Diagnóstico Bucal , Dor Facial/diagnóstico , Humanos , Má Oclusão/diagnóstico , Anamnese , Exame Neurológico , Exame Físico , Testes Psicológicos , Transtornos da Articulação Temporomandibular/complicaçõesRESUMO
Taking a history and performing an examination on an orofacial pain patient differs significantly from that in the general dental patient. Orofacial pain dentists must be familiar with the disorders that cause chronic head and neck pain. In addition, they must know the pertinent aspects of history taking with regard to the chief complaint, history of the present illness, the relevance of the past medical and dental history and how the social history can act as an important etiologic and prognostic factor. The clinician must also be versed in the elements of the orofacial pain examination which include evaluation of the TMJ and cervical spine; head, neck and dental examination; and, often, neurological and otolaryngological screening. The clinician should also have a familiarity with blood testing, urinalysis and know the uses and limitations of diagnostic imaging.