Virtually Accompanied Eating in the Outpatient Therapy of Anorexia Nervosa.

BACKGROUND: Normalizing the eating pattern and weight recovery are the main objectives in treating anorexia nervosa (AN). Eating accompaniment through shared mealtimes is a common strategy in eating disorder management programs. This study aims to examine the impact on weight gain of an internet-delivered meal support group on patients with AN who were under ambulatory treatment with the Eating Disorders Unit of the UC Christus Health Network, Chile. METHODS: An observational study of 54 female patients with AN diagnosis who participated in Online Meal Support Groups (OMSGs) three times a week was performed. Their weight, BMI and BMI%, was reviewed at the beginning of the sessions and at 45- and 90-day follow-up. RESULTS: Patients showed significant weight gain during follow-up. At the 90-day follow-up, patients had gained 4.41 (SD ± 2.82) kg with an effect size of -1.563. CONCLUSIONS: Statistically significant differences were found between the weight at the beginning of the intervention and at the 45- and 90-day follow-up, meaning that eating support online groups may be an effective intervention for weight gain and maintenance in patients with AN. These findings highlight the viability of developing cost-effective and more accessible interventions for AN and thus help reduce the duration of untreated disease and its consequences.

[Avoidant/Restrictive Food Intake Disorder (ARFID): What the pediatrician should know]. / Trastorno de Evitación y Restricción de la Ingesta de Alimentos (ARFID): Lo que el pediatra debe saber.

Feeding problems during childhood have been described over time by various authors. In 2013, Avoi dant/Restrictive Food Intake Disorder (ARFID) was included in the Diagnostic and Statistical Ma nual of Mental Disorders, 5th Edition (DSM-5), as a new diagnosis within the Feeding and Eating di sorders, to describe a group of patients with avoidant or restrictive eating behaviors unrelated to body image disorder or weight loss desire. ARFID may appear as significant weight loss and/or nutritional deficiency and/or a marked interference in psychosocial functioning. There are three forms of pre sentation, which can co-occur or occur independently. The first one includes children with sensory aversions (selective), who reject certain foods due to their taste, texture, smell, or shape; the second one includes those children with poor appetite or limited intake (limited intake); and the third one includes those children who reject certain foods or stop eating as a result of a traumatic event (aversi- ve). Due to the recent incorporation of ARFID into the DSM-5, there is a lack of information regar ding its treatment. The purpose of this review is to clarify diagnostic criteria and to describe targeted management and treatment interventions with a multidisciplinary approach, without deepening on the treatment of organic medical causes.

Dietas vegetarianas en alumnos universitarios / Vegetarian diets in first year university students

INTRODUCCIÓN: Se ha observado un aumento en la popularidad de las dietas vegetarianas, en especial en la población adolescente y adulto joven. Estas dietas se presentan como saludables y balanceadas pero las recomendaciones son controversiales en cuanto a los potenciales déficit nutricionales. OBJETIVO: Identificar la frecuencia y tipos de dieta vegetariana utilizada, su motivación y fuentes de información. PACIENTES Y MÉTODO: Estudio transversal y analítico en universitarios de primer año de la Pontificia Universidad Católica de Chile (PUC). Se realizó una encuesta vía online obteniendo información demográfica y caracterización de dietas de aquellos que se consideraban vegetarianos. Las variables fueron analizadas mediante el software IDM SPSS Statistics® y en planilla Excel® de forma cuantitativa. RESULTADOS: 152 alumnos respondieron la encuesta (15,2% del total), siendo el 49,4% de estos vegetariano. El 32,4% inició este patrón alimentario entre los 12-18 años; sus motivaciones más frecuentes fueron las medio ambientalistas (91,9%) y animalistas (72,9%). El 52,9% de los vegetarianos reciben suplementación de vitamina b 12 pero solo un 15,9% reportó presentar este déficit. El 75,7% obtiene información relacionada acerca de las dietas vegetarianas a través de medios digitales. CONCLUSIÓN: Se encontró un alto porcentaje de estudiantes vegetarianos en las encuestas contestadas, lo que hace necesario que los profesionales de salud estén capacitados en esta área para asegurar una adecuada educación nutricional, suplementación si es necesario, y seguimiento.

INTRODUCTION: There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE: To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD: Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS: 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION: In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.

Vegetarian diets in first year university students. / Dietas vegetarianas en alumnos universitarios.

INTRODUCTION: There has been an increase in the popularity of vegetarian diets, especially among adolescents and young adults. These diets seem to be healthy and balanced, but the recommendations are contro versial regarding potential nutritional deficits. OBJECTIVE: To identify the frequency and types of ve getarian diet used, their motivation, and sources of information. PATIENTS AND METHOD: Cross-sec tional analytical study in freshmen students from the Pontifical Catholic University of Chile (PUC). Through an online survey, we collected demographic information and diet characterization of those who considered themselves as vegetarians. Variables were analyzed using IDM SPSS Statistics® soft ware and in Excel® spreadsheet in a quantitative way. RESULTS: 152 students answered the survey (15.2% of the sample) and, out of these, 49.4% were vegetarian. 32.4% started this eating pattern bet ween the ages 12 and 18 and among their most frequent motivations were environmentalists (91.9%) and animalists (72.9%). 52.9% of vegetarians take vitamin B 12 supplementation but only 15.9% reported having this deficiency. 75.7% obtain information related to vegetarian diets through digital media. CONCLUSION: In the surveys answered, we found a high percentage of vegetarian students, the refore, health professionals need to be trained in this area to assure adequate nutritional education, supplementation if necessary, and follow-up.

[An update on inpatient treatment of anorexia nervosa: practical recommendations]. / Actualizaciones en el manejo intrahospitalario de la anorexia nerviosa: recomendaciones prácticas.

Anorexia Nervosa (AN) is the psychiatric illness with the highest mortality, especially if it is associated with psychiatric and somatic comorbidity. Medical complications can be multiple and jeopardize the normal development of children and adolescents, even permanently. Although its prevalence is lower compared with other psychiatric disorders, its tendency to chronicity and the severity of its consequences are remarkable. Although outpatient treatment of anorexia is privileged as far as possible, the risks associated with poor response to treatment or lack of adherence of the patient or family, require the possibility of hospitalization at any time of the disease. We searched and analyzed the national and international literature available (especially clinical guidelines) about the indication for hospital treatment in AN and the interventions recognized as necessary and effective during hospitalization. Despite the lack of standardized criteria for hospitalization, the available information converge on the need for a multidisciplinary work by a specialist team, to make family interventions especially in adolescents and tailor treatment according to the individual physical, psychological and social needs.

Actualizaciones en el manejo intrahospitalario de la anorexia nerviosa: recomendaciones prácticas / An update on inpatient treatment of anorexia nervosa: practical recommendations

Anorexia Nervosa (AN) is the psychiatric illness with the highest mortality, especially if it is associated with psychiatric and somatic comorbidity. Medical complications can be multiple and jeopardize the normal development of children and adolescents, even permanently. Although its prevalence is lower compared with other psychiatric disorders, its tendency to chronicity and the severity of its consequences are remarkable. Although outpatient treatment of anorexia is privileged as far as possible, the risks associated with poor response to treatment or lack of adherence of the patient or family, require the possibility of hospitalization at any time of the disease. We searched and analyzed the national and international literature available (especially clinical guidelines) about the indication for hospital treatment in AN and the interventions recognized as necessary and effective during hospitalization. Despite the lack of standardized criteria for hospitalization, the available information converge on the need for a multidisciplinary work by a specialist team, to make family interventions especially in adolescents and tailor treatment according to the individual physical, psychological and social needs.

[Clinical features of adolescent males with eating disorders]. / Características clínicas de adolescentes de sexo masculino con trastornos de la conducta alimentaria: estudio de casos clínicos.

BACKGROUND: There is a higher prevalence of eating disorders (ED) among adolescent females. These are less common in men and there are clinical differences between genders. AIM: To describe the clinical features of adolescent males with ED. MATERIAL AND METHODS: Review of 38 medical records of male patients with ED seen in an ED Unit in Chile, between 2001 and 2009. RESULTS: Mean age at first medical visit was 14.4 ± 2.2 years. Symptoms appeared 9.5 ± 8.9 months prior to the first visit. Anorexia nervosa (AN) of the restricting type was diagnosed in 21 patients (55.2%), with a mean weight loss of 11.2 kg ± 9.4 kg. In 37% of patients, there was a past medical history of overweight. All patients either increased or maintained weight during follow up. Sixty three percent had a psychiatric co-morbidity at first visit. After 3 months of treatment, 82% of patients remained in the program. CONCLUSIONS: There was a delay in diagnosis of ED in men. The high prevalence of AN found in this group is characteristic of patients recently diagnosed with ED. Overweight could be a precipitating factor. Nearly two thirds of male ED patients had a psychiatric comorbidity. This high prevalence may suggest a susceptibility to develop ED in males.

Características clínicas de adolescentes de sexo masculino con trastornos de la conducta alimentaria: Estudio de casos clínicos / Clinical features of adolescent males with eating disorders

Background: There is a higher prevalence of eating disorders (ED) among adolescent females. These are less common in men and there are clinical differences between genders. Aim: To describe the clinical features of adolescent males with ED. Material and Methods: Review of 38 medical records of male patients with ED seen in an ED Unit in Chile, between 2001 and 2009. Results: Mean age at first medical visit was 14.4 ± 2.2 years. Symptoms appeared 9.5 ± 8.9 months prior to the first visit. Anorexia Nervosa (AN) of the restricting type was diagnosed in 21 patients (55.2 percent), with a mean weight loss of 11.2 kg ± 9.4 kg. In 37 percent of patients, there was a past medical history of overweight. All patients either increased or maintained weight during follow up. Sixty three percent had a psychiatric co-morbidity at first visit. After 3 months of treatment, 82 percent of patients remained in the program. Conclusions: There was a delay in diagnosis of ED in men. The high prevalence of AN found in this group is characteristic of patients recently diagnosed with ED. Overweight could be a precipitating factor. Nearly two thirds of male ED patients had a psychiatric comorbidity. This high prevalence may suggest a susceptibility to develop ED in males.

[Program of eating disorders in Chilean adolescents and young adults: six months outcome]. / Programa de transtornos de alimentación en adolescentes y jóvenes chilenos: variaciones a seis meses de tratamiento.

BACKGROUND: Eating disorders may have serious organic consequences derived from under nutrition, specific nutrient deficiencies and electrolytic disturbances and reach a mortality as high as 12%. AIM: To describe the features and outcome after six months of treatment of patients attending the Eating Disorders Unit at the Catholic University Hospital in Chile. MATERIAL AND METHODS: Review of medical records of patients with eating disorders that received a multidisciplinary treatment by a team of nutritionists, psychiatrists and psychologists and were seen at least twice in a period of six months. RESULTS: The records of 81 patients (mean age 16.3+/-3 years, only one male) were included in the review. Forty nine patients had Anorexia Nervosa of the restricting type, five of the purging type, 22 had Bulimia Nervosa of the purging type and two of the non purging type and three patients had an eating disorder not otherwise specified. Eighty percent consulted within the first year of symptom appearance. Sixty five percent came from families with both parents living together, 57% had a rigid and agglutinated family structure and 65% had occult crises. Depression or dysthymia was found in 45% of patients and drug therapy was required at the beginning of treatment in 25%. Obsessive traits (40.4%) were significantly related to restrictive eaters. A past history of obesity or overweight was common. After six months of treatment, body mass index increasing significantly in restrictive eaters with obsessive traits and occult family crises was noticed. CONCLUSIONS: A multidisciplinary therapeutic intervention improved body mass index and family symptoms in patients with restrictive eating disorders.

Tratamiento medicamentoso de las enfermedades enteroparasitarias infantiles / Drug treatment of the enteroparasitary diseases in children

La infección por parásitos intestinales es un problema que el médico enfrenta frecuentemente. Muchas veces ocurre por más de un parásito, siendo útil tener alternativas de tratamiento único para dos o más agentes. Se revisarán los parásitos más frecuentes en el niño y su tratamiento