Is orthorexia nervosa a feature of obsessive-compulsive disorder? A multicentric, controlled study.

PURPOSE: The term orthorexia nervosa (ON) was coined to describe altered thoughts and behaviours related to healthy eating. The prevalence of ON was found to scale up to almost 90% among high-risk populations (ballet dancers, athletes, and health workers). ON seem to share psychopathological aspects with both Eating Disorders (ED) and Obsessive-Compulsive Disorder (OCD). The aim of the study was to analyse the frequency and intensity of ON symptoms among subjects diagnosed with OCD, hypothesising that they would be higher than in two control groups (subjects with anxiety-depressive disorders and general population). METHODS: We conducted a multi-centre, observational, controlled study. Subjects filled in a socio-demographic questionnaire including questions related to life-style and two psychometric instruments: ORTO-15, for ON symptoms, and OCI-R, for OCD symptoms. Post hoc analysis of the dataset was performed using the revised version of ORTO-15, the ORTO-R. RESULTS: In the final sample of 328 subjects, the overall prevalence of ORTO-15-ON was 59.5%, mean score 37.9 ± 4.2. The mean score at the ORTO-R was 16.6 ± 4.6. No statistically significant differences were found in the prevalence of ON or in the mean ORTO-15 score among OCD patients and the two control groups, and this was confirmed by the multiple regression analysis. At the ORTO-R re-scoring, OCD patients scored significantly lower than the two clinical subgroups (p = .0005) and a lower ORTO-R score was associated to positivity at the OCI-R, confirming the initial hypothesis of the study. CONCLUSIONS: ON symptoms do seem to be more prevalent among subjects suffering from OCD. The psychometric properties of tools available to calculate ON symptoms, namely ORTO-15 vs. ORTO-R, play a relevant role in explaining such finding. ORTO-R seems to be a valid alternative able to overcome such difficulties, though further studies are needed to confirm this.

Modelo de instilación intra-traqueal de jugo gástrico en la rata: curso temporal de las alteraciones histológicas / Intra-tracheal instillation of gastric juice in the rat: time course of histological changes

Introduction: Aspiration of gastric content is associated with a wide range of clinical conditions (acute lung injury, severe interstitial pneumonia or bronchiolitis obliterans following lung transplantation). Objective: To study the course of histological alterations in a model of intra-tracheal instillation of gastric juice in rats. Methods: Anesthetized rats were euthanized at different times: 4, 12 and 24 hours and 4 and 7 days after intratacheal (IT) instillation of gastric juice. Animals that were not intervened served as controls. The right inferior lobe was studied (H-E) and a histological injury score was given according to a recently published score system. Results: Between 4-24 h an inflammatory-hemorragic pattern with bronchiol-centric distribution was characterized by a large proportion of neutrophils in both alveoli and interstitium, alveolarfluid accumulation, proteinaceous material andfew hyaline membranes. Between 4 and 7 days, mononuclear cells were more prevalent, the hemorrhagic component disappeared, the percentage of abnormal bronchioles was significantly reduced and there was organization of the alveolar infiltrate, with Masson bodies, granulomas and giant cells associated with gastric juice particles. Conclusions: In rats, IT instillation of gastric juice induces diffuse alveolar damage that evolves towards an early granulomatous interstitial pneumonia along with lax fibrous tissue. Knowledge of the temporary course of the pulmonary responses helps to the understanding of the consequences of the several clinical conditions that favor gastric content aspiration.

Introducción: La aspiración de contenido gástrico se asocia con diversas condiciones clínicas (daño pulmonar agudo, neumonía intersticial severa o bronquiolitis obliterante post-trasplante). Objetivo: Estudiar el curso de las alteraciones histológicas en un modelo de instilación intra-traqueal (IT)de jugo gástrico en ratas. Métodos: Ratas anestesiadas recibieron vía ITjugo gástrico de un pool obtenido previamente. Los animales fueron sacrificados a las: 4, 12 y 24 h y 4 y 7 días post-instilación. Animales sin intervención sirvieron como controles. El lóbulo inferior derecho fue estudiado (H-E) para la asignación de un puntaje de daño histológico de acuerdo a un sistema de puntuación recientemente publicado. Resultados: Entre 4-24 h se observó un patrón inflamatorio-hemorrágico de distribución bronquíolo-céntrica, con predominio de neutrófilos intersticiales y alveolares, edema, material proteináceo alveolar y escasas membranas hialinas. Entre los 4 y 7 días, se observó predominio mononuclear y desaparición del componente hemorrágico, se redujo significativamente el porcentaje de bronquíolos afectados y se observó organización del infiltrado inflamatorio, con cuerpos de Masson, granulomas y células gigantes asociadas a partículas del jugo gástrico. Conclusiones: En ratas, la instilación IT de jugo gástrico induce daño alveolar difuso que progresa hacia una neumonía intersticial granulo-matosa temprana con tejido fibroso laxo. El conocimiento del curso de la respuesta pulmonar en este modelo, contribuye a comprender las posibles consecuencias de las condiciones clínicas que favorecen la aspiración de contenido gástrico.