Rosana Christine Cavalcanti Ximenes

Eating disorders in adolescents and their repercussions in oral health.

OBJECTIVE To examine the prevalence of oral alterations related to eating disorders and associated factors. METHOD A cross-sectional study including 650 adolescents aged from 12 to 16 was carried out through self-report questionnaires (EAT-26; BITE and self-rating hamilton depression questionnaire, SRHDQ) and dental examination. RESULTS Significant associations were observed in mucositis, cheilitis, hypertrophy of salivary glands, and dental erosions. The prevalence of adolescents at risk for eating disorders was of 33.1%, according to EAT-26 and 1.7% (high scores) and 36.5% (medium scores), in BITE, higher among 13-year-old females, with brothers, parents or responsible person who are illiterate, being the youngest child, living in a residence of at most two rooms and who showed depressive symptoms. All these factors showed significant relation to eating disorders. DISCUSSION Presence of oral alterations is associated to symptoms of eating disorders, helping precocious detection of sub clinical cases.

Prevalence of Suicide Risk Among Adolescents With Depressive Symptoms

OBJECTIVE To determine the prevalence of the risk of suicide among adolescents and to investigate associations between the risk of suicide and depressive symptoms. METHODS A population-based cross-sectional study was conducted with 1,379 students aged 10-17 years enrolled in state-run public schools in northeastern Brazil in 2014. The following instruments were used to collect data: a socio-bio-demographic questionnaire; the Childrens Depression Inventory (CDI) and the International Neuropsychiatric Interview (M.I.N.I. Brazilian version 5.0.0). Unidimensional and bidimensional tables were constructed for the data analysis, with absolute and relative frequencies. Odds ratios (OR) and respective intervals (95% confidence) were calculated and associated with the descriptive levels of Pearsons chi-square independence test. RESULTS The prevalence of the risk of suicide was 29.7% in the population studied. Females aged between 14 and 17, those with siblings and those with depressive symptoms were at the greatest risk. CONCLUSION The present findings revealed a very high risk of suicide and confirmed the significant that depressive symptoms are significantly associated with the risk of suicide among adolescents. Thus, it is necessary to develop suicide prevention programs for schools, with interdisciplinary primary healthcare actions.

Frequência de comportamentos alimentares inadequados e sua relação com a insatisfação corporal em adolescentes

OBJETIVO: Descrever a relacao entre a frequencia de insatisfacao com a imagem corporal e a presenca de sintomas de transtornos alimentares em adolescentes. METODOS: O estudo foi realizado com uma amostra de 300 adolescentes, de ambos os sexos, na faixa etaria de 10 a 17 anos, estudantes de uma escola publica estadual da cidade do Recife, Brasil. Foram utilizadas as versoes brasileiras para adolescentes de tres escalas autoaplicativas (EAT-26, BITE e BSQ), alem de um questionario contendo dados biodemograficos. RESULTADOS: A frequencia de sintomas de transtornos alimentares detectada pelo EAT-26 foi de 32,3%; 2,3% para comportamentos sugestivos de bulimia nervosa, por meio da escala BITE, tendo 36,67% dos alunos apresentado padrao alimentar nao usual; 5,6% apresentaram insatisfacao com a imagem corporal; 8,6% demonstraram tendencia a preocupacao com a insatisfacao com a imagem corporal e 17,6% apresentaram leve insatisfacao, alem de 66,3%, que mostraram normalidade em relacao a sua forma corporal. CONCLUSAO: Os adolescentes apresentaram niveis de alteracao na autoimagem corporal, com alta frequencia de insatisfacao da imagem corporal, podendo apresentar associacao com comportamentos alimentares inadequados.

Cyclodextrins improving the physicochemical and pharmacological properties of antidepressant drugs: a patent review

ABSTRACT Introduction: Depression is a serious mood disorder and is one of the most common mental illnesses. Despite the availability of several classes of antidepressants, a substantial percentage of patients are unresponsive to these drugs, which have a slow onset of action in addition to producing undesirable side effects. Some scientific evidence suggests that cyclodextrins (CDs) can improve the physicochemical and pharmacological profile of antidepressant drugs (ADDs). The purpose of this paper is to disclose current data technology prospects involving antidepressant drugs and cyclodextrins. Areas covered: We conducted a patent review to evaluate the antidepressive activity of the compounds complexed in CDs, and we analyzed whether these complexes improved their physicochemical properties and pharmacological action. The present review used 8 specialized patent databases for patent research, using the term ‘cyclodextrin’ combined with ‘antidepressive agents’ and its related terms. We found 608 patents. In the end, considering the inclusion criteria, 27 patents reporting the benefits of complexation of ADDs with CDs were included. Expert opinion: The use of CDs can be considered an important tool for the optimization of physicochemical and pharmacological properties of ADDs, such as stability, solubility and bioavailability.

Differences in cortisol concentrations in adolescents with eating disorders: a systematic review

OBJECTIVE To perform a systematic review of the literature for scientific evidence of possible differences in cortisol concentrations in adolescents with eating disorders. SOURCE OF DATA Electronic searches were conducting in the PubMed, Scientific Electronic Library Online, Virtual Health Library, and Science Direct databases for articles published between 2007 and 2017 using the keywords, cortisol, hydrocortisone; eating disorders, bulimia, bulimia nervosa, anorexia, anorexia nervosa; adolescence, adolescent, adolescents. SYNTHESIS OF DATA A total of 192 articles were found. After the analysis of the eligibility criteria using the PRISMA method, 19 articles were selected for the present review. Most studies were conducted in Europe. Adolescents diagnosed with anorexia nervosa were evaluated in all studies, except one, when other eating disorders were investigated. Blood was the means used for the determination of cortisol. In ten studies, cortisol levels were higher in the group with anorexia than the control group and a reduction in cortisol levels occurred in the adolescents after being submitted to nutritional recovery. CONCLUSIONS Patients with eating disorders may have several clinical consequences, such as changes in body fat distribution, changes in bone mineral density, worsening of neurocognitive ability, and endocrine changes (e.g., hypercortisolemia), which in turn can lead to hyperglycemia, insulin resistance, hypertension, and increased risk of infections. The findings demonstrate that adolescents with eating disorders, especially anorexia nervosa, have increased cortisol levels, which are reduced after the treatment period. Further studies on differences in cortisol concentrations in adolescents with other eating disorders are needed, using different methods.

As terapias cognitivo-comportamentais no tratamento da bulimia nervosa: uma revisão

Objective To review the literature about the use of cognitive-behavior therapy in bulimia nervosa treatment, between 2009 and 2013. Methods Three electronic databases were researched, and articles in English, Portuguese and Spanish were selected. Results After the analysis and exclusion of the articles, followed the PRISMA methods, were chosen 20 articles. Selected articles were produced in Europe or in United States of America, in English. The diagnosis of the sample ranged from only bulimia nervosa (60%) that included the people with binge eating disorders (35%), and mixed eating disorders diagnoses (5%). The researches were conducted mostly with women. The cognitive-behavior therapy in your classic form in office were used all of articles, sometimes used singly, sometimes used with other intervention (internet, CD-ROM, self-help). The cognitive behavior therapy decreases binge eating and purgation symptoms. It provides secondary benefits to participants like: decreases depressive and anxiety symptoms and change the participant’s personality. The other interventions studied have been successful in modifying symptoms, demonstrating that there is a new way forward climbed with these news forms of treatment. Conclusion Treatment of bulimia nervosa have enough evidences to be performed with the cognitive-behavioral therapy. Beyond, innovative psychotherapeutic interventions based on classical CBT have good indicators of effectiveness. Future research on these different interventions are needed.

Temporomandibular disorders and eating disorders: a literature review

INTRODUCTION Temporomandibular disorders (TMD) and eating disorders (ED) affect function and parafunction of the oral cavity and have high rates of medical and psychological comorbidity. However, little is known about the possible associations between them, and few studies have investigated the existence of such associations. METHODS A search was conducted on the SciELO, LILACS, and PubMed/MEDLINE databases to find relevant articles written in English and Portuguese. Only studies involving human beings were included, and there was no limit for year of publication. RESULTS AND CONCLUSIONS There is evidence of the correlation between TMD and ED, but their comorbidity must be better understood. The presence of depressive symptoms is an aggravating factor that must also be taken into account during the diagnosis and treatment of those patients.

Influence of Age and Education on the Performance of Elderly in the Brazilian Version of the Montreal Cognitive Assessment Battery

Aims: To provide normative data for the Brazilian version of the Montreal Cognitive Assessment (MoCA-BR) and to measure the effect of sociodemographic variables on the cognitive performance of cognitively healthy elderly people. Methods: A sample of 110 cognitively healthy individuals, aged over 65 years, with at least 4 years of schooling were recruited from 3 health care centers for the elderly in Recife, Brazil. The cognitive performance was assessed using MoCA-BR. Results: The average score of these elderly people in the MoCA-BR was 23.2 ± 2.7. Their schooling correlated positively with the cognitive performance, with a Spearman’s coefficient of 0.33 (p < 0.001). There was a statistically significant negative correlation between age and the cognitive performance (Spearman’s rho = –0.19). The multiple linear regression model with the highest adjusted coefficient of determination was the one that included schooling and age (adjusted R2 = 0.127). Conclusions: The cognitive performance of healthy elderly was evaluated and was strongly influenced by schooling and, to a lower degree, by age.

Risk of Suicide in Adolescents with Symptoms of Eating Disorders andDepression

Objective: The aim of the present study was to determine the risk of suicide in adolescents with symptoms of eating disorders and depression. Methods: A population-based, cross-sectional study was conducted with 1379 students of public schools aged 10 to 17 years. The following evaluation tools were employed: A socio-demographic questionnaire, Eating Attitudes Test (EAT-26), Bulimic Investigatory Test of Edinburgh (BITE), Children’s depression inventory (CDI) and the Mini International Neuropsychiatric Interview (M.I.N.I. – Brazilian version 5.0.0). Data analysis involved one-dimensional and two-dimensional tables with absolute and relative frequencies as well as the calculation of odds ratios (OR) and respective 95% confidence intervals associated with the levels described using Pearson’s chi-square test. In the multivariate analysis, a binary logistic regression model was adjusted, including variables with a p-value <0.05 in the binary analysis as possible explanatory variables. Results: Through the ORs, it was estimated that the probability of an adolescent in the population analysed of being at risk of suicide was higher when the adolescent was older than 11 years, of the female gender, had symptoms of an eating disorder and had depressive symptoms. Conclusion: The risk of suicide is not restricted to clinical samples of adolescents with eating disorders, but can also be detected in non-clinical samples. Moreover, the risk is higher among adolescents with symptoms of both eating disorders and depression.