RESUMEN
BACKGROUND: The study aims to explore, using indirect ecological measures of exposure, the role of viral infections in the development of anorexia nervosa (AN). METHOD: The cohort of participants consisted of all female subjects born in the Veneto region in the period between 1970 and 1984, and residing in the urban and suburban area of Padua (27,682 female subjects in an area of 424 km2). The main outcome measure was the diagnosis of AN resulting from the Public Mental Health Database, the Register of Hospital Admissions, and the Register of the Eating Disorders Unit (n=402, 1.4%). The number of cases of rubella, chickenpox, influenza and measles was ascertained for each month for the 15-year period. RESULTS: Exposures during the sixth month of pregnancy to the peaks of chickenpox [odds ratio (OR) 1.6, 95% confidence interval (CI) 1.2-2.0] and rubella infections (OR 1.5, 95% CI 1.1-2.0) were significantly associated with an increased risk of developing AN, even after controlling for socio-economic status, urbanization and month of birth. We found weak evidence of a season-of-birth bias. CONCLUSIONS: In utero exposure to viral infection could be a risk factor for developing AN. We need further epidemiological and serological studies to confirm this hypothesis.
Asunto(s)
Anorexia Nerviosa/epidemiología , Anorexia Nerviosa/virología , Complicaciones Infecciosas del Embarazo/virología , Efectos Tardíos de la Exposición Prenatal/virología , Adolescente , Adulto , Varicela/complicaciones , Varicela/epidemiología , Estudios de Cohortes , Femenino , Humanos , Gripe Humana/complicaciones , Gripe Humana/epidemiología , Entrevistas como Asunto , Italia/epidemiología , Modelos Logísticos , Sarampión/complicaciones , Sarampión/epidemiología , Embarazo , Sistema de Registros , Factores de Riesgo , Rubéola (Sarampión Alemán)/complicaciones , Rubéola (Sarampión Alemán)/epidemiología , Adulto JovenRESUMEN
We report about a complex case of pica in comorbidity with multiple sclerosis and binge eating disorder. Pica is classified among the feeding and eating disorders of infancy and early childhood, but there is a debate in the literature about the psychopathology and classification of this behavior. Some authors emphasize the similarities with the obsessive-compulsive spectrum disorders, whereas others propose an interpretation of pica as an addiction or as an impulsive behavior. The clinical case that we describe provides a picture of impulsive and compulsive features that are very difficult to disentangle. It is noteworthy that hypercalcemia is reported to have a protective/therapeutic effect against multiple sclerosis and seems to increase the plasmatic levels of beta-endorphins. The nature, diagnostic classification, and functions of pica are a topic worthy of future investigation.
Asunto(s)
Trastorno por Atracón/complicaciones , Esclerosis Múltiple/complicaciones , Pica/complicaciones , Conducta Compulsiva/complicaciones , Conducta Compulsiva/diagnóstico , Depresión/complicaciones , Femenino , Humanos , Conducta Impulsiva/complicaciones , Conducta Impulsiva/diagnóstico , Persona de Mediana Edad , Pica/diagnósticoRESUMEN
Este resumen se refiere a un caso clínico de fractura vertical de la raíz del diente 36 asociada al trauma de oclusión. La línea de fractura se extendía desde la cara oclusal hasta el 1/3 mediano de la cara vestibular. El tratamiento incluyó aumento de corona clínica con preservación de la región de furca y posteriormente, confección de prótesis unitária metalocerámica