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Eating disorders continue to be studied among civilian women. Gross disturbances in eating behaviors characterize the condition of anorexia nervosa (AN), currently seen among 1 to 2% of non-active duty women. Bulimia nervosa (BN) is prevalent among 2% of the female population, and both disorders have a female-to-male ratios of 10:1. Another category of eating disorders known as not otherwise specified (NOS) occurs in 3 to 35% of individuals in the reported literature. This study examined the prevalence of AN, BN, and NOS among a large sample of active duty women currently serving in the Army, Navy, Air Force, and Marines. Multiple military, professional, and behavioral variables were analyzed to provide an increased understanding and awareness of these disorders among all active duty service women. This descriptive, correlational study of 3,613 service women targeted females from the total population of three major medical centers (Army, Navy, and Air Force) and the total population of Marine women serving in Okinawa, Japan, at the time of the study. Anonymous survey return was obtained at 34% (N = 1,278). The study revealed an overall prevalence of 1.1% for AN, 8.1% for BN, and 62.8% for NOS among all service women. However, AN, BN, and NOS were found at significantly higher rates (p = 0.000) among women in the Marines, who reported AN at 4.9%, BN at 15.9%, and NOS at 76.7%. Use of laxatives, diuretics, diet pills, vomiting, and fasting for standards increased during the body measurement and fitness periods for all services, but year-round use of many of these behaviors occurred at significantly higher rates among Marines (p = 0.000). Multiple logistic regression analysis predicted several factors associated with the manifestation of eating disorders in this population of active duty women.
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PMID:Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force, and Marines. 1119 99

Eating disorders are frequently observed in young people. They can induce major complications involving several organs, either directly or through protein energy malnutrition. Gastrointestinal problems are the most common and somewhat different in restrictive and bulimic anorexia. Delayed gastric emptying prevails in restrictive anorexia, with slower intestinal transit and atrophy of the smooth muscles of the gastrointestinal tract. In bulimic anorexia, vomiting is the cause of several oesophageal and gastric lesions, from oesophagitis to perforation of the oesophagus or stomach. C.G. is a 16-year old boy who weighs 41.8 kg, is 174 cm tall and has a BMI 13.7 (kg/m2). At 14 he started to suffer from restrictive anorexia, then bulimic anorexia for the last two months. The day before admission, the patient ate a large quantity of "sfoglia-telle" in about 2 hours during a bulimic crisis. After 8 hours, he had spontaneous vomiting, malaise, abdominal tension and slight mental confusion. Physical examination showed a tense and tender abdomen with infrequent peristalsis, mental confusion and dehydration. Laboratory evaluation confirmed dehydration (serum albumin 5.7 g/dL); a plain abdomen film showed marked gastrectasia. Instrumental examinations (abdominal CT scan, upper endoscopy) confirmed the diagnosis of gastrectasia with tight pyloric stenosis.
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PMID:Gastrointestinal complications in a patient with eating disorders. 1121 32

This paper reports young adolescent female norms for the Eating Disorder Examination Questionnaire (EDE-Q). The standardization sample was comprised of 808 girls aged between 12 and 14 years from three single-sex schools (one private and two state schools). Means, standard deviations and percentile ranks for raw EDE-Q subscale scores are presented. Prevalence figures for key eating disorder behaviors over the previous two weeks were as follows: 4% self-induced vomiting; 1% laxative misuse; 0.4% diuretic misuse; and 8% regular binge eating.
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PMID:Eating disorder examination questionnaire: norms for young adolescent girls. 1134 Dec 55

Bulimia nervosa is an eating disorder characterised by recurrent episodes of binge eating and associated efforts to purge the ingested calories through self-induced vomiting, laxative or diuretic abuse, fasting or intensive exercise. The aetiopathogenesis and pathophysiology of the disorder are currently unclear. Biological bases have been proposed repeatedly, based on several lines of evidence: hunger, satiety and food choice are regulated by neurotransmitters and neuropeptides, and impairment of eating habits may be related to alterations in the secretion of these chemicals; genetic studies suggest that these neurotransmitter systems are dysfunctional in individuals with bulimia nervosa; and the frequent comorbidity of bulimia nervosa with major depressive and obsessive-compulsive disorders, conditions in which multiple alterations of brain biochemical functions have been demonstrated. Data in the literature suggest that levels of noradrenaline (norepinephrine) and serotonin (5-hydroxytryptamine; 5-HT) are lower in individuals with bulimia nervosa than in healthy controls. Levels of dopamine are similar to, or lower than, those in controls. After remission of the disorder, noradrenergic function returns to that seen in controls, whereas dopaminergic and serotonergic function rebound to levels higher than in controls. Among the neuropeptides, alterations in the levels of neuropeptide Y, peptide YY, beta-endorphin, corticotrophin-releasing hormone, somatostatin, cholecystokinin and vasopressin have been found in the symptomatic phase of bulimia nervosa, with a return to levels seen in controls after remission. Pharmacological treatment of bulimia nervosa that is directed at correction of the neurochemical alterations observed is difficult because of the complexity of the impairments. However, such treatment is necessary and should be continued long after symptomatic remission to ensure reinstitution of cerebral biochemical homeostasis.
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PMID:Aetiopathogenesis and pathophysiology of bulimia nervosa: biological bases and implications for treatment. 1146 Aug 90

Binge eating disorder (BED) was included in the DSM IV as a proposed diagnostic category for further study and as an example for an eating disorder not otherwise specified (EDNOS). BED is characterized by recurrent episodes of binge eating in the absence of regular compensatory behavior such as vomiting or laxative abuse. Related features include eating until uncomfortably full, eating when not physically hungry, eating alone and feelings of depression or guilt. BED is associated with increased psychopathology including depression and personality disorders. Although BED is not limited to obese individuals, it is most common in this group and those who seek help do so for treatment of overweight rather than for binge eating. In community samples, the prevalence of BED has been found to be 2-5%, in individuals who seek weight control treatment the prevalence is 30%. BED is more equal in gender ratio than bulimia nervosa. Eating disorder treatments such as cognitive behavior therapy (CBT) or interpersonal psychotherapy (IPT) improve binge eating with abstinence rates of about 50%. Antidepressants are also effective in reducing binge eating, though less so than psychotherapy. Standard weight loss treatments including bariatric surgery do not seem to exacerbate binge eating problems. Thus, both eating disorder and obesity treatments seem to be beneficial in BED. However, it is recommended today that treatment should first be directed at the disordered eating and associated psychopathology.
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PMID:Binge eating disorder and obesity. 1146 89

An 11-year-old girl presented with recurrent vomiting, reduced food and fluid intake, weight loss and dizziness. In an external hospital she was diagnosed as having habitual vomiting and a beginning eating disorder. The physical examination revealed a very thin, malnourished child with abdominal pain on palpation but without neurologic deficits. Laboratory findings, X-rays, endoscopy and ultrasound revealed no pathological results either. Since the EEG and the cranial computed tomography (CT) were normal, we also suspected the beginning of an eating disorder especially due to some psychical peculiarities. The MRI which was done for ultimate exclusion of an infratentorial tumor showed a well defined displacing structure in the dorsal medulla oblongata and in the upper cervical spinal cord. A corresponding prolongation of the central conduction time was found in the median nerve SSEP whereas the BAEPs were normal. The tumor was excised in toto and the histological examination confirmed the suspected diagnosis of cavernous hemangioma (cavernoma). The post operative phase was without any complications and the intiated nutrition was well tolerated. Neurological deficits were not observed.
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PMID:[Cavernoma of the medulla oblongata mimicking "Anorexia nervosa" - a case report]. 1182 53

We could find no previous data describing the extent to which eating disorders are a public health problem in Jamaica, and so we carried out two exercises to assess this. We investigated the number of cases of anorexia nervosa (AN) and bulimia nervosa (BN) presenting at the University Hospital of the West Indies (UHWI) between 1985 and 1998, using case records, and carried out a survey among health professionals (psychiatrists, clinical psychologists, paediatricians and nutritionists/dietitians) to determine the number of patients with eating disorders seen by them between 1996 and 1998. We also examined the diagnostic criteria used and correlates of eating disorders. Only two cases of AN were treated at UHWI. Eleven cases each of AN and BN (two males) had presented to the health professionals surveyed, chiefly the psychiatrists. The AN patients ranged in age from 14 to 28 years (mean 20.9 years), and the BN patients from 11 to 35 years (mean 22.2 years). Eating disorders were reported primarily among urban dwellers (76%), and half of the cases were among students. Limiting food intake, excessive exercise and vomiting were the most frequently used methods of weight control. Nine eating disorder patients (41%) were also diagnosed with depression, and five (23%) patients reported previous emotional trauma. The occurrence of eating disorders in Jamaica appears to be very low.
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PMID:Presence of anorexia nervosa and bulimia nervosa in Jamaica. 1208 65

Bulimia nervosa (BN) and binge-eating disorder (BED) are separate entities with the common denominator of binge eating. In this chapter, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for BN are reviewed, including both recurrent episodes of binge eating and inappropriate compensatory behaviors to prevent weight gain in one whose self-evaluation is unduly influenced by body weight and shape. Two percent of adolescent females and 0.3% of adolescent males fulfill criteria for BN. Risk factors, medical complications of binge eating (vomiting, use of ipecac, diet pills, diuretics, and laxatives), physical and laboratory findings, and treatment options and outcome are discussed. BED is seen in 1-2% of adolescents. The DSM-IV lists BED under Eating Disorder Not Otherwise Specified. DSM-IV research criteria for BED is reviewed, including binge eating, distress over binge eating, and absence of regular extreme compensatory behaviors. The mean age of onset is 17.2 years. Up to 30% of obese patients have BED. Risk factors are discussed. Because most patients with BED are obese, medical evaluation is similar to that for obesity. Treatment goals must be geared not only toward decreased binge eating but toward weight loss. Outcome is discussed.
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PMID:Bulimia nervosa and binge-eating disorder in adolescents. 1252 96

OBJECTIVE: To compare eating behaviors and alcohol drinking habits between 2 groups of female college students: varsity athletes and controls (nonathletes). DESIGN AND SETTING: We obtained descriptive data using an anonymous, self-report survey instrument. The instrument assessed eating habits and behaviors as well as alcohol consumption and drinking behaviors. SUBJECTS: One hundred forty-nine female varsity athletes and 209 female controls (nonathletes) from 2 National Collegiate Athletic Association Division I universities. MEASUREMENTS: Data collected included weight and desired weight, meal patterns, methods of gaining or losing weight, details of past or current eating problem, 2-week alcohol consumption quantity and frequency (binge drinking), and problem alcohol behaviors. We used chi-square analysis for nominal data and t tests and multivariate analysis of variance for interval data. RESULTS: Compared with athletes, nonathletes ate fewer meals, and more of them reported feeling that they were too heavy and lied about their weight-control practices. Neither group reported high rates of pathologic behaviors such as vomiting. Nearly 18% of athletes and 26% of controls reported a past or current eating disorder. Athletes did not differ from controls in reported 2-week alcohol consumption, including binge drinking (nearly 50% of both groups). CONCLUSIONS: Self-reported problem drinking and eating behaviors exist in both athletes and controls but not at different rates. This finding may be a result of coach, athletic trainer, and peer-group counseling at these 2 schools or a general trend for lower rates of unhealthy behaviors among female athletes.
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PMID:Weight Concerns, Problem Eating Behaviors, and Problem Drinking Behaviors in Female Collegiate Athletes. 1293 74

The aim of this paper was to explore the relationships between depressive symptoms and weight control strategies in DSM-IV eating disordered patients with binge eating behaviours. We hypothesised that weight control strategies characterised by a loss of control, such as vomiting and purging, may be clinically associated with increased levels of depression. The study population consisted of 402 consecutive outpatients: 27 with binge eating/purging anorexia nervosa (AN-BN), 213 with purging bulimia nervosa (BN-P), 73 with non-purging bulimia nervosa (BN-NP), and 89 with binge eating disorder (BED). The severity of depression was measured using the Beck Depression Inventory (BDI), and binge eating behaviours were investigated using the self-report scale for bulimic behaviours. In the sample as a whole, the severity of depression significantly correlated with the severity of binge eating behaviours, but no significant differences were found in the severity of depression by diagnostic sub-types. In order to avoid the confounding erasing effect of time, a smaller sample of patients with a short history of binge eating behaviours was further explored. Furthermore, because weight control strategies and the eating disorder diagnostic sub-types overlapped imperfectly, the patients were compared on the basis of presence or absence of strategies reflecting an active attempt to master the weight gain due to bingeing behaviours. The patients adopting active control strategies (N = 14) had significantly less severe depressive symptoms than those adopting non-active weight control strategies (N = 39). Finally, the Authors discuss some hypotheses concerning the defensive role of weight control strategies and the impact of illness duration on the clinical expression of depression in eating disordered patients.
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PMID:Binge eating behaviours, depression and weight control strategies. 1464 83


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