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We implemented universal SARS-CoV-2 testing of patients undergoing surgical procedures as a means to conserve personal protective equipment (PPE). The rate of asymptomatic SARS-CoV-2 infection was <0.5%, and suggests that early local public health interventions were successful. While our protocol was resource-intensive, it prevented exposures to healthcare team members.
Glacial environments exhibit temporally variable microseismicity. To investigate how microseismicity influences event detection, we implement two noise-adaptive digital power detectors to process seismic data from Taylor Glacier, Antarctica. We add scaled icequake waveforms to the original data stream, run detectors on the hybrid data stream to estimate reliable detection magnitudes and compare analytical magnitudes predicted from an ice crack source model. We find that detection capability is influenced by environmental microseismicity for seismic events with source size comparable to thermal penetration depths. When event counts and minimum detectable event sizes change in the same direction (i.e. increase in event counts and minimum detectable event size), we interpret measured seismicity changes as ‘true’ seismicity changes rather than as changes in detection. Generally, one detector (two degree of freedom (2dof)) outperforms the other: it identifies more events, a more prominent summertime diurnal signal and maintains a higher detection capability. We conclude that real physical processes are responsible for the summertime diurnal inter-detector difference. One detector (3dof) identifies this process as environmental microseismicity; the other detector (2dof) identifies it as elevated waveform activity. Our analysis provides an example for minimizing detection biases and estimating source sizes when interpreting temporal seismicity patterns to better infer glacial seismogenic processes.
This study aimed to assess the validity of a portable anthropometer against the gold standard among 2-year-old infants from the 2015 Pelotas (Brazil) Birth Cohort.
Birth cohort study.
A fixed Harpenden® infant anthropometer was considered as the gold standard for measuring infant length due to its greater precision and stability. The portable SANNY® (model ES2000) anthropometer was the instrument to be validated. The acceptable mean difference in length between the anthropometers was 0·5 cm. In order to compare length estimates, the interviewers carried out two length measures for each of the anthropometers (fixed and portable) and for each child. The mean of the two lengths was calculated for each anthropometer, and their difference was calculated.
A subsample of 252 24-month-old members of the 2015 Pelotas (Brazil) birth cohort study.
Children’s mean age was 23·5 months. According to Bland–Altman plot, there were no differences in overall lengths between the portable and the fixed anthropometers, or in lengths according to sex. There was a high overall concordance between the length estimates of the fixed and portable anthropometers (ρ = 0·94; 95 % CI 0·92, 0·95).
The portable anthropometer proved to be accurate to measure the length of 24-month-old infants, being applicable to studies using the same standardised protocol used in the present study.
We evaluated the differences between the supplementation of urea in rumen and/or abomasum on forage digestion, N metabolism and urea kinetics in cattle fed a low-quality tropical forage. Five Nellore heifers were fitted with rumen and abomasum fistulas and assigned to a Latin square design. The treatments were control, continuous infusion of urea in the abomasum (AC), continuous infusion of urea in the rumen, a pulse dose of urea in the rumen every 12 h (PR) and a combination of PR and AC. The control exhibited the lowest (P < 0·10) faecal and urinary N losses, which were, overall, increased by supplementation. The highest urinary N losses (P < 0·10) were observed when urea was either totally or partially supplied as a ruminal pulse dose. The rumen N balance was negative for the control and when urea was totally supplied in the abomasum. The greatest microbial N production (P < 0·10) was obtained when urea was partially or totally supplied in the abomasum. Urea supplementation increased (P < 0·10) the amount of urea recycled to the gastrointestinal tract and the amount of urea-N returned to the ornithine cycle. The greatest (P < 0·10) amounts of urea-N used for anabolism were observed when urea was totally and continuously infused in the abomasum. The continuous abomasal infusion also resulted in the highest (P < 0·10) assimilation of microbial N from recycling. The continuous releasing of urea throughout day either in the rumen or abomasum is able to improve N accretion in the animal body, despite mechanism responsible for that being different.
Less is known about the relationship between conduct disorder (CD), callous–unemotional (CU) traits, and positive and negative parenting in youth compared to early childhood. We combined traditional univariate analyses with a novel machine learning classifier (Angle-based Generalized Matrix Learning Vector Quantization) to classify youth (N = 756; 9–18 years) into typically developing (TD) or CD groups with or without elevated CU traits (CD/HCU, CD/LCU, respectively) using youth- and parent-reports of parenting behavior. At the group level, both CD/HCU and CD/LCU were associated with high negative and low positive parenting relative to TD. However, only positive parenting differed between the CD/HCU and CD/LCU groups. In classification analyses, performance was best when distinguishing CD/HCU from TD groups and poorest when distinguishing CD/HCU from CD/LCU groups. Positive and negative parenting were both relevant when distinguishing CD/HCU from TD, negative parenting was most relevant when distinguishing between CD/LCU and TD, and positive parenting was most relevant when distinguishing CD/HCU from CD/LCU groups. These findings suggest that while positive parenting distinguishes between CD/HCU and CD/LCU, negative parenting is associated with both CD subtypes. These results highlight the importance of considering multiple parenting behaviors in CD with varying levels of CU traits in late childhood/adolescence.
Nitric oxide synthase (NOS) activity, an enzyme potentially involved in the major depressive episodes (MDE), could be indirectly measured by the L-Citrulline/L-Arginine ratio (L-Cit/L-Arg). The aim of this study was: (1) to compare the NOS activity of patients with a MDE to that of healthy controls (HC); (2) to assess its change after antidepressant treatment.
A total of 460 patients with a current MDE in a context of major depressive disorder (MDD) were compared to 895 HC for NOS activity (L-Cit/L-Arg plasma ratio). L-Arg and L-Cit plasma levels were measured using a MS-based liquid chromatography method. Depressed patients were assessed at baseline, and after 3 and 6 months of antidepressant treatment for depression severity and clinical response.
Depressed patients had a lower NOS activity than HC at baseline [0.31 ± 0.09 v. 0.38 ± 0.12; 95% confidence interval (CI) −0.084 to −0.062, p < 0.0001]. Lower NOS activity at baseline predicted a higher response rate [odds ratio (OR) = 29.20; 95% CI 1.58–536.37; p = 0.023]. NOS activity in depressed patients increased significantly up to 0.34 ± 0.08 after antidepressant treatment (Est = 0.0034; 95% CI 0.0002–0.0067; p = 0.03).
Depressed patients have a decreased NOS activity that improves after antidepressant treatment and predicts drug response. NOS activity may be a promising biomarker for MDE in a context of MDD.
Prototyping is an essential activity in product development, but novice designers lack awareness and purpose when they prototype. To foster prototyping mindsets in novice designers, we introduce a prototyping support tool that structures prototyping activities. This paper outlines the Prototyping Planner's development, evolution, and evaluation by 125 novice designers. The majority of novice designers’ experienced that the Prototyping Planner helped them create purposeful prototypes and evaluate results from prototyping.
The energy content of finishing diets offered to feedlot cattle may vary across countries. We assumed that the lower is the energy content of the finishing diet, the shorter can be the adaptation period to high-concentrate diets without negatively impacting rumen health while still improving feedlot performance. This study was designed to determine the effects of adaptation periods of 6, 9, 14 and 21 days on feedlot performance, feeding behaviour, blood gas profile, carcass characteristics and rumen morphometrics of Nellore cattle. The experiment was designed as a completely randomised block, replicated 6 times, in which 96 20-month-old yearling Nellore bulls (391.1 ± 30.9 kg) were fed in 24 pens (4 animals/pen) according to the adaptation period adopted: 6, 9, 14 or 21 days. The adaptation diets contained 70%, 75% and 80.5% concentrate, and the finishing diet contained 86% concentrate. After adaptation, one animal per pen was slaughtered (n = 24) for rumen morphometric evaluations and the remaining 72 animals were harvested after 88 days on feed. Orthogonal contrasts were used to assess linear, quadratic and cubic relationships between days of adaptation and the dependent variable. Overall, as days of adaptation increased, final BW (P = 0.06), average daily gain (ADG) (P = 0.07), hot carcass weight (P = 0.04) and gain to feed ratio (G : F) (P = 0.07) were affected quadratically, in which yearling bulls adapted by 14 days presented greater final BW, ADG, hot carcass weight and improved G : F. No significant (P > 0.10) days of adaptation effect was observed for any of feeding behaviour variables. As days of adaptation increased, the absorptive surface area of the rumen was affected cubically, where yearling bulls adapted by 14 days presented greater absorptive surface area (P = 0.03). Thus, Nellore yearling bulls should be adapted by 14 days because it led to improved feedlot performance and greater development of rumen epithelium without increasing rumenitis scores.
This study examined the impact of a school readiness intervention on external response monitoring in children in foster care. Behavioral and event-related potential (ERP) data were collected during a flanker task from children who received the Kids In Transition to School (KITS) Program (n = 26) and children who received services as usual (n = 19) before and after the intervention. While there were no significant group differences on the behavioral data, the ERP data for the two groups of children significantly differed. Specifically, in contrast to the children who received services as usual, the children who received the KITS Program displayed greater amplitude differences between positive and negative performance feedback over time for the N1, which reflects early attention processes, and feedback-related negativity, which reflects evaluation processes. In addition, although the two groups did not differ on amplitude differences between positive and negative performance feedback for these ERP components before the intervention, the children who received the KITS Program displayed greater amplitude differences than the children who received services as usual after the intervention. These results suggest that the KITS Program had an effect on responsivity to external performance feedback, which may be beneficial during the transition into kindergarten.
Surveillance for acute flaccid paralysis (AFP) cases are essential for polio eradication. However, as most poliovirus infections are asymptomatic and some regions of the world are inaccessible, additional surveillance tools require development. Within England and Wales, we demonstrate how inclusion of environmental sampling (ENV) improves the sensitivity of detecting both wild and vaccine-derived polioviruses (VDPVs) when compared to current surveillance. Statistical modelling was used to estimate the spatial risk of wild and VDPV importation and circulation in England and Wales. We estimate the sensitivity of each surveillance mode to detect poliovirus and the probability of being free from poliovirus, defined as being below a pre-specified prevalence of infection. Poliovirus risk was higher within local authorities in Manchester, Birmingham, Bradford and London. The sensitivity of detecting wild poliovirus within a given month using AFP and enterovirus surveillance was estimated to be 0.096 (95% CI 0.055–0.134). Inclusion of ENV in the three highest risk local authorities and a site in London increased surveillance sensitivity to 0.192 (95% CI 0.191–0.193). The sensitivity of ENV strategies can be compared using the framework by varying sites and the frequency of sampling. The probability of being free from poliovirus slowly increased from the date of the last case in 1993. ENV within areas thought to have the highest risk improves detection of poliovirus, and has the potential to improve confidence in the polio-free status of England and Wales and detect VDPVs.
Innovation Concept: In Sudbury, ON 44% of out-of-hospital cardiac arrest (OHCA) patients receive bystander CPR (bCPR), and only 4.7% survive cardiac arrest. The Northern City of Heroes (NCH) community initiative was launched in April 2019 with a goal of improving survival from OHCA through hands-only bCPR in the municipality. One NCH initiative is an interactive exhibit at Science North, a science centre in Sudbury that hosts 250,000 visitors annually. The exhibit employs simulation trainers for CPR, accompanying signage and interactive elements. The goals of the exhibit are to activate bCPR, change and measure behaviours through exhibit interactions on how to deliver excellent CPR, and improve survival rates in OHCA patients. Methods: Data is being collected from 3000 visitors using self-reported surveying via SurveyGizmo to assess likelihood of performing bCPR, pre and post interacting with the exhibit. Visitor behaviour will be examined at the exhibit using video-recorded interactions and coding those behaviours using BORIS software. Behavioural data will be analyzed using the Visitor Engagement Framework (VEF) where initiation, transition and breakthrough learning-behaviours are coded and an exhibit Visitor Engagement Profile (VEP) is created. The VEF and VEP are tools used in informal learning settings to assess exhibit impacts on learning. Curriculum, Tool, or Material: The use of an easily-apprehendable, hands-on exhibit tool located in a public setting, such as a science centre, creates a platform for engaging large and diverse public audiences. This type of bCPR exhibitry has not been implemented in other similar environments. The informal learning setting allows the science centre staff to engage in personalized interactions that can solidify the quality of learning and confidence in employing the new skills developed. Conclusion: The NCH exhibit and new strategies for embedding informal curriculum are powerful tools to reach diverse audiences, build knowledge and skills, and have a measurable impact on bCPR and OHCA survival rates. Data is being captured and tracked by Health Sciences North around the City of Greater Sudbury's bCPR and OHCA survival rates to monitor long-term impacts of the NCH community initiatives. Limitations of the study may be found in the focused demographics as well as the nature of self-reported learning. Future research directions include broader geographical surveying to assess improvements in community response to OHCA as a direct result of an interactive bCPR exhibitry.
Thrombocytopenia is a risk factor for patent ductus arteriosus. Immature and mature platelets exhibit distinct haemostatic properties; however, whether platelet maturity plays a role in postnatal, ductus arteriosus closure is unknown.
In this observational study, counts of immature and mature platelets (=total platelet count − immature platelet count) were assessed on days 1, 3, and 7 of life in very low birth weight infants (<1500 g birth weight). We performed echocardiographic screening for haemodynamically significant patent ductus arteriosus on day 7.
Counts of mature platelets did not differ on day 1 in infants with (n = 24) and without (n = 45) haemodynamically significant patent ductus arteriosus, while infants with significant patent ductus arteriosus exhibited lower counts of mature platelet on postnatal days 3 and 7. Relative counts of immature platelets (fraction, in %) were higher in infants with patent ductus arteriosus on day 7 but not on days 1 and 3. Receiver operating characteristic curve analysis unraveled associations between both lower mature platelet counts and higher immature platelet fraction (percentage) values on days 3 and 7, with haemodynamically significant ductus arteriosus. Logistic regression analysis revealed that mature platelet counts, but not immature platelet fraction values, were independent predictors of haemodynamically significant patent ductus arteriosus.
During the first week of postnatal life, lower counts of mature platelets and higher immature platelet fraction values are associated with haemodynamically significant patent ductus arteriosus. Lower counts of mature platelet were found to be independent predictors of haemodynamically significant patent ductus arteriosus.
This study presents two years of characterization of a warm temperate rhodolith bed in order to analyse how certain environmental changes influence the community ecology. The biomass of rhodoliths and associated species were analysed during this period and in situ experiments were conducted to evaluate the primary production, calcification and respiration of the dominant species of rhodoliths and epiphytes. The highest total biomass of rhodoliths occurred during austral winter. Lithothamnion crispatum was the most abundant rhodolith species in austral summer. Epiphytic macroalgae occurred only in January 2015, with Padina gymnospora being the most abundant. Considering associated fauna, the biomass of Mollusca increased from February 2015 to February 2016. Population densities of key reef fish species inside and around the rhodolith beds showed significant variations in time. The densities of grouper (carnivores/piscivores) increased in time, especially from 2015 to 2016. On the other hand, grunts (macroinvertebrate feeders) had a modest decrease over time (from 2014 to 2016). Other parameters such as primary production and calcification of L. crispatum were higher under enhanced irradiance, yet decreased in the presence of P. gymnospora. Community structure and physiological responses can be explained by the interaction of abiotic and biotic factors, which are driven by environmental changes over time. Biomass changes can indicate that herbivores play a role in limiting the growth of epiphytes, and this is beneficial to the rhodoliths because it decreases competition for environmental resources with fleshy algae.
5-HT2C receptors are well known to be involved in anxiety, but their implication in stress-induced changes of 5-HT transmission remained to be investigated. We thus assess the behavioral and neurochemical effects of 5-HT2C receptor activation in naïve and stressed mice, and after chronic paroxetine known to exert anxiolytic effects in humans.
Methods and results
The effects of the preferential 5-HT2C agonists m-chlorophenylpiperazine (mCPP) and RO60-0175, the selective 5-HT2C receptor antagonist SB242,084 and restraint-stress on anxiety-like behavior in mice were assessed using the social interaction test, while the neurochemical effects of these treatments on 5-HT turnover (5-HIAA/5-HT ratio) and extracellular 5-HT were determined using HPLC and microdialysis. Both mCPP and restraint-stress increased anxiety-like behavior in the social interaction test, and these effects were blocked by pretreatment with SB242,084. Restraint-stress increased 5-HT turnover in various brain areas, and this effect could be prevented by the 5-HT2C receptor agonist RO60-0175. Acute administration of SB242,084 potentiated the stress-induced increase in 5-HT turnover and blocked the inhibitory effect of RO60-0175. Microdialysis studies in frontal cortex revealed that RO60-0175 has an inhibitory effect on the stress-induced increase in extracellular 5-HT levels, but not on basal 5-HT levels. Chronic paroxetine prevented the anxiogenic effect of mCPP and prevented the inhibitory effect of RO60-0175 on restraint-stress-induced increase in 5-HT turnover.
These data strongly suggest that 5-HT2C receptor activation mediates the anxiogenic effect of stress. In addition, the anxiolytic action of long term treatment with SSRIs might be causally related to a clear-cut 5-HT2C receptor desensitization.
To study whether there are personality characteristics that discriminate between IPV women and non-abused control women, taking into account the effect of emotional state (depressive symptoms).
A total of 176 women victim of IPV and 193 non-abused control women were assessed with the Dimensional Assessment of Personality Pathology (DAPP-BQ; Livesley, 1990), the Beck Depression Inventory -II (BDI-II; Beck, 1996), and the Index of Spouse Abuse (ISA; Hudson & McIntosh, 1981). Women victim of IPV were recruited from Domestic Violence Centers, and non-abused control women were recruited from Primary Care Centers and Mental Health Services. A two way analysis of variance (IPV * Depression) were used for detecting differences in personality traits taking into account the effect of depression (BDI ≥ 17).
After controlling for depression, IPV victims scored higher than control women in submissiveness (F=6.41; p=0.01), cognitive distortion (F=4.35; p=0.04), intimacy problems (F=27.02; p< 0.001), suspiciousness (F=5.02; p=0.03) and self-harm (F=4.93; p=0.03), and lower in rejection (F=14.66; p< 0.001).
IPV victims showed high submission, low hostility, intimacy problems, suspiciousness, tendency to depersonalization or derealization, and suicidal ideation and attempts, as a result of chronic abuse. Some of these aspects could be explained by the presence of PTSD, more than by pre-existing personality characteristics. Traumatic and chronic stress can alter functional aspects of the brain and lead to the development of dysfunctional cognitive and behavioral characteristics that may be considered in the psychotherapeutic approach.
“Rite of passage” is an etnographic concept developed by VanGennep that defines the vital transition of an individual between two different status. It is divided in three stages: separation, liminal/threshold and aggregation. Turner described the liminal phase, and the terms of “communitas” and “liminoid” (structure of a rite without religious/spiritual elements). One widely-known Rite of Passage is the initiation of the shamans.
Study the elements of a rite of passage present in Psychiatric Trainning.
• Field study (observational, descriptive, non-experimental).
• Preliminary Sample=10trainees (5man+5women); last year of Psychiatric Trainning.
• “ad hoc” semi-structured interview (21items subdivided in open questions). 10interviews (average duration=75mins). Permanent register:digital recorder.
• Summary and analysis of the answers. Review of the literature.
- Psychiatric Trainning shared the elements and tri-phasic structure of VanGennep's “rite of passage” concept
- Trainees saw themselves as more empathic(7/10) and humanistic(8/10) than other specialties colleagues. Stigma towards mental illness(8/10) and fear of suicide(9/10) were also considered as their distinctives.
- The collective behaved as a communitas(10/10)
- No spiritual elements(0/10): liminoid process
- Resemblances of the ancestral shamans' Initiation: Despite bloody practices were over, suffering was also present(7/10), but was seen as necessary(6/10) and well tolerated(7/10).
- Trainees felt that they grew spiritual and mentally(7/10) during the trainning years
Results suggest that Psychiatric Trainning has stable phenomena that:
• are compatible with the Rite of Passage schema
• Are considered exclusive of Psychiatry by trainees
• Have not been systematically studied as a whole, which could help to improve the training.
As part of a process to improve bipolar disorders (BPD) treatment and outcome in France, AFBP developed recommendations in the management of patients with bipolar disorders for French practitioners. The recommendations aim to reflect both evidence-based practice and real-world experience. Here, we will focus on the management of BPD with comorbid addictive disorders.
A formalized method by expert consensus panel was used. 239 questions were developed and sent to a panel of 40 French experts in order to assess six domains:
1) screening and diagnosis,
2) acute phase treatment,
3) maintenance and non pharmacological treatment,
4) somatic comorbidities,
5) psychiatric comorbidities and suicide risk management and
6) special populations.
Special attention was made to situations where evidence based treatment are lacking.
The treatment of BPD and comorbid addictive disorders should be concurrent. The only exception is during an alcohol withdrawal where mood state may be reassessed for a second time. Experts recommend the use of atypical antipsychotics or anticonvulsants during a manic, mixed or depressive episode as well as in prophylaxia. During a depressive episode, the adjunction of an antidepressant may be considered. If adjunctive sedative treatment is necessary, a sedative classical antipsychotic seems to be a better choice that benzodiazepine. Substitution treatment for opioid must not be stopped. A psychotherapy focused on the addiction should be systematic in susbtance dependence and proposed in substance abuse.
The French expert panel recommends different therapeutic options for patients with dual diagnosis compared to usual BPD patients.
Despite lithium has been used for the last 50 years as a maintenance treatment for bipolar disorder during pregnancy, there is limited information about perinatal clinical outcomes from fetal exposure to lithium.
1. To quantify the rate of lithium placental passage
2. To assess any association between plasma concentration of lithium at delivery and perinatal outcome.
Observational and prospective study. Subjects: Women in maintenance treatment with lithium, being attended during pregnancy at the Perinatal Psychiatry Programme of Hospital Clínic (Barcelona, Spain) between 2007 and 2009. Procedure: We assessed sociodemographical data; dose/day of lithium carbonate; other drugs doses; plasmatic concentration of lithium carbonate in maternal blood intrapartum and in the umbilical cord; obstetrical maternal complications; gestational age at delivery; weight at delivery; Apgar scores; congenital malformations; hospital stays, infant serum concetrations of thyroid-stimulating hormone.
Eight mother-child diads. Mean age of the mother (SD): 32.1 (4,7); 100% caucasian and married. Mean dose of maternal lithium (SD): 675mg (237,5mg). Premature rupture of membranes (%):25. Gestational mean age (in weeks) (SD): 39,9 (1). Birth weight (SD) : 3625gr (451,2gr); Mean Apgar1min (SD): 8,38 (1,1); Mean Apgar5min (SD): 9,75 (0,4). Loss of fetal intrapartum wellness (%): 12,5. Days of hospitalization (mean) (SD):9,5(16,6). Lithium plasmatic concentration (mEq/L), mean (SD): maternal 0,45(0,1), umbilical cord 0,33(0,1), lithium ratio uc/m 0,93 (0,3); infant TSH μU/mL mean (SD): 4,9(4,6).
Lithium placental passsage was 0,93 (0,63-1,07). ≤At umbilical cord lithium levels ≤ 0.60 mEq/L, we didn't have any preterm deliveries, low birth weight newborns, nor neonatal complications.
During the 2017 European hepatitis A (HA) outbreak we assessed HA incidence in our cohort of 2300 HIV-infected patients, implemented preventive measures and evaluated practices and knowledge on sexually transmitted diseases (STD). HA incidence was assessed between 1 January 2017 and 31 December 2017 and included all symptomatic patients with virologically confirmed HA. Preventive measures consisted in identifying at risk and not immunised patients to propose them a free HAV vaccination, and an anonymous survey related to transmission routes of STD and to sexual behaviours. Twenty HA were diagnosed. All were homosexual men recently diagnosed with HIV and another STD. None were vaccinated against hepatitis A virus (HAV). Hospitalisation was required for 52%. We identified 250 patients at risk to acquire HAV and invited them to a free immunisation program. A total of 110 (44%) were vaccinated, of whom 74 responded to our survey. A majority of them (84%) reported recent active anal and oral sexuality with multiple (52%) male partners (81%), and ChemSex consumption (14%). Internet was the meeting link for 58%. Another STD history was found in 69%. One third of these individuals had no idea about STD transmission modes. This HA outbreak pointed the insufficient vaccine coverage against HAV and knowledge on STD, which may be improved by Internet.
The results showed that the adolescents were more concerned about their physical appearance (body dissatisfaction and obsession with being thin), by their social environment (interpersonal distrust). The Anorexia (AN) has alarming increase of the disorders of the food conduct in the last two decades. The conception etiopatogénica current is multifactorial: biopsicosocial, where the more important are the sociocultural factors.
To assess the presence of symptoms of cognitive and behavioural symptoms characteristic of eating disorders in adolescents.
Aims and methods
Clinical case: four neighbors of the same village, who initiated being adolescents, food restriction. Finally, three of them needed hospitable revenue. In our case, they are athletes, favorite children of the best families and they form part of the regional soccer team. Like a jobby, being children, they competed furtively “to see wich one lost more weight “
Theory Multifactorial postulates that the Anorexia nervosa would be a complex interaction betewing the psychological and family factors that would lead the teenager to rejecting the food; the consistent malnutrition would produce changes hipotalámicos and endocrine that would contribute to the disorders of the corporal image and the fear of the obesity.
Our adolescents with normal weight showed specific factors for developing eating disorders in the future. The sociocultural influences and concretly, “the longing thinness ” constitute the principal factor predisposition of maintenance of these disorders. It seems to be important to anticipate the clinical conditions that they could accompany on the future cases in our young men.