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Biomedical subjects

Josefina Castro

Publications and source records attributed to Josefina Castro.

12 recordsLinked to original sources
PubMed2006

Antineuronal antibodies in a group of children with obsessive-compulsive disorder and Tourette syndrome.

An autoimmune hypothesis has been suggested for early onset obsessive-compulsive disorder and Tourette syndrome. The term: Paediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) has been proposed as an aetiological subtype of OCD and TS, related to a Group A beta haemolytic streptococcal (GABHS) infection that triggers an autoimmune response. Antineural antibodies have been studied and found in the sera of some patients with these disorders, and they are thought to cross-react with streptococcal and basal ganglia antigens. The present study included 32 prepubertal-onset OCD patients, 21 with TS diagnosis (some of them meeting criteria for PANDAS) and 19 normal children, all aged between 9 and 17 years. Antibodies were assayed by immunohistochemistry and immunoblot. Special attention was paid to the methodology and a high serum dilution was used to minimize non-specific binding. No anti-basal ganglia antibodies were detected by immunohistochemistry in any of the samples. Two proteins, with approximate molecular weights of 86 kDa and 55 kDa, were found in sera from 7 patients. Though the study supports the hypothesis of an autoimmune process underlying OCD or TS in some patients, further research is needed.

Adolescent↗
PubMed2006

Eating disorders and body image in Spanish and Mexican female adolescents.

OBJECTIVE: To compare the prevalence of eating disorders (ED), socio-cultural risk factors, and body image characteristics in two populations of female adolescents, one Mexican and one Spanish, from similar socio-economic backgrounds. METHOD: A total of 467 Spanish and 329 Mexican girls aged from 11-12 to 17-18 years were assessed using the Eating Attitude Test-26 (EAT-26), the CETCA (Eating Disorders Assessment Questionnaire), the CIMEC (Questionnaire on Influences on Body Shape Model), and a survey of socio-demographic and risk factors produced for this study. RESULTS: One out of four subjects showed a significant risk of an eating disorder and 6-7% probably already had one. No significant differences were found between the two samples. Significant differences were found in risk behaviors: more Spanish girls reported body dissatisfaction and binging; more Mexican girls had a history of psychiatric and psychological treatment, pressure from parents and friends to lose weight, dieting, physical activity and vomiting to lose weight, and a history of greater weight loss. In both the groups around 50% of subjects wanted to increase the size of their breasts. However, significantly more Mexican girls desired thinner arms and narrower shoulders and back, and more Spanish girls wanted thinner hips, buttocks, and legs, parts of the body that many Mexicans wanted to increase. CONCLUSIONS: Risk behaviors and the ideal body models of these Spanish and Mexican adolescent girls varied significantly, indicating major socio-cultural differences. However, the prevalence of ED was similar. Further research should aim to clarify whether the similarities found between this Spanish sample and a Mexican sample taken from an upper-middle class urban environment, a minority that is unrepresentative of the general population, are also observed in samples from other sectors of Mexican society.

Adolescent↗
PubMed2005

Anorexia nervosa and obsessive-compulsive disorder in a prepubertal patient with bone dysplasia: a case report.

OBJECTIVE: The current article describes the case of a 13-year-old girl with body dysplasia, anorexia nervosa, and obsessive-compulsive disorder (OCD). METHOD: She was given cognitive-behavioral therapy and pharmacologic treatment for the obsessive-compulsive symptomatology and exogenous growth hormone to increase her height. RESULTS: She experienced an adequate weight and height increase and remission of obsessive-compulsive symptomatology, and reestablished adequate social and academic functioning. CONCLUSION: After a follow-up of almost 2 years, she had had her menarche, continued her positive eating habits, and had not relapsed into OCD.

Adolescent↗
PubMed2005

Anorexia nervosa in male adolescents: body image, eating attitudes and psychological traits.

PURPOSE: To evaluate body image and its relationship with psychological and behavioral traits associated with anorexia nervosa in male patients. METHODS: Thirty male adolescents with anorexia nervosa (AN) were compared with 421 male adolescents from the general population. Body image was evaluated with the Subjective Body Dimensions Apparatus. Eating attitudes were evaluated by the Eating Attitudes Test in its 26-item version (EAT-26). In 19 AN patients and 200 boys from the comparison group, the Eating Disorders Inventory (EDI) was also administered. RESULTS: AN patients had higher mean scores in the EAT-26 and the Body Dissatisfaction scale on the EDI, but not on the other EDI scales. Both groups overestimated all parts of their bodies but AN patients presented a greater overestimation of shoulders (p = .007), hips (p = .01) and thighs (p = .019). Correlations in the anorexic group were high and negative between body overestimation and body mass index and also high but positive between overestimation and the EAT and the Drive for Thinness scale on the EDI. Overestimation did not correlate significantly with other EDI scales. CONCLUSIONS: Male patients with anorexia nervosa overestimate some parts of their bodies more often than controls; this overestimation is related to body mass index, abnormal eating attitudes and drive for thinness, but not to other psychological traits evaluated by the EDI.

Adolescent↗
PubMed2005

D8/17 monoclonal antibody: an unclear neuropsychiatric marker.

OBJECTIVE: It has been hypothesized that monoclonal antibody D8/17 identifies a B lymphocyte antigen with expanded expression in patients with rheumatic fever, childhood onset obsessive-compulsive disorder (OCD), Tourette syndrome (TS) or prepubertal anorexia nervosa (AN). Our purpose was to replicate these studies in a Spanish population and to determine whether D8/17 identifies a subgroup of these patients, focusing especially on OCD subjects. METHOD: D8/17 expression was assessed with double immunofluorescence and flow cytometry using monoclonal immunoglobulin M (IgM) in three groups of patients with diagnoses of OCD (n = 17), TS (n = 5) and prepubertal AN (n = 5), recruited during 2001. RESULTS: In the sample studied the average percentage of B cells expressing D8/17 was 4.8%. The D8/17 positive proportion of B lymphocytes was above 11% in only two out of 17 OCD patients (7.4% of total sample) and in none of the TS or prepubertal AN patients. No statistically significant differences were found in mean percentages of D8/17 between the three groups. CONCLUSIONS: In the sample studied the expression of D8/17 in B cells was very low and the great majority of patients were negative for the D8/17 marker. The molecular characterization of D8/17 would be a major step forward in clarifying its implication for these diseases.

Adolescent↗
PubMed2004

Persistence of nutritional deficiencies after short-term weight recovery in adolescents with anorexia nervosa.

OBJECTIVES: To study nutritional abnormalities in adolescent anorexia nervosa and to establish whether certain abnormalities persist after short-term refeeding. METHOD: Sixty-one patients (10-19 years old) admitted to a reference unit for eating disorders between 1999 and 2000 with a diagnosis of anorexia nervosa were evaluated at admission and at discharge. A range of biochemical, nutritional, and hormonal parameters were determined. RESULTS: At admission, no protein or lipid deficiencies were found, although many patients presented with hormonal abnormalities and red blood cell folate and zinc deficiencies. Hormonal abnormalities reverted significantly (p <.000) after renutrition. There were decreases in erythrocytes and in levels of hemoglobin (p <.000) and folic acid (p <.05). Red blood cell folate and zinc increased but did not reach normal levels. CONCLUSIONS: In a large proportion of adolescent anorexic patients, supplementation of folic acid and zinc is recommended although protein or hormonal replacement does not seem to be necessary.

Adolescent↗
PubMed2004

Predictors of rehospitalization after total weight recovery in adolescents with anorexia nervosa.

OBJECTIVE: The current study analyzed the variables related to rehospitalization after total weight recovery in adolescents with anorexia nervosa. METHOD: One hundred and one patients first admitted for inpatient treatment, aged 11-19 years, were followed up for 12 months after discharge. RESULTS: Twenty-five subjects (24.8%) required readmission after complete weight recovery and 76 (75.2%) did not. Duration of disorder, weight loss, body mass index at first admission, and global body image distortion were similar in the two groups. Patients needing readmission had a lower rate of weight gain (p < .001), a lower mean age (p = . 007), a higher mean score on the Eating Attitudes Test (EAT; p = .009), and a higher percentage of hips overestimation (p = .049). In a stepwise logistic regression analysis, these three variables predicted readmission and correctly classified 77.6% of patients. Taken as discrete variables, age younger than 15 years old, EAT score above 55, and a rate of weight gain lower than 150 grams per day were associated with a higher percentage of readmissions. DISCUSSION: The variables most clearly related to readmission were young age, abnormal eating attitudes, and a low rate of weight gain.

Adolescent↗
PubMed2004

Perfectionism dimensions in children and adolescents with anorexia nervosa.

PURPOSE: To assess the dimensions of perfectionism in adolescents with anorexia nervosa in comparison with adolescents from the general population and to validate the Spanish versions of two measures of perfectionism. METHODS: The Child and Adolescents Perfectionism Scale (CAPS), the Perfectionistic Self-Presentation Scale (PSPS) scale, the Eating Attitudes Test (EAT), and the Beck Depression Inventory (BDI) were administered to a group of 71 anorexia nervosa patients (mean age 15.3 years). Moreover, the CAPS and the PSPS were also administered to 113 adolescents from the general population (mean age 14.6 years). The CAPS and the PSPS were administered again after 1 week in 68 subjects to evaluate test-retest reliability. RESULTS: Both the CAPS and the PSPS demonstrated good internal consistency (Cronbach alpha for anorexia nervosa patients = .91; Cronbach alpha for general population = .85) and the two scales of the CAPS also had alpha coefficients in excess of .7. One-week test-retest reliability was also adequate (r = .80). Anorexia nervosa patients had higher mean scores in Self-oriented perfectionism (p < .001) and Perfectionistic self-presentation (p < .001) but not in Socially prescribed perfectionism (p = .292). There were significant correlations among perfectionism and the EAT and the BDI. A percentage of anorexia nervosa patients between 39% and 42% obtained a score higher than the mean in the comparison group plus two standard deviations in Self-oriented perfectionism and Perfectionistics self-presentation. CONCLUSIONS: The Spanish version of the CAPS and the PSPS showed good psychometric properties. A percentage of 40% of adolescent patients with anorexia nervosa show high Self-oriented perfectionism and Perfectionistic self-presentation.

Adolescent↗
PubMed2003

Reversibility of cardiac abnormalities in adolescents with anorexia nervosa after weight recovery.

OBJECTIVE: Anorexia nervosa is a life-threatening condition, with significant risk for death due to cardiac complications. The objective of this study was to analyze the cardiac involvement in anorexia nervosa and to study the reversibility of cardiac abnormalities. METHOD: Thirty-one consecutive adolescents (aged 12 to 17 years) with a diagnosis of anorexia nervosa were evaluated from January 1998 to January 1999 at the Hospital Clínic (University of Barcelona, Catalonia, Spain). An electrocardiogram, an echocardiogram, a 24-hour Holter recording with heart rate variability, an exercise test, and a tilt test were performed at initial examination and after refeeding (3 to 18 months later). RESULTS: The basal body mass index was 15.2 +/- 2 kg/m2. Sinus bradycardia was found in 35% of patients, 93% showed a decreased left ventricular mass, and 70% had a diminished thickness of cardiac walls. The Holter recordings showed nocturnal bradycardia in 60% with an increased heart rate variability. After refeeding, a significant decrease in QT interval (p <.05) and QT dispersion (p <.01) was observed. Echocardiograms showed an increase in cardiac diameters (p <.01), left ventricular mass (p <.001), and cardiac output (p <.001). There was also an improvement in the exercise capacity (p <.05) and a normalization of the heart rate and heart rate variability (p <.05). CONCLUSION: Cardiac structural and functional abnormalities provoked by anorexia nervosa are reversible in young adolescents after refeeding.

Adolescent↗
PubMed2002

Bone mineral density in male adolescents with anorexia nervosa.

OBJECTIVES: To determine the percentage of male adolescent patients with abnormal bone mineral density (BMD), to identify the variables related to BMD loss, and to study BMD change after follow-up. METHOD: Dual-energy-x-ray absorptiometry tests at the lumbar spine (L2-L4) and the femoral neck were administered in 20 male adolescents with anorexia nervosa (treated from 1997 until 2000 at the Department of Child and Adolescent Psychiatry and Psychology of the Hospital Clinic Universitari in Barcelona). Examinations were repeated in 15 patients after a follow-up of 6 to 24 months. RESULTS: Thirty-five percent of patients had osteopenia at the lumbar spine and femoral neck. The following variables were related to osteopenia: >12 months' duration of anorexia (p = .003), <3 hours/week of physical activity (p = .009), and calcium intake <600 mg/day (p = .015). In a stepwise logistic regression analysis to predict spinal BMD with the three variables mentioned above, only months of duration entered in the equation (beta = 3.5, SE = 1.3, p = .008) and correctly classified 85% of patients. At the follow-up, patients with only partial weight recovery had a BMD loss of 3.2% at lumbar spine and 6.4% at femoral neck, whereas patients with total weight recovery had an increase of 7.8% at lumbar spine and 6.7% at femoral neck. CONCLUSIONS: The risk of osteopenia in male adolescents with anorexia of more than 12 months' duration is high. In patients with total weight recovery, BMD increase is higher than normal.

Absorptiometry, Photon↗