leora pinhas

Childhood and adolescence are critical periods of neural development and physical growth. The malnutrition and related medical complications resulting from eating disorders such as anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified may have more severe and potentially more protracted consequences during youth than during other age periods. The consensus opinion of an international workgroup of experts on the diagnosis and treatment of child and adolescent eating disorders is that (a) lower and more developmentally sensitive thresholds of symptom severity (e.g. lower frequency of purging behaviours, significant deviations from growth curves as indicators of clinical severity) be used as diagnostic boundaries for children and adolescents, (b) behavioural indicators of psychological features of eating disorders be considered even in the absence of direct self-report of such symptoms and (c) multiple informants (e.g. parents) be used to ascertain symptom profiles. Collectively, these recommendations will permit earlier identification and intervention to prevent the exacerbation of eating disorder symptoms. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.

Objective:The aim of this study was to determine the prevalence and potential causes of secondary nocturnal enuresis (NE) in adolescents with anorexia nervosa (AN).The aim of this study was to determine the prevalence and potential causes of secondary nocturnal enuresis (NE) in adolescents with anorexia nervosa (AN).Method:Adolescents with AN completed the Incontinence Symptom Index-Pediatric (ISI-P), a self-report urinary incontinence survey. Those who had NE associated with the onset of AN on the ISI-P completed a comprehensive clinical and laboratory evaluation, including urinary flow measurements.Adolescents with AN completed the Incontinence Symptom Index-Pediatric (ISI-P), a self-report urinary incontinence survey. Those who had NE associated with the onset of AN on the ISI-P completed a comprehensive clinical and laboratory evaluation, including urinary flow measurements.Results:The prevalence of NE in adolescents with AN was 17.0% (10 of 59). The overall frequency of day- and night-time urinary incontinence symptoms in adolescents with AN was 62.7%; urgency incontinence, 57.6%; stress incontinence, 32.2%; and insensate incontinence, 17.0%. Nine of the 10 adolescents with NE had secondary NE and confirmed that bedwetting ceased after weight restoration.The prevalence of NE in adolescents with AN was 17.0% (10 of 59). The overall frequency of day- and night-time urinary incontinence symptoms in adolescents with AN was 62.7%; urgency incontinence, 57.6%; stress incontinence, 32.2%; and insensate incontinence, 17.0%. Nine of the 10 adolescents with NE had secondary NE and confirmed that bedwetting ceased after weight restoration.Discussion:Decreased functional bladder capacity and detrusor instability may contribute to the NE observed in this population. The high prevalence of NE in adolescents with AN warrants further study to determine the potential causative pathways. Clinicians who work with adolescents with AN should assess for this problem. © 2010 by Wiley Periodicals,Inc. (Int J Eat Disord 2011; 44:349–355)Decreased functional bladder capacity and detrusor instability may contribute to the NE observed in this population. The high prevalence of NE in adolescents with AN warrants further study to determine the potential causative pathways. Clinicians who work with adolescents with AN should assess for this problem. © 2010 by Wiley Periodicals,Inc. (Int J Eat Disord 2011; 44:349–355)

Objective:The purpose of this article is to describe the content of pro-anorexia websites, both qualitatively and quantitatively.The purpose of this article is to describe the content of pro-anorexia websites, both qualitatively and quantitatively.Method:An Internet search protocol was developed to identify pro-anorexia websites. A grounded theory approach was used to generate themes from Internet-based information. Basic descriptive analysis was employed to report on key website characteristics.An Internet search protocol was developed to identify pro-anorexia websites. A grounded theory approach was used to generate themes from Internet-based information. Basic descriptive analysis was employed to report on key website characteristics.Results:Twenty pro-anorexia websites met inclusion criteria. Saturation of themes was achieved after review of 12 websites. Key website characteristics included purpose of website (75%), information about webmaster (67%), website disclaimers (58%), and information on “tips and tricks” (67%). Religious metaphors, lifestyle descriptions, and “thinspiration” (inspirational photo galleries and quotes that aim to serve as motivators for weight loss) were frequently present. A total of 10 themes were generated. The most prevalent themes included control, success, and perfection.Twenty pro-anorexia websites met inclusion criteria. Saturation of themes was achieved after review of 12 websites. Key website characteristics included purpose of website (75%), information about webmaster (67%), website disclaimers (58%), and information on “tips and tricks” (67%). Religious metaphors, lifestyle descriptions, and “thinspiration” (inspirational photo galleries and quotes that aim to serve as motivators for weight loss) were frequently present. A total of 10 themes were generated. The most prevalent themes included control, success, and perfection.Conclusion:Health-care providers and caregivers should be aware of pro-anorexia websites and their content, as these websites contain information that promote and support anorexia nervosa. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006Health-care providers and caregivers should be aware of pro-anorexia websites and their content, as these websites contain information that promote and support anorexia nervosa. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006

Anorexia nervosa (AN) can cause both functional and structural cardiac complications, including a variety of different conduction abnormalities. This is the first case report of symptomatic diurnal second-degree atrioventricular (AV) block (Mobitz Type I) in an adolescent with AN. We present a 12-year-old girl with AN, restrictor sub-type who reported cardiac symptoms during weight gain, at the time of the initial diagnosis of AV block. Second-degree AV block (Mobitz Type I) is discussed as a possible complication of the AN, as well as being an intrinsic conduction system disease. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2009

The Ontario Community Outreach Program for Eating Disorders is a pilot training project within the eating disorder programs at the University Health Network—Toronto General Hospital (TGH) and the Hospital for Sick Children. This system provides ongoing training, consultation, and research evaluation in areas ranging from prevention through to tertiary care, in the hopes of increasing the capacity of practitioners to respond to the healthcare pressures of those experiencing eating disorders. A total of 3,315 health care practitioners and educators in Ontario participated in community-based training workshops. A pre–post analysis of participants' self-report evaluations was conducted using chi-square analyses. The findings revealed that there was a statistically significant increase in participants' (a) knowledge of eating disorders and of body image issues and (b) level of comfort to either treat clients with eating disorders or teach a curriculum on body image. The contribution of the training program to the development of a provincial network of specialized eating disorder services, designed to promote the public's access to timely and appropriate care for the full spectrum of eating disorders, are discussed. © 2005 by Wiley Periodicals, Inc.