Female adolescents with eating disordes: cardiac abnormalitiesBackground: Cardiovascular complications can occur in up to 80% of adolescent patients with eating disorders (ED) and account for 30% of their mortality. Aim: To evaluate cardiovascular complications in adolescents with ED and their evolution after refeeding. Patients and Methods: In adolescents with ED admitted to treatment, we assessed the nutritional status, weight loss prior to consultation, presence of bradycardia (BC, defined as heart rate < 60 bpm), we performed an electrocardiogram (ECG) and an echocardiography and measured thyroid hormones. Results: We studied 53 women aged 16.4 ± 2.3 years. Fifteen had a diagnosis of Anorexia Nervosa (AN), seven of Bulimia (BN), eight a not otherwise specified ED (ED-NOS), four a Binge Eating Disorder (BED), sixteen an Atypical Anorexia (AAN) and three an Atypical Bulimia (ABN). Thirty four percent were malnourished and 3.8% overweight. The most common cardiac problem was BC in 51%. In eight of 26 patients in whom an echocardiogram was done, it was abnormal. Six had a decreased ventricular mass, three a pericardial effusion and three valvular involvement. There was a significant association between bradycardia and malnutrition, weight loss and low free triiodothyronine levels. BC was significantly more common in patients with AN, but it also occurred in half of the patients with AAN and in one of three patients with other types of ED. At follow up, bradycardia significantly improved with refeeding. Conclusions: There is an association between all types of ED and bradycardia, as well as anatomical and functional cardiac anomalies.

Background: Preliminary research suggests that eating disorders (ED) are common among overweight teenagers. Missing the diagnosis is (Rev Med Chile 2014; 142: 1253-1258

After discounting the effect on anxiety reduction over time, the estimated PGB effect over UC increase on both sleep disturbances and disability scores were still significant (gϭ-3.99, pϽ0.001 and gϭ-3.07, pϽ0.001, respectively). Mediation analysis showed that 70% and 58% of the direct effect of PGB over, respectively, sleep disturbances and disability remained after discounting the mediated effect of anxiety improvement. CONCLUSIONS: Adding pregabalin to usual care produced better improvements in sleep disturbances and disability related GAD symptoms in outpatients treated in real world conditions. 70% and 58% of the total effect of PGB over usual care was explained by its direct effect not mediated by improvements in anxiety symptoms.OBJECTIVES: Specific instruments are developed measuring HRQoL in children and adolescents. Currently, these instruments are not applicable in health economic studies as valuations for health states are lacking. The aim of the current study was to compare the psychometric properties of a generic child-specific and a generic preference based instrument in children and adolescents with ADHD. METHODS: A questionnaire survey was performed among parents with a child diagnosed with ADHD. Results on the proxy versions of the KIDSCREEN-10 and the EQ-5D were used to compare the constructs describing HRQoL of the instruments and their responsiveness to different health states. Principal Component Analaysis (PCA) with varimax rotation was used for identifying factors underlying the constructs of both instruments. A comparison was performed of the index scores on both instruments between respondents with different stimulant medication profiles and different comorbidity profiles using Student's t-tests. Additionally, Cohen's effect sizes were calculated for an indirect comparison of the instruments' responsiveness and discriminating ability. RESULTS: Using the EQ-5D dimensions and the items of the KIDSCREEN -10 the PCA identified 5 separate components of HRQoL. A physical component and a mental component included a combination of EQ-5D dimensions and KIDSCREEN-10 items. No associations of the EQ-5D dimensions 'self-care' and 'usual activities' and KIDSCREEN-10 items was found. Additionally, no association was found of KIDSCREEN-10 items related to performance at school and satisfaction with free time activities and EQ-5D dimensions. Scores of both instruments differed significantly according to respondents' treatment and comorbidity profile. Cohen's effect sizes indicated comparable responsiveness and discriminative ability of the instruments. CONCLUSIONS: The results highlight that the two instruments measure different constructs of HRQoL. Despite this, the analyses showed comparable responsiveness to different health states and discriminative ability of the instruments. These results suggest that the KIDSCREEN and the EQ-5D are complementary instruments.

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