Assessing Family Functioning Before and After an Integrated Multidisciplinary Family Treatment for Adolescents With Restrictive Eating Disorders.

The present study presents an investigation of family functioning in the families of adolescents with severe restrictive eating disorders (REDs) assessed before and 6 months after a multidisciplinary family treatment program that combined psychodynamic psychotherapy, parental role intervention, and triadic or family-centered interventions. Nutritional counseling and neuropsychiatric monitoring of the overall treatment and care process were also provided. Family functioning was assessed using the clinical version of the Lausanne Trilogue Play (LTPc), a semi-structured procedure for observing family dynamics, previously validated for this patient population. The LTPc is divided into four phases. In phase 1, the mother interacts with the patient while the father assumes the role of observer. In phase 2, the father plans an activity with the patient while the mother observes. In phase 3, all the family members interact. Finally, in phase 4, the parents talk while the adolescent observes. A significant change emerged in family functioning after the treatment, but only for the interactive phase 2, when the father is required to interact with the daughter while the mother silently observes. The results of this study suggest that a relatively brief multidisciplinary treatment program may significantly improve family functioning in the families of patients diagnosed with severe REDs. Although appropriate clinical trials are needed to further test the efficacy of this treatment, the results also reinforce the concept that treatment programs targeting the individual patient and both the parents should be a first-line approach in adolescents with severe REDs.

Radiographic Measurements of the Cardiac Silhouette in Healthy Blue-Fronted Amazon Parrots (Amazona aestiva).

The objective of this investigation was to determine radiographic measurements, without chemical restraint, of the cardiac silhouette in 34 healthy, adult blue-fronted Amazon parrots (Amazona aestiva) of unknown sex with a mean body weight of 393 g. The birds were fasted 3 hours before the radiographic examinations. Three thoracic radiographic views (ventrodorsal, right lateral, and left lateral) were obtained from each bird for assessment. There was no significant statistical difference between right and left radiographic measurements. The mean values of the measurements in the ventrodorsal views were heart width of 21.04 mm and coelomic cavity width of 50.61 mm. The mean values of the measurements in the lateral views were left heart length of 23.44 mm, right heart length of 23.40 mm, left sternal length of 65.69 mm, and right sternal length of 65.03 mm. A strong correlation and ratio of 43% between the heart width and coelomic cavity width and a moderate correlation and ratio of 36% between the heart length and sternal length were observed. In conclusion, the radiographic measurements of the cardiac silhouette in healthy blue-fronted Amazon parrots can be obtained without chemical restraint. The values obtained can be used to assist in the detection of cardiomegaly or microcardia in blue-fronted Amazon parrots.

Description of the D4/D4 genotype in Miniature horses with dwarfism.

Four causative mutations (D1, D2, D3*, and D4) of chondrodysplastic dwarfism have been described in the equine aggrecan (ACAN) gene. Homozygotes for one of these mutations and heterozygotes for any combination of these mutations exhibit the disproportionate dwarfism phenotype. However, no case description of homozygotes for D4 (D4/D4) has been reported in the literature, to our knowledge. We report 2 Miniature horses with the genotype D4/D4 in the ACAN gene. Clinically, the 2 dwarfs had a domed head that was large compared to the rest of the body, mandibular prognathism, and short and bowed limbs, mainly in the proximal region of the metatarsal bones. Radiographic examination revealed contour irregularities of the subchondral bone in the long bones and confirmed mandibular prognathism; histopathology revealed irregular chondrocyte organization. To determine the genotypes of the horses, we performed DNA extraction from white blood cells, PCR, and Sanger sequencing. Genotyping demonstrated that these 2 animals had the D4/D4 genotype in the ACAN gene. The D4/D4 dwarfs were clinically similar to animals with the other ACAN genotypes reported for this disease. Identification of heterozygous animals makes mating selection possible and is the most important control measure to minimize economic losses and casualties.

B-mode and Doppler ultrasonography in the assessment of the common carotid arteries of equines and mules and the relation with body mass, age and neck circumference / Estudo de ultrassonografia modo-B e Doppler na avaliação das artérias carótidas comuns de equinos e muares e a relação com o peso, idade e a circunferência do pescoço

As age increases, changes in cardiovascular anatomy and physiology occur, even in the absence of disease. Thus, studies of vessel hemodynamics are considered primordial to detect any cardiovascular changes. The objective of this study has been to describe the parameters of B-mode and spectral Doppler ultrasonography in the evaluation of the common carotid arteries of 11 equine and 11 mules, and correlate with age, body mass and neck circumferences. The diameters, intima - media thickness (IMT), resistivity index (RI), pulsatility index (PI), systolic velocity (SV), diastolic velocity (DV), maximum velocity (MV), vascular flow index (VFI), body mass, age, circumference and neck length. Ultrasonographic variables were evaluated in three different region called cranial, middle and caudal. Equine females presented higher values regarding the body mass, age and neck length, as compared to the neck circumferences of the animals, those of the mules were superior. The age of the mules had a positive correlation with the body mass, diameter and neck circumferences, it has a negative correlation between age and vessel diameters. The body mass of the mules had a positive correlation with age and vessel diameters, and with vessel diameters and neck circumferences in equine females. The RI and PI variables had a positive correlation with body mass for mules, and with age for equine females. The DV had a negative correlation with body mass for both equine and mule females. Regarding the variables MV and VFI, age correlated negatively for mules, while it was not significant for equine females. It found a difference between equine females and mules in the correlations performed, with body mass, age, neck circumferences and between B-mode and Doppler ultrasonography variables.(AU)

Com o aumento da idade ocorrem alterações na anatomia e fisiologia cardiovascular, mesmo na ausência de doenças. Assim, os estudos da hemodinâmica dos vasos são considerados primordiais para detectar quaisquer alterações cardiovasculares. Esse trabalho tem como objetivo descrever as variáveis de ultrassonografia modo-B e Doppler espectral na avaliação das artérias carótidas comuns de 11 fêmeas equinas e 11 muares, e correlacionar com idade, massa corpórea e circunferências dos pescoços. Para tais procedimentos foram avaliados os diâmetros, espessura da camada íntima média (EIM), índice de resistividade (IR), índice de pulsatilidade (IP), velocidade sistólica (VS), velocidade diastólica (VD), velocidade máxima (VM), índice de vascularização de fluxo (IVF), massa corpórea, idade, circunferências e comprimentos dos pescoços. As variáveis ultrassonográficas foram avaliadas em três regiões diferentes denominados de crania médio e caudal. As fêmeas equinas apresentaram valores maiores referente ao massa corpórea, idade e comprimento dos pescoços, já em relação às circunferências dos pescoços dos animais, as dos muares foram superiores. A idade dos muares possuiu correlação positiva com a massa corpórea, diâmetro e com as circunferências dos pescoços, com as fêmeas equinas, possui correlação negativa entre idade e os diâmetros dos vasos. A massa corpórea dos muares teve correlação positiva com idade e diâmetros dos vasos, já às fêmeas equinas com diâmetros dos vasos e as circunferências dos pescoços. As variáveis IR e IP tiveram correlação positiva com a massa corpórea para os muares, e com idade para fêmeas equinas. O VD teve correlação negativa com a massa corpórea tanto para as fêmeas equinas quanto nos muares. Já as variáveis VM e IVF, a idade correlacionou negativamente para os muares, enquanto não foi significativo para as fêmeas equinas. Averiguou diferença entre fêmeas equinas e muares nas correlações realizadas, com a massa corpórea, idade, circunferências dos pescoços e entre as variáveis da ultrassonografia modo-B e Doppler.(AU)

New Treatment Perspectives in Adolescents With Anorexia Nervosa: The Efficacy of Non-invasive Brain-Directed Treatment.

Poor treatment outcomes are available for anorexia nervosa (AN) and treatment innovations are urgently needed. Recently, non-invasive neuromodulation tools have suggested to have potential for reducing an symptomatology targeting brain alterations. The objective of the study was to verify whether left anodal/right cathodal prefrontal cortex transcranial direct current stimulation (tDCS), may aid in altering/resetting inter-hemispheric balance in patients with AN, re-establishing control over eating behaviors. Twenty-three adolescents with an underwent a treatment as usual (AU), including nutritional, pharmacological, and psychoeducational treatment, plus 18 sessions of tDCS (TDCS+AU = n11; mean age = 13.9, SD = 1.8 years) or a family based therapy (FBT+AU = n12, mean age = 15.1, SD = 1.5 years). Psychopathological scales and the body mass index (BMI) were assessed before and after treatment. After 6 weeks of treatment, the BMI values increased only in the tDCS group, even at 1-month follow-up. Independently of the treatment, all participants improved in several psychopathological measures, included AN psychopathology and mood and anxiety symptoms. Our results demonstrated for the first time a specific effect of the left anodal/right cathodal tDCS treatment protocol on stable weight gain and a superiority compared to an active control treatment for adolescents with AN. Results were interpreted as a possible direct/indirect effect of tDCS in into some pathophysiological mechanisms of AN, involving the mesocortical dopaminergic pathways and the promotion of food intake. This pilot study opens new perspectives in the treatment of an in adolescence, supporting the targeted and beneficial effects of a brain-based treatment.