Loss of control (LOC) eating in youth is associated cross-sectionally with eating-related and psychosocial distress, and is predictive of excessive weight gain. However, few longitudinal studies have examined the psychological impact and persistence of pediatric LOC eating. We administered the Eating Disorder Examination (EDE) and self-reported measures of depressive and anxiety symptoms to 195 boys and girls (M = 10.4, SD = 1.5 y) at baseline and again 4.7 (SD = 1.2) y later to 118 of these youth. Missing data were imputed. Baseline report of LOC was associated with the development of partial or full-syndrome binge eating disorder (p=.03), even after accounting for the contribution of sex, race, baseline characteristics (age, disordered eating attitudes and mood symptoms), body mass index growth between baseline and follow-up, and years in study. Half (52.2%, CI=1.15–6.22) of children who endorsed experiencing LOC at baseline reported persistence of LOC at follow-up (p=.02). Compared to children who never reported LOC eating or reported LOC only at baseline, those with persistent LOC experienced significantly greater increases in disordered eating attitudes (ps<.001) and depressive symptoms (p=.027) over time. These data suggest that LOC eating in children is a problematic behavior that frequently persists into adolescence and that persistent LOC eating is associated with worsening of emotional distress.

Objective-Limited data suggest that disordered-eating may predispose children to excessive weight gain. We investigated the relationship between baseline responses to the Eating Disorder Examination adapted for Children (ChEDE) and change in BMI (kg/m 2 ) in children at high risk for adult obesity.Method-Children (6-12 years) were administered the ChEDE to assess loss of control (LOC) eating, dietary restraint, and eating, shape, and weight concern. Height and weight were measured at baseline and annually.Results-Between July, 1999, and August, 2007, 772 measurements were obtained from 143 children over 4.5 ± 1.9 years. LOC eating predicted an increased rate of BMI growth over time (p = .02). Compared with children without LOC, those reporting LOC gained an additional mean 2.4 kg of weight per year.Conclusion-LOC is a salient predictor of weight gain during middle childhood. Interventions that decrease LOC eating should be evaluated for their ability to prevent excessive pediatric weight gain.

The phenomenology of childhood and adolescent loss of control (LOC) eating is unknown. The authors interviewed 445 youths to assess aspects of aberrant eating. LOC was associated with eating NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript forbidden food before the episode; eating when not hungry; eating alone; and experiencing secrecy, negative emotions, and a sense of "numbing" while eating (ps < .01). Hierarchical cluster analysis revealed a subgroup, most of whom reported LOC eating. Cluster members reported having a trigger initiate episodes, eating while watching television, and having decreased awareness regarding the amount consumed. The authors conclude that aspects of LOC eating during youth are similar to aspects of adult episodes, but a youth-specific presentation may exist. Findings may provide an intervening point to prevent excessive weight gain and eating disorders.Keywords binge eating; loss of control eating; children; adolescentsThe prevalence of pediatric overweight has nearly tripled in recent years (Ogden et al., 2006). Overweight during youth puts individuals at high risk for becoming obese adults (Field, Cook, & Gillman, 2005;Freedman, Khan, Dietz, Srinivasan, & Berenson, 2001;Guo, Wu, Chumlea, & Roche, 2002;Whitaker, Wright, Pepe, Seidel, & Dietz, 1997;Williams, 2001). Given the serious untoward medical (Adams et al., 2006;Freedman et al., 2001) and psychosocial (Puhl & Brownell, 2002;Strauss & Pollack, 2003) consequences of excess weight, overweight during childhood and adolescence is a major public health problem. Prevention and early intervention are critical to reduce the current epidemically high prevalence of pediatric overweight (Styne, 2003). Targeting behavioral factors that promote excessive weight gain may be a potential point of intervention. However, clarification of relevant behavioral factors is required before prevention efforts may be designed and implemented.Binge eating is defined as eating a large amount of food given the context, during which a sense of lack of control over eating is experienced (American Psychiatric Association [APA], 2000). Recurrent binge eating is the hallmark behavior of binge eating disorder BED; (APA, 2000). Compared to obese adults without an eating disorder, adults with BED suffer from poorer physical health (J. G. Johnson, Spitzer, & Williams, 2001) and higher levels of eating disorder psychopathology (e.g., Masheb & Grilo, 2000;Wilfley et al., 2000) and are more likely to be diagnosed with a comorbid psychiatric disorder (e.g., Marcus, 1995;Wilfley et al., 2000;Yanovski, Nelson, Dubbert, & Spitzer, 1993). BED and subthreshold binge eating are often associated with excess body weight and obesity (de Zwaan, 2001;Yanovski et al., 1993). Not only is BED a disorder of clinical significance (Wilfley, Wilson, & Agras. 2003), but some (Sherwood, Jeffery, & Wing, 1999;Yanovski, Gormally, Leser, Gwirtsman, & Yanovski, 1994), although not all (Wadden, Foster, & Letizia, 1992), data suggest that the presence of the ...

Primary extracranial meningiomas are rare neoplasms, frequently misdiagnosed, resulting in inappropriate clinical management. To date, a large clinicopathologic study has not been reported. One hundred and forty-six cases diagnosed between 1970 and 1999 were retrieved from the files of the Armed Forces Institute of Pathology. Histologic features were reviewed, immunohistochemistry analysis was performed (n = 85), and patient follow-up was obtained (n = 110). The patients included 74 (50.7%) females and 72 (49.3%) males. Tumors of the skin were much more common in males than females (1.7:1). There was an overall mean age at presentation of 42.4 years, with a range of 0.3–88 years. The overall mean age at presentation was significantly younger for skin primaries (36.2 years) than for ear (50.1 years) and nasal cavity (47.1 years) primaries. Symptoms were in general non-specific and reflected the anatomic site of involvement, affecting the following areas in order of frequency: scalp skin (40.4%), ear and temporal bone (26%), and sinonasal tract (24%). The tumors ranged in size from 0.5 up to 8 cm, with a mean size of 2.3 cm. Histologically, the majority of tumors were meningothelial (77.4%), followed by atypical (7.5%), psammomatous (4.1%) and anaplastic (2.7%). Psammoma bodies were present in 45 tumors (30.8%), and bone invasion in 31 (21.2%) of tumors. The vast majority were WHO Grade I tumors (87.7%), followed by Grade II (9.6%) and Grade III (2.7%) tumors. Immunohistochemically, the tumor cells labeled for EMA (76%; 61/80), S-100 protein (19%; 15/78), CK 7 (22%; 12/55), and while there was ki-67 labeling in 27% (21/78), <3% of cells were positive. The differential diagnosis included a number of mesenchymal and epithelial tumors (paraganglioma, schwannoma, carcinoma, melanoma, neuroendocrine adenoma of the middle ear), depending on the anatomic site of involvement. Treatment and follow-up was available in 110 patients: Biopsy, local excision, or wide excision was employed. Follow-up time ranged from 1 month to 32 years, with an average of 14.5 years. Recurrences were noted in 26 (23.6%) patients, who were further managed by additional surgery. At last follow-up, recurrent disease was persistent in 15 patients (mean, 7.7 years): 13 patients were dead (died with disease) and two were alive; the remaining patients were disease free (alive 60, mean 19.0 years, dead 35, mean 9.6 years). There is no statistically significant difference in 5-year survival rates by site: ear and temporal bone: 83.3%; nasal cavity: 81.8%; scalp skin: 78.5%; other sites: 65.5% (P = 0.155). Meningiomas can present in a wide variety of sites, especially within the head and neck region. They behave as slow-growing neoplasms with a good prognosis, with longest survival associated with younger age, and complete resection. Awareness of this diagnosis in an unexpected location will help to avoid potential difficulties associated with the diagnosis and management of these tumors.

The fucosylated ABH antigens, which constitute the molecular basis for the ABO blood group system, are also expressed in salivary secretions and gastrointestinal epithelia in individuals of positive secretor status; however, the biological function of the ABO blood group system is unknown. Gastric mucosa biopsies of 41 Rhesus monkeys originating from Southern Asia were analyzed by immunohistochemistry. A majority of these animals were found to be of blood group B and weak-secretor phenotype (i.e., expressing both Lewis a and Lewis b antigens), which are also common in South Asian human populations. A selected group of ten monkeys was inoculated with Helicobacter pylori and studied for changes in gastric mucosal glycosylation during a 10-month period. We observed a loss in mucosal fucosylation and concurrent induction and time-dependent dynamics in gastric mucosal sialylation (carbohydrate marker of inflammation), which affect H. pylori adhesion targets and thus modulate host–bacterial interactions. Of particular relevance, gastric mucosal density of H. pylori, gastritis, and sialylation were all higher in secretor individuals compared to weak-secretors, the latter being apparently “protected.” These results demonstrate that the secretor status plays an intrinsic role in resistance to H. pylori infection and suggest that the fucosylated secretor ABH antigens constitute interactive members of the human and primate mucosal innate immune system.