Prevalence and correlates of a positive screen for eating disorders among Syrian refugees

The objective of this cross‐sectional study was to examine the prevalence and correlates of a positive screen for eating disorders (EDs) in a sample of Syrian refugees living in North Lebanon. The study was conducted on a convenience sample of 450 (84.67% women and 15.33% men) refugees, aged between 18 and 45 years. The prevalence of a positive screen for ED was 5.79%. Bivariate analyses revealed that female gender (p = 0.02), presence of medical conditions (p = 0.01), old occurrence of major stressful life event (p < 0.01), and positive primary care post‐traumatic stress disorder screen (p < 0.01) were associated with the positive sick, control, one stone, fat, food tool. Multiple logistic regression analyses showed that subjects screened with post‐traumatic stress disorder had a three times higher risk of having a positive screen for ED (odds ratio = 3.2; 95% confidence interval [1.32, 7.78]). Early detection of ED and related factors may help identify refugees who would benefit from interventions to improve mental health.     

Insuffisance surrénalienne secondaire : actualités diagnostiques et thérapeutiques: News in diagnosis and therapeutics of secondary adrenal insufficiency

Immunotherapy and opioids treatment are new causes of secondary adrenal insufficiency (SAI). Prevalence of SAI with immunotherapy is more frequent with combined therapy (8% vs 4 to 10% with CTLA4 blocking antibody and 1% with PD1 blocking antibody). Although hypophysitis are more frequently observed with CTLA4 blocking antibody, some cases of Isolated SAI have been reported in patients treated by PD1 blocking antibody. SAI could be transient, requiring long-term monitoring. The use of opioid analgesics is increasing in many countries, thus becoming a public health problem. Prevalence of opioid-related SAI is unclear but recent prospective studies reveal a prevalence between 5 and 20%. The main risk factor to develop this pathology is morphine-equivalent daily dose. Diagnosis relies on 8.00 am plasma cortisol measurement and cortisol increase after Synacthen^® administration. Recent cortisol immuno-assays, in agreement with mass spectrometry, give lower reference values, encouraging reevaluation of the current cut-off of 500 nmol/L. New modified-release hydrocortisone preparations have been recently developed to better mimic the physiological cortisol rhythm and to improve compliance in adrenocortical deficient patients. Nowadays, continuous subcutaneous hydrocortisone infusion seems to be a unique replacement therapy allowing adequate circadian biorhythm but should be restricted to specific patients due to the complexity of this substituting strategy.© 2019 Published by Elsevier Masson SAS. All rights reserved.Cet article fait partie du numéro supplément Les Must de l’Endocrinologie 2019 réalisé avec le soutien institutionnel de Ipsen-Pharma.     

Human metapneumovirus infection in wild mountain gorillas, Rwanda

The genetic relatedness of mountain gorillas and humans has led to concerns about interspecies transmission of infectious agents. Human-to-gorilla transmission may explain human metapneumovirus in 2 wild mountain gorillas that died during a respiratory disease outbreak in Rwanda in 2009. Surveillance is needed to ensure survival of these critically endangered animals.