AIM:To assess the symptomatic efficacy of Lactobacillus plantarum 299v(L.plantarum 299v)(DSM 9843) for the relief of abdominal symptoms in a large subset of irritable bowel syndrome(IBS) patients fulfilling the Rome ...AIM:To assess the symptomatic efficacy of Lactobacillus plantarum 299v(L.plantarum 299v)(DSM 9843) for the relief of abdominal symptoms in a large subset of irritable bowel syndrome(IBS) patients fulfilling the Rome Ⅲ criteria.METHODS:In this double blind,placebo-controlled,parallel-designed study,subjects were randomized to daily receive either one capsule of L.plantarum 299v(DSM 9843) or placebo for 4 wk.Frequency and intensity of abdominal pain,bloating and feeling of incomplete rectal emptying were assessed weekly on a visual analogue scale while stool frequency was calculated.RESULTS:Two hundred and fourteen IBS patients were recruited.After 4 wk,both pain severity(0.68 + 0.53 vs 0.92 + 0.57,P < 0.05) and daily frequency(1.01 + 0.77 vs 1.71 + 0.93,P < 0.05) were lower with L.plantarum 299v(DSM 9843) than with placebo.Similar results were obtained for bloating.At week 4,78.1 % of the patients scored the L.plantarum 299v(DSM 9843) symptomatic effect as excellent or good vs only 8.1 % for placebo(P < 0.01).CONCLUSION:A 4-wk treatment with L.plantarum 299v(DSM 9843) provided effective symptom relief,particularly of abdominal pain and bloating,in IBS patients fulfilling the Rome Ⅲ criteria.展开更多
Tuberculosis(TB)remains a global threat,with the rise of multiple and extensively drug resistant TB posing additional challenges.The International health community has set various 5-yearly targets for TB elimination:m...Tuberculosis(TB)remains a global threat,with the rise of multiple and extensively drug resistant TB posing additional challenges.The International health community has set various 5-yearly targets for TB elimination:mathematical modelling suggests that a 2050 target is feasible with a strategy combining better diagnostics,drugs,and vaccines to detect and treat both latent and active infection.The availability of rapid and highly sensitive diagnostic tools(Gene-Xpert,TB-Quick)will vastly facilitate population-level identification of TB(including rifampicin resistance and through it,multi-drug-resistant TB).Basicresearch advances have illuminated molecular mechanisms in TB,including the protective role of Vitamin D.Also,Mycobacterium tuberculosis impairs the host immune response through epigenetic mechanisms(histone-binding modulation).Imaging will continue to be key,both for initial diagnosis and follow-up.We discuss advances in multiple imaging modalities to evaluate TB tissue changes,such as molecular imaging techniques(including pathogen-specific positron emission tomography imaging agents),non-invasive temporal monitoring,and computing enhancements to improve data acquisition and reduce scan times.Big data analysis and Artificial Intelligence(AI)algorithms,notably in the AI subfield called“Deep Learning”,can potentially increase the speed and accuracy of diagnosis.Additionally,Federated learning makes multi-institutional/multi-city AI-based collaborations possible without sharing identifiable patient data.More powerful hardware designs-e.g.,Edge and Quantum Computing-will facilitate the role of computing applications in TB.However,“Artificial Intelligence needs real Intelligence to guide it!”To have maximal impact,AI must use a holistic approach that incorporates time tested human wisdom gained over decades from the full gamut of TB,i.e.,key imaging and clinical parameters,including prognostic indicators,plus bacterial and epidemiologic data.We propose a similar holistic approach at the level of national/international policy formulation and implementation,to enable effective culmination of TB’s endgame,summarizing it with the acronym“TB-REVISITED”.展开更多
There has been a revolutionary advance in the treatment and management of schizophrenia from a clinical aspect yet the social and functional outcomes remain poor. Cognitive function is impaired in schizophrenia and sh...There has been a revolutionary advance in the treatment and management of schizophrenia from a clinical aspect yet the social and functional outcomes remain poor. Cognitive function is impaired in schizophrenia and shows various domains of dysfunction like verbal memory, processing speed and working memory. It is also known to be a factor associated with poor outcome in schizophrenia. Resilience is a new concept psychobiological concept which is defined as individual’s ability to adapt swiftly to adverse life events and bounces back to normalcy. Resilience has genetic, neurobiological, neurochemical and psychological underpinnings. It is the ability to effectively deal with psychosocial stressors and appears to be one of the many factors associated with favourable outcomes in schizophrenia. Besides several neurobiological abnormalities associated with resilience, neucognitive functions are of particular interest. Persistent psychosocial stressors also lead to significant neurobiological changes which may be synergetic to poor outcome due to cognitive changes. Though there has been extensive research in the field of cognitive function in schizophrenia, the trajectory of its pathway of poor outcome remains undetermined. Resilience being a protective factor may be one of the psychobiological functions which modulate the effect of neurocognition on the outcome of schizophrenia. There has been some success with interventions aimed at improving cognitive function in schizophrenia whether pharmacological or non pharmacological. In this paper, we discuss a hypothesis that resilience may be a “linkage” between cognition and outcome. There is a need for interventions aimed at increasing resilience in patients with schizophrenia and we hypothesize giving evidence that this may in turn improve outcome and neurocognitive functioning in schizophrenia.展开更多
Climate change is the variation in climate that human activities contribute to,directly or indirectly.Furthermore,climate change impacts human activity,but it also affects human existence and sustenance[1].Climate cha...Climate change is the variation in climate that human activities contribute to,directly or indirectly.Furthermore,climate change impacts human activity,but it also affects human existence and sustenance[1].Climate change has shown a negative impact on the quality of life,morbidity,and mortality of people across the globe[1,2].In Central African Republic(CAR),the number of reported weather-related natural disasters has more than tripled since the 1960s[2].Since then,these disasters have resulted in over 600000 deaths[2].展开更多
Current understanding of mental disorders is based upon “biopsychosocial model”. Research also suggests what biological changes take place in a particular disorder as well as nature of risk which arises from psychol...Current understanding of mental disorders is based upon “biopsychosocial model”. Research also suggests what biological changes take place in a particular disorder as well as nature of risk which arises from psychological, social and environmental conditions. However it remains unclear how these psychosocial and environmental risk factors interact with biological factors which lead to clinical syndromes. This paper examines interrelationship of psychosocial and environmental risk and biological changes observed in mental disorders and tries to identify the possibility of a pathway of the psychopathology of psychiatric disorders. The review aims to demonstrate that significant advances in the fields of psychosocial, cultural, anthropological and neurobiological research provide novel insights into the etiology of mental disorders. There are neurochemical, functional and structural neurobiological, neurocognitive, immunological findings and findings from gene-environment interaction that appears promising. However these findings are in an isolated manner. Comprehensive studies examining major biological changes together in relation to psychosocial risk factors are lacking. Every individual reacts differently to the same environmental risk while there tends to be similarities in individual outcome in response to such stressors. The findings though robust independently, remain very preliminary to suggest a sequential trajectory for developing a clear pathway for pathogenesis. It is currently unclear whether there is a differential psychopathological impact of psychosocial stressors in different cultures despite the extensive variability both between and within major social groups and societies. Further research investigating modifiable and non-modifiable risk factors in context of prevailing socio-economic conditions is urgently needed to plan effective interventions.展开更多
Although the Kraepelinian classification paradigm is widely used, observations of overlapping boundaries among the symptoms associated with bipolar disorder and schizophrenia are beginning to challenge this dichotomy....Although the Kraepelinian classification paradigm is widely used, observations of overlapping boundaries among the symptoms associated with bipolar disorder and schizophrenia are beginning to challenge this dichotomy. The objective of this research was to explore the symptoms of individuals diagnosed with schizophrenia and with bipolar mood disorder in order to determine the frequency of symptom overlap. One hundred patients of a psychiatry ward were divided into two main groups based on their diagnosis—schizophrenia or bipolar mood disorder. Chi-square analyses were used to determine whether the symptoms measured in this study differed between individuals diagnosed with schizophrenia and those diagnosed with bipolar mood disorder. The results suggest that both positive/manic symptoms and negative/depressive symptoms are present in individuals diagnosed with schizophrenia and with bipolar mood disorder and, consequently, they do not present a reliable means of differentiating between these two groups. These findings have many implications for the ways in which mental illness is conceptualized and classified. Treatment efforts and interventions may be enhanced if a more dimensional approach to diagnosing mental illness is utilized.展开更多
Objective: To determine if there is a significant rise in serum prolactin (PRL) in acute psychosis related to disease process and weather there is a significant gender difference in the level of PRL and its correlatio...Objective: To determine if there is a significant rise in serum prolactin (PRL) in acute psychosis related to disease process and weather there is a significant gender difference in the level of PRL and its correlation psychopathology. Procedure: Naturalistic study involved 60 consenting outpatients and inpatients in a tertiary psychiatric setting. Patient base was comprised of men (n?= 30) and women (n?= 30) with 83% in the age range of 21 - 40 years old. All subjects had confirmed first episode diagnosis set forth by the Diagnostic and Statistical Manual of Mental Disorders. Patients were drug free and drug na?ve. Standardization for control was done using 15 control PRL samples obtained from healthy individuals. Methodology involved assessment by radioimmunoassay, the Brief Psychiatric Rating Scale and the Positive and Negative Syndrome Scale at day 1, 3 weeks and again at 6 weeks. All patients were treated with atypical antipsychotic drugs. Results: Serum PRL was elevated on baseline in 75% of first episode psychosis schizophrenia, yet found to have a negative correlation to psychopathology at base week 3 and week 6 samples. Conclusions: Elevated serum PRL is not a potential indicator of acute schizophrenia. Levels are higher in females than in males, yet females respond better to treatment at a lower dose than males.展开更多
基金Supported by Rosell-Lallemand Institute,France and Probi AB,Sweden
文摘AIM:To assess the symptomatic efficacy of Lactobacillus plantarum 299v(L.plantarum 299v)(DSM 9843) for the relief of abdominal symptoms in a large subset of irritable bowel syndrome(IBS) patients fulfilling the Rome Ⅲ criteria.METHODS:In this double blind,placebo-controlled,parallel-designed study,subjects were randomized to daily receive either one capsule of L.plantarum 299v(DSM 9843) or placebo for 4 wk.Frequency and intensity of abdominal pain,bloating and feeling of incomplete rectal emptying were assessed weekly on a visual analogue scale while stool frequency was calculated.RESULTS:Two hundred and fourteen IBS patients were recruited.After 4 wk,both pain severity(0.68 + 0.53 vs 0.92 + 0.57,P < 0.05) and daily frequency(1.01 + 0.77 vs 1.71 + 0.93,P < 0.05) were lower with L.plantarum 299v(DSM 9843) than with placebo.Similar results were obtained for bloating.At week 4,78.1 % of the patients scored the L.plantarum 299v(DSM 9843) symptomatic effect as excellent or good vs only 8.1 % for placebo(P < 0.01).CONCLUSION:A 4-wk treatment with L.plantarum 299v(DSM 9843) provided effective symptom relief,particularly of abdominal pain and bloating,in IBS patients fulfilling the Rome Ⅲ criteria.
文摘Tuberculosis(TB)remains a global threat,with the rise of multiple and extensively drug resistant TB posing additional challenges.The International health community has set various 5-yearly targets for TB elimination:mathematical modelling suggests that a 2050 target is feasible with a strategy combining better diagnostics,drugs,and vaccines to detect and treat both latent and active infection.The availability of rapid and highly sensitive diagnostic tools(Gene-Xpert,TB-Quick)will vastly facilitate population-level identification of TB(including rifampicin resistance and through it,multi-drug-resistant TB).Basicresearch advances have illuminated molecular mechanisms in TB,including the protective role of Vitamin D.Also,Mycobacterium tuberculosis impairs the host immune response through epigenetic mechanisms(histone-binding modulation).Imaging will continue to be key,both for initial diagnosis and follow-up.We discuss advances in multiple imaging modalities to evaluate TB tissue changes,such as molecular imaging techniques(including pathogen-specific positron emission tomography imaging agents),non-invasive temporal monitoring,and computing enhancements to improve data acquisition and reduce scan times.Big data analysis and Artificial Intelligence(AI)algorithms,notably in the AI subfield called“Deep Learning”,can potentially increase the speed and accuracy of diagnosis.Additionally,Federated learning makes multi-institutional/multi-city AI-based collaborations possible without sharing identifiable patient data.More powerful hardware designs-e.g.,Edge and Quantum Computing-will facilitate the role of computing applications in TB.However,“Artificial Intelligence needs real Intelligence to guide it!”To have maximal impact,AI must use a holistic approach that incorporates time tested human wisdom gained over decades from the full gamut of TB,i.e.,key imaging and clinical parameters,including prognostic indicators,plus bacterial and epidemiologic data.We propose a similar holistic approach at the level of national/international policy formulation and implementation,to enable effective culmination of TB’s endgame,summarizing it with the acronym“TB-REVISITED”.
文摘There has been a revolutionary advance in the treatment and management of schizophrenia from a clinical aspect yet the social and functional outcomes remain poor. Cognitive function is impaired in schizophrenia and shows various domains of dysfunction like verbal memory, processing speed and working memory. It is also known to be a factor associated with poor outcome in schizophrenia. Resilience is a new concept psychobiological concept which is defined as individual’s ability to adapt swiftly to adverse life events and bounces back to normalcy. Resilience has genetic, neurobiological, neurochemical and psychological underpinnings. It is the ability to effectively deal with psychosocial stressors and appears to be one of the many factors associated with favourable outcomes in schizophrenia. Besides several neurobiological abnormalities associated with resilience, neucognitive functions are of particular interest. Persistent psychosocial stressors also lead to significant neurobiological changes which may be synergetic to poor outcome due to cognitive changes. Though there has been extensive research in the field of cognitive function in schizophrenia, the trajectory of its pathway of poor outcome remains undetermined. Resilience being a protective factor may be one of the psychobiological functions which modulate the effect of neurocognition on the outcome of schizophrenia. There has been some success with interventions aimed at improving cognitive function in schizophrenia whether pharmacological or non pharmacological. In this paper, we discuss a hypothesis that resilience may be a “linkage” between cognition and outcome. There is a need for interventions aimed at increasing resilience in patients with schizophrenia and we hypothesize giving evidence that this may in turn improve outcome and neurocognitive functioning in schizophrenia.
文摘Climate change is the variation in climate that human activities contribute to,directly or indirectly.Furthermore,climate change impacts human activity,but it also affects human existence and sustenance[1].Climate change has shown a negative impact on the quality of life,morbidity,and mortality of people across the globe[1,2].In Central African Republic(CAR),the number of reported weather-related natural disasters has more than tripled since the 1960s[2].Since then,these disasters have resulted in over 600000 deaths[2].
文摘Current understanding of mental disorders is based upon “biopsychosocial model”. Research also suggests what biological changes take place in a particular disorder as well as nature of risk which arises from psychological, social and environmental conditions. However it remains unclear how these psychosocial and environmental risk factors interact with biological factors which lead to clinical syndromes. This paper examines interrelationship of psychosocial and environmental risk and biological changes observed in mental disorders and tries to identify the possibility of a pathway of the psychopathology of psychiatric disorders. The review aims to demonstrate that significant advances in the fields of psychosocial, cultural, anthropological and neurobiological research provide novel insights into the etiology of mental disorders. There are neurochemical, functional and structural neurobiological, neurocognitive, immunological findings and findings from gene-environment interaction that appears promising. However these findings are in an isolated manner. Comprehensive studies examining major biological changes together in relation to psychosocial risk factors are lacking. Every individual reacts differently to the same environmental risk while there tends to be similarities in individual outcome in response to such stressors. The findings though robust independently, remain very preliminary to suggest a sequential trajectory for developing a clear pathway for pathogenesis. It is currently unclear whether there is a differential psychopathological impact of psychosocial stressors in different cultures despite the extensive variability both between and within major social groups and societies. Further research investigating modifiable and non-modifiable risk factors in context of prevailing socio-economic conditions is urgently needed to plan effective interventions.
文摘Although the Kraepelinian classification paradigm is widely used, observations of overlapping boundaries among the symptoms associated with bipolar disorder and schizophrenia are beginning to challenge this dichotomy. The objective of this research was to explore the symptoms of individuals diagnosed with schizophrenia and with bipolar mood disorder in order to determine the frequency of symptom overlap. One hundred patients of a psychiatry ward were divided into two main groups based on their diagnosis—schizophrenia or bipolar mood disorder. Chi-square analyses were used to determine whether the symptoms measured in this study differed between individuals diagnosed with schizophrenia and those diagnosed with bipolar mood disorder. The results suggest that both positive/manic symptoms and negative/depressive symptoms are present in individuals diagnosed with schizophrenia and with bipolar mood disorder and, consequently, they do not present a reliable means of differentiating between these two groups. These findings have many implications for the ways in which mental illness is conceptualized and classified. Treatment efforts and interventions may be enhanced if a more dimensional approach to diagnosing mental illness is utilized.
文摘Objective: To determine if there is a significant rise in serum prolactin (PRL) in acute psychosis related to disease process and weather there is a significant gender difference in the level of PRL and its correlation psychopathology. Procedure: Naturalistic study involved 60 consenting outpatients and inpatients in a tertiary psychiatric setting. Patient base was comprised of men (n?= 30) and women (n?= 30) with 83% in the age range of 21 - 40 years old. All subjects had confirmed first episode diagnosis set forth by the Diagnostic and Statistical Manual of Mental Disorders. Patients were drug free and drug na?ve. Standardization for control was done using 15 control PRL samples obtained from healthy individuals. Methodology involved assessment by radioimmunoassay, the Brief Psychiatric Rating Scale and the Positive and Negative Syndrome Scale at day 1, 3 weeks and again at 6 weeks. All patients were treated with atypical antipsychotic drugs. Results: Serum PRL was elevated on baseline in 75% of first episode psychosis schizophrenia, yet found to have a negative correlation to psychopathology at base week 3 and week 6 samples. Conclusions: Elevated serum PRL is not a potential indicator of acute schizophrenia. Levels are higher in females than in males, yet females respond better to treatment at a lower dose than males.