Symptom Rating Scale Research Articles

A Latent Class Analysis on Indicators of Early Prolonged Grief Disorder and Well-Being Among Dutch Adults Bereaved During the First Year of the COVID-19 Pandemic.

Most studies examining prolonged grief disorder (PGD) in people bereaved during the COVID-19 pandemic are focused on psychopathology. However, mental health encompasses both absence of psychopathology and presence of well-being. This is the first study examining symptom profiles of early PGD and subjective mental well-being in 266 Dutch adults recently bereaved during the pandemic. Early PGD and well-being indicators were assessed with the Traumatic Grief Inventory-Self Report Plus and the World Health Organization-Five Well-Being Index, respectively. Latent class analysis identified four classes: low PGD/high well-being (32%), low PGD/moderate well-being (24%), moderate PGD/high well-being (23%) and high PGD/low well-being class (21%). People in the poorer mental health classes were more likely to be female, lower educated, suffering from a mental disorder, have a poor health status, closer kinship to the deceased, and higher risk of severe COVID-19. Classifying adults according to symptom profiles of negative and positive outcomes provides a more complete picture of mental health in bereaved people and offers potential intervention targets.

Terapi Thought Stopping pada Pasien Gangguan Persepsi Sensori Halusinasi: Studi Kasus

Background of Study: Hallucinations are one of the symptoms of mental disorders in which patients experience changes in sensory perception, as well as feeling false sensations in the form of sound, sight, taste, touch, or smell. This research explains Thought Stopping therapy which is used to reduce signs of hallucinations. Methods: his case study uses the Psychotic Symptom Rating Scales (PYSRAT) instrument to measure signs of hallucinatory symptoms before and after Thought Stopping therapy. The number of patients who received therapy was 3 patients. Results: igns of hallucinations. This case study uses the Psychotic Symptom Rating Scales (PYSRAT) instrument to measure signs of hallucinatory symptoms before and after Thought Stopping therapy. Before therapy, the questionnaire score obtained in patient 1 was 25, patient 2 was 30, and patient 3 was 11. After being implemented for 5 consecutive days, it was found that 2 of the 3 patients experienced a decrease in the score for signs of hallucinations, namely patient 1 obtained a score of 21 and patient 2 was 25. Meanwhile, patient 3 did not experience a decrease in score due to several obstacles, namely the patient's focus. Conclusion: ased on the results of this application, thought stopping therapy can be used as additional therapy for patients with hallucinations by paying attention to the criteria for patients who will be given therapy such as cooperative patients, patients with phase 1 hallucinations, patients with good concentration and a calm environment Keywords: Case Study; Hallucination; Schizophrenia; Thought Stopping Theraphy

OM Chanting Reduces Psychological Distress Level in Office Workers During Covid 19 Pandemic

Purpose: psychological stress caused due to the current COVID 19 pandemic lock down may have an adverse impact on the quality of life (QoL) in office shift workers. The purpose of the present study was to investigate the effect of OM chanting on the levels of perceived psychological stress, quality of life and sleep among office workers who are confined at home and work during the global COVID-19 pandemic. Material & Methods: an online OM chanting session was conducted for 20 workers who stayed at home and worked during the pandemic lockdown. Prior to and at the end of the training all the participants finished a battery of self-reported online inventories, including the Depression, Anxiety and Stress Scale with 21 items (DASS-21) and quality of life (WHOQOL-BREF). Results: after ten days of OM chanting, all the participants stated a significant enhancement in all domains of quality of life and a reduction of psychological distress (P<0.05). Conclusions: OM chanting is feasible, safe and has a positive effect on psychological quality of life of participants. Still further studies have to be done to warrant the findings with suitable study design.

Combined Korean medicine therapies in children with allergic rhinitis: A prospective, multicenter, observational registry study at primary-care network clinics

IntroductionAllergic rhinitis (AR) causes symptoms such as hyper-rhinorrhea, sneezing, nasal congestion, itching, and pain by triggering inflammation in the nasal mucosa and an immune response caused by antigen-specific Immunoglobulin E (IgE). This prospective multicenter observational study aimed to evaluate the symptoms change and safety of combined Korean medicine (KM) therapy in patients with AR. MethodsThis study was conducted in HAMSOA Korean Medicine Clinics, a network specializing in treating pediatric patients in Korea, and 15 centers participated. The patients were divided into three groups (mild, moderate, and severe) according to their baseline total nasal symptom score. The patients were treated with herbal medicine, acupuncture, cupping therapy, and moxibustion therapy. ResultsThe study involved 72 subjects aged 6.47 ± 2.37 years. The average Numeric Rating Scale for allergic rhinitis symptoms at the baseline and final follow-up were 4.39 ± 2.14 to 3.47 ± 2.51, respectively, indicating a significant improvement over an average of 4 weeks. The Pediatric Allergic Disease Quality of Life Questionnaire scores at the final screening improved in all three groups. The mean difference was -10.44, with a 95 % confidence interval of -15.35 to -5.54 (p < 0.01.). Furthermore, no adverse events were reported in any patient in this study. ConclusionThe results provide preliminary evidence suggesting that KM treatment may be a safe and effective option for reducing symptoms associated with allergic rhinitis in children. Additional prospective studies are required to confirm the results of the present study.

Impact of Istradefylline on Levodopa Dose Escalation in Parkinson's Disease: ISTRA ADJUST PD Study, a Multicenter, Open-Label, Randomized, Parallel-Group Controlled Study.

A higher levodopa dose is a risk factor for motor complications in Parkinson's disease (PD). Istradefylline (IST) is used as adjunctive treatment to levodopa in PD patients with off episodes, but its impact on levodopa dose titration remains unclear. The objective of this study was to investigate the effect of IST on levodopa dose escalation in PD patients with wearing-off. This was a multicenter, open-label, randomized, parallel-group controlled study (ISTRA ADJUST PD) in which PD patients experiencing wearing-off (n = 114) who were receiving levodopa 300-400mg/day were randomized to receive IST or no IST (control). Levodopa dose was escalated according to clinical severity. The primary endpoint was cumulative additional levodopa dose, and secondary endpoints were changes in symptom rating scales, motor activity determined by a wearable device, and safety outcomes. The cumulative additional levodopa dose throughout 37weeks and dose increase over 36weeks were significantly lower in the IST group than in the control group (both p < 0.0001). The Movement Disorder Society Unified Parkinson's Disease Rating Scale Part I and device-evaluated motor activities improved significantly from baseline to 36weeks in the IST group only (all p < 0.05). Other secondary endpoints were comparable between the groups. Adverse drug reactions (ADRs) occurred in 28.8% and 13.2% of patients in the IST and control groups, respectively, with no serious ADRs in either group. IST treatment reduced levodopa dose escalation in PD patients, resulting in less cumulative levodopa use. Adjunctive IST may improve motor function more objectively than increased levodopa dose in patients with PD. Japan Registry of Clinical Trials: jRCTs031180248.

Revisiting delusion subtypes in schizophrenia based on their underlying structures

A clear understanding of the pathophysiology of schizophrenia and related spectrum disorders has been limited by clinical heterogeneity. We investigated whether relative severity and predominance of one or more delusion subtypes might yield clinically differentiable patient profiles. Patients (N = 286) with schizophrenia spectrum disorders (SSD) completed the 21-item Peters et al. Delusions Inventory (PDI-21). We performed factor analysis followed by k-means clustering to identify delusion factors and patient subtypes. Patients were further assessed via the Brief Psychiatric Rating Scale, Brief Negative Symptom Scale, Digit Symbol and Digit Substitution tasks, use of cannabis and tobacco, and stressful life events. The overall patient sample clustered into subtypes corresponding to Low-Delusion, Grandiose-Predominant, Paranoid-Predominant, and Pan-Delusion patients. Paranoid-Predominant and Pan-Delusion patients showed significantly higher burden of positive symptoms, while Low-Delusion patients showed the highest burden of negative symptoms. The Paranoia delusion factor score showed a positive association with Digit Symbol and Digit Substitution tasks in the overall sample, and the Paranoid-Predominant subtype exhibited the best performance on both tasks. Grandiose-Predominant patients showed significantly higher tobacco smoking severity than other subtypes, while Paranoid-Predominant patients were significantly more likely to have a lifetime diagnosis of Cannabis Use Disorder. We suggest that delusion self-report inventories such as the PDI-21 may be of utility in identifying sub-syndromes in SSD. From the current study, a Paranoid-Predominant form may be most distinctive, with features including less cognitive impairment and a stronger association with cannabis use.

Protocol of efficacy of bifidobacteria intake on gastrointestinal symptoms in symptomatic type 2 diabetes mellitus patients in abdominis: An open-label, randomized controlled trial (Binary STAR study).

This randomized, parallel-group study aims to investigate the effects of the probiotic Bifidobacterium bifidum G9-1 (BBG9-1) on the symptoms of diarrhea or constipation in patients with type 2 diabetes mellitus (T2DM). This study will examine 100 patients with T2DM who suffering from symptoms of diarrhea or constipation. Eligible patients will be randomly assigned 1:1 to two groups (group A, BBG9-1 group; group B, control group), after the baseline examination. Patients assigned to group A will receive probiotic BBG9-1 oral administration along with their current treatment for 12 weeks, and patients assigned to group B will continue the current treatment for 12 weeks without probiotic BBG9-1 oral administration. Subsequently, examinations similar to the baseline examinations will be performed. The primary endpoint will be a change in the Gastrointestinal Symptom Rating Scale (GSRS) total score from baseline to week 12. Secondary endpoints will include the following: change and percent change in parameters such as GSRS subdomain scores, fecal properties/Bristol stool form scale, defecation frequency, biomarkers, gut microbiota, and macronutrients and factors that affect GSRS total score or constipation/diarrhea subdomain scores from baseline to week 12. The results of this study will clarify the utility of probiotic BBG9-1 in the treatment of diarrhea or constipation in patients with T2DM. jRCTs051220127.

Risperidone plasma level, and its correlation with CYP2D6 gene polymorphism, clinical response and side effects in chronic schizophrenia patients

BackgroundTo explore the influence of CYP2D6 genetic polymorphism on risperidone metabolism, thereby affecting risperidone’s effects and safeties in patients with chronic schizophrenia.MethodsSixty-nine subjects with chronic schizophrenia treated with risperidone were recruited. CYP2D6 genotypes was determined using targeted sequencing and translated into phenotype using activity system. Risperidone plasma concentrations were measured using HPLC. Positive and Negative Symptom Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) were used to evaluate the existence and severity of psychiatric symptoms, Barnes Akathisia Scale (BAS) and Extrapyramidal Symptom Rating Scale (ESRS) for neurological side effects. Metabolic and endocrine status assess were also included.ResultsThe plasma drug concentrations varied hugely among individuals. Intermediate metabolizer (IM) group had higher plasma levels of RIP and dose corrected RIP concentration, RIP/9-OH-RIP ratio and C/D ratio than normal metabolizer (NM) group (p < 0.01). There was no statistic difference between responders and non-responders in dose-adjusted plasma concentrations and ratios of RIP/9-OH-RIP and C/D. The occurrence of EPS was related to active moiety levels in 4th week (p < 0.05). The prolactin (PRL) levels in two follow-ups were both significantly higher than baseline (p < 0.01). PRL change from baseline to week 4 and week 8 were both positively associated with active moiety concentration detected in week 4 (p < 0.05).ConclusionsThe risperidone plasma levels have great inter- and intraindividual variations, and are associated with the CYP2D6 phenotypes, as well as the changes in serum prolactin in patients diagnosed with chronic schizophrenia.

Living with a friend mediates PTSD and CPTSD symptoms among trauma-exposed Ukrainians during the second year of 2022 Russian invasion

Purpose This study aims to develop and test multivariable psychosocial prediction models of perceived post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) symptoms development among trauma-exposed Ukrainian adults (n = 761) after 1.5 years of the 2022 Russian invasion of Ukraine. Design/methodology/approach This research was designed as a survey in line with the methodology of “Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis” checklist. The survey included a questionnaire on sociodemographic characteristics and specifics of trauma exposure, as well as validated self-reported inventories: The International Trauma Questionnaire, Acceptance and Action Questionnaire – version 2, Connor–Davidson Resilience Scale-10 and the Modified BBC Subjective Well-being Scale. Findings Regression analysis revealed different prediction models for PTSD and CPTSD symptoms, explaining 18.4% and 41.4% of their variance with five and eight predictors, respectively. Four variables were similar in predicting PTSD and CPTSD: war-relatedness of trauma, living with a friend, perceived physical health and regret for the past. War-relatedness of trauma the respondents were exposed to was among the strongest predictors for PTSD and CPTSD severity. However, living with a friend was almost equally strong in mitigating these mental consequences. Regret for past and lowly rated physical health were assessed as relatively weaker but statistically significant predictors in this study. Originality/value Upon the original theoretical framework, two psychosocial prediction models were developed for PTSD and CPTSD symptoms in a non-clinical sample of trauma-exposed Ukrainian adults.

Dominance Analysis of Bright and Dark Dispositional Predictors of Socially Desirable Responding.

Although the role of so-called dark traits in the prediction of maladaptive behavior has seen a large increase in interest by researchers, the Big Five still maintain their ubiquity in the prediction of most behaviors. This study uses measures of the Dark Tetrad and the Big Five personality traits to predict a very specific form of maladaptive behavior: the impression management form of socially desirable responding. In regression-based dominance analysis, results suggest that not all of the Big Five nor the Dark Tetrad provide statistically significant incremental validity but as a block, the Big Five dominate the Dark Tetrad in the prediction of the purposeful misrepresentation of one's self to others on self-report inventories. More specifically, four of the Big Five as well as the traits of Machiavellianism and sadism from the Dark Tetrad are significant predictors of impression management.

A first look at childhood abuse in women with obstructive sleep apnea

Study objectivesWomen who experienced childhood sexual abuse have higher rates of obesity, a risk factor for obstructive sleep apnea (OSA). We assessed if prior childhood sexual abuse was more common in women with OSA vs. those in the control group, with possible mediation by obesity.MethodsIn a secondary analysis of a larger project, we studied 21 women with OSA (age mean ± SD 59 ± 12 years, body mass index [BMI] 33 ± 8 kg/m2, respiratory event index [REI] 25 ± 16 events/hour, and Epworth Sleepiness Scale [ESS] score 8 ± 5) and 21 women without OSA (age 53 ± 9 years, BMI 25 ± 5 kg/m2, REI [in 7/21 women] 1 ± 1 events/hour, and ESS score, 5 ± 3). We evaluated four categories of trauma (general, physical, emotional, and sexual abuse) with the Early Trauma Inventory Self-Report–Short Form (ETISR-SF). We assessed group differences in trauma scores with independent samples t-tests and multiple regressions. Parametric Sobel tests were used to model BMI as a mediator for individual trauma scores predicting OSA in women.ResultsEarly childhood sexual abuse reported on the ETISR-SF was 2.4 times more common in women with vs. without OSA (p = 0.02 for group difference). Other trauma scores were not significantly different between women with and without OSA. However, BMI was a significant mediator (p = 0.02) in predicting OSA in women who experienced childhood physical abuse.ConclusionChildhood sexual abuse was more common in women with vs. without OSA. BMI was a mediator for OSA of childhood physical but not sexual abuse. This preliminary hypothesis-generating study suggests that there may be physiological impacts of childhood trauma in women that predispose them to OSA.

Nurses’ knowledge of and attitude toward postoperative patient-controlled analgesia (PCA) and the associated factors

BackgroundPostoperative pain control is pivotal for surgical care; it facilitates patient recovery. Although patient-controlled analgesia (PCA) has been available for decades, inadequate pain control remains. Nurses’ knowledge of and attitude toward PCA may influence the efficacy on clinic application.PurposeThe purpose of this study is to evaluate nurses’ knowledge of and attitude toward postoperative PCA and investigate the associated factors.MethodsThis is a cross-sectional study. We enrolled registered nurses from a 2200-bed medical center in northern Taiwan within one year. The participants completed an anonymous self-reported PCA knowledge inventory and PCA attitude inventory. Data were analyzed descriptively and associated were tested using logistic regression.ResultsWith 303 participants enrolled, we discovered that nurses had limited knowledge of and a negative attitude toward PCA. Under half of the participants know how to set up a bolus dose and lockout intervals. The majority held misconceptions regarding side effect management for opioids. The minority agree to increase the dose when a patient experienced persistent pain or suggested the use of PCA. Surprisingly, participants with a bachelor’s or master’s degree had lower knowledge scores than those with a junior college degree. Those with 6–10 years of work experience also are lower than those with under 5 years of experience. However, the participants with experience of using PCA for patient care had higher knowledge scores and a more positive attitude.ConclusionsAlthough postoperative PCA has been available for decades and education programs are routinely provided, nurses had limited knowledge of and a negative attitude toward PCA. A higher education level and longer work experience were not associated with more knowledge. The current education programs on PCA should be revised to enhance their efficacy in delivering up-to-date knowledge and situation training which may convey supportive attitude toward clinical application of PCA.

Clinical effects of traditional Chinese herbal medicine management in patients with COVID-19 sequelae: A hospital-based retrospective cohort study in Taiwan.

Introduction: An estimated 43% of COVID-19 patients showed sequelae, including fatigue, neurocognitive impairment, respiratory symptoms, and smell or taste disorders. These sequelae significantly affect an individual's health, work capacity, healthcare systems, and socioeconomic aspects. Traditional Chinese herbal medicine (TCHM) management showed clinical benefits in treating patients with COVID-19 sequelae. This study aimed to analyze the effects of personalized TCHM management in patients with COVID-19 sequelae. Methods: After the COVID-19 outbreak in Taiwan, we recorded Chronic Obstructive Pulmonary Disease Assessment Tool (CAT), Chalder Fatigue Questionnaire (CFQ-11), and Brief Symptom Rating Scale (BSRS-5) to assess post-COVID respiratory, fatigue, and emotional distress symptoms, respectively. In this study, we retrospectively reviewed the medical records between July 2022 and March 2023. We analyzed the effects of TCHM administration after 14- and 28-days of treatment. Results: 47 patients were included in this study. The results demonstrated that personalized TCHM treatment significantly improved the CAT, CFQ-11, and BSRS-5 scores after 14 and 28 days. TCHM alleviated physical and psychological fatigue. In logistic regression analysis, there was no statistically significant differences in the severity of the baseline symptoms and TCHM administration effects concerning the duration since the initial confirmation of COVID-19, sex, age, or dietary preference (non-vegetarian or vegetarian). Conclusions: Our study suggested that personalized TCHM treatment notably reduced fatigue, respiratory and emotional distress symptoms after 14- and 28-days of treatment in patients with COVID-19 sequelae. We propose that TCHM should be considered as an effective intervention for patients with COVID-19 sequelae.

Clinical prediction of GBA carrier status in Parkinson’s disease

IntroductionGiven the unique natural history of GBA-related Parkinson’s disease (GBA-PD) and the potential for novel treatments in this population, genetic testing prioritization for the identification of GBA-PD patients is crucial for prognostication, individualizing treatment, and stratification for clinical trials. Assessing the predictive value of certain clinical traits for the GBA-variant carrier status will help target genetic testing in clinical settings where cost and access limit its availability. MethodsIn-depth clinical characterization through standardized rating scales for motor and non-motor symptoms and self-reported binomial information of a cohort of subjects with PD (n = 100) from our center and from the larger cohort of the Parkinson’s Progression Marker Initiative (PPMI) was utilized to evaluate the predictive values of clinical traits for GBA variant carrier status. The model was cross-validated across the two cohorts. ResultsLeveraging non-motor symptoms of PD, we established successful discrimination of GBA variants in the PPMI cohort and study cohort (AUC 0.897 and 0.738, respectively). The PPMI cohort model successfully generalized to the study cohort data using both MDS-UPDRS scores and binomial data (AUC 0.740 and 0.734, respectively) while the study cohort model did not. ConclusionsWe assessed the predictive value of non-motor symptoms of PD for identifying GBA carrier status in the general PD population. These data can be used to determine a simple, clinically oriented model using either the MDS-UPDRS or subjective symptom reporting from patients. Our results can inform patient counseling about the expected carrier risk and test prioritization for the expected identification of GBA variants.

Changes of brain structure and structural covariance networks in Parkinson's disease associated cognitive impairment.

Cognitive impairment (CI) is common in Parkinson's disease (PD). Multiple brain regions and their interactions are involved in PD associated CI. Magnetic resonance imaging (MRI) technology is a non-invasive method in investigating brain structure and inter-regional connections. In this study, by comparing cortical thickness, subcortical volume, and brain network topology properties in PD patients with and without CI, we aimed to understand the changes of brain structure and structural covariance network properties in PD associated CI. A total of 18 PD patients with CI and 33 PD patients without CI were recruited. Movement Disorder Society Unified Parkinson's Disease Rating Scale, Hoehn and Yahr stage, Mini Mental State Examination Scale, Non-motor Symptom Rating Scale, Hamilton Anxiety Scale, and Hamilton Depression Scale were assessed. All participants underwent structural 3T MRI. Cortical thickness, subcortical volume, global and nodal network topology properties were measured. Compared with PD patients without CI, the volumes of white matter, thalamus and hippocampus were lower in PD patients with CI. And decreased whole-brain local efficiency is associated with CI in PD patients. While the cortical thickness and nodal network topology properties were comparable between PD patients with and without CI. Our findings support the alterations of brain structure and disruption of structural covariance network are involved in PD associated CI, providing a new insight into the association between graph properties and PD associated CI.

Different Food Preferences in Patients with Gastrointestinal Disorders.

Objective Gastrointestinal (GI) disorders such as functional dyspepsia (FD), irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and inflammatory bowel disease (IBD) can exhibit overlapping GI symptoms, including abdominal pain and alterations in bowel habits. The symptoms of GI disorders are commonly considered to be triggered and exacerbated by fatty food intake. Therefore, this study aimed to compare the food preferences of patients with GI disorders. Methods Forty food images (including fatty and light foods) and 20 animal images were selected to evaluate food preferences. The preference score was assessed using a visual analog scale ranging from 1 to 100. GI symptoms were evaluated using the GI Symptom Rating Scale (GSRS), and correlations between the GSRS and preference scores were investigated. Results Overall, 22 healthy controls and 23, 29, 27, and 20 patients with FD, IBS, GERD, and IBD, respectively, were enrolled. The preference score for all foods in patients with FD was significantly lower than that in healthy controls and those with IBS, GERD, and IBD (52.9 vs. 66.5 vs. 68.5 vs. 69.1 vs. 70.7, p<0.01). The score of fatty foods was lower in patients with FD than in healthy controls and those with IBS, GERD, and IBD (43.8 vs. 72.3 vs. 77.5 vs. 77.4 vs. 80.7, p<0.01), whereas that of light foods and animal images was not different among the groups. No significant correlation was found between the preference score and symptom severity. Conclusions Patients with FD had a negative preference for foods, particularly fatty foods, independent of the severity of GI symptoms.

Safety and Tolerability of Microbial Inulinase Supplementation in Healthy Adults: A Randomized, Placebo-Controlled Trial

BACKGROUND AND AIMSDietary fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) contribute to gastrointestinal (GI) symptoms in individuals with FODMAP sensitivity and/or irritable bowel syndrome (IBS). Oral enzyme supplementation is a strategy to reduce dietary FODMAP exposure and limit FODMAP-associated GI distress. This clinical trial investigated the safety of dietary supplementation with a food-grade, microbial inulinase known to hydrolyze fructan-type or inulin-type FODMAPs and related fructo-oligosaccharides (FOS) in vitro. METHODSA randomized, double-blind, placebo-controlled, parallel design trial was conducted in 60 healthy adult participants of both sexes. Following a 2-week run-in placebo phase, participants were randomized to consume inulinase or placebo capsules twice daily with meals for 4 weeks. The total daily dose of inulinase was 2,000 inulinase activity units (INU). Safety measures included blood clinical chemistry, hematology, lipid profile, high-sensitivity C-reactive protein (hs-CRP), insulin, lactate, and uric acid. GI symptoms were recorded weekly using the 15-item Gastrointestinal Symptom Rating Scale (GSRS). RESULTSFifty-eight participants completed the study. There were no clinically meaningful between-group differences in blood biomarkers. During the 4-week intervention period, 5 (16.7%) of 30 participants reported 5 adverse events (AEs) in the inulinase group, and 8 (26.7%) of 30 participants reported 13 AEs in the placebo group. No statistically significant between-group differences were observed in the change from baseline to 1, 2, 3, or 4 weeks of supplementation with respect to GSRS overall or domain scores. CONCLUSIONSMicrobial inulinase supplementation demonstrated a favorable safety profile in healthy adults. Further investigation in a dose-ranging study in individuals with dietary FODMAP, fructan, or inulin sensitivity or IBS is warranted. ClinicalTrials.gov: NCT05744700.

Lactobacillus plantarum 24-7 improves postoperative bloating and hard stools by modulating intestinal microbiota in patients with congenital heart disease: a randomized controlled trial.

Gastrointestinal symptoms are a common postoperative complication in patients with congenital heart disease (CHD), affecting their postoperative recovery. Probiotic intervention may be a promising therapeutic approach to alleviate postoperative gastrointestinal symptoms. This study aimed to evaluate the potential of Lactobacillus plantarum 24-7 (L. plantarum 24-7) in mitigating postoperative gastrointestinal symptoms and promoting patient recovery. Adult CHD patients scheduled for surgical intervention were recruited. One hundred and twenty patients were randomized and received L. plantarum or placebo intervention twice daily for ten days. Gastrointestinal symptoms were assessed utilizing the Gastrointestinal Symptom Rating Scale (GSRS). Various postoperative variables were analyzed across both groups. Alterations in gut microbiota were evaluated through 16S rRNA sequencing. 112 patients completed the study, with 55 in the probiotic group and 57 in the placebo group. While the disparity in overall postoperative GSRS scores between the two groups did not reach statistical significance (P = 0.067), marked differences were observed in bloating (P = 0.004) and hard stool (P = 0.030) scores. Furthermore, individuals within the probiotic group exhibited lower postoperative neutrophil counts (P = 0.007) and concurrently higher lymphocyte counts (P = 0.001). Variations in the diversity and composition of postoperative gut microbiota were discerned between the probiotic and placebo groups. Remarkably, no probiotic-related adverse events were documented. Supplementation with L. plantarum was well-tolerated and demonstrated partial efficacy in ameliorating gastrointestinal symptoms in postoperative CHD patients. Modulating the gut microbiota may be a potential mechanism by which L. plantarum exerts clinical benefits.

Gait Training Based-Motor Imagery and EEG Neurofeedback in Lokomat: A Clinical Intervention with Complete Spinal Cord Injury Individuals.

Robotic systems, such as Lokomat® have shown promising results in people with severe motor impairments, who suffered a stroke or other neurological damage. Robotic devices have also been used by people with more challenging damages, such as Spinal Cord Injury (SCI), using feedback strategies that provide information about the brain activity in real-time. This study proposes a novel Motor Imagery (MI)-based Electroencephalogram (EEG) Visual Neurofeedback (VNFB) system for Lokomat® to teach individuals how to modulate their own μ (8-12 Hz) and β (15-20 Hz) rhythms during passive walking. Two individuals with complete SCI tested our VNFB system completing a total of 12 sessions, each on different days. For evaluation, clinical outcomes before and after the intervention and brain connectivity were analyzed. As findings, the sensitivity related to light touch and painful discrimination increased for both individuals. Furthermore, an improvement in neurogenic bladder and bowel functions was observed according to the American Spinal Injury Association Impairment Scale, Neurogenic Bladder Symptom Score, and Gastrointestinal Symptom Rating Scale. Moreover, brain connectivity between different EEG locations significantly (p <0.05) increased, mainly in the motor cortex. As other highlight, both SCI individuals enhanced their μ rhythm, suggesting motor learning. These results indicate that our gait training approach may have substantial clinical benefits in complete SCI individuals.

Postbariatric hypoglycemia, abdominal pain and gastrointestinal symptoms after Roux-en-Y gastric bypass explored by continuous glucose monitoring.

BackgroundAbdominal pain and postbariatric hypoglycemia (PBH) are common after bariatric surgery. ObjectivesThis study aimed to explore the potential relationship between abdominal pain, gastrointestinal symptoms, and PBH more than a decade after Roux-en-Y gastric bypass (RYGB) and whether continuous glucose monitoring (CGM) with dietary intervention has an educational role in reducing symptoms. SubjectsAt two public hospitals in Norway (one University Hospital) 22 of 46 invited patients who reported abdominal pain more than weekly took part. Recruited from a prospective follow-up study of 546 patients 14.5 years after RYGB. MethodsThey used a CGM for two 14-day periods, with a dietary intervention between periods. The Gastrointestinal Symptom Rating Scale (GSRS) and the Dumping Severity Score (DSS) questionnaires were completed at the start and end of the study. ResultsThe 22 women had preoperative age 39.6 ± 7.7 years and body mass index (BMI) 42.0 ± 4.0 kg/m2, present age 54.6 ± 7.7 years and BMI 29.8 ± 4.8 kg/m2. The total GSRS score and DSS of early dumping decreased after the diet intervention. The number of events with Level 1 (<3.9 mmol/L) or Level 2 (<3.0 mmol/L) hypoglycemia did not change in the second period. Half of the patients had fewer, three had unchanged, and eight had more frequent events with Level 1 hypoglycemia after the intervention. Ten patients had Level 2 hypoglycemia. ConclusionThough inconclusive findings, a personalized dietary intervention reduces GSRS. This intervention was accompanied by lower mean absolute glucose in patients with recurrent abdominal pain after bariatric surgery. However, further studies are needed to explore the benefits of CGM in this setting.