Effect of Lactobacillus casei Shirota on colonic transit time in patients with chronic constipation

Background

Slow-transit constipation (STC) is caused by a motility disorder of the colon which leads to delayed transit (>72?h). The probiotic strain Lactobacillus casei Shirota (LcS) has been shown to improve constipation-related symptoms, such as stool frequency and consistency. A randomized double-blind placebo-controlled trial was performed to determine the effect of LcS on the colonic transit time in patients with STC.

Patients and methods

Colonic transit time of all consecutive outpatients with chronic constipation was determined by the Hinton test using radiopaque markers. Patients with a transit time longer than 72?h were included in the study. A total of 24 patients received either a dairy drink containing 6.5×10⁹ colony forming units (cfu) of LcS or a placebo daily for 4 weeks. General gastrointestinal symptoms were evaluated weekly by a questionnaire and the measurement of colonic transit time was repeated after the intervention.

Results

The intake of LcS resulted in a significant acceleration of the total colonic transit time from 95.6?h to 76.5?h (p=0.05). This effect was most pronounced in the sigmoid and rectum transit time (p<0.007). In the placebo group no statistically significant change in the total colonic transit time was observed (before: 95.8?h, after: 87.1?h, p=0.282)

Conclusion

The daily intake of a probiotic drink containing LcS significantly reduced the colonic transit time in patients with STC.     

Systematic identification and stratification of help-seeking school-aged youth with mental health problems: a novel approach to stage-based stepped-care

We investigated whether a novel visitation model for school-aged youth with mental health problems based on a stage-based stepped-care approach facilitated a systematic identification and stratification process without problems with equity in access. The visitation model was developed within the context of evaluating a new transdiagnostic early treatment for youth with anxiety, depressive symptoms, and/or behavioural problems. The model aimed to identify youth with mental health problems requiring an intervention, and to stratify the youth into three groups with increasing severity of problems. This was accomplished using a two-phase stratification process involving a web-based assessment and a semi-structured psychopathological interview of the youth and parents. To assess problems with inequity in access, individual-level socioeconomic data were obtained from national registers with data on both the youth participating in the visitation and the background population. Altogether, 573 youth and their parents took part in the visitation process. Seventy-five (13%) youth had mental health problems below the intervention threshold, 396 (69%) were deemed eligible for the early treatment, and 52 (9%) had symptoms of severe mental health problems. Fifty (9%) youth were excluded for other reasons. Eighty percent of the 396 youth eligible for early treatment fulfilled criteria of a mental disorder. The severity of mental health problems highlights the urgent need for a systematic approach. Potential problems in reaching youth of less resourceful parents, and older youth were identified. These findings can help ensure that actions are taken to avoid equity problems in future mental health care implementations.

     

Interferon-alpha, cytokines and possible implications for mood disorders

Schaefer M, Schmidt F, Neumer R, Scholler G, Schwarz M. Interferon-alpha, cytokines and possible implications for mood disorders. Bipolar Disord 2002: 4(Suppl. 1): 111–113. © Blackwell Munksgaard, 2002     

Long-Term Safety and Efficacy of Prebiotic Enriched Infant Formula—A Randomized Controlled Trial

The present study aims to evaluate the effects of an infant formula supplemented with a mixture of prebiotic short and long chain inulin-type oligosaccharides on health outcomes, safety and tolerance, as well as on fecal microbiota composition during the first year of life. In a prospective, multicenter, randomized, double-blind study, n = 160 healthy term infants under 4 months of age were randomized to receive either an infant formula enriched with 0.8 g/dL of Orafti^®Synergy1 or an unsupplemented control formula until the age of 12 months. Growth, fever (>38 °C) and infections were regularly followed up by a pediatrician. Digestive symptoms, stool consistency as well as crying and sleeping patterns were recorded during one week each study month. Fecal microbiota and immunological biomarkers were determined from a subgroup of infants after 2, 6 and 12 months of life. The intention to treat (ITT) population consisted of n = 149 infants. Both formulae were well tolerated. Mean duration of infections was significantly lower in the prebiotic fed infants (p < 0.05). The prebiotic group showed higher Bifidobacterium counts at month 6 (p = 0.006), and higher proportions of Bifidobacterium in relation to total bacteria at month 2 and 6 (p = 0.042 and p = 0.013, respectively). Stools of infants receiving the prebiotic formula were softer (p < 0.05). Orafti^®Synergy1 tended to beneficially impact total daily amount of crying (p = 0.0594). Supplementation with inulin-type prebiotic oligosaccharides during the first year of life beneficially modulates the infant gut microbiota towards higher Bifidobacterium levels at the first 6 months of life, and is associated with reduced duration of infections.     

Anxious Self-Statements in Clinic-Referred U.S. and Norwegian Anxiety-Disordered Youth

Examined the relationship between negative self-statements and symptoms of anxiety, depression, and attention-deficit/hyperactivity and functional impairment in two studies of anxiety-disordered youth. Study 1 included 144 anxiety-disordered youth (7–13 years; 54.9 % male) from a university-based research clinic in the USA. Study 2 included 111 treatment-seeking youth (7–13 years; 58.6 % male) from Norwegian community clinics. Results from both studies indicated that total negative self-statements were associated with increased symptoms of anxiety and depression as per child-report. Content specific associations were observed for child-reported symptoms of anxiety but not depression. Associations between child-reported negative self-statements and mother-reported symptoms were mixed. In Study 1, total negative and anxious self-statements were associated with greater functional impairment. The role of negative self-statements in youth’s internalizing symptomatology and the clinical implications are discussed.     

The Dresden Predictor Study of anxiety and depression: objectives, design, and methods

Objective  

The present report describes the objectives, design, and methods of the Dresden Predictor Study (DPS) of anxiety and depression, a prospective epidemiological study investigating anxiety disorders and depression in 3,065 young German women (18–25 years of age).     

Epidemiology of specific phobia subtypes: findings from the Dresden Mental Health Study.

This study determined the prevalence, age of onset, comorbidity, and impairment associated with specific phobia subtypes in the community. Data were drawn from the Dresden Mental Health Study (N=2064), a representative community-based sample of young women in Dresden, Germany. The lifetime prevalence of any specific phobia was 12.8%, with subtypes ranging in prevalence between 0.2% (vomiting, infections) and 5.0% (animals). There were significant differences in the mean age of onset of specific phobias. Significant differences in comorbidity patterns also emerged between subtypes. No significant differences were found in level of impairment associated with the subtypes. The findings suggest that specific phobias are common among young women and that they differ in prevalence, associated comorbidity, and mean age of onset. These data suggest significant differences in the phenomenology and clinical significance of specific phobia subtypes.     

Primary prevention of anxious and depressive symptoms in adolescents

This paper describes the design of a large scaled intervention study to prove the effectiveness of a prevention programme for anxiety and depression. In addition the development and application of a programme for the primary prevention of anxiety and depression in adolescents is presented. The treatment targets anxious and depressive symptoms, cognitive distortions and attributional styles as well as social skills in 14 to 18 year old high-school students. First results on the efficacy of the prevention treatment are reported. We found small but positive effects on cognitive and social risk factors over a 6 months period. The effects of the prevention programme depend on the fidelity of the treatment implementation.     

Restriction fragment length polymorphism of the insulin receptor gene, type 2 diabetes and insulin binding.

In searching for a genetic marker of type 2 diabetes we estimated the frequency of alleles of the Bgl II restriction fragment length polymorphism (RFLP) of the insulin receptor gene in a group of type II diabetic patients (n = 50), characterized by OGTT (glucose, insulin, C-peptide) and insulin receptor binding parameters. Leucocyte DNA was incubated with restriction endonuclease Bgl II and specific fragments were determined by Southern blot technique, using radioactive plasmid pINSR 13.1 as insulin receptor gene probe for hybridization. Insulin receptor numbers and receptor affinity were estimated by 125I-(Tyr-A-14)- insulin binding to red blood cells. Among control subjects the 20 kb fragment (allele Bgl II+) had a frequency of 0.21. In our group of diabetic patients this allele had a frequency of 0.10 (n.s., p greater than 0.05). In our study the insulin receptor genotype had no influence on body mass index, insulin and C-peptide during OGTT as well as insulin receptor binding data. So far, etiopathogenetic linkage between diabetes and insulin receptor variants (mutants) could unambiguously be proved in patients with extreme insulin resistance only. In our opinion, the estimation of the role of the gene as the reason underlying the disease inevitably requires the investigation of large families with multiple occurrence of type 2 diabetes.