In defense of psychosomatic theory: A critical analysis of Allison and Heshka's critical analysis

This article analyses Allison and Heshka's (International Journal of Eating Disorders, 13, 289–295, 1993.) critical analysis of studies supporting psychosomatic theory. Questionned first is, Allison and Heshka's contention that the obese overreport emotional eating as a result of effects of demand characteristics, social desirability, and interpersonal expectancies. These effects, however, indicate that a more plausible response would be an underreport of emotional eating. Also addressed is Allison and Heshka's (Eating Disorders: The Journal of Treatment and Prevention, 1, 31–38, 1993.) contention that a high correlation between a measurement instrument and a measure of social desirability invalidates that measurement instrument. Finally, in a rebuttal of Allison and Heshka's critical analysis of studies supporting psychosomatic theory, it is elaborated why emotional eating explains so little variance in weight gain and obesity. © 1995 by John Wiley & Sons, Inc.     

Guanidinoacetate–creatine in secondary progressive multiple sclerosis: a case report

Acute secondary progressive multiple sclerosis (SPMS) is characterized by escalating neurological disability, with limited disease-modifying therapeutic options. A 48-year-old woman with acute SPMS being treated with interferon beta-1a and oral corticosteroids presented as a clinical outpatient with no disease-modifying effects after treatment. A decision was made to treat her with a combination of guanidinoacetate and creatine for 21 days. She had made clinical progress at follow-up, with the intensity of fatigue dropping from severe to mild. Magnetic resonance spectroscopy revealed increased brain choline, creatine, N-acetylaspartate, and glutathione. Patients with SPMS may benefit from guanidinoacetate–creatine treatment in terms of patient- and clinician-reported outcomes; this requires additional study.     

The predictive validity of the Dutch Restrained Eating Scale

The present study aims to determine the predictive validity of the 10-item Dutch Restrained Eating Scale. The ultimate criterion of restrained eating is the degree to which an individual eats less than he or she actually would like to eat. Since a study on both actual food consumption and restriction of food intake is very complicated, if not impossible, the difference between actual and desired intake of energy was studied indirectly, that is, from estimates of deviations from the required energy intake. The relationships were studied between restrained eating scores and the magnitude of the deviation from energy requirement, and between restrained eating scores and intake of fat and sugar, because restriction in intake of these may also reflect dietary restraint. About 20% of the variance of scores on the Restrained Eating Scale could be explained from these measures of food intake, which suggests that the Dutch Restrained Eating Scale has moderate to good predictive validity.     

Markers of inflammation and microvascular complications in type 1 diabetes

Aims

Long-term hyperglycemia, characteristic for type 1 diabetes, causes enhanced oxidative stress, chronic inflammation and endothelial dysfunction which are the key events in the development of vascular complications. On the other hand, some data shows that existence of chronic degenerative complications may cause increased inflammatory marker levels in diabetic patients, mainly as a repercussion of malfunctioned endothelial repair process. Our study aims to determinate a degree of inflammation in type 1 diabetes patients and to investigate its relation to development of the chronic microvascular complications.

Methods

General information, anthropometric, glucose metabolism, lipid and lipoprotein parameters, levels of C reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were analyzed and screening tests for detection of the chronic microvascular complications were conducted in 76 type 1 diabetes patients.

Results

Forty six patients had at least one of the complications. They were older and had longer duration of diabetes (p=0.015; p<0.0001) and higher values of total (p=0.021), LDL-cholesterol (p=0.048) and triglycerides (p=0.002). Levels of CRP (p=0.004) and TNF-α (p=0.048) were higher in patients with chronic microvascular complications in regard to patients without diagnosed microangiopathy.

Conclusion

Low grade chronic inflammation is characteristic for type 1 diabetes patients with developed chronic microvascular complications.     

Botulinum toxin efficacy in the treatment of patients with spasmodic dysphonia

BACKGROUND/AIM: Spasmodic dysphonia (DS) is a disabling speech disturbance appearing as the consequence of dystonic vocal folds contraction. Its intermittent appearance in the laryngeal muscles causes vocal function discontinuation. The quality of life of these patients is significantly disturbed. Surgical and a medical therapy appear to be inadequate and unsuccessful ones of no steady improvement. It is the botulinum toxin therapy that proved to be highly efficacious one, with the established improvement in 80-100% of patients. The aim of our study was to evaluate the efficacy of botulinum toxin therapy in patients with SD and to show our preliminary results. METHODS: The study included 10 patients with adductor spasmodic dysphonia. After diagnostic procedures, botulinum toxin was applied either in one or both vocal folds, in doses of 12-16 units each. In our study we applied indirect technique originally developed by Hocevar and Pirtosek. Perceptive voice and speech analysis was performed prior to and after the instillation of botuline toxin as per structured Scale of pathological characteristics of voice and speech appearing in the spasmodic dysphonia. RESULTS: The majority of our patients experienced both subjective improvement and the improvement in the terms of the quality of life, Voice Henolicap Index--(VHI) that was rated as rather significant one (t = 3.562; p = 0.006). CONCLUSION: Regardless unquestionable improvement of definite phonation, further function restitution requires individual vocal therapy and psychotherapy. Vocal therapy includes structural vocal techniques which reduce degree of vocal tension and rapid changes in the power and the height of voice. Further investigations are necessary for the scope of the definition of a standardized therapeutically procedure for spasmodic dysphonia treatment which comprises multidisciplinary approach in diagnosis, therapy and treatment efficacy evaluation.     

Altered interregional molecular associations of the serotonin transporter in attention deficit/hyperactivity disorder assessed with PET

Altered serotonergic neurotransmission has been found to cause impulsive and aggressive behavior, as well as increased motor activity, all exemplifying key symptoms of ADHD. The main objectives of this positron emission tomography (PET) study were to investigate the serotonin transporter binding potential (SERT BP_ND) in patients with ADHD and to assess associations of SERT BP_ND between the brain regions. 25 medication‐free patients with ADHD (age ± SD; 32.39 ± 10.15; 10 females) without any psychiatric comorbidity and 25 age and sex matched healthy control subjects (33.74 ± 10.20) were measured once with PET and the highly selective and specific radioligand [¹¹C]DASB. SERT BP_ND maps in nine a priori defined ROIs exhibiting high SERT binding were compared between groups by means of a linear mixed model. Finally, adopted from structural and functional connectivity analyses, we performed correlational analyses using regional SERT binding potentials to examine molecular interregional associations between all selected ROIs. We observed significant differences in the interregional correlations between the precuneus and the hippocampus in patients with ADHD compared to healthy controls, using SERT BP_ND of the investigated ROIs (P < 0.05; Bonferroni corrected). When correlating SERT BP_ND and age in the ADHD and the healthy control group, we confirmed an age‐related decline in brain SERT binding in the thalamus and insula (R² = 0.284, R² = 0.167, Ps < 0.05; Bonferroni corrected). The results show significantly different interregional molecular associations of the SERT expression for the precuneus with hippocampus in patients with ADHD, indicating presumably altered functional coupling. Altered interregional coupling between brain regions might be a sensitive approach to demonstrate functional and molecular alterations in psychiatric conditions. Hum Brain Mapp 38:792–802, 2017. © 2016 Wiley Periodicals, Inc.     

A hazardous link between malnutrition, inflammation and oxidative stress in renal patients

BackgroundAtherosclerosis is the main cause of mortality in end stage renal disease (ESRD) patients.Design and methodsMalnutrition, inflammation and diminished paraoxonase activity were used to calculate the sum of risk factors for atherosclerosis development in a cohort of 141 chronic renal disease patients. Kaplan–Meier survival analysis was implemented to assess risk of death.ResultsKaplan–Meier analysis (Log rank = 12.06, P = 0.0072) showed higher risk of death with increasing number of risk factors in haemodialysis patients.ConclusionsMalnutrition in combination with inflammation and oxidative stress is associated with higher mortality in patients on long-term haemodialysis.