scholarly journals Prevention of Stress-Induced Depressive-Like Behavior by Saffron Extract is Associated with Modulation of Kynurenine Pathway and Monoamine Neurotransmission

Pharmaceutics ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2155
Author(s):  
Camille Monchaux De Oliveira ◽  
Véronique De Smedt-Peyrusse ◽  
Jennifer Morael ◽  
Sylvie Vancassel ◽  
Lucile Capuron ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Forced Swim Test ◽  
Treatment Options ◽  
Kynurenine Pathway ◽  
High Rate ◽  
Health Concern ◽  
Nutritional Interventions ◽  
Saffron Extract ◽  
Underlying Mechanisms ◽  
The Impact

Depressive disorders are a major public health concern. Despite currently available treatment options, their prevalence steadily increases, and a high rate of therapeutic failure is often reported, together with important antidepressant-related side effects. This highlights the need to improve existing therapeutic strategies, including by using nutritional interventions. In that context, saffron recently received particular attention for its beneficial effects on mood, although the underlying mechanisms are poorly understood. This study investigated in mice the impact of a saffron extract (Safr’Inside™; 6.25 mg/kg, per os) on acute restraint stress (ARS)-induced depressive-like behavior and related neurobiological alterations, by focusing on hypothalamic–pituitary–adrenal axis, inflammation-related metabolic pathways, and monoaminergic systems, all known to be altered by stress and involved in depressive disorder pathophysiology. When given before stress onset, Safr’Inside administration attenuated ARS-induced depressive-like behavior in the forced swim test. Importantly, it concomitantly reversed several stress-induced monoamine dysregulations and modulated the expression of key enzymes of the kynurenine pathway, likely reducing kynurenine-related neurotoxicity. These results show that saffron pretreatment prevents the development of stress-induced depressive symptoms and improves our understanding about the underlying mechanisms, which is a central issue to validate the therapeutic relevance of nutritional interventions with saffron in depressed patients.

scholarly journals Saffron Extract-Induced Improvement of Depressive-Like Behavior in Mice Is Associated with Modulation of Monoaminergic Neurotransmission

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 904
Author(s):  
Camille Monchaux De Oliveira ◽  
Line Pourtau ◽  
Sylvie Vancassel ◽  
Camille Pouchieu ◽  
Lucile Capuron ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Depressive Disorders ◽  
Forced Swim Test ◽  
Preclinical Study ◽  
Health Concern ◽  
Promising Candidate ◽  
Nutritional Interventions ◽  
Saffron Extract ◽  
Underlying Mechanisms ◽  
Behavioral Improvement

Depressive disorders represent a major public health concern and display a continuously rising prevalence. Importantly, a large proportion of patients develops aversive side effects and/or does not respond properly to conventional antidepressants. These issues highlight the need to identify further therapeutic strategies, including nutritional approaches using natural plant extracts with known beneficial impacts on health. In that context, growing evidence suggests that saffron could be a particularly promising candidate. This preclinical study aimed therefore to test its antidepressant-like properties in mice and to decipher the underlying mechanisms by focusing on monoaminergic neurotransmission, due to its strong implication in mood disorders. For this purpose, the behavioral and neurobiochemical impact of a saffron extract, Safr’Inside™ (6.5 mg/kg per os) was measured in naïve mice. Saffron extract reduced depressive-like behavior in the forced swim test. This behavioral improvement was associated with neurobiological modifications, particularly changes in serotonergic and dopaminergic neurotransmission, suggesting that Safr’Inside™ may share common targets with conventional pharmacological antidepressants. This study provides useful information on the therapeutic relevance of nutritional interventions with saffron extracts to improve management of mood disorders.

Measuring the impact of integrating palliative care into a multidisciplinary brain and spine oncology clinic.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 163-163
Author(s):  
Matthew Manning ◽  
Mary Larach ◽  
Susan Boyles ◽  
Abigail Stern
Keyword(s):  
Palliative Care ◽  
Treatment Options ◽  
Disease Status ◽  
Patient Characteristics ◽  
High Rate ◽  
Do Not Resuscitate ◽  
Goals Of Care ◽  
Cancer Centers ◽  
Metastatic Lung ◽  
The Impact

163 Background: Recent literature indicates that palliative care (PC) improves the outcomes of patients with cancer. Integration of PC providers into cancer centers is increasingly recognized to enhance symptom management with a beneficial effect on patient survival. In order to predict the impact of widespread PC integration, we hypothesized that a small pilot program may provide evidence supporting broader implementation. The current study endeavors to measure the result of adding a dedicated PC provider to a multidisciplinary brain and spine oncology program. Methods: Over the six month study period, a PC nurse practitioner was integrated into an existing weekly multidisciplinary brain and spine oncology conference and clinic. The provider participated in the multidisciplinary conference reviewing recent MRIs and discussing current disease status and treatment options. Following conference, the PC provider would consult on up to four of the clinic patients. Data were recorded regarding patient characteristics, goals of care, and changes in therapy. Results: The PC provider participated in 14 multidisciplinary clinics with a total of 180 subjects. Of those, 24 subjects met with the PC provider in formal consultation. The most common diagnoses were 41.6% with metastatic lung cancer and 25% with glioblastoma. For goals of care, an Advanced Directive discussion was documented in 100%. Do Not Resuscitate (DNR) orders were activated in 37.5% and documented in 54%. Medical Orders for Scope of Treatment (MOST) forms were introduced in 87.5% and completed in 25%. For changes in therapy, enrollment in hospice occurred in 33.3%. Pain medication was changed in 33.3%. Other symptoms including fatigue, weakness, anorexia, constipation, anxiety, lymphedema, dysphagia, depression, insomnia, and alopecia were managed in 87.5%. Conclusions: This study suggests that the integration of a PC provider into an existing multidisciplinary cancer program can produce a high rate of establishing goals of care and result in changes in treatment in a significant number of cases. Further study on the impact of integrating PC in cancer centers seems to be warranted.

Cognition in Schizophrenia Spectrum and Other Psychotic Disorders

2019 ◽  
pp. 290-306
Author(s):  
Martin Strassnig ◽  
Philip D. Harvey
Keyword(s):  
Mental Illness ◽  
Depressive Disorders ◽  
Psychotic Disorders ◽  
Cognitive Impairments ◽  
Treatment Options ◽  
Psychotic Episode ◽  
Schizophrenia Spectrum ◽  
Mental Illness Treatment ◽  
Bipolar Patients ◽  
The Impact

Cognitive impairments are present in patients with severe mental illness (SMI) at the time of the first psychotic episode. People with schizophrenia are more impaired across the lifespan compared to bipolar patients or patients with major depression. Although schizophrenia patients appear to generally function on a lower level than bipolar patients, the functional correlates of cognitive impairment are similar. There is much less research on cognition and its functional impact in depression, with the depression literature largely focusing on the impact of symptoms and only some recent studies examining cognition and functional capacity. Complicating both bipolar and major depressive disorders is the influence of mood states on cognition. Moreover, patients with SMI are often medically compromised, with higher rates of obesity and related comorbidities as well as poor lifestyles, which add further cognitive and functional implications. Cognitive impairments are known determinants of disability in SMI and a rate-limiting step in recovering from mental illness. Treatment options are reviewed in this chapter, and potential ways forward are discussed.

scholarly journals Sarcopenia: Etiology, Nutritional Approaches, and miRNAs

2021 ◽  
Vol 22 (18) ◽  
pp. 9724
Author(s):  
Roberto Cannataro ◽  
Leandro Carbone ◽  
Jorge L. Petro ◽  
Erika Cione ◽  
Salvador Vargas ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Protein Intake ◽  
Nutritional Interventions ◽  
Age Related ◽  
Early Biomarker ◽  
Underlying Mechanisms ◽  
And Function ◽  
The Impact

Sarcopenia, an age-related decline in skeletal muscle mass and function, dramatically affects the quality of life. Although there is a consensus that sarcopenia is a multifactorial syndrome, the etiology and underlying mechanisms are not yet delineated. Moreover, research about nutritional interventions to prevent the development of sarcopenia is mainly focused on the amount and quality of protein intake. The impact of several nutrition strategies that consider timing of food intake, anti-inflammatory nutrients, metabolic control, and the role of mitochondrial function on the progression of sarcopenia is not fully understood. This narrative review summarizes the metabolic background of this phenomenon and proposes an integral nutritional approach (including dietary supplements such as creatine monohydrate) to target potential molecular pathways that may affect reduce or ameliorate the adverse effects of sarcopenia. Lastly, miRNAs, in particular those produced by skeletal muscle (MyomiR), might represent a valid tool to evaluate sarcopenia progression as a potential rapid and early biomarker for diagnosis and characterization.

scholarly journals Nutrition and Obesity in the Pathogenesis of Youth-Onset Type 1 Diabetes and Its Complications

2021 ◽  
Vol 12 ◽  
Author(s):  
Christine A. March ◽  
Dorothy J. Becker ◽  
Ingrid M. Libman
Keyword(s):  
Type 1 Diabetes ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Cardiovascular Complications ◽  
Overweight And Obesity ◽  
Nutritional Interventions ◽  
Before And After ◽  
The Impact

Since the 1980s, there has been a dramatic rise in the prevalence of overweight and obesity in pediatric populations, in large part driven by sedentary lifestyles and changing dietary patterns with more processed foods. In parallel with the rise in pediatric obesity in the general population, the prevalence of overweight and obesity has increased among children and adolescents with type 1 diabetes. Adiposity has been implicated in a variety of mechanisms both potentiating the risk for type 1 diabetes as well as exacerbating long-term complications, particularly cardiovascular disease. Treatment options targeting the unique needs of obese pediatric patients, both before and after diagnosis of type 1 diabetes, are limited. In this review, we discuss the history of the epidemiology of the obesity epidemic in the context of pediatric type 1 diabetes, highlight the possible role of obesity in type 1 diabetes pathogenesis and review the concept of “double diabetes”. The impact of obesity at and after diagnosis will be discussed, including noted differences in clinical and biochemical markers, lipid abnormalities, and long-term cardiovascular complications. Finally, we will review the existing literature on pharmacologic and nutritional interventions as potential treatment strategies for youth with coexisting type 1 diabetes and obesity.

scholarly journals Skeletal System Biology and Smoke Damage: From Basic Science to Medical Clinic

2021 ◽  
Vol 22 (12) ◽  
pp. 6629
Author(s):  
Umberto Tarantino ◽  
Ida Cariati ◽  
Chiara Greggi ◽  
Elena Gasbarra ◽  
Alberto Belluati ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Fracture Healing ◽  
Bone Fractures ◽  
Negative Impact ◽  
Fragility Fractures ◽  
Health Concern ◽  
Skeletal System ◽  
Hospital Stays ◽  
Underlying Mechanisms ◽  
The Impact

Cigarette smoking has a negative impact on the skeletal system, as it reduces bone mass and increases fracture risk through its direct or indirect effects on bone remodeling. Recent evidence demonstrates that smoking causes an imbalance in bone turnover, making bone vulnerable to osteoporosis and fragility fractures. Moreover, cigarette smoking is known to have deleterious effects on fracture healing, as a positive correlation between the daily number of cigarettes smoked and years of exposure has been shown, even though the underlying mechanisms are not fully understood. It is also well known that smoking causes several medical/surgical complications responsible for longer hospital stays and a consequent increase in the consumption of resources. Smoking cessation is, therefore, highly advisable to prevent the onset of bone metabolic disease. However, even with cessation, some of the consequences appear to continue for decades afterwards. Based on this evidence, the aim of our review was to evaluate the impact of smoking on the skeletal system, especially on bone fractures, and to identify the pathophysiological mechanisms responsible for the impairment of fracture healing. Since smoking is a major public health concern, understanding the association between cigarette smoking and the occurrence of bone disease is necessary in order to identify potential new targets for intervention.

scholarly journals The impact of shared decision-making on the treatment of anxiety and depressive disorders: systematic review

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Tyler Marshall ◽  
Chelsea Stellick ◽  
Adam Abba-Aji ◽  
Richard Lewanczuk ◽  
Xin-Min Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Patient Satisfaction ◽  
Shared Decision Making ◽  
Depressive Disorders ◽  
Treatment Options ◽  
Study Patient ◽  
Shared Decision ◽  
Adequate Treatment ◽  
The Impact

Background Shared decision-making encourages patients to explore treatment options/choices in collaboration with their healthcare provider, inclusive of the best available evidence and the patient's values/preferences. Several effective treatments exist for people with anxiety and/or depressive disorders; shared decision-making may be particularly useful in this context. Aims To investigate whether shared decision-making enhances clinical outcomes in adults with anxiety and/or depressive disorders. Method A systematic review was conducted. Five electronic health databases were searched from database inception until August 2019, in addition to reference lists of included studies. Prospective controlled studies of shared decision-making in adults (aged 18–64 years) diagnosed with an anxiety and/or depressive disorder were included. Two reviewers independently conducted each stage of the review process. Results Six randomised controlled trials (N = 1834 participants) were included. Patient satisfaction improved in four studies. Patients were more likely to receive adequate treatment for depression in three studies. Anxiety symptoms decreased in one study. Patient involvement in decision-making increased in three studies. Because of the lack of blinded interventions and outcome assessment, the included studies were at moderate risk of bias. The certainty of evidence ranged from low to moderate, per GRADE criteria. Conclusions Shared decision-making shows promise for enhancing quality-of-care outcomes such as patient satisfaction, without increasing consultation time. but appears unlikely to improve symptoms of depression. However, it appears to be understudied in patients with anxiety disorders. Heterogeneity regarding definition and measurement of shared decision-making posed challenges for interpreting the results. More research is recommended to advance the field.

scholarly journals P010 Management of fibromyalgia patients in secondary care: a retrospective audit

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Youngjoo Kang ◽  
Ralph Smith ◽  
Anushka Soni
Keyword(s):  
Secondary Care ◽  
Treatment Options ◽  
Multidisciplinary Treatment ◽  
Chronic Widespread Pain ◽  
High Rate ◽  
Management Approach ◽  
Electronic Patient Records ◽  
Retrospective Audit ◽  
Multimodal Management ◽  
The Impact

Abstract Background/Aims  To examine the management of fibromyalgia patients referred to secondary care with respect to 2017 European Alliance of Associations for Rheumatology (EULAR) guidelines. Methods  Eighty-two patients referred to the Complex Musculoskeletal Clinic in the Rheumatology Department with a resulting diagnosis of fibromyalgia were included in the audit. Data was collected retrospectively via Electronic Patient Records over the study period of December 2017 to March 2020. Variables assessed included patient demographics, clinical presentation at assessment and management. Statistical analyses were conducted using Excel 2019 and the Excel Analysis ToolPak. Results  The majority of the patients were female 77/82(94%), and the mean age was 43.2yrs (SD = 12.6). Co-morbidities were common: 31/82 (38%) had a further painful musculoskeletal condition, 40/82 (49%) were obese and 46/82 (56%) had an active mental health problem. Alongside chronic widespread pain, patients reported fatigue 64/82 (78%), waking unrefreshed 69/82 (84%), and cognitive disturbance 31/82 (38%). Compared to a 2014 audit conducted in the same population and department, more patients had received pharmacological treatment (71/82 [87%] vs 34/50 [68%]; z = 2.64, p = 0.008), had received physiotherapy (28/82 [34%] vs 5/50 [10%]; z = 3.0, p = 0.002) and psychological input (16/82 [20%] vs 3/50 [6%]; z = 2.20, p = 0.03) prior to referral to secondary care. At secondary care consultation, all patients received an assessment of their pain and function, and 64/82 (78%) were assessed for psychosocial context. Fifty-three (65%) patients received information in the form of a website recommendation, leaflet or verbal education. After clinician assessment, the majority were referred to a multidisciplinary pain management programme, in a significant increase from 2014 (64/82 [78%] vs 4/50 [8%]; z = 8.04, p < 0.0001). All medication recommendations were made according to 2017 EULAR guidelines. Alongside multidisciplinary pain rehabilitation, patients were referred to physiotherapy 21/82 (26%), physical activity 26/82 (26%), sleep hygiene 9/82 (11%) and psychological 7/82 (9%) treatment options. Conclusion  Multidisciplinary treatment and first-line, non-pharmacological approaches have become the standard management approach in secondary care, alongside EULAR compliant pharmacological recommendations. EULAR’s non-pharmacological recommendations of assessing not only pain, but function and psychosocial context occurs for the majority of patients. The limitation of consultation duration likely plays a role in whether psychosocial context is adequately assessed. Providing patients with information about their condition, though occurring for approximately 2/3 of patients, was recognized as an area for improvement. The high rate of co-morbidities combined with the demographics of Fibromyalgia patients emphasizes the importance of early, multimodal management. Follow-up audits are warranted to examine the effects of the COVID-19 pandemic, and the impact of the upcoming 2021 NICE guidance for chronic pain. Disclosure  Y. Kang: None. R. Smith: None. A. Soni: Grants/research support; Oxford-UCB Prize Fellowship.

scholarly journals Introduction: The Impact and Management of the Bipolar Spectrum in 2004

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S12) ◽  
pp. 5-5
Author(s):  
Eric Hollander
Keyword(s):  
Bipolar Disorder ◽  
Psychosocial Interventions ◽  
High Rate ◽  
Health Concern ◽  
Bipolar Spectrum ◽  
Bipolar Ii ◽  
Affective Instability ◽  
Cluster B Personality Disorders ◽  
Pharmacologic Treatments ◽  
The Impact

This academic supplement to CNS Spectrums high-lights the impact of the broader bipolar spectrum as a considerable public health concern, the side effects that must be considered in a risk/benefit analysis of effective pharmacologic treatments of bipolar disorder, and the state of the art of psychosocial interventions utilized to manage the disorder.One important development in the conceptualization of bipolar disorder is that a common underlying endophenotype may mediate a range of presentations manifesting as the broader bipolar spectrum. This includes variants of bipolar disorder, such as bipolar II, cyclothymia, and mixed states; disorders characterized by affective instability, such as cluster B personality disorders; and disorders characterized by impulsivity associated with affective instability, such as impulse-control disorders. Since there may be various phenotypic expressions of a common underlying endophenotype, this may also help to explain the high rate of comorbidity found in bipolar disorder.

scholarly journals Challenges and perspectives in obstructive sleep apnoea

2018 ◽  
Vol 52 (3) ◽  
pp. 1702616 ◽  
Author(s):  
Winfried Randerath ◽  
Claudio L. Bassetti ◽  
Maria R. Bonsignore ◽  
Ramon Farre ◽  
Luigi Ferini-Strambi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Stage ◽  
Treatment Options ◽  
Sleep Apnoea ◽  
Future Research ◽  
Poor Correlation ◽  
Pressure Therapy ◽  
Obstructive Sleep ◽  
Underlying Mechanisms ◽  
The Impact

Obstructive sleep apnoea (OSA) is a major challenge for physicians and healthcare systems throughout the world. The high prevalence and the impact on daily life of OSA oblige clinicians to offer effective and acceptable treatment options. However, recent evidence has raised questions about the benefits of positive airway pressure therapy in ameliorating comorbidities.An international expert group considered the current state of knowledge based on the most relevant publications in the previous 5 years, discussed the current challenges in the field, and proposed topics for future research on epidemiology, phenotyping, underlying mechanisms, prognostic implications and optimal treatment of patients with OSA.The group concluded that a revision to the diagnostic criteria for OSA is required to include factors that reflect different clinical and pathophysiological phenotypes and relevant comorbidities (e.g.nondipping nocturnal blood pressure). Furthermore, current severity thresholds require revision to reflect factors such as the disparity in the apnoea–hypopnoea index (AHI) between polysomnography and sleep studies that do not include sleep stage measurements, in addition to the poor correlation between AHI and daytime symptoms such as sleepiness. Management decisions should be linked to the underlying phenotype and consider outcomes beyond AHI.

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