Fasting Interventions for Stress, Anxiety and Depressive Symptoms: A Systematic Review and Meta-Analysis

Background. Fasting interventions have shown effectiveness in alleviating stress, anxiety and depressive symptoms. However, no quantitative analysis has been carried out thus far. The objective was to determine the effectiveness of fasting interventions on stress, anxiety and depression and if these interventions were associated with increased or decreased fatigue/energy. Methods. Overall, 11 studies and 1436 participants were included in the quantitative analyses. Results. After limiting analyses to randomized controlled trials with low risk of bias, we found that fasting groups had lower anxiety (b = −0.508, p = 0.038), depression levels (b= −0.281, p = 0.012) and body mass index compared to controls without increased fatigue. There was no publication bias and no heterogeneity for these results. These interventions were safe, even in patients with type 2 diabetes. Conclusions. These results should be taken with a caveat. These results are preliminary and encouraging and fasting appears to be a safe intervention. Data are not sufficient to recommend one fasting intervention more than the others. No study was carried out in psychiatric populations and further trials should be carried out in these populations that may be good candidates for fasting interventions.

Yoga and Weight Management

A comprehensive lifestyle intervention that is effective, yet safe, for weight loss is recommended for weight management. Yoga is one such intervention that includes (1) increased physical activity and (2) suggestions about healthy eating and other behavioral changes. With this, there have been attempts to assess the effectiveness of yoga for weight management. The present review aimed at (1) evaluating studies assessing the effects of yoga on obesity and (2) grade them according to standard grading methods. Twenty-three studies, of which nine were RCTs, were included. The rating of RCTs was between 70.6 and 94.2, which can be considered fairly good. However the present review shows that there are fewer studies with (1) adequate sample sizes, (2) study designs, (3) long term follow up, and (4) adequate reporting of adverse events to conclude that yoga is an effective and safe intervention for weight loss. Hence, further studies with the points described above are required to conclude the safety and efficacy of yoga for weight loss.

Peer Relations and Delinquency Among Girls in Foster Care Following a Skill-Building Preventive Intervention

There is evidence that risk for delinquency is elevated among girls with foster care histories, and one correlate of delinquency is affiliating with peers who engage in delinquent behavior. Although intervention studies have shown positive effects of interventions that target delinquent peer affiliation on reductions in delinquency among adolescents with juvenile justice histories, the success of such interventions for younger girls in foster care, without prior involvement with juvenile justice, is unknown. We analyzed data from a randomized clinical trial of the middle school version of the Keep Safe intervention in a sample of girls in foster care ( n = 100). The intervention was delivered to girls and foster parents during the transition to middle school. Path analysis suggested a significant intervention effect on reduction in affiliation with delinquent peers at 12 months ( B = −.21). No significant mediation effects were identified. The middle school Keep Safe intervention shows promise as a preventative intervention for reducing affiliation with delinquent peers, which importantly is associated with adolescent delinquent behavior. Implications for researchers and professionals who tailor and deliver evidence-based programs for girls in foster care are discussed.

Eight Weeks of Pulmonary Rehabilitation in Patients with Pulmonary Embolism: A Preliminary Report

Aim: Pulmonary rehabilitation (PR) is an important and safe intervention which can improve health indicators and quality of life. The purpose of our study was to investigate the effect of 8 weeks of PR in patients with pulmonary embolism (PE) during (tele)rehabilitation and self-selected exercise (SSE) versus supervised exercise in a rehabilitation center (SE). Material & Method: 14 patients with PE participated in our study (age, 50.7 ± 15.1 yrs; BMI, 30.0 ± 3.3 kg/m2; male, 78.6%) and were divided into two groups (SSE, n = 7, vs. SE, n = 7). Inclusion criteria were diagnosis of PE > 6 months and weekly exercise ≤ 100 min. For each patient, demographics, characteristics of PE episodes, follow-up after the thromboembolic event, and echocardiography were recorded. Before and after the PR program we recorded anthropometric characteristics and questioners [Quality of life (SF-36) and Pittsburg sleep quality index (PSQI)], and we performed blood sampling for NT-proBNB measurement. Patients underwent cardiopulmonary exercise testing until exhausting.The PR exercise program included the following: SE, 3/w, 30-min intermittent exercise 1/1 in cycle ergometer at 70% VO2max calculated from heart rate, 10-min respiratory physiotherapy, and 10-min strength exercises; SSE, 50-min walking at 60% VO2max, 10-min (tele)respiratory physiotherapy and 10-min strength exercise. Results: The SSE group differed in mean arterial pressure at the end of ergospirometry pre- and post-PR (87.6 ± 3.3 vs. 95.0 ± 5.5 mmHg, p< 0.05). All patients showed differences pre-and post-PR in SF-36 (general health, 57.5 ± 14.9 vs. 63.8 ± 20.5 p< 0.05; physical health, 63.8 ± 189 vs. 75.6 ± 14.5, p< 0.05) and PSQI (cannot get to sleep within 30 min, 5.3 ± 2.2 vs. 3.5 ± 1.7, p< 0.05; enthusiasm, 1.3 ± 0.7 vs. 0.3 ± 0.5 p< 0.05) but we observed no differences between groups. The ΝΤ-proBNB (73.8 ± 11.8 vs. 104.0 ± 55.7 pg/mL) and ergospirometry parameters were not significantly different pre- and post-PR or between groups. Conclusions: PR may present a safe intervention in patients with PE. Post-PR results are similar in patients with SE and SSE.

Intestinal perforation caused by ventriculoperitoneal shunt

Ventriculoperitoneal shunt implantation is one of the most common procedures in paediatric neurosurgery. Although the procedure is used often in general neurosurgical practice and regarded as a safe intervention, it has several usual and unusual complications. About a half of these complications involve the peritoneal catheter. Spontaneous transanal protrusion of ventriculoperitoneal shunt is very rare. A 4-month-old baby was admitted to hospital due to spontaneous, asymptomatic transanal protrusion of ventriculoperitoneal catheter. The boy was put on intravenous antibiotics and taken to surgery. Treatment consisted of extrusion of the peritoneal catheter through the anus and temporary externalisation of the proximal part of the shunt. The previously implanted valve was preserved. Laparotomy was not necessary. Postoperative parenteral nutrition was used. No gastrointestinal complications were found on postoperative observation. Finally, a new peritoneal catheter was implanted.

Dietary restriction with and without caloric restriction for healthy aging

Caloric restriction is the most effective and reproducible dietary intervention known to regulate aging and increase the healthy lifespan in various model organisms, ranging from the unicellular yeast to worms, flies, rodents, and primates. However, caloric restriction, which in most cases entails a 20–40% reduction of food consumption relative to normal intake, is a severe intervention that results in both beneficial and detrimental effects. Specific types of chronic, intermittent, or periodic dietary restrictions without chronic caloric restriction have instead the potential to provide a significant healthspan increase while minimizing adverse effects. Improved periodic or targeted dietary restriction regimens that uncouple the challenge of food deprivation from the beneficial effects will allow a safe intervention feasible for a major portion of the population. Here we focus on healthspan interventions that are not chronic or do not require calorie restriction.