Low-FODMAP vs regular rye bread in irritable bowel syndrome: Randomized SmartPill (R) study

AIMTo compare the effects of regular vs low-FODMAP rye bread on irritable bowel syndrome (IBS) symptoms and to study gastrointestinal conditions with SmartPill (R).METHODSOur aim was to evaluate if rye bread low in FODMAPs would cause reduced hydrogen excretion, lower intraluminal pressure, higher colonic pH, different transit times, and fewer IBS symptoms than regular rye bread. The study was a randomized, double-blind, controlled cross-over meal study. Female IBS patients (n = 7) ate study breads at three consecutive meals during one day. The diet was similar for both study periods except for the FODMAP content of the bread consumed during the study day. Intraluminal pH, transit time, and pressure were measured by SmartPill, an indigestible motility capsule.RESULTSHydrogen excretion (a marker of colonic fermentation) expressed as area under the curve (AUC)((0-630 min)) was [median (range)] 6300 (1785-10800) ppm.min for low-FODMAP rye bread and 10 635 (4215-13080) ppm.min for regular bread (P = 0.028). Mean scores of gastrointestinal symptoms showed no statistically significant differences but suggested less flatulence after low-FODMAP bread consumption (P = 0.063). Intraluminal pressure correlated significantly with total symptom score after regular rye bread (rho = 0.786, P = 0.036) and nearly significantly after lowFODMAP bread consumption (rho = 0.75, P = 0.052). We found no differences in pH, pressure, or transit times between the breads. Gastric residence of SmartPill was slower than expected. SmartPill left the stomach in less than 5 h only during one measurement (out of 14 measurements in total) and therefore did not follow on par with the rye bread bolus.CONCLUSIONLow-FODMAP rye bread reduced colonic fermentation vs regular rye bread. No difference was found in median values of intraluminal conditions of the gastrointestinal tract

Do gastrointestinal complaints increase the risk for subsequent medically certified long-term sickness absence? The HUSK study

<p>Abstract</p> <p>Background</p> <p>Gastrointestinal complaints are very common in the general population and very often co-occur with common mental disorders. We aimed to study the prospective impact of gastrointestinal complaints on long term sickness absence, and address the contribution from co-occurring common mental disorders and other somatic symptoms.</p> <p>Method</p> <p>Health data on 13 880 40-45 year olds from the Hordaland Health Study (1997-99) were linked to national registries on sickness absence. As part of a wider health screening, gastrointestinal complaints were ascertained. Participant's anxiety and depression, and the presence of other somatic symptoms were evaluated. In Cox regression models, we predicted sickness absences over an average 5.4 years follow-up, with adjustment for confounders, anxiety and depression and other somatic symptoms.</p> <p>Results</p> <p>After adjusting for gender, level of education and smoking, those reporting GI complaints had higher risk for later sickness absence (HR = 1.42, 95% CI 1.34-1.51). GI complaints were associated with both anxiety (OR = 3.66, 95% CI 3.31-4.04) and depression (OR = 3.28, 95% CI 2.89-3.72), and a high level of other somatic symptoms (OR = 8.50, 95% CI 7.69-9.40). The association of GI complaints was still independently associated with future sickness absence (HR = 1.17, 95% CI 1.10-1.16) adjusting for mental illness and other somatic symptoms.</p> <p>Discussion</p> <p>Sickness absence is a complex behavioural outcome, but our results suggest GI complaints contribute by increasing the risk of long term sickness absence independently of comorbid mental illness and presence of other somatic symptoms. Occupational consequences of illness are important, and should also be addressed clinically with patients presenting with GI complaints.</p

Prevalence of irritable bowel syndrome according to different diagnostic criteria in a non-selected adult population

Background: Prevalence of irritable bowel syndrome shows great variation among epidemiological studies, which may be due to different diagnostic criteria. Aim: To assess prevalence of irritable bowel syndrome according to various diagnostic criteria and to study differences in symptom severity, psychopathology, and use of health care resources between subjects fulfilling different diagnostic criteria. Methods: A questionnaire was mailed to 5000 randomly selected adults. Presence of irritable bowel syndrome was assessed by four diagnostic criteria: Manning 2 (at least two Manning symptoms), Manning 3 (at least three Manning symptoms), Rome I and Rome II. Results: Response rate was 73%. Prevalence of irritable bowel syndrome by Manning 2, Manning 3, Rome I and Rome II criteria was 16.2%, 9.7%, 5.6%, and 5.1% respectively. Of those fulfilling Rome II criteria, 97% fulfilled Manning 2. Severe or very severe abdominal pain was reported by 27-30% of Manning-positive subjects, and 44% of Rome-positives. Prevalence of depression in Manning 2, and Rome II groups was 30.6 and 39.3%. Conclusions: Prevalence of irritable bowel syndrome by Rome II criteria is considerably lower than by Manning criteria. Subjects fulfilling Rome criteria form a subgroup of Manning-positive subjects with more severe abdominal symptoms, more psychopathology, and more frequent use of the health care system.Peer reviewe

From monster to ideal boyfriend:morality and family

The aim of this thesis is to chronologically study the changes in morality and in the families of vampires represented in literature. The analysis focuses on three vampires from different eras: Dracula, Lestat and Edward. The material consists of the Gothic horror novel Dracula by Bram Stoker, the first two books of The Vampire Chronicles by Anne Rice, (Interview with a Vampire and The Vampire Lestat), and all four books of the young adult romance series Twilight Saga by Stephanie Meyer. The main method of analysis is semiotics and Uspensky’s point of view levels: space-time level, psychological level, ideological level and phraseology level. These point of view levels are used to study the characteristics and values of these characters, both moral and family values. This thesis may be used as an example of how to examine chronological changes of a mythological creature or perhaps used to guide the analysis of female vampires in literature or in television. One could also study the phraseology of these books deeper or examine aspects other than morality and family. In the introduction, it is explained that this thesis is necessary, because even though there are plenty of studies written about vampires already, there is a lack of more vast and detailed analysis of vampires. In the second section, the material and the characters are introduced and there is also a subsection explaining the method of analysis. The third section consists of the description of semiotics, terms of analysis and Uspensky’s point of view levels and how they will be used to analyze the characters. The fourth section consists of the analysis of each of the three vampires separately. These three subsections are further divided into morality and family subsections that are analyzed by using Uspensky’s point of view levels. The fifth section focuses on the chronological changes and similarities between these vampires. Finally, the results of the analysis show that vampires have been obviously humanized through time, changing from monsters to heroic romantic partners. Also, vampires were represented more as lone hunters before, whereas now they have larger families. Vampires have stayed patriarchal and sensual, yet, genderless at the same time. Vampire sexuality has varied and has often been incestuous, but at the moment they are often represented in a heteronormative manner. Recently, vampires have gained the ability to have intercourse and create babies with humans. All of this makes vampires more relatable and more human to the readers.Tämän opinnäytetyön tarkoitus on tutkia kronologisesti muutoksia kirjallisuudessa kuvattujen vampyyrien moraalisuudessa ja perheissä. Analyysi keskittyy kolmeen vampyyriin eri aikakausilta: Draculaan, Lestatiin ja Edward Culleniin. Materiaali sisältää vain kirjallisuutta ja se koostuu goottisesta kauhuromaanista Bram Stokerin Draculasta, Anne Ricen Vampyyrikronikoiden kahdesta ensimmäisestä kirjasta, (Veren Vangit ja Vampyyri Lestat), ja Stephanie Meyerin nuorten aikuisten romantiikka sarjan Twilight Saagan kaikista neljästä osasta. Analyysin päätutkintamenetelmä on semiotiikka ja Uspenskyn näkökulmatasojen analyysi: kirjojen tapahtumispaikan ja -ajan taso, psykologinen taso, ideologinen taso ja fraseologien taso. Uspenskyn näkökulmatasot selitetään Ann Shukmanin kirjassa Literature and Semiotics: A study of the writings of Yu. M. Lotman (1977). Uspenskyn näkökulmatasoja käytetään hahmojen luonteenpiirteiden ja arvojen analyysissä, sekä moraalisten että perhe arvojen. Tätä opinnäytetyötä voidaan käyttää esimerkkinä, miten voi tutkia myyttisten olioiden kronologisia muutoksia tai ehkä esimerkkinä kirjallisuuden tai television naisvampyyrien tutkimiseen. Materiaaliksi käytettyjen kirjojen fraseologiaa voitaisiin myös tutkia syvemmin tai analysoida muitakin ominaisuuksia kuin moraalisuutta ja perhettä. Johdannossa selitetään, että tämä opinnäytetyö on tarpeellinen, koska vaikka vampyyreistä on jo kirjoitettu monia tutkimuksia, vampyyreistä ei ole tehty laajoja ja yksityiskohtaisia analyysejä. Toisessa luvussa esitellään käytetty materiaali ja henkilöhahmot ja se sisältää myös alaluvun, jossa analyysimenetelmä selitetään. Kolmas luku sisältää kuvauksen semiotiikasta, käytetyistä termeistä ja Uspenskyn näkökulmatasoista ja siitä miten niitä käytetään hahmojen analyysissä. Neljännes luku sisältää erikseen analyysit jokaisesta näistä kolmesta vampyyristä alaluvuissa. Nämä kolme alalukua ovat vielä jaettu alalukuihin hahmojen moraalisuudesta ja perheestä, joita tutkitaan Uspenskyn näkökulmatasojen avulla. Viidennessä luvussa keskitytään kronologisiin muutoksiin ja samankailtaisuuksiin näiden vampyyrien välillä. Viimeiseksi, analyysin tulokset näyttävät, että vampyyrejä ollaan inhimillistetty ajan kuluessa, muuttuen hirviöistä romanttisiksi kumppaneiksi. Lisäksi, vampyyrejä kuvattiin ennen enemmän yksinäisinä metsästäjinä, mutta nykyään heillä on suurempia perheitä. Vampyyrit ovat säilyneet patriarkaalisina ja sensuelleina, mutta silti sukupuolettomina samaan aikaan. Vampyyrien seksuaalisuus on ollut monipuolinen ja usein insestimäinen, mutta tällä hetkellä niitä kuvataan usein heteronormatiivisellä tavalla. Vampyyrit ovat vasta saaneet kyvyn seksualliseen kanssakäymiseen ja lasten tekemiseen ihmisten kanssa. Kaikki tämä tekee vampyyreistä samaistuttavampia ja ihmismäisempiä lukijoille

Effects of daily L-dopa administration on learning and brain structure in older adults undergoing cognitive training: a randomised clinical trial

Cognitive aging creates major individual and societal burden, motivating search for treatment and preventive care strategies. Behavioural interventions can improve cognitive performance in older age, but effects are small. Basic research has implicated dopaminergic signalling in plasticity. We investigated whether supplementation with the dopamine-precursor L-dopa improves effects of cognitive training on performance. Sixty-three participants for this randomised, parallel-group, double-blind, placebo-controlled trial were recruited via newspaper advertisements. Inclusion criteria were: age of 65-75 years, Mini-Mental State Examination score >25, absence of serious medical conditions. Eligible subjects were randomly allocated to either receive 100/25 mg L-dopa/benserazide (n = 32) or placebo (n = 31) prior to each of twenty cognitive training sessions administered during a four-week period. Participants and staff were blinded to group assignment. Primary outcomes were latent variables of spatial and verbal fluid intelligence. Compared to the placebo group, subjects receiving L-dopa improved less in spatial intelligence (-0.267 SDs; 95%CI [-0.498, -0.036]; p = 0.024). Change in verbal intelligence did not significantly differ between the groups (-0.081 SDs, 95%CI [-0.242, 0.080]; p = 0.323). Subjects receiving L-dopa also progressed slower through the training and the groups displayed differential volumetric changes in the midbrain. No statistically significant differences were found for the secondary cognitive outcomes. Adverse events occurred for 10 (31%) and 7 (23%) participants in the active and control groups, correspondingly. The results speak against early pharmacological interventions in older healthy adults to improve broader cognitive functions by targeting the dopaminergic system and provide no support for learning-enhancing properties of L-dopa supplements in the healthy elderly. The findings warrant closer investigation about the cognitive effects of early dopamine-replacement therapy in neurological disorders. This trial was preregistered at the European Clinical Trial Registry, EudraCT#2016-000891-54 (2016-10-05).Pharmacolog

Irritable bowel syndrome and functional dyspepsia in patients with eating disorders ‐ a systematic review

Objectives: The prevalence of eating disorders is rising worldwide. The low body weight in anorexia nervosa as well as the increase in body mass index due to binge eating disorder are contributing to a strikingly high morbidity and mortality. In a similar pattern, the prevalence and burden of the disease of functional gastrointestinal disorders such as functional dyspepsia and irritable bowel syndrome is increasing. As gastrointestinal complaints are commonly reported by patients with eating disorders, the question arose whether there is a relationship between eating disorders and functional gastrointestinal disorders. Methods: To address the need to better understand the interplay between eating disorders and functional gastrointestinal disorders as well as factors that might influence this connection, the data bases Medline, Web of Science and Embase were systematically searched. Results: After removal of duplicates the search yielded 388 studies which were screened manually. As a result, 36 publications were selected for inclusion in this systematic review. Conclusion: The occurrence of functional gastrointestinal disorders like irritable bowel syndrome and functional dyspepsia in patients with eating disorders is considerably high and often associated with psychological, hormonal and functional alterations. In the future, further research addressing the underlying mechanisms accounting for this relationship is required