Синдром раздраженного кишечника

Изложены современные данные об этиологии, патогенезе, диагностике и принципах лечения синдрома раздраженного кишечника. Приведены существующие классификации заболевания. Патогенетически обоснован выбор современных фармакологических средств, диетотерапии, физических методов для лечения синдрома раздраженного кишечника.Modern data about the etiology, pathogenesis, diagnosis and treatment principles in syndrome of irritated intestine are reported. The existing classifications of the disease are given. The choice of modern drugs, diet and physical methods of treatment is validated pathogenetically

The relation between creativity and students’ performance on different types of geometrical problems in elementary education

Aim: In the current study we aimed to investigate the relation between creativity and mathematical problem solving in the upper grades of elementary school. Methods: To examine how student’s levels of general creativity were related to their performance on different types of geometrical problems, a geometry test with diverse problems was administered to a sample of 1665 Dutch students from third to sixth grade, as well as a creativity test. The geometry test consisted of four closed-ended routine problems, six closed-ended non-routine problems (related to a visual artwork) and four open-ended non-routine problems (multiple solutions problems). The Test of Creative Thinking—Drawing Production was used to measure students’ creativity. Multivariate multilevel analyses were conducted to take the nested structure of the data into account. Results: The results showed that creativity was a significant predictor of students’ performance on all types of geometrical problems, but most strongly associated with performance on open-ended non-routine problems, suggesting that students with higher levels of creativity perform better in solving geometry problems in general, but especially in geometry problems asking for multiple solutions

Fatal Retroperitoneal Bleeding Caused by Neurofibromatosis: A Case Report and Review of the Literature

A young female was brought into the emergency department with pulseless electrical activity (PEA) after local resection of neurofibromateous lesions. Chest ultrasonography was normal. Abdominal ultrasonography was not performed. After successful resuscitation a total body CT-scan was performed to rule out potential bleeding sources. However, haemodynamic instability reoccurred and the scan had to be aborted at the thoracoabdominal level. No thoracic abnormalities were found. Resuscitation was reinitiated and abdominal ultrasonography was performed, showing a large amount of abdominal fluid. A progressive fall in haemoglobin was noted. Emergency laparotomy was performed, revealing a large retroperitoneal haematoma. Despite ligation and packing, bleeding continued. Postoperative angiography showed active bleeding from a branch of the left internal iliac artery, which could be successfully coiled. Unfortunately, the patient died five days later due to irreversible brain damage. Revision of an MRI scan made one year earlier showed a 10 cm large retroperitoneal neurofibromatous lesion exactly at the location of the current bleeding. This case shows that patients with neurofibromatosis might develop spontaneous life-threatening bleeding from retroperitoneal located lesions. Furthermore, it points out the necessity of focused assessment with ultrasonography of the abdomen in all patients with PEA of unknown origin

Cannabidiol enhancement of exposure therapy in treatment refractory patients with social anxiety disorder and panic disorder with agoraphobia:A randomised controlled trial

Preclinical research suggests that enhancing CB1 receptor agonism may improve fear extinction. In order to translate this knowledge into a clinical application we examined whether cannabidiol (CBD), a hydrolysis inhibitor of the endogenous CB1 receptor agonist anandamide (AEA), would enhance the effects of exposure therapy in treatment refractory patients with anxiety disorders. Patients with panic disorder with agoraphobia or social anxiety disorder were recruited for a double-blind parallel randomised controlled trial at three mental health care centres in the Netherlands. Eight therapist-assisted exposure in vivo sessions (weekly, outpatient) were augmented with 300 mg oral CBD (n = 39) or placebo (n = 41). The Fear Questionnaire (FQ) was assessed at baseline, mid-and post-treatment, and at 3 and 6 months follow-up. Primary analyses were on an intent-to-treat basis. No differences were found in treatment outcome over time between CBD and placebo on FQ scores, neither across (beta = 0.32, 95% CI [-0.60; 1.25]) nor within diagnosis groups (beta = -0.11, 95% CI [-1.62; 1.40]). In contrast to our hypotheses, CBD augmentation did not enhance early treatment response, within-session fear extinction or extinction learning. Incidence of adverse effects was equal in the CBD (n = 4, 10.3%) and placebo condition (n = 6, 15.4%). In this first clinical trial examining CBD as an adjunctive therapy in anxiety disorders, CBD did not improve treatment outcome. Future clinical trials may investigate different dosage regimens. (c) 2022 Published by Elsevier B.V

Dismantling the relative effectiveness of core components of cognitive behavioural therapy in preventing depression in adolescents

__Background:__ Both depressive disorder and subclinical depressive symptoms during adolescence are a major public health concern. Therefore, it is important that depression is detected at an early stage and is treated preventively. Prevention based on the principles of Cognitive Behavioural Therapy (CBT) has proven to be the most effective, however research has mainly focused on the effectiveness of "prevention packages" consisting of multiple CBT-components, rather than on the distinct CBT-components. This study will evaluate the relative effectiveness of four core components of CBT (cognitive restructuring (CR), behavioural activation (BA), problem solving (PS) and relaxation (RE)). In addition the relative (cost-)effectiveness of four different sequences of these components will be evaluated: (1) CR - BA - RE - PS, (2) BA - CR - RE - PS, (3) PS - GA - CR - RE and (4) RE - PS - BA - CR. __Methods:__ We will perform a non-blinded multisite cluster randomized prevention microtrial with four parallel conditions consisting of the four sequences. The four sequences of components will be offered in groups of high school students with elevated depressive symptoms. For each CBT-component a module of three sessions is developed. Assessments will be conducted at baseline, after each CBT-component, prior to each session, at post-intervention and at 6-month follow-up. Potential moderators and mediators will be evaluated exploratively to shed light on for whom the (sequences of) CBT-components are most effective and how effects are mediated. __Discussion:__ The potential value of the study is insight in the relative effectiveness of the four most commonly used CBT-components and four different sequences, and possible moderators and mediators in the prevention of depression among adolescents. This knowledge can be used to optimize and personalize CBT-programs

A review of applications of the Bayes factor in psychological research

The last 25 years have shown a steady increase in attention for the Bayes factor as a tool for hypothesis evaluation and model selection. The present review highlights the potential of the Bayes factor in psychological research. We discuss six types of applications: Bayesian evaluation of point null, interval, and informative hypotheses, Bayesian evidence synthesis, Bayesian variable selection and model averaging, and Bayesian evaluation of cognitive models. We elaborate what each application entails, give illustrative examples, and provide an overview of key references and software with links to other applications. The paper is concluded with a discussion of the opportunities and pitfalls of Bayes factor applications and a sketch of corresponding future research lines