Prospective Study on the Association between Harm Avoidance and Postpartum Depressive State in a Maternal Cohort of Japanese Women

BACKGROUND: Recent studies have displayed increased interest in examining the relationship between personality traits and the onset, treatment response patterns, and relapse of depression. This study aimed to examine whether or not harm avoidance (HA) was a risk factor for postpartum depression measured by the Edinburgh Postnatal Depression Scale (EPDS) and the state dependency of HA. METHODS: Pregnant women (n=460; mean age 31.9±4.2 years) who participated in a prenatal program completed the EPDS as a measure of depressive state and the Temperament and Character Inventory (TCI) as a measure of HA during three periods: early pregnancy (T1), late pregnancy (around 36 weeks), and 1 month postpartum (T2). Changes in EPDS and HA scores from T1 to T2 were compared between the non depressive (ND) group and the postpartum depressive (PD) group. RESULTS: There was no significant difference in the level of HA between the ND and PD groups at T1. In the ND group, EPDS and HA scores did not change significantly from T1 to T2. In the PD group, both scores increased significantly from T1 to T2 (EPDS, p<0.0001; HA, p<0.048). In the ND and PD groups, a significant positive correlation was observed in changes in EPDS and HA scores from T1 to T2 (r=0.31, p=0.002). CONCLUSIONS: These results suggest that HA cannot be considered a risk factor for the development of postpartum depression measured by EPDS. Furthermore, HA may be state dependent

Positive basophil activation test with soymilk protein identifies Gly m 4–related soymilk allergy

Abstract Soymilk allergy is caused by cross‐reaction of either birch Bet v 1–specific or alder Aln g 1–specific IgE to soybean Gly m 4, which belongs to pathogenesis‐related protein‐10 (PR‐10) family. Gly m 4–specific IgE test identifies soybean allergy patients with high sensitivity. In this case study, we found that CD203c expression–based basophil activation test (CD203c‐BAT) with soymilk protein became positive in the three cases of Gly m 4–related soymilk allergy at the concentrated of 1 μg/ml, but not in the control subjects. CD203c‐BAT may possibly be useful as a diagnostic tool to identify patients with soymilk allergy

Usefulness of Gly m 4‐specific IgE test in the diagnosis of Rosaceae fruit‐oral allergy syndrome caused by Betulaceae pollen sensitization

Abstract Background Pollen‐food allergy syndrome (PFAS) is caused by the cross‐reaction of the specific IgE to pollen allergens with similar allergens contained in fruits, vegetable, and nuts. The representative allergen responsible for this cross‐reaction is pathogenesis‐related protein (PR)‐10. Specific IgE test using Gly m 4, soybean PR‐10, is widely used to diagnose soy allergy. We aimed to investigate whether the Gly m 4‐specific IgE test is useful for predicting oral allergy symptoms (OAS) to Rosaceae fruits in PFAS caused by Betulaceae pollen sensitization. Methods Forty‐one patients with suspected PFAS were enrolled. Specific IgE levels were measured against alder pollen, apple, peach, pear, and Gly m 4, and correlation between test results and allergic symptoms was assessed to compare the accuracy of these allergen‐specific IgE tests. Results Of the 41 patients, 32 were positive for alder pollen‐specific IgE. Of those, 16 showed OAS to at least one of apple, peach, and pear (OAS (+) group), and the rest 16 cases showed no symptoms (OAS (−) group). The Gly m 4‐specific IgE value was significantly higher in the OAS (+) group (p = .014), and the highest in area under the receiver operating characteristics curve. The cut‐off value for detection of the OAS (+) group was 2.65 UA/ml, with a sensitivity of 62.5% and a specificity of 81.3%. Other allergen‐specific IgE values were not significantly different between the two groups. Conclusions In the subjects sensitized to Betulaceae pollen allergens, the Gly m 4‐specific IgE test is useful for predicting OAS of Rosaceae fruits

Clinical Effectiveness and Cost-effectiveness of Videoconference-Based Integrated Cognitive Behavioral Therapy for Chronic Pain: Randomized Controlled Trial

BackgroundCognitive behavioral therapy is known to improve the management of chronic pain. However, the components of this therapy are still being investigated and debated. ObjectiveThis study aimed to examine the effectiveness of an integrated cognitive behavioral therapy program with new components (attention-shift, memory work, video feedback, and image training) delivered via videoconferencing. MethodsThis study was unblinded and participants were recruited and assessed face-to-face in the outpatient department. We conducted a randomized controlled trial for chronic pain to compare 16 weekly videoconference-based cognitive behavioral therapy (vCBT) sessions provided by a therapist with treatment as usual (TAU). Thirty patients (age range, 22-75 years) with chronic pain were randomly assigned to either vCBT (n=15) or TAU (n=15). Patients were evaluated at week 1 (baseline), week 8 (midintervention), and week 16 (postintervention). The primary outcome was the change in pain intensity, which was recorded using the numerical rating scale at 16 weeks from the baseline. Secondary outcomes were pain severity and pain interference, which were assessed using the Brief Pain Inventory. Additionally, we evaluated disability, pain catastrophizing cognition, depression, anxiety, quality of life, and cost utility. ResultsIn the eligibility assessment, 30 patients were eventually randomized and enrolled; finally, 15 patients in the vCBT and 14 patients in the TAU group were analyzed. Although no significant difference was found between the 2 groups in terms of changes in pain intensity by the numerical rating scale scores at week 16 from baseline (P=.36), there was a significant improvement in the comprehensive evaluation of pain by total score of Brief Pain Inventory (–1.43, 95% CI –2.49 to –0.37, df=24; P=.01). Further, significant improvement was seen in pain interference by using the Brief Pain Inventory (–9.42, 95% CI –14.47 to –4.36, df=25; P=.001) and in disability by using the Pain Disability Assessment Scale (–1.95, 95% CI –3.33 to –0.56, df=24; P=.008) compared with TAU. As for the Medical Economic Evaluation, the incremental cost-effectiveness ratio for 1 year was estimated at 2.9 million yen (about US $25,000) per quality-adjusted life year gained. ConclusionsThe findings of our study suggest that integrated cognitive behavioral therapy delivered by videoconferencing in regular medical care may reduce pain interference but not pain intensity. Further, this treatment method may be cost-effective, although this needs to be further verified using a larger sample size. Trial RegistrationUniversity Hospital Medical Information Network UMIN000031124; https://tinyurl.com/2pr3xsz

Effect of Resistant Starch on the Gut Microbiota and Its Metabolites in Patients with Coronary Artery Disease

Aim: Bacteroides vulgates and B. dorei have a protective effect against atherosclerosis, suggesting that expansion of these species in the gut microbiota could help patients with coronary artery disease (CAD). This study aimed to investigate the effect of resistant starch (RS) on the gut microbiota and its metabolites in fecal sample cultures from patients with CAD and individuals without CAD, using a single-batch fermentation system. Methods: Fecal samples from 11 patients with CAD and 10 individuals without CAD were fermented for 30 h with or without RS in the Kobe University Human Intestinal Microbiota Model (KUHIMM). Gut microbiota and the abundance of B. vulgatus and B. dorei were analyzed using 16S ribosomal ribonucleic acid (rRNA) gene sequencing and the quantitative polymerase chain reaction. Short-chain fatty acids were analyzed using high-performance liquid chromatography. Results: Gut microbial analysis showed significantly lower levels of B. vulgatus and B. dorei in the original fecal samples from patients with CAD, which was simulated after 30 h of fermentation in the KUHIMM. Although RS significantly increased the absolute numbers of B. vulgatus and B. dorei, and butyrate levels in CAD fecal sample cultures, the numbers varied among each patient. Conclusions: The effect of RS on gut microbiota and its metabolites in the KUHIMM varied between CAD and non-CAD fecal sample cultures. The KUHIMM may be useful for preclinical evaluations of the effects of RS on the gut microbiota and its metabolites