Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of ...psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence. We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Participants’ responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration (p < 0.05). Gains were largely maintained at follow-up to 36 weeks. The intensity of effects in the first psilocybin session (at week 4) strongly predicted change in drinking during weeks 5–8 (r = 0.76 to r = 0.89) and also predicted decreases in craving and increases in abstinence self-efficacy during week 5. There were no significant treatment-related adverse events. These preliminary findings provide a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms.
TRIAL REGISTRATION: NCT02061293
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
This report describes psychological assessments of the first time ritual use of ayahuasca in the religious groups Uniāo do Vegetal and Santo Daime. Nineteen subjects who tried the beverage in Santo ...Daime rituals and nine subjects who tried it in Uniāo do Vegetal rituals were evaluated one to four days before their first ayahuasca experience in life and one to two weeks after this experience. Semistructured interviews and a structured psychiatric scale were used in the first evaluation to elicit set variables concerning attitudes towards the ayahuasca experience and to elicit mental health status. Mental health status was reassessed in the second evaluation, which also included a semistructured interview concerning the phenomenology of altered states of consciousness (ASCs). Predominantly positive expectancies concerning the ayahuasca experience were the most prominent findings concerning set variables. Visual phenomena, numinousness, peacefulness, insights and a distressing reaction were the most salient ASC experiences. A significant reduction of the intensity of minor psychiatric symptoms occurred in the Santo Daime group after the hallucinogen experience. Subjects in both groups reported behavioral changes towards assertiveness, serenity and vivacity/joy. The set and setting hypothesis, suggestibility processes, as well as the supposed unique effects of ayahuasca are used in discussing these findings.
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DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Autonomic diabetic neuropathy is one of the most common complications of type 1 diabetes mellitus, and studies using heart rate variability to investigate these individuals have shown inconclusive ...results regarding autonomic nervous system activation. Aims To investigate the dynamics of heart rate in young subjects with type 1 diabetes mellitus through nonlinear and linear methods of heart rate variability.
We evaluated 20 subjects with type 1 diabetes mellitus and 23 healthy control subjects. We obtained the following nonlinear indices from the recurrence plot: recurrence rate (REC), determinism (DET), and Shanon entropy (ES), and we analysed indices in the frequency (LF and HF in ms2 and normalised units - nu - and LF/HF ratio) and time domains (SDNN and RMSSD), through analysis of 1000 R-R intervals, captured by a heart rate monitor.
There were reduced values (p<0.05) for individuals with type 1 diabetes mellitus compared with healthy subjects in the following indices: DET, REC, ES, RMSSD, SDNN, LF (ms2), and HF (ms2). In relation to the recurrence plot, subjects with type 1 diabetes mellitus demonstrated lower recurrence and greater variation in their plot, inter-group and intra-group, respectively.
Young subjects with type 1 diabetes mellitus have autonomic nervous system behaviour that tends to randomness compared with healthy young subjects. Moreover, this behaviour is related to reduced sympathetic and parasympathetic activity of the autonomic nervous system.
The objective of this study was to verify possible associations between heart rate variability indices and physical activity, body composition, and metabolic and cardiovascular parameters in ...individuals with type 1 diabetes.
A total of 39 young patients with type 1 diabetes were included. Body composition, physical activity, cardiovascular parameters, and metabolic parameters were assessed. For the heart rate variability analysis, heart rate was recorded beat-by-beat using a Polar S810i heart rate monitor for 30 minutes, with the volunteers in the supine position; subsequently, the following indices were considered: standard deviation of all normal RR intervals; root-mean square of differences between adjacent normal RR intervals in a time interval; percentage of adjacent RR intervals with a difference of duration >50 ms; high frequency component in milliseconds squared; high frequency component in normalised units; standard deviation of the instantaneous variability beat-to-beat; and standard deviation of the long-term variability. The association between the heart rate variability indices and independent variables was verified through linear regression in unadjusted and adjusted models (considering gender and age). The statistical significance was set at 5% and the confidence interval at 95%.
High values of at-rest heart rate were associated with reduced parasympathetic activity and global heart rate variability, and higher values of waist-to-hip ratio were related to lower parasympathetic activity, independent of age or gender.
For young patients with type 1 diabetes, increases in at-rest heart rate values are associated with reduced parasympathetic activity and global heart rate variability, whereas higher waist-to-hip ratio values are related to lower parasympathetic activity, both independent of age and gender.
This study assessed the long-term effects of botulinum toxin type A (BoNT-A) in subjective pain, pain sensibility, and muscle thickness in persistent myofascial temporomandibular-disorder pain ...(MFP-TMD) patients. Fourteen female subjects with persistent MFP received BoNT-A treatment with different doses (10U-25U for temporalis muscle and 30U-75U for masseter muscle). The treatment was injected bilaterally in the masseter and anterior temporalis muscles in a single session. Clinical measurements included: self-perceived pain (VAS), pain sensibility (PPT), and muscles thickness (ultrasonography). Follow-up occurred 1, 3, 6, and 72 months after treatment for VAS and PPT and 1, 3, and 72 months for ultrasonography. For statistical analysis, the Friedman test with the Bonferroni test for multiple comparisons as a post hoc test was used for non-parametric repeated measures comparisons among the evaluation times. A 5% probability level was considered significant in all tests. VAS values presented a significant decrease throughout the study (
< 0.05). Regarding PPT values, a significant increase was found when comparing baseline data with post-treatment follow-ups (p < 0.05), and even though a significant decrease was found in muscle thickness when baseline values were compared with the 1- and 3-months assessments, no differences were found when compared with the 72 months follow-up (
> 0.05). A single injection of BoNT-A presents long-term effects in reducing pain in persistent MFP-TMD patients, and a reversibility of adverse effects on masticatory-muscle thickness.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Abstract Statement of problem Validated questionnaires and guidelines for assessing sleep bruxism (SB) that can be administered by dentists in clinical practice are still lacking. Purpose The purpose ...of this preliminary study was to compare the third edition of the International Classification of Sleep Disorders (ICSD-3) criteria for diagnosing SB with the results of the gold standard polysomnography (PSG) examination. Material and methods Twenty consecutive postgraduate students and staff at Bauru School of Dentistry, University of São Paulo, Bauru, Brazil, participated. Each participant underwent interview, clinical assessment, and a PSG evaluation. Bruxers and nonbruxers were identified based only on the PSG analysis. The validity of the ICSD-3 criteria was assessed by receiver operating characteristics curve analysis, area under the curve (AUC), likelihood ratios (LR), and the diagnostic odds ratio (DOR). Results The ICSD-3 diagnostic criteria items for SB had fair to moderate concordance with the PSG diagnosis, with AUC ranging from 0.55 to 0.75. The best value of agreement was the association of SB more than once a week with transient morning jaw muscle pain or fatigue with a moderate but significant agreement with the PSG diagnosis of SB (AUC=0.75), with 90% specificity, positive LR=6, and DOR=13.5. When the frequency of self-reported SB increased to more than 4 times a week, the combination of this finding with tooth wear also had high values of agreement with the PSG diagnosis of SB (AUC= 0.75, +LR=6, DOR=13.6). Conclusions The report of regular or frequent SB and the presence of (1) incident of abnormal tooth wear or (2) incidents of transient morning jaw muscle pain or fatigue were the best discriminatory items of ICSD-3 for SB diagnosis.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Purpose
The aim of this study was to determine an appropriate cutoff value and the number of nights of sleep with the portable single-channel EMG device (GrindCare) necessary for a valid sleep ...bruxism (SB) diagnosis.
Methods
Twenty consecutive post-graduate students and staff at Bauru School of Dentistry composed the sample. Each participant underwent the GrindCare for five consecutive nights and the polysomnography (PSG). The discrimination between bruxers and non-bruxers was based only on the PSG analysis. Data about electromyography per hour with GrindCare (EMG/h) and PSG (bursts/h) were scored.
Results
There were positive correlations between the two devices for EMG/h and bursts/h in three and five consecutive nights. Bland-Altman analysis of the EMG bursts/h showed positive agreement between the methods. The receiver operating characteristic (ROC) analyses also showed that using a minimum of 18 EMG/h for three nights and 19 EMG/h for five nights in GrindCare as cutoffs resulted in a 90 % specificity and positive likelihood ratio equal to 5.
Conclusions
GrindCare is able to discriminate SB diagnosed by PSG and gold standard criteria, when used for three or five consecutive nights, and it may be a valid choice in clinical practice for SB assessment.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
To determine sleep quality and associated factors in a group of patients with painful TMDs.
The medical records of 80 patients with arthralgia and/or myofascial pain were reviewed and compared to a ...healthy control group. Data about sex, age, subjective pain, physical activity, social activity, subjective sleep quality (Pittsburgh Sleep Quality Index PSQI), pain vigilance (Pain Vigilance and Awareness Questionnaire PVAQ), and pain catastrophizing (Pain Catastrophizing Scale PCS) were collected. Relationships between PSQI, age, pain intensity, PVAQ, and PCS in the TMD group were also analyzed. Data from the control group were used to transform the PSQI results into T-scores, which were then used to divide the TMD group into two subgroups: normal and impaired sleep.
TMD patients presented a significantly higher (
< .001) PSQI score than the control group. Also, in the TMD group, there was a low to moderate correlation between PSQI and pain intensity and a significant correlation between PVAQ and PCS. The impaired sleep group presented a significantly higher (
< .001) PSQI T-score than the normal sleep group. Univariate analysis showed that subjective pain, social activity, and the PCS total and subscale scores differed significantly between the different PSQI T-score groups. The comparison between TMD pain patients and control subjects showed a significantly higher prevalence of T-score discordance in almost all PSQI components in TMD patients with impaired sleep.
Subjective sleep quality in painful TMD patients could be associated with and influenced by psychosocial factors (catastrophizing and hypervigilance), social activity, and pain intensity.
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