In the last decade, increasing evidence has emerged linking alterations in the brain-derived neurotrophic factor (BDNF) expression with the development of Alzheimer's disease (AD). Because of the ...important role of BDNF in cognition and its association with AD pathogenesis, the aim of this study was to evaluate the potential difference in plasma BDNF concentrations between subjects with mild cognitive impairment (MCI; N = 209) and AD patients (N = 295) and to determine the possible association between BDNF plasma levels and the degree of cognitive decline in these individuals. The results showed a significantly higher (
< 0.001) concentration of plasma BDNF in subjects with AD (1.16; 0.13-21.34) compared with individuals with MCI (0.68; 0.02-19.14). The results of the present study additionally indicated a negative correlation between cognitive functions and BDNF plasma concentrations, suggesting higher BDNF levels in subjects with more pronounced cognitive decline. The correlation analysis revealed a significant negative correlation between BDNF plasma levels and both Mini-Mental State Examination (
< 0.001) and Clock Drawing test (
< 0.001) scores. In conclusion, the results of our study point towards elevated plasma BDNF levels in AD patients compared with MCI subjects, which may be due to the body's attempt to counteract the early and middle stages of neurodegeneration.
Methods
A systematic analysis was performed of the medical specialization academic programs of 20 different countries to establish which medical specialties take into account mental health issues in ...the specialty curricular design and which mental health content these programs address. The criteria that were explored in the educational programs include: 1) name of the medical specialties that take into account mental health content in curriculum design, 2) name of the mental health issues addressed by these programs. After independent review and data extraction, paired investigators compared the findings and reached consensus on all discrepancies before the final presentation of the data. Descriptive statistics evaluated the frequency of the data presented.
Results
Internal medicine, family medicine, neurology, pediatrics and geriatrics were the specialties that included mental health topics in their programs. In four countries: Bangladesh, Serbia, the Netherlands and France, 50%of all graduate specialty training programs include mental health content. In ten countries: Germany, Sweden, the United Kingdom, Mexico, Belgium, India, Russia, Canada, Israel and Spain, between 20% and 49% of all graduate specialty training programs include mental health content. In six countries - Brazil, Chile, Colombia, Croatia, Kenya, and the United States-less than 20% of all graduate specialty training programs include mental health content.
Discussion
The proposal that we have made in this article should be taken into account by decision-makers, in order to complement the different postgraduate training programs with mental health issues that are frequently present with other physical symptoms. It is not our intention that the different specialists know how to treat psychiatric comorbidities, but rather pay attention to their existence and implications in the diagnosis, evolution and prognosis of many other diseases. The current fragmentation of medicine into ever finer specialties makes the management of comorbidity ever more difficult: a reorientation of post- graduate training might improve the situation.
Background: Brain-gut interaction involves, among others, peptidergic
growth factors which are native in GI tract and have strong antiulcer potency and
thus could from periphery beneficially affect ...CNS-disorders. We focused on the
stable gastric pentadecapeptide BPC 157, an antiulcer peptidergic agent, safe in
inflammatory bowel disease trials and now in multiple sclerosis trial, native and
stable in human gastric juice.
Methods: Review of our research on BPC 157 in terms of brain-gut axis.
Results: BPC 157 may serve as a novel mediator of Robert's cytoprotection, involved
in maintaining of GI mucosa integrity, with no toxic effect. BPC 157 was successful
in the therapy of GI tract, periodontitis, liver and pancreas lesions, and in the healing of various tissues
and wounds. Stimulated Egr-1 gene, NAB2, FAK-paxillin and JAK-2 pathways are hitherto implicated.
Initially corresponding beneficial central influence was seen when BPC 157 was given peripherally and a
serotonin release in particular brain areas, mostly nigrostriatal, was changed. BPC 157 modulates
serotonergic and dopaminergic systems, beneficially affects various behavioral disturbances that
otherwise appeared due to specifically (over)stimulated/damaged neurotransmitters systems. Besides,
BPC 157 has neuroprotective effects: protects somatosensory neurons; peripheral nerve regeneration
appearent after transection; after traumatic brain injury counteracts the otherwise progressing course, in
rat spinal cord compression with tail paralysis, axonal and neuronal necrosis, demyelination, cyst
formation and rescues tail function in both short-terms and long-terms; after NSAIDs or insulin overdose
or cuprizone encephalopathies were attenuated along with GI, liver and vascular injuries.
Conclusion: BPC 157, a gastric peptide, may serve as remedy in various CNS-disorders.
Purpose of review
Despite a significant body of literature related to the treatment of gambling disorder, there are still an insufficient number of evaluation studies regarding their effectiveness or ...firm conclusions on specific treatment elements that contribute to it. The aim of this article was to provide a review of scientific results regarding the treatment of gambling disorder, to present the most commonly applied modalities of treatment and to explore the elements of the most successful therapeutic interventions.
Recent findings
A substantial body of literature has shown that the most successful therapeutic protocols are psychological interventions, especially based on cognitive-behavioral therapy/methods and/or motivational interviewing. Other interventions with promising results include different self-help interventions and mindfulness. Interventions such as couples therapy and support groups, may have positive effects in terms of increasing therapeutic adherence and retention, while pharmacotherapy is especially useful in patients with comorbidities.
Summary
Gambling disorder is a complex mental health problem caused by a wide spectrum of different biological, psychological, and social risk factors. Treatment options for gambling disorder need to be wide, flexible, accessible, and economically justified, providing early inclusion, retention, and sustainability of long-term effects of the treatment, that is, abstinence and higher quality of psychosocial functioning.
PURPOSE OF REVIEWDespite of the heightened risks and burdens of physical comorbidities across the entire spectrum of mental disorders, relatively little is known about physical multimorbidity in this ...population. The aim of this narrative review is to present recent data regarding the onset and accumulation of physical multimorbidity and to assess its impact on the onset, course, treatment, and outcomes of mental disorders.
RECENT FINDINGSA substantial body of literature shows increased risk of physical multimorbidity among people with mental disorders. The disparity in physical multimorbidity occurs even before the diagnosis of mental disorder, and the younger age group appears to be at particular risk. Numerous patterns of association between mental disorders and medical disorders involving multiple organ systems have been identified. Physical multimorbidity affects people with mental disorders across their life spans, is associated with a wide range of unfavorable outcomes and presents significant clinical and public health concerns.
SUMMARYTo address physical health inequalities among people with mental disorders compared with the general population, we must focus on the physical health from the very first point of contact with a mental health service. Treatment of mental disorders must be customized to meet the needs of patients with different physical multimorbidity patterns. Future work is needed to clarify how physical multimorbidity influences mental disorder treatment outcomes.
We attempted throughout the NO-system to achieve the particular counteraction of the ketamine-induced resembling “negative-like” schizophrenia symptoms in rats using pentadecapeptide BPC 157, and ...NO-agents, NG-nitro-L-arginine methylester (L-NAME), and/or L-arginine, triple application. This might be the find out the NO-system organized therapy (i.e., simultaneously implied NO-system blockade (L-NAME) vs. NO-system over-stimulation (L-arginine) vs. NO-system immobilization (L-NAME+L-arginine)). The ketamine regimen (intraperitoneally/kg) included: 3 mg (cognitive dysfunction, novel object recognition test), 30 mg (anxiogenic effect (open field test) and anhedonia (sucrose test)), and 8 mg/3 days (social withdrawal). Medication (mg/kg intraperitoneally) was L-NAME (5), L-arginine (100), and BPC 157 (0.01), alone and/or together, given immediately before ketamine (L-NAME, L-arginine, and combination) or given immediately after (BPC 157 and combinations). BPC 157 counteracted ketamine-cognition dysfunction, social withdrawal, and anhedonia, and exerted additional anxiolytic effect. L-NAME (antagonization, social withdrawal) and L-arginine (antagonization, cognitive dysfunction, anhedonia) both included worsening cognitive dysfunction, anhedonia, and anxiogenic effect (L-NAME), social withdrawal, and anxiogenic effect (L-arginine). Thus, ketamine-induced resembling “negative-like” schizophrenia symptoms were “L-NAME non-responsive, L-arginine responsive” (cognition dysfunction), “L-NAME responsive, L-arginine non-responsive” (social withdrawal), “L-NAME responsive, L-arginine responsive, opposite effect” (anhedonia) and “L-NAME responsive, L-arginine responsive, parallel effect” (both anxiogening). In cognition dysfunction, BPC 157 overwhelmed NO-agents effects. The mRNA expression studies in brain tissue evidenced considerable overlapping of gene overexpression in healthy rats treated with ketamine or BPC 157. With the BPC 157 therapy applied immediately after ketamine, the effect on Nos1, Nos2, Plcg1, Prkcg, and Ptgs2 (increased or decreased expression), appeared as a timely specific BPC 157 effect on ketamine-specific targets.