Decrease in Salivary Serotonin in Response to Probiotic Supplementation With Saccharomyces boulardii in Healthy Volunteers Under Psychological Stress: Secondary Analysis of a Randomized, Double-Blind, Placebo-Controlled Trial.

Background: Bacterial probiotics are thought to exert a serotonergic effect relevant to their potential antidepressant and pro-cognitive action, but yeast probiotics have not been tested. The aim of the present study was to determine whether 30-day supplementation with Saccharomyces boulardii affects the level of salivary serotonin under psychological stress and identify the factors associated with it. Methods: Healthy medical students were randomized to ingest Saccharomyces boulardii CNCM I-1079 or placebo before a stressful event. Salivary serotonin concentration was assessed before and at the end of supplementation. Moreover, obtained results were compared to psychological, biochemical, physiological and sociodemographic study participants data. Results: Data of thirty-two participants (22.8 ± 1.7 years of age, 16 males) was available for the main analysis. Supplementation with Saccharomyces boulardii decreased salivary serotonin concentration under psychological stress by 3.13 (95% CI 0.20 to 6.07) ng/mL, p = 0.037, as compared to placebo. Salivary serotonin was positively correlated with salivary metanephrine (ß = 0.27, 95% CI 0.02 to 0.52, p = 0.031) and pulse rate (ß = 0.28, 95% CI 0.05 to 0.50, p = 0.018), but insignificantly with anxiety, depression, eating attitudes and information retrieval. Conclusions: Saccharomyces boulardii CNCM I-1079 may be distinct from bacterial probiotics in its salivary serotonergic effect, which appears positively linked to symapathoadrenal markers. The study requires cautious interpretation, and further investigation.

Effect of Supplementation with Saccharomyces Boulardii on Academic Examination Performance and Related Stress in Healthy Medical Students: A Randomized, Double-Blind, Placebo-Controlled Trial.

In recent years, bacterial probiotic dietary supplementation has emerged as a promising way to improve cognition and to alleviate stress and anxiety; however, yeast probiotics have not been tested. The aim of the present study was to determine whether 30-day supplementation with Saccharomyces boulardii enhances academic performance under stress and affects stress markers. The trial was retrospectively registered at clinicaltrials.gov (NCT03427515). Healthy medical students were randomized to supplement their diet with Saccharomyces boulardii CNCM I-1079 or placebo before sitting for an academic examination, which served as a model of stress. The grades of a final examination adjusted to subject knowledge tested in non-stressful conditions was used as a primary outcome measure. Psychometrically evaluated state anxiety, cortisol and metanephrine salivary levels, and pulse rate were tested at a non-stressful time point before the intervention as well as just before the stressor. Fifty enrolled participants (22.6 ± 1.4 years of age, 19 males) completed the trial in the Saccharomyces and placebo arms. Supplementation with Saccharomyces did not significantly modify examination performance or increase in state anxiety, salivary cortisol, and metanephrine. However, the intervention resulted in higher increase in pulse rate under stress as compared to placebo by 10.4 (95% CI 4.2-16.6) min-1 (p = 0.0018), and the effect positively correlated with increase in salivary metanephrine (Pearson's r = 0.35, 95% CI 0.09-0.58, p = 0.012). An intention-to-treat analysis was in line with the per-protocol one. In conclusion, supplementation with Saccharomyces boulardii CNCM I-1079 appears largely ineffective in improving academic performance under stress and in alleviating some stress markers, but it seems to increase pulse rate under stress, which may hypothetically reflect enhanced sympathoadrenal activity.

Duration of breastfeeding and psychomotor development in 1-year-old children - Polish Mother and Child Cohort Study.

OBJECTIVES: The objective of this study was to evaluate the association between breastfeeding duration and child neurodevelopment based on the Polish Mother and Child Cohort Study. MATERIAL AND METHODS: The current analysis included 501 mother-child pairs. The analysis evaluating the association between the length of breastfeeding and child neurodevelopment considered the following variables: maternal age and body mass index, weight gain during pregnancy, parental level of education, marital status, socioeconomic status, child gender, birthweight, type of delivery, preterm delivery, pre- and postnatal exposure to tobacco constituents and child day care attendance. Psychomotor development was assessed in 1-year-olds on the Bayley Scales of Infant and Toddler Development. RESULTS: The length of breastfeeding correlated positively with maternal age at delivery (ρ = 0.13), maternal and paternal level of education (ρ = 0.2 and ρ = 0.14 respectively), birthweight (ρ = 0.1) and marital status (ρ = 0.16) (p < 0.05). A negative correlation between the length of breastfeeding and maternal smoking status during the first year after delivery (ρ = -0.19) and weight gain during pregnancy (r = -0.1) was observed (p < 0.05). The association between the duration of breastfeeding and child development was not statistically significant in the model with the inclusion of confounding variables. A significant association between language development and maternal level of education (p = 0.004), gender of the child (p = 0.0007) and maternal weight gain during pregnancy (p = 0.01) was found. A negative association between cognitive development and maternal salivary cotinine during pregnancy (p = 0.03) and a negative association between motor development and maternal smoking status during the first year after delivery (p = 0.007) were also found. CONCLUSIONS: This study found no significant association between the duration of breastfeeding and child development after adjustment for confounders. Int J Occup Med Environ Health. 2019;32(2):175-84.

Anxiety and depression levels in rheumatoid arthritis patients before and after joint replacement procedure.

The progression of the inflammatory process in the course of rheumatoid arthiritis (RA) may cause a permanent destruction of joints, which in case of bigger ones (i.e. hip or knee) may be particularly a psychological burden for a patient. AIM: The aim of the study was to verify whether implantation of hip or knee endoprosthesis affect anxiety and depressive symptoms among patients with RA. MATERIALS AND METHODS: The study enrolled a group of 128 rheumatoid arthritis patients, including 64 patients before and 64 patients after the joint replacement procedure. Anxiety was assessed using State- Trait Anxiety Inventory and depression - Beck Depression Inventory. RESULTS: Patients before the endoprosthesis implantation scored statistically significantly higher on the state anxiety scale than patients after the procedure (43.17±10.69 vs 36.95±10.63, p<0.01). There was no statistically significant difference in trait anxiety scores between patients before and after alloplasty (p=0.28). Patients before the procedure scored statistically significantly higher on BDI than patients after the joint replacement (15.28±8.99 vs 11.48±8.45, p<0.05). CONCLUSIONS: Patients with RA after knee or hip alloplasty had lower levels of anxiety and depressive symptoms than patient before the procedure. Endoprosthesis implantation as a treatment option for severe joint destruction in RA might also improve depressive symptoms and anxiety among patients with RA.

Personality traits and styles of coping with stress in physicians.

UNLABELLED: The stress of being a doctor and being responsible for own decisions is one of the most intense feelings the doctors have to cope with. The stress coping styles are determined by the factors dependent on psychological variables such as personality. AIM: The aim of study was to assess the relation between personality traits and stress coping among physicians. MATERIALS AND METHODS: The study group consisted of 50 physicians (males n=25; 50%) employed in Norbert Barlicki Memorial Medical University Teaching Hospital No 1 in Lodz. The stress coping styles were assessed using Coping Inventory for Stressful Situations, whereas the tool used for personality assessment was NEO Five Factor Inventory of Personality. RESULTS: Task-oriented coping (TOC) was the predominant stress coping style among physicians (mean sten value 6.7±2.0; high sten scores - 8-10 in 38%). Among all dimensions of the doctors' personality, extraversion predominated significantly (mean sten value 9.7±0.7). Neuroticism correlated positively with emotional oriented coping (EOC) (r=0.43). Extraversion influenced more infrequent adoption of EOC by males (r=-0.43) and older subjects (≥44years) (r=-0.52). Conscientiousness influenced more frequent adoption of TOC by females (r=0.46). Both the doctors' age (r=-0.49 p<0.05)), and duration of employment (r=-0.49 p<0.05)) significantly correlated negatively with AOC. The doctors' gender did not affect their stress coping styles. CONCLUSIONS: Task oriented coping was the dominant stress coping style among physicians. High levels of neuroticism correlated positively, and those of extraversion negatively with the adoption of emotional oriented coping with stress. The tendency to choose the avoidance oriented coping decreases with the physicians' age and duration of employment.

Board game versus lecture-based seminar in the teaching of pharmacology of antimicrobial drugs--a randomized controlled trial.

The effectiveness of an educational board game developed to teach the pharmacology of antimicrobial drugs to medical students was compared with the lecture-based seminar as a supplemental tool to improve short- and long-term knowledge retention and the perception of the learning method by students. A group of 124 students was randomized to board game and control groups. Short-term knowledge retention was assessed by comparing differences in post- and pre-tests scores, and long-term knowledge retention by comparing final examination scores. Both didactic methods seem to improve short-term knowledge retention to similar extent. Long-term knowledge retention of board game seminar participants was higher than those who attended the lecture-based seminar (ANCOVA, P = 0.035). The effect was most pronounced within 14 days after the intervention (ANOVA, P = 0.007). The board game was well perceived by the students. The board game seems to be a promising didactic tool, however, it should be further tested to assess its full educational utility.

Selected factors determining a way of coping with stress in type 2 diabetic patients.

OBJECTIVES: The aim of the study was to examine factors which determine stress coping styles in type 2 diabetic (T2D) patients, with regard to selected demographic variables, clinical diabetes-related variables and selected psychical variables (anxiety level and assessment of depressive disorders). METHODS: 50 T2D patients, aged 59.9 ± 10.2 years were assessed by Coping Inventory for Stressful Situations (CISS), Spielberger State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). In the statistical analysis simple and multivariable logistic regression models were used. RESULTS: Variables significantly increasing the selection risk of stress coping style different from preferred task-oriented strategy in a simple logistic regression model are: hypoglycemia within three months prior to the research: odds ratio (OR) = 6.86 (95% confidence interval (CI) 1.25-37.61), taking antidepressants or neuroleptics: OR =15.42 (95% CI 2.42-98.33), severe depression in Beck's scale: OR = 84.00 (95% CI 6.51-1083.65), high state-anxiety level: OR = 9.60 (95% CI 1.08-85.16), and high trait-anxiety level: OR = 18.40 (95%CI 2.96-114.31), but in a multivariable model, diagnosed depression is the strongest factor: OR = 32.38 (95% CI 4.94-212.13). CONCLUSIONS: In T2D patients, the strategy to cope with stress appears to be mostly influenced by psychical predisposition.