Effects of Duloxetine on Gastrointestinal Symptoms, Depression, Anxiety, Stress, and Quality of Life in Patients with the Moderate-to-Severe Irritable Bowel Syndrome.

Background: Irritable bowel syndrome (IBS) is a chronic disease. There are very few studies on the Duloxetine efficacy in improving the gastrointestinal and psychological symptoms, in IBS. The current study attempted to evaluate the effectiveness of Duloxetine in symptoms and quality of life in moderate-to-severe IBS patients. Materials and Methods: This is a double-blind placebo-controlled clinical trial in which the population is composed of 37 patients with moderate-to-severe IBS in Isfahan from March 2018 to March 2019. For the intervention group, Duloxetine was administered for three months, and the treatment protocol was the same for the control group but using a placebo. The severity of IBS symptoms, quality of life, and negative emotions such as depression, anxiety, and stress were assessed. Results: Our data showed no significant difference between the two groups of the study for the severity of IBS symptoms (P value = 0.150); however, in the intervention group, it was significantly lower than controls after six, eight, and ten weeks of the intervention (P value = 0.023). Overall evaluation of the quality of life in patients indicated significantly higher quality of life in the Duloxetine group than the control group from the eighth week to the twelfth week after the intervention (P value <0.038). Anxiety and stress in the Duloxetine group were significantly lower than controls after the intervention (P value <0.05). Conclusion: Duloxetine is probably helpful for reducing anxiety, stress, and the severity of symptoms in IBS patients. It also could increase the quality of life in patients.

Impacts of bioreactor operating parameters on removal efficiency, biodegradation rate, molecular distribution, and toxicity of commercial naphthenic acids.

Effects of naphthenic acids (NAs) concentration (50-200 mg NA L-1; 35-140 mg TOC L-1) and loading rate (1.4-1249 mg NA L-1 h-1; 1-874 mg TOC L-1 h-1) on removal efficiency, removal rate, and molecular distribution of NAs, and effluent toxicity were evaluated for biodegradation of commercial NAs mixture in circulating packed bed bioreactors (CPBBs). Increase of NAs concentration and loading rate (shorter residence times) increased the removal rate, while removal efficiency initially declined and then stabilized. The maximum biodegradation rates for 50, 100, 150, and 200 mg NA L-1 were 128.0, 321.7, 430.2, and 630.0 mg TOC L-1 h-1 at loading rates of 218.5, 455.6, 673.5 and 874.0 mg TOC L-1 h-1, respectively, with removal efficiencies of 58.6, 70.6, 63.9 and 72.1%. Analysis of influent and treated effluents with gas chromatography-mass spectrometry showed that molecular weight and cyclicity (C and Z numbers) affected the biodegradation, with low molecular weight acyclic NAs (C = 6-12) were the most amenable to biodegradation and those with intermediate and high molecular weights (C = 13-22) and moderate cyclicity (Z = - 4, - 6) were the most recalcitrant. In the biofilm, Proteobacteria and Actinobacteria were the most abundant phyla, and Alphaproteobacteria, Betaproteobacteria, and Gammaproteobacteria were the dominant classes. Toxicity analyses with Artemia salina and Vibrio fischeri (Microtox) showed that high influent concentrations and loading rates (short residence times) led to higher NAs residual concentration and effluent toxicity. To design and operate large-scale CPBBs, intermediate loading rates and residence times that result in high removal efficiency, reasonable removal rates, and low toxicity are recommended.

Role of Traumatic Events and Motivational Structure in Ambiguity Tolerance of Irritable Bowel Syndrome.

Background: The main purpose of this study was to delineate the role of motivational structure and traumatic events in the prediction of ambiguity tolerance in patients with irritable bowel syndrome (IBS). Methods: A total of 200 patients with the diagnosis of IBS, referred to the Shariati hospital in 2018, were enrolled using a correlational design and convenience sampling. All participants were asked to complete the ambiguity tolerance questionnaire, the life event checklist, and the personal concerns inventory. Data analysis was performed by Pearson correlation method and regression analysis test in SPSS software. Results: Findings showed that there was a significant relationship between traumatic events (r=- 0.66, P=0.01) and adaptive (r=0.24, P=0.01) and non-adaptive motivational structure (non-AMS) (r=- 0.10, P=0.01) with tolerance of ambiguity (P<0.05). With increasing non-AMS and with decreasing non-AMS and traumatic events, the tolerance of ambiguity is increased. Moreover, the motivational structure (adaptive and non-adaptive) and traumatic events could define and predict 43% of the variance in ambiguity tolerance. Conclusion: Thus, regarding the important role of motivational structure and traumatic events in predicting ambiguity tolerance in IBS patients, it is prudent to put emphasis on these measures to improve patients' overall health and probably alleviate symptoms and provide psychologic rehabilitation.

Psychometric Properties of the Persian Version of Screening for Somatic Symptom Disorders-7(SOMS-7).

Objective: Somatic symptoms are one of the most prevalent complaints in both psychiatric and general population, and validated scales are required to assess these problems. The present study was conducted to determine psychometric properties of the Persian version of Screening for Somatic Symptom Disorders-7(SOMS-7) in an Iranian population. Method : This was a multi centric comprehensive study conducted in Psychosomatic Research Center of Isfahan University of Medical Sciences in collaboration with Department of Clinical Psychology of Philipp University of Marburg, Germany. This part of the study includes 100 patients with anxiety/mood disorders and 291 healthy individuals. All participants completed the Patient Health Questionnaire (PHQ-15) and Screening for Somatic symptom disorders 7(SOMS-7). Data were analyzed by Pearson and Spearman correlation coefficient, factor analysis, independent t test, and discriminant analysis using SPSS-20 software. Results: Reliability coefficient based on Cronbach's alpha was 0.92 and 0.94 (clinical vs. healthy sample). Validity index of the SOMS according to correlation between factor 1 and 2 with PHQ somatic subscale was. 51 and. 59, respectively. Score of 15.5 as cut-off point was accompanied with sensitivity of 77% and specificity of 66%. Factor analysis extracted 2 factors in patients and 4 factors in healthy population. Conclusion: Findings of this study indicated that the Persian version of SOMS-7 has appropriate reliability and validity for the assessment of somatic symptoms disorder and evaluation of treatment effects in these patients.

Effects of rivastigmine on memory and cognition in multiple sclerosis.

BACKGROUND: Cognitive dysfunction is one of the common clinical symptoms in multiple sclerosis (MS), but there is no effective treatment for it. OBJECTIVE: The aim of this study was to evaluate the effect of rivastigmine in treating memory and cognitive dysfunction in MS. METHODS: A single-center double-blind placebo-controlled randomized clinical trial conducted from October 2005 to February 2007. Sixty definite MS patients with cognitive impairment age 16 to 54 years were randomly allocated to receive a 12-week treatment course of either rivastigmine (1.5 mg once a day increment over 4 weeks to 3 mg twice daily) or placebo. Response to treatment was assessed by the Wechsler Memory Scale (WMS) at baseline and 12 weeks after start of therapy. RESULTS: A slight, but significant memory improvement occurred in both groups. Of the 30 patients treated with rivastigmine, the mean (SD) WMS general memory score increased from 60.3 (4.2) at baseline to 64.9 (5.3) at the end of study period (P<0.001). Correspondingly, in the 30 patients treated with placebo, the mean (SD) WMS general memory score increased from 60.5 (4.9) to 64.5 (3.7) (P < 0.001). The average WMS general memory score at the end of trial did not changed between rivastigmine and placebo group (mean difference, 0.4; 95% CI, -2.0, 2.8). CONCLUSION: No significant differences were seen between rivastigmine and placebo on the mean (SD) WMS general memory score. A larger multicenter study of rivastigmine in MS is warranted in order to more definitely assess the efficacy of this intervention.