BackgroundProbiotics have generated intensive research interest in recent years as a novel mode of treatment for physical and mental illness. Nevertheless, the anxiolytic potential of probiotics remains unclear. The present systematic review and meta-analysis aimed to evaluate the clinical and preclinical (animal model) evidence regarding the effect of probiotic administration on anxiety.MethodsThe PubMed, PsycINFO, and Web of Science databases were reviewed for preclinical and clinical studies that met the defined inclusion and exclusion criteria. The effects of probiotics on anxiety-like behavior and symptoms of anxiety were analyzed by meta-analyses. Separate subgroup analyses were conducted on diseased versus healthy animals, specific preclinical probiotic species, and clinical versus healthy human samples.ResultsData were extracted from 22 preclinical studies (743 animals) and 14 clinical studies (1527 individuals). Overall, probiotics reduced anxiety-like behavior in animals (Hedges’ g = -0.47, 95% CI -0.77 –-0.16, p = 0.004). Subgroup analyses revealed a significant reduction only among diseased animals. Probiotic species-level analyses identified only Lactobacillus (L.) rhamnosus as an anxiolytic species, but these analyses were broadly under-powered. Probiotics did not significantly reduce symptoms of anxiety in humans (Hedges’ g = -0.12, 95% CI -0.29–0.05, p = 0.151), and did not differentially affect clinical and healthy human samples.ConclusionsWhile preclinical (animal) studies suggest that probiotics may help reduce anxiety, such findings have not yet translated to clinical research in humans, perhaps due to the dearth of extant research with clinically anxious populations. Further investigation of probiotic treatment for clinically relevant anxiety is warranted, particularly with respect to the probiotic species L. rhamnosus.
Leiomyosarcoma, a malignant neoplasm of smooth muscle, accounts for 7% of the sarcomas. Patients with leiomyosarcoma tumors have an average survival of 5 years. These tumors, which are derived from mesenchymal tissues, are difficult to diagnose and treatment options remain controversial. The relatively rare incidence of this soft tissue sarcoma subtype has limited the number of patients available for studies and research. This study examines whether the imaging characteristics of positron emission tomography (PET) with radiolabeled fluorodeoxyglucose (FDG) provide a reliable, noninvasive means to predict tumor behavior in patients with leiomyosarcomas. 18F-FDG PET was performed on the tumors of participating patients before the neoadjuvant chemotherapy or resection, and a maximum tumor standard uptake value (SUV max ) was calculated. The SUV max was correlated with tumor grade (P=0.001) and tumor size as greatest dimension (Pλ=λ0.004). Analysis of this data indicated the potential effectiveness of FDG PET imaging in predicting tumor grade. In leiomyosarcoma, the SUV max from FDG PET is a likely predictor of tumor behavior. Improvements made in the clinical treatment of leiomyosarcomas by use of FDG PET imaging data may lead to an increase in patient survival.
Background:Synovial chondromatosis (SCh) can undergo malignant transformation. Pathologic diagnosis of secondary synovial chondrosarcoma (SChS) is challenging and misdiagnosis may result in over- or undertreatment.Method:A systematic review revealed 48 cases of SChS published in 27 reports since 1957. Data was collected to identify findings indicative of SChS and outcomes of treatment.Results:At median follow-up of 18 months, patients were reported as alive (10%), alive without disease (22%), alive with disease (15%), dead of disease (19%), dead of pulmonary embolism (4%), and unknown (29%). Initial diagnosis of SChS (grade: low/unknown 48%, intermediate/high 52%) was after biopsy in 58%, local resection in 29%, and amputation in 13%. Seventy-four percent of patients underwent 1.8 (mean) resections. Patients treated prior to 1992 were managed with amputation in 79% of cases compared to 48% after 1992. Symptoms were present for 72 mos prior to diagnosis of SChS.Synovial chondrosarcoma demonstrated symptom progression over several months (82%), rapid recurrence after complete resection (30%), and medullary canal invasion (43%). The SChS tumor dimensions were seldom quantified.Conclusion:Malignant degeneration of synovial chondromatosis is rare but can necessitate morbid surgery or result in death. Pathognomonic signs for SChS including intramedullary infiltration are present in the minority of cases. Progression of symptoms, quick local recurrence, and muscle infiltration are more suggestive of SChS. Periarticular cortical erosion, extra-capsular extension, and metaplastic chondroid features are non-specific. Although poorly documented for SChS, tumor size is a strong indicator of malignancy.Biopsy and partial resection are prone to diagnostic error. Surgical decisions are frequently based on size and clinical appearance and may be in conflict with pathologic diagnosis.
Fifty-one youth athletes (n ϭ 27 female, age ϭ 14.53 years, SD ϭ 1.85) presented to a local hospital outpatient concussion clinic on average 7.67 days postconcussion for standard medical assessment, including the self-report Sport-Concussion Assessment Tool-2 (Time 1). They completed follow-up symptom assessments at Time 2 (7.48 Ϯ 1.24 days after Time 1) and Time 3 (7.63 Ϯ 1.42 days after Time 2). We assessed the relations between theoretically relevant personal and situational variables, assessed at Time 2, and concussion symptom reports at Time 2 and Time 3. Using hierarchical regression, we also assessed relations between personal/situational factors and changes in symptom intensity from Time 1 to Time 2, Time 1 to Time 3, and Time 2 to Time 3, controlling for Time 1 postconcussion symptom intensity, age, gender, concussion history over the past 12 months, and the number of days since sustaining the current concussion. Controlling for these factors, the combined influence of the psychosocial factors predicted 43% of the variance in symptom expression at Time 3. Psychosocial factors also accounted for 27% of the variance in symptom change from Time 1 to Time 2, and 23% of the variance in symptom change from Time 1 to Time 3. Athletic identity, performance anxiety, and amotivation were the most consistent and influential person variables, each being related to more intense symptom reports and slower recovery. Results suggest the potential importance of psychological factors in concussion recovery.
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