Can dose reduction be made in patients with allergic bronchopulmonary aspergillosis receiving high-dose omalizumab treatment?

Summary

Background. Allergic bronchopulmonary aspergillosis (ABPA) is an endotype of severe asthma which frequently needs biologics for their steroid sparing effect. We aimed to evaluate the outcomes of reducing the omalizumab dose in patients with ABPA who were on long-term omalizumab treatment. Methods. Once asthma was controlled, two approaches were used to reduce total monthly omalizumab dose: 1) both extending dose intervals from 2 to 4 weeks and decrease omalizumab dose, 2) to reduce omalizumab dose while keeping dose intervals stable. Results. Thirteen patients with ABPA (8F/5M, mean age 53.4 ± 13.0 years) were included. Pre-omalizumab, mean numbers of attacks and hospitalizations were 2.5 ± 1.5 and 1.3 ± 0.8, mean oral corticosteroid (OCS, as methylprednisolone) dose was 12.2 ± 10.4 mg daily. First omalizumab dose reduction was made to all patients at a median time of 35 months (min 13, max 47). The 2nd dose reduction was made in four patients at median of 23.5 months. Mean OCS decreased to 0.69 ± 0.95 mg/day (p = 0.001) in the 1st year of omalizumab, could be stopped in 11 patients in last evaluation. Attacks/hospitalizations decreased significantly to 0.31 ± 0.86 and 0, respectively, in the 1st year of omalizumab. Total omalizumab dose was reduced by median 40% (min 20, max 60) in 1st intervention and 50% (min 20, max 67) after 2nd intervention. After omalizumab dose reduction, asthma control did not deteriorate and there was no need to increase the omalizumab or OCS-dose. Conclusions. Decreasing the total omalizumab dose does not cause clinical deterioration in ABPA after the disease is controlled.

The effect of emotion recognition and mindfulness on depression symptoms: A case-control study

Introduction

Abnormalities in emotion recognition (ER) are frequently reported in depression, with lowered recognition accuracy in patients with major depressive disorder (MDD) when compared to healthy individuals. Mindfulness was found to directly impact the severity of depressive symptoms, by negative cognition and dysfunctional reaction recognition.

Objectives

The aims of this study were to compare ER and mindfulness levels between MDD patients and healthy controls (HC), as well as to examine whether ER and mindfulness are related to symptom severity in MDD patients.

Methods

68 patients with MDD and 93 HC participated in the study. A sociodemographic form, Reading the Mind in the Eyes Test (RMET), Five Facet Mindfulness Questionnaire-Short Form (FFMQ-S) and the Montgomery Asperg Depression Scale (MADRS) were administered. Group comparison in ER and mindfulness was assessed using the Multivariate analysis of covariance (MANCOVA). Bivariate correlations and multiple linear regression analyses were performed to assess the associations between depression severity, ER and mindfulness in the patient group.

Results

Better ER and higher levels of mindfulness were found in HCs relative to the MDD group. A positive association between depression severity and the non-reactivity facet of mindfulness was found, indicating that in the MDD group non-reactivity was a significant predictor for depression severity. On the other hand, ER was not significant in predicting symptom severity.

Conclusions

Non-reactivity, unlike other dimensions of mindfulness, seems to increase with the severity of depressive symptoms among MDD patients. To particularly focus on this subdimension in mindfulness techniques may yield better outcomes in alleviation of depressive symptoms.

Disclosure

No significant relationships.

The evaluation of the effect of mindfulness and metacognition on anxiety symptoms: A case-control study

Introduction

Anxiety disorders (ADs) are pervasive, detrimental, and associated with numerous psychiatric disorders; however, their etiology and effective treatment strategies are not yet fully explored.

Objectives

We aimed to study whether the symptom severity of ADs is related to mindfulness and metacognition among adults. In addition, we wanted to compare metacognition and mindfulness between patients with ADs and healthy controls (HC).

Methods

Two hundred participants were enrolled in this study. Structured clinical interview, sociodemographic form, Five Facet Mindfulness Questionnaire-Short Form (FFMQ-S), Metacognition Questionnaire-30 (MCQ-30), and Hamilton Anxiety Rating Scale (HAM-A) were administered. Multivariate analysis of covariance (MANCOVA) was conducted to compare the groups in terms of mindfulness and metacognition. Correlation and multiple linear regression analyses were performed to measure the association between anxiety symptom severity, mindfulness, and metacognition.

Results

The main finding indicates that Positive Beliefs about Worry are associated with reduced symptom severity of ADs. Furthermore, the results suggest that HC have more Positive Beliefs about Worry and Nonjudging of Inner Experience compared to patients with ADs, who use Negative Beliefs about Uncontrollability and Danger and Need to Control Thoughts to a greater extent.

Conclusions

This study suggests that dysfunctional metacognitive beliefs may influence symptom severity of ADs among adults. We advise that focusing on reducing maladaptive metacognitions may be beneficial while treating ADs in adults

Disclosure

No significant relationships.

Psychometric validation of the desire thinking questionnaire in a Turkish adolescent sample: Associations with internet gaming disorder

BACKGROUND

Desire thinking is a conscious and voluntary cognitive process that consists of perseverative focus on information, memories, and prefiguration of images related to a desired target. The Desire Thinking Questionnaire (DTQ) is acknowledged as a reliable and valid tool to measure desire thinking in both adults and adolescents. The aim of the present study was to examine the psychometric properties of the DTQ in Turkish adolescent sample.

METHODS

A convenience sample of 200 adolescents completed the Turkish version of the DTQ (DTQ-T) and an Exploratory Factor Analysis (EFA) was performed. Subsequently, a convenience sample of 701 adolescents completed the DTQ-T and a battery of questionnaires assessing personality traits, affect, boredom, impulsivity, and Internet Gaming Disorder (IGD). A Confirmatory Factor Analysis (CFA) was performed on the DTQ-T and validity was determined by examining correlations with other measures.

RESULTS

A 9-item two-factor structure was observed in the EFA. An 8-item two-factor structure was established in the CFA. Results demonstrated that the DTQ-T yields adequate levels of reliability and concurrent validity. Additionally, an examination of incremental validity showed that DTQ-T significantly predicted IGD when controlling for personality traits, affect, boredom, and impulsivity.

CONCLUSIONS

The 8-item DTQ-T was found to be a reliable and valid measure of desire thinking among Turkish adolescents. Desire thinking may be a feasible target for mental health workers to alleviate the symptoms of IGD.

The predictor role of metacognition and emotion recognition in internet gaming disorder among late adolescents

Introduction

Internet gaming is acknowledged as a common leisure activity among adolescents yet only a little known about the pscyhodevelopmental roots. Emotion recognition and metacognition which are proved to be determinants in behavioral disorders may be considered salient factors in also internet gaming disorder (IGD).

Objectives

The research to date has focused on psychological comorbidities rather than risk factors (e.g. dysfunctional metacognitive beliefs, emotion recognition deficits), whereas, improved early intervention would be more likely if risk factors were well defined, especially before the onset of the illness. The objective of this study was to investigate these areas by analyzing associations between metacognitive beliefs, emotion recognition, and IGD among late adolescents with tendency for pathological gaming behavior.

Methods

806 high school students were recruited and instructed to take Internet Gaming Disorder Scale (IGDT), Meta-Cognitions Questionnaire for Children and Adolescents (MCQ-C) and Reading the Mind in the Eyes Test - Children’s Version (RMET).

Results

Mean comparisons corresponding to IGD risk potential showed that positive meta-worry and superstitious, punishment, and responsibility beliefs of MCQ-C were significantly higher in the risky group, whereas; RMET neutral subtest was significantly higher in the non-risky group. Additionally, a positive correlation was found in all subtests of MCQ-C, RMET positive emotions and IGD. Regression analysis revealed that RMET positive subtest and positive meta-worry of MCQ-C predict IGD risk.

Conclusions

The findings of the study partially corroborated the early results found among early adolescents; however, they also indicated the requirement of distinct therapeutic approach for cognitive interventions of IGD in late adolescence period.

Disclosure

No significant relationships.

The relationship between cognitive test anxiety and mindfulness among university students

Introduction

Cognitive test anxiety is acknowledged as intense anxiety that prevents the effective use of the previously learned knowledge during the exam and leads to a decrease in success. Mindfulness is indicated as the ability to bring one’s attention to experiences in the present moment in a non-judgmental way. Despite promising outcomes of mindfulness techniques in regulating stress levels, much uncertainty still exists about the specific associations between cognitive test anxiety and mindfulness subcategories.

Objectives

The aim of this study was to investigate the relationship between cognitive test anxiety and subcategories of mindfulness among university students which may help improving current mindfulness interventions that show promising results to tackle cognitive test anxiety.

Methods

One hundred-eighty-two university students were recruited for the study via online forms. Mindfulness was measured with Five Facet Mindfulness (FFMQ-S) and the cognitive test anxiety was assessed with Cognitive Test Anxiety Scale-Revised (CTAR).

Results

Total scores of CTAR-R has an association between subscales of FFMQ; act-aware and non-judge in a positive direction, whereas; observe and describe in a negative direction. In addition, according to our regression model, FFMQ subscales of describing to indicated lower levels of CTAR scores, whereas act aware and non-judge indicated higher levels of CTAR scores.

Conclusions

The findings of the study partially corroborated the previous results by offering inferences about the subcategories of mindfulness. Additionally, these findings suggest that current interventions may target specific subcategories of mindfulness to maximize the positive outcomes of the treatment.

Disclosure

No significant relationships.

Effects of tamoxifen on survival of cutaneous and myocutaneous flap (experimental study)

OBJECTIVES

Breast cancer is the most common non-skin malignancy in women. In breast cancer, the basic principle of endocrine therapy is to deprive tumor cell from the growth-stimulating effect of estrogens. The oldest, best-known and most widely used endocrine therapy medicine is tamoxifen, which is a selective estrogen receptor blocker. All factors that are known to have adverse effects on flap and pre-reconstruction flap survive should be eliminated 3 weeks before the surgery and started at the end of the 3rd week after the surgery. When the literature is reviewed, there are limited studies about that tamoxifen increases the risk of deep vein thrombosis and pulmonary embolism. The aim of this study was to research whether tamoxifen had adverse effects on the skin flap and muscle-skin flap survive.

MATERIALS AND METHODS

In this study, 32 female Sprague-Davley rats were used. Their weights ranged from 220 to 250 g. 4 groups, each consisting of 8 rats, were formed. In this experimental study, in which rat models were used caudal based rat dorsal skin flap and superior pedicle rectus abdominis musculocutaneous flaps were applied. Control groups were formed for both flap models. Study groups were treated with tamoxifen citrat and control groups were treated with placebo.

RESULTS

As a result of the statistical evaluation done by measuring the surviving flap areas, it was found out that tamoxifen had no negative effect on flap survive.

CONCLUTIONS

Based on these findings, it was concluded that there was no need to stop tamoxifen as long as 6-7 weeks in patients undergoing breast reconstruction with pedicle flap techniques.