Dose Escalation and Safety of Capsaicin for Cerebral Perfusion Augmentation: A Pilot Study.

Background and Purpose: Sphenopalatine ganglion (SPG) electrical stimulation has been studied in the setting of acute ischemic stroke to enhance collateral flow. Capsaicin poses an alternative to chemically stimulate the sphenopalatine ganglion. Therefore, the objective of this study was to determine the safety and effect of increasing doses of capsaicin upon serial transcranial Doppler markers of cerebral blood flow. Methods: We performed serial transcranial Doppler testing in 30 healthy volunteers divided into 5 equal groups. Capsaicin doses ranged from 33 to 165 µMol. We recorded peak systolic and end-diastolic velocities in the middle cerebral artery, arterial pressure, and perceived pungency in 5-minute intervals up to 20 minutes. We then calculated the mean velocity, the pulsatility index, and the cerebral blood flow index. Results: The participants' median age was 21 years (range, 5 years); all reported consumption of capsaicin in their diets. After and during the study, none reported side effects. Perceived pungency peaked at 5 minutes, and by the 20-minute mark, none perceived any pungency. All the tested doses produced the same pattern, consisting of augmentation of the middle cerebral artery mean velocity with the pulsatility index's diminution. The effects peaked between the 5- and the 10-minute measurements and then returned to basal levels except for the 66-µMol doses, which produced a sustained effect. We found no correlation between perceived pungency and dose, but the middle cerebral artery mean velocity was strongly correlated with the dose administered. Conclusions: This study provides evidence supporting the safety and tolerability of oral capsaicin in a population of healthy volunteers. Capsaicin appears to produce effects similar to those of sphenopalatine ganglion electrical stimulation. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04545892.

Gastric responses to acute psychological stress in climacteric women: a pilot study.

OBJECTIVE: Women exhibit reduced ovarian sex hormones during the menopausal period that result in well-known physical and psychological symptoms. However, symptoms related to gastric motility (GM) have not been thoroughly investigated. We hypothesized that stress response gastric motility (SRGM) is lower in postmenopausal (PM) and perimenopausal (PERIM) women than in premenopausal (PREM) women. Estrogenic decline leads to neuroendocrine changes in different areas of the brain. These changes can result in hypothalamic vasomotor symptoms, disorders in eating behaviours, and altered blood pressure, in addition to psychological disorders such as stress, anxiety, depression, and irritability related to alterations in the limbic system. METHODS: In this pilot study, 55 PREM, PERIM, and PM women were clinically evaluated using the Nowack stress profile (SP) and State-Trait Anxiety Inventory (STAI). GM was assessed via electrical bioimpedance using two psychological stress tests (Stroop and Raven tests). RESULTS: Basal SP and STAI-anxiety test scores were similar among the three groups of women (P > 0.05). PERIM women had lower GM in the basal state (P < 0.05) than did other women. PREM and PM women had significantly decreased GM during the stress tests (P < 0.05). However, PERIM did not exhibit GM changes during stress tests (P > 0.05). CONCLUSION: Changes in sex hormones during PERIM may affect GM and SRGM.

Effects of occupational stress on the gastrointestinal tract.

The aim of this review is to provide a general overview of the relationship between occupational stress and gastrointestinal alterations. The International Labour Organization suggests occupational health includes psychological aspects to achieve mental well-being. However, the definition of health risks for an occupation includes biological, chemical, physical and ergonomic factors but does not address psychological stress or other affective disorders. Nevertheless, multiple investigations have studied occupational stress and its physiological consequences, focusing on specific risk groups and occupations considered stressful. Among the physiological effects of stress, gastrointestinal tract (GIT) alterations are highly prevalent. The relationship between occupational stress and GIT diseases is evident in everyday clinical practice; however, the usual strategy is to attack the effects but not the root of the problem. That is, in clinics, occupational stress is recognized as a source of GIT problems, but employers do not ascribe it enough importance as a risk factor, in general, and for gastrointestinal health, in particular. The identification, stratification, measurement and evaluation of stress and its associated corrective strategies, particularly for occupational stress, are important topics to address in the near future to establish the basis for considering stress as an important risk factor in occupational health.

Electrical bioimpedance and other techniques for gastric emptying and motility evaluation.

The aim of this article is to identify non-invasive, inexpensive, highly sensitive and accurate techniques for evaluating and diagnosing gastric diseases. In the case of the stomach, there are highly sensitive and specific methods for assessing gastric motility and emptying (GME). However, these methods are invasive, expensive and/or not technically feasible for all clinicians and patients. We present a summary of the most relevant international information on non-invasive methods and techniques for clinically evaluating GME. We particularly emphasize the potential of gastric electrical bioimpedance (EBI). EBI was initially used mainly in gastric emptying studies and was essentially abandoned in favor of techniques such as electrogastrography and the gold standard, scintigraphy. The current research evaluating the utility of gastric EBI either combines this technique with other frequently used techniques or uses new methods for gastric EBI signal analysis. In this context, we discuss our results and those of other researchers who have worked with gastric EBI. In this review article, we present the following topics: (1) a description of the oldest methods and procedures for evaluating GME; (2) an explanation of the methods currently used to evaluate gastric activity; and (3) a perspective on the newest trends and techniques in clinical and research GME methods. We conclude that gastric EBI is a highly effective non-invasive, easy to use and inexpensive technique for assessing GME.

Effect of psychological stress on gastric motility assessed by electrical bio-impedance.

AIM: To evaluate gastric motility using electrical bio-impedance (EBI) and gastric changes as a result of stress induced by psychological tests. METHODS: A group of 57 healthy women, aged 40-60 years, was recruited, and a clinical history and physical examination were performed. The women were free from severe anxiety, chronic or acute stress, severe depression, mental diseases and conditions that affect gastric activity. The women were evaluated under fasting conditions, and using a four-electrode configuration, the gastric signals were obtained through a BIOPAC MP-150 system. The volunteers were evaluated using the following paradigm: basal state, recording during the Stroop Test, intermediate resting period, recording during the Raven Test, and a final resting period. We analyzed the relative areas of the frequency spectrum: A1 (1-2 cpm), A2 (2-4 cpm), A3 (4-8 cpm), and A4 (8-12 cpm), as well as the median of area A2 + A3. The data were analyzed by an autoregressive method using a Butterworth filter with MatLab and Origin. Analysis of variance (ANOVA) and Friedman ANOVA (for nonparametric variables) were performed; in addition, pairs of groups were compared using the T dependent and Wilcoxon T tests. RESULTS: The results of the main values of area A2 were not significantly different comparing the five steps of the experimental paradigm. Nevertheless, there was a tendency of this A2 region to decrease during the stress tests, with recuperation at the final resting step. When an extended gastric region was considered (1-4 cpm), significant differences with the psychological stress tests were present (F = 3.85, P = 0.005). The A3 region also showed significant changes when the stress psychological tests were administered (F = 7.25, P < 0.001). These differences were influenced by the changes in the adjacent gastric region of A2. The parameter that we proposed in previous studies for the evaluation of gastric motility by electrical bio-impedance (EBI) was the median of the area under the region from 2 to 8 cpm (A2 + A3). The mean values of these frequencies (median of the A2 + A3 area) with the stress test showed significant changes (F = 5.5, P < 0.001). The results of the Wilcoxon T test for the A4 area parameter, which is influenced by the breathing response, changed significantly during the Raven stress test (P < 0.05). CONCLUSION: We confirm that the gastric response to acute psychological stress can be evaluated by short-term EBI.

Effects of metoclopramide on gastric motility measured by short-term bio-impedance.

AIM: To analyze the accuracy of short-term bio-impedance as a means of measuring gastric motility. METHODS: We evaluated differences in the short-term electrical bio-impedance signal from the gastric region in the following conditions: (1) fasting state, (2) after the administration of metoclopramide (a drug that induces an increase in gastric motility) and (3) after food ingestion in 23 healthy volunteers. We recorded the real component of the electrical impedance signal from the gastric region for 1000 s. We performed a Fast Fourier Transform (FFT) on this data and then compared the signal among the fasting, medicated, and postprandial conditions using the median of the area under the curve, the relative area under the curve and the main peak activity. RESULTS: The median of the area under the curve of the frequency range in the region between 2-8 cycles per minute (cpm) decreased from 4.7 cpm in the fasting condition to 4.0 cpm in the medicated state (t = 3.32, P = 0.004). This concurred with the decrease seen in the relative area under the FFT curve in the region from 4 to 8 cpm from 38.3% to 26.6% (t = 2.81, P = 0.012) and the increase in area in the region from 2 to 4 cpm from 22.4% to 27.7%, respectively (t = -2.5, P = 0.022). Finally the main peak position also decreased in the region from 2 to 8 cpm. Main peak activity in the fasting state was 4.72 cpm and declined to 3.45 cpm in the medicated state (t = 2.47, P = 0.025). There was a decrease from the fasting state to the postprandial state at 3.02 cpm (t = 4.0, P = 0.0013). CONCLUSION: Short-term electrical bio-impedance can assess gastric motility changes in individuals experiencing gastric stress by analyzing the area medians and relative areas under the FFT curve.

Comparison of mood among male and female workers as a function of reproductive stage / Comparación del ánimo entre los trabajadores hombres y mujeres como una función de la etapa reproductiva

El propósito de este estudio fue comparar la frecuencia de alteraciones del estado de ánimo de los trabajadores masculinos y femeninos maduros. También se intentó demostrar la relación de los síntomas con algunos aspectos psicológicos como la autoestima de los voluntarios (AE), la satisfacción marital (SM) y las actitudes hacia la sexualidad (AHS). Materiales y métodos: En un diseño transversal, se determina la frecuencia de la depresión, la ansiedad, los síntomas no específicos de la depresión (SNED), MS, y los sentimientos de síndrome del nido vacío (SSNV) en 103 hombres y 129 mujeres de 40 a 64 años de edad. Depresión, los SNED y la ansiedad fueron evaluados según los criterios DSM-III-R calificados con la prueba de Bech-Rafaelsen Hamilton. La AE se evaluó con la prueba Coopersmith, AHS y SSNV con un cuestionario previamente validado y SM con la prueba de selección De Weiss. Las mujeres se dividieron en función de su último período menstrual en pre, peri y postmenopáusicas. Resultados: Los resultados demostraron que el SSNV fue más frecuente en mujeres que en varones (p = 0,03). Las mujeres perimenopáusicas tuvieron mayor frecuencia de depresión, ansiedad y SNED que los hombres y las mujeres pre y posmenopáusicas. La AE fue asociada positivamente con alteraciones del estado de ánimo en el trabajo masculino y femenino. En los hombres, la MS estuvo significativamente asociada con SSNV y con la depresión y los SNED en las mujeres perimenopáusicas. Conclusiones: Llegamos a la conclusión de que las alteraciones del estado de ánimo son más frecuentes en las mujeres que en los hombres maduros. También hemos demostrado que en las mujeres maduras una pobre AE podría ser un factor de riesgo para el desarrollo de problemas del estado de ánimo. En ambos, hombres maduros y mujeres posmenopáusicas, la MS juega un papel importante en la aparición de SSNV.

Objectives: The purpose of this study was to compare the frequencies of mood alterations of mature male and female workers. Also we aimed to demonstrate the relationship of symptoms with some psychological aspects such as volunteer's self-esteem (SE), marital satisfaction (MS) and attitudes toward sexuality (ATS). Materials and methods: In a cross-sectional design, we determine the frequencies of depression, anxiety, non-specific symptoms of depression (NSSD), MS, and the feelings of empty nest syndrome (FENS) in 103 males and 129 females from 40 to 64 years of age. Depression, NSSD and anxiety were evaluated according to DSMIII-R criteria and scored with the Hamilton Bech-Rafaelsen test. SE was evaluated with the Coopersmith test, ATS and FENS with a previously validated questionnaire, and MS with the Pick De Weiss test. Women were divided according to their last menstrual period in pre- peri- and postmenopausal. Results: The results demonstrated that FENS were more frequent in females than in males (p=0.03). Perimenopausal women had higher frequencies of depression, anxiety, and NSSD than males and pre- and postmenopausal females did. SE was positively associated with mood alterations in both male and female labors. In males, MS was significant associated with FENS; and with depression and NSSD in perimenopausal females. Conclusions: We concluded that mood alterations are more frequent in mature females than in males. Also we demonstrated that in mature females poor SE could be a risk factor to development mood problems. In both mature male and postmenopausal females, MS plays an important role in the appearance of FENS.