From probiotics to psychobiotics - the gut-brain axis in psychiatric disorders.

This review aims to present a comprehensive state-of-the-art analysis of the bidirectional crosstalk between gut microbiota and the central nervous system (CNS). The literature concerning the potential effects of gut microbiota on psychiatric disorders through neural pathways comprising the 'gut-brain axis' were gathered. In addition, the influence of probiotics and prebiotics and dairy-rich diets combined with the intake of probiotics and prebiotics on gut microbiota and the subsequent relationship with brain function was reviewed. However, a meta-analysis on the effectiveness of probiotic supplementation in psychiatric disorders is lacking. Therefore, a systematic search of PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases from January 1969 to December 2019 was conducted. It led to the identification of a total of 844 research articles. Of these, a total of 23 studies met the meta-analysis criteria. Statistical analysis revealed that there was no significant difference in the symptoms of schizophrenia, stress, and anxiety between probiotic and placebo groups, post-intervention. Probiotic administration reduced depressive symptoms among patients with depression in a statistically significant manner (standardised mean difference (SMD) = -0.87; 95% confidence interval (95% confidence interval): -1.66, -0.99; P=0.03). Further evidence from larger and more rigorous studies with longer duration of probiotic administration, as well as well-defined populations, homogenous probiotic intervention and outcome measures, are needed to clarify the potential therapeutic effects of probiotics on psychiatric symptoms. Based on the current literature, it seems that not all probiotic-/prebiotic-/dairy-rich diet-based treatments exhibited a psychobiotic effect on the CNS. Among the parameters determining the success of the given treatment, the most significant were probiotic composition (multi-strain formulation), the quantity of ingested psychobiotics and the duration of the study.

Evaluation of patients' adherence to statins in Poland.

INTRODUCTION: High efficacy of statin therapy in primary and secondary prevention of coronary heart disease (CHD) has been confirmed in numerous clinical trials. However, studies' results do not reflect patient benefits in everyday clinical practice. Observed discrepancies are the result of patients' failure to comply with medical recommendations regarding both non-pharmacological and pharmacological treatment. Non-compliance can lead to serious health and economic consequences. OBJECTIVES: The purpose of the presented study was the retrospective analysis of compliance in patients treated with statins on the basis of Polish reimbursement data from the National Health Fund (NFZ). METHODS: Medication Possession Ratio (MPR) was used for the compliance assessment; proportion of patients achieving the minimum level of compliance which ensure a satisfactory clinical response was also evaluated. Number of days to discontinuation was calculated in order to estimate patient persistence representing the time over which a patient continues to fill a prescription. RESULTS: The results of the analysis indicate that only 12% of the population of patients treated with statins demonstrates proper level of both compliance and persistence. Statistically significant differences were found among different patient groups; however, in all the groups, compliance was lower than the minimal level required for clinical benefits. CONCLUSIONS: The study revealed poor compliance among patients receiving statin prescriptions for hyperlipidaemia treatment. We presume that the most important factor for non-adherence can be lack of proper patient education, thus all patients on statin treatment should receive sufficient attention, supervision and better information.