Ginseng and ginkgo biloba effects on cognition as modulated by cardiovascular reactivity: a randomised trial

Background There is some evidence to suggest that ginseng and Ginkgo biloba can improve cognitive performance, however, very little is known about the mechanisms associated with such improvement. Here, we tested whether cardiovascular reactivity to a task is associated with cognitive improvement. Methodology/Principal findings Using a double-blind, placebo controlled, crossover design, participants (N = 24) received two doses of Panax Ginseng (500, 1000 mg) or Ginkgo Biloba (120, 240 mg) (N = 24), and underwent a series of cognitive tests while systolic, diastolic, and heart rate readings were taken. Ginkgo Biloba improved aspects of executive functioning (Stroop and Berg tasks) in females but not in males. Ginseng had no effect on cognition. Ginkgo biloba in females reversed the initial (i.e. placebo) increase in cardiovascular reactivity (systolic and diastolic readings increased compared to baseline) to cognitive tasks. This effect (reversal) was most notable after those tasks (Stroop and Iowa) that elicited the greatest cardiovascular reactivity during placebo. In males, although ginkgo also decreased cardiovascular readings, it did so from an initial (placebo) blunted response (i.e. decrease or no change from baseline) to cognitive tasks. Ginseng, on the contrary, increased cardiovascular readings compared to placebo. Conclusions/Significance These results suggest that cardiovascular reactivity may be a mechanism by which ginkgo but not ginseng, in females is associated with certain forms of cognitive improvement

National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy

Purpose: To summarise recommendations about 20 non-surgical interventions for recent onset (&lt;12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority. Methods: Two multidisciplinary working groups formulated recommendations based on the GRADE approach. Results: Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active. If treatment is needed, the guidelines suggest using patient education, different types of supervised exercise, and manual therapy. The guidelines recommend against acupuncture, routine use of imaging, targeted treatment, extraforaminal glucocorticoid injection, paracetamol, NSAIDs, and opioids. Conclusion: Recommendations are based on low to moderate quality evidence or on consensus, but are well aligned with recommendations from international guidelines. The guideline working groups recommend that research efforts in relation to all aspects of management of LBP and LR be intensified.</p

Communautés d’habitants au Moyen Âge

La formation des communautés d’habitants (sous une forme villageoise ou urbaine, groupée ou non) est un phénomène clé qui a touché l’ensemble de l’Occident latin à partir du xie siècle. Son étude a connu une certaine vogue dans le dernier quart du xxe siècle, dans divers pays d’Europe, où l’on s’est toutefois appuyé sur des présupposés notionnels et méthodologiques très variables qui ont abouti à des résultats intéressants mais peu articulés. Le travail collectif mené dans le cadre du LaMOP (Paris 1) a visé à dépasser l’hétérogénéité des points de vue, à l’aide d’hypothèses de travail spécifiques. En particulier, il s’est agi de prendre au sérieux le fait social qu’est « l’habiter », impliquant entre autres que la cohésion des communautés reposait moins sur des rapports de parenté que sur l’idée d’appartenance commune à un lieu. Cet attachement se fondait quant à lui sur la définition d’un certain nombre de ressources réservées et liées à l’habitat lui-même, d’une part, et sur la définition de pôles d’attraction durable et eux aussi monopolistiques : les églises paroissiales et leur cimetière. Avec ces deux référents que sont l’habitat et la paroisse, le statut dépendant des tenanciers paysans passe à l’arrière-plan : les agriculteurs dépendants ne sont donc plus pensés par rapport à leurs seigneurs mais par rapport à leur lieu de résidence et de culte. Les dépendants sont ainsi transformés en habitants, et les communautés d’habitants peuvent donc être considérées comme des formes d’enchantement, de la domination sociale, contribuant ainsi à la reproduction à long terme du système seigneurial

POS0955 EXTRACELLULAR MATRIX PROTEIN TURNOVER MARKERS ARE ASSOCIATED WITH axSpA – A COMPARISON WITH CONTROL SUBJECTS WITH OR WITHOUT PELVIC, BUTTOCK OR BACK PAIN

Background:Axial spondyloarthritis (axSpA) is a common chronic inflammatory disease, associated with extracellular matrix (ECM) remodeling of the cartilage, bone and connective tissues. The primary symptom of axSpA is back pain, caused by inflammation. However, there is a medical need to truly identify patients with axSpA from other subjects with buttock or low back pain attributable to other reasons. Tissue-derived extracellular (ECM) markers quantified in serum may serve to differentiate axSpA patients from other diagnostic entities.Objectives:To investigate circulating ECM turnover markers as potential biomarkers to differentiate patients with axSpA from a control group of subjects with buttock or pelvic pain attributed to other reasons, including postpartum women and healthy subjects.Methods:Biomarkers of ECM degradation/chronic inflammation (C1M, C3M, C4M, C6M, CRPM, C10C and COL10NC) and ECM formation (PRO-C3 and PRO-C6) were measured in 204 participants from the MASH study [1] (Table 1). Biomarker levels were compared among patients with axSpA and control group, and two new variables (Type 3 and Type 6) were included, corresponding to the index of formation/degradation of type III and type VI collagen respectively. The biomarker data was log10 transformed for normalization when necessary and linear regression models with pairwise comparisons were performed. Clinical scores and the SPARCC MRI scores for sacroiliac joint (SIJ) inflammation were correlated with the biomarkers data (data not shown).Table 1.Comparison of blood-tested biomarkers levels in MASH study. Data was adjusted for confounders age, gender, and body mass index (BMI).Biomarkers(Mean (SD))Patientswith axSpA(n = 41)Control groups (n=163)pC1M84.3 (85.8)36.2 (22.1)&lt;0.0001C3M15.6 (4.0)13.9 (3.0)0.011C4M34.9 (10.2)27.9 (7.7)&lt;0.0001C6M20.5 (5.8)17.4 (4.2)&lt;0.0001CRPM11.9 (2.9)11.0 (5.9)0.027C10C2567 (462)2568 (560)0.31COL10NC9.15 (5.81)9.43 (8.27)0.43PRO_C310.2 (2.5)11.3 (3.0)0.0052PRO_C66.94 (2.45)6.86 (2.53)0.93Type 3 (PRO-C3/C3M)0.70 (0.28)0.86 (0.31)0.0004Type 6 (PRO-C6/C6M)0.36 (0.16)0.41 (0.14)0.0024Results:We found that patients with axSpA had significantly increased MMP-mediated degradation of type I (C1M), type III (C3M), type IV (C4M) and type VI (C6M) collagens (p&lt;0.0001, p=0.01,p&lt;0.001,p&lt;0.001, respectively), and CRP-metabolite (CRPM, p=0.027), and significantly decreased formation of type III collagen (p= 0.052) compared with control groups when adjusting for age, gender and body mass index (BMI). Significantly decreased rates of Type 3 and Type 6 variables were also observed in patients with axSpA (p=0.004, p=0.002, respectively). We further adjusted the analyses by the SPARCC SIJ inflammation scores since differences in these were found among the two groups [1], and similar differences in biomarker levels were found, indicating that the relationship between the level of biomarkers and the SPARCC SIJ inflammation scores was independent between the two groups.Conclusion:Biomarkers of type I, III, IV and V collagen and a CRP-metabolite showed an altered turnover in patients with axSpA compared with the control group including subjects with or without buttock or pelvic pain attributable to other reasons. Such biomarkers may be used in combination with MRI or independently to separate patients with axSpA from other back pain conditions.References:[1]Seven, S., Østergaard, M., Morsel-Carlsen, L., Sørensen, I. J., Bonde, B., Thamsborg, G., ... &amp; Pedersen, S. J. (2019). Magnetic Resonance Imaging of Lesions in the Sacroiliac Joints for Differentiation of Patients With Axial Spondyloarthritis From Control Subjects With or Without Pelvic or Buttock Pain: A Prospective, Cross-Sectional Study of 204 Participants. Arthritis &amp; Rheumatology, 71(12), 2034-2046.Acknowledgements:The study was supported by Innovation Fund Denmark, Rigshospitalet and the Danish Rheumatism Association (grant no. R102-A2132-B98, R159-A5061 and R150-A4467-B98).Disclosure of Interests:Helena Port Employee of: Industrial PhD student at Nordic Bioscience and University of Copenhagen, Signe Holm Nielsen Employee of: Full time employee at Nordic Bioscience, Joseph Blair Employee of: Full time employee at Nordic Bioscience, Sofie Falkenløve Madsen Employee of: Full time employee at Nordic Bioscience A/S, Anne-Christine Bay-Jensen Shareholder of: Nordic Bioscience A/S, Employee of: Full time employee at Nordic Bioscience A/S, Morten Karsdal Shareholder of: Nordic Bioscience A/S, Employee of: Full time employee at Nordic Bioscience A/S, Sengül Seven: None declared, Inge Juul Sørensen: None declared, Lone Morsel-Carlsen: None declared, Mikkel Østergaard: None declared, Susanne Juhl Pedersen: None declared</jats:sec