INSPIRE study: does stress management improve the course of inflammatory bowel disease and disease-specific quality of life in distressed patients with ulcerative colitis or Crohn's disease? A randomized controlled trial.

Background: The use of stress management psychotherapy is hypothesized to produce greater improvement in disease course and disease-specific quality of life (IBDQ) compared to usual medical care alone in patients with ulcerative colitis (UC) or Crohn's disease (CD) showing high levels of stress (based on the Perceived Stress Questionnaire [PSQ]).

Methods: Fifty-eight patients with UC and 56 patients with CD who had experienced continuous disease activity or had relapsed over the previous 18 months, with an activity index for UC or CD ≥ 4, a PSQ ≥ 60, and without serious psychiatric disorders or other serious medical conditions were randomized to receive either treatment as usual (TAU) or TAU plus stress management psychotherapy. Psychotherapy consisted of three group sessions (psychoeducation, problem-solving, relaxation) and 6-9 individual sessions based on cognitive behavior therapy-related methods with 1-3 booster sessions at 6 and 12 months follow-up.

NORADRENALINE STORES IN NERVE TERMINALS OF THE SPLEEN: CHANGES DURING HEMORRHAGIC SHOCK.

In dogs subjected to hemorrhagic shock, a marked decrease in the noradrenaline content of the sympathetic nerve terminals in the normally innervated spleen is revealed by means of a histochemical fluorescence method. Deprivation of the sympathetic impulse-flow to the tissue immediately before the animals are subjected to shock prevents this depletion. The results support the hypothesis that the vasoconstriction which occurs during shock is due to the effect of noradrenaline released locally in the tissues, and not to circulating noradrenaline.