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Kamila Ivanová

University Hospital Trnava, Slovakia

Title: Microbioma, psychobiotics and the “second brain” theory

Abstract

Mental health (especially in light of the COVID-19 pandemic) without doubt represents a great problem worthy of general attention and increased vigilance. The WHO talks about an epidemic of the 21st century. Worsening mental health contributes with a great deal to the global health burden. More than 2000 years ago, Hippocrates declared that "all disease begins in the gut." (Lynch and Pedersen, 2016). Indeed, the human intestine can be compared to an anaerobic bioreactor, a reservoir of a huge population of microorganisms (called the microbiome). Preclinical evidence has firmly established bidirectional interactions among the brain, the gut, and the gut microbiome. Core signaling molecules and at least three communication channels have been identified. The bidirectional connection between the GUT and BRAIN is undeniable. The microbiome plays a serious role in the field of human health. Dysbiosis of the intestinal microbiota is believed to be a key factor in the development of myriad physical and psychiatric/neuropsychiatric disorders. Current research and studies continuously demonstrate the important role of the gut microflora in the regulation of e.g. anxiety, mood, sleep, cognition and pain. Emerging literature and research results really point out that patients suffering from various neuropsychiatric disorders show significant differences in the composition of their gut microbiome, levels of inflammatory and anti-inflammatory blood markers, cortisol etc. Probiotics have been widely discussed not only among us - doctors/physicians, but also among the general population. The topic “resonates” in the media more and more often than before. Patients and physicians have brought manifold queries. Probiotics are defined as “a live microorganism that, when ingested in adequate amounts, produces a health benefit in patients suffering from psychiatric illness” (Dinan et al., 2013). Probiotics (psychobiotics) and targeted tailored treatment with them have become a great challenge in neuropsychiatry nowadays. The potential of psychobiotics in the prevention and treatment of neuropsychiatric disorders is being seriously discussed and investigated. For psychiatrists and general practitioners it is necessary to deep dive into this issue and correctly understand the current body of evidence. Subsequently they need to be able to provide accurate and informed recommendations to their patients about probiotics (psychobiotics) and their possible microbiome interventions. 

Biography

Profile
- Physician with more than 8 years’ experience in the field of psychiatry and attestation in the field (June 3,.2020), with previous 2 years of clinical experience in radiation and clinical oncology, including clinical oncology studies and one and a half years’ experience in the field of medical examiner for the Office of Labor, Social Affairs and Family in Trnava.
- Empathetic, communicative and detail-oriented person focused on work performance, efficiency and exactness.
- Currently employed at Psychiatric Department of the Teaching Hospital Trnava as Deputy Head of Department.
- From October 1,.2020 included in the postgraduate specialisation study in the specialisation field: Master of Public Health (MPH) at the Slovak Medical University in Bratislava. Expected date of final exam - 09/2023.
- Member of the Slovak Psychiatric Society.
- From March 2022 member of the Slovak Obesity Association.
- External member of the working group of the Slovak Psychiatric Society SLS (Slovak Medical Association) in the field of suicidality prevention (year 2023).
- Member of the European Association for the Study of Obesity (EASO).

Skills and competencies
-  Communication and presentation skills
-  Analytical thinking
- Flexibility
- Credibility
- Prioritisation

Education
- Studied at Comenius University in Bratislava, Faculty of Medicine, degree: MUDr. (2001- 2007)
- During medical studies practised several months at the Institute of Experimental Oncology of the Slovak Academy of Sciences in Bratislava (SAV)

Work experience
- July 2007 – January 2012 National Oncology Institute, Bratislava - Secondary physician
- July 2007 – September 2008 worked at Department of Radiation Oncology
- Physician at Radiation Oncology Ward, responsible for comprehensive management of patient care indicated for external radiotherapy or brachytherapy
- Participated in the preparation of individual radiation plan
- September 2008 – January 2009 worked at Department of Clinical Studies
- Selected suitable patients for clinical studies
- Direct administration of clinically tested drugs of patients with comprehensive monitoring and collection of clinical data - conducted in English
- Cooperation with specialised departments within the National Oncology Institute and with international oncological research centres
- January 2009 – January 2012 maternity and parental leave

From June 2016 to December 2017: Office of Labor, Social Affairs and Family Trnava –Medical Assessor
- Elaborated expert medical reports based on the detailed study of medical documentation (adults, children – reviewing requests for extension of parental leaves)
- Knowledge of relevant legislation
- Expertly assessed the severity of diagnoses and the degree of functional disability of severely disabled persons and subsequently assigned allowances such as disability cards, personal assistants, financial compensations, nursing, etc.
- Personal consultations with patients through commissions
- Considered and acknowledged the suitability/ unsuitability of free job positions offered to citizens listed by the Office of Labor, Social Affairs and Family Trnava

From February 2012 until now: Psychiatric Department, Teaching Hospital Trnava - Psychiatrist, Deputy Head of Department
- Management of psychiatric treatment of adult patients in the general psychiatric ward - in the acute and post-treatment phase of treatment
- Diagnosis of mental disorders, including associated somatic diseases
- Psychopharmacological medication and psychotherapeutic intervention
- Participation in clinical trials
- Lectures and publications
- Management of patients in the day psychiatric stationary
- Dispensary for outpatients, including patients on depot injectable antipsychotics
- Hospital emergency services
- From April 2015 to May 2018 on maternity/ parental leave
- From May 2018 returned to full-time employment
- In July 2018 lectured and discussed the topic of depression and anxiety at the music festival Pohoda Pieš?any/ project DOCTOR TENT
- Clinician within the University Hospital Trnava
- Physician at the psychiatric surgery at Psychiatric Department of the University Hospital Trnava
- From July 2019 - Deputy Head of Psychiatric Department at the University Hospital Trnava
- Autumn 2019 - article in the journal “Modern Gynecology and Obstetrics “- Postpartum Psychosis as an interdisciplinary problem
- June 2020 - specialisation exam in the field of psychiatry
- 2021 - article in the journal “Psychiatry for practice 01/2021 “- Psychiatric aspects of bariatric operations
- 2021 - article in the journal “Psychiatry for practice 04/2021” - Psychological profile of a morbidly obese patient interested in metabolic-bariatric surgery, case study
- 13.10.2022 - presentation at the 43rd SSVPL conference (The Slovak Society of General Practice of the Slovak Medical Association) - Block of the Slovak Obesity

Association - Psychiatric aspects of bariatric/metabolic surgery
- 22.10.2022 - 4th Congress of the Slovak Obesity Association and 20th Slovak Obesity Day with international participation - Psychiatric aspects of bariatric/metabolic surgery
- 2022 - article in the journal - “Psychiatry for practice 03/2022” - Amyotrophic lateral sclerosis - more than just a neurological diagnosis
- 15.11.2022 - 2nd International Conference on Neuroscience and Neurology (Scientex) - Paris - Psychiatric aspects of bariatric surgery (Obesity, an escalating problem)
- 19.11.2022 - online webinar, Neuropsychiatric symposium - Scientex conferences, Psychiatric aspects of bariatric surgery (Obesity, an escalating problem)

Other work experience
- From October 10, 2020 until December 31, 2022 - Medirex a.s., office: Holubyho 35, 90201 Pezinok. Job description: Collection of biological material - Covid 19 testing.
- From January 2023 until now - psychiatrist at the Senior House Betánia in Bratislava, Partizánska 1255/6, 81103 Bratislava.

Language skills
- Slovak language - native speaker
- Czech language - near-native speaker
- English language - upper intermediate (B2/C1 level)
- German language - intermediate (A2 level)
- Hungarian language - passive