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PubMed2006

Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance.

RATIONALE: Although psilocybin has been used for centuries for religious purposes, little is known scientifically about its acute and persisting effects. OBJECTIVES: This double-blind study evaluated the acute and longer-term psychological effects of a high dose of psilocybin relative to a comparison compound administered under comfortable, supportive conditions. MATERIALS AND METHODS: The participants were hallucinogen-naïve adults reporting regular participation in religious or spiritual activities. Two or three sessions were conducted at 2-month intervals. Thirty volunteers received orally administered psilocybin (30 mg/70 kg) and methylphenidate hydrochloride (40 mg/70 kg) in counterbalanced order. To obscure the study design, six additional volunteers received methylphenidate in the first two sessions and unblinded psilocybin in a third session. The 8-h sessions were conducted individually. Volunteers were encouraged to close their eyes and direct their attention inward. Study monitors rated volunteers' behavior during sessions. Volunteers completed questionnaires assessing drug effects and mystical experience immediately after and 2 months after sessions. Community observers rated changes in the volunteer's attitudes and behavior. RESULTS: Psilocybin produced a range of acute perceptual changes, subjective experiences, and labile moods including anxiety. Psilocybin also increased measures of mystical experience. At 2 months, the volunteers rated the psilocybin experience as having substantial personal meaning and spiritual significance and attributed to the experience sustained positive changes in attitudes and behavior consistent with changes rated by community observers. CONCLUSIONS: When administered under supportive conditions, psilocybin occasioned experiences similar to spontaneously occurring mystical experiences. The ability to occasion such experiences prospectively will allow rigorous scientific investigations of their causes and consequences.

Adult↗
PubMed2004

Determination of epidemic clonality among multidrug-resistant strains of Acinetobacter spp. and Pseudomonas aeruginosa in the MYSTIC Programme (USA, 1999-2003).

The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme was initiated in 1997 (1999 for the United States). This program monitors resistance in participant medical centers where carbapenems are prescribed and drug use data can be obtained. An earlier report found antimicrobial use was not a clear cause of local or aggregate changes in resistance rates. This study addresses the role of dissemination of resistant clones on susceptibility rates for nonfermentors, Acinetobacter spp. (ACB) and Pseudomonas aeruginosa (PSA). Carbapenem (CARB)-multidrug-resistant strains (MDR) from among 236 ACB and 1,111 PSA were tested by reference broth microdilution methods, automated ribotyping, and pulsed field gel electrophoresis to determine possible clonal dissemination. Each strain was also tested for metallo-beta-lactamases (MbetaL) (phenotypic and polymerase chain reaction); and then analyzed by CARB-R rate and defined daily dose (DDD)/100 days use groupings (high, moderate, and low). For the aggregate 15 sites in the MYSTIC Programme each year, the CARB-resistant rate decreased over 5 years; but other drug-resistance rates generally escalated. Changes were not related to antimicrobial use calculations. The discovered clonally spread MDR-PSA strains were more frequent in high- (1.8 clones/site) and moderate-resistance (0.6 clones/site) rate centers (21.7% to 29.5% were clonal), compared with unique strains in low-resistance hospitals. ACB clonality was extreme in one geographic area, with dissemination of 5 different clones (931.7/B, C, or D; 1090.2/A; 167.5/A) in 4 centers (02, 04, 06, and 18). Resistance rates in ACB and PSA were clearly related to clonal occurrence and spread, and one MbetaL (VIM-7) was detected. Decreased CARB resistance rates from 1999 through 2002 were directly attributed to the disappearance of resistance clones in some locations. In conclusion, ACB and PSA CARB and MDR resistance rates in MYSTIC Programme institutions have been greatly influenced by clonal dissemination and less by antimicrobial use patterns. The most serious examples of resistance were the clonality observed among ACB in New York City and the documented endemic nature of VIM-7-producing PSA (0.09% of all PSA isolates). Meropenem remained the most active antimicrobial agent tested in the program, and surveillance networks must implement epidemiologic typing to accurately assess the role of clonal spread on the study results.

Acinetobacter↗
PubMed2005

Use of a program-specific website to disseminate surveillance data obtained from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Study.

The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program is a multicenter, longitudinal surveillance study initiated in 1997 that compares the activity of meropenem and comparator antimicrobials in centers that are actively prescribing meropenem. Antimicrobial surveillance programs, such as MYSTIC, provide important information on the emergence of bacterial resistance and the nature of the underlying mechanisms in different geographical regions. Data concerning these mechanisms and patterns of antimicrobial resistance allow the implementation of changes in antimicrobial prescribing practices and infection control interventions. Therefore, it is important that data from surveillance programs be analyzed and accessible to clinicians within reasonable, clinically useful, intervals. In this article, the use of a website designed to disseminate data collected from the MYSTIC program is described. This web-based program allows specific surveillance data to be examined in a timely manner and can assist the clinician when choosing the most appropriate antibiotic for the situation encountered and hopefully maximize successful clinical outcomes.

Anti-Bacterial Agents↗
PubMed2004

Results from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme: report of the 2001 data from 15 United States medical centres.

The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme is an international surveillance network of more than 100 medical centres where meropenem is the primary therapeutic carbapenem. Institutions have been monitored since 1997 (1999 in United States (US)) using National Committee for Clinical Laboratory Standards (NCCLS) reference susceptibility methods to monitor in vitro activity of meropenem and selected other broad-spectrum antimicrobial agents. In 2001, a total of 2874 strains were processed from the 15 US medical centres. Molecular methods were associated with MIC methods as needed for defining epidemic spread of resistant strains. The meropenem MIC(90) values were 0.03 mg/l for Citrobacter spp., Escherichia coli and Klebsiella spp.; 0.06 mg/l for Proteus mirabilis and Serratia spp. and 0.12 mg/l for Enterobacter spp. This potency was 8-16-fold greater than that of imipenem and the meropenem spectrum of activity versus the Enterobacteriaceae was the broadest of all tested antimicrobial agents. Only piperacillin/tazobactam (MIC(9), 64 mg/l) and tobramycin (MIC(90), 4 mg/l) were active against more than 90.0% of Pseudomonas aeruginosa at the NCCLS susceptible breakpoint, and the carbapenems were the most active compounds against Acinetobacter spp. However, Acinetobacter spp. isolates were resistant to all of the antimicrobial agents tested and the molecular typing results suggested that they were epidemiologically related. Only ciprofloxacin and ceftazidime had significantly reduced activity against oxacillin-susceptible staphylococci (87.9-92.6% susceptible. These 2001 US MYSTIC Programme results demonstrated no significant decline in carbapenem activity or susceptibility rates compared with the previously monitored years (1999-2000). Most apparent were the decreasing susceptibility rates for ciprofloxacin and ceftazidime against staphylococci. Continued surveillance in these institutions appears warranted as sites of high potential emerging resistance risk.

Academic Medical Centers↗
PubMed2006

Neural correlates of a mystical experience in Carmelite nuns.

The main goal of this functional magnetic resonance imaging (fMRI) study was to identify the neural correlates of a mystical experience. The brain activity of Carmelite nuns was measured while they were subjectively in a state of union with God. This state was associated with significant loci of activation in the right medial orbitofrontal cortex, right middle temporal cortex, right inferior and superior parietal lobules, right caudate, left medial prefrontal cortex, left anterior cingulate cortex, left inferior parietal lobule, left insula, left caudate, and left brainstem. Other loci of activation were seen in the extra-striate visual cortex. These results suggest that mystical experiences are mediated by several brain regions and systems.

Adult↗
PubMed2001

Unit differences in pathogen occurrence arising from the MYSTIC program European database (1997-2000).

The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program is a longitudinal global antimicrobial surveillance study that compares the activity of meropenem and comparator antimicrobial agents against pathogens isolated from intensive care, neutropenic or cystic fibrosis patients, and general wards. Data from the different European MYSTIC Program units (1997-2000) showed that the most prevalent isolates tested overall were methicillin-susceptible Staphylococcus aureus (MSSA; in accordance with study design methicillin-resistant S. aureus was not tested), Pseudomonas aeruginosa and Escherichia coli. In all the unit types, E. coli (approximately 20% having an extended spectrum beta-lactamase phenotype) and MSSA were highly susceptible to meropenem (97-99% susceptibility). Isolates of MSSA showed lower levels of susceptibility to ciprofloxacin (61-77% susceptibility) in both cystic fibrosis and neutropenia patients, and particularly high levels of resistance to ceftazidime (38% susceptibility) in cystic fibrosis units. Ciprofloxacin (54% susceptibility) and gentamicin (46% susceptibility) demonstrated low levels of activity against P. aeruginosa (frequently encountered in cystic fibrosis units). Meropenem and piperacillin/tazobactam were the most active agents against P. aeruginosa in all the unit types. Carbapenems and piperacillin/tazobactam have sustained > 90% susceptibility rates overall against the most frequently isolated pathogens. The analysis of specific units that house patients with a high-risk of contracting antimicrobial-resistant pathogens remains very important for the optimal selection of empiric regimens.

Burkholderia cepacia↗
PubMed1985

'Psychic sensitivity', mystical experience, head injury and brain pathology.

The 'psychic' experiences of 17 students (sensitives) from the College of Psychic Studies were compared with those of 17 church-going control subjects, who were matched for age, sex, and approximate intellectual level. At interview, 67 items of information relating to the medical history, family history, 'psychic gifts', head injuries, and mystical experiences were obtained. The shortened WAIS, the Benton Visual Retention Test, with tests of both dominant (Wechsler Logical Memory) and non-dominant temporal lobe function (the Rey-Osterreith Test) were given. The results showed that the sensitive population contained more single or divorced people, and people who had sometime consulted a psychiatrist. They had experienced more head injuries and serious illnesses than the controls. Sixty-six per cent showed evidence of right hemisphere and right temporal lobe dysfunction and, of these, 35 per cent had poor visual memories. There was evidence to suggest that some 'psychic' experiences were associated with brain dysfunction. Despite an increased occurrence of head injury, no clear correlation with the onset of 'psychic' sensitivity was found. Mystical experiences showed a trend towards being related to non-dominant hemisphere dysfunction. Vagueness about the position of the sensitive's 'psychic helper' in physical space was also associated with non-dominant hemisphere dysfunction.

Adult↗
PubMed1979

The mystic experience: a psychiatric reflection.

This paper reviews the phenomenology of the mystical experience and its varied contexts epilepsy, toxicity, organic brain syndromes, the major psychoses and hysterical dissociative states as well as in apparently normal persons. The impact of the experience on the personality is noted and its significance briefly reviewed. The author notes that two fallacies await the unwary psychiatrist: the fallacy of reductionism which defines the mystical experience in pathological terms only; and the fallacy of speculation without adequate philosophical or theological tools.

Alcoholism↗
PubMed2002

Marion Milner, mysticism and psychoanalysis.

It is unusual to combine mysticism and psychoanalysis. Marion Milner, however, achieved precisely this. Through her self-analysis and analytic work with children and adults--and using as an illustration her own and others' imaginative ideas, paintings, doodles, drawings and pictures--she drew attention to the potential for health and creativity of undoing the obstacles to mystical experience of oneness with what is beyond or other than the self, which she sometimes called God, the unconscious or the id. This article seeks to explain and highlight this aspect of her contribution to, and continuing importance for, psychoanalytic theory and practice--particularly that associated with Winnicott--through detailing her early life and diary-keeping experiments, some of her psychoanalytic case histories during and after the Second World War, her work as an artist, ending with her travels and her involvement during the 1980s and 1990s with the Squiggle Foundation and British Association of Art Therapists.

History, 20th Century↗
PubMed2001

The Hood Mysticism Scale: does the presence of a neutral response-item affect response style.

The widely used Hood Mysticism Scale (1975) was administered to one of two groups of college students in its original version and a modified version without the option of responding with "?" to an item. Scoring of the scale assigns an intermediate value to the "?" response, suggesting this response implies a meaning on the item somewhere between "probably true" and "probably not true." Omitting this response option requires respondents to make a forced-choice answer, either to agree or to disagree with a statement and eliminates the middle ground. It was hypothesized that, if the response reflects a neutral attitude, then randomly selected groups administered the scale with or without the option should show no difference in overall means. An intact group of 23 advanced psychology students achieved a mean of 114.4 (SD = 20.4) on the original mysticism scale, while 25 advanced psychology students in a second intact group had a mean of 113.3 (SD = 17.1) on the modified version. This difference was not significant and supported the hypothesis that the scales were equivalent. Advantages of the modification and implications for interpretation of the "?" response are discussed.

Adult↗
PubMed1998

Jewish mystical movements and the European ergot epidemics.

Chronic intake of ergot, a chemical present in bread blighted by ergot-producing fungi, results in a wide variety of neuropsychiatric and vascular symptoms. The symptomatology and epidemiology of outbreaks of ergot poisoning are traced, and are shown to coincide with the emergence of Jewish mystical movements, such as the early Pietist movement in Germany, Sabbateanism and Chasidism, thus suggesting that environmental ergotism contributed to these mystical movements. The interaction between ergotism and other nutritional, neuropsychiatric, social, psychological and historical influences is considered.

Disease Outbreaks↗
PubMed2004

Pharmacodynamic comparisons of antimicrobials against nosocomial isolates of escherichia coli, klebsiella pneumoniae, acinetobacter baumannii and pseudomonas aeruginosa from the MYSTIC surveillance program: the OPTAMA Program, South America 2002.

The OPTAMA (Optimizing Pharmacodynamic Target Attainment using the MYSTIC [Meropenem Yearly Susceptibility Test Information Collection] Antibiogram) Program provides insight into the appropriate antibiotic options for empiric therapy for common nosocomial pathogens. In this report, South America is represented by Brazil, Colombia, Peru, and Venezuela. A 5000-subject Monte Carlo Simulation estimated pharmacodynamic target attainment for meropenem, imipenem, ceftazidime, cefepime, piperacillin/tazobactam, and ciprofloxacin against Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. Pharmacokinetic parameter variability was derived from existing healthy volunteer data, and minimum inhibitory concentration (MIC) data came from the 2002 MYSTIC program. Piperacillin/tazobactam and ciprofloxacin displayed the lowest target attainment against all bacterial species (14% to 24% for A. baumannii, 26% to 37% for P. aeruginosa, and 48% to 66% for the Enterobacteriaceae). Overall, the carbapenems had the highest probabilities of attainment against the Enterobacteriaceae (98% to 100%) and A. baumannii (73% to 74%), whereas cefepime obtained the greatest target attainment against P. aeruginosa (65%). Because no single regimen had high target attainment against A. baumannii and P. aeruginosa, the use of combination therapy to treat these pathogens in South America may be justified. Because of the lack of agreement with percent susceptibility for certain antimicrobial regimens, the use of pharmacodynamic target attainment may be a more accurate predictor of microbiologic success.

Acinetobacter baumannii↗
PubMed2006

Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: report from the MYSTIC Program (1999-2005).

Among 8885 Enterobacteriaceae tested in the 1999 to 2005 period as part of the USA Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program, 51 strains with increased imipenem and meropenem MIC values (> or =2 microg/mL) were detected. bla(KPC) was identified from 28 Klebsiella pneumoniae from 3 medical centers in the New York City area (8 ribotypes), 2 Klebsiella oxytoca from Arkansas (same ribotype), 7 Citrobacter freundii (6 from New York [5 ribotypes] and 1 from Delaware), 4 Enterobacter spp. from New York (2 species, different ribotypes), 3 Escherichia coli (2 from New York and 1 from Ohio, same ribotype), and 1 Serratia marcescens (New York). Sequencing confirmed KPC-2 or -3 in all of the strains. S. marcescens strains harboring SME-1 (2 isolates, same ribotype) and SME-2 (1 isolate) were identified from medical centers in Illinois and Washington state, respectively. Our results indicate that bla(KPC-2/3) has emerged widely (New York City area, Arkansas, Delaware, and Ohio) among Enterobacteriaceae isolated in the MYSTIC Program participant sites (2000-2005) and continues to be isolated from multiple species, as a result of clonal expansion and horizontal gene transfer. The escalating occurrence (0.35%) of serine carbapenemases could compromise the role of carbapenems and other beta-lactams in USA clinical practice although observed in only a few locations to date.

Academic Medical Centers↗
PubMed2004

Bacteraemia in Europe--antimicrobial susceptibility data from the MYSTIC surveillance programme.

The in vitro antimicrobial susceptibility of organisms isolated from bacteraemic versus non-bacteraemic patients was evaluated using data (1997-2001) from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme. Minimum inhibitory concentration values and susceptibility breakpoints of meropenem and other broad-spectrum antimicrobials were determined using standard methodology. Three thousand one hundred and thirty-six blood culture (BC) isolates and 17261 non-BC isolates were obtained from 51 European MYSTIC centres. Gram-positive bacteria appeared to be more prevalent in BC isolates compared with other sources. Escherichia coli, methicillin-susceptible Staphylococcus aureus and Pseudomonas aeruginosa were isolated most frequently. Antimicrobial susceptibility of isolates from bacteraemic versus non-bacteraemic patients was similar. Meropenem and imipenem were the most active agents against the majority of the Gram-positive and Gram-negative organisms. Ceftazidime, gentamicin and ciprofloxacin generally exhibited the lowest activities against the most commonly isolated organisms. Meropenem was most active against P. aeruginosa and showed the highest potency and activity against all extended-spectrum and AmpC beta-lactamase producers. These results are relevant to the choice of initial, empirical therapy for patients with suspected bacteraemia.

Anti-Bacterial Agents↗
PubMed2004

The OPTAMA programme: utilizing MYSTIC (2002) to predict critical pharmacodynamic target attainment against nosocomial pathogens in Europe.

OBJECTIVES: The Optimising Pharmacodynamic Target Attainment using the MYSTIC (Meropenem Yearly Susceptibility Test Information Collection) Antibiogram (OPTAMA) programme identifies antibiotic regimens with the highest probability of attaining critical pharmacodynamic targets, accounting for the inherent variability in pharmacokinetics, dosages and MIC distributions. METHODS: European MIC data were obtained from the MYSTIC programme. Pharmacodynamic target attainment was calculated by Monte Carlo simulation for meropenem, imipenem, ceftazidime, cefepime, piperacillin/tazobactam and ciprofloxacin against Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. RESULTS: Significant differences in probability of target attainment were found, with Northern Europe demonstrating the highest probabilities of target attainment and Eastern Europe the lowest. The carbapenems had the highest target attainments and susceptibility levels across all regions and pathogens. The cephalosporins demonstrated high target attainments and susceptibility results against E. coli and K. pneumoniae in Northern and Southern Europe. Piperacillin/tazobactam and ciprofloxacin had the lowest levels for both parameters in all regions. Desirable target attainment was not achieved (except for carbapenems in Northern Europe) for A. baumannii and P. aeruginosa; thus, combination therapy may be appropriate empirical therapy for these pathogens in Southern and Eastern Europe. The closest correlations between target attainment and susceptibility were for meropenem 1 g every 8 h, imipenem 0.5 g every 6 h and ceftazidime 1 g every 8 h. CONCLUSIONS: The study highlighted significant overestimations between the probability of target attainment and the reported percentage susceptibility, particularly for piperacillin/tazobactam and ciprofloxacin. The approach of the OPTAMA programme provides a novel tool which complements susceptibility data to help in the selection of appropriate empirical antibiotic therapy.

Acinetobacter baumannii↗
PubMed2002

Emerging antimicrobial resistances among Proteus mirabilis in Europe: report from the MYSTIC Program (1997-2001). Meropenem Yearly Susceptibility Test Information Collection.

Resistance patterns that are currently problematic in Europe can vary greatly within the same species over time, among various patient populations and among geographic regions on the same continent. The results from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program, which monitors carbapenem resistance rates in institutions using meropenem, were used to determine resistance differences among Proteus mirabilis. MIC results from 688 P. mirabilis strains were classified into 4 patient care groups: ICU (n=426), neutropenia patients (NP; n=145), general wards (n=97) and cystic fibrosis patients (CF; n=20). A total of 40 centers from 12 European countries have participated since 1997, divided into 3 geographic regions (East, North, South). All testing was performed by NCCLS reference methods and interpretive criteria, including screening of extended-spectrum beta-lactamase (ESBL) phenotypes. Over the monitored interval the resistance rates varied for each agent without a clear trend toward a greater rate. Rank order of susceptibility was: meropenem (99%) > piperacillin/tazobactam (TAZ; 96%) > cefepime (95%) > ceftazidime (CAZ; 94%) > imipenem (IPM; 92%). Ciprofloxacin (CIP) was the least active agent tested (MIC90 4 microg/ml; 86% susceptible). Unexpectedly, 3.6% of P. mirabilis were imipenem-resistant (MIC, > or = 16 microg/ml). Greater rates of resistance were found for strains from NP and CF patients, and from eastern or southern European sites, usually associated with epidemic clusters. Generally susceptible species such as P. mirabilis have recently emerged as therapeutic problems in European medical centers following mutations that compromise CIP, CAZ and aminoglycoside use. Imipenem also showed decreased susceptibility of greater than 7% compared to less than 1% for meropenem. Continued surveillance by the MYSTIC Program appears to be a prudent practice to focus effective empiric treatment regimens.

Anti-Bacterial Agents↗
PubMed2000

Detection of emerging resistance patterns within longitudinal surveillance systems: data sensitivity and microbial susceptibility. MYSTIC Advisory Board. Meropenem Yearly Susceptibility Test Information Collection.

Communicating information from antimicrobial resistance surveillance study data to microbiologists and physicians can be challenging. Large amounts of data, commonly reaching millions of MICs or zone diameter endpoints, must be analysed and condensed to easily-read tables or figures. Furthermore, data must not be prejudged relative to susceptibility categories, because of the diverse nature of interpretive criteria available internationally. An attempt must be made to present results of all surveillance studies in a mode that can be reinterpreted for immediate use in different geographical areas, or used to compare future data with relative ease and high accuracy. Such data displays require peer-reviewed journals to permit greater numbers of more complex tables to present results. The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) study is a year-on-year global surveillance programme in medical centres where meropenem is available for use. We have developed a presentation strategy that expands the long-term clinical value of MYSTIC results. In addition to statistical parameters, tables of cumulative percentages or numbers of strains inhibited at each tested antimicrobial concentration will be presented. Alternative figures (Finland-o-grams) could also be used, but these generally lack precise extractable rates and require more journal space. Regardless of study design, promotion of this presentation philosophy enhances any surveillance study's value to each reader or user and facilitates application to locally appropriate interpretations. The widespread use of these analysis and presentation principles as benchmarks by various resistance studies and networks is strongly encouraged, particularly by investigations across international boundaries.

Anti-Bacterial Agents↗
PubMed1964

SCIENCE, MYSTICISM AND PSYCHOPHARMACOLOGY.

Historically, psychopharmaceutical agents have been used to produce a mystical state with the religious connotation of "a union with Divine Nature" or of "oneness with God." Such transcendental states are also known to occur in starvation, self-flagellation, Yoga and various psychoses.A common psychological origin is suggested for these states, in which there is a psychic regression to an early phase of development. This genetically is the phase wherein the infant is still united with the mother and has not yet established the boundaries between the "self" and the "not-self." In a subtler form, the desire to regress to this phase may be a universal yearning which affects the physician, the investigator and even the manufacturer of drugs. Accordingly, we have a profusion of tranquilizers, euphoriants and ataractics the prescription or the investigation of which may give vicarious pleasure and relief of tension to the physician and scientist by a process of identification with the person receiving the drug.Mankind's quest for psychic development is difficult and precarious, alternately marked by progression and regression. Excesses in the use of drugs are indicated as regressive in nature.

Humans↗