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Mounting evidence shows that the complex gut microbial ecosystem in the human gastrointestinal (GI) tract regulates the physiology of the central nervous system (CNS) via microbiota and the gut–brain (MGB) axis. The GI microbial ecosystem communicates with the brain through the neuroendocrine, immune, and autonomic nervous systems. Recent studies have bolstered the involvement of dysfunctional MGB axis signaling in the pathophysiology of several neurodegenerative, neurodevelopmental, and neuropsychiatric disorders (NPDs). Several investigations on the dynamic microbial system and genetic–environmental interactions with the gut microbiota (GM) have shown that changes in the composition, diversity and/or functions of gut microbes (termed "gut dysbiosis" (GD)) affect neuropsychiatric health by inducing alterations in the signaling pathways of the MGB axis. Interestingly, both preclinical and clinical evidence shows a positive correlation between GD and the pathogenesis and progression of NPDs. Long-term GD leads to overstimulation of hypothalamic–pituitary–adrenal (HPA) axis and the neuroimmune system, along with altered neurotransmitter levels, resulting in dysfunctional signal transduction, inflammation, increased oxidative stress (OS), mitochondrial dysfunction, and neuronal death. Further studies on the MGB axis have highlighted the significance of GM in the development of brain regions specific to stress-related behaviors, including depression and anxiety, and the immune system in the early life. GD-mediated deregulation of the MGB axis imbalances host homeostasis significantly by disrupting the integrity of the intestinal and blood–brain barrier (BBB), mucus secretion, and gut immune and brain immune functions. This review collates evidence on the potential interaction between GD and NPDs from preclinical and clinical data. Additionally, we summarize the use of non-therapeutic modulators such as pro-, pre-, syn- and post-biotics, and specific diets or fecal microbiota transplantation (FMT), which are promising targets for the management of NPDs. [ABSTRACT FROM AUTHOR]

Introduction: Electroencephalographically-measured frontal alpha asymmetry is shown to reflect changes in mood. Negative mood changes are purported to limit exercise capacity in some groups, thereby contributing to the current epidemic of overweight, obesity and related diseases. Aim: This study tests the hypothesis that the mood changes associated with aerobic exercise are correlated with changes in frontal EEG asymmetry. Materials and Methods: Healthy young adult African-American (AA) men (n=8) and women (n=8) were subjected to quantitative EEG brain mapping of delta, theta, alpha and beta bandwidths after a period of rest or a period of aerobic exercise at a fixed energy expenditure. Brain mapping was performed within 30 min after rest or exercise, immediately before completing a questionnaire which included a total mood disturbance score (tMDS) and specific mood subcategory scores consisting of vigor, fatigue, anger, confusion tension, depression. Prefrontal and inferior frontal asymmetry were evaluated. Significance of differences between rest and exercise prefrontal and inferior frontal asymmetry was evaluated by one-way ANOVA. Results: Exercise-related decrements in asymmetry were significant for prefrontal delta (p≤0.05) and marginally significant for prefrontal alpha and theta (p=0.07) in the male subjects. There were significant decrements in tension and tMDS for the males and females and a decrement in depression score for the females between the post-control rest and the post-exercise conditions. Significant negative correlation between the tMDS and prefrontal beta asymmetry was found, across post-rest and post-exercise (r= -0.38, p≤0.05, 30 df). There were also significant correlations between confusion and prefrontal beta asymmetry during rest (r= 0.48, p≤0.05, 14 df), between vigor and inferior frontal beta asymmetry, between vigor and both inferior frontal theta asymmetry and inferior frontal delta asymmetry during exercise (r= 0.46, -0.54, p≤0.05, 14 df), and between vigor, confusion, tension and inferior frontal delta asymmetry post-exercise (r= -0.49, -0.45, -0.49, p≤0.05, 14 df). Conclusion: The high prefrontal beta asymmetry associated with depressed mood in AA males and females, the lessening of prefrontal delta, theta and alpha asymmetry in the males and the lower depression scores after aerobic exercise in the females seem to support the hypothesis that decreased asymmetry with increased activation of the right prefrontal and frontal cortices may accompany the mood changes associated with aerobic exercise. [ABSTRACT FROM AUTHOR]

Introduction: Beetroot Juice (BJ) contains dietary nitrates that increase the blood Nitric Oxide (NO) level, decrease Blood Pressure (BP), increase athletic performance and improve cognitive functions but the mechanism remains unclear. Ultrasonographic measurement of middle cerebral artery blood flow velocity with computation of Cerebral Augmentation Index (CAIx) is a measure of the reflected flow signal, modulated by changes in cerebrovascular resistance and compliance. Aim: This pilot study tests the hypothesis that ingestion of an amount of BJ sufficient to raise the blood NO level two-to threefold, decreases Transcranial Doppler (TCD) measured CAIx. Materials and Methods: Ten healthy young-adult African- American women were studied at two levels of submaximal exercise, 40% and 80% of their predetermined peak oxygen consumptions.The subjects ingested nitrate-free orange juice (OJ, control) and an isocaloric BJ beverage (1.5 mg/mL nitrate, 220 Cal), on different days, 1-2 weeks apart. Results: The BJ treatment increased blood NO and decreased systolic BP at rest and at the two levels of exercise. The BJ treatment decreased CAIx only at the two levels of exercise (from 79 ± 2% to 62 ± 2% and from 80 ± 2% to 60 ± 3%, p<0.05). Exercise increased TCD-measured resistance and pulsatility indices (RIx, PIx) without changing AIx. The BJ treatment had no effect on RIx and PIx. Conclusion: These findings suggest that decreased CAIx associated with aerobic exercise reflects the change in cerebral haemodynamics resulting from dietary nitrate supplementation. Future studies should determine whether the BJ-induced decrement in CAIx is correlated with an improvement in brain function. [ABSTRACT FROM AUTHOR]

This systematic review aimed to look at the effectiveness of venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy in treating fulminant myocarditis and evaluating the optimal length of time a patient should be placed on VA-ECMO. Fulminant myocarditis is a potentially life-threatening medical condition most commonly brought on by cardiogenic shock, which often progresses to severe circulatory compromise, requiring the patient to be placed on some form of mechanical circulatory assistance to maintain adequate tissue perfusion. Medical centers have multiple mechanical assistive devices available for treatment at their disposal, but our area of focus was placed on one system in particular: VA-ECMO therapy. Although the technology has been around for more than 30 years, there is limited information on how effective VA-ECMO is regarding the treatment of fulminant myocarditis. Due to the lack of data regarding the treatment administration of VA-ECMO for fulminant myocarditis, standard treatment duration guidelines do not exist, resulting in a wide variation of treatment administrations among medical centers. In regard to short-term outcomes, VA-ECMO has shown to be effective in treating fulminant myocarditis, with a one-year post-hospital survival rate ranging from 57.1% to 78% at discharge. For long-term health and survival, the studies that recorded long-term survival ranged from 65% to 94.1%. However, given the small number of studies that pursue this, more research is needed to prove the efficacy of VA-ECMO for the treatment of fulminant myocarditis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Briglio et al.)

Non-alcoholic fatty liver disease (NAFLD) is steatosis of the liver that resembles alcohol-induced liver injury but is a metabolic disorder. Most patients are obese with increased triglyceride levels due to increased intake of fatty food, which can cause excess fat to build up in the liver. At the same time, continuous ingestion of fatty foods can lead to gallstones (GS) due to the overproduction of cholesterol. NAFLD and GS have been seen to coincide, and there might be a relationship between them. This systematic review analyzes the incidence of NAFLD and GS to determine a bidirectional relationship. A comprehensive literature review was done using ProQuest, PubMed, and ScienceDirect, and included only experimental studies and meta-analyses. The search included the keywords 'gallstones and non-alcoholic fatty liver disease' and 'cholelithiasis and non-alcoholic fatty liver disease'. Our initial search included 10,665 articles and was narrowed down to 19 through extensive inclusion and exclusion criteria. There is a bidirectional relationship between the incidence of NAFLD and GS, where an increase in either can lead to an increase in the other. Both NAFLD and GS share similar risk factors leading to the development of each disease. On average, there's an increase in the prevalence of gallstones in NAFLD patients, and patients with GS were also more likely to have NAFLD. There was a prevalence of NAFLD in those with asymptomatic gallstones as well, indicating that the risk factors are crucial in the development of both. As a result, some research is determining whether an evaluation of the liver should be routine during cholecystectomy due to the increased risk of developing NAFLD., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Slouha et al.)

Inferior vena cava (IVC) filters have been used since the 1960s to treat patients with acute risk of pulmonary embolism (PE) to prevent migration of thrombus by trapping it within the filter. Traditional usage has been in patients with contraindication to anticoagulation that carry a significant mortality risk. In this systematic review, we sought to evaluate complications associated with placement of inferior vena cava filters based on published data from the past 20 years. A search was performed on October 6th, 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews, using three databases (ProQuest, PubMed and ScienceDirect) for articles published between the dates of February 1, 2002 and October 1, 2022. Results were filtered to include full-text, clinical studies, and randomized trials written in English pertaining to keywords "IVC filter AND complications", "Inferior Vena Cava Filter AND complications", "IVC filter AND thrombosis" and "Inferior Vena Cava Filter AND thrombosis". Articles identified by the three databases were pooled and further screened for relevance based on inclusion and exclusion criteria. Initial search results yielded 33,265 hits from all three databases combined. Screening criteria were applied, with 7721 results remaining. After further manual screening, including removal of duplicate hits, a total of 117 articles were selected for review. While there are no consensus guidelines for best practice, there is compelling evidence that IVC filters can provide significant protection against PE with minimal complications if the treatment window is appropriate. Increase in the variety of filter models has led to broader availability, but skepticism remains about their efficacy and safety, with ongoing controversy surrounding appropriate indications. Further research is needed to establish clear guidelines on appropriate indications for IVC placement and to determine time course of complications versus benefits for indwelling filters., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Bajda et al.)

Introduction: Obesity and cardiovascular disease are inextricably linked and the health community's response to the current epidemic of adolescent obesity may be improved by the ability to target adolescents at highest risk for developing cardiovascular disease in the future. Overweight manifests early as autonomic dysregulation and current methods do not permit differentiation of overweight adolescents or young adults at highest risk for developing cardiovascular disease., Aim: This study was designed to test the hypothesis that scaling exponents motivated by nonlinear fractal analyses of Heart Rate Variability (HRV) differentiate overweight, otherwise healthy adolescent/young adult subjects at risk for developing prehypertension, the primary forerunner of cardiovascular disease., Materials and Methods: The subjects were 18-20year old males with Body Mass Index (BMI) 20.1-42.5kg/m(2). Electrocardiographic inter-beat (RR) intervals were measured during 3h periods of bed rest after overnight fasting and ingestion of 900Cal high-carbohydrate and high-fat test beverages on separate days. Detrended Fluctuation Analysis (DFA), k-means cluster and ANOVA analyses of scaling coefficients α, α(1), and α(2), showed dependencies on hourly measurements of systolic blood pressure and on premeasured BMI., Results: It was observed that α value increased during the caloric challenge, appears to represent metabolically-induced changes in HRV across the participants. An ancillary analysis was performed to determine the dependency on BMI without BMI as a parameter. Cluster analysis of the high-carbohydrate test beverage treatment and the high-fat treatment produced grouping with very little overlap. ANOVA on both clusters demonstrated significance at p<0.001. We were able to demonstrate increased sympathetic modulation of our study group during ingestion and metabolism of isocaloric high-carbohydrate and high-fat test beverages., Conclusion: These findings demonstrate significantly different clustering of α, α1, and α2 and Systolic Blood Pressure (SBP) with respect to normal, overweight and obese BMI.

During routine anatomy dissection classes for undergraduate medical students, an unilateral case of superficial ulnar artery (SUA) in a 75-year-old male human cadaver arosing from the third part of the right axillary artery at the junction of the two median nerve roots was observed. In the hand, the SUA coursed over the flexor retinaculum and anastomosed with the superficial palmar branch of the radial artery to form the superficial palmar arch. After the origin of the SUA, the axillary artery continued as the brachial artery, which was divided into radial and common interosseous arteries at the neck of the radius. The normal ulnar artery was absent. In the same cadaver, a thin walled dilatation was seen on its palmar aspect at the base of the 1st metacarpal bone (Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk.