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Objective: A healthy diet is a modifiable risk factor that may impact cognition. A unique type of diet may include intermittent fasting (IF), an eating pattern in which individuals go extended periods with little or no meal intake, intervening with periods of normal food intake. IF has multiple health benefits including maintenance of blood glucose levels, reduction of insulin levels, depletion or reduction of glycogen stores, mobilization of fatty acids, and generation of ketones. IF has shown neuroprotective effects as it may lead to increased neurogenesis in the hippocampus, which may contribute to cognitive resilience. Diets including IF were examined as lifestyle modifications in the prevention and management of cognitive decline. Methods: A systematic literature search was conducted for randomized controlled trials (RCTs) which assessed the effect of dieting on cognitive functions in adults. Results: Dietary Approaches to Stop Hypertension (DASH), low-glycemic diets, and caloric restriction have shown improvement in cognitive function; however, there was a negative impact on problem-solving in those with comorbid cardiovascular disease. There is also contradictory evidence that caloric restriction and diet alone may not be sufficient for the improvement of cognitive functions and that exercise may have better efficacy on cognition. Conclusion: IF is considered a safe intervention, and no adverse effects were found in the reviewed studies; however, evidence is limited as there were only 9 low-quality RCTs that assessed the impact of IF on cognition. DASH, low-glycemic diets, and exercise may have effective roles in the management and prevention of cognitive decline, although further research is needed. [ABSTRACT FROM AUTHOR]

Background/Aims: Cannabis is increasingly used in the management of pain, though minimal research exists to support its use since approval. Reduction in stigma has led to a growing interest in pharmaceutical cannabinoids as a possible treatment for lower back pain (LBP). The objective of this review was to assess the role and efficacy of cannabis and its derivatives in the management of LBP and compile global data related to the role of cannabis in the management of LBP in an aging population. Methods: A systematic review was conducted using predetermined keywords by 3 independent researchers. Predetermined inclusion and exclusion criteria were applied, and 23 articles were selected for further analysis. Results: Studies identified both significant and insignificant impacts of cannabis on LBP. Contradicting evidence was noted on the role of cannabis in the management of anxiety and insomnia, 2 common comorbidities with LBP. The existing literature suggests that cannabis may be used in the management of LBP and comorbid symptoms. Conclusions: Further research is needed to consider cannabis as an independent management option. There is a lack of evidence pertaining to the benefits of cannabis in an aged population, and thus, additional research is warranted to support its use in the aged population. [ABSTRACT FROM AUTHOR]

Background: Chronic neuropathic pain (CNP) is a complex condition that has profound impacts on quality of life. Pulsed radiofrequency (PRF) on the dorsal root ganglia (DRGs) is a novel treatment that has shown clinical efficacy in pain relief, however, its mechanism remains unknown. Objectives: The objective of this review is to synthesize the literature on inflammatory markers and clinical pain outcomes in CNP patients treated with PRF. Study Design: A narrative review was conducted. Setting: Eligibility criteria included human trials on adults diagnosed with CNP. Monopolar and bipolar PRF treatments on the DRG were included. Methods: Four peer reviewed electronic databases (Medline, EMBASE, PubMed, and Cochrane) were systematically searched for studies on PRF on the DRG to treat CNP. The primary outcome measures included pain scores and cerebrospinal fluid samples taken pre- and posttreatment measuring inflammatory markers. Results: Thirty-three articles were identified in the database searches. Titles, abstracts, and full-text articles were evaluated, and eight articles met the inclusion criteria. The study designs included five randomized-controlled trials and three quasi-experimental studies. Patients: There were 311 patients pooled with an age range of 35–76 years. Types of CNP included chronic radicular pain, postmastectomy pain syndrome, chronic lumbosacral pain, and postherpetic neuralgia. Intervention: Treatments in included studies included monopolar and bipolar PRF stimulation ranging from 120 s at 2 Hz to 360 s with 5 Hz pulses. Measurement: The main findings revealed that PRF treatment provided significant pain relief (P < 0.05), with the greatest pain reduction at 3 months. Pro-inflammatory markers were found to decrease, whereas anti-inflammatory markers increased post-PRF intervention. Limitations: There were differing PRF procedure standards, and it is uncertain whether a higher frequency or duration is correlated with better outcomes. Studies had small sample sizes increasing the margin of error. Longer duration randomized-controlled trials are needed to understand the optimal therapeutic duration using PRF. [ABSTRACT FROM AUTHOR]

Introduction: Several forms of cannabinoids are currently being used to manage nausea and vomiting (N/V). Emerging cases of refractory N/V associated with chronic cannabis use among adults and older patients have been reported named cannabis hyperemesis syndrome (CHS). CHS is a condition that leads to repeated and severe N/V in long-term users of cannabinoids.Objective: The aim of this study was to outline current treatments for the management of CHS.Methods: A systematic review was conducted using PubMed, Ovid MEDLINE, Cochrane Central, EMBASE, and Google Scholar. Databases were used to search for articles on CHS published from January 2009 to June 2021, yielding 225 results of which 17 were deemed relevant and underwent review by 2 separate reviewers.Results: The duration of cannabis administration ranged between 6 months to 11 years may precipitate symptoms of CHS. The Rome IV diagnostic criteria of CHS require cannabinoid use and persistence of N/V symptoms for at least the past 6 months. Cannabis cessation is noted to be the most successful management, but other treatments also demonstrated symptom relief; these include hot water hydrotherapy, topical capsaicin cream, haloperidol, droperidol, benzodiazepines, propranolol, and aprepitant administration.Conclusion: More research on CHS is needed to enhance knowledge translation, education, and create awareness in the medical community on the side effects of cannabinoids and to propose the best treatment options. [ABSTRACT FROM AUTHOR]