Press reviews
2024-07-24
The beneficial effects of Vitamin D supplementation in women with polycystic ovary syndrome
Allergology and Immunology Gynecology
Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of childbearing age. It is characterised by hormonal imbalances, menstrual disorders and ovarian cysts. PCOS is one of the main causes of female infertility and is associated with a variety of symptoms and complications. This study explored the effects of vitamin D supplementation on metabolic parameters in women with polycystic ovary syndrome (PCOS). PCOS is often associated with metabolic abnormalities such as obesity and insulin resistance. The aim of this study was to determine whether vitamin D supplementation could improve these parameters in women with PCOS who are vitamin D deficient or deficient.
Un total de 60 femmes atteintes de SOPK avec une carence ou une insuffisance en vitamine D ont été recrutées pour cet essai contrôlé randomisé. Les participantes ont été réparties aléatoirement en deux groupes : un groupe recevant de la vitamine D (2000 UI/jour) et un groupe contrôle. Les paramètres observés ont été mesurés au départ et après le traitement, incluant l'indice de masse corporelle (IMC), le rapport taille/hanche (RTH), le test de tolérance au glucose oral (OGTT) et le test de libération d'insuline, ainsi que les paramètres du métabolisme lipidique.
Les concentrations sériques de 25(OH)D à différents moments après la supplémentation en vitamine D étaient significativement plus élevées que dans le groupe contrôle. L'IMC, le RTH, les concentrations d'insuline, le modèle d'évaluation de l'homéostasie de la résistance à l'insuline, les triglycérides (TG), le cholestérol total (TC) et les concentrations de cholestérol à lipoprotéines de basse densité (LDL-C) chez les femmes du groupe vitamine D après 12 semaines de traitement étaient significativement plus bas que chez les femmes du groupe contrôle. Les concentrations sériques d'insuline et le HOMA-IR à différents moments de l'OGTT, les concentrations sériques de TG, TC et LDL-C chez les femmes du groupe vitamine D étaient significativement plus bas comparé au groupe contrôle.
In conclusion, vitamin D supplementation has beneficial effects on metabolic parameters in women with PCOS, particularly in women who are obese or have insulin resistance. These results suggest that vitamin D supplementation could be an effective strategy for improving metabolic abnormalities in this specific population.
In conclusion, vitamin D supplementation has beneficial effects on metabolic parameters in women with PCOS, particularly in women who are obese or have insulin resistance. These results suggest that vitamin D supplementation could be an effective strategy for improving metabolic abnormalities in this specific population.
Autism, or autism spectrum disorder (ASD), is a complex neurodevelopmental disorder that affects communication, social interaction and behaviour. Symptoms generally appear in early childhood, often before the age of three, and persist throughout life. The term ‘spectrum’ underlines the great variability in the manifestations and levels of severity of autism. The study entitled ‘Healthy Prenatal Dietary Pattern and Offspring Autism’ explored the association between prenatal dietary habits and the diagnosis of autism, as well as the traits associated with autism in children. This research was carried out using data from two large prospective cohorts: the Norwegian Mother Father and Child Cohort Study (MoBa) and the Avon Longitudinal Study of Parents and Children (ALSPAC).
The aims of the study were to determine whether a healthy prenatal diet could be associated with a reduced risk of autism diagnosis and social communication difficulties in children. The participants were women with singleton pregnancies who completed food frequency questionnaires.
The primary exposure studied was adherence to a healthy prenatal diet, derived by factor analysis and modelled as low, medium or high adherence. The primary outcomes measured included diagnosis of autism and a high score on the social communication questionnaire at ages 3 and 8 for MoBa, and a high score on a checklist of social communication difficulties at age 8 for ALSPAC. The final adjusted results showed that high adherence to a healthy diet during pregnancy was associated with reduced odds of diagnosis of autism and social communication difficulties at age 3 in MoBa and at age 8 in ALSPAC.
These results suggest that a healthy prenatal diet may play a protective role against the development of autism and social communication difficulties in children. However, the study did not find a consistent association with restrictive and repetitive behaviours, indicating that the beneficial effect of prenatal diet may be specific to certain aspects of the autism spectrum.
In conclusion, adherence to a healthy diet during pregnancy appears to be associated with a reduced risk of autism diagnosis and social communication difficulties in children, but further research is needed to confirm these results and explore the underlying mechanisms.
2024-07-22
Consumption of sugary drinks promotes chronic back pain
Endocrinology and metabolism Rhumatology
Chronic lumbar pain is defined as pain in the lumbar region that has been present for more than 3 months. This pain may radiate to the buttock, the iliac crest or even the thigh, and only exceptionally extends beyond the knee. This study examined the relationship between sweetened beverage consumption (SSB) and chronic low back pain (CLBP). SSB consumption has become a major public health problem worldwide. However, no study had specifically examined the link between SSB intake and CLBP prior to this research. The main objective of this study was to establish the links and the risk associated with CLBP.
This cross-sectional study recruited participants aged 20 to 69 from the National Health and Nutrition Examination Survey (NHANES). CLBP was defined as persistent low back pain for a consecutive period of three months. SSB consumption was assessed and calculated on the basis of dietary recall interviews. Survey-weighted logistic regression models were used to assess the association between SSB intake and CLBP risk, while restricted cubic spline (RCS) analysis was used to determine whether non-linear associations existed between SSB intake and CLBP risk. In addition, subgroup analysis was performed using stratification and interaction analysis for all covariates.
A total of 4,146 participants were included in the final analysis. The results of the survey-weighted logistic regression models showed that SSB consumption was significantly associated with an increased risk of CLBP in individuals aged 20-69 years. In addition, the results of the subgroup analysis and interaction analysis showed that the association between SSB intake and the risk of CLBP was modified by smoking status and hypertension. More specifically, the risk of CLBP associated with SSB consumption was more pronounced in smokers and people suffering from hypertension.
In conclusion, reducing SSB consumption could help prevent CLBP in individuals aged between 20 and 69. In addition, smokers or people with hypertension should be more vigilant about the risk of LBP associated with SSB consumption. Nevertheless, caution should be exercised in interpreting the results of this study, as further research is needed to explore the association between SSB consumption and CLBP in greater depth.
These results highlight the importance of moderating sweetened beverage consumption, not only to prevent metabolic pathologies such as obesity and diabetes, but also to potentially reduce the risk of chronic low back pain, particularly in at-risk populations.
Translated with DeepL.com (free version)
2024-07-17
Endocrinology and metabolism
The distribution of adipose tissue and muscle mass in different regions of the body may reflect various mechanisms influencing mortality in individuals with type 2 diabetes (T2D). The aim of this study was to explore the associations between body fat and muscle mass and mortality from cardiovascular disease (CVD) and non-cardiovascular disease (non-CVD).
The study was carried out on a sample of 1417 adults aged 50 and over with T2D selected from the National Health and Nutrition Examination Survey. Dual-energy X-ray absorptiometry (DXA) was used to assess fat mass index (FMI) and muscle mass index (MMI) for the whole body as well as for the trunk, arms and legs. Mortality data up to 31 December 2019 were extracted from the National Death Index. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated from proportional Cox regression models.
The weighted mean age of participants was 63.7 years, with an equal distribution between men and women. During a median follow-up of 13.6 years, 797 deaths were recorded, 371 related to CVD and 426 to non-CVD causes.
The main results were as follows:
- An increase in IMF in the arms was associated with an increased risk of non-CVD mortality, whereas an increase in IMF in the trunk or legs was not significantly associated with CVD or non-CVD mortality.
- An increase in MMI in the arms was associated with a reduced risk of CVD and non-CVD mortality
- A significant interaction between smoking status and FMI in the arms on non-CVD mortality was observed. In current or former smokers, a higher IMF in the arms was associated with a higher risk of non-CVD mortality, but this association was not found in non-smokers.
The results of this study showed that body fat and muscle mass, particularly in the arms, have different associations with CVD and non-CVD mortality in people with T2D. These findings highlight the predictive value of arm body composition in predicting mortality in older adults with T2D. It is essential to take into account the regional distribution of fat and muscle mass when assessing mortality risk in this population.
2024-07-16
High levels of HDL cholesterol reduce the risk of developing low back pain
Endocrinology and metabolism
Low back pain affects many people and can have a variety of causes, including metabolic factors. Lipid levels, such as HDL cholesterol (HDL-C), LDL cholesterol (LDL-C) and triglycerides (TG), have been associated with various health problems, but their link with low back pain remains unclear. The aim of this study was to assess whether lipid levels directly influenced the risk of low back pain using Mendelian Randomisation (MR), a method that helps to establish causal links by minimising confounding bias and reverse causation.
This two-sample MR study used data extracted from the public database of the Integrative Epidemiology Unit of the MRC (Medical Research Council). The authors selected three single-nucleotide polymorphisms (SNPs) associated with lipid levels (HDL-C, LDL-C and TG) and two SNPs associated with risk of low back pain (LBP and back pain). These SNPs were used as genetic instrumental variables.
Statistical analyses were performed using several methods, including inverse-variance weighted (IVW), weighted median, MR-Egger, robust adjusted profile score (MR-RAPS) and MR-PRESSO, to examine potential causal associations between lipid levels and risk of LBP.
This two-sample MR study used data extracted from the public database of the Integrative Epidemiology Unit of the MRC (Medical Research Council). The authors selected three single-nucleotide polymorphisms (SNPs) associated with lipid levels (HDL-C, LDL-C and TG) and two SNPs associated with risk of low back pain (LBP and back pain). These SNPs were used as genetic instrumental variables.
Statistical analyses were performed using several methods, including inverse-variance weighted (IVW), weighted median, MR-Egger, robust adjusted profile score (MR-RAPS) and MR-PRESSO, to examine potential causal associations between lipid levels and risk of LBP.
Estimates by IVW (fixed effect) indicated that an increased level of HDL-C was negatively associated with the risk of low back pain in European populations. Similar results were obtained with IVW (random effect), MR-Egger, MR-RAPS and MR-PRESSO.
However, no association was observed between LDL-C or TG levels and the risk of low back pain.
This two-sample MR study demonstrated a causal relationship between HDL-C levels and the risk of low back pain, suggesting that higher levels of HDL-C may reduce the risk of developing low back pain. These results are significant as they provide evidence of a potential protective link of HDL-C levels against low back pain, which may have implications for the prevention and management of low back pain through optimisation of lipid levels.
The authors highlighted the need for further research to elucidate the specific mechanisms by which lipid levels influence the development of low back pain. Future investigations could include prospective studies and clinical trials to confirm these findings and explore possible interventions to modulate lipid levels to prevent low back pain.
In conclusion, this study provides important evidence on the role of HDL-C levels in reducing the risk of low back pain, while highlighting the absence of a causal association with LDL-C and TG levels. These results contribute to a better understanding of the metabolic factors involved in low back pain and open up prospects for prevention strategies based on lipid management.
In conclusion, this study provides important evidence on the role of HDL-C levels in reducing the risk of low back pain, while highlighting the absence of a causal association with LDL-C and TG levels. These results contribute to a better understanding of the metabolic factors involved in low back pain and open up prospects for prevention strategies based on lipid management.
2024-07-15
The mediating role of depression in Gastroesophageal Reflux Disease (GERD) and migraine
Neurology Psychiatry
Gastro-oesophageal reflux disease (GERD) and migraine are common and often co-exist in patients. Understanding the link between these two conditions could improve the clinical management and prevention of both conditions. This study used Mendelian randomisation (MR) methods to assess these relationships while taking into account potential confounding factors and the role of depression as a mediator.
The study used data from genome-wide association studies (GWAS) to conduct two-sample bidirectional RM analyses. This approach allowed causality to be tested in both directions: from GERD to migraine and vice versa. Multivariate MR analysis was performed to adjust for potential confounders such as smoking, alcohol consumption, obesity, type 2 diabetes and depression. MR mediation analysis was used to assess the role of depression in the relationship between GERD and migraine.
The main methods used included the inverse variance weighted (IVW) method, as well as sensitivity methods such as MR-Egger, weighted median and leave-one-out analysis. Heterogeneity and pleiotropy were assessed to ensure the reliability of the results.
The two-way RM analysis revealed a positive causal effect of GERD on migraine, indicating that people with GERD have an increased risk of developing migraines. In contrast, migraine does not increase the risk of GERD. Multivariable MR analysis confirmed that the positive causal effect of GERD on migraine persisted after adjustment for confounders. The MR mediation analysis revealed that depression mediated 28.72% of the effect of GERD on migraine, highlighting the importance of depression as an intermediary factor in this relationship.
The results of this study clarified the positive causal effect of GERD on migraine risk, while highlighting the significant mediating role of depression. This suggests that effective management of GERD, particularly through interventions targeting depression, could help prevent migraine. These findings have important clinical implications, indicating that treatments aimed at controlling GERD and reducing depression could reduce the prevalence and severity of migraines.
The authors call for future research to further explore the specific pathophysiological mechanisms by which GERD influences migraine risk. Such studies could facilitate the development of more effective pharmacological targets or disease management strategies to reduce the impact of GERD and migraine on patients' quality of life.
2024-07-10
Gastroenterology and Hepatology
FMT (Fecal Microbiota Transplantation) is a therapeutic intervention used to treat diseases associated with the gut microbiome, and phages play a crucial role in modulating the bacterial communities of the microbiota.
Intestinal phages influence human health by modulating the bacterial communities of the microbiota. Successful engraftment of donor phages correlates with the efficacy of FMT treatment. However, the effect of FMT on recipient phage populations and, consequently, on the gut environment is not yet well understood.
This study investigated the effects of FMT on the phagome composition of participants in the Gut Bugs Trial (GBT), a double-blind, randomised, placebo-controlled clinical trial evaluating the efficacy of FMT in the treatment of obesity and co-morbidities in adolescents.
Stool samples were taken from donors at the time of treatment and from recipients at four different times (at the start of the study, and at 6 weeks, 12 weeks, and 26 weeks post-intervention). These samples underwent shotgun metagenomic sequencing. Phage sequences were identified and characterised in silico to examine evidence of phage engraftment and to assess the extent of FMT-induced changes in recipient phagome composition. Donor phages engrafted stably in recipients after FMT, constituting a significant proportion of their phagome throughout the study (33.8% ± 1.2% in females and 33.9% ± 3.7% in males). Phage engraftment varied between donors and its efficacy was positively correlated with the alpha diversity of the donor phagome. FMT induced a shift in recipient phagome towards donor composition and increased phagome alpha diversity and variability over time..
FMT significantly modified the phage populations and, more generally, the microbial populations of the recipients. The increase in microbial diversity and variability is consistent with a change in microbial population dynamics. These results suggest that phages play a critical role in modulating the gut environment and open up new avenues for understanding the effectiveness of FMT in modifying the recipient microbiome. The results of this study are important for the development of new therapeutic approaches based on the modulation of the intestinal microbiome by phages. They also highlight the need to further explore the role of phages in the success of FMT treatments and other microbiome-related interventions.
Intestinal phages influence human health by modulating the bacterial communities of the microbiota. Successful engraftment of donor phages correlates with the efficacy of FMT treatment. However, the effect of FMT on recipient phage populations and, consequently, on the gut environment is not yet well understood.
This study investigated the effects of FMT on the phagome composition of participants in the Gut Bugs Trial (GBT), a double-blind, randomised, placebo-controlled clinical trial evaluating the efficacy of FMT in the treatment of obesity and co-morbidities in adolescents.
Stool samples were taken from donors at the time of treatment and from recipients at four different times (at the start of the study, and at 6 weeks, 12 weeks, and 26 weeks post-intervention). These samples underwent shotgun metagenomic sequencing. Phage sequences were identified and characterised in silico to examine evidence of phage engraftment and to assess the extent of FMT-induced changes in recipient phagome composition. Donor phages engrafted stably in recipients after FMT, constituting a significant proportion of their phagome throughout the study (33.8% ± 1.2% in females and 33.9% ± 3.7% in males). Phage engraftment varied between donors and its efficacy was positively correlated with the alpha diversity of the donor phagome. FMT induced a shift in recipient phagome towards donor composition and increased phagome alpha diversity and variability over time..
FMT significantly modified the phage populations and, more generally, the microbial populations of the recipients. The increase in microbial diversity and variability is consistent with a change in microbial population dynamics. These results suggest that phages play a critical role in modulating the gut environment and open up new avenues for understanding the effectiveness of FMT in modifying the recipient microbiome. The results of this study are important for the development of new therapeutic approaches based on the modulation of the intestinal microbiome by phages. They also highlight the need to further explore the role of phages in the success of FMT treatments and other microbiome-related interventions.
2024-07-09
Effects of magnesium supplementation on muscle pain after different types of physical activity
Physical Medicine and Rehabilitation
Magnesium, an essential micronutrient, plays a crucial role in many biochemical reactions, including energy production and storage, control of neuronal and vasomotor activity, cardiac excitability and muscle contraction. Magnesium deficiency can lead to a reduction in physical performance and increase delayed muscle soreness after training.
This systematic review showed the effects of magnesium supplementation on muscle pain in physically active individuals. The study focused exclusively on MgS (MagnesiumSupplementation), excluding studies in which magnesium was administered with other substances. The aim was to determine the optimal type, timing and dosage of MgS to reduce muscle soreness and improve muscle recovery and performance.
The four studies selected showed that magnesium supplementation reduced muscle pain, improved performance and recovery, and had a protective effect against muscle damage. The results suggested that magnesium supplementation of 10-20% above the needs of sedentary people was necessary for individuals practising intense exercise.
In conclusion, magnesium supplementation is beneficial for individuals involved in intense physical activity. It helps to reduce muscle soreness, improve performance and recovery, and protect muscles from damage. To achieve these positive effects, it is essential to increase magnesium intake before training and to maintain adequate magnesium levels throughout the year, including during periods of rest.
These results are important for sportspeople and healthcare professionals seeking to optimise performance and muscle recovery through magnesium supplementation. They highlight the need for appropriate dosage and precise timing to maximise the benefits of MgS in the context of intense physical activity.
This systematic review showed the effects of magnesium supplementation on muscle pain in physically active individuals. The study focused exclusively on MgS (MagnesiumSupplementation), excluding studies in which magnesium was administered with other substances. The aim was to determine the optimal type, timing and dosage of MgS to reduce muscle soreness and improve muscle recovery and performance.
The four studies selected showed that magnesium supplementation reduced muscle pain, improved performance and recovery, and had a protective effect against muscle damage. The results suggested that magnesium supplementation of 10-20% above the needs of sedentary people was necessary for individuals practising intense exercise.
In conclusion, magnesium supplementation is beneficial for individuals involved in intense physical activity. It helps to reduce muscle soreness, improve performance and recovery, and protect muscles from damage. To achieve these positive effects, it is essential to increase magnesium intake before training and to maintain adequate magnesium levels throughout the year, including during periods of rest.
These results are important for sportspeople and healthcare professionals seeking to optimise performance and muscle recovery through magnesium supplementation. They highlight the need for appropriate dosage and precise timing to maximise the benefits of MgS in the context of intense physical activity.
2024-07-08
Cases of Alopecia Aerata following vaccination against Covid-19
Dermatology and Venereology
Since the roll-out of COVID-19 vaccines, various adverse events have been reported, including alopecia areata (AA), which, although rare, has been a notable effect due to its significant social and psychological impact on patients.
The aim of this study was to review the literature on cases of AA following vaccination against COVID-19 in order to provide an overview of the available data.
The systematic review was conducted by searching for articles on AA after COVID-19 vaccination in international databases such as Embase, MEDLINE, PubMed, Web of Knowledge and Ovid, covering the period December 2019 to December 2023. Included studies were required to provide data on patients who developed AA after at least one dose of COVID-19 vaccine. Information collected included gender, age, country/region of origin, vaccine type, time from vaccination to symptom onset, clinical manifestations of AA, trichoscopy and histopathology findings, treatments and outcomes.
Of a total of 579 studies reviewed, 25 articles involving 51 patients were included in the review. Of these patients, 27 (52.9%) developed new AA after receiving the COVID-19 vaccine, while 24 (47.1%) patients with pre-existing AA had a recurrence or exacerbation after vaccination. Five vaccines were associated with cases of AA, with Pfizer vaccine accounting for the highest percentage of cases (45.1%), followed by ChAdOx1 nCoV-19 vaccine (27.5%), Moderna mRNA-1273 (19.6%), Sinopharm (3.9%) and SinoVac (3.9%).
Cases of AA occurred mainly in the month following the first dose of vaccine, then the incidence gradually decreased over time. With regard to treatment, 38 patients were treated with topical or systemic corticosteroids. Eleven patients received Janus Kinase inhibitors (jakinib), eight with tofacitinib and three with an unspecified jakinib. However, three of the eleven patients treated with jakinibs experienced post-treatment exacerbations.
AA after vaccination against COVID-19 is a rare but significant phenomenon. Physicians need to be aware of this possibility to enable early diagnosis and appropriate treatment. This review highlights the need for increased vigilance and early recognition of symptoms of post-vaccination AA in order to effectively manage this potential complication.
The aim of this study was to review the literature on cases of AA following vaccination against COVID-19 in order to provide an overview of the available data.
The systematic review was conducted by searching for articles on AA after COVID-19 vaccination in international databases such as Embase, MEDLINE, PubMed, Web of Knowledge and Ovid, covering the period December 2019 to December 2023. Included studies were required to provide data on patients who developed AA after at least one dose of COVID-19 vaccine. Information collected included gender, age, country/region of origin, vaccine type, time from vaccination to symptom onset, clinical manifestations of AA, trichoscopy and histopathology findings, treatments and outcomes.
Of a total of 579 studies reviewed, 25 articles involving 51 patients were included in the review. Of these patients, 27 (52.9%) developed new AA after receiving the COVID-19 vaccine, while 24 (47.1%) patients with pre-existing AA had a recurrence or exacerbation after vaccination. Five vaccines were associated with cases of AA, with Pfizer vaccine accounting for the highest percentage of cases (45.1%), followed by ChAdOx1 nCoV-19 vaccine (27.5%), Moderna mRNA-1273 (19.6%), Sinopharm (3.9%) and SinoVac (3.9%).
Cases of AA occurred mainly in the month following the first dose of vaccine, then the incidence gradually decreased over time. With regard to treatment, 38 patients were treated with topical or systemic corticosteroids. Eleven patients received Janus Kinase inhibitors (jakinib), eight with tofacitinib and three with an unspecified jakinib. However, three of the eleven patients treated with jakinibs experienced post-treatment exacerbations.
AA after vaccination against COVID-19 is a rare but significant phenomenon. Physicians need to be aware of this possibility to enable early diagnosis and appropriate treatment. This review highlights the need for increased vigilance and early recognition of symptoms of post-vaccination AA in order to effectively manage this potential complication.
2024-07-04
Infectiology
Sepsis is a serious medical condition associated with high morbidity and mortality rates. It often leads to complications such as acute respiratory distress syndrome (ARDS) and sepsis-induced cardiomyopathy (SCM).
Between January 2019 and December 2021, a randomised controlled trial was conducted on patients admitted to the Intensive Care Unit (ICU) of Wuhan Union Hospital, diagnosed with ARDS and SCM. Patients were divided into two groups: a sivelestat-treated group and a control group. Sivelestat was administered intravenously at a dose of 0.2 mg/kg/hour from the time of diagnosis and continued until discharge from the ICU or for up to 14 days.
The clinical efficacy of sivelestat was assessed by measuring levels of plasma inflammatory factors (IL-6, IL-8, TNF-α, HMGB1), cardiac function (by echocardiography) and heart rate variability (HRV) at different time points: at ICU admission, and after 12, 24, 48 and 72 hours of treatment.
A total of 70 patients were included in this study, equally divided between the sivelestat and control groups. IL-6, IL-8 and TNF-α levels were significantly lower in the sivelestat group at different time points (12, 24, 48 and 72 hours). HMGB1 levels showed a significant reduction in the sivelestat group after 72 hours of treatment. In terms of cardiac function, systolic ejection volume (SEV), tricuspid annulus excursion (TAPSE), and early-to-late diastolic flow velocity ratios (E/A), as well as early (e') and late (a') diastolic relaxation velocities, were significantly better in the sivelestat group compared with the control group. The Tei index, an indicator of myocardial performance, was also significantly lower in the sivelestat group, indicating better overall cardiac function.
VFC analyses revealed significant differences between the two groups for the parameters SDNN (standard deviation of normal RR intervals), LF (low frequency), and the LF/HF ratio (high frequency). The control group showed a significant decrease in these indices compared with the sivelestat group, suggesting better cardiac autonomic modulation in the latter.This study confirmed that sivelestat effectively reduced serum inflammatory factor levels, improved cardiac function and reduced heart rate variability in patients with sepsis-induced ARDS and SCM.
By inhibiting neutrophil elastase, sivelestat appears to reduce the production of inflammatory cytokines and protect against tissue damage induced by inflammation and ischaemia-reperfusion. These results are consistent with previous studies showing the anti-inflammatory and protective effects of sivelestat in various pathological conditions associated with excessive inflammation.
Depression is a mental illness with multiple causes, including social, environmental, genetic and psychological factors. The role of nutrition, particularly vitamins and minerals, in mental health has been increasingly studied. Vitamin D deficiency is particularly associated with mood disorders and mental illness. Vitamin D plays a crucial role in the regulation of neurotransmitters and neuro-immune modulation, thus potentially influencing the pathophysiology of depression.
The depressed teenage participants were divided into two groups in this randomised controlled trial: a vitamin D supplementation group (2250 IU per day) and a control group receiving a lower dose (250 IU per day) for nine weeks.
Adolescents were assessed for vitamin D status and depression using the BDI-II questionnaire at the start and end of the intervention. The BDI-II is a self-administered questionnaire with 21 items, each scored on a Likert scale. Vitamin D levels were measured by blood analysis before and after the intervention.
The main results of the study showed a significant reduction in depression scores in the high-dose vitamin D group compared with the control group.
Statistical analysis revealed that the vitamin D supplementation group showed a significant reduction in depression scores compared with the control group, which showed no significant improvement. An intention-to-treat analysis and a per-protocol analysis were carried out, confirming the robustness of these results.
This study highlights the importance of vitamin D in mental health, particularly in adolescents living in areas where vitamin D deficiency is common. The mechanisms by which vitamin D influences depression include its ability to modulate pro-inflammatory cytokines and to protect against the depletion of dopamine and serotonin, two key neurotransmitters in the regulation of mood.
The results of this study are consistent with other research indicating that vitamin D supplementation can improve depression scores. For example, a study by Bahrami et al. in Iran showed similar improvements in adolescent girls who received a high dose of vitamin D. A meta-analysis by Vellekkatt and Menon also found that vitamin D supplementation had a positive impact on depression scores in individuals suffering from major depression.
To conclude, vitamin D supplementation represents a potentially effective, cost-effective and accessible intervention for improving the mental health of adolescents, particularly in low- and middle-income countries where micronutrient deficiencies are common.
To conclude, vitamin D supplementation represents a potentially effective, cost-effective and accessible intervention for improving the mental health of adolescents, particularly in low- and middle-income countries where micronutrient deficiencies are common.
2024-07-01
Physical Medicine and Rehabilitation
Stroke is a serious cerebrovascular disease that can lead to significant neurological sequelae, particularly in the upper limbs. Robotic rehabilitation is increasingly recognised as a promising method of improving upper limb function in stroke patients. The Rebless® is a motorised device that provides movement and resistance exercises for the elbow and wrist, collecting data on the number of repetitions, range of motion (ROM) and levels of resistance and assistance.
In this study, patients were randomly assigned to either the experimental or control group. Each group received upper limb training for 30 minutes per session, with a total of 10 sessions over 4 weeks. The experimental group used the Rebless®, while the control group used the Motomed®, an ergometer for upper limb training. Clinical measures included assessment of motor and functional functions, as well as spasticity, evaluated before and after training.
The results showed a significant improvement in the Fugl-Meyer upper extremity score (FMA-UE) and a reduction in elbow flexor spasticity in the experimental group compared with the control group. The FMA-UE score of the experimental group rose from 27.67 ± 8.41 to 32.00 ± 9.23, while that of the control group rose from 22.07 ± 10.12 to 23.76 ± 9.47. The reduction in elbow flexor spasticity, measured by the Modified Ashworth Scale (MAS), was also more significant in the experimental group.
Cortical activity measured by functional near-infrared spectroscopy showed a significant decrease in cortical activity in the unaffected hemisphere after training in the experimental group, which was not observed in the control group. This suggests a recovery of the contralateral predominance of activation in motor function.
This study shows that Rebless® training is more effective than conventional therapy in improving upper limb function in chronic stroke patients. Improvements in FMA-UE score and elbow flexor spasticity suggest that Rebless® may help restore upper limb motor function and the predominance of contralateral activation.
In conclusion, training with the Rebless® robotic rehabilitation device significantly improves upper limb function and reduces spasticity in chronic stroke patients. It is recommended that robotic rehabilitation devices be incorporated into rehabilitation programmes for these patients in order to maximise functional gains and promote neurofunctional recovery. Further research is needed to assess the long-term effects and effectiveness of these devices in acute stroke patients.
Cystic fibrosis is an autosomal recessive genetic disease. It affects multiple organs, but the most serious consequences are in the lungs. Around 90% of patients succumb to the progression of this lung disease.
Experimental studies have demonstrated the role of the TMEM16A antibody in the production and secretion of mucus.
Benzbromarone, a uricosuric agent used to treat chronic gout, has been shown to inhibit TMEM16A activity in animal models, suggesting potential therapeutic benefits by reducing mucus production and the severity of this disease.
The study was a prospective, open-label pilot trial involving ten cystic fibrosis patients followed up at a tertiary referral centre in southern Brazil. These patients received benzbromarone 100 mg/day orally for 90 days. Inclusion criteria included a positive sweat chloride test (>60 mEq/L), two identified pathogenic variants in the CFTR gene, and a predicted FEV1% of less than 90%. Exclusion criteria included pregnancy, initiation of new therapy, use of CFTR modulators, and pulmonary exacerbations in the four weeks prior to the study.
The primary endpoint was benzbromarone safety, assessed by pulmonary exacerbations, vital signs, physical examinations, haematological and coagulation markers, and drug-related adverse events.
Spirometry tests (FEV1%) were performed at screening, at baseline (day 1), and during follow-up (at 30, 60 and 90 days). Changes in FEV1% were assessed by comparing the values obtained at Day 1 with those obtained at the final visit.
This pilot study was the first to evaluate the use of oral benzbromarone as an adjuvant treatment for cystic fibrosis. Benzbromarone was found to be safe and well tolerated.
The results indicated an increase in FEV1%, suggesting a potential therapeutic benefit.
These results are consistent with preclinical studies showing that inhibition of TMEM16A could reduce mucus production and bronchial hyperresponsiveness. However, larger-scale studies are required to confirm these results and determine the efficacy of benzbromarone as adjuvant therapy.
Oral administration of benzbromarone appears to be a safe therapeutic option with a trend towards improved lung function in cystic fibrosis patients.
2024-06-26
Prebiotics alone are not enough to treat non-alcoholic fatty liver disease
Gastroenterology and Hepatology
Non-alcoholic fatty liver disease (NAFLD) is a common liver disease that often progresses to more serious conditions such as fibrosis and cirrhosis of the liver. There is a strong association between this disease and metabolic syndrome.
Alteration of the gut microbiota has been suggested as a factor contributing to the development and progression of NAFLD.
Here, this randomised, double-blind, placebo-controlled clinical trial explores whether administration of prebiotics can influence liver fat content and other metabolic and inflammatory parameters in patients with NAFLD.
Patients with NAFLD and metabolic syndrome were randomised to receive either 16 g/day of prebiotics (inulin-like fructans, ITFs) or placebo (maltodextrin) for 12 weeks. Measurements included liver fat content (LFC) by NMR spectroscopy (H1MRS), faecal microbiota composition, and metabolic and inflammatory parameters before and after the intervention.
The main results of this study indicated that administration of prebiotics led to a significant increase in the abundance of Bifidobacterium in the faecal samples of patients in the prebiotic group compared with the placebo group.
However, liver fat levels, liver function tests, lipid profiles, fasting blood glucose, insulin levels, HbA1c, HOMA-IR and CRP levels did not show significant changes between the groups after 12 weeks.
The results of this pilot study suggest that prebiotic treatment alone, without weight loss, is not sufficient. Although the increase in Bifidobacterium is promising, it did not translate into significant clinical improvements in terms of liver fat content or other metabolic and inflammatory markers.
This indicates that modification of the gut microbiota by prebiotics may require additional lifestyle changes, such as weight loss, to be effective in the treatment of NAFLD.
Future research should explore combinations of prebiotic treatments with weight loss strategies or other lifestyle modifications to assess their synergistic efficacy.
2024-06-24
Rhumatology
Rheumatoid arthritis (RA) is an autoimmune disease characterised by chronic inflammation of the joints. Anaemia, a common complication in patients with RA, is associated with an increased risk of physical disability and early mortality.
This study aims to clarify the prevalence of anaemia in patients with RA and to explore its association with the Inflammatory Food Index (IFI), which measures the inflammatory potential of the diet.
The data for this study comes from the National Health and Nutrition Examination Survey (NHANES) covering the period from 1999 to 2018. Participants in the study were individuals who had self-reported a diagnosis of RA. After careful selection and exclusion of those with missing data, 2287 participants were included. Anemia was defined according to World Health Organization (WHO) diagnostic criteria. ADI levels were calculated from participants' 24-hour dietary recalls, based on 28 dietary components.
The prevalence of anaemia in RA patients in the United States has been estimated at 10.25%. The lowest prevalence of anaemia was observed around the age of 60. In addition, levels of IAA were significantly higher in anaemic patients compared to non-anaemic patients.
Multivariate regression analyses revealed a significant association between increased risk of anaemia and increasing levels of IAA.
The study used stepwise regression to identify the most crucial dietary factors associated with anaemia risk in RA patients.
The study provides strong evidence for the association between pro-inflammatory diets and increased risk of anaemia in RA patients. The consumption of anti-inflammatory foods could potentially reduce systemic inflammation and therefore reduce the risk of anaemia. However, factors such as socio-economic status and the use of anti-rheumatic drugs could also influence these results.
In conclusion, this study showed that the prevalence of anaemia in patients with RA is significantly associated with high levels of IAA. Management of dietary inflammation could play a crucial role in the prevention and treatment of anaemia in these patients. Further research, including prospective studies, is needed to confirm these results and explore the underlying mechanisms.
