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The Bidirectional Gut-Brain Axis: Impact of Dysbiosis on Depression Through the HPA Axis
No full textEmerging research suggests that depression is not solely a brain disorder but is deeply influenced by the gut microbiome. The gut-brain axis (GBA) is a bidirectional communication system linking the gastrointestinal system and the brain, modulating mood, behavior, and mental health. Gut microbiota produce metabolites, such as short-chain fatty acids (SCFAs) and tryptophan catabolites, that influence neurotransmission and the stress response via the hypothalamic-pituitary-adrenal (HPA) axis. Dysbiosis, or microbial imbalance, disrupts these pathways, contributing to a major depressive disorder (MDD). Evidence from germ-free animal studies and fecal microbiota transplants (FMT) highlights the role of gut microbiota in emotional regulation and stress response. Targeting the gut microbiome through probiotics, prebiotics, and dietary interventions presents a promising avenue for innovative and personalized depressive treatments
Quality of Life and Surgical Treatment Regret in Patients With Benign Prostatic Hypertrophy: A Multicenter Study
No full textINTRODUCTION: Benign prostatic hypertrophy (BPH) is a common condition affecting men later in life, significantly impacting quality of life (QOL). Surgical intervention is often pursued when medical management fails, but patient satisfaction with outcomes varies. Decisional regret can affect perceived success and patient satisfaction post-surgery. This study evaluates the relationship between post-surgical symptoms and decisional regret across BPH procedures. METHODS: A prospective, multicenter cohort study included 54 patients undergoing BPH surgery between March 2023 and February 2024. Patients completed the International Prostate Symptom Score-QOL (IPSS-QOL) scale preoperatively and at least three months postoperatively, along with the Decision Regret Scale (DRS). Surgical types included Urolift, Greenlight Laser, Rezum, Aquablation, and transurethral resection of the prostate (TURP). A DRS score of ≥25 indicated significant regret. Changes in IPSS-QOL were correlated with DRS scores (Spearman\u27s rho), and subgroup comparisons were conducted using Mann-Whitney U tests. RESULTS: The average DRS score was 18.3, with 33% of patients reporting a DRS ≥25. Moderate correlations existed between quality of life (QOL) change (ρ = 0.34, p \u3c 0.05) and total regret score. Minimally invasive surgical treatment (MISTs) patients demonstrated higher regret correlations than TURP. Lack of efficacy (75%), new symptoms (41%), and postoperative complications (25%) were the most common reasons for regret. CONCLUSION: While BPH surgery generally improves symptoms, a substantial portion of patients experience decisional regret. This underscores the importance of preoperative counseling to establish realistic expectations and reduce regret. Further research should explore strategies to enhance shared decision-making and align patient expectations with possible surgical outcomes
Response to Letter to the Editor Regarding the Article “Acute Myocardial Infarction and Stage E Shock: Insights From the RECOVER III Study”
No full textTumour Necrosis Factor-Alpha at the Intersection of Renal Epithelial and Immune Cell Function
No full textThis review explores the roles of tumour necrosis factor-alpha (TNF) in kidney physiology and pathology. TNF, produced by renal epithelial cells, regulates glucose, electrolyte, water and urea transport by modulating key transporters such as sodium-glucose co-transporter-2 (SGLT2), sodium-potassium-chloride cotransporter 2 (NKCC2), sodium chloride cotransporter (NCC), epithelial sodium channel (ENaC), aquaporin-2 (AQP2) and urea transporters. Under non-inflammatory conditions, TNF functions as a regulatory ‘brake’ on water and solute transport, particularly by attenuating NKCC2 and AQP2 activity. Disruption of these actions, coupled with increased salt intake, shifts mice from being salt-resistant to salt-sensitive, thereby altering their blood pressure. In autoimmune diseases, chronic kidney disease (CKD), hypertension with renal inflammation, and sepsis, TNF drives immune responses and disease progression. Although mechanisms underlying tubular epithelial cell (TEC)-immune cell interactions remain unclear, emerging evidence indicates that the spatial organization of immune responses in the kidney is associated with distinct TEC signature phenotypes. Hypertonicity- and NFAT5 (i.e. nuclear factor of activated T cells 5)-driven TNF production in TECs and T lymphocytes may influence immune cell communication by affecting co-stimulatory molecule expression and ENaC activity on macrophages and dendritic cells. Although TNF is generally pathogenic in renal diseases, its inhibition does not always confer protection because its effects on endoplasmic reticulum stress, ion transport, vascular smooth muscle and immune cells are influenced by distinct cellular sources and signalling mechanisms through TNF receptors 1 and 2. Anti-TNF therapies are crucial for treating chronic inflammatory diseases and may also aid in preventing the progression of acute kidney injury to CKD. A more complete understanding of the role of TNF in immunophysiological responses may enable the development of more targeted therapeutic strategies. (Figure presented.)
Artificial Intelligence Advancements in Oncology: A Review of Current Trends and Future Directions
No full textCancer remains one of the leading causes of mortality worldwide, driving the need for innovative approaches in research and treatment. Artificial intelligence (AI) has emerged as a powerful tool in oncology, with the potential to revolutionize cancer diagnosis, treatment, and management. This paper reviews recent advancements in AI applications within cancer research, focusing on early detection through computer-aided diagnosis, personalized treatment strategies, and drug discovery. We survey AI-enhanced diagnostic applications and explore AI techniques such as deep learning, as well as the integration of AI with nanomedicine and immunotherapy for cancer care. Comparative analyses of AI-based models versus traditional diagnostic methods are presented, highlighting AI’s superior potential. Additionally, we discuss the importance of integrating social determinants of health to optimize cancer care. Despite these advancements, challenges such as data quality, algorithmic biases, and clinical validation remain, limiting widespread adoption. The review concludes with a discussion of the future directions of AI in oncology, emphasizing its potential to reshape cancer care by enhancing diagnosis, personalizing treatments and targeted therapies, and ultimately improving patient outcomes
Rigorous Process for Isolation of Gut-Derived Extracellular Vesicles (Evs) and the Effect on Latent HIV
No full textThe human gastrointestinal (GI) track host trillions of microorganisms that secrete molecules, including extracellular vesicles (EVs) and extracellular condensates (ECs) that may affect physiological and patho-physiological activities in the host. However, efficient protocols for the isolation of pure and functional GI-derived EVs|ECs is lacking. Here, we describe the use of high-resolution particle purification liquid chromatography (PPLC) gradient-bead-column integrated with polyvinylpolypyrrolidone (PVPP)-mediated extraction of impurities to isolate EVs from colonic content (ColEVs). PVPP facilitates the isolation of pure, non-toxic, and functionally active ColEVs that were internalized by cells and functionally activate HIV LTR promoter. ColEVs isolated without PVPP have a reductive effect on MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) without living cells, suggesting that ColEVs contain reductases capable of catalyzing the reduction of MTT to formazan. The assessment of the origin of ColEVs reveals that they are composed of both bacteria and host particles. This protocol requires ~12 h (5 h preprocessing, 7 h isolation) to complete and should be used to purify EVs from sources contaminated with microbial agents to improve rigor. This protocol provides a robust tool for researchers and clinicians investigating GI-derived EVs and the translational use of GI-derived EVs for diagnostic and therapeutic use. Additionally, GI-derived EVs may serve as a window into the pathogenesis of diseases
Reproductive Health Literacy and Knowledge Among Female Refugees: A Scoping Review of Measurement Methodologies and Effect on Health Behavior
No full textReproductive health literacy (RHL) is essential to women’s ability to make informed reproductive health (RH) decisions and is a key determinant of RH outcomes. Resettled refugee women often experience poorer RH outcomes, yet there is limited research on their RHL and its influence on RH decision-making. This scoping review aims to (1) to evaluate existing methods for measuring RHL among resettled refugee women and (2) to characterize the relationship between RHL, RH decision-making, behavior, and outcomes among refugee women residing in high-income countries. A search of peer-reviewed literature published in English found limited direct measurement of RHL. Measurement methods were primarily qualitative or based on unvalidated survey instruments, limiting comparability and generalizability. The current methodologies do not adequately capture RH knowledge or RHL proficiency. A range of additional factors were found to influence RH decision-making and behavior, supporting the need for a means to accurately measure RHL. Further quantitative research is needed to clarify the extent to which RHL and knowledge influence RH behavior and outcomes. The development of a culturally relevant, validated RHL instrument that integrates knowledge and contextual influences would support healthcare providers and public health agents in serving and designing effective interventions for refugee women post-resettlement
Cardiovascular Effects of Cannabinoids
No full textMarijuana is now one of the most widely used substances in the United States that has been rising in prevalence given increasing legalization and recreational and medical usage. Despite its widespread use, there have been increasing concerns regarding the cardiovascular safety of marijuana. Recent studies have found a link between marijuana use and the development of cardiovascular disease. Most notably, marijuana has been found to be associated with various cardiac complications, including atherosclerosis, myocardial infarction, stroke, cardiomyopathy, arrhythmia, and arteritis. Given these growing concerns, this article seeks to examine the effects and significance of marijuana on cardiovascular health
Hypothermia on Admission Predicts Poor Outcomes in Adult Trauma Patients
No full textBackground: Hypothermia is known to contribute to poor outcomes in trauma patients during acute phases. The aim of our study is to evaluate the effect of hypothermia on admission, upon in-hospital complications and mortality in adult trauma patients. Methods: We performed a 5-year analysis of ACS-TQIP database (2017–2021). Patients with incomplete data, burns, inter-facility transfers, or documented as dead on arrival were excluded. Hypothermia (HT) was defined as a temperature of \u3c35 degrees Celsius (°C), and Normothermia (NT) as ≥35 °C to≤40 °C measured at the time of patient arrival. Data were collected including demographic variables, mechanism of injury, injury severity, injury patterns, and shock index. Outcome variables were mortality, ICU length of stay (LOS), duration of mechanical ventilation, hospital LOS, and in-hospital complications. Multivariable regression analysis was performed. Results: A total of 3,043,030 patients were included and 1 % were hypothermic. HT patients were severely injured, developed in-hospital complications (17.1 %vs.4.5 %), had longer ICU LOS (4 (2–9) vs. 3 (2–5) days), hospital LOS (5 (2–12) vs. 4 (2–6) days), and higher mortality (23.4 % vs. 2.3 %). Hypothermia was independently associated with higher odds of mortality (OR:1.934 [1.858–2.013]). Subgroup analysis of patients with isolated traumatic brain injury revealed pre-hospital hypothermia to still be an independent predictor of mortality (OR: 1.728[1.600–1.867]). HT who underwent rewarming had a lower mortality, shorter hospital and ICU LOS. Conclusion: Pre-hospital hypothermia is independently associated with higher resource utilization, in-hospital complications, and mortality. Even in patients with isolated TBI, pre-hospital hypothermia increases the odds of mortality. Rewarming interventions can potentially improve outcomes among patients, even with mild hypothermia. Level of evidence: Level III retrospective stud