Antihypertensives and Antibiotics: Impact on Intestinal Dysfunction and Hypertension.

Gut dysfunction has emerged as a contributor to hypertension, the leading risk factor for disease globally, including stroke, heart failure, and kidney disease. This is underpinned by breakdown of the homeostatic relationship connecting intestinal epithelial function, the microbiota and immune responses. Antihypertensive medications have been shown to reverse intestinal dysfunction and gut dysbiosis. However, the mechanisms underlying this restoration of gut structure and function remain largely unknown. In this review, we examine current knowledge supporting a role for impaired intestinal epithelial permeability in hypertension, focusing on electrolyte movement, the renin-angiotensin-aldosterone system, and the restorative effects of orally administered antihypertensive medications and antibiotics. Further work is required to determine if the association between intestinal dysfunction and hypertension is causal. This is a rapidly evolving field, with intestinal dysfunction and dysbiosis representing an area that may be exploited to improve treatment of hypertension and cardiovascular disease.

Using occupation to facilitate self-awareness in people who have acquired brain injury: a pilot study.

BACKGROUND: Impaired self-awareness in people who have had an acquired brain injury (ABI) is a complex phenomenon that impedes rehabilitation progress and outcome. PURPOSE: This pilot study investigated the effect of an occupation-based intervention program on the self-awareness and emotional status of people after ABI. Four male adults with impaired self-awareness following ABI participated in this study. Each received a 10-week individualized program that focused on the performance of three occupations for 1 to 2 hours per week. A facilitative approach was taken, using techniques to improve self-awareness described in the literature. Repeated measures of participants'self-awareness and emotional status were taken pre- and post-intervention, and analyzed descriptively. RESULTS: Results indicated preliminary support for the effectiveness of the program in facilitating participants' self-awareness. However, consideration of baseline and follow-up data indicated a complex picture. Increased anxiety was found to accompany improvements in participants' self-awareness in all four cases. PRACTICE IMPLICATIONS: This study will assist occupational therapists with program development for clients who have had an acquired brain injury.