Stress matters: Randomized controlled trial on the effect of probiotics on neurocognition.

Probiotics are microorganisms that provide health benefits when consumed. In animals, probiotics reverse gut microbiome-related alterations in depression-like symptoms, in cognition, and in hormonal stress response. However, in humans, a causal understanding of the gut-brain link in emotion and cognition is lacking. Additionally, whether the effects of probiotics on neurocognition are visible only in presence of stress, remains unclear. We investigated the effects of a multispecies probiotic (Ecologic®Barrier) on specific neurocognitive measures of emotion reactivity, emotion regulation, and cognitive control using fMRI. Critically, we also tested whether probiotics can buffer against the detrimental effects of acute stress on working memory. In a double blind, randomized, placebo-controlled, between-subjects intervention study, 58 healthy participants were tested once before and once after a 28-day intervention. Without stress induction, probiotics did not affect brain, behavioral, or related self-report measures. However, relative to placebo, the probiotics group did show a significant stress-related increase in working memory performance after supplementation. This change was associated with intervention-related neural changes in frontal cortex during cognitive control exclusively in the probiotics group. Overall, our results show neurocognitive effects of a multispecies probiotic in healthy women only under challenging situations, buffering against the detrimental effects of stress on cognition.

Consensus in chronic ankle instability: aetiology, assessment, surgical indications and place for arthroscopy.

Ankle sprains are the most common injuries sustained during sports activities. Most ankle sprains recover fully with non-operative treatment but 20-30% develop chronic ankle instability. Predicting which patients who sustain an ankle sprain will develop instability is difficult. This paper summarises a consensus on identifying which patients may require surgery, the optimal surgical intervention along with treatment of concomitant pathology given the evidence available today. It also discusses the role of arthroscopic treatment and the anatomical basis for individual procedures.

The arthroscopic Lapidus procedure.

BACKGROUND: Hypermobility of the first metatarsocuneiform (MC) joint is one of the causes believed to contribute to symptomatic hallux valgus. An arthrodesis of the first MC joint offers definitive correction of the intermetatarsal angle. This procedure can be associated with pseudoarthrosis and shortening of the first ray. This study presents our experience and results with an arthroscopic technique for performing this arthrodesis. MATERIALS AND METHODS: Five patients with severe hallux valgus associated with hypermobility of the first MC joint were treated with this operation. RESULTS: The functional assessment scales revealed very good results. Radiographic evaluation confirmed fusion in all the patients. The hallux valgus angle improved by 25.6°, the intermetatarsal angle improved by 10.6°. The shortening of the first ray was limited to 2.7 mm. CONCLUSION: This new technique is a valid option for performing an arthrodesis of the MC joint.

An arthroscopic technique to treat the iliotibial band syndrome.

Iliotibial band syndrome (ITBS) is an overuse injury mainly affecting runners. The initial treatment is conservative. Only, in recalcitrant cases surgery is indicated. Several open techniques have been described. The purpose of this study is to evaluate the results of a standardized arthroscopic technique for treatment of a resistant ITBS. Thirty-six athletes with a resistant ITBS were treated with a standardized arthroscopic technique, limited to the resection of lateral synovial recess. Thirty-three patients were available for follow-up (mean 2 years 4 months). Thirty-two patients (34 knees) had good or excellent results. All patients went back to sports after 3 months. In two patients a meniscal lesion was found, which required treatment. One patient with only a fair result had associated cartilage lesions of the femoral condyle. Our results show that arthroscopic treatment of resistant ITBS is a valid option with a consistently good outcome. In addition, this arthroscopic approach allows excluding or treating other intra-articular pathology.

Osseous overgrowth in congenital amputations of the upper limb: report of 3 cases treated with autologous stump plasty.

Osseous overgrowth is an important problem after traumatic or surgical amputations in children. It is rather exceptional in congenital amputations. We report three cases of congenital amputation of the humerus with osseous overgrowth. They were treated with an autologous stump plasty according to Marquardt's technique.

A balance of tastes. Chefs & dietitians roundtable discussion.

The demands from foodservice customers for healthier foods that also taste good have compelled chefs & dietitians to break off their traditional separation of powers & begin forming working partnerships. These new partnerships are producing menus that strike a balance just as new--a balance between the preferences & priorities of both professions. It means a combining of two different but not incompatible perspectives that magnifies both the pleasure & the benefit of the good food they serve. In recognition of these new partnerships, FM convened the first roundtable with chefs & dietitians, all of whom are on the leading edge of this emerging trend. Excerpts of their discussion reflect striking similarities in opinion--as well as differences still to be reconciled.

Reduced lipid contamination in in vivo 1H MRSI using time-domain fitting and neural network classification.

It is a well-known problem that metabolite maps, reconstructed from in vivo 1H MRSI data sets, may suffer from contamination caused by the presence of strong lipid signals. In the present investigation, the lipid problem was addressed by applying specific signal processing and data-analysis techniques, combined with pattern recognition based on the concept of the artificial neural network. In order to arrive at images, cleaned from lipid artifacts, we have applied our previously introduced iterative and noniterative time-domain fitting procedures. Furthermore, reduction in computational time of the image reconstructions could be realized by using information provided by a neural network classification of the spectra, calculated from the MRSI data sets.