Thyroid Hormone and Mitochondrial Dysfunction: Therapeutic Implications for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly termed nonalcoholic fatty liver disease (NAFLD), is a widespread global health concern that affects around 25% of the global population. Its influence is expanding, and it is anticipated to overtake alcohol as the leading cause of liver failure and liver-related death worldwide. Unfortunately, there are no approved therapies for MASLD; as such, national and international regulatory health agencies undertook strategies and action plans designed to expedite the development of drugs for treatment of MASLD. A sedentary lifestyle and an unhealthy diet intake are important risk factors. Western countries have a greater estimated prevalence of MASLD partly due to lifestyle habits. Mitochondrial dysfunction is strongly linked to the development of MASLD. Further, it has been speculated that mitophagy, a type of mitochondrial quality control, may be impaired in MASLD. Thyroid hormone (TH) coordinates signals from the nuclear and mitochondrial genomes to control mitochondrial biogenesis and function in hepatocytes. Mitochondria are known TH targets, and preclinical and clinical studies suggest that TH, thyroid receptor ß (TR-ß) analogs, and synthetic analogs specific to the liver could be of therapeutic benefit in treating MASLD. In this review, we highlight how mitochondrial dysfunction contributes to development of MASLD, and how understanding the role of TH in improving mitochondrial function paved the way for innovative drug development programs of TH-based therapies targeting MASLD.

FMT: What's Next? A Narrative Review of Fecal Microbiota Transplantation in Clostridioides difficile Infection and Inflammatory Bowel Disease.

Fecal microbiota transplantation (FMT) is an increasingly employed treatment option for Clostridioides difficile infection (CDI), with growing data supporting its safety and effectiveness in patients with concurrent inflammatory bowel disease (IBD). Given that alterations in the gut microbiome are associated with both ulcerative colitis (UC) and Crohn's disease (CD), the use of FMT for the treatment of IBD itself is another area of active investigation. In this narrative review, we highlight the evidence for use of FMT in the treatment of CDI in patients with IBD, as well as for IBD alone, and provide insight into the future of microbiome therapeutics.

Mobile Mitral Valve Vegetations: Not Your Usual Endocarditis.

Mitral annular calcification (MAC) is a chronic degenerative condition that is associated with age, chronic kidney disease, diabetes, dyslipidemia, hypertension, and tobacco use. Mobile calcified lesions can be mistaken for endocarditis on trans-thoracic echocardiogram (TTE), creating a unique diagnostic challenge. In this case, we describe a young dialysis patient who presented with dyspnea on exertion with no obvious etiology on initial work-up. TTE was obtained, which showed mobile lesions on the mitral and aortic valves, initially thought to be endocarditis, but later diagnosed as MAC. Trans-esophageal echocardiography (TEE) is a useful modality to differentiate mobile masses on the mitral valve.

Non-suicidal self-injury in developing countries: A review.

BACKGROUND: Non-suicidal self-injury (NSSI) may be understood as a physical and behavioral expression of emotional distress. Over the past 70 years, it has been variably formulated as a type of emotional reaction to various stressors. NSSI has complex goals, sometimes implicit, but overall it serves as a transient psychological relief. Many believe that NSSI is a maladaptive behavior and is not related to suicide, with the primary differentiating factor between suicide and NSSI being the 'intention' to die. NSSI is an important mental health problem in current modern societies, and it is part of a trend in current psychiatric and mental health practice to medicalize maladaptive behaviors or psychological distress. AIMS: To review the prevalence, associated factors, purpose, and psychological and social significance of NSSI in developing countries. METHOD: This article is a narrative review. However, of the total 1,094 articles, 13 articles were included to derive information on the prevalence and methods of NSSI in the developing country. RESULTS: NSSI rates are very variable, ranging from 11.5% to as high as 33.8%, depending on the nature of the sample and study design, but data show an increasing trend globally, including in developing countries. CONCLUSION: The recent emerging data does not support the notion that it is common in developed Western countries, though the meaning, context and reason for NSSI might differ in developing and developed countries. NSSI is almost equally prevalent in both developing and developed countries.

Tendon repair augmented with a novel circulating stem cell population.

Tendon ruptures are common sports-related injuries that are often treated surgically by the use of sutures followed by immobilization. However, tendon repair by standard technique is associated with long healing time and often suboptimal repair. Methods to enhance tendon repair time as well as the quality of repair are currently unmet clinical needs. Our hypothesis is that the introduction of a unique stem cell population at the site of tendon transection would result in an improved rate and quality of repair. Achilles tendons of fifty-one Sprague-Dawley rats were transected and suture-repaired. In half of the rats, a biodegradable scaffold seeded with allogenic circulating stem cells was placed as an onlay to the defect site in addition to the suture repair. The other half was treated with suture alone to serve as the control group. Animals were randomized to a two-, four-, or six-week time group. At the time of necropsy, tendons were harvested and prepared for either biomechanical or histological analysis. Histological slides were evaluated in a blinded fashion with the use of a grading scale. By two weeks, the experimental group demonstrated a significant improvement in repair compared to controls with no failures. Average histological scores of 0.6 and 2.6 were observed for the experimental and control group respectively. The experimental group demonstrated complete bridging of the transection site with parallel collagen fiber arrangement. By four weeks, both groups showed a continuing trend of healing, with the scaffold group exceeding the histological quality of the tissue repaired with suture alone. Biomechanically, the experimental group had a decreasing cross-sectional area with time which was also associated with a significant increase in the ultimate tensile strength of the tendons, reaching 4.2MPa by six weeks. The experimental group also achieved a significantly higher elastic toughness by six weeks and saw an increase in the tensile modulus, reaching 31Mpa by six weeks. The use of circulating stem cells as an adjunct in tendon repair demonstrates superior biomechanical properties and an improved level of histological organization, when compared to the suture alone control group. These improvements were not previously observed when gene therapy, protein therapy, or current tissue engineering technologies were used.