Role of Lifestyle in Neuroplasticity and Neurogenesis in an Aging Brain.

Neuroplasticity is the brain's ability to transform its shape, adapt, and develop a new neuronal connection provided with a new stimulus. The stronger the electrical stimulation, the robust is the transformation. Neurogenesis is a complex process when the new neuronal blast cells present in the dentate gyrus divide in the hippocampus. We collected articles from the past 11 years for review, using the Medical Subject Headings (MeSH) strategy from PubMed. Quality appraisal was done for each research article using various assessment tools. A total of 24 articles were chosen, applying all the mentioned inclusion and exclusion criteria and reviewed. The reviewed studies emphasized that modifiable lifestyle factors such as diet and exercise should be implemented as an intervention in the elderly for healthy aging of the brain, as the world's aging population is going to be increased, leading to the expansion of health care and cost. Multiple studies have publicized the relation of diet and exercise with cognition function in aging people. A diet consisting of curcumin in its food has its anti-oxidative property, which prevents rapid aging of the brain, other diet patterns such as a caloric restriction diet can influence brain plasticity and preclude the decline of memory. Exercise can increase brain-derived growth factor (BDGF), vascular endothelial growth factor (VEGF), synapsin one, and tyrosine kinase activity that can expand the size of the brain, enhance the plasticity and neurogenesis. This review aimed at exploring lifestyle factors that contribute to neuroplasticity and neurogenesis. Thus, providing a new path for clinicians and researchers to map out the future possible significant benefits for optimal brain aging in a healthy fashion.

Does Treatment for Depression With Collaborative Care Improve the Glycemic Levels in Diabetic Patients with Depression? A Systematic Review.

Diabetes is a chronic disease with a high prevalence in the United States. If not treated adequately, it can have serious complications. Furthermore, when depression affects concomitantly, adherence to treatment can be decreased. Therefore, a cascade of complications may develop, affecting the quality of life and increasing the risk of death. Depression is underdiagnosed in patients with diabetes, and even if diagnosed, the treatment for both diabetes and depression is not well established in primary care. This study aims to evaluate if treatment for depression with collaborative care can improve glycemic levels and depression treatment response in diabetic patients with depression. As well, we will investigate if treatment with antidepressants will aid in improving glycemic levels. For this systematic review, we followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and used PubMed, PubMed Central, and MEDLINE as database. Keywords: "diabetes improvement with depression treatment'. For collaborative care intervention, we selected three systematic reviews and meta-analysis. These three studies gave us a total of 1637 patients evaluated for the glycemic outcome and 1793 patients for depression outcomes. For the intervention with antidepressants, we included two articles. One systematic review and meta-analysis that evaluated the effect of selective serotonin reuptake inhibitors (SSRIs) on glycemic levels and the second article involved was a systematic review that assessed the effect of antidepressants on glycemia. A total of 4119 diabetic patients taking antidepressants were evaluated for glucose levels of the outcome. For the collaborative care outcome: two of the three studies showed non-significant improvement of glycemic levels with intervention. However, one study that had a bigger sample size exhibited significant improvement of glycemia with collaborative care. It is necessary to elaborate on new studies to confirm this finding. For the glycemic outcome with antidepressants: SSRIs improve glycemic levels. This class of antidepressants is the most studied, and it would be interesting to perform trials comparing different classes of antidepressants with a bigger sample size and run for a more extended period. According to our review, collaborative care improves glycemia and depression treatment response. At the same time, it improves the adherence to treatment of both oral hypoglycemic drugs and antidepressants. SSRIs demonstrated to be more effective in glycemic control. The most studied and effective SSRIs are fluoxetine, escitalopram, and citalopram.

Bariatric Surgery and Type 2 Diabetes Mellitus: Assessing Factors Leading to Remission. A Systematic Review.

Type 2 Diabetes Mellitus (T2DM) is a health problem of paramount proportions and is associated with significant morbidity and mortality. Our study aims to review data published on the effects of different types of bariatric surgeries on T2DM remission, compared to lifestyle and medical intervention (LMI) exclusively, along with a comprehensive finding of numerous preoperative factors that lead to remission. We used PubMed, PubMed Central (PMC), and MEDLINE to search for literature. Our criteria included peer-reviewed, English language articles published in 2010 and onwards, consisting of adults with T2DM and a body mass index (BMI) of >30 kg/m2 as the population of interest. Twenty-four articles with 5,411 patients were selected for this systematic review, which included nine randomized controlled trials (RCTs) and 15 observational studies. The primary endpoint was T2DM remission. Based on the review, bariatric surgery is superior to LMI in inducing remission in T2DM, especially when employing the Roux-en-Y Gastric Bypass (RYGB) technique. Lower age of onset and shorter duration of T2DM, along with a high BMI are some of the factors that can lead to greater remission rates. Further research in RCTs is needed by incorporating double/triple-blind protocols, a standard definition of T2DM remission, long follow-up periods to evaluate for relapses in remission and any side effects, with a focus on inflammatory markers (eg, osteopontin), scoring systems (eg, DiaRem), and benefits of One-Anastomosis Gastric Bypass (OAGB) over other modalities, to advance our understanding of T2DM remission.

Obesity and Atrial Fibrillation: Should We Screen for Atrial Fibrillation in Obese Individuals? A Comprehensive Review.

Obesity and obesity-related illnesses (ORIs) constitute a significant burden on the healthcare system, with a very high prevalence in the general population. Atrial fibrillation (AF) is the most common arrhythmia seen by healthcare providers. The risk of AF in obese individuals is reported to be high and in correlation with Body Mass Index (BMI), leading to the high prevalence of AF in the general population and the expected epidemic of AF to come. Greater left atrial dimensions and left atrial remodeling together form the AF substrate in the obese population along with the role of epicardial adipose tissue (EAT) in inducing inflammation and fibrosis of the atrial myocardium and thus facilitating the onset of AF. In our paper, we reviewed the literature published on the link between obesity and AF, as well as the potential behind new management approaches. Multiple studies have explored different approaches, either conventional or novel. Considering the impact of prevention in medicine nowadays, we proposed a screening practice for AF in obese individuals. More research is needed to acquire a comprehensive protocol for the management of AF in the obese population that can be applied by primary healthcare providers to combat this evolving matter.

Investigational drugs for treating anal cancer and future perspectives.

INTRODUCTION: Anal cancer is a relatively rare malignancy which comprises about 2.5% of all digestive system malignancies in the United States. The majority of cases are squamous cell carcinoma which is closely related to human papilloma virus (HPV) infection. Despite high cure rates with chemoradiation alone, 10 - 20% of patients do develop metastatic disease with little data to guide their treatment. AREAS COVERED: In this review article, the authors describe the current standard treatment of early and advanced squamous cell carcinoma of the anal canal based on published data. The authors then describe the new approaches to the disease, focusing on new radio sensitizing agents, systemic targeted drugs and immunotherapy. EXPERT OPINION: The authors believe that current standard treatment options for squamous cell carcinoma of the anal canal are well defined with acceptable results. However the major challenge in the treatment of anal cancer is the lack of randomized or even large single arm Phase II trials due to rarity of the disease, especially in the metastatic disease. But we are slowly making progress. Currently, the most promising areas of research are immunotherapy, targeted therapy and even HPV prevention. We are eagerly anticipating the results of these studies in order to expand the treatment armamentarium.

Neuroproteomics: a biochemical means to discriminate the extent and modality of brain injury.

Diagnosis and treatment of stroke and traumatic brain injury remain significant health care challenges to society. Patient care stands to benefit from an improved understanding of the interactive biochemistry underlying neurotrauma pathobiology. In this study, we assessed the power of neuroproteomics to contrast biochemical responses following ischemic and traumatic brain injuries in the rat. A middle cerebral artery occlusion (MCAO) model was employed in groups of 30-min and 2-h focal neocortical ischemia with reperfusion. Neuroproteomes were assessed via tandem cation-anion exchange chromatography-gel electrophoresis, followed by reversed-phase liquid chromatography-tandem mass spectrometry. MCAO results were compared with those from a previous study of focal contusional brain injury employing the same methodology to characterize homologous neocortical tissues at 2 days post-injury. The 30-min MCAO neuroproteome depicted abridged energy production involving pentose phosphate, modulated synaptic function and plasticity, and increased chaperone activity and cell survival factors. The 2-h MCAO data indicated near complete loss of ATP production, synaptic dysfunction with degraded cytoarchitecture, more conservative chaperone activity, and additional cell survival factors than those seen in the 30-min MCAO model. The TBI group exhibited disrupted metabolism, but with retained malate shuttle functionality. Synaptic dysfunction and cytoarchitectural degradation resembled the 2-h MCAO group; however, chaperone and cell survival factors were more depressed following TBI. These results underscore the utility of neuroproteomics for characterizing interactive biochemistry for profiling and contrasting the molecular aspects underlying the pathobiological differences between types of brain injuries.

El rol social de la donación de sangre. Un caso de detección de brucelosis / The social role of the blood donation. Detection's case of brucellosis

En el siguiente artículo se expondrá, a partir del análisis de un caso clínico hallado en el Servicio de Hemoterapia del Hospital Materno infantil San Roque (Paraná, Entre Ríos). la importancia de la donación de sangre como factor fundamental en la detección de patologías encubiertas o desconocidas para un donan­te. En el caso en cuestión y, a partir de pertenecer a una zona endémica, se reconoce la importancia en la detección de un caso de Brucelosis.

In the following article it will be exposed, from the analysis a clinical case, found in the Service of Hemoterapia of the infantile Maternal Hospital San Roque (Paraná, Entre Ríos), the importance of the donation of blood like fundamental factor in the detection of concealed pathologies or strangers for a donor. In the case at issue and, from belonging to an endemic zone, the importance in the detection of a case of Brucelosis is recognized.

Proteolysis of multiple myelin basic protein isoforms after neurotrauma: characterization by mass spectrometry.

Neurotrauma, as in the case of traumatic brain injury, promotes protease over-activation characterized by the select fragmentation of brain proteins. The resulting polypeptides are indicators of biochemical processes, which can be used to study post-injury dynamics and may also be developed into biomarkers. To this end, we devised a novel mass spectrometry approach to characterize post-injury calpain proteolytic processing of myelin basic protein (MBP), a biomarker of brain injury that denotes white matter damage and recovery. Our approach exceeds conventional immunological assays in its deconvolution of multiple protein isoforms, its absolute quantification of proteolytic fragments and its polypeptide selectivity. We quantified and characterized post-injury proteolytic processing of all MBP isoforms identified in adult rat cortex. Further, the translation of calpain-cleaved MBP into CSF was verified following brain injury. We ascertained that the exon-6 sequence of MBP resulted in a characteristic shift in gel migration for intact and fragmented protein alike. We also found evidence for a second post-TBI cleavage event within exon-2 and for the dimerization of the post-TBI 4.3 kDa fragment. Ultimately, the novel methodology described here can be used to study MBP dynamics and other similar proteolytic events of relevance to brain injury and other CNS processes.