The Gut Microbiota Profile in Heart Failure Patients: A Systematic Review.

BACKGROUND AND AIMS: Traditional cardiovascular risk factors are established predictors of heart failure (HF). However, the human gut microbiota is suggested to potentially interact with the cardiovascular system through the "gut-heart axis", which induces inflammation and contributes to HF pathogenesis. This systematic review aims to confirm the interconnection between the gut microbiome in HF patients. METHODS: Peer-reviewed human studies comparing the gut microbiota profile in adult patients with HF and healthy controls (HCs) up to April 18, 2022, were searched in Ovid MEDLINE, Ovid EMBASE, SCOPUS, and the Cochrane Library. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: A total of nine studies, including 317 HF patients and 510 HCs, were included in the review. Decreased gut microbiota richness and similar microbial diversity (alpha diversity), and significantly different gut microbiota composition (beta diversity) were observed between HF patients and HCs. In comparison to HCs, HF patients had a greater abundance of Actinobacteria, Proteobacteria, and Synergistetes phyla; Enterococcus, Escherichia, Klebsiella, Lactobacillus, Streptococcus, and Veilonella genera and Ruminococcus gnavus, Streptococcus sp., and Veilonella sp. species. In contrast, there was decreased abundance of Firmicutes phylum; Blautia, Eubacterium, Faecalibacterium, and Lachnospiraceae FCS020 genera; and Dorea longicatena, Eubacterium rectale, Faecalibacterium prausnitzii, Oscillibacter sp., and Sutterella wadsworthensis species in HF patients. CONCLUSIONS: Gut microbiota diversity, richness, and composition in HF patients differ significantly from the healthy population. Overall, short-chain fatty acid (SCFA)-producing gut microbiota was depleted in HF patients. However, different underlying comorbidities, environments, lifestyles, and dietary choices could affect gut microbiota heterogeneity.

Health cadres empowerment program through smartphone application-based educational videos to promote child growth and development.

Indonesia's health care system relies on non-health professionals called cadres to operate child health promotion programs in the Public Health Center (Puskesmas). Despite this effort, the child malnutrition rate remains high. This study aimed to identify and develop health promotion media that can assist health cadres in promoting child health. This study was divided into three-phase. The first phase was the need assessment using focus group discussion and knowledge, attitude, and practice (KAP); the second phase is video development, which involves medical students, general practitioners, pediatricians, and health promotion experts; and the third phase was video viewing by cadres and post-viewing tests for health cadres. A comparison of pre-test and post-test participants' total scores was performed with the student's T-test. Need assessment showed that the knowledge of the cadres needs improvement and there was a need for proper educational media material that can be used by the Puskesmas. Five videos were produced, four videos were about children's nutritional intake recommendations during four different age groups and one video was about the information and invitation to come to Integrated Health Service Post (Posyandu). There was a significant improvement from pre-test total scores to post-test total scores (p < 0.001). Smartphone application-based educational videos are effective and reliable child health promotion media for Puskesmas staff and parents.

Neutrophil-to-lymphocyte ratio on admission to predict the severity and mortality of COVID-19 patients: A meta-analysis.

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR), an inflammatory marker, was suggested to be predictive of severity and mortality in COVID-19 patients. Here, we investigated whether NLR levels on admission could predict the severity and mortality of COVID-19 patients. METHODS: A literature search was conducted on 23 July 2020 to retrieve all published articles, including grey literature and preprints, investigating the association between on-admission NLR values and severity or mortality in COVID-19 patients. A meta-analysis was performed to determine the overall standardized mean difference (SMD) in NLR values and the pooled risk ratio (RR) for severity and mortality with the 95% Confidence Interval (95%CI). RESULTS: A total of 38 articles, including 5699 patients with severity outcomes and 6033 patients with mortality outcomes, were included. The meta-analysis showed that severe and non-survivors of COVID-19 had higher on-admission NLR levels than non-severe and survivors (SMD 0.88; 95%CI 0.72-1.04; I2 = 75.52% and 1.87; 95%CI 1.25-2.49; I2 = 97.81%, respectively). Regardless of the different NLR cut-off values, the pooled mortality RR in patients with elevated vs. normal NLR levels was 2.74 (95%CI 0.98-7.66). CONCLUSION: High NLR levels on admission were associated with severe COVID-19 and mortality. Further studies need to focus on determining the optimal cut-off value for NLR before clinical use.