Choroid plexus imaging in multiple sclerosis management - a systematic review.

INTRODUCTION: Multiple sclerosis (MS) is a central nervous system (CNS) disease associated with inflammation, demyelination, and neurodegeneration. It affects more than 2 million people globally, and usually occurs in young adults, three-quarters of whom are women. Importantly, accurate diagnosis and treatment are essential, as this disease can lead to the rapid development of disability. The choroid plexus (CP) is a structure widely known as the main cerebrospinal fluid source. However, it is also involved in immune cell trafficking to the cerebrospinal fluid, which is increased in different neurological disorders, particularly those associated with neuroinflammation. As MS is generally thought to be caused by an autoimmune process, it has been suggested that the choroid plexus may play a significant role in its pathogenesis, manifesting via changes in imaging characteristics. MATERIAL AND METHODS: Although research regarding this topic has been very limited, the results of the available studies appear promising. To further investigate this subject, we performed a systematic literature review according to the PRISMA 2020 guidelines. The PubMed and Embase databases were searched for relevant articles, and after thorough analysis, 16 studies were included in our review. RESULTS: CP volume was significantly increased in MS patients compared to healthy individuals. Furthermore, some studies found that CP enlargement occurs even before a definite diagnosis. Moreover, a few articles reported correlations between CP volume and brain atrophy, or even disease severity. CONCLUSIONS: Our findings show that CP imaging has the potential to become a novel and valuable tool in multiple sclerosis management.

A Narrative Review of Preclinical In Vitro Studies Investigating microRNAs in Myocarditis.

According to the World Health Organization's statement, myocarditis is an inflammatory myocardium disease. Although an endometrial biopsy remains the diagnostic gold standard, it is an invasive procedure, and thus, cardiac magnetic resonance imaging has become more widely used and is called a non-invasive diagnostic gold standard. Myocarditis treatment is challenging, with primarily symptomatic therapies. An increasing number of studies are searching for novel diagnostic biomarkers and potential therapeutic targets. Microribonucleic acids (miRNAs) are small, non-coding RNA molecules that decrease gene expression by inhibiting the translation or promoting the degradation of complementary mRNAs. Their role in different fields of medicine has been recently extensively studied. This review discusses all relevant preclinical in vitro studies regarding microRNAs in myocarditis. We searched the PubMed database, and after excluding unsuitable studies and clinical and preclinical in vivo trials, we included and discussed 22 preclinical in vitro studies in this narrative review. Several microRNAs presented altered levels in myocarditis patients in comparison to healthy controls. Moreover, microRNAs influenced inflammation, cell apoptosis, and viral replication. Finally, microRNAs were also found to determine the level of myocardial damage. Further studies may show the vital role of microRNAs as novel therapeutic agents or diagnostic/prognostic biomarkers in myocarditis management.

Is there a correlation between migraine and eating disorders? A systematic literature review.

INTRODUCTION: Migraine is a common primary headache disorder, which affects mainly young females, usually those with some specific personality traits including neuroticism and obsessive-compulsive disorder. Among many factors that may trigger headache are to be found those associated with eating patterns and behaviours. Eating disorders are psychiatric disorders of abnormal eating or weight-control behaviours. According to the most up-to-date classification, six main types are identified, including anorexia nervosa, bulimia nervosa, and binge eating disorder. Similar to migraine, eating disorders are mainly diagnosed in young adults and, moreover, personality pattern, in at least some of the eating disorders, is also suggested to be consistent. MATERIAL AND METHODS: This systematic review aimed to summarise the available literature related to this topic. We performed an electronic article search through the Embase, PubMed, and Cochrane databases and included 16 articles into analysis in accordance with PRISMA 2020 guidelines. RESULTS: Most of the studies revealed the presence of a putative correlation between migraine and eating disorders, and these encourage further investigations. Moreover, apart from the clinical aspect, also the pathogenesis underlying both disorders is suggested to be similar. More frequent co-occurrence of other psychiatric disorders in migraineurs, such as depression and anxiety, was reported and should be considered in future research. Furthermore, adverse interactions between pharmacotherapy and symptoms of comorbid conditions underline the importance of this problem. CONCLUSIONS: A correlation between migraine and eating disorders appears highly probable. However, further investigations are required focusing on diverse aspects such as clinical, psychological, and pathogenic.

MicroRNAs in Myocarditis-Review of the Preclinical In Vivo Trials.

Myocarditis is an inflammatory heart disease with viruses as the most common cause. Regardless of multiple studies that have recently been conducted, the diagnostic options still need to be improved. Although endomyocardial biopsy is known as a diagnostic gold standard, it is invasive and, thus, only sometimes performed. Novel techniques of cardiac magnetic resonance are not readily available. Therapy in viral infections is based mainly on symptomatic treatment, while steroids and intravenous immunoglobulins are used in autoimmune myocarditis. The effectiveness of neither of these methods has been explicitly proven to date. Therefore, novel diagnostic and therapeutic strategies are highly needed. MiRNAs are small, non-coding molecules that regulate fundamental cell functions, including differentiation, metabolism, and apoptosis. They present altered levels in different diseases, including myocarditis. Numerous studies investigating the role of miRNAs in myocarditis have already been conducted. In this review, we discussed only the original preclinical in vivo research. We eventually included 30 studies relevant to the discussed area. The altered miRNA levels have been observed, including upregulation and downregulation of different miRNAs in the mice models of myocarditis. Furthermore, the administration of mimics or inhibitors of particular miRNAs was shown to significantly influence inflammation, morphology, and function of the heart and overall survival. Finally, some studies presented prospective advantages in vaccine development.

ANALYSIS OF FACTORS ASSOCIATED WITH FRAILTY SYNDROME IN PATIENTS WITH HEART FAILURE.

OBJECTIVE: Aim: Determination of factors associated with frailty syndrome (FS) in patients with heart failure (HF). PATIENTS AND METHODS: Materials and methods: Consecutive patients hospitalized in the department were assessed for the presence of FS using L. Fried criteria, Edmonton Frail Scale (EFS) and Tilburg Frailty Indicator (TFI). Presence of arterial hypertension, diabetes, obesity, chronic obstructive pulmonary disease (COPD), and heart failure was included in the analysis based on patients' medical history and findings from current hospitalization. Patients were assessed for the presence of depression using Beck's Depression Inventory (BDI). Physical capacity was assessed using NYHA classification. RESULTS: Results: 87 patients (mean age 81.4±6.7; 57 women; 11 HFrEF, mean NYHA 2.36±1.21; 11 HFmrEF, mean NYHA 2.18±1.08; 65 HFpEF mean NYHA 1.94±1.09) were included in the analysis. Multivariable analysis showed significant relationship between FS assessed with EFS and age (ß=0.316, SE=0.08; p=0.0001), arterial hypertension (ß=-0.194, SE=0.08; p=0.0173), COPD (ß=0.176, SE=0.08; p=0.0300) and depression (ß=0.565, SE=0.08; p=0.0000). FS assessed with L. Fried criteria was significantly related to age (ß=0.359, SE=0.09; p= 0.0001), NYHA classification (ß= 0.336, SE=0.09; p=0.0002) and depression (ß=0.297, SE=0.09; p=0.0010). Age (ß=0.251, SE=0.10; p=0.0114) and depression (ß=0.375, SE=0.1; p=0.0002) were significantly related to FS assessed using TFI. In multivariable analysis HF phenotype was not significantly related to FS. CONCLUSION: Conclusions: Age and depression assessed with BDI are related to FS in patients with HF. Arterial hypertension and COPD are linked to FS assessed using EFS, whereas NYHA classification is linked to FS assessed with L. Fried criteria. No statistically significant relationship was found between FS and HF phenotype.

The Role of MicroRNA in Migraine: A Systemic Literature Review.

Migraine is a common primary headache disorder, affecting about 14% of the population. Importantly, it was indicated as the second cause of disability globally and the leading cause among young women. Despite the widespread prevalence, migraine remains underdiagnosed and undertreated. The possible solution may be microRNAs-small, non-coding molecules. Until now, multiple studies have shown the great value of microRNA in both the diagnosis and treatment of different human diseases. Furthermore, a significant role in neurological disorders has been suggested. Little research regarding the utility of microRNA in migraine has been conducted, however, the results so far appear to be promising. We performed an electronic article search through PubMed and Embase Database to further explore the topic. After the analysis, according to PRISMA 2020 guidelines, we included 21 studies. The dysregulation was observed in migraine in general, as well as in different types and phases; thus, miRNAs emerge as promising diagnostic biomarkers. Additionally, some studies showed the influence of the intervention with miRNA levels on neuroinflammation and the expression of peptides, which are crucial in migraine pathogenesis. This review aims to summarize the current knowledge about the role of miRNAs in migraine and encourage to further research in this field.Kindly check and confirm the edit made in the title.I checked and confirm.

The Role of MicroRNAs in Myocarditis-What Can We Learn from Clinical Trials?

Myocarditis is an inflammatory disease of the heart with a viral infection as the most common cause. It affects most commonly young adults. Although endomyocardial biopsy and cardiac magnetic resonance are used in the diagnosis, neither of them demonstrates all the required qualities. There is a clear need for a non-invasive, generally available diagnostic tool that will still remain highly specific and sensitive. These requirements could be possibly met by microribonucleic acids (miRNAs), which are small, non-coding RNA molecules that regulate many fundamental cell functions. They can be isolated from cells, tissues, or body fluids. Recently, several clinical studies have shown the deregulation of different miRNAs in myocarditis. The phase of the disease has also been evidenced to influence miRNA levels. These changes have been observed both in adult and pediatric patients. Some studies have revealed a correlation between the change in particular miRNA concentration and the degree of cardiac damage and inflammation. All of this indicates miRNAs as potential novel biomarkers in the diagnosis of myocarditis, as well as a prognostic tool for this condition. This review aims to summarize the current knowledge about the role of miRNAs in myocarditis based on the results of clinical studies.

Angiomyolipoma rupture: does size always matter?

Angiomyolipoma (AML) is the most common benign renal neoplasm. Although asymptomatic lesions rarely lead to clinical dilemma, the management of ruptured tumours can become challenging. The size of the tumour has been widely accepted as a prognostic factor for intervention but there exists some evidence against considering the size as the only prognostic factor for intervention in AML. In our study, we described three recent cases of ruptured AML which were treated with different approaches - in two cases radical nephrectomy was performed, and in one patient a minimally invasive approach was adopted.