RESUMEN
Introduction: Gut microbiota has emerged as a pivotal player in cardiovascular health and disease, extending its influence beyond the gut through intricate metabolic processes and interactions with the immune system. Accumulating evidence supports a significant association between gut microbiota and cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Dietary patterns have been identified as key factors shaping the composition of the gut microbiota and exerting notable impacts on cardiovascular health. Probiotics and prebiotics have shown promise in mitigating the risks of cardiovascular disease by modulating key cardiovascular parameters. Faecal microbiota transplantation (FMT) has recently emerged as a novel and intriguing therapeutic strategy. Aim: This review paper aims to explore and elucidate the multifaceted role of gut microbiota in cardiovascular health. It will also address the prevailing challenges and limitations in gut microbiota studies, emphasizing the importance of future research in overcoming these obstacles to expand our understanding of the gut-heart axis. Materials and methods: A comprehensive literature search was conducted using various databases including ClinicalTrials, Google Scholar, PubMed, ScienceDirect, MEDLINE, and Ovid Resources. The search strategy included utilizing keywords such as "Gut microbiota," "Randomized controlled trials (RCTs)," "Gut-heart axis," "Dysbiosis," "Diet," "Probiotics," "Prebiotics," "Faecal Microbiota transplantation," "cardiovascular disease," "Meta-analyses," and other compatible terms thereof. Only articles written in English were considered, and selection criteria included relevance to the research objectives, reasonable sample sizes, and robust methodology. In addition to the identified articles, meta-analyses, animal models and studies, and references from the selected articles were also examined to ensure a comprehensive review of the literature. Results: Dietary patterns exert a significant influence on the composition of the gut microbiota, and certain diets, such as the Mediterranean diet, have been associated with a favourable gut microbiota profile and a reduced risk of cardiovascular disease (CVD). Probiotics and prebiotics have emerged as potential interventions to mitigate CVD risks by modulating blood pressure, glycemic control, lipid profiles, and gut dysbiosis. Another innovative therapeutic approach is FMT, which involves transferring faecal material from a healthy donor to restore a balanced gut microbiota. FMT holds promise for improving cardiometabolic parameters in individuals with CVD, although further research is needed to elucidate its precise mechanisms and assess its effectiveness. Conclusion: The gut microbiota is emerging as a potential therapeutic target for CVD prevention and management. However, current research has limitations, including the need for larger and more diverse studies, the challenges of establishing causality, and concerns regarding the long-term consequences and safety of gut microbiota modulation. Despite these limitations, understanding the gut-heart axis holds promise for the development of personalized therapies and interventions for cardiovascular health. Further research is needed to expand our knowledge and address the ethical and safety issues associated with gut microbiota modification.
RESUMEN
In this study, we looked at the clinical outcomes of individuals who had a symptomatic torn anterior cruciate ligament and had their anterior cruciate ligament repaired using a four-strand hamstring (4SHS) tendon autograft at least two years later. This is a retrospective study of 34 cases of anterior cruciate ligament arthroscopic reconstruction using the four-strand hamstring graft, collected from Traumatology and Orthopedics at Cheikh Khalifa Hospital in Casablanca, Morocco between January 2017 and January 2021. Different surgeons performed the operations. Physical findings and functional scores were recorded before the follow-up physical examination and surgery; thus, knee radiographs have been evaluated. A six-month rehabilitation program was devised following surgery. The average age of the patients was 30 years, with a male predominance of 94%. Thirty patients (88%) reported negative pivot shift tests and the Lachman test. The average Lysholm score enhanced from 59.3 before surgery to 85.29 at the time of the assessment. Three patients (8.82%) with a positive pivot shift test had no background of extra knee damage. In comparison to the appearance on the preoperative radiographs, no proof of progressive degenerative deterioration was found on the follow-up radiographs. All of the patients, however, had tunnel extension. The tibial tunnel grew on average by 18%, while the femoral tunnel grew on average by 30%. In 88% of patients assessed at least two years after surgery, ligamentoplasty of the anterior cruciate ligament using the four-strand hamstring graft eradicated anterior tibial subluxation. The failure rate was overall 10%. The functional knee scores had greatly improved at the time of the follow-up.