Management of Cardiovascular Diseases by Short-Chain Fatty Acid Postbiotics.

PURPOSE OF REVIEW: Global health concerns persist in the realm of cardiovascular diseases (CVDs), necessitating innovative strategies for both prevention and treatment. This narrative review aims to explore the potential of short-chain fatty acids (SCFAs)-namely, acetate, propionate, and butyrate-as agents in the realm of postbiotics for the management of CVDs. RECENT FINDINGS: We commence our discussion by elucidating the concept of postbiotics and their pivotal significance in mitigating various aspects of cardiovascular diseases. This review centers on a comprehensive examination of diverse SCFAs and their associated receptors, notably GPR41, GPR43, and GPR109a. In addition, we delve into the intricate cellular and pharmacological mechanisms through which these receptors operate, providing insights into their specific roles in managing cardiovascular conditions such as hypertension, atherosclerosis, heart failure, and stroke. The integration of current information in our analysis highlights the potential of both SCFAs and their receptors as a promising path for innovative therapeutic approaches in the field of cardiovascular health. The idea of postbiotics arises as an optimistic and inventive method, presenting new opportunities for preventing and treating cardiovascular diseases.

Which Psychological and Electrodiagnostic Factors Are Associated With Limb Disability in Patients With Carpal Tunnel Syndrome?

BACKGROUND: It has been observed that patients with carpal tunnel syndrome (CTS) who also experience emotional distress, depression, or anxiety report more severe symptoms. As patients' own perspectives about their health increasingly are guiding treatment decisions, it seems important to study the simultaneous association of psychological distress and neuropathology with hand disability in patients who have CTS, as this may help prioritize and sequence management steps. QUESTIONS/PURPOSES: What are the relationships among validated scores for (1) depression, (2) anxiety, (3) pain catastrophizing, and (4) nerve electrodiagnostic severity with measures of hand disability in patients with confirmed CTS? METHODS: Between 2017 and 2019, we evaluated 116 patients for CTS in a referral urban hospital in Mashhad, Iran. Of those, we considered 85% (99) as potentially eligible by considering the following Electromyography-Nerve Conduction Study (EMG-NCS) diagnostic criteria: sensory latency ≥ 3.5 Ms, median-ulnar latency difference ≥ 0.5 Ms, motor latency ≥ 4.2 Ms, and abnormal EMG findings in the opponens pollicis muscle (neurogenic motor unit action potentials, positive sharp waves, or fibrillation). A further 13% (15 of 116) were excluded because of nonidiopathic CTS and prior surgery, and another 12% (14 of 116) were lost because of incomplete datasets, leaving 60% (70 of 116) for final inclusion in this cross-sectional study. In all, 89% of patients were women with total mean age of 47 years. We measured depression and anxiety using the Hospital Anxiety and Depression Scale (HADS) questionnaire (scored from 0 to 21, with a minimum clinically important difference [MCID] of 1.7 points), and we evaluated patients' state of mind regarding pain using the Pain Catastrophizing Scale (PCS) (scored from 0 to 52). Higher scores on these questionnaires represent more distress and pain catastrophizing. Hand disability was assessed with Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire outcomes (scored from 0 [no disability] to 100 [most severe disability]; MCID of 15 points), Likert pain score (from 0 to 10), and grip/pinch dynamometry results. Correlational analyses were conducted once among HADS and PCS scores and again among EMG-NCS indices with pain and disability variables to answer our first, third, and fourth questions, respectively. Regression analysis was performed to assess the percentage of variance in QuickDASH and pain severity, which could be explained by psychological and electrodiagnostic factors. We did not include grip and pinch in our multivariable model (regression analysis) as dependent variables because they did not correlate with any of psychological or EMG-NCS variables (all p values > 0.1). Significance was set at p < 0.05. RESULTS: Correlational analysis showed that the scores of all three psychological questionnaires correlated with the QuickDASH score (r = 0.50, 0.42, and 0.53 for HADS-A, HADS-D, and PCS, respectively; p < 0.001 for all three), while EMG-NCS parameters had no correlation with QuickDASH and pain scores. We also found that 37% of the variance in QuickDASH score can be explained by HADS and PCS scores (r2 = 0.37; p < 0.001). CONCLUSION: Evaluation and treatment of psychological distress before deciding on elective surgery for CTS is important because patient-reported disability-often used as a factor in surgical decision-making-is substantially correlated with emotional distress. Future prospective, controlled studies on this topic are recommended; ideally, these should evaluate psychological interventions specifically to ascertain whether they improve patients' ratings of hand disability. LEVEL OF EVIDENCE: Level III, prognostic study.

Comparison of self-ligating Damon3 and conventional MBT brackets regarding alignment efficiency and pain experience: A randomized clinical trial.

Background. Self-ligating brackets might be more efficient than conventional appliance systems during the initial alignment stage of orthodontic treatment due to reduced frictional resistance. This study aimed to compare the alignment efficiency and pain experience of Damon3 self-ligating and MBT pre-adjusted brackets in the initial alignment stage. Methods. In this randomized clinical trial, 30 patients aged 14‒20 years, who needed non-extraction treatment in both maxillary and mandibular arches, were randomly assigned to two groups; 15 patients were treated with MBT pre-adjusted brackets, and 15 patients received Damon3 self-ligating brackets, both with 0.022-in slots. Alginate impressions were taken at the start of treatment (T0) and four monthly visits (T1, T2, T3, and T4). Little's irregularity index (LII) was used to assess the tooth displacements. The patients rated their pain experience immediately after the insertion of the archwire, 4 hours, 24 hours, 3 days, 7 days, and at each monthly visit using a visual analog scale (VAS). Results. The rate of upper dental alignment between T0 and T4 was significantly higher with the Damon3 compared to MBT brackets (P=0.015). Although significantly more changes in the lower LII scores were observed during the first three months with the Damon3 system, the rate of improvement in the irregularity of lower teeth over the 4-month period was not significantly different between the two groups (P=0.50). The patients' pain experience was not significantly different between the bracket groups (P=0.29). Conclusion. During the four-month alignment stage, significantly more improvement in the upper dental irregularity was observed with self-ligating compared to conventional brackets. The bracket type had no effect on pain experience during the alignment stage.