Common Outcome Research Articles

Impact of pubertal timing on growth progression and final height in subjects affected by RASopathies

BackgroundRASopathies, including Noonan syndrome and related disorders, are multisystem conditions caused by mutations in various genes encoding proteins involved in the RAS/MAPK signaling pathway resulting in increased signal flow. They are clinically characterized by failure to thrive, facial dysmorphisms, congenital heart defects, lymphatic malformations, skeletal anomalies, and variable cognitive impairment, with variable prevalence in the different conditions and subtypes. Pubertal development, which affects growth and final height, is often delayed in Noonan syndrome patients, though not universally. This study aimed to evaluate the timing and progression of puberty and its impact on growth and final height in patients with RASopathies.Subjects and methodsA retrospective longitudinal study was conducted involving 103 patients with molecularly confirmed RASopathies. A subgroup of 40 patients who had completed pubertal development was analyzed. Anthropometric, hormonal (FSH, LH, estradiol/testosterone), and radiological data were collected.ResultsAmong the 40 patients who had completed puberty, 75% had a diagnosis of Noonan syndrome. The median age at pubertal onset was 11.8 years in males and 13.2 years in females. Delayed puberty was observed in 27.8% of patients, with a higher incidence in females. Median final height was significantly lower in those with delayed pubertal onset compared to those with normal development (p < 0.01). No significant differences in final height were observed between patients with growth hormone deficiency treated with growth hormone and those who were untreated.ConclusionsDelayed pubertal onset negatively impacts final height in patients with RASopathies, with inadequate pubertal catch-up growth being a common outcome. While most patients initiate puberty spontaneously, careful monitoring of growth and pubertal progression is crucial to optimize therapeutic interventions and improve final height outcomes.

Elevated blood glucose and unfavourable tuberculosis treatment outcomes in a low-income setting: findings from a prospective cohort study in Eswatini

IntroductionThe increasing burden of diabetes mellitus in low- and middle-income countries negatively impacts tuberculosis control. To understand this dual burden in Eswatini, we describe the prevalence and predictors of elevated...

The Learning Curve in Urogynecology and Functional Urology: A Systematic Review.

When adopting new methods, surgeons may experience a period of complexity and longer operation times because of their inexperience. This period is known as the "learning curve." This study was aimed at systematically reviewing the current literature on functional urology learning curves. A comprehensive search was conducted across multiple databases from inception to July 2023 with no language restrictions. All original studies on urogynecological and functional urological procedures, including cross-sectional, cohort, and clinical trials, were eligible for inclusion. Relevant data were extracted, and methodological quality was appraised using standardized Joanna Briggs Institute critical appraisal tools. To quantitatively investigate learning curves, a mixed-effects generalized linear regression analysis was conducted on studies employing cumulative summation methods. From the 7,104 records, 68 studies met the inclusion criteria. The majority of studies were observational and the most common outcome measures were surgical duration, blood loss, and hospital stay. The learning curves varied by procedure type-for incontinence surgeries, 15-80 cases were required; for pelvic organ prolapse surgeries, 18-47 cases; for laparoscopic procedures, 10-105 cases; and for robotic procedures, 5-84 cases. The analysis showed that the number of cases required to surpass the learning curve decreased over time, likely reflecting technological advancements and increased surgical experience. The learning curve for surgical procedures varies significantly. It varies between 5 cases for robotic supratrigonal cystectomy to 75 cases for robot-assisted ventral mesh rectopexy or robotic sacrocolpopexy surgery in 84 cases. These variable learning curves highlight the need for structured training programs and ongoing assessment.

Measuring What Matters: Patient-Reported Outcomes in Colon Cancer Care

AbstractPatients have common and personalized questions about expected outcomes after colon cancer treatment. Surgeons and oncologists can use high-quality clinical counseling and patient-reported outcomes to identify what matters most to each patient. This article reviews common patient-centered outcomes and how to elicit personalized outcomes, preferences, and values for patients facing colon cancer.

Physiotherapy Professionals: A Questionnaire for the Evaluation of Telerehabilitation Services in Egypt

Purpose: This study aimed to evaluate the utilization of telerehabilitation services in Egypt and to investigate the concerns and barriers faced by Egyptian physiotherapists for implementation. Methods: This cross-sectional study recruited 306 Egyptian physiotherapists who were asked to complete an online survey including questions about the utilization of telerehabilitation services, awareness, perception, and attitude. Results: A total of 299 physiotherapists completed the online survey. Within the sample, 38.5% utilized telerehabilitation at work. Telerehabilitation was used frequently to deliver patient advice (17.6%), follow-up (16%), and exercise prescription (15.2%). Pain (16.2%) was the most common outcome assessed utilizing telerehabilitation. Additionally, 85.3% of physiotherapists agreed that the inclusion of telerehabilitation during the rehabilitation program is effective. The main barriers to implementing telerehabilitation in Egypt were lack of awareness (59.9%) and technical issues (58.2%). Conclusion: This study sheds light on the trends and challenges in utilizing telerehabilitation and may help in shaping the future of telerehabilitation in Egypt.

Physical and neurophysiological maturation associated with ADHD among previously institutionalized children: a randomized controlled trial.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental outcome among children with a history of early institutional care. Prior research on institutionalized children suggested that accelerated physical growth in childhood is a risk factor for ADHD outcomes. The current study examined physical and neurophysiological growth trajectories among institutionalized children randomized to foster care treatment (n = 59) or care as usual (n = 54), and never institutionalized children (n = 64) enrolled in the Bucharest Early Intervention Project (NCT00747396, clinicaltrials.gov). Participants completed physical and electroencephalography (EEG) assessments at six time points from infancy through adolescence, as well as structured diagnostic interviews at the 54-month and 12-year time points. A series of multilevel growth models and cross-lagged path models were estimated to examine associations among physical and neurophysiological maturation, treatment group, age of foster care placement, and ADHD diagnostic outcomes. Twenty-seven percent of the institutionalized children met research criteria for ADHD at one or both time points. Slowed, prolonged growth of height and head circumference were associated with both ADHD and delayed foster care placement. Placement in foster care versus care as usual, but not ADHD, was associated with maturation of the peak alpha frequency. Among children randomized to foster care, average theta-beta ratio was lower among those with ADHD. There was no evidence that rapid physical maturation led to atypical cortical activity. Delayed, prolonged physical growth and atypical neurophysiology from infancy through adolescence is associated with ADHD among institutionalized children, over and above the protective effects of foster care.

Country-specific key lifestyle factors and health outcomes for resource allocation in the general population: a network analysis across 29 countries.

We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements. From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network. Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study's cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research. global; across-country comparisons; lifestyle; health outcomes; network analysis.

Extended Reality Interventions for Health and Procedural Anxiety: Panoramic Meta-Analysis Based on Overviews of Reviews.

Extended reality (XR) technologies are increasingly being used to reduce health and procedural anxieties. The global effectiveness of these interventions is uncertain, and there is a lack of understanding of how patient outcomes might vary between different contexts and modalities. This research used panoramic meta-analysis to synthesize evidence across the diverse clinical contexts in which XR is used to address common outcomes of health and procedural anxiety. Review-level evidence was obtained from 4 databases (MEDLINE, Embase, APA PsycINFO, and Epistemonikos) from the beginning of 2013 until May 30, 2023. Reviews that performed meta-analysis of randomized controlled trials relating to patient-directed XR interventions for health and procedural anxiety were included. Studies that analyzed physiological measures, or focused on technologies that did not include meaningful immersive components, were excluded. Furthermore, data were only included from studies that compared intervention outcomes against no-treatment or treatment-as-usual controls. Analyses followed a preregistered, publicly available protocol. Trial effect sizes were extracted from reviews and expressed as standardized mean differences, which were entered into a 3-level generalized linear model. Here, outcomes were estimated for patients (level 1), studies (level 2), and anxiety indications (level 3), while meta-regressions explored possible influences of age, immersion, and different mechanisms of action. Where relevant, the quality of reviews was appraised using the AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews, Revised Instrument) tool. Data from 83 individual trials were extracted from 18 eligible meta-analyses. Most studies involved pediatric patient groups and focused on procedural, as opposed to general, health anxieties (eg, relating to needle insertion, dental operations, and acute surgery contexts). Interventions targeted distraction-, education-, and exposure-based mechanisms, and were provided via a range of immersive and nonimmersive systems. These interventions proved broadly effective in reducing patient anxiety, with models revealing significant but heterogeneous effects for both procedural (d=-0.75, 95% CI -0.95 to -0.54) and general health (d=-0.82, 95% CI -1.20 to -0.45) indications (when compared with nontreatment or usual-care control conditions). For procedural anxieties, effects may be influenced by publication bias and appear more pronounced for children (vs adults) and nonimmersive (vs immersive) technology interventions, but they were not different by indication. Results demonstrate that XR interventions have successfully reduced patient anxiety across diverse clinical contexts. However, significant uncertainty remains about the generalizability of effects within various unexplored indications, and existing evidence is limited in methodological quality. Although current research is broadly positive in this area, it is premature to assert that XR interventions are effective for any given health or procedural anxiety indication.

Evaluation of Real-World Evidence to Assess Effectiveness Outcomes of Janus Kinase Inhibitors for Rheumatoid Arthritis: A Systematic Review of US Studies.

This review summarized the real-world effectiveness outcomes of Janus kinase inhibitors (JAKi) for rheumatoid arthritis (RA) based on observational studies. A systematic review followed PRISMA guidelines, with searches conducted in PubMed, Embase, and CINAHL from each database's inception to June 2, 2023. Studies were included if they evaluated real-world effectiveness outcomes of JAKi for US RA patients. Search terms included "RA", "JAKi", and "real-world". All citations were imported into COVIDENCE platform. Two reviewers independently performed title/abstract screening and full-text eligibility. For each article, study characteristics and effectiveness measures focusing on treatment pattern, clinical response, and patient-reported outcomes (PROs) of JAKi were extracted. Newcastle-Ottawa Scale (NOS) was utilized to assess the quality of the included articles. In total, 35 studies representing 252-30,556 patients were included. A majority used the administrative claims datasets (n=23, 65.71%), followed by 9 studies using electronic medical record (EMR) data and 3 studies using patient registry databases. Across claims-based studies, adherence, persistence, and effectiveness of JAKi were common outcomes. Adherence rates varied, with a proportion of days covered (PDC) ranging from 0.53 to 0.83 across 11 studies. Persistence of JAKi in RA patients was reported in 14 studies, where the median persistence time in treatment was reported to be between 121-516 days. Six studies applied effectiveness algorithms, with 14.8-26% of patients meeting effective treatment criteria. In addition, the most common measure of clinical response throughout the studies was Clinical Disease Activity Index (CDAI), with 10 articles reporting mean CDAI changes between -4.7 and 5.1. Across 12 studies that measured the PROs, the most prevalent PRO was pain, with the mean change in pain ranging from -9.3 to 8.9 across these studies. Real-world studies on JAKi for RA reflect a range of effectiveness measures, illustrating the expanding role of JAKi in clinical practice.

Genetic Associations of Persistent Opioid Use After Surgery Point to OPRM1 but Not Other Opioid-Related Loci as the Main Driver of Opioid Use Disorder.

Persistent opioid use after surgery is a common morbidity outcome associated with subsequent opioid use disorder, overdose, and death. While phenotypic associations have been described, genetic associations remain unidentified. Here, we conducted the largest genetic study of persistent opioid use after surgery, comprising ~40,000 non-Hispanic, European-ancestry Michigan Genomics Initiative participants (3198 cases and 36,321 surgically exposed controls). Our study primarily focused on the reproducibility and reliability of 72 genetic studies of opioid use disorder phenotypes. Nominal associations (p < 0.05) occurred at 12 of 80 unique (r2 < 0.8) signals from these studies. Six occurred in OPRM1 (most significant: rs79704991-T, OR = 1.17, p = 8.7 × 10-5), with two surviving multiple testing correction. Other associations were rs640561-LRRIQ3 (p = 0.015), rs4680-COMT (p = 0.016), rs9478495 (p = 0.017, intergenic), rs10886472-GRK5 (p = 0.028), rs9291211-SLC30A9/BEND4 (p = 0.043), and rs112068658-KCNN1 (p = 0.048). Two highly referenced genes, OPRD1 and DRD2/ANKK1, had no signals in MGI. Associations at previously identified OPRM1 variants suggest common biology between persistent opioid use and opioid use disorder, further demonstrating connections between opioid dependence and addiction phenotypes. Lack of significant associations at other variants challenges previous studies' reliability.

A scoping review of interventions to optimize medication adherence in hypertension comorbidity.

Patients with hypertension and other comorbidities have difficulties adhering to their medications which have negative impacts on clinical outcomes. Although some studies have identified strategies to improve medication adherence, a thorough analysis of these interventions will provide synthesized evidence for clinical decision-making and improved health outcomes for patients with hypertension comorbidities. To conduct a scoping review on interventions that have been utilised to improve medication adherence in patients with hypertension and other co-morbid conditions. A systematic literature search was conducted in the following databases: CINAHL, COCHRANE TRIALS, MEDLINE, and SCOPUS. One (1) search engine, GOOGLE SCHOLAR was included. This was done between September 2023 to February 2024. The PRISMA-SCR guidelines were followed for this review. A total of 456 unique studies were identified after duplicates were removed. Following screening and eligibility assessments, 26 papers were selected for review with a focus on the study aim and purpose, study population, interventions used and adherence measures. Most of the interventions were delivered by pharmacists, with 25 studies utilising the multimodal intervention approach. A total of 22 studies (80% of the total) found that the interventions significantly improved medication adherence. Results from 16 studies showed a significant improvement in blood pressure. Improvements in medication adherence were a common outcome of interventions that focused on patient education. Interventions such as patient education, simplified treatment regimens, and multidisciplinary care can improve medication adherence and clinical outcomes in patients with hypertension and comorbidities, but further research is needed to understand long-term effects.

Use of Digital Health Interventions for Cancer Prevention Among People Living With Disabilities in the United States: A Scoping Review.

The use of digital health strategies for cancer care increased dramatically in the United States over the past 4 years. However, a dearth of knowledge remains about the use of digital health for cancer prevention for some populations with heath disparities. Therefore, the purpose of the present scoping review was to identify digital health interventions for cancer prevention designed for people with disabilities. This scoping review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and the Arksey and O'Malley methodological framework. The Embase, PubMed, Ovid MEDLINE, and CINAHL/EBSCO databases were searched for peer-reviewed articles published from database inception to February 5, 2024. Reports published in English of studies that employed digital health strategies for cancer prevention, were conducted among people with disabilities regardless of age, and were conducted in the United States were included. Following screening for eligibility, seven articles were identified. The types of disabilities were cancer (n = 4), bipolar I or II disorder (n = 1), obesity (n = 1), and deafness (n = 1). Interventions focused on education (n = 4), screening (n = 3), smoking cessation (n = 3), physical activity (n = 1), and cessation support (n = 1). Digital health strategies consisted of educational content delivered online, text messaging, interactive educational games, and downloadable informational applications. The common outcome of interest across all manuscripts was intervention efficacy. Overall, limited research is available to evaluate the use of digital health for cancer prevention among people with disabilities. This review identified gaps in knowledge that, if addressed, may help guide continued innovation in the use of digital health strategies for cancer prevention among people with disabilities.

Unraveling Ferroptosis: A New Frontier in Combating Renal Fibrosis and CKD Progression

Chronic kidney disease (CKD) is a global health concern caused by conditions such as hypertension, diabetes, hyperlipidemia, and chronic nephritis, leading to structural and functional kidney injury. Kidney fibrosis is a common outcome of CKD progression, with abnormal fatty acid oxidation (FAO) disrupting renal energy homeostasis and leading to functional impairments. This results in maladaptive repair mechanisms and the secretion of profibrotic factors, and exacerbates renal fibrosis. Understanding the molecular mechanisms of renal fibrosis is crucial for delaying CKD progression. Ferroptosis is a type of discovered an iron-dependent lipid peroxidation-regulated cell death. Notably, Ferroptosis contributes to tissue and organ fibrosis, which is correlated with the degree of renal fibrosis. This study aims to clarify the complex mechanisms of ferroptosis in renal parenchymal cells and explore how ferroptosis intervention may help alleviate renal fibrosis, particularly by addressing the gap in CKD mechanisms related to abnormal lipid metabolism under the ferroptosis context. The goal is to provide a new theoretical basis for clinically delaying CKD progression.

Remote appointments in Orthodontics and Oral and Maxillofacial Surgery: Part 1 service evaluation.

To assess the type, number and outcome of remote appointments in Orthodontics and Oral and Maxillofacial Surgery (OMFS) in one acute hospital trust and to establish whether remote appointments carried out during the Covid-19 pandemic were successful in saving a face-to-face appointment. Service evaluation. Orthodontic and OMFS departments at Buckinghamshire Healthcare NHS Trust. A retrospective service evaluation was carried out, analysing the types, numbers and outcomes of remote appointments in Orthodontics and OMFS over a nine-month period (March-December 2020) during the Covid-19 pandemic in one hospital trust. Data were collected from the trust online booking system and departmental spreadsheets and recorded on Microsoft® Excel. A total of 901 remote appointments were analysed, 42% (n = 387) of which were Orthodontic and 58% (n = 523) OMFS. Low failure to attend rates were seen in both specialties (3% (n = 18) OMFS; 6% (n = 21) Orthodontics). Retainer reviews accounted for 83% (n = 315) of all Orthodontic remote appointments and the most common outcome of remote appointments was discharge after attendance (49% n = 189). New patient consultations accounted for 41% (n = 212) of OMFS remote appointments and the most common outcomes were Oral Medicine review (31% n = 162) and discharge following attendance (20% n = 103). Remote platforms saved a follow-up face-to-face appointment in 92% (n = 352) of Orthodontic appointments, compared to 81% (n = 421) for OMFS remote appointments. When appropriately triaged, the majority of remote appointments do save a face-to-face visit, and there is a place for remote platforms in both specialties going forward. However further research is required in the post-pandemic era to ascertain the full long-term applicability of remote Orthodontic and OMFS appointments.

Clinically important effect sizes for clinical trials using infarct growth reduction as the primary outcome: a systematic review

BackgroundInfarct growth on multimodal imaging is a common lead outcome in phase 2 proof-of-concept and dose-optimization neuroprotective agent stroke trials. However, the effect size in infarct growth reduction that correlates...

The pseudoknot structure of a viral RNA reveals a conserved mechanism for programmed exoribonuclease resistance.

Exoribonuclease-resistant RNAs (xrRNAs) are viral RNA structures that block degradation by cellular 5'-3' exoribonucleases to produce subgenomic viral RNAs during infection. Initially discovered in flaviviruses, xrRNAs have since been identified in wide range of RNA viruses, including those that infect plants. High sequence variability among viral xrRNAs raises questions about the shared molecular features that characterize this functional RNA class. Here, we present the first structure of a plant-virus xrRNA in its active exoribonuclease-resistant conformation. The xrRNA forms a 9 base pair pseudoknot that creates a knot-like topology similar to that of flavivirus xrRNAs, despite lacking sequence similarity. Biophysical assays confirm a compact pseudoknot structure in solution, and functional studies validate its relevance both in vitro and during infection. Our study reveals how viral RNAs achieve a common functional outcome through highly divergent sequences and identifies the knot-like topology as a defining feature of xrRNAs.

An integrated view of the pathophysiological crosstalk between adipose tissue, bone and cardiovascular system in men and women.

Obesity,bone-related and cardiovascular diseases (CVD) are among the leading global health concerns. Growing evidence suggests that these conditions share common pathophysiological pathways and disease outcomes. PATHOGENETIC INTERACTIONS OF OBESITY, CVD AND BONE-RELATED DISEASES: Obesity is a well-established risk factor for atherosclerotic CVD (ASCVD), as dysfunctional ectopic adipose tissue may produce endocrine/paracrine hormones modulating metabolic processes and inflammation, predisposing to ASCVD. Although obesityhas been considered a protective factor for bone loss, it may lead to osteoporosis development and increased fracture risk at specific sites. Biological and epidemiological evidence has demonstrated the existence of a dynamic relationship between ASCVD and osteoporosis, since atherosclerotic calcification and bone mineralization share common pathophysiological mechanisms. Therefore, addressing ASCVD, obesity, and bone-related diseases requires multiple-level approach, which involve accurate screening, lifestyle modifications and pharmacological interventions.The current evidence about the pathophysiological relationships between obesity, bone-related diseases and ASCVD is discussed herein, highlighting common risk factors, proposed biomolecular mechanisms, clinical outcomes, lifestyle changes and pharmacological treatments. As populations become increasingly older and obese, understanding the correlation within this triad highlights an unmet clinical need. Applying this knowledge would help to reduce both societal and individual costs, while supporting the development of novel preventive, diagnostic and therapeutic strategies to reduce morbidity and disability associated with cardio-metabolic and bone-related diseases.

The role of executive functioning in smoking cessation: A scoping review.

Creating and implementing a plan to successfully quit smoking likely requires executive function (EF) skills such as inhibition, cognitive flexibility, attention and working memory. This scoping review consolidates the research evidence evaluating the role of EF in smoking cessation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), researchers and a medical librarian searched PubMed, EMBASE, ERIC, CINAHL and PSYCINFO in June 2022, hand-search in September 2022 using relevant MeSH terms, and an updated search was completed in August 2024. Fifteen articles were included. Self-regulation was the most frequently evaluated EF across all studies. Performance on measures of impulsivity was most frequently related to successful smoking cessation. Across studies, performance on measures in areas of attention, working memory, cognitive flexibility and higher-level EF was variable as it relates to smoking cessation success. There was considerable variability in the measures used to evaluate EF and definitions of cessation success. Across studies, very little research evaluates higher-level EF. Differences in EF and cessation measures make comparisons across studies difficult. Future work is needed utilising common assessment and outcome measures that will improve our understanding of the complex cognitive skills needed for successful cessation. Particular consideration should be given to higher-level EFs including reasoning, planning, problem-solving and decision-making.

Impact of Diphenyl Diselenide on Acute Ethanol-Induced Disruption of Antioxidant Defense and Inflammatory Gene Expression in Rats

Perturbation in antioxidant status which often leads to inflammation of liver cells and alteration in activities of purinergic enzymes are common outcomes of ethanol intoxication, this makes any compound that is able to prevent or repair the redox imbalances induced by alcohol intoxication a potential therapeutic measure. Hence, this study aims to assess the effect of diphenyl diselenide (DPDSe) on oxidative stress indicators, inflammatory genes and activities of purinergic enzymes in ethanol intoxicated male Wistar rats. 10mg/kg DPDSe was administered orally 30 minutes before and after a single dose of 13 ml/kg (28% ethanol solution) was given to the rats. Thereafter, the antioxidant status, activities of purinergic enzymes and expression of redox-sensitive genes in the rats were evaluated. It was observed that ethanol evoked high production of lipid peroxidation with concomitant decrease in thiol level, increased Nucleotidase and NTPDase activities, it also causes the downregulation of Nrf2 and upregulation of (NF-kB), however, pre- and post-treatment with DPDSe caused a reversal effects on the biochemical parameters and molecular parameters evaluated respectively. The reversal of ethanol-induced changes in biochemical parameters, expression of genes linked to inflammation and antioxidant status in the liver of acute ethanol intoxicated rats by DPDSe suggests that it has high prospect as a suitable therapeutic agent for hepatotoxicity linked with acute ethanol intoxication.

Gut-microbiota-brain Axis and post-traumatic epilepsy.

There has been growing evidence that perturbations in gut-microbiota-brain axis (GMBA) are involved in mechanisms of chronic sequelae of traumatic brain injury (TBI). This review discusses the connection between GMBA and post-traumatic epilepsy (PTE), the latter being a common outcome of TBI. The focus is on two aspects of post-TBI GMBA dysfunction that are relevant to epilepsy. First are impairments in intestinal permeability with subsequent translocation of gut bacteria into the bloodstream. Specifically, endotoxemia following TBI may have a serendipitous protective effect against PTE through lipopolysaccharide conditioning, which may be leveraged for the development of therapeutic interventions. Second are changes in microbial composition (i.e., dysbiosis). Here, the GMBA-PTE connection is explored from predictive biomarker perspective, whereby the risk of PTE can be stratified based on specific microbial profiles. Finally, microbiota transplantation is discussed both as a tool to examine the role of gut microbiota in PTE and as a prelude to novel approaches for PTE therapy and prevention.