Guillain-Barre Syndrome linked to SARS-CoV-2 infection – meta-analysis and literature review

Background The novel coronavirus disease-2019 (COVID-19), which is caused by Severe Acute Respiratory Distress Syndrome coronavirus 2 (SARS-CoV2), was originally detected in Wuhan, China in December 2019. In this meta-analysis and literature review, we compared and summarized the clinical presentation, cerebrospinal fluid (CSF) and electromyography (EMG) findings and outcomes in SARS-CoV-2 patients with Guillain-Barre Syndrome (GBS) and its variants. Methods We conducted a literature review in February 2023 searching for terms “Guillain-Barre Syndrome and COVID-19", “SARS neurology”, “COVID-19 complications”. We used PubMed and Google Scholar databases inquiring case reports or series of cases published between April 1, 2020, and September 14, 2023. Results Of the 52 GBS cases 61,5% (n=32) were male and 39,5% (n=20) were female. The mean age was 57 years old. A total of 75% (n=33) patients presented acute inflammatory demyelinating polyneuropathy (AIDP) variant, 6,8% (n=3) presented acute motor axonal neuropathy (AMAN) variant, 15,9% (n=7) presented acute motor-sensory axonal neuropathy (AMSAN) variant. A total of 85,7% (n=42) of patients were diagnosed with albuminocytological dissociation. During the hospitalization, a total of 30,8% (n=16) required mechanical ventilation. A total of 61,5% (n=32) of patients were treated with a 5-day regimen of intravenous immunoglobulin (IVIG) in dose 0.4 g/kg/day. There were 46,1% (n=24) complete recoveries from GBS, 32,7% (n=17) partial recoveries and 9,6% (n=5) of patients did not respond to treatment. A total of 11,5% (n=6) of patients died. Conclusion It is crucial to follow patients with COVID-19 and GBS over time to estimate properly the efficacy of treatment and evaluate the real percentage of recovery and complications

Impact of blue light exposition to alertness of shift workers, patients with sleep deprivation, Alzheimer’s disease, or post-traumatic stress disorder

Introduction and purpose:   In certain professions it is necessary to work at night and to maintain alertness and concentration at that time. Additionally in some conditions such as Alzheimer’s disease and post-traumatic stress disorder sleep deprivation is both a symptom and an aggravating factor. A non-pharmacological method is needed to impact the maintenance of concentration and to help the workers adapt to shift work as well as improve their sleep quality. The purpose of this paper is to present recent scientific findings on the effects of blue light on improving concentration and attentiveness in shift workers and people suffering from sleep disorders, Alzheimer's disease, or post-traumatic stress disorder.     A brief description of the state of knowledge: Circadian rhythm is a mechanism, which regulates daily functioning of humans and a variety of other species. Light exposure, especially to blue light, is the most crucial factor disrupting circadian consistency. The relationship between the time maladjustment, biological rhythms and factors from the outside world is called phase angle of entrainment. Summary:   Studies conducted on various groups have shown the effectiveness of modified light interventions on concentration and focus during shift work at night. Exposure to blue light appears to be a safe method that can improve work quality, concentration and focus in people who work at night. Exposure to light brings hope for improving the quality of life of people with Alzheimer's disease and maintaining their independence longer, which can ease the burden on their caregivers. Establishing some routine in the form of blue light exposure in people with post-traumatic stress disorder also appears to be an easy and accessible method for reducing the severity of PTSD symptoms, especially sleep disturbances

Impact of various dietary interventions on the reduction of symptoms in polycystic ovary syndrome (PCOS)

Introduction and purpose. Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder diagnosed in women. Symptoms include menstrual disorders, infertility, acne, seborrhea, hirsutism and carbohydrate metabolism disorders. Treatment is based on the reduction of symptoms, as it is not possible to completely cure the disease. To achieve the optimal therapeutic effect, it is advisable to change eating habits. The aim of the study is to summarize the effectiveness of the mediterranean diet, ketogenic diet, lactose-free diet and supplementation in reducing PCOS symptoms. State of knowledge. The mediterranean diet, which is includes large amounts of fish rich in omega-3 fatty acids, leads to a reduction in the severity of PCOS symptoms by reducing the bioavailability of androgens and lowering the concentration of triglycerides and glucose in the blood serum. A high-fat ketogenic diet reduces postprandial insulin release, improving insulin sensitivity. In addition, it causes a significant reduction in body fat, which in turn reduces the level of free testosterone and improves the LH/FSH ratio. Milk proteins have a strong effect on the secretion of lactose and incretin, however, their effect on insulin resistance is still unclear. Conclusions. The most effective nutritional model is the mediterranean diet, as it reduces the risk of other diseases such as hypertension, diabetes and osteoarthritis. The ketogenic diet remains an alternative solution, but it should be used for a limited time. The least effective intervention turns out to be a lactose-free diet. To obtain optimal therapeutic effects, the important role of PUFA, inositol and probiotic supplementation should not be forgotten

Metabolic bariatric surgery and combined multilevel surgery as a treatment for obstructive sleep apnea patient with obesity

Body mass index (BMI) and the degree of obstructive sleep apnea (OSA) are strongly correlated. Managing obesity is an important strategy for preventing and treating OSA. Bariatric surgery can lead to significant weight loss and improvements in metabolic function, which can have beneficial effects on OSA symptoms within obese population. There is a relative lack of data directly comparing the different types of bariatric surgery and multilevel upper airway surgery for the treatment of obstructive sleep apnea (OSA). While there is some evidence to suggest that bariatric surgery can improve OSA symptoms in obese individuals, and multilevel upper airway surgery can improve OSA symptoms in some cases of anatomical obstruction, there is limited research directly comparing these treatment options. Therefore, this review provides an update on the relationship between OSA, MBS and MLS for demonstrating the significance of multidisciplinary surgery approach for obese patients with OSA

What do we know about the connection between gut microbiota and pain?

Introduction and objective    The relationship between gut microbiota and pain is crucial. Several studies demonstrate the evidence that gut microbiota play a key role in visceral, neuropathic and inflammatory pain. The proper profile of microbiota is also important in patients after surgeries and injuries who suffer from postoperative pain. In the present review study we assessed a comprehensive range of relevant literature to present the role of gut microbiota as the key factor in maintaining the structural integrity of the intestinal mucosal barrier, pain perception and modulation of the immune system.    Review methods    We conducted a literature review in February, 2023 searching for terms “Gut microbiome and pain", “Probiotic supplementation”, “Fecal microbial transplantation in patients with pain”. This publication includes the analysis of several case reports, which describe patients who were successfully treated with modification of gut microbiota composition.    Brief description of the state of knowledge    The gut microbiota is a diversity of many different microorganisms. They inhabit our gut and are the key to many aspects of human health. To understand how important the gut microbiome is we have to be aware of a bidirectional connection between the gut and the brain. The gut microbiota has an impact on the nervous system via the microbiome-gut-brain axis and the hypothalamic-pituitary-adrenal axis.   Summary   We propose novel therapeutic methods like probiotics or prebiotics or fecal microbiota transplantation as the new strategy for the management of pain. To reach this goal we need more clinical evidence to implement our theoretical knowledge to clinical practice.

Intermittent fasting – a novel approach to treating overweight and obesity? – meta-analysis and literature review

Introduction Intermittent fasting (IF) is a form of dietary intervention that includes periods of regular calorie intake alternated with periods of fasting. IF has gained a lot of attention as a potential approach to treating metabolic syndrome-related diseases. Therefore, health care professionals need to be able to provide their patients with evidence-based information on IF. The aim of this article is to review data on effectiveness of IF in weight loss, especially in comparison with calorie restriction. MethodsPubMed and Google Scholar databases were searched for studies published from 1.01.2017 to 31.12.2022 that included phrases “intermittent fasting” or “alternate day fasting”, “intermittent fasting obesity”, “alternate day fasting obesity”. Intervention studies on obese or overweight patients were included. We excluded studies of short duration and studies that focused on intercurrent medical conditions. In total, 14 articles that suited those criteria were identified. ResultsIntermittent fasting induces pronounced metabolic changes in the body due to strict and time-limited restriction of calorie intake and in animal models was proved to prolong lifespan and modulate tumorigenesis and aging. It is a proposed new approach to treating obesity, which is a a major risk factor for cardiovascular diseases and diabetes. ConclusionsIn our study, IF was found as effective, but not superior to calorie restriction in reducing body mass, improving body composition and reducing other cardiometabolic risk factors. Our findings are consistent with other recent systematic reviews. Further research is needed to directly compare various IF regimens and determine patients’ characteristics that may be associated with more successful implementation of intermittent fasting regimens

What do we know about the connection between gut microbiota and pain?

Introduction and objective    The relationship between gut microbiota and pain is crucial. Several studies demonstrate the evidence that gut microbiota play a key role in visceral, neuropathic and inflammatory pain. The proper profile of microbiota is also important in patients after surgeries and injuries who suffer from postoperative pain. In the present review study we assessed a comprehensive range of relevant literature to present the role of gut microbiota as the key factor in maintaining the structural integrity of the intestinal mucosal barrier, pain perception and modulation of the immune system.    Review methods    We conducted a literature review in February, 2023 searching for terms “Gut microbiome and pain", “Probiotic supplementation”, “Fecal microbial transplantation in patients with pain”. This publication includes the analysis of several case reports, which describe patients who were successfully treated with modification of gut microbiota composition.    Brief description of the state of knowledge    The gut microbiota is a diversity of many different microorganisms. They inhabit our gut and are the key to many aspects of human health. To understand how important the gut microbiome is we have to be aware of a bidirectional connection between the gut and the brain. The gut microbiota has an impact on the nervous system via the microbiome-gut-brain axis and the hypothalamic-pituitary-adrenal axis.   Summary   We propose novel therapeutic methods like probiotics or prebiotics or fecal microbiota transplantation as the new strategy for the management of pain. To reach this goal we need more clinical evidence to implement our theoretical knowledge to clinical practice.

Intermittent fasting – a novel approach to treating overweight and obesity? – meta-analysis and literature review

Introduction Intermittent fasting (IF) is a form of dietary intervention that includes periods of regular calorie intake alternated with periods of fasting. IF has gained a lot of attention as a potential approach to treating metabolic syndrome-related diseases. Therefore, health care professionals need to be able to provide their patients with evidence-based information on IF. The aim of this article is to review data on effectiveness of IF in weight loss, especially in comparison with calorie restriction. Methods PubMed and Google Scholar databases were searched for studies published from 1.01.2017 to 31.12.2022 that included phrases “intermittent fasting” or “alternate day fasting”, “intermittent fasting obesity”, “alternate day fasting obesity”. Intervention studies on obese or overweight patients were included. We excluded studies of short duration and studies that focused on intercurrent medical conditions. In total, 14 articles that suited those criteria were identified. Results Intermittent fasting induces pronounced metabolic changes in the body due to strict and time-limited restriction of calorie intake and in animal models was proved to prolong lifespan and modulate tumorigenesis and aging. It is a proposed new approach to treating obesity, which is a a major risk factor for cardiovascular diseases and diabetes. Conclusions In our study, IF was found as effective, but not superior to calorie restriction in reducing body mass, improving body composition and reducing other cardiometabolic risk factors. Our findings are consistent with other recent systematic reviews. Further research is needed to directly compare various IF regimens and determine patients’ characteristics that may be associated with more successful implementation of intermittent fasting regimens

Metabolic bariatric surgery and combined multilevel surgery as a treatment for obstructive sleep apnea patient with obesity

Body mass index (BMI) and the degree of obstructive sleep apnea (OSA) are strongly correlated. Managing obesity is an important strategy for preventing and treating OSA. Bariatric surgery can lead to significant weight loss and improvements in metabolic function, which can have beneficial effects on OSA symptoms within obese population. There is a relative lack of data directly comparing the different types of bariatric surgery and multilevel upper airway surgery for the treatment of obstructive sleep apnea (OSA). While there is some evidence to suggest that bariatric surgery can improve OSA symptoms in obese individuals, and multilevel upper airway surgery can improve OSA symptoms in some cases of anatomical obstruction, there is limited research directly comparing these treatment options. Therefore, this review provides an update on the relationship between OSA, MBS and MLS for demonstrating the significance of multidisciplinary surgery approach for obese patients with OSA

A rare case of spiradenoma or a common sebaceous cyst? - A case study

Spiradenoma is a rare and adnexal skin tumor of the sweat gland appearing equally frequently in both female and male patients. When having a patient with a solitary, nodule occurring on a scalp, a spiradenoma diagnosis should be considered. However, it always ought be differentiated with more common skin lesions e.g. sebaceous cyst. This case report presents a 36 year old male presented with a solitary 1,5 centimeter in diameter mass on the scalp of the left temporal region. The patient underwent an ultrasound and excision biopsy which revealed spiradenoma diagnosis. This tumor transforms into malignant form extremely rarely. However, transformation is more likely in elderly patients having a long-standing lesions This is why early and wide excision is crucial and considered to be a gold standard treatment