BACKGROUND: Age-related neurodegenerative diseases (NDs) pose a formidable challenge to healthcare systems worldwide due to their complex pathogenesis, significant morbidity, and mortality. Scope and Approach: This comprehensive review aims to elucidate the central role of the microbiotagut- brain axis (MGBA) in ND pathogenesis. Specifically, it delves into the perturbations within the gut microbiota and its metabolomic landscape, as well as the structural and functional transformations of the gastrointestinal and blood-brain barrier interfaces in ND patients. Additionally, it provides a comprehensive overview of the recent advancements in medicinal and dietary interventions tailored to modulate the MGBA for ND therapy. CONCLUSION: Accumulating evidence underscores the pivotal role of the gut microbiota in ND pathogenesis through the MGBA. Dysbiosis of the gut microbiota and associated metabolites instigate structural modifications and augmented permeability of both the gastrointestinal barrier and the blood-brain barrier (BBB). These alterations facilitate the transit of microbial molecules from the gut to the brain via neural, endocrine, and immune pathways, potentially contributing to the etiology of NDs. Numerous investigational strategies, encompassing prebiotic and probiotic interventions, pharmaceutical trials, and dietary adaptations, are actively explored to harness the microbiota for ND treatment. This work endeavors to enhance our comprehension of the intricate mechanisms underpinning ND pathogenesis, offering valuable insights for the development of innovative therapeutic modalities targeting these debilitating disorders.
- MeSH
- Dysbiosis metabolism MeSH
- Blood-Brain Barrier metabolism MeSH
- Humans MeSH
- Brain * metabolism MeSH
- Neurodegenerative Diseases * microbiology metabolism MeSH
- Brain-Gut Axis * physiology MeSH
- Probiotics MeSH
- Aging * MeSH
- Gastrointestinal Microbiome * physiology MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
There is growing evidence that endocrine disruptive chemicals have deleterious effects on sexual and reproductive function. To examine subjective sexual functions in human females and their relationship to postnatal phthalate exposure and perinatal androgenization, a Sexuality Score (SS) was established from a first-stage survey questionnaire of subjective sexual function filled out by female university students (n = 68; average age 25.23 ± 5.17 years; rural 25.51 ± 6.74 vs. urban 25.85 ± 1.43 years). Seventeen phthalate metabolites in urine samples were analyzed by high-performance liquid chromatography (HPLC) and tandem mass spectrometry (MS/MS). Females were also assessed for the 2D:4D digit ratio as an index of perinatal androgenization. The mean age of menarche was 12.82 ± 1.35 years (rural 12.59 ± 1.39 vs. urban 13.18 ± 1.27; p = 0.01). The mean age at first sexual intercourse was 14.88 ± 6.89 years (rural 14.62 ± 7.20 vs. urban 15.24 ± 6.55), and as the age of first sexual intercourse increases, the SS score tends to increase as well, albeit moderately (r = 0.25, p = 0.037). Mono-iso-butyl phthalate, mono(2-ethyl-5-carboxypentyl) phthalate, mono(hydroxy-n-butyl) phthalate, mono(2-ethyl-5-oxohexyl) phthalate (p ≤ 0.05) and mono(2-carboxymethylhexyl) phthalate (p ≤ 0.01) were negatively associated with SS. A compounding butterfly effect of prenatal exposure to androgens was observed with disruptive effects of mono(2-ethyl-5-oxohexyl) phthalate and mono(2-ethyl-5-carboxypentyl) phthalate on sexual function. Exposure to phthalates in adult females may lead to disruption of subjective sexual function, especially concerning sexual desire and sexual satisfaction, and perinatal androgenization could augment these effects.
- MeSH
- Androgens * MeSH
- Adult MeSH
- Endocrine Disruptors * MeSH
- Phthalic Acids * urine MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Surveys and Questionnaires MeSH
- Sexual Behavior * drug effects MeSH
- Pregnancy MeSH
- Prenatal Exposure Delayed Effects * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Ways of supporting the communication skills of children with neurodevelopmental disorders in the home environment seem to be a marginal area of professional interest. The aim of this paper is to present one of the alternative and augmentative communication strategies - namely, modelling, that can be provided to families by early intervention. The paper situates modelling in the context of alternative and augmentative communication and presents this strategy as a potentially relevant way in which families can repeatedly convey the meaning and principles of communication to children with these disorders.
- Keywords
- modelování,
- MeSH
- Child MeSH
- Communication MeSH
- Humans MeSH
- Neurodevelopmental Disorders * MeSH
- Early Intervention, Educational MeSH
- Check Tag
- Child MeSH
- Humans MeSH
Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health problem closely linked to dietary habits, particularly high fructose consumption. This study investigates the combined effects of fructose and common food preservatives (sodium benzoate, sodium nitrite, and potassium sorbate) on the development and progression of MASLD. Methods: We utilized a human microbiota-associated mouse model, administering 10% fructose with or without preservatives for 11 weeks. Liver histology, hepatic gene expression (microarray analysis), biochemical markers, cytokine profiles, intestinal permeability, and gut microbiome composition (16S rRNA and Internal Transcribed Spacer (ITS) sequencing) were evaluated. Results: Fructose and potassium sorbate synergistically induced liver pathology characterized by increased steatosis, inflammation and fibrosis. These histological changes were associated with elevated liver function markers and altered lipid profiles. The treatments also induced significant changes in both the bacterial and fungal communities and disrupted intestinal barrier function, leading to increased pro-inflammatory responses in the mesenteric lymph nodes. Liver gene expression analysis revealed a wide range of transcriptional changes induced by fructose and modulated by the preservative. Key genes involved in lipid metabolism, oxidative stress, and inflammatory responses were affected. Conclusions: Our findings highlight the complex interactions between dietary components, gut microbiota, and host metabolism in the development of MASLD. The study identifies potential risks associated with the combined consumption of fructose and preservatives, particularly potassium sorbate. Our data reveal new mechanisms that are involved in the development of MASLD and open up a new avenue for the prevention and treatment of MASLD through dietary interventions and the modulation of the microbiome.
- MeSH
- Gene Expression drug effects MeSH
- Fructose * adverse effects MeSH
- Liver * metabolism drug effects MeSH
- Sorbic Acid pharmacology MeSH
- Disease Models, Animal MeSH
- Mice, Inbred C57BL MeSH
- Mice MeSH
- Food Preservatives * pharmacology adverse effects MeSH
- Gastrointestinal Microbiome * drug effects MeSH
- Drug Synergism MeSH
- Fatty Liver MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
OBJECTIVES: There have been significant advances in the medical management of severe postpartum hemorrhage (sPPH) over recent decades, which is reflected in numerous published guidelines. To date, many of the currently available national and international guidelines recommend recombinant factor VIIa (rFVIIa) to be used only at a very late stage in the course of sPPH, as a "last resort", before or after hysterectomy. Based on new safety data, rFVIIa has recently been approved by the European Medicines Agency (EMA) and Swissmedic for use in sPPH, if uterotonics are insufficient to achieve hemostasis, which in fact is significantly earlier in the course of postpartum hemorrhage (PPH). We therefore aimed to develop expert consensus guidance as a step toward standardizing care with the use of rFVIIa for clinicians managing women experiencing life-threatening sPPH. METHODS: The consensus process consisted of one face-to-face meeting with a group of nine experts, including eight obstetrician-gynecologists and a hematologist highly experienced in sPPH care in tertiary care perinatal centers. The panel was representative of multidisciplinary expertise in the European obstetrics community and provided consensus opinion in answer to pre-defined questions around clinical practice with rFVIIa in the management of sPPH. Recommendations have been based on current national and international guidelines, extensive clinical experience, and consensus opinion, as well as the availability of efficacy and new safety data. RESULTS: The expert panel developed 17 consensus statements in response to the 13 pre-defined questions on the use of rFVIIa in the management of sPPH including: available efficacy and safety data and the need for interdisciplinary expertise between obstetricians, anesthesiologists, and hematologists in the management of sPPH. Based on novel data, the experts recommend: (1) earlier administration of rFVIIa in patients with sPPH who do not respond to uterotonic administration to optimize the efficacy of rFVIIa; (2) the importance of hematological parameter prerequisites prior to the administration of rFVIIa to maximize efficacy; and (3) continued evaluation or initiation of further invasive procedures according to standard practice. Furthermore, recommendations on the timing of rFVIIa treatment within the sPPH management algorithm are outlined in a range of specified clinical scenarios and settings, including vaginal delivery, cesarean section, and smaller birthing units before transfer to a tertiary care center. The panel agreed that according to available, and new data, as well as real-world experience, there is no evidence that the use of rFVIIa in patients with sPPH increases the risk of thromboembolism. The authors acknowledge that there is still limited clinical effectiveness data, as well as pharmacoeconomic data, on the use of rFVIIa in sPPH, and recommend further clinical trials and efficacy investigation. CONCLUSIONS: This expert panel provides consensus guidance based on recently available data, clinical experience, and expert opinion, augmented by the recent approval of rFVIIa for use in sPPH by the EMA. These consensus statements are intended to support clinical care for sPPH and may help to provide the impetus and a starting point for updates to existing clinical practice guidelines.
- MeSH
- Cesarean Section MeSH
- Factor VIIa therapeutic use MeSH
- Humans MeSH
- Postpartum Hemorrhage * drug therapy MeSH
- Postpartum Period MeSH
- Recombinant Proteins MeSH
- Pregnancy MeSH
- Check Tag
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
OBJECTIVES: Clinical practice guidelines (CPGs) are often created through collaboration among organizations. The use of inconsistent terminology may cause poor communication and delays. This study aimed to develop a glossary of terms related to collaboration in guideline development. STUDY DESIGN AND SETTING: A literature review of collaborative guidelines was performed to develop an initial list of terms related to guideline collaboration. The list of terms was presented to the members of the Guideline International Network Guidelines Collaboration Working Group, who provided presumptive definitions for each term and proposed additional terms to be included. The revised list was subsequently reviewed by an international, multidisciplinary panel of expert stakeholders. Recommendations received during this pre-Delphi review were implemented to augment an initial draft glossary. The glossary was then critically evaluated and refined through two rounds of Delphi surveys and a virtual consensus meeting with all panel members as Delphi participants. RESULTS: Forty-nine experts participated in the pre-Delphi survey, and 44 participated in the two-round Delphi process. Consensus was reached for 37 terms and definitions. CONCLUSION: Uptake and utilization of this guideline collaboration glossary by key organizations and stakeholder groups may facilitate collaboration among guideline-producing organizations by improving communication, minimizing conflicts, and increasing guideline development efficiency.
- MeSH
- Delphi Technique MeSH
- Communication * MeSH
- Consensus MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Amyotrofická laterální skleróza (ALS) je progresivní neurodegenerativní onemocnění. K typickým symptomům onemocnění patří mj. dysartrie a dysfagie (tzv. bulbární příznaky). Postupné oslabení až ztráta řečových funkcí staví pacienty s ALS do pozice vážných kandidátů pro zavedení alternativní a augmentativní komunikace (AAK). Pacienti s ALS by měli být od počátku onemocnění sledováni klinickým logopedem s pravidelným hodnocením řečových funkcí, doporučením a nastavením AAK. Zajištění možnosti komunikace po celou dobu onemocnění výrazně zlepšuje kvalitu života pacientů i jejich blízkých. Příspěvek prezentuje výsledky dlouhodobého sledování souboru 89 pacientů s ALS se symptomy bulbární dysfunkce se zaměřením na využívání metod AAK a načasování zahájení jejich použití. Ve sledovaném období využívala v našem souboru AAK necelá polovina pacientů. Dle očekávání šlo většinou o pacienty s těžkou dysartrií či anartrií. K využívání AAK přistoupili pacienti nejčastěji přibližně po 16 měsících od začátku rozvoje bulbárních příznaků. Doba zapojení AAK však byla výrazně individuálně variabilní a u některých pacientů nebyla v našem souboru AAK využívána dokonce ani po více než 8 letech od iniciální manifestace bulbární dysfunkce.
Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease. Among others, dysarthria and dysphagia (i.e. bulbar dysfunction) represent common clinical manifestations of ALS. Gradual impairment or even loss of speech functions puts ALS patients in the position of serious candidates for the implementation of Alternative and Augmentative Communication (AAC). Regular follow-up with the assessment of speech functions and AAC recommendation and settings in the relevant cases provided by the Clinical Speech Therapist are recommended in all ALS patients, from the onset of the disease. Maintaining the possibility of communication and interaction with the family and friends throughout the disease significantly improves the quality of life of patients and their caregivers. The paper presents the results of the long-term follow-up of a group of 89 ALS patients with bulbar impairment, focused on the use of AAC and the timing of AAC onset. Almost one-half of our patients started to use AAC in the follow-up period. Not surprisingly, the AAC methods were used mainly by patients with severe dysarthria or anarthria. In the study sample, patients started to use AAC approximately 16 months after the onset of bulbar symptoms. However, the time to onset of AAC was significantly variable individually, and a few patients did not use any AAC methods, even in the interval of more than 8 years from the onset of clinical bulbar impairment.
- MeSH
- Amyotrophic Lateral Sclerosis * complications MeSH
- Dysarthria therapy MeSH
- Quality of Life MeSH
- Humans MeSH
- Communication Devices for People with Disabilities * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Předkládané kazuistiky seznamují s možnostmi využití pomůcek alternativní a augmentativní komunikace u dětí s kombinovaným postižením a symptomatickou poruchou řeči. Představíme a porovnáme náhradní způsoby komunikace u dvou chlapců s vývojovou anartrií. První případová studie se věnuje dítěti se syndromem Lesch-Nyhan, druhá chlapci s vývojovou poruchou centrálního nervového systému. Naším cílem je ukázat hledání cest k funkční komunikaci a rozvoji dítěte, které není schopné mluvené řeči.
We introduce the application of alternative and augmentative communication aids in children with combined disabilities and symptomatic speech disorders. We will briefly introduce and compare alternative routes of communication in two boys with developmental anarthria. The first case study is devoted to a child with Lesch-Nyhan syndrome, the second to a boy with a developmental disorder of the central nervous system. Our goal is to map the avenues for functional communication and the development of a child unable to speak.
- MeSH
- Child MeSH
- Dysarthria * therapy MeSH
- Communication MeSH
- Lesch-Nyhan Syndrome complications therapy MeSH
- Humans MeSH
- Adolescent MeSH
- Communication Devices for People with Disabilities * MeSH
- Speech Disorders * therapy MeSH
- Speech Therapy methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Tradičná AAK intervencia sa zameriavala na rozvoj produkcie používateľa AAK. Pomocné jazykové modelovanie je populárna intervenčná stratégia AAK, ktorá je založená na dôkazoch a má pozitívny vplyv nie len na produkciu grafických znakov, ale aj na zlepšovanie porozumenia hovorenej reči. Základným princípom tejto intervencie je, že komunikačný partner používa AAK popri hovorenej reči s cieľom poskytnúť dieťaťu model/vzor takej komunikačnej modality, akú bude dieťa používať na produkciu. Ukázalo sa a dokazujú to viaceré výskumy, že tento typ AAK intervencie pomáha pri rozvoji aj ďalších komunikačných schopností používateľov AAK.
The traditional AAC intervention is focused on developing the production of the AAC user. Aided Language Modelling is a popular evidence-based AAC intervention strategy and has a positive impact not only on the production of graphic symbols, but also on improving speech comprehension. The basic principle of this intervention is that the communication partner uses AAC in addition to spoken language, in order to provide the child with a model of the communication modality that the child will use for production. Several studies have shown and demonstrated that this type of AAC intervention helps to develop other communication skills of AAC users.
