Association of worsening of nonalcoholic fatty liver disease with cardiometabolic function and intestinal bacterial overgrowth: A cross-sectional study.

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) has been associated with small bowel bacterial overgrowth (SIBO) and cardiometabolic dysfunction. This cross-sectional study aimed to evaluate the cardio-metabolic parameters and SIBO in patients with different degrees of hepatic fibrosis estimated by NAFLD fibrosis score (NFS). METHODS: Subjects (n = 78) were allocated to three groups: Healthy control (n = 30), NAFLD with low risk of advanced fibrosis (NAFLD-LRAF, n = 17) and NAFLD with a high risk of advanced fibrosis (NAFLD-HRAF, n = 31). Anthropometrics, blood pressure, electrocardiogram and heart rate variability (HRV) were evaluated. Only the NAFLD-LRAF and NAFLD-HRAF groups were submitted to blood biochemical analysis and glucose hydrogen breath tests. RESULTS: The NAFLD-HRAF group had higher age and body mass index when compared to the control and NAFLD-LRAF groups. The prevalence of SIBO in the NAFLD group was 8.33%. The low frequency/high-frequency ratio (LF/HF ratio) was augmented in NAFLD-LRAF (p < 0.05) when compared with control group. NAFLD-HRAF group had a wide QRS complex (p < 0.05) and reduced LF/HF ratio (p < 0.05) compared to the control and NAFLD-LRAF groups. Serum levels of albumin and platelets were more reduced in the NAFLD-HRAF subjects (p < 0.05) than in the NAFLD-LRAF. CONCLUSIONS: NAFLD impairs cardiac autonomic function. Greater impairment was found in subjects with a worse degree of hepatic fibrosis estimated by NFS. Hypoalbuminemia and thrombocytopenia were higher in subjects with a worse degree of hepatic fibrosis, whereas prevalence of SIBO positive was similar between the groups.

Gut microbiota and probiotic intervention as a promising therapeutic for pregnant women with cardiometabolic disorders: Present and future directions.

Maternal cardiometabolic disorders, such as gestational diabetes mellitus, pre-eclampsia, obesity, and dyslipidemia, are the most common conditions that predispose offspring to risk for future cardiometabolic diseases, needing appropriate therapeutic approach. The implications of microbiota in the pathophysiology of maternal cardiometabolic disorders are progressively emerging and probiotics may be a simple and safe therapeutic strategy for maternal cardiometabolic management. In this review, we argue the importance of cardiometabolic dysfunction during pregnancy and/or lactation on the offspring risk for cardiometabolic disease in later life. In addition, we comprehensively discuss the microbial diversity observed in maternal cardiometabolic disorders and we present the main findings on probiotic intervention as a potential strategy for management of maternal cardiometabolic disorders. Current data reveal that gut microbiota may be transmitted from mother to offspring. Whether targeting microbiota with probiotic intervention during the periconceptional period prevents or delays the onset of cardiometabolic disorders in adult offspring should be tested in future clinical trials.

Efficacy of physical therapy associated with botulinum toxin type A on functional performance in post-stroke spasticity: A randomized, double-blinded, placebo-controlled trial.

The aim was to investigate if botulinum toxin type A (BTx-A) associated with physical therapy is superior to physical therapy alone in post stroke spasticity. A randomized, double-blinded controlled trial was performed in a rehabilitation unit on Northeastern, Brazil. Patients with post stroke spasticity were enrolled either to BTx-A injections and a pre-defined program of physical therapy or saline injections plus physical therapy. Primary endpoint was functional performance evaluated through time up and go test, six minutes walking test and Fugl-Meyer scale for upper limb. Secondary endpoint was spasticity improvement. Confidence interval was considered at 95%. Although there was a significant decrease in upper limbs flexor tonus (P<0.05) in the BTx-A group, there was no difference regarding functional performance after 9 months of treatment. When analyzing gait speed and performance, both groups showed a significant improvement in the third month of treatment, however it was not sustained over time. Although BTx-A shows superiority to improve muscle tone, physical therapy is the cornerstone to improve function in the upper limbs of post stroke patients.

Anodal transcranial direct current stimulation over the posterior parietal cortex reduces the onset time to the rubber hand illusion and increases the body ownership.

The body ownership induced by the rubber hand illusion (RHI) has been related to a neural network involving a frontal-parietal circuit. Previous functional neuroimaging studies have demonstrated neural activation in the parietal area relative to the multisensory integration processing and to the recalibration of the felt position of body while a ventral premotor cortex activation has been linked to bodily self-attribution during the RHI. Our study aimed to investigate the effects of transcranial direct current stimulation (tDCS) on the posterior parietal cortex (PPC) or on the premotor cortex (PMv) during RHI to address the specific roles of these two brain areas in the illusion. 156 young adult participants (21.2 ± 3.13 years old; all right-handed) were enrolled for this between-subjects design experiment. Participants received anodal, cathodal and sham tDCS in three different sessions on the right PPC or right PMv and experienced visual-tactile stimulation from the brushes touching the rubber hand and their own left hand in synchronous or asynchronous manner. The RHI was quantified by the (1) onset time for the feeling of body ownership of the rubber hand, (2) proprioceptive drift, and (3) questionnaire about the intensity of the illusion as reported by the participant. All subjects felt the RHI during the synchronous condition. However, we found that the illusion onset time can be modulated by the anodal tDCS condition on the PPC: anodal tDCS decreased the illusion onset time and the subjective experience of body ownership. These findings suggest that the parietal area plays a crucial role in the speed of visual and tactile multisensory integration in the RHI and introduce tDCS as technique that can accelerate the time to integrate an artificial body part and increased the perception of body ownership.

The influence of skin colour on the experience of ownership in the rubber hand illusion.

Racial prejudice is associated with a fundamental distinction between "us" and "them"-a distinction linked to the perceived overlap between representations of the self and others. Implicit prejudice has been shown to reduce the intensity of White individuals' hand ownership sensation as induced by the Rubber Hand Illusion (RHI) with dark rubber hands. However, evidence for this link to implicit prejudice comes from self-report questionnaire data regarding the RHI. As an alternative, we assessed the onset time of the RHI. We hypothesized that onset time of the RHI would be higher for the black compared to the white RH, acting as the mediator between implicit prejudice and magnitude of the RH illusion and proprioceptive drift. As expected, participants took longer to incorporate the black RH and presented lower RH illusion magnitude and a smaller proprioceptive drift for the black RH. Mediation analysis revealed a significant indirect effect of implicit racial bias on proprioceptive drift and magnitude of illusion through onset time to illusion only for the black RH. These findings further illuminate the connection between implicit prejudice and embodied perception, suggesting new perspectives on how implicit biases operate.

Ilusão da mão de borracha induzida por estímulos controlados por equipamento eletrônico / Rubber hand illusion induced by electronic equipment­controlled stimuli / Ilusión de la mano de goma inducida por estímulos controlados por los equipos electrónicos

A indução da ilusão da mão de borracha (IMB) é tipicamente realizada por pincéis de forma manual. Nesse sentido, elaboramos um equipamento eletrônico com intuito de aumentar a precisão dos estímulos táteis na IMB. Objetivo: verificar a eficácia de um equipamento eletrônico para indução da IMB. Método: participaram do estudo 51 participantes, com idades entre 11 e 59 anos divididos em quatro grupos. Para coleta de dados utilizamos próteses de mãos e o equipamento eletrônico desenvolvido. A intensidade da IMB foi avaliada por um questionário subjetivo contendo 13 perguntas classificadas entre concordância ou discordância sobre as sensações percebidas do paradigma. Resultados: encontramos efeitos significativos em todas as perguntas de incorporação da mão de borracha. Conclusão: o equipamento eletrônico mostrou‑se eficaz na velocidade, sincronia e precisão da movimentação dos pincéis, com indução robusta do paradigma da IMB. Sugere‑se a utilização desse equipamento em experimentação científica do paradigma da IMB.

The induction of rubber hand illusion (RHI) is typically manually performed by brushes. In this direction, we developed an electronic device in order to increase the accuracy of tactile stimuli in RHI. Objective: To determine the effectiveness of an electronic and programmable apparatus developed for induction of RHI. Method: The study included 51 participants, age (11 and 59 years) distributed in four groups. For data collection we used the prosthetic hands and the personaly developed electronic equipment. The intensity of RHI was assessed using a subjective questionnaire containing 13 questions ranked in agreement or disagreement on the sensations perceived paradigm. Results: We found significant effects on all questions about incorporation of the rubber hand. Conclusion: The electronic equipment was effective in speed, timing and accuracy of movement of brushes and displayed the robust induction of RHI. Hence, we propose the use of such eletronic equipment in the RHI paradigm in scientific studies.

La inducción de la ilusión de la mano de goma (IMG) se realiza normalmente manualmente mediante cepillos. De este modo, hemos elaborado un dispositivo electrónico con el fin de aumentar la precisión de los estímulos táctiles en IMG. Objetivo: determinar la eficacia de un aparato electrónico y programable desarrollado para la inducción de IMG. Método: el estudio incluyó a 51 participantes, entre 11 y 59 años, divididos en cuatro grupos. Para la obtención de datos se utilizaron prótesis de mano y equipos electrónicos desarrollados. Para evaluar la intensidad de la inducción la IMG, se utilizó un cuestionario subjetivo que contiene 13 preguntas sobre la sensación ilusoria de incorporación de la mano. Resultados: un efecto significativo de las preguntas sobre la sensación ilusoria de incorporación de la mano de goma fue observado. Conclusión: el equipo electrónico fue eficaz en la velocidad, el tiempo y la precisión de movimiento de los cepillos con la inducción robusta de la IMG. Sugerimos el uso de estos equipos en el paradigma de la IMG experimentación científica.

Administração neonatal de sertralina causa resistência à depressão experimental induzida em ratos adultos / Neonatal administration of sertraline causes resistence on the experimental induced depression in adult rats

Modelos animais contribuem para o entendimento da participação do sistema serotoninérgico na gênese do comportamento depressivo e da ação dos antidepressivos. No presente estudo foi investigado o comportamento depressivo e o comportamento exploratório de ratos adultos jovens, tratados no período neonatal com sertralina, um inibidor seletivo da recaptação de serotonina. Os animais receberam via subcutânea, 15mg/kg de sertralina (n=33) o 1ml/kg de água destilada (n=27), diariamente do 1ºao 21º dia da vida pós-natal. A depressão experimental foi induzida através do teste do nado forçado, onde foram mensurados a latência da tentativa de fuga e o tempo de morbidade. E o comportamento exploratório foi observado através da atividade exploratóira no Hole board. Os animais tratados com a sertralina apresentaram resistência à indução experimental da depressão. O nado forçado reduziu o comportamento exploratório independente do tratamento farmacológico. Esses achados confirmam a importante participação dos sistema serotoninérgico na fisiologia do humor.