Correlation between vitamin D and alterations in MRI among patients with multiple sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is a disease of unknown etiology. Diagnosis of MS is primarily based on detection of myelin damage by magnetic resonance imaging (MRI) and classification of demyelination according to the McDonald Criteria. Cholecalciferol (vitamin D3) has been shown to affect the onset and progression of MS via its immunomodulating properties. The role of vitamin D in MS pathogenesis and treatment deserves further investigation, as there is sufficient evidence to suggest a correlation between vitamin D blood level and brain MRI lesion load. STATE OF KNOWLEDGE: Elevated blood vitamin D concentration is linked with demyelination, as determined by T2-weighted and gadolinium-enhanced MRI. Blood vitamin D blood levels are affected by sun exposure, among other factors; however, there is no evident connection between abnormalities in myelination and seasonality. Vitamin D supplementation among MS patients has been associated with a lower probability of new lesions and loss of existing lesion volume, as observed seen in T1-weighted MRI scans (p=0.03). An increase in TGF-beta levels was noted among patients using vitamin D supplementation, which may suggest a mechanism by which cholecalciferol may improve MS prognosis. Patients with clinically isolated syndrome (CIS) exhibited an inverse correlation between vitamin D concentration and risk of new lesions as seen in T2-weighted MRI scans. Moreover, vitamin D intake among these patients lowered the risk of progression to clinically definite multiple sclerosis (CDMS). Daily intake of vitamin D during fingolimod treatment correlated strongly with lower numbers of new lesions. High dose vitamin D supplementation during interferon beta-1a treatment was linked to lower mean percentage of lesions compared with volume pre-treatment seen by T2-weighted MRI. RESULTS: Recent findings advocate for the monitoring of vitamin D blood levels in MS patients. Vitamin D supplementation should be considered in both MS patients and patients with CIS, where other signs of disease may be delayed. Moreover, vitamin D supplementation appears to lower the likelihood of new demyelination changes apparent in MRI examinations.

Dark side of laundry pods: Analysis of exposure to laundry detergent capsules in children.

AIM: We aimed to evaluate the epidemiological characteristic and clinical features of laundry detergent capsule (LDC) exposure in children. METHODS: Retrospective review of medical records of patients hospitalised due to the exposure to LDC at the Department of Paediatrics and Gastroenterology, Medical University of Lublin, Poland, from 2014 to 2019 was conducted. RESULTS: During the study period, 38 children including 19 (50%) boys and 19 (50%) girls were admitted to our department due to exposure to LDC. The age of patients ranged from 11 months to 9 years, with a mean 48.61 ± 28.85 months of age. About 66% of patients were younger than 5 years. The major route of exposure was ingestion (n = 37; 97%). Most patients (n = 27; 71%) exhibited symptoms of exposure to the LDC. The most common symptoms were vomiting (n = 23; 60%), cough (n = 7; 18%) and salivation (n = 5; 13%). Seven patients required gastroscopy. Abnormalities were subsequently identified in three children. CONCLUSIONS: Accidental exposure to LDC usually occurs in children younger than 5 years. Although the majority of cases had mild or moderate clinical outcomes, ingestion of LDC may lead to some severe consequences. Improvements in parental education regarding the risks of LDC, and in the packaging of LDC may prevent serious injury.

Application of Citicoline in Neurological Disorders: A Systematic Review.

Citicoline is a chemical compound involved in the synthesis of cell membranes. It also has other, not yet explained functions. Research on the use of citicoline is conducted in neurology, ophthalmology, and psychiatry. Citicoline is widely available as a dietary supplement. It is often used to enhance cognitive functions. In our article, accessible databases were searched for articles regarding citicoline use in neurological diseases. This article has a systemic review form. After rejecting non-eligible reports, 47 remaining articles were reviewed. The review found that citicoline has been proven to be a useful compound in preventing dementia progression. It also enhances cognitive functions among healthy individuals and improves prognosis after stroke. In an animal model of nerve damage and neuropathy, citicoline stimulated regeneration and lessened pain. Among patients who underwent brain trauma, citicoline has an unclear clinical effect. Citicoline has a wide range of effects and could be an essential substance in the treatment of many neurological diseases. Its positive impact on learning and cognitive functions among the healthy population is also worth noting.

Smoking as a risk factor of onset and relapse of Multiple Sclerosis - a review.

INTRODUCTION AND OBJECTIVE: Multiple Sclerosis (MS) is a chronic demyelinating disease caused by damage to myelin in the brain and spinal cord. The cause of the disease is unclear, but it is probably correlated with dysregulation of the immunological system, as well as non-modifiable and modifiable risk factors. Unfortunately, there is no cure for MS. However, the course of the condition has been shown to be modifiable by treatment and various environmental factors. Cigarette smoking is one of the most common addictions around the world, and may be a key modifiable risk factor in MS. Here, we review data available on Pubmed and Scopus from the last 10 years. The following consecutive key words were used in our search: "multiple sclerosis", "smoking", "cigarette", "impact", "progression", and "tobacco". This search yielded 248 initial articles, 43 of which were included in our review. CURRENT STATE OF KNOWLEDGE: In our review, we have examined the impact of smoking on the immunology, course, treatment, relapse, recurrence, quality of life, and changes visualised on MRI among patients with MS in general. We have also explored these patterns in MS subtypes. In general, smoking is reported to have negative effects on MS, including a decrease in quality of life, as well as cognitive and mental state, and an increase in disability, as well as in the frequency of relapses and recurrences. CLINICAL IMPLICATIONS: Smoking has a widespread negative impact on patients with MS. Thus, it is important to educate patients and to help them to give up smoking to improve their health and quality of life. FUTURE DIRECTIONS: Further research about the impact of smoking and nicotine on MS and other neurodegenerative diseases is needed; in particular, research on e-cigarettes.