Probiotic Mixture Containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum Affects Brain Responses Toward an Emotional Task in Healthy Subjects: A Randomized Clinical Trial.

Background: Evidence from preclinical studies suggests that probiotics affect brain function via the microbiome-gut-brain axis, but evidence in humans remains limited. Objective: The present proof-of-concept study investigated if a probiotic product containing a mixture of Bifidobacterium longum R0175, Lactobacillus helveticus R0052 and Lactiplantibacillus plantarum R1012 (in total 3 × 109 CFU/day) affected functional brain responses in healthy subjects during an emotional attention task. Design: In this double-blinded, randomized, placebo-controlled crossover study (Clinicaltrials.gov, NCT03615651), 22 healthy subjects (24.2 ± 3.4 years, 6 males/16 females) were exposed to a probiotic intervention and a placebo for 4 weeks each, separated by a 4-week washout period. Subjects underwent functional magnetic resonance imaging while performing an emotional attention task after each intervention period. Differential brain activity and functional connectivity were assessed. Results: Altered brain responses were observed in brain regions implicated in emotional, cognitive and face processing. Increased activation in the orbitofrontal cortex, a region that receives extensive sensory input and in turn projects to regions implicated in emotional processing, was found after probiotic intervention compared to placebo using a cluster-based analysis of functionally defined areas. Significantly reduced task-related functional connectivity was observed after the probiotic intervention compared to placebo. Fecal microbiota composition was not majorly affected by probiotic intervention. Conclusion: The probiotic intervention resulted in subtly altered brain activity and functional connectivity in healthy subjects performing an emotional task without major effects on the fecal microbiota composition. This indicates that the probiotic effects occurred via microbe-host interactions on other levels. Further analysis of signaling molecules could give possible insights into the modes of action of the probiotic intervention on the gut-brain axis in general and brain function specifically. The presented findings further support the growing consensus that probiotic supplementation influences brain function and emotional regulation, even in healthy subjects. Future studies including patients with altered emotional processing, such as anxiety or depression symptoms are of great interest. Clinical Trial Registration: [http://clinicaltrials.gov/], identifier [NCT03615651].

Virtual non-contrast dual-energy CT compared to single-energy CT of the urinary tract: a prospective study.

BACKGROUND: Dual-energy computed tomography (DECT) has been shown to be useful for subtracting bone or calcium in CT angiography and gives an opportunity to produce a virtual non-contrast-enhanced (VNC) image from a series where contrast agents have been given intravenously. High noise levels and low resolution have previously limited the diagnostic value of the VNC images created with the first generation of DECT. With the recent introduction of a second generation of DECT, there is a possibility of obtaining VNC images with better image quality at hopefully lower radiation dose compared to the previous generation. PURPOSE: To compare the image quality of the single-energy series to a VNC series obtained with a two generations of DECT scanners. CT of the urinary tract was used as a model. MATERIAL AND METHODS: Thirty patients referred for evaluation of hematuria were examined with an older system (Somatom Definition) and another 30 patients with a new generation (Somatom Definition Flash). One single-energy series was obtained before and one dual-energy series after administration of intravenous contrast media. We created a VNC series from the contrast-enhanced images. Images were assessed concerning image quality with a visual grading scale evaluation of the VNC series with the single-energy series as gold standard. RESULTS: The image quality of the VNC images was rated inferior to the single-energy variant for both scanners, OR 11.5-67.3 for the Definition and OR 2.1-2.8 for the Definition Flash. Visual noise and overall quality were regarded as better with Flash than Definition. CONCLUSION: Image quality of VNC images obtained with the new generation of DECT is still slightly inferior compared to native images. However, the difference is smaller with the new compared to the older system.

Non-invasive investigations of potential renal artery stenosis in renal insufficiency.

BACKGROUND: The diagnostic value of non-invasive methods for diagnosing renal artery stenosis in patients with renal insufficiency is incompletely known. METHODS: Forty-seven consecutive patients with moderately impaired renal function and a clinical suspicion of renal artery stenosis were investigated with computed tomography angiography (CTA), gadolinium-enhanced magnetic resonance angiography (MRA), contrast-enhanced Doppler ultrasound and captopril renography. The primary reference standard was stenosis reducing the vessel diameter by at least 50% on CTA, and an alternative reference standard ('morphological and functional stenosis') was defined as at least 50% diameter reduction on CTA or MRA, combined with a positive finding from ultrasound or captopril renography. RESULTS: The frequency of positive findings, calculated on the basis of individual patients, was 70% for CTA, 60% for MRA, 53% for ultrasound and 30% for captopril renography. Counting kidneys rather than patients, corresponding frequencies were 53%, 41%, 29% and 15%, respectively. In relation to the CTA standard, the sensitivity (and specificity) at the patient level was 0.81 (0.79) for MRA, 0.70 (0.89) for ultrasound and 0.42 (1.00) for captopril renography, and at the kidney level 0.76 (0.82), 0.53 (0.81) and 0.30 (0.86), respectively. Relative to the alternative reference standard, corresponding values at the patient level were 1.00 (0.62) for CTA, 0.90 (0.69) for MRA, 0.91 (1.00) for ultrasound and 0.67 (1.00) for captopril renography, and at the kidney level 0.96 (0.76), 0.85 (0.79), 0.71 (0.97) and 0.50 (0.97), respectively. CONCLUSIONS: CTA and MRA are superior to ultrasound and captopril renography at diagnosing morphological stenosis, but ultrasound may be useful as a screening method and captopril renography for verifying renin-dependent hypertension.