Magnesium Orotate and the Microbiome–Gut–Brain Axis Modulation: New Approaches in Psychological Comorbidities of Gastrointestinal Functional Disorders

Magnesium orotate has been cited in the medical literature for the past three years as a possible adjuvant in some pediatric and adult gastroenterological disorders associated with dysbiosis. Studies also focus on the possibility of adding magnesium orotate in psychiatric disorders’ treatment, such as major depression and anxiety. The most relevant element in these studies is the efficiency of magnesium orotate therapy in cases with both gastroenterological and psychiatric symptoms. This article proposes a literature review, focused on the studies published in the last three years, targeting magnesium orotate treatment and probiotic supplementation in patients with both digestive and psychiatric symptoms. Moreover, this review will compare the efficiency of magnesium orotate and probiotics within both the pediatric and adult communities, focusing on the possibility of gut–brain axis modulation and its involvement in the clinical evolution of these patients.     

"Spontaneous", "delayed" and "occult" ruptures of the normal and pathologic spleen. Nosologic classification

The anatomic particularities and the diversity of the splenic pathology determine a wide spectrum of the traumatic lesions of the spleen. The classical acute rupture with consecutive hemoperitoneum and mandatory surgical indication is opposed to the controversial "spontaneous" ruptures of the normal and pathologic spleen and also to the delayed and occult ruptures the lasts of them sometimes minimal or with chronic evolution. A series of eight cases all males with ages between 40-77 years is presented in order to exemplify all these entities. There are underlined the variety of etiologic conditions, the difficulties of the diagnosis which impose an insistent anamnesis and clinical examination (searching even a "trivial" trauma) completed with ultrasonography and CT scan which are preferred to radionuclide scan of arteriography and finally peritoneal lavage after punction, laparoscopy and even laparotomy. Splenectomy--often laborious--was effective in all our patients (obviously only temporary for the cases with nonhodgkin malignant lymphoma and respectively with splenic metastasis from a renal carcinoma). In some situations--especially in children--the conservative treatment can be considered.     

Increased cerebral metabolism after 1 year of deep brain stimulation in Alzheimer disease

BACKGROUND The importance of developing unique, neural circuitry-based treatments for the cognitive and neuropsychiatric symptoms of Alzheimer disease (AD) was the impetus for a phase I study of deep brain stimulation (DBS) in patients with AD that targeted the fornix. OBJECTIVE To test the hypotheses that DBS would increase cerebral glucose metabolism in cortical and hippocampal circuits and that increased metabolism would be correlated with better clinical outcomes. DESIGN Open-label trial. SETTING Academic medical center. PATIENTS A total of 5 patients with mild, probable AD (1 woman and 4 men, with a mean [SD] age of 62.6 [4.2] years). INTERVENTION Deep brain stimulation of the fornix. MAIN OUTCOME MEASURES All patients underwent clinical follow-up and high-resolution positron emission tomography studies of cerebral glucose metabolism after 1 year of DBS. RESULTS Functional connectivity analyses revealed that 1 year of DBS increased cerebral glucose metabolism in 2 orthogonal networks: a frontal-temporal-parietal-striatal-thalamic network and a frontal-temporal-parietal-occipital-hippocampal network. In similar cortical regions, higher baseline metabolism prior to DBS and increased metabolism after 1 year of DBS were correlated with better outcomes in global cognition, memory, and quality of life. CONCLUSIONS Increased connectivity after 1 year of DBS is observed, which is in contrast to the decreased connectivity observed over the course of AD. The persistent cortical metabolic increases after 1 year of DBS were associated with better clinical outcomes in this patient sample and are greater in magnitude and more extensive in the effects on cortical circuitry compared with the effects reported for pharmacotherapy over 1 year in AD.     

Assessment of the risk of infection among Romanian physicians at the outbreak of the SARS CoV-2 pandemic

BackgroundIn March 2020, the WHO declared the SARS CoV-2 pandemic. This had an immediate and dramatic impact on Romanian physicians.ObjectivesTo analyse SARS-CoV-2 risk perception among Romanian physicians following the official WHO pandemic announcement.MethodsA questionnaire was sent to Romanian physicians (n = 319) between 13 and 27 of March 2020 to determine the perceived threat of exposure to SARS CoV-2 infection, the assessment COVID-19 sources of documentation, physicians’ access to personal protective equipment and the attitude towards a prospective vaccine against SARS CoV-2.ResultsConfronted with a new and unknown disease, the lack of appropriate information regarding disease management, media pressure and the lack of protective equipment, physicians experiencing a highly stressful a period. We found a significant relationship between the perceived level of fear and the risk of infection with SARS CoV-2 among respondents. A relationship was also found between the perceived level of fear related to COVID-19 and the acceptance of future vaccines against SARS CoV-2. Our data show that doctors working in urban areas considered the medical research on COVID-19 as clearer than those working in rural locations did.ConclusionPandemic preparedness should focus on measures that make medical practice safe (supplies, working protocols, experience sharing with experts/colleagues from other countries).