University of South Florida Morsani College of Medicine is one of the graduate schools of the University of South Florida. It is located in north Tampa, Florida and serves the greater Tampa Bay Area. Established by the Florida Legislature in 1965, the college enrolled its charter class in 1971.
Age-related neurodegenerative disorders, including Alzheimer’s disease, Parkinson’s disease, and mild cognitive impairment, represent a growing global health challenge. The present medicines offer only symptomatic alleviation with poor disease-modifying efficacy. Increasing data suggests that the gut–brain axis and dietary health are measurable contributions to cognitive impairment as we age. This review first focused on the mechanistic link between gut dysbiosis and neurodegeneration. Furthermore, the review discusses preclinical and clinical research that show how probiotics and dietary supplements improve brain function in the elderly using supplemental therapy methods. It also indicates that randomized clinical studies and meta-analyses suggest that probiotics and particular nutritional supplements provide modest but consistent cognitive advantages, which are most noticeable when patients receive therapy at the initial stage of their disease development. These advantages might originate from the combined impact of gut microbiota, immunological signaling, and neuroprotective pathways, rather than specific targeted approaches. Thus, the current review highlights the reports, suggesting that probiotics and dietary supplements might be effective and safe therapies for age-related neurodegeneration.
BACKGROUND:The contact aspiration (CA) technique is often used to perform endovascular thrombectomy (EVT) for acute ischemic stroke (AIS); however, rescue strategies are necessary if CA fails to achieve recanalization. This study investigates the outcomes of incorporating stent retriever (SR) thrombectomy in the rescue strategy following failed CA. METHODS:EVT patients with failed CA attempts were identified from a large multicenter registry and stratified by rescue technique: CA alone or incorporating SR in the rescue strategy. Outcomes included successful recanalization, 90-day functional outcomes (defined by the modified Rankin Scale (mRS) score), symptomatic intracranial hemorrhage (sICH), and 90-day mortality. RESULTS:Among 1885 patients with failed CA attempts, conversion to SR was associated with higher recanalization rates (85.2% vs 80.6%; p=0.03), higher rates of second-pass recanalization (31.2% vs 23.4%; p<0.001), and better 90-day outcomes (mRS 0-2: 35.2% vs 29.9%; p=0.04) when compared with repeated CA attempts. Trevo SRs showed higher odds of successful recanalization (adjusted odds ratio (aOR)=1.9; p=0.02), second-pass recanalization (aOR=1.7; p=0.01), and reduced odds of sICH (aOR=0.3; p=0.02). EmboTrap SRs were associated with higher odds of 90-day mortality (aOR=2.6; p=0.004) and sICH (aOR=2.9; p=0.04) and lower odds of recanalization (aOR=0.5; p=0.03). CONCLUSIONS:Incorporating SR in the rescue strategy after a failed CA improves recanalization rates and functional outcomes. Trevo SRs demonstrated superior efficacy and safety when incorporated into the rescue strategy.
Chronic subretinal fluid (SRF) is a common complication of dome-shaped macula (DSM), yet its optimal management remains uncertain. This paper presents a case of spontaneous resolution of chronic SRF associated with DSM following discontinuation of anti-vascular endothelial growth factor (anti-VEGF) therapy. The patient, in her late 70s, with DSM and chronic SRF in the left eye was treated with multiple anti-VEGF agents, including ranibizumab, aflibercept and faricimab, over 19 months. Despite ongoing therapy, her SRF persisted and best-corrected visual acuity (BCVA) remained stable at 20/20 to 20/25. 45 days after treatment cessation, optical coherence tomography showed complete resolution of SRF. Over 26 months of subsequent observation without further treatment, the retina remained dry and BCVA remained stable. This suggests that in DSM, chronic SRF refractory to anti-VEGF therapy may spontaneously resolve after discontinuing treatment. Observation is a reasonable management strategy in specific patients to minimise unnecessary injections and associated risks.
