Autism spectrum disorder (ASD) has become widespread neurodevelopmental disorder, which currently can be treated with only few therapeutic options. Furthermore, their effectiveness is limited therefore novel treatment strategies for ASD are needed. This review seeks to address this need by discussing a ketogenic diet (KD) in the context of ASD therapy. KD effects have been examined in animal and human studies. They indicate effectiveness of KD by improving autistic features. Moreover, animal studies have revealed clinically useful information about caloric restriction component of KD, which is not necessary to achieve therapeutic effects. Significantly administration of KD but not β-hydroxybutyrate or acetone has a therapeutic effect on social interactions. Human studies are scarce, however previous researches imply KD as an effective treatment at least in certain types of autism. KD in an altered form as: modified Atkins diet (MAD), ketogenic gluten-free diet with supplemental medium-chain triglyceride (MCT), and John Radcliffe ketogenic diet is an alternative to classic KD. These variants provide better quality of nutrition and are less strict, thus less difficult to maintain. KD is described as safe with limited, easily manageable adverse effects. Taken together human and animal studies would seem to suggest that KD will become part of ASD treatment. However, in order to determine accurate recommendations for all ASD patients, further studies are required.
This review discusses the effects of glucocorticoids (GCs) on brown adipose tissue (BAT) in the context of obesity prevention and therapy. Due to the unique expression of the uncoupling protein 1 (UCP1), BAT is capable of non‑shivering thermogenesis, also defined as a metabolic heat production, related to increased metabolic rate. All processes that contribute to an increase in activity and/or quantity of BAT are able to upturn metabolism, and thus enable the above therapeutic goals to be achieved. GCs may stimulate BAT differentiation and proliferation. In the case of differentiation, the opposite effect of GCs has been also described. Within white adipose tissue (WAT) GCs inhibit the formation of so called beige adipocytes that are functionally and morphologically similar to the adipocytes from BAT. The activity of GCs with concomitant inhibition of WAT browning is mediated by the induction of microRNA-27b (MIR27B) expression. GCs are responsible for the decline in BAT activity as the body ages. Depriving the body of an enzyme responsible for local reduction of cortisone into an active GC‑cortisol in BAT (11β‑hydroxysteroid dehydrogenase type 1; 11β‑HSD1) prevents the reduction of BAT activity. The effects of high doses of GCs on BAT generally depend on the exposure time. Prolonged elevation in GCs level decreases BAT activity. During adrenergic stimulation the effect of GCs on BAT is ambiguous, because both decrease and increase in activity has been described. A full understanding of the GCs impact on brown remodeling in WAT may reveal a discovery of a novel preventive and therapeutic strategies for obesity and possibly other metabolic disorders.
Shooting may impact the frequency of neuropathies in the upper extremity nerves or of cervical disc–root conflicts. This study was undertaken to assess whether shooting sports trained with a handgun by civilians may influence the risk factor for carpal tunnel syndrome (CTS) and other neuropathies of the brachial plexus nerve fibers. Neurophysiological studies using surface electromyography (rEMG at rest and mcEMG during maximal contraction), electroneurography (ENG), and motor-evoked potential recordings (MEPs) were performed in a select population of nine shooters, which were rigorously screened as positive through a clinical examination for carpal tunnel syndrome and other brachial plexus neuropathies among a population of forty-two subjects, to confirm the existence of pathologies in the upper extremities. Increased muscle tension in rEMG and a simultaneous decrease in motor unit activity in mcEMG were recorded both in the proximal and distal muscles of the upper extremities more frequently in the shooters than in the healthy controls—volunteers. An ENG examination confirmed CTS in the shooting hand of four subjects (4/42; 9.5%), additionally revealing a significantly decreased F-wave at the C6–C7 levels in the dominant extremities of the shooting group in comparison to the control population (p = 0.05). All the examined subjects had revealed brachial plexus pathologies on both sides according to the results of the MEP recordings upon stimulation at the C4–C8 levels (various significant differences between the shooters and control group were found), and two had ulnar neuropathy in the wrist on the shooting side. It was concluded that shooting sports are a moderate risk factor for carpal tunnel syndrome and that they significantly influence the development of other brachial plexus neuropathies.
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