Rethinking the role of microglia in obesity

Microglia are the macrophages of the central nervous system (CNS), implying their role in maintaining brain homeostasis. To achieve this, these cells are sensitive to a plethora of endogenous and exogenous signals, such as neuronal activity, cellular debris, hormones, and pathological patterns, among many others. More recent research suggests that microglia are highly responsive to nutrients and dietary variations. In this context, numerous studies have demonstrated their significant role in the development of obesity under calorie surfeit. Because many reviews already exist on this topic, we have chosen to present the state of our reflections on various concepts put forth in the literature, bringing a new perspective whenever possible. Our literature review focuses on studies conducted in the arcuate nucleus of the hypothalamus, a key structure in the control of food intake. Specifically, we present the recent data available on the modifications of microglial energy metabolism following the consumption of an obesogenic diet and their consequences on hypothalamic neuron activity. We also highlight the studies unraveling the mechanisms underlying obesity-related sexual dimorphism. The review concludes with a list of questions that remain to be addressed in the field to achieve a comprehensive understanding of the role of microglia in the regulation of body energy metabolism. This article is part of the Special Issue on "Microglia".

Psychological Distress in Primary Healthcare Workers during the COVID-19 Pandemic in Greece

OBJECTIVE

The present study aims to evaluate the symptoms of psychological distress during the COVID-19 pandemic, in Greek primary healthcare workers, correlating them with their individual characteristics.

MATERIALS AND METHODS

The research is based on a self-report questionnaire distributed to primary HCWs of Thessaloniki's public health care units. A sample of 143 respondents was gathered. The questionnaire consists of 21 items: 6 demographic questions, 9 on personal distress, 5 on work-related distress and 1 on one dominant feeling of the participants. These items were based on existing validated measures, such as the "Depression Anxiety Stress Scale-21", the "Kessler Psychological Distress Scale-10", "General Health Questionnaire- 28" and "Hospital Anxiety and Depression Scale". The associations between participants' gender, education, specialty and parenthood were determined with Pearson's chi-squared (χ2) test.

RESULTS

Overall, 70.4% of HCWs were generally affected by the pandemic. The personal distress factors revealed that the majority (67%) experienced distress due to routine changes. The effects on health behavior (sleep, eating behavior and substance use) were not high. Psychological/psychiatric needs were relatively low, while negative emotions and need of social support were high. 31.4% displayed intense emotional instability. All work-related distress factors were rated high. Worry about contracting COVID-19 in the workplace scored the highest (82.6%). Almost half of the participants felt exposed to COVID-19 infection (47.0%). Anxiety (47.2%) and burn-out (78.4%) symptoms were also revealed. Female participants appeared to be more anxious (P<0.01) and upset (P=0.013).

CONCLUSION

The exposure to a constant risk could potentially lead to an increase in HCWs' psychological distress. Designing the right tools and organizing the right plans are of paramount importance to prevent the deterioration of their wellness and quality of life.

Clinical outcomes of lingual nerve repair

Lingual nerve injury, a well-described complication of third molar removal, may result in permanent lingual sensory deficit leading to symptoms including lost or altered sensation, inadvertent tongue biting, and the development of unpleasant neuropathic pain, with consequent impaired quality of life. We analysed outcomes of a prospective case series to determine whether direct anastomosis of the lingual nerve results in improved sensory recovery and reduced neuropathic pain, and whether delayed surgery is worthwhile. In 114 patients who underwent nerve repair at our nerve injury clinic following damage sustained during mandibular third molar removal, sensory deficit was assessed before and after surgery using a questionnaire and visual analogue scales (VAS) to assess pain, tingling, and discomfort. Neurosensory tests were utilised to evaluate light touch, pin-prick, and two-point discrimination thresholds. Subjectively, 94% patients felt their sensation had improved following nerve repair, with significant reductions in the incidence of tongue biting (p<0.0001), impaired speech (p<0.0001), and neuropathic pain (p=0.0017). Quantitative neurosensory data showed highly significant improvements in light touch, pin-prick, and two-point discrimination (all p<0.0001), and VAS scores for pain (p=0.0145), tingling (p<0.0025), and discomfort (p<0.0001) were significantly reduced. Patients with high levels of pain preoperatively (VAS>40) showed highly significant reductions in pain (p<0.0001). No correlation was found between surgical outcome and patient's age or delay until surgery. Lingual nerve repair results in good sensory outcomes and significant improvements in the incidence and degree of neuropathic pain, even when delayed.

Aggressive denosumab-related jaw necrosis - a case series

Medication related osteonecrosis of the jaw is becoming a repeatedly seen complication in cancer patients. Stage 0 of the disease is more likely to be seen by the patients' general dental practitioners. We are presenting four cases of MRONJ related to denosumab treatment showing increasingly aggressive pictures of the disease. Nevertheless, we also present a good response to a drug holiday arranged by the patients' treating oncologists.

[Healthy elderly--healthy aging]

Human statistics show an extraordinary increase in the proportion of old people in the world, in Europe, and in Greece. The role of the nurse in covering the health needs of this group of the population is analyzed. Emphasis is placed in keeping old people active and independent.