• 文章类型: Journal Article
    这篇综述的目的是总结有关儿童功能性便秘的家庭动态和/或治疗依从性的相关文献。在MEDLINE上进行了结构化的系统文献检索,Embase,和WebofScience核心馆藏库从2000年到2023年,使用特定的搜索词:便秘,治疗依从性,家庭动态,父母教养方式,和儿科。确定并列入了71份出版物供审查。在根据与审查的一致性进行筛选后,还有20份出版物。这些出版物根据其意图和发现分为三类:(1)进一步提高依从性的建议,(2)分析依从性因素的研究,(3)研究表明需要更好地了解家庭因素。未来的研究领域是确定家庭因素与便秘治疗方案依从性之间的关联。这些研究的结果将增加积极治疗结果的数量,并减少不必要的医疗费用。
    The objective of this review is to summarize pertinent literature looking at family dynamics and/or adherence to treatment in pediatric functional constipation. A structured systematic literature search was conducted on MEDLINE, Embase, and Web of Science core collection libraries from the years 2000 to 2023 using specific search terms: constipation, treatment adherence, family dynamics, parenting style, and pediatrics. Seventy-one publications were identified and included for review. After screening based on alignment to the review, 20 publications remained. These publications were placed into three categories depending on their intent and findings: (1) recommendations to further increase adherence, (2) studies analyzing factors of adherence, and (3) studies stating a need for a better understanding of family factors. A future area of research is identifying the associations between family factors on adherence to constipation treatment regimens. Results from such studies would increase the amount of positive treatment outcomes and decrease unnecessary healthcare costs.
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  • 文章类型: Journal Article
    近年来,影响肠促胰岛素系统的新降血糖药物在2型糖尿病(T2DM)的治疗中越来越受欢迎:胰高血糖素样受体1激动剂(GLP1RAs),二肽基肽酶4抑制剂(DPP4is)和最近开发的双重胰高血糖素样受体1激动剂和葡萄糖依赖性促胰岛素多肽(tirzepatide)。这些药物的主要作用是使血糖水平正常化。此外,GLP1RA被批准用于治疗体重过重。影响肠促胰岛素系统的药物的功效在文献中有很好的描述,然而,关于他们安全的报道仍然很少。这篇综述旨在总结当前关于肠促胰岛素影响药物治疗期间急性胰腺炎(AP)风险的研究和荟萃分析的结果。
    使用现有文献进行叙述性综述,试图确定AP与影响肠促胰岛素的药物之间的关系。使用以下关键词:急性胰腺炎,胰高血糖素样受体1激动剂,二肽基肽酶4抑制剂和替西平肽。
    已证明使用DPP4is对大多数T2DM患者是安全的,而在GLP1RAs治疗的情况下,应注意AP的风险。迄今为止,大多数研究发现,替瑞哌肽治疗与AP风险增加之间没有显著关联.
    大多数研究表明DPP4是,GLP1RAs和替利西帕肽在大多数T2DM患者中是有效和安全的。然而,替瑞哌肽治疗的患者随访时间短,因此需要更多的研究来证实这种药物的安全性。
    UNASSIGNED: In recent years, new hypoglycaemic drugs that affect the incretin system have become increasingly popular in the treatment of type 2 diabetes mellitus (T2DM): glucagon-like receptor 1 agonists (GLP1RAs), dipeptidyl peptidase 4 inhibitors (DPP4is) and the recently developed dual glucagon-like receptor 1 agonist and glucose-dependent insulinotropic polypeptide (tirzepatide). Their main role of these drugs is to normalise blood glucose levels. In addition, GLP1RAs are approved for the treatment of excessive body weight. The efficacy of drugs affecting the incretin system is well described in the literature, however, there are still only few reports about their safety. This review aims to summarize the results of current research and meta-analyses on risk of acute pancreatitis (AP) during incretin-affecting drugs treatment.
    UNASSIGNED: A narrative review was performed using present literature in an attempt to identify the relationship between AP and incretin-affecting drugs. The following keywords were used: acute pancreatitis, glucagon-like receptor 1 agonists, dipeptidyl peptidase 4 inhibitors and tirzepatide.
    UNASSIGNED: It was demonstrated that the use of DPP4is is safe for the majority of patients with T2DM, whereas a risk of AP should be noted in case of GLP1RAs therapy. To date, most studies found no significant association between tirzepatide therapy and the increased risk of AP.
    UNASSIGNED: The majority of studies have shown that DPP4is, GLP1RAs and tirzepatide are effective and safe in most T2DM patients. However, the follow-up time for patients treated with tirzepatide is short, therefore more studies are required to confirm the safety of this drug.
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  • 文章类型: Journal Article
    近年来,新型钾竞争性酸阻滞剂(P-CABs)已成为有效的抑酸药。替代质子泵抑制剂(PPI)。我们的目的是比较P-CABs与PPI治疗有或没有幽门螺杆菌的消化性溃疡的疗效和安全性(H.幽门螺杆菌)感染。我们在PubMed搜索,Embase,WOS,科克伦图书馆,ClinicalTrials.gov,CNKI,和万方数据库(截至2024年1月的所有年份)。使用比值比(OR)和95%置信区间(CI)评估疗效和安全性结果。使用累积排名下的表面(SUCRA)概率对每个干预进行排名。在筛选的14056项研究中,对涉及9792名参与者的56项研究进行了分析。Vonoprazan在溃疡愈合率和幽门螺杆菌根除率方面表现出最佳疗效(SUCRA=86.4%和90.7%,分别)。Keverprazan在溃疡愈合率方面排名第二(SUCRA=76.0%),在疼痛缓解率方面更有效(SUCRA=91.7%)。Keverprazan(SUCRA=11.8%)和tegoprazan(SUCRA=12.9%)的不良事件风险较低,并证明了vonoprazan的中度风险(SUCRA=44.3%)。与兰索拉唑相比,vonoprazan表现出更高的药物相关不良事件(OR:2.15;95%CI:1.60-2.89)和严重不良事件(OR:2.22;95%CI:1.11-4.42)的风险。对幽门螺杆菌阳性消化性溃疡患者的亚组分析显示,vonoprazan在SUCRA排名中名列前茅,其次是Keverprazan.Vonoprazan在消化性溃疡中表现优异,特别是幽门螺杆菌阳性消化性溃疡患者。然而,应注意与vonoprazan相关的不良事件风险.Keverprazan也显示出良好的治疗效果,并且在安全性方面表现更好。
    Novel potassium-competitive acid blockers (P-CABs) have emerged as effective acid-suppressive drugs in recent years, replacing proton pump inhibitors (PPIs). We aim to compare the efficacy and safety of P-CABs versus PPIs in the treatment of peptic ulcers with or without Helicobacter pylori (H. pylori) infection. We searched in PubMed, Embase, WOS, Cochrane Library, ClinicalTrials.gov, CNKI, and Wanfang databases (all years up to January 2024). Efficacy and safety outcomes were evaluated using odds ratio (OR) and 95% confidence intervals (CI). The Surface Under the Cumulative Ranking (SUCRA) probabilities were used to rank each intervention. Among 14,056 studies screened, 56 studies involving 9792 participants were analyzed. Vonoprazan demonstrated the best efficacy in ulcer healing rate and H. pylori eradication rate (SUCRA = 86.4% and 90.7%, respectively). Keverprazan ranked second in ulcer healing rates (SUCRA = 76.0%) and was more effective in pain remission rates (SUCRA = 91.7%). The risk of adverse events was low for keverprazan (SUCRA = 11.8%) and tegoprazan (SUCRA = 12.9%), and moderate risk for vonoprazan (SUCRA = 44.3%) was demonstrated. Compared to lansoprazole, vonoprazan exhibited a higher risk of drug-related adverse events (OR: 2.15; 95% CI: 1.60-2.89) and serious adverse events (OR: 2.22; 95% CI: 1.11-4.42). Subgroup analysis on patients with H. pylori-positive peptic ulcers showed that vonoprazan was at the top of the SUCRA rankings, followed by keverprazan. Vonoprazan showed superior performance in peptic ulcers, especially for patients with H. pylori-positive peptic ulcers. However, the risk of adverse events associated with vonoprazan should be noted. Keverprazan has also shown good therapeutic outcomes and has performed better in terms of safety.
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  • 文章类型: Journal Article
    杏仁的消费与一些健康益处有关,特别是关于心血管和肠道健康。在这次全面审查中,我们编制并仔细研究了食用杏仁对心血管疾病(CVD)危险因素和肠道健康的影响。杏仁富含单不饱和脂肪,纤维,维生素,矿物,和多酚,这有助于它们促进健康的特性。经常摄入杏仁已被证明可以通过降低LDL胆固醇和增强HDL功能来改善脂质状况。此外,杏仁有助于血糖控制,血压降低,和慢性炎症的改善,这对心血管健康至关重要。杏仁的抗氧化性能,主要是由于它们的维生素E含量高,帮助减少氧化应激标志物。此外,杏仁通过减少体脂百分比和中枢肥胖和增强饱腹感积极影响身体成分,从而有助于体重管理。在这里,我们还考虑了肠-心轴的新兴概念,杏仁的食用似乎可以调节肠道微生物组,促进有益菌的生长,增加短链脂肪酸的产生,特别是丁酸。这些作用共同有助于杏仁的抗炎和心脏保护益处。通过涵盖这些不同的方面,我们最终提供了关于杏仁消费对心血管健康和肠道微生物组的多方面益处的系统和更新的观点,在降低心血管疾病风险的饮食指南和公共卫生建议中,证实了他们更广泛的考虑。
    The consumption of almonds has been associated with several health benefits, particularly concerning cardiovascular and intestinal health. In this comprehensive review, we compile and deliberate studies investigating the effects of almond consumption on cardiovascular disease (CVD) risk factors and gut health. Almonds are rich in monounsaturated fats, fiber, vitamins, minerals, and polyphenols, which contribute to their health-promoting properties. Regular intake of almonds has been shown to improve lipid profiles by reducing LDL cholesterol and enhancing HDL functionality. Additionally, almonds aid in glycemic control, blood pressure reduction, and chronic inflammation amelioration, which are critical for cardiovascular health. The antioxidant properties of almonds, primarily due to their high vitamin E content, help in reducing oxidative stress markers. Furthermore, almonds positively influence body composition by reducing body fat percentage and central adiposity and enhancing satiety, thus aiding in weight management. Herein, we also contemplate the emerging concept of the gut-heart axis, where almond consumption appears to modulate the gut microbiome, promoting the growth of beneficial bacteria and increasing short-chain fatty acid production, particularly butyrate. These effects collectively contribute to the anti-inflammatory and cardioprotective benefits of almonds. By encompassing these diverse aspects, we eventually provide a systematic and updated perspective on the multifaceted benefits of almond consumption for cardiovascular health and gut microbiome, corroborating their broader consideration in dietary guidelines and public health recommendations for CVD risk reduction.
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  • 文章类型: Journal Article
    2型糖尿病是对个体具有显著健康后果的疾病。目前,正在寻找可能影响这种疾病的新机制和治疗方法。其中之一是2型糖尿病与微生物群的关联。通过肠神经系统和肠道微生物群轴,微生物群影响身体的功能。它已被证明对影响葡萄糖和脂质代谢以及胰岛素敏感性具有实际影响。生态失调,细菌通过破坏的肠屏障易位增加,体内炎症增加。在糖尿病中,微生物群的组成改变了,例如,一类更丰富的变形杆菌。这些疾病的后果与涉及短链脂肪酸的机制有关,支链氨基酸,和细菌脂多糖,在其他人中。针对肠道微生物群的干预措施作为糖尿病管理的一种有希望的方法正在获得关注。目前正在对供应益生菌和益生元的影响进行研究,以及粪便微生物移植,在糖尿病的过程中。进一步的研究将使我们能够充分发展我们对该主题的知识,并可能最好地治疗和预防2型糖尿病。
    Type 2 diabetes is a disease with significant health consequences for the individual. Currently, new mechanisms and therapeutic approaches that may affect this disease are being sought. One of them is the association of type 2 diabetes with microbiota. Through the enteric nervous system and the gut-microbiota axis, the microbiota affects the functioning of the body. It has been proven to have a real impact on influencing glucose and lipid metabolism and insulin sensitivity. With dysbiosis, there is increased bacterial translocation through the disrupted intestinal barrier and increased inflammation in the body. In diabetes, the microbiota\'s composition is altered with, for example, a more abundant class of Betaproteobacteria. The consequences of these disorders are linked to mechanisms involving short-chain fatty acids, branched-chain amino acids, and bacterial lipopolysaccharide, among others. Interventions focusing on the gut microbiota are gaining traction as a promising approach to diabetes management. Studies are currently being conducted on the effects of the supply of probiotics and prebiotics, as well as fecal microbiota transplantation, on the course of diabetes. Further research will allow us to fully develop our knowledge on the subject and possibly best treat and prevent type 2 diabetes.
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  • 文章类型: Journal Article
    脉冲,作为人类饮食的重要组成部分,可以作为优质植物蛋白的来源。脉冲蛋白及其水解产物在缓解代谢综合征和调节肠道微生物群中显示出有希望的结果。它们的生物活性已成为研究的热点,在最近的研究中增加了许多新发现。本文全面综述了抗高血压,抗高血糖,在最近的体外和体内研究中,豆类蛋白及其水解产物的抗血脂异常和抗肥胖生物活性,这显示了预防和治疗代谢综合征的巨大潜力。此外,脉冲蛋白及其水解产物可以调节肠道微生物组,这反过来会对代谢综合征的治疗产生积极影响。此外,一些豆类蛋白及其水解产物对代谢综合征的有益作用已得到临床研究的支持。本综述可为豆类蛋白及其水解产物在代谢综合征患者功能性食品或营养补充剂中的应用提供参考。
    Pulses, as an important part of the human diet, can act as a source of high-quality plant proteins. Pulse proteins and their hydrolysates have shown promising results in alleviating metabolic syndrome and modulating the gut microbiome. Their bioactivities have become a focus of research, with many new findings added in recent studies. This paper comprehensively reviews the anti-hypertension, anti-hyperglycemia, anti-dyslipidemia and anti-obesity bioactivities of pulse proteins and their hydrolysates in recent in vitro and in vivo studies, which show great potential for the prevention and treatment of metabolic syndrome. In addition, pulse proteins and their hydrolysates can regulate the gut microbiome, which in turn can have a positive impact on the treatment of metabolic syndrome. Furthermore, the beneficial effects of some pulse proteins and their hydrolysates on metabolic syndrome have been supported by clinical studies. This review might provide a reference for the application of pulse proteins and their hydrolysates in functional foods or nutritional supplements for people with metabolic syndrome.
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  • 文章类型: Journal Article
    背景:粘膜纤毛清除障碍,如囊性纤维化(CF),原发性纤毛运动障碍(PCD)和不明原因的支气管扩张,以呼吸道症状增加的时期为特征,称为肺加重。这些恶化很难预测,并且与肺功能下降和生活质量下降有关。为了优化治疗和保持肺功能,需要非侵入性且可靠的检测方法。呼吸分析可能是这样一种方法。方法:我们系统回顾了现有的呼吸分析文献,以检测粘液纤毛清除障碍的肺加重。提取的数据包括研究设计,测量技术,恶化的定义,已识别的化合物和诊断准确性。结果:在244篇确定的文章中,18人被纳入审查。所有研究包括患有CF的患者和两名也患有PCD的患者。研究之间的年龄和恶化的定义有所不同。有五个使用气相色谱-质谱法测量呼出气中的挥发性有机化合物(VOC),两个使用电子鼻和11测量的有机化合物在呼出的呼吸冷凝液。大多数研究表明,肺加重与一种或多种化合物之间存在显着相关性,主要是碳氢化合物和细胞因子,但这些结果在其他研究中缺乏验证.结论:通过分析呼出气中的化合物来检测肺加重似乎是可能的,但由于结果的主要差异,因此并不接近临床应用。研究设计和恶化的定义。需要更大的研究,纵向设计,国际公认的恶化定义和独立队列结果的验证。
    Background: Disorders of mucociliary clearance, such as cystic fibrosis (CF), primary ciliary dyskinesia (PCD) and bronchiectasis of unknown origin, are characterised by periods with increased respiratory symptoms, referred to as pulmonary exacerbations. These exacerbations are hard to predict and associated with lung function decline and the loss of quality of life. To optimise treatment and preserve lung function, there is a need for non-invasive and reliable methods of detection. Breath analysis might be such a method. Methods: We systematically reviewed the existing literature on breath analysis to detect pulmonary exacerbations in mucociliary clearance disorders. Extracted data included the study design, technique of measurement, definition of an exacerbation, identified compounds and diagnostic accuracy. Results: Out of 244 identified articles, 18 were included in the review. All studies included patients with CF and two also with PCD. Age and the definition of exacerbation differed between the studies. There were five that measured volatile organic compounds (VOCs) in exhaled breath using gas chromatography with mass spectrometry, two using an electronic nose and eleven measured organic compounds in exhaled breath condensate. Most studies showed a significant correlation between pulmonary exacerbations and one or multiple compounds, mainly hydrocarbons and cytokines, but the validation of these results in other studies was lacking. Conclusions: The detection of pulmonary exacerbations by the analysis of compounds in exhaled breath seems possible but is not near clinical application due to major differences in results, study design and the definition of an exacerbation. There is a need for larger studies, with a longitudinal design, international accepted definition of an exacerbation and validation of the results in independent cohorts.
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  • 文章类型: Journal Article
    自身免疫性胰腺炎(AIP)是慢性胰腺炎的一种独特形式,具有多因素的发病机理。历史上,根据其临床和组织学特征,已将其分为1型和2型。AIP的诊断具有挑战性,并且依赖于临床,组织病理学,血清学,和成像特性。在可用的指南中,AIP的影像学标志基于横断面成像和胰胆管造影术逆行内镜发现.内窥镜超声(EUS)通常用于胰腺组织采集,以排除胰腺癌并以有限的准确性诊断AIP。几篇论文报道了EUS提供AIP信息形态特征的可靠性。如今,EUS常规图像分辨率的提高和新辅助技术的发展进一步提高了EUS的诊断率:对比增强EUS和EUS弹性成像是非侵入性和实时技术,有力地支持胰腺疾病的诊断和管理.在这篇评论文章中,我们将介绍常规EUS和辅助诊断技术在AIP诊断中的作用,以支持临床医师和腔内超声医师管理这种情况.
    Autoimmune pancreatitis (AIP) is a unique form of chronic pancreatitis with a multifactorial pathogenesis. Historically, it has been classified as type 1 and type 2, according to its clinical and histological features. The diagnosis of AIP is challenging and relies on a combination of clinical, histopathologic, serologic, and imaging characteristics. In the available guidelines, the imaging hallmarks of AIP are based on cross-sectional imaging and cholangiopancreatography retrograde endoscopic findings. Endoscopic ultrasound (EUS) is generally used for pancreatic tissue acquisition to rule out pancreatic cancer and diagnose AIP with limited accuracy. Several papers reported the reliability of EUS for providing informative morphologic features of AIP. Nowadays, the improvement in the resolution of EUS conventional images and the development of new ancillary technologies have further increased the diagnostic yield of EUS: contrast-enhanced EUS and EUS elastography are non-invasive and real-time techniques that strongly support the diagnosis and management of pancreatic diseases. In this review article, we will present the role of conventional EUS and ancillary diagnostic techniques in the diagnosis of AIP to support clinicians and endosonographers in managing this condition.
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  • 文章类型: Journal Article
    越来越多的文献表明肠综合征之间存在联系(例如,肠易激综合征和炎症性肠病),肠道微生物组改变,和精神疾病。这篇叙述性综述旨在探讨肠道菌群在强迫症(OCD)的发病机制和临床表现中的潜在作用,并探讨在OCD的评估和治疗过程中是否有足够的证据需要考虑胃肠道症状及其对肠道菌群的影响。为此,PubMed对强迫症研究的搜索,肠道菌群,肠易激综合征,炎症性肠病由两名独立评审员进行。虽然目前关于强迫症中肠道微生物组和胃肠道问题的文献仍然有限,新出现的证据表明,该人群的肠道微生物组改变和肠道综合征的高发率。这些发现强调了将全面的胃肠道评估纳入“强迫症全球评估”的重要性。这种评估应包括各种因素,包括胃肠道的合并症和症状,营养习惯,排便习惯,液体摄入,锻炼模式,和潜在的微生物组功能障碍和炎症。考虑到治疗的影响,针对肠道健康的干预措施,如益生菌和饮食调整,可能有望改善合并胃肠道疾病的强迫症患者的症状。有必要在这一领域进行进一步的研究,以更好地了解肠道健康与强迫症之间的相互作用,并探索有针对性的干预措施在改善临床结果方面的有效性。
    A growing body of literature suggests a link between bowel syndromes (e.g., irritable bowel syndrome and inflammatory bowel disease), gut microbiome alterations, and psychiatric disorders. This narrative review aims to explore the potential role of the gut microbiome in the pathogenesis and clinical presentation of obsessive-compulsive disorder (OCD) and to explore whether there is sufficient evidence to warrant considering gastrointestinal symptoms and their implication for the gut microbiome during the assessment and treatment of OCD. For this purpose, a PubMed search of studies focusing on OCD, gut microbiota, irritable bowel syndrome, and inflammatory bowel disease was conducted by two independent reviewers. While the current literature on gut microbiome and gastrointestinal issues in OCD remains limited, emerging evidence suggests gut microbiome alterations and high rates of bowel syndromes in this population. These findings emphasize the importance of incorporating comprehensive gastrointestinal assessments into the \"global assessment of OCD\". Such assessment should encompass various factors, including gastrointestinal physical comorbidities and symptoms, nutritional habits, bowel habits, fluid intake, exercise patterns, and potential microbiome dysfunctions and inflammation. Considering the treatment implications, interventions targeting gut health, such as probiotics and dietary modifications, may hold promise in improving symptoms in OCD patients with comorbid gastrointestinal problems. Further research in this area is warranted to better understand the interplay between gut health and OCD and to explore the effectiveness of targeted interventions in improving clinical outcomes.
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  • 文章类型: Journal Article
    偏头痛是一种常见且使人衰弱的神经系统疾病,其特征是脉动性头痛的反复发作,通常位于头部的一侧,并伴有其他致残症状。比如恶心,增加对光的敏感度,声音、气味和情绪变化。各种临床因素,包括过度使用偏头痛药物,不充分的急性治疗和应激事件,会导致病情恶化,可能演变成慢性偏头痛,也就是说,头痛出现>15天/月至少3个月。慢性偏头痛通常与各种合并症有关,包括焦虑和情绪障碍,尤其是抑郁症,使预后复杂化,对治疗的反应和总体临床结果。新兴研究表明,肠道微生物群组成的改变与心理健康状况之间存在联系,尤其是焦虑和抑郁,这被认为是肠-脑轴的疾病。这强调了调节肠道微生物群作为管理这些疾病的新途径的潜力。在这种情况下,调查偏头痛是否有趣,特别是其慢性形式,表现出与焦虑和抑郁个体相似的生态失调特征。这可能为旨在调节肠道微生物群治疗难以控制的偏头痛的干预措施铺平道路。
    Migraine is a common and debilitating neurological disorder characterized by the recurrent attack of pulsating headaches typically localized on one side of the head associated with other disabling symptoms, such as nausea, increased sensitivity to light, sound and smell and mood changes. Various clinical factors, including the excessive use of migraine medication, inadequate acute treatment and stressful events, can contribute to the worsening of the condition, which may evolve to chronic migraine, that is, a headache present on >15 days/month for at least 3 months. Chronic migraine is frequently associated with various comorbidities, including anxiety and mood disorders, particularly depression, which complicate the prognosis, response to treatment and overall clinical outcomes. Emerging research indicates a connection between alterations in the composition of the gut microbiota and mental health conditions, particularly anxiety and depression, which are considered disorders of the gut-brain axis. This underscores the potential of modulating the gut microbiota as a new avenue for managing these conditions. In this context, it is interesting to investigate whether migraine, particularly in its chronic form, exhibits a dysbiosis profile similar to that observed in individuals with anxiety and depression. This could pave the way for interventions aimed at modulating the gut microbiota for treating difficult-to-manage migraines.
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