Parkinson's Disease and the Gut: Symptoms, Nutrition, and Microbiota.

Parkinson's disease (PD) is the second most common neurodegenerative disease worldwide, characterized by symptoms of bradykinesia, rigidity, postural instability, and tremor. Recently, there has been a growing focus on the relationship between the gut and the development of PD. Emerging to the forefront, an interesting concept has developed suggesting that the initial pathophysiological changes occur in the gastrointestinal tract before changes are seen within the brain. This review is aimed at highlighting the relationship between PD and the gastrointestinal tract, along with the supporting evidence for this. Firstly, we will focus on the gastrointestinal conditions and symptoms which commonly affects patients, including both upper and lower gastrointestinal issues. Secondly, the impact of nutrition and diet on neurological health and PD physiology, with particular emphasis on commonly consumed items including macronutrients and micronutrients. Finally, variability of the gut microbiome will also be discussed and its link with both the symptoms and signs of PD. The evidence presented in this review highly suggests that the initial pathogenesis in the gut may proceed the development of prodromal PD subtypes, and therefore building on this further could be imperative and lead to earlier diagnosis with new and improved therapeutics.

Effects of ropinirole on nonmotor symptoms of Parkinson disease: a prospective multicenter study.

OBJECTIVE: To evaluate the effects of ropinirole on selected nonmotor symptoms of Parkinson's disease (PD), including anxiety, depressive symptoms, sleep disturbances/excessive daytime sleepiness, and sexual functions. METHODS: Forty-four consecutive PD patients with or without motor complications (MC+ group and MC- group, respectively); 6-month prospective study; scales administered in the "on" motor state: Unified Parkinson's Disease Rating Scale, Hamilton Anxiety Scale (HAMA), Montgomery-Asberg Depression Rating Scale (MADRS), Parkinson's Disease Sleep Scale, Epworth Sleep Scale, International Index of Erectile Function, and Female Sexual Function Index; serum sexual hormones collected. RESULTS: The median ropinirole dose was 10 mg, and the median L-dopa dose was decreased in both groups. In addition to motor symptoms and motor complications improvement, both median HAMA and MADRS scores dropped significantly in MC+ group; patients in our MC- group had little or no anxiety and depression at the baseline visit. In men, the baseline anxiety score was negatively correlated with the serum testosterone level. We did not observe any changes in the scales assessing sleep and sexual functions. Changes in Unified Parkinson's Disease Rating Scale III scores significantly correlated with ropinirole dosage. Changes in HAMA and MADRS correlated only with changes in Parkinson's Disease Sleep Scale scores. CONCLUSION: In addition to controlling motor symptoms, ropinirole improved both anxiety and depressive symptoms in PD patients with motor fluctuations and/or dyskinesias. Changes in mood and anxiety correlated with changes in sleep scores.

[Guidelines for antiretroviral therapy of human immunodeficiency virus (HIV)-infected subjects in the Czech Republic]. / Komplexní postup antiretrovirové lécby osob infikovaných virem lidské imunodeficience (HIV) v Ceské republice.

HIV infection remains an incurable disease because of the impossibility to eradicate the HIV from the organism. However, the combination antiretroviral therapy (cART) is able to efficiently limit HIV replication and slow down progression of immunodeficiency and thus prolong and improve the quality of HIV+ patients? lives. In HIV(+) pregnant women, the antiretroviral therapy substantially reduces the risk of vertical transmission of the infection. According to present knowledge, the cART is indicated mainly in symptomatic patients with stage B or C diseases and for vertical transmission and postexposure prophylaxis; less clear is the indication of cART for treating acute HIV infection and in asymptomatic patients. Various guidelines for the use of antiretroviral agents issued worldwide, e.g. in the USA, Europe or by the WHO, are not completely identical. The authors present a draft of recommendations for the use of antiretroviral agents in the Czech Republic based on the above-mentioned guidelines as well as on their own experience with taking care of HIV/AIDS patients.

[Clinical manifestations and treatment of Lyme disease]. / Klinické projevy a lécba lymské boreliózy.

Survey of criteria necessary to establish the diagnosis of Lyme disease according to its definitions by various organizations and institutions in the USA and Europe (European Union Concerted Action on Lyme Borreliosis, Centers for Disease Control and Prevention, The International Lyme and Associated Diseases Society). In the discussion the authors present other possible clinical manifestations connected with the involvement of various organs. In the second part of their paper they describe patterns of therapy for individual forms of Lyme disease in Europe and the USA and their differences.