Gut microbiota dysbiosis associated with glucose metabolism disorders and the metabolic syndrome in older adults.

Obesity and associated metabolic disorders have become highly prevalent diseases worldwide, and the human gut microbiota, due to its influence on host energy metabolism, has been attributed an important role therein. This pilot study explores host-microbiota relationships in men and women affected by various types of glucose metabolism disorder. Among 20 individuals aged 58 to 71 years with either normal glucose tolerance, prediabetes, or type 2 diabetes mellitus the gut bacterial communities were compared based on barcoded 454 sequencing of 16S rRNA genes amplified from stool samples. We found that specific microbiota groups were relatively enriched or reduced in different metabolic states. Further, positive or negative associations with clinical manifestations of metabolic disease suggest that these organisms indicate and possibly contribute to metabolic impairment or health. For instance, a higher prevalence of Erysipelotrichaceae and Lachnospiraceae was found associated with metabolic disorders, and the Holdemania and Blautia genera correlated with clinical indicators of an impaired lipid and glucose metabolism. The Bacteroidetes and groups therein, by contrast, displayed inverse relationships with metabolic disease parameters and were found relatively enriched in participants not diagnosed with metabolic syndrome or obesity. Further, the prevalence of specific Clostridia and Rikenellaceae members also pointed towards a healthier metabolic state. Links with diet as an intermediate factor included positive and negative associations of Lachnospiraceae with relative consumption rates of fat and carbohydrates, respectively, and positive associations of Turicibacteraceae with the consumption of protein. Identifying critical roles of major gut microbiota components in metabolic disorders has important translational implications regarding the prevention and treatment of metabolic diseases by means of preventing or reversing dysbiosis and by controlling exacerbating diet and life style factors particularly in sensitive population groups.

A European evidence-based guideline for the prevention of type 2 diabetes.

BACKGROUND: The prevalence and socioeconomic burden of type 2 diabetes (T2DM) and associated co-morbidities are rising worldwide. AIMS: This guideline provides evidence-based recommendations for preventing T2DM. METHODS: A European multidisciplinary consortium systematically reviewed the evidence on the effectiveness of screening and interventions for T2DM prevention using SIGN criteria. RESULTS: Obesity and sedentary lifestyle are the main modifiable risk factors. Age and ethnicity are non-modifiable risk factors. Case-finding should follow a step-wise procedure using risk questionnaires and oral glucose tolerance testing. Persons with impaired glucose tolerance and/or fasting glucose are at high-risk and should be prioritized for intensive intervention. Interventions supporting lifestyle changes delay the onset of T2DM in high-risk adults (number-needed-to-treat: 6.4 over 1.8-4.6 years). These should be supported by inter-sectoral strategies that create health promoting environments. Sustained body weight reduction by >or= 5 % lowers risk. Currently metformin, acarbose and orlistat can be considered as second-line prevention options. The population approach should use organized measures to raise awareness and change lifestyle with specific approaches for adolescents, minorities and disadvantaged people. Interventions promoting lifestyle changes are more effective if they target both diet and physical activity, mobilize social support, involve the planned use of established behaviour change techniques, and provide frequent contacts. Cost-effectiveness analysis should take a societal perspective. CONCLUSIONS: Prevention using lifestyle modifications in high-risk individuals is cost-effective and should be embedded in evaluated models of care. Effective prevention plans are predicated upon sustained government initiatives comprising advocacy, community support, fiscal and legislative changes, private sector engagement and continuous media communication.

[Analysis of heart rate variability in assessment of baroreflex sensitivity in anesthetized rats].

Spectral analysis of the heart rate variability can be used as a measure of baroreflex sensitivity in ketamine anesthetized rats. Stimulation of delta1-receptors with phenylephrine (0.01 mg/kg, i.v.) results in a rise of the strength of heart rate regulation, principally in the low frequency band. Maximal deviations of spectral indexes from basal level were observed on 4-8 min for low (0.2-1 Hz) and high (1-3 Hz) frequencies bands and on 10-15 min for very low (0.08-0.2 Hz) frequency band after phenylephrine injection.

[Recurrent thromboembolism of the pulmonary artery in a female patient with a gallbladder tumor]. / Sluchai retsidiviruiushchei tromboembolii legochnoi arterii u bol'noi s opukhol'iu zhelchnogo puzyria.

A clinical case is submitted of development in a female patient of recurring thromboembolism of small branches of the pulmonary arteries preceding the clinical manifestations of a disease. Subsequently the above female patient was diagnosed as having developed carcinoma of gallbladder. An item of information is given concerning the syndrome of hypercoagulation and development of thromboembolism in malignant tumors.

[A case of Gierke's disease]. / Sluchai bolezni Girke.

A rare clinical case is reported of a patient presenting with glucose-6-phosphatase deficiency (Gierke's disease). Shown in the advanced stage of the disease is the polyorgan involvement. The report contains a brief review of relevant medical literature concerning etiology, pathogenesis, clinical picture, diagnosis of von Gierke's disease.

[Heart sounds in glomerular nephritis]. / O tonakh serdtsa pri glomerulonefrite.

Enrolled in the present study were 58 patients with acute glomerulonephritis, 58 with chronic glomerulonephritis and 16 controls. Chronic glomerulonephritis patients demonstrated a significant decrease in the amplitude in the first heart sound and increase in the amplitude of the second sound. The third and fourth sounds were detected in 61 patient with glomerulonephritis. There was a striking increase in the frequency of their emergence in those cases presenting with heart failure.