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Introduction Microscopic colitis (MC) is a clinical syndrome of severe watery diarrhea with few or no endoscopic abnormalities. The incidence of MC is reported similar to that of other inflammatory bowel diseases. The need for histological confirmation of MC frequently guides reimbursement health policies. With the advent of high-definition (HD) coloscopes, the incidence of reporting distinct endoscopic findings in MC has risen. This has the potential to improve timely diagnosis and cost-effective MC management and diminish the workload and costs of busy modern endoscopy units. Methods Publications on distinct endoscopic findings in MC available until March 31st, 2017 were searched systematically (electronic and manual) in PubMed database. The following search terms/descriptors were used: collagenous colitis ( CC ) OR lymphocytic colitis ( LC ) AND endoscopy, colonoscopy, findings, macroscopic, erythema, mucosa, vasculature, scars, lacerations, fractures . An additional search for MC AND perforation was made. Results Eighty (n = 80) articles, predominantly single case reports (n = 49), were found. Overall, 1582 (1159F; 61.6 ± 14.1 years) patients (pts) with MC and endoscopic findings were reported. The majority of articles (n = 62) were on CC (pts 756; 77.5% females). We identified 16 papers comprising 779 pts (69.2% females) with LC and 7 articles describing 47 pts (72.3% females) diagnosed as MC. The youngest patient was 10 and the oldest a 97-year-old. Aside diarrhea, symptoms included abdominal pain, weight loss, bloating, flatulence, edema and others. In the study group we found 615 (38.8%) persons with macroscopic lesions in gut. Isolated linear ulcerations were identified in 7 pts (1.1%) while non-ulcerous lesions i.e. pseudomembranes, a variable degree of vasculature pruning & dwindling, mucosal lacerations and abnormalities such as erythema/edema/nodularity, or surface textural alteration in 608 pts (98.1%). The location of endoscopic findings was not reported in 27 articles. The distinct endoscopic findings were described in the left (descending, sigmoid, rectum – 10/21/11 studies), right (cecum, ascending – 7/7 studies), transverse colon (n = 12), as well as duodenum (n = 4), and terminal ileum (n = 2). In 17 (1.1%) pts colonic perforation occurred. Conclusion Endoscopic findings are recognized with increased frequency in pts with MC. This could improve MC diagnosis by prompting a more extensive biopsy protocol in such cases and an earlier initiation of treatment. Procedure-related perforation has been reported in this group; therefore, cautious air insufflation is advisable when endoscopic findings are recognised. [ABSTRACT FROM AUTHOR]

[Display omitted] • Among health benefits of bovine colostrum supplementation (BCS), prevention from the upper respiratory tract infections (URTI) is best known. • The need to update existing meta-analyses along with meta-regression is of high importance. • We provide data that BCS significantly decreases the risk of developing the URTI with the assessed random RR=0.68, p=0.001. Prevention from the upper respiratory tract infections (URTIs) is one of the best known of the numerous health benefits of bovine colostrum supplementation (BCS). We aimed to systematically review the effectiveness of colostrum supplementation to counteract URTIs. We systematically searched available databases and performed random-effect meta-analyses of the incidence of self-reported URTIs, their duration and severity. For the risk ratio (RR) of URTIs, our systematic review involved 445 randomized participants in 7 trials and was significantly diminished upon BCS (RR = 0.64 with a 95 % confidence interval of 0.498–0.822; z = − 3.493, p < 0.001). This effect was found to be somewhat dependent on the supplementation duration (coefficient = 0.015, standard error = 0.008, Z = 1.89, p = 0.056). Our systemic review and meta-analysis including more than triple number of participants as compared to previous analysis of this kind, strongly confirms that BCS significantly reduces the incidence of URTIs. We also demonstrated that the efficacy of BCS can depend to some extend on the duration of supplementation, but neither on the dose size, sex distribution nor physical activity lifestyle. [ABSTRACT FROM AUTHOR]

Background : Trastuzumab has had a major impact on the treatment of human epidermal growth factor receptor 2 (HER2) positive breast cancer patients. However, it is associated with cardiotoxicity, expressed as an asymptomatic decrease in left ventricular ejection fraction (LVEF) and less often as clinical HF. The aim of this meta-analysis is to identify the association of conventional cardiovascular risk factors with the development of trastuzumab-induced cardiotoxicity (TIC). Methods : A literature search of PubMed was conducted to identify studies examining the association between cardiovascular risk factors and TIC. Data were extracted and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated examining the odds of developing TIC for each of the risk factors. Results : A total of 35 studies were included in the analysis. Age (OR:0.7; 95%CI 0.318-1.09; P = 0.0004), hypertension (OR:0.69; 95%CI 0.26-1.12; P = 0.001), smoking(OR:0.35; 95%CI 0.01- 0.69; P = 0.038), diabetes mellitus (OR:0.44; 95%CI 0.24- 0.68; P = 0.0001) and family history of CAD (OR:5.51, 95%CI 1.76-17.25; P < 0.00001)were significantly associated with the development of cardiotoxicity. Known history of CAD (OR: 3.72; 95%CI 2.11-6.57; P = 0.0005) was also associated with the development of TIC. Conclusion(s) : Identifying women at risk for TIC have several important potential applications. Clinicians may decide to assess LVEF more frequently in patients at highest risk for TIC in order to detect LV systolic dysfunction earlier. Additionally, this could help identify patients who would benefit most from prophylactic therapy for preventing TIC. [ABSTRACT FROM AUTHOR]

One very promising hypothesis of Major Depressive Disorder (MDD) pathogenesis is the gut-brain axis (GBA) dysfunction, which can lead to subclinical inflammation, hypothalamic–pituitary (HPA) axis dysregulation, and altered neural, metabolic and endocrine pathways. One of the most important parts of GBA is gut microbiota, which was shown to regulate different functions in the central nervous system (CNS). The purpose of this scoping review was to present the current state of research on the relationship between MDD and gut microbiota and extract causal relationships. Further, we presented the relationship between the use of probiotics and antidepressants, and the microbiota changes. We evaluated the data from 27 studies aimed to investigate microbial fingerprints associated with depression phenotype. We abstracted data from 16 and 11 observational and clinical studies, respectively; the latter was divided into trials evaluating the effects of psychiatric treatment (n = 3) and probiotic intervention (n = 9) on the microbiome composition and function. In total, the data of 1187 individuals from observational studies were assessed. In clinical studies, there were 490 individuals analysed. In probiotic studies, 220 and 218 patients with MDD received the intervention and non-active study comparator, respectively. It was concluded that in MDD, the microbiota is altered. Although the mechanism of this relationship is unknown, we hypothesise that the taxonomic changes observed in patients with MDD are associated with bacterial proinflammatory activity, reduced Schort Chain Fatty Acids (SCFAs) production, impaired intestinal barrier integrity and neurotransmitter production, impaired carbohydrates, tryptophane and glutamate metabolic pathways. However, only in few publications this effect was confirmed by metagenomic, metabolomic analysis, or by assessment of immunological parameters or intestinal permeability markers. Future research requires standardisation process starting from patient selection, material collection, DNA sequencing, and bioinformatic analysis. We did not observe whether antidepressive medications influence on gut microbiota, but the use of psychobiotics in patients with MDD has great prospects; however, this procedure requires also standardisation and thorough mechanistic research. The microbiota should be treated as an environmental element, which considers the aetiopathogenesis of the disease and provides new possibilities for monitoring and treating patients with MDD. • The gut microbiota is altered in patients with MDD. • The microbial taxonomic changes are associated with MDD pathomechanism. • Causative role of gut microbiota in MDD has not been proven. • Antidepression medications did not affect gut microbiota. • Psychobiotics use in patients with MDD has great prospects. [ABSTRACT FROM AUTHOR]

For decades, metformin has been the drug of first choice in the management of type 2 diabetes. However, approximately 2–13% of patients do not tolerate metformin due to gastrointestinal (GI) side effects. Since metformin influences the gut microbiota, we hypothesized that a multi-strain probiotics supplementation would mitigate the gastrointestinal symptoms associated with metformin usage. This randomized, double-blind, placebo-controlled, single-center, cross-over trial (ProGasMet study) assessed the efficacy of a multi-strain probiotic in 37 patients with metformin intolerance. Patients were randomly allocated (1:1) to receive probiotic (PRO-PLA) or placebo (PLA-PRO) at baseline and, after 12 weeks (period 1), they crossed-over to the other treatment arm (period 2). The primary outcome was the reduction of GI adverse events of metformin. 37 out of 82 eligible patients were enrolled in the final analysis of whom 35 completed the 32 weeks study period and 2 patients resigned at visit 5. Regardless of the treatment arm allocation, while on probiotic supplementation, there was a significant reduction of incidence (for the probiotic period in PRO-PLA/PLA-PRO: P = 0.017/P = 0.054), quantity and severity of nausea (P = 0.016/P = 0.024), frequency (P = 0.009/P = 0.015) and severity (P = 0.019/P = 0.005) of abdominal bloating/pain as well as significant improvement in self-assessed tolerability of metformin (P < 0.01/P = 0.005). Moreover, there was significant reduction of incidence of diarrhea while on probiotic supplementation in PRO-PLA treatment arm (P = 0.036). A multi-strain probiotic diminishes the incidence of gastrointestinal adverse effects in patients with type 2 diabetes and metformin intolerance. [ABSTRACT FROM AUTHOR]

Low nephron number has been recognised as an important cardiovascular risk factor and recently a strong correlation between renal mass and nephron number has been demonstrated in newborns. The aim of this study was to investigate individual, as well as combined, effects of common variants of genes which encode for major components of the renin–angiotensin system ( REN G10601A, AGT G(− 6)A, ACE I/D, AGTR1 A1166C) on kidney size in healthy, full-term newborns. A significant additive main effect of the ACE I/D polymorphism, as well as an additive-by-additive interaction between AGT G(− 6)A and AGTR1 A1166C variants, were found. The variance attributed to the epistatic effect was 27.9 ml 2 /m 4 , which accounted for 73.8% of the interaction variance (37.8 ml 2 /m 4 ), 66.4% of the genetic variance (42.0 ml 2 /m 4 ) and 4.4% to the total phenotypic variance (628 ml 2 /m 4 ). No other statistically significant main or epistatic effects were detected. Our results highlight the importance of considering gene–gene interactions as part of the genetic architecture of congenital nephron number, even when the loci do not show significant single locus effects. Unravelling the genetic determinants of low nephron number, along with early molecular screening, may well help to identify children at risk for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background and Aims: Glucocorticoids and their receptors are involved in inflammation and many cardiovascular risk factors. We examined associations of Tth111I, N363S and ER22/23EK NR3C1 gene polymorphisms and haplotypes, with coronary artery disease (CAD), severity of CAD (single-vessel vs. multivessel disease) and risk factors. Methods: Three hundred ten individuals were submitted to coronary angiography. Selected genotypes were determined by PCR-RFLP. Results: Carriers of the Tth111I allele T were found significantly less often in the CAD compared with the non-CAD group (49.7 vs. 64.6%, p = 0.013); this association was similar for TGA haplotype carriers (49.2 vs. 62.8%, p = 0.024); the T allele was more frequent in females (66.3 vs. 51.1%, p = 0.020) and its presence was associated with higher levels of HDL-cholesterol (46.6 ± 12.7 vs. 43.5 ± 10.1 mg/dL for T-carriers vs. noncarriers, p = 0.045). The TT genotype proved to be less common in MVD than SVD (5.9 vs. 14.1%, p = 0.075). The 363S allele was significantly associated with diabetes mellitus (DM) (24.4 vs. 10.9%; carriers in DM and non-DM subjects, respectively, p = 0.027), the TT genotype or TGA/TGA diplotype (in which the 363S allele was absent) were less frequent in DM than in non-DM subjects (p = 0.012 for Tth111I-TT and p = 0.020 for TGA/TGA diplotype). No significant associations between CAD and N363S or ER22/23EK polymorphisms were found. Conclusions: Our results suggest that the Tth111I NR3C1 polymorphism may play a protective role in the development of CAD, and homozygous TT in development of MVD. The N363S polymorphisms may contribute to the development of diabetes in the Polish population. [Copyright &y& Elsevier]

Chronic inflammatory conditions resulting from elevated levels of circulating proinflammatory mediators are common in the elderly. The aim of the paper was to analyze the balance between proinflammatory and anti-inflammatory markers in longevous individuals. The study was conducted in persons aged >90 years old, residents of Poland living either at home or staying at residential care facilities. The study included 90 persons (69 women and 21 men) aged between 90 and 103 years. Persons with abnormal CRP presented with a statistical tendency toward higher fibrinogen and lower IL10 and IL-1α levels compared to patients in whom CRP level was within the normal range. IL-6 concentration predicted abnormality within CRP. Inflammation in persons above the age of 90 years old might be linked to abnormal fibrinogen and IL-6 levels. • Fibrinogen level decline with age. • Persons with abnormal CRP (>5) have tendency toward higher fibrinogen and lower IL-10 and IL-1α levels. • CRP abnormality might be predicted by IL-6 concentration. [ABSTRACT FROM AUTHOR]

Previous studies have reported on the relationship between gut microbiota and major depressive disorder (MDD). However, there remain gaps in literature concerning the role of the intestinal barrier and microflora in the pathogenesis of depression. This study analyzes the potential causative relationship between gut microbiota and inflammatory and gut integrity markers and clinical symptoms in inpatients with depressive episodes. Sixteen inpatients (50% females) being treated with escitalopram (5–20 mg daily) in standardized conditions were included in the study. The composition of fecal microbiota was evaluated at baseline and endpoint using 16S rRNA sequencing. A significant correlation between depression severity was found, as measured with HDRS24 (Hamilton Depression Rating Scale-24 item), and the following abundance in bacteria: positive correlation with Paraprevotella (r = 0.80, q = 0.012), strong, negative correlations with Clostridiales (r = −0.70, q = 0.016), Clostridia (r = −0.71, q = 0.026), Firmicutes (r = −0.67. q = 0.032), and the RF32 order (r = −0.70, p = 0.016) in the Alphaproteobacteria (r = −0.66, q = 0.031). After six weeks of treatment, clinical outcomes were found to have a negative correlation with levels of plasma intestinal fatty acid-binding protein (IFABP) at the beginning of the study. Still they had a positive correlation with changes in fecal calprotectin during hospitalization. In conclusion, gut microbiota was associated with the severity of depressive symptoms. However, these findings do not serve as predictors of symptomatic improvement during antidepressant treatment in inpatient treatment for MDD. In turn, intestinal integrity and inflammation markers were associated with the response to treatment of patients with MDD and symptom severity. Additional studies are needed to confirm and extend these findings. • Gut microbiota is associated with a severity of depressive symptoms. • Microbiota changes are not predictive of clinical improvement in patients with MDD. • Gut integrity and inflammatory markers are associated with symptom severity and response to treatment of patients with depressive episodes. [ABSTRACT FROM AUTHOR]