Kidney transplantation is the most effective treatment for end-stage renal failure but is associated with complications, including post-transplant diabetes mellitus (PTDM). It affects the quality of life and survival of patients and the transplanted organ. It can cause complications, including infections and episodes of acute rejection, further threatening graft survival. The prevalence of PTDM, depending on the source, can range from 4 to 30% in transplant patients. This article aims to discuss issues related to diabetes in kidney transplant patients and the latest treatments. Knowledge of the mechanisms of action of immunosuppressive drugs used after transplantation and their effect on carbohydrate metabolism is key to the rapid and effective detection of PTDM. Patient therapy should not only include standard management such as lifestyle modification, insulin therapy or pharmacotherapy based on well-known oral and injection drugs. New opportunities are offered by hypoglycemic drugs still in clinical trials, including glucokinase activators, such as dorzagliatin, ADV-1002401, LY2608204, TMG-123, imeglimine, amycretin and pramlintide. Although many therapeutic options are currently available, PTDM often creates uncertainty about the most appropriate treatment strategy. Therefore, more research is needed to individualize therapeutic plans and monitor these patients.
The human body is colonized by trillions of microorganisms in a symbiotic relationship. The oral cavity represents one of the most abundant microbial habitats in our body. Advances in sequencing techniques provide a more detailed understanding of the oral microbiota and how imbalances between bacteria, the phenomenon of dysbiosis, can affect not only the development of dental caries or inflammation within the oral cavity but also systemic diseases and cancers in distant locations. This narrative review evaluates the relationship between oral microbiota and its impact on gastrointestinal cancers. Using the keywords “oral microbiota ‘AND’ gastrointestinal cancers”, the PubMed Web of Science and Scopus databases were searched for articles published between 2014 and 2024. Based on the review, the relationship between oral microbiota and oral, esophageal, gastric, colorectal, hepatocellular, and pancreatic cancers was described. Potential oncogenic mechanisms exploited by the microbiota such as the production of pro-inflammatory cytokines, induction of abnormal immune responses, and disruption of cell metabolic pathways were assessed. Further research and a thorough understanding of the impact of the oral microbiota on the development of cancers of the gastrointestinal tract may play a key role in their prevention, diagnosis, and treatment in the future.
13 October 2023 in Journal of Education, Health and Sport
Depressive disorders are a widespread problem in modern medicine. According to current data from the World Health Organisation, an estimated 280 million people worldwide suffer from depression. In recent years, there have been reports of a correlation between the composition of the gut microbiota and the development of depressive disorders and attempts to modify it through the use of psychobiotics. The literature from the PubMed database published between 2018-2023 has been explored. 596 articles were selected based on the keywords "probiotics" and "depression". Six randomized clinical trials were finally included in the analysis. As defined elsewhere, psychobiotics are probiotic bacteria which supplemented in adequate amounts, interact with the gut-brain axis and show beneficial effects on patients' mental health. Results from recent RCTs suggest that daily probiotic supplementation significantly reduces the severity of depression compared to placebo (p<0.05). Additionally, this effect may be enhanced by the combined use of a probiotic with a prebiotic. Furthermore, some researchers indicate that probiotics may lead to significant improvements in cognitive function in patients suffering from depressive disorders. In conclusion, intestinal dysbiosis may be an important factor leading to the development of mental illness. Results of recent studies suggest that specific strains of probiotic bacteria may offer therapeutic benefits in the treatment of the aforementioned disorders. However, further clinical studies are needed to objectively confirm the relationship between gut microbiota composition and the development of depression.
Mycoplasma pneumoniae is one of the main pathogens responsible for atypical pneumonia, especially in children over the age of 5, where it accounts for about 40% of cases of extramedullary pneumonia. In addition to respiratory-related symptoms, it can lead to a variety of extrapulmonary manifestations associated with involvement of other organs. In this article, we present case reports of two pediatric patients with detected M. pneumoniae infection with associated cardiac and skin complications. The first case report describes an 11.5-year-old boy who was admitted to the Department of Pediatrics because of chest pain, fever and moist cough for several days, who was diagnosed with myocarditis during M. pneumoniae infection. The second case report describes a 17-year-old girl with a recent respiratory infection who was admitted to the hospital for pain, swelling, blistering of the lips and oral mucosa. Mycoplasma pneumoniae infection can lead to extrapulmonary complications in children, which can produce nonspecific symptoms, so clinical vigilance and early recognition are important to minimize the risk of complications.
13 October 2023 in Journal of Education, Health and Sport
Background: Proton pump inhibitors (PPIs) are widely used drugs that reduce gastric acid secretion. In recent years, there has been a gradual increase in their use. The safety of prolonged PPI therapy and the potential for cumulative side effects of these drugs raise legitimate concerns. An association between PPI administration and the risk of Clostridioides difficile infection has been suggested. The findings regarding this phenomenon require further unequivocal verification. Material and methods: A review of publications obtained from the PubMed database and published between 2016-2023. Based on the keywords "proton pump inhibitor", "PPI" and "Clostridium", 132 articles were selected. Finally, 6 meta-analyses were included in the analysis. Results: Studies conducted in recent years have shown a statistically significant increase in the risk of C. difficile infection in patients taking PPIs compared to those who avoid this therapy. The aforementioned relationship was observed in both adults and pediatric patients. One study proved that the risk remained high even up to 1 year after the end of treatment. The described relationship is still a matter of debate due to the fact that patients using antacids are usually elderly, have several comorbidities and a higher risk of developing C. difficile infection regardless of PPI use. Conclusions: The relationship between the use of PPIs and the risk of developing C. difficile infection is still controversial, which justifies the need for continued clinical trials to objectively resolve this issue. PPIs exert high efficacy in the treatment of acid-dependent diseases, but due to the many ambiguities surrounding possible side effects, caution in their administration seems warranted, especially for long-term therapy in elderly patients with polypharmacy.
This article reviews the potential impact of herpes simplex viruses (HSV) on chronic fatigue syndrome (CFS). HSV-1 and HSV-2 are prevalent pathogens, with HSV-1 acquired early in life and HSV-2 typically transmitted sexually. Studies have shown an association between HSV and CFS, with HSV-1 detected in saliva and cerebrospinal fluid of CFS patients and elevated HSV-2 antibodies found in CFS patients. Immunological abnormalities, including increased pro-inflammatory cytokines and chemokines, suggest immune dysregulation in CFS patients infected with HSV. HSV infections can also disrupt the hypothalamic-pituitary-adrenal axis and autonomic nervous system, impacting energy metabolism regulation and contributing to CFS fatigue. Neuroinflammation, indicated by increased translocator protein binding in CFS patients' brains, may play a role in CFS symptoms. However, the mechanisms linking HSV to CFS and the contribution of viral-induced neuroinflammation are still unclear. Despite the evidence, understanding the complex interactions between HSV, immune responses, and other factors in CFS remains challenging. In conclusion, HSV, particularly HSV-1 and HSV-2, may contribute to CFS development. Further research is needed to unravel the mechanisms involved and identify potential therapeutic interventions.