Probiotics and primary prevention of atopic dermatitis: a meta-analysis of randomized controlled studies.

BACKGROUND: Atopic Dermatitis (AD) has an increasing incidence and the real cause of the disease is not known yet. Probiotics may be involved in AD prevention, but their role is controversial. OBJECTIVE: The purpose of our study was to evaluate the role of probiotics in AD occurrence. METHODS: We carried out an extensive search on this topic in the international databases (Pubmed, Scopus,Web of knowledge, EBSCO, ARTO, Google Scholar, ClinicalTrials.gov.) selecting only those studies where the role of probiotics in AD occurrence was analysed. For the selected studies we calculated odds ratio (OR) and 95% confidence interval (CIs). RESULTS: Initially, we found 1513 articles, of which only 26 studies fulfilled our criteria. After exclusion of studies on the same populations, 16 studies were included in the final analysis. The meta-analysis of these studies revealed that probiotics administration confers protection against AD occurrence (OR = 0.64, P < 0.001). The subgroup meta-analysis, in general population and population at high risk for allergies, suggested that probiotics administration is protective for AD development in both subgroups (OR = 0.53, P = 0.005; OR = 0.66, P < 0.001). Additional subgroup analysis showed that probiotics prenatal administration followed by postnatal administration was protective (OR = 0.61, P < 0.001) unlike only administration in postnatal period (OR = 0.95, P < 0.82). Finally, the subgroup analysis based on the type of treatment suggested that both Lactobacillus alone and Lactobacillus with Bifidobacterium are protective against AD (OR = 0.70, P = 0.004; OR = 0.62, P < 0.001). CONCLUSION: Probiotics seem to have a protective role in AD prevention if there are administration in pre and postnatal period in both general and allergic risk population.

Investigation of P213S SELL gene polymorphism in type 2 diabetes mellitus and related end stage renal disease. A case-control study.

SELL (L-selectin) is a candidate gene for several complex diseases including diabetes mellitus and renal failure. Our aim was to investigate the involvement of P213S SELL gene polymorphism (rs2229569) in type 2 diabetes mellitus (T2DM) and related end stage renal disease (ESRD). Type 2 diabetes mellitus patients without ESRD (n=250) or with ESRD (n=90), ESRD patients without diabetes (n=119) and sex and age matched healthy subjects (n=459) were analyzed in this study. DNA samples from all these subjects were genotyped for the P213S polymorphism by PCR-RFLP technique. Statistical analysis indicated that SELL P213S genotypes and alleles were similar distributed in the patients and control groups (ORSS=0.37, CI 95%: 0.131>0.372>1.06, p=0.05, Yate's correction p=0.09, for T2DM patients without ESRD, ORSS=2.04, CI 95%: 0.365>2.047>1.465, p=0.4, Yate's correction p=0.67, for T2DM patients with ESRD and ORSS=1, CI95%: 0.198>1>5.057, p=1, Yate's correction p=0.67, for non-diabetic with ESRD patients). Also, no significant differences were noticed when we compared the ESRD subjects with diabetes vs. non-diabetic ones (OR=1.798, CI 95%: 0.392>1.798>8.245, p=0.44, Yate's correction p=0.7). No statistically significant results were found in order to sustain the hypothesis of association between SELL gene P213S polymorphism, type 2 diabetes mellitus and end stage renal disease.

Massive cortico-subcortical ischemic stroke with a consecutive hemorrhagic event: a case report.

BACKGROUND: We report a case of a 78-year-old woman with a large cerebral infarction probably due to athermanous embolism following atrial fibrillation. CASE DESCRIPTION: The patient, known with atrial fibrillation, high blood pressure and heart failure, complained of headache and motor impairment on the left side of the body. CT imaging revealed a subacute ischemic lesion in the right fronto-occipital lobes, and an old ischemic lesion in the right fronto-parietal lobes. Anticoagulant treatment was conducted with careful monitoring of the coagulability status. After almost three weeks, suddenly the patient became comatose and died shortly after. Macroscopic and microscopic examination confirmed the cortico-subcortical ischemic lesions, but also identified a fresh hemorrhagic site in pons, distant from the initial lesion sites. An immunohistochemical study identified blood vessels in the ischemic sites completely isolated from any glial support. CONCLUSIONS: This is a rare case of a large cerebral infarction with a pontine hemorrhagic event.

Polymorphism of catalase gene promoter in Romanian patients with diabetic kidney disease and type 1 diabetes.

Hyperglycaemia leads to ROS (Reactive oxygen species) generation, affecting the cells that cannot decrease glucose uptake such as: glomerular epithelial cells, mesangial cells and proximal tubule cells. ROS excess seems to activate important pathogenic pathways of development of diabetic nephropathy. The decrease of CAT activity, one of the most important antioxidant enzymes, following to some genetic defects, may be a risk factor for diabetic nephropathy. The purpose of this study is to investigate the association of 21A/T (rs7943316) polymorphism of CAT gene with advanced diabetic nephropathy in patients with type 1 diabetes in Romania. There have been studied 238 patients with T1D (type 1 diabetes), divided into the group with diabetic nephropathy (DN) (106 patients) and the group without renal affectation (132 patients). The genotyping has been made by using PCR-RFLP technique. The analysis of association has been made by using DeFinetti programme. The value considered significant has been p < 0.05. There has been a deviation from Hardy-Weinberg equilibrium in the group with diabetic nephropathy (p = 0.019), the equilibrium being preserved by the control group (p = 0.771). T allele does not confer a risk for advanced diabetic nephropathy (ORT = 0.757, 95% C.I. = 0.405-1.414; P = 0.381), the result being statistically insignificant even taking into consideration the risk allele A (ORA = 0.793, 95% C.I. = 0.465-1.350; P = 0.392). The results remain concordant too after applying the Cochran -Armitage test. Our data do not suggest an effect of 21A/T (rs7943316) polymorphism in the susceptibility for diabetic nephropathy in Romanian patients with type 1 diabetes. Further studies are necessary in order to demonstrate or exclude the role of CAT gene in diabetic nephropathy in patients with type 1 diabetes.

Association of +35A/C (intron3/exon3) polymorphism in SOD1-gene with diabetic nephropathy in type 1 diabetes.

Diabetic nephropathy is a major complication of type 1 diabetes whose pathogenesis is insufficiently known, but oxidative stress and genetic susceptibility seem to be involved. The purpose of this study is to assess the possible association of +35A/C (rs2234694) polymorphism in SOD1-gene with advanced stages of diabetic nephropathy in patients with type 1 diabetes in Romania. There have been enrolled 238 unrelated patients, having type 1 diabetes, divided into group A (106 patients) with diabetic nephropathy - macroalbuminuria or ESRD (End Stage Renal Disease) and group B (132 patients) without diabetic nephropathy. The genomic DNA was extracted from the peripheral venous blood and the genotyping of +35A/C (rs2234694) polymorphism has been made using the PCR-RFLP technique. The statistical analysis has been made using De Finetti's program. There has not been a significant deviation from the Hardy-Weinberg equilibrium for any group (p=0.229 and p=0.894, respectively). The data analysis revealed that the presence of a C-allele confers a significant risk (p=0.008) for the advanced diabetes nephropathy (OR=4.940, 95% C.I.=1.341-18.198), and the CA-genotype (p=0.015) confers a little lower risk (OR=4.491, 95% C.I.=1.203-16.766). This study shows the association of a mutant C-allele of rs2234694 polymorphism in SOD1-gene with the advanced stages of diabetic nephropathy in patients with type 1 diabetes in Romania, suggesting the involvement of the defense against oxidative stress, as an important link in the pathogeny of diabetic nephropathy.

Oxidative stress in diabetic kidney disease.

Diabetic Kidney Disease (DKD) represents a worldwide public health problem, due to its ever growing incidence and high costs connected to the imposed therapies regarding substitution of kidney functions. DKD includes all the anatomical, clinical and functional alterations that occur at kidney level in a patient with Diabetes Mellitus (DM), as a result of numerous metabolic and haemodynamic factors at the level of kidney microcirculation, based on a polygenous genetical polymorphism that generates an individual susceptibility for this complication. DKD is found in 20-40% of DM patients and it represents the main cause of chronic kidney disease. In DKD pathogeny, an important part is played by the oxidative stress determined by hyperglycemia. Among the mechanisms by which hyperglycemia may affect the kidney we may enumerate polyol pathway activation, C protein-kinase activation (PKC), non-enzymatic protein glycosylation. Out of the highly reactive molecules involved in the oxidative stress of DKD, an important role is attributed to *O2-, *NO and ONOO-. The role of oxidative stress played in DKD pathogeny is also supported by the promising results of some antioxidant therapies in DKD: AGE inhibitors (pyridorin, 2,3 diamino-phenazine, bromo-phenylacetic thiazolium, aminoguanidine/pimagedine), diacylglycerol pathway inhibitors (vitamin E, thiamine, benfotiamine, aminoguanidine), PKC inhibitors (ruboxistaurin), transketolase activators (thiamine and benfotiamine).

The glycemic control and temporal characteristics of diabetes as risk factors for the occurence of diabetic renal disease.

Diabetes is one of the most spread pandemy, which affects nowadays the world, its incidence increasing globally. The chronic complications of diabetes are extremely important, out of which the diabetic kidney disease (DKD) being by far the most expensive and severe. On the basis of statistic studies, we tried to identify the risk factors within some epidemiological studies. The research started in two directions: the hypothesis of environmental factors and associated diseases and the hypothesis of genetic factors. In this article we are trying to assess the role of glycaemic control, age, total duration and post-pubertal duration of diabetes as risk factors for diabetic nephropathy. The glycaemic control proved to be an essential risk factor in developing microvascular complications and DKD, the "normal" glycaemia being the only limit below which there are no microvascular complications. We do not know for sure exactly the role played by the total duration of diabetes and age in developing the diabetic nephropathy as well as other microvascular complications. The age of onset and the post-pubertal duration seem to be better associated to the development of nephropathy, but the causality has not been demonstrated yet. These are a part of the 21 risk factors quoted in the speciality literature as influencing the occurrence of DKD.

[Puberty, pregnancy, gender and hormonal status--putative risk factors for diabetic nephropathy]. / Pubertatea, sarcina, sexul si statusul hormonal--posibili factori de risc pentru nefropatia diabetica.

Contemplation of non-genetic risk factors that are influencing the onset and development of diabetic nephropathy (diabetic kidney disease--DKD) is very important. This article is integrative, assessing the existent data about several possible risk factors for DKD. Because the age of onset and postpubertal duration of diabetes seems to be strongly correlated with DKD, it is feasible for puberty to be another independent risk factor. Data analysis regarding puberty and possible explanatory mechanisms to link it with DKD, as the connection with DKD of other situations, with special hormonal status (like pregnancy), is also part of this article. Summing up the data about hormonal status, we can conclude that ANF levels are a risk factor for diabetic nephropathy because they are implicated in diminution of urinary Na elimination and hypertension and subsequent urinary albumin excretion (UAE) in case of inadequate glycaemic control. The evidences regarding GH are indicating that it is a risk factor for DKD and that he is probably implicated in glomerular hypertrophy onset at puberty. The urinary elimination levels of GH are very strong correlated with UAE being putative early marker for DKD. Also the GH deficiency seems to be a protective mechanism for DKD apparition. GH is strongly correlated with IGF-1 that has very high urinary levels in microalbuminuric patients. These levels are very well related to UAE, kidney volume--important markers for glomerular hypertrophy. The evidences accumulated until now regarding the role of masculine gender, testosterone and estrogens in DKD are inarticulate.

Soya--the medicine food product.

Soya, cultivated for more than 3000 years, is both a drug and a food product. It has numerous nutritional benefits, given by its content of isoflavones, essential amino acids, fibers, poly-unsaturated fatty acids, vitamins and minerals. The use of soy reduces the risk of cardiovascular diseases: it has an antioxidant effect, reduces cholesterol levels and modulates the endothelial function; the soy foods, rich in isoflavones, reduce the risk of breast cancer; men with heredocolateral cancer antecedents or with minimal increase of prostate antigen must consider the consumption of soy and soy foods. Soy and soy foods play an important role in reducing the incidence of osteoporosis and controlling the pre- and postmenopausal symptoms; the soy ingestion has benefic metabolic effects in patients with Diabetes Mellitus and overweight. Taking into consideration the nutritional profile of soy, the nutritionists should encourage the population to consume more soy and soy foods. Nevertheless, long term studies are needed to discover a possible "dark side" of soy consumption. Among the most popular soy foods we mention: soymilk, soy cheese (tofu), soy meat (pie, salami, textured soy in granule form). Most of the products are soy flour derivatives, while tofu is obtained by curdling soymilk.