Probiotics have beneficial metabolic effects in patients with type 2 diabetes mellitus : a meta-analysis of randomized clinical trials

Probiotics have been reported to have a positive impact on the metabolic control of patients with type 2 diabetes. We aimed to systematically evaluate the effects of probiotics on cardiometabolic parameters in type 2 diabetes based on randomized controlled studies. MEDLINE, Embase, and CENTRAL databases were reviewed to search for randomized controlled trials that examined the effects of probiotic supplementation on cardiometabolic parameters in patients with type 2 diabetes. 32 trials provided results suitable to be included in the analysis. The effects of probiotics were calculated for the following parameters: BMI, total cholesterol levels, LDL, triglycerides, HDL, CRP, HbA1c levels, fasting plasma glucose, fasting insulin levels, systolic and diastolic blood pressure values. Data analysis showed a significant effect of probiotics on reducing total cholesterol, triglyceride levels, CRP, HbA1c, fasting plasma glucose, fasting insulin levels, and both systolic and diastolic blood pressure values. Supplementation with probiotics increased HDL levels however did not have a significant effect on BMI or LDL levels. Our data clearly suggest that probiotics could be a supplementary therapeutic approach in type 2 diabetes mellitus patients to improve dyslipidemia and to promote better metabolic control. According to our analysis, probiotic supplementation is beneficial in type 2 diabetes mellitus

Predictive Value of Tachycardia for Mortality in Trauma-Related Haemorrhagic Shock: A Systematic Review and Meta-Regression

OBJECTIVES: Heart rate (HR) is one of the physiological variables in the early assessment of trauma-related haemorrhagic shock, according to Advanced Trauma Life Support (ATLS). However, its efficiency as predictor of mortality is contradicted by several studies. Furthermore, the linear association between HR and the severity of shock and blood loss presented by ATLS is doubtful. This systematic review aims to update current knowledge on the role of HR in the initial haemodynamic assessment of patients who had a trauma. DESIGN: This study is a systematic review and meta-regression that follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. DATA SOURCES: EMBASE, MEDLINE, CENTRAL and Web of Science databases were systematically searched through on 1 September 2020. ELIGIBILITY CRITERIA: Papers providing early HR and mortality data on bleeding patients who had a trauma were included. Patient cohorts were considered haemorrhagic if the inclusion criteria of the studies contained transfusion and/or positive focused assessment with sonography for trauma and/or postinjury haemodynamical instability and/or abdominal gunshot injury. Studies on burns, traumatic spinal or brain injuries were excluded. Papers published before January 2010 were not considered. DATA EXTRACTION AND SYNTHESIS: Data extraction and risk of bias were assessed by two independent investigators. The association between HR and mortality of patients who had a trauma was assessed using meta-regression analysis. As subgroup analysis, meta-regression was performed on patients who received blood products. RESULTS: From a total of 2017 papers, 19 studies met our eligibility criteria. Our primary meta-regression did not find a significant relation (p=0.847) between HR and mortality in patients who had a trauma with haemorrhage. Our subgroup analysis included 10 studies, and it could not reveal a linear association between HR and mortality rate. CONCLUSIONS: In accordance with the literature demonstrating the multiphasic response of HR to bleeding, our study presents the lack of linear association between postinjury HR and mortality. Modifying the pattern of HR derangements in the ATLS shock classification may result in a more precise teaching tool for young clinicians

Angiotensin Converting Enzyme Activity in Anti-TNF-Treated Rheumatoid Arthritis and Ankylosing Spondylitis Patients

Angiotensin-converting enzyme (ACE) and ACE2 have been implicated in the regulation of vascular physiology. Elevated synovial and decreased or normal ACE or ACE2 levels have been found in rheumatoid arthritis (RA). Very little is known about the effects of tumor necrosis factor α (TNF-α) inhibition on ACE or ACE2 homeostasis. In this study, we assessed the effects of one-year anti-TNF therapy on ACE and ACE2 production in RA and ankylosing spondylitis (AS) in association with other biomarkers. Patients and Methods Forty patients including 24 RA patients treated with either etanercept (ETN) or certolizumab pegol (CZP) and 16 AS patients treated with ETN were included in a 12-month follow-up study. Serum ACE levels were determined by commercial ELISA, while serum ACE2 activity was assessed using a specific quenched fluorescent substrate. Ultrasonography was performed to determine flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT) and arterial pulse-wave velocity (PWV) in all patients. In addition, CRP, rheumatoid factor (RF) and ACPA were also measured. All assessments were performed at baseline and 6 and 12 months after treatment initiation. Results Anti-TNF therapy increased ACE levels in the full cohort, as well as in the RA and AS subsets. ACE2 activity increased in the full cohort, while the ACE/ACE2 ratio increased in the full cohort and in the RA subset (p < 0.05). Uni- and multivariable regression analyses determined associations between ACE or ACE/ACE2 ratios at different time points and disease duration, CRP, RF, FMD and IMT (p < 0.05). ACE2 activity correlated with CRP. The changes of ACE or ACE2 over 12 months were determined by treatment together with either RF or FMD (p < 0.05). Conclusions Anti-TNF treatment may increase ACE and ACE2 in the sera of RA and AS patients. ACE and ACE2 may be associated with disease duration, markers of inflammation and vascular pathophysiology. The effects of TNF inhibition on ACE and ACE2 may reflect, in part, the effects of these biologics on the cardiovascular system

Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model

Chronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare

Die Ausbildung von GerichtsdolmetscherInnen am Beispiel der Eötvös Loránd Universität Budapest

Die vorliegende Arbeit beschäftigt sich mit der Thematik des Gerichtsdolmetschens unter besonderer Berücksichtigung der GerichtsdolmetscherInnenausbildung an der ungarischen Eötvös Loránd Universität. Das Ziel der Masterarbeit ist, die Ausbildung zu untersuchen, zu analysieren und ihre Besonderheiten zu erläutern. Das erste Kapitel bietet einen Überblick über die Definitionen und Ausbildungsmöglichkeiten für das Gerichtsdolmetschen außerhalb und innerhalb von Europa. Kapitel 2 widmet sich den verschiedenen Verordnungen und Gesetzen, die den Beruf der GerichtsdolmetscherInnen in Österreich und Ungarn regeln. Das nächste Kapitel geht der Frage nach, welche Ähnlichkeiten und Unterschiede im Beruf in den zwei Ländern existieren. Dabei werden verschiedene Themen wie etwa Urkundenübersetzung, Bezahlung und Interessenvertretung der GerichtsdolmetscherInnen näher betrachtet. In Kapitel 4 stehen die Forschungsfragen und Forschungsmethoden im Mittelpunkt. Im letzten, empirischen Teil der Arbeit liegt das besondere Augenmerk auf der ungarischen GerichtsdolmetscherInnenausbildung. Das 5. Kapitel zielt darauf ab, die wichtigsten Charakteristika des Lehrgangs „Dolmetschen bei Gericht und Behörden“ zu forschen. Im Rahmen von Interviews wird die Meinung der AbsolventInnen und der Lehrstuhlleiterin in Bezug auf die notwendigen Kompetenzen, die Lehrveranstaltungen, die Arbeitsmöglichkeiten und den Bedarf an GerichtsdolmetscherInnen in Ungarn untersucht. Schließlich werden die Ergebnisse der Fallstudie präsentiert, um Schlussfolgerungen ziehen zu können.The present thesis deals with the topic of court interpreting with particular focus on the court interpreter training at the Eötvös Loránd University, Hungary. The aim of the master’s thesis is to examine and analyse the programme as well as to describe its characteristics. The first chapter provides an overview of the definitions and training opportunities of court interpreting outside and within Europe. Chapter 2 is devoted to various regulations and laws, which govern the profession of court interpreters in Austria and Hungary. The following section examines the question of which similarities and differences exist in the profession in both countries. Several topics are hereby considered such as translation of deeds, payment and representation of interests of court interpreters. Furthermore, chapter 4 focuses on research questions and methods. The last, empirical part of the thesis pays special attention to the Hungarian court interpreter training. Chapter 5 aims to explore the most important characteristics of the training course “Court and Public Service Interpreter”. In the course of interviews, the opinion of the graduates and the head of the training course is analysed with regard to the necessary competences, lectures, job opportunities and the demand for court interpreters. Finally, the results of the case study are presented to draw conclusions