Cardio metabolic risk factors for atrial fibrillation in type 2 diabetes mellitus: Focus on hypertension, metabolic syndrome and obesity

Objective. Atrial fibrillation (AF) in type 2 diabetes mellitus (T2DM) has been little explored so far. However, there are several cardio metabolic risk factors for AF in T2DM patients, such as arterial hypertension, obesity or the metabolic syndrome. Our objective was to evaluate cardio metabolic risk factors for AF in T2DM patients. Methods. We studied the medical records of T2DM patients hospitalized in the Internal Medicine department of an emergency referral hospital in Bucharest, Romania. The study was observational, retrospective and carried out between January-June 2018. Results. The study group included 221 T2DM patients (with a mean age of 68.65 ± 10.64, ranging between 37-93 years): 116 women (52.49%; with a mean age of 70.53 ± 10.69, ranging between 37-93 years) and 105 men (47.51%; with a mean age of 66.57 ± 10.23, ranging between 38-91 years). 92 patients had AF (41.63%): 40 women (34.48%) and 52 men (49.52%). 180 patients (81.45%) were hypertensive: 103 women (88.79%) and 77 men (73.33%). 113 patients (51.13%) had metabolic syndrome: 58 women (50.00%) and 55 men (52.38%). 77 patients (34.84%) were obese: 45 women (38.79%) and 32 men (30.48%). AF patients associated obesity in 26 cases (28.26%), hypertension in 73 cases (79.35%) and metabolic syndrome in 56 cases (60.87%). Conclusions. Out of the study group, 92 T2DM patients (41.63%) had AF, men being more likely to suffer from AF than women (p=0.0288). Hypertension affected 180 patients (81.45%) and in greater proportion women vs. men (p=0.0051). The metabolic syndrome and obesity were discovered in 113 patients (51.13%) and 77 patients (34.84%), respectively, with no significant differences in terms of gender. In our research, the highest cardio metabolic risk factors for AF in T2DM were hypertension (OR = 3.6675) and the metabolic syndrome (OR = 3.3388)

The Role of Oxidative Stress and the Effects of Antioxidants on the Incidence of Infectious Complications of Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is characterized by a predominant humoral immune deficiency predisposing the patients to infections. Oxidative stress leads to an increased immunoglobulin k light chain production in B cells and contributes to the antibodies’ deficiency and hypogammaglobulinemia. Aim of the Study. To evaluate the global oxidative status in patients with CLL and to determine whether the administration of antioxidants decreases complications due to infections. Patients and Method. We studied 84 patients with CLL stratified by Binet staging. Free oxygen radicals and antioxidant status were determined by the FORT and FORD test, respectively, at diagnosis and in the presence of infections. The patients were distributed in two groups: group A, treated only with antileukemic treatment, and group B, treated with antileukemic treatment and antioxidants. Results. By FORD and FORT assay, all patients had at diagnosis a low antioxidant capacity, and high levels of hydroperoxides. Infectious complications were more frequent in group A (B/C stages of disease) than in group B. Administrations of antioxidants stimulated the immune response and decreased infectious complications in CLL. Conclusions. Administrations of antioxidants and a healthy life style may improve the quality of life of patients with CLL and reduce the risk of infectious complications

Intestinal microbiota – a possible contributor to cardiovascular diseases?

The intestinal microbiota represents an interesting and emergent field of research, with already known implications in metabolic and immunological functions. Recently, there is increasing evidence that specific gut microbial populations are associated with cardiovascular diseases. Numerous completed and ongoing studies aim to evaluate the potential of intestinal microbiota assessment to improve the prevention, diagnosis, and therapeutic arsenal of cardiovascular diseases, considering dysbiosis as a cardiovascular risk factor. There is strong evidence for a correlation between intestinal flora imbalance and metabolic changes secondary to bacterial metabolites. In this minireview, we discuss recent data about the connections between intestinal microbiota and cardiovascular disease

A lack of diversity, equity, and inclusion in clinical research has direct impact on patient care

info:eu-repo/semantics/publishedVersio

Gut microbiota and myeloproliferative neoplams

The human gut microbiota refers to the collective assembly of microorganisms inhabiting and colonizing the gastrointestinal tract, including bacteria, archaea, and eukarya.1 This intricate microbial ecosystem exists in a symbiotic relationship with the host, with trillions of microorganisms playing key roles in maintaining human health.2 Firmicutes and Bacteroidetes represent the predominant bacterial phyla that form the intestinal microbiome.2 The gut microbiota has developed adaptive mechanisms to promote its survival within the gastrointestinal tract. Development of the intestinal microbiome has been depicted and seems to be influenced by a variety of factors, e.g., mode of delivery, diet during infancy and adulthood, illnesses, and antibiotic treatment causing variation in the composition of the microbiota.3 Before the age of three, children’s intestinal microbiome already resembles the gut microbiota of adult individuals in terms of functional capabilities, diversity, and composition.4 The gut microbiota offers numerous benefits to the host as its metabolic activity is responsible for the generation of short-chain fatty acids which are a source of energy for the host, and for the fermentation of carbohydrates leading to the synthesis of oxalates, reducing the risk of oxalate stones in the kidney.5 In addition, the microbiota promotes lipid metabolism, vitamin synthesis, polyphenol breakdown, drug metabolism, immunomodulation, which offers immune-protection, and maintains the structural integrity of the gastrointestinal tract.3 Therefore, the gut microbiota represents an intricate microbial ecosystem that plays a critical role in maintaining human health. Continue..

La liberté syndicale, l'inviolabilité des locaux syndicaux, le secret de la correspondance et des conversations syndicales

peer reviewe

Risk Factors for Pancreatic Cancer: Emerging Role of Viral Hepatitis

Pancreatic cancer is one of the most aggressive malignant neoplastic diseases. The incidence and mortality rates of this disease vary depending on geographical area, which might be explained by the different exposure to risk factors. To improve the prognosis of patients with pancreatic cancer, different approaches are needed for an earlier diagnosis. Identification of risk factors and implementation of screening strategies are essential for a better prognosis. Currently, the risk factors for pancreatic cancer fall into two broad categories, namely extrinsic and intrinsic factors. Extrinsic factors include alcohol consumption, smoking, a diet rich in saturated fats, and viral infections such as chronic infection with hepatitis B and C viruses. The pathophysiological mechanisms explaining how these hepatotropic viruses contribute to the development of pancreatic cancer are not fully elucidated. The common origin of hepatocytes and pancreatic cells in the multipotent endodermal cells, the common origin of the blood vessels and biliary ducts of the pancreas and the liver, or chronic inflammatory changes may be involved in this interaction. A careful monitoring of patients with viral liver infections may contribute to the early diagnosis of pancreatic cancer and improve the prognosis of these patients

Essential Thrombocythemia: One-Center Data in a Changing Disease

Introduction: Essential thrombocythemia is a chronic myeloproliferative neoplasm associated with thrombo-hemorrhagic events and the progression to myelofibrosis or acute myeloid leukemia. The purpose of this article is to present real-world data on ET cases diagnosed and managed between 1998 and 2020 in the largest, tertiary hematology reference center in Romania and to evaluate the impact of thrombotic events on survival. Methods: A real-world, retrospective cohort-type study was conducted. We collected and statistically analyzed data from 168 patients who met the 2016 WHO diagnostic criteria for ET and who were managed between 1998 and 2020 in our center. Results: The median age at diagnosis of ET was 51.8 years, with a female predominance (66.07%). The JAK2V617F mutation was detected in 60.71% of patients. Leukocytosis at diagnosis was associated with a higher risk of thrombosis, and JAK2V617F-positive cases exhibited a 1.5-fold higher risk of developing thrombotic events. The average survival in ET with major thrombosis was 14.5 years versus 20.6 years in ET cases without major thrombosis. Other predictors of survival were high-risk IPSET score and age >60 years. Conclusions: Romanian patients diagnosed with ET are generally younger than 60 years and are predominantly female. The occurrence of thrombotic events was influenced by gender, leukocyte count at diagnosis and JAK2V617F positivity. Survival was impacted by age, the presence of JAK2V617F mutation, hypertension, major thrombotic complications and IPSET score. Notably, these findings warrant careful interpretation and further confirmation in the setting of prospective studies

The influence of fasting and energy-restricted diets on leptin and adiponectin levels in humans: A systematic review and meta-analysis

Background & aims: Fasting and energy-restricted diets have been evaluated in several studies as a means of improving cardiometabolic biomarkers related to body fat loss. However, further investigation is required to understand potential alterations of leptin and adiponectin concentrations. Thus, we performed a systematic review and meta-analysis to derive a more precise estimate of the influence of fasting and energy-restricted diets on leptin and adiponectin levels in humans, as well as to detect potential sources of heterogeneity in the available literature. Methods: A comprehensive systematic search was performed in Web of Science, PubMed/MEDLINE, Cochrane, SCOPUS and Embase from inception until June 2019. All clinical trials investigating the effects of fasting and energy-restricted diets on leptin and adiponectin in adults were included. Results: Twelve studies containing 17 arms and a total of 495 individuals (intervention = 249, control = 246) reported changes in serum leptin concentrations, and 10 studies containing 12 arms with a total of 438 individuals (intervention = 222, control = 216) reported changes in serum adiponectin concentrations. The combined effect sizes suggested a significant effect of fasting and energy-restricted diets on leptin concentrations (WMD: ?3.690 ng/ml, 95% CI: ?5.190, ?2.190, p ? 0.001; I2 = 84.9%). However, no significant effect of fasting and energy-restricted diets on adiponectin concentrations was found (WMD: ?159.520 ng/ml, 95% CI: ?689.491, 370.451, p = 0.555; I2 = 74.2%). Stratified analyses showed that energy-restricted regimens significantly increased adiponectin (WMD: 554.129 ng/ml, 95% CI: 150.295, 957.964; I2 = 0.0%). In addition, subsequent subgroup analyses revealed that energy restriction, to ?50% normal required daily energy intake, resulted in significantly reduced concentrations of leptin (WMD: ?4.199 ng/ml, 95% CI: ?7.279, ?1.118; I2 = 83.9%) and significantly increased concentrations of adiponectin (WMD: 524.04 ng/ml, 95% CI: 115.618, 932.469: I2 = 0.0%). Conclusion: Fasting and energy-restricted diets elicit significant reductions in serum leptin concentrations. Increases in adiponectin may also be observed when energy intake is ?50% of normal requirements, although limited data preclude definitive conclusions on this point. 2020 Elsevier Ltd and European Society for Clinical Nutrition and MetabolismThis work was supported financially by the National Nutrition and Food Technology Research Institute , Shahid Beheshti University of Medical Sciences , Tehran, Iran (Grant Number: 1000328 ).Scopu