Disruptions of anaerobic gut bacteria are associated with stroke and post-stroke infection: a prospective case-control study

In recent years, preclinical studies have illustrated the potential role of intestinal bacterial composition in the risk of stroke and post-stroke infections. The results of these studies suggest that bacteria capable of producing volatile metabolites, including trimethylamine-N-oxide (TMAO) and butyrate, play opposing, yet important roles in the cascade of events leading to stroke. However, no large-scale studies have been undertaken to determine the abundance of these bacterial communities in stroke patients and to assess the impact of disrupted compositions of the intestinal microbiota on patient outcomes. In this prospective case-control study, rectal swabs from 349 ischemic and hemorrhagic stroke patients (median age, 71 years; IQR: 67-75) were collected within 24 h of hospital admission. Samples were subjected to 16S rRNA amplicon sequencing and subsequently compared with samples obtained from 51 outpatient age- and sex-matched controls (median age, 72 years; IQR, 62-80) with similar cardiovascular risk profiles but without active signs of stroke. Plasma protein biomarkers were analyzed using a combination of nuclear magnetic resonance (NMR) spectroscopy and liquid chromatography-mass spectrometry (LC-MS). Alpha and beta diversity analyses revealed higher disruption of intestinal communities during ischemic and hemorrhagic stroke compared with non-stroke matched control subjects. Additionally, we observed an enrichment of bacteria implicated in TMAO production and a loss of butyrate-producing bacteria. Stroke patients displayed two-fold lower plasma levels of TMAO than controls (median 1.97 vs 4.03 mu M, Wilcoxonp < 0.0001). Finally, lower abundance of butyrate-producing bacteria within 24 h of hospital admission was an independent predictor of enhanced risk of post-stroke infection (odds ratio 0.77,p = 0.005), but not of mortality or functional patient outcome. In conclusion, aberrations in trimethylamine- and butyrate-producing gut bacteria are associated with stroke and stroke-associated infections.Proteomic

Parkinson's disease, levodopa-use and the risk of melanoma.

Item does not contain fulltextSince the early 1970s, the literature has suggested an association between Parkinson's Disease (PD) and/or levodopa-use and an increased risk for the development of malignant melanoma. In some countries, this possible association has even led to a warning in the drug insert leaflet of the possible risk. Recently, five studies have been published that have investigated both associations and three conclusions can be drawn. Firstly, there appears to be an increased risk in the development of melanomas in patients with PD. Secondly, this increased risk is already present before the PD is diagnosed. Finally, it is unlikely that levodopa plays any role in this phenomenon. It is not known which factors are responsible for this increase in the development of melanomas in PD patients and this needs further investigation. We recommend the removal of the warning from the drug insert leaflet, since this can lead to unnecessary fear on the part of the patients and physician resistance to prescribing this medication

Geoloketten leert: hanteerbaarheid voor de gebruiker is grootste knelpunt

Het project GeoLoketten wil geo-informatie in Nederland optimaal toegankelijk maken via webservices. In het kader van het innovatieprogramma Ruimte voor Geo-informatie worden daarvoor methoden en technieken ontwikkeld. Innoveren moet je leren, maar dit leertraject bleek bijzonder dynamisch. Al is de geosector nog zo snel, de ict-wereld achterhaalt haar we

A SEPSECS mutation in a 23-year-old woman with microcephaly and progressive cerebellar ataxia

Genetics of disease, diagnosis and treatmen