Keywords: childbirth; fibrinolysis system; thrombocytopathy; thromboelastography; tranexamic acid; idiopathic arterial hypotension.

Introduction

Many clinical studies have proved the effectiveness of probiotics in metabolic disorders associated with insulin resistance. However, the impact of probiotic therapy on pancreatic β-cell function is ambiguous. The influence of probiotic supplementation vs. placebo on β-cell function in people with type 2 diabetes (T2D) was assessed in a double-blind, single-center, randomized, placebo-controlled trial (RCT).

Methods

Sixty-eight patients with T2D were selected for participation in the RCT. Patients were randomly allocated to consumption of live multistrain probiotics or a placebo for 8 weeks, administered as a sachet formulation in double-blind treatment. The primary main outcome was the assessment of β-cell function as change in C-peptide and HOMA-β (homeostasis model assessment-estimated β-cell function), which was calculated using the HOMA2 calculator (Diabetes Trials Unit, University of Oxford). Secondary outcomes were the changes in glycemic control-related parameters, anthropomorphic variables, and cytokines levels. Analysis of covariance was used to assess the difference between groups.

Results

Supplementation with live multiprobiotic was associated with slight significant improvement of β-cell function (HOMA-β increased from 32.48 ± 13.12 to 45.71 ± 25.18; p = 0.003) and reduction of fasting glucose level (13.03 ± 3.46 vs 10.66 ± 2.63 mmol/L and 234.63 ± 62.36 vs 192.07 ± 47.46 mg/dL; p < 0.001) and HbA1c (8.86 ± 1.28 vs 8.48 ± 1.22; p = 0.043) as compared to placebo. Probiotic therapy significantly affects chronic systemic inflammation in people with T2D by reducing pro-inflammatory cytokine levels.

Conclusions

Probiotic therapies modestly improved β-cell function in patients with T2D. Modulating the gut microbiota represents a new diabetes treatment and should be tested in more extensive studies.

Trial Registration

NCT05765292.

ABSTRACT
Pregnancy-associated renal thrombotic microangiopathy is a rare condition with poor maternal outcome. Pregnancy may trigger atypical hemolytic uremic syndrome or thrombotic thrombocytopenic purpura. The article describes the clinical case of a 37-year-old woman who developed acute renal failure following complicated delivery. A turn-based differential diagnosis of atypical hemolytic uremic syndrome was performed. Unwarranted discontinuation of the targeted therapy with Eculisumab led to the development of chronic renal failure. Pregnancy-associated atypical hemolytic uremic syndrome is a life-threatening condition rarely seen in pregnancy making its early recognition difficult. As thrombotic microangiopathies require urgent treatment, plasmapheresis should be started as soon as they are suspected, followed by Eculisumab after the confirmation of the diagnosis of atypical hemolytic uremic syndrome. This may contribute to reducing maternal morbidity and mortality rates.
 KEY WORDS: acute kidney injury, hemorrhage, atypical hemolytic-uremic syndrome

ILLUSTRATED STUDENT GUIDE is a study guide on histology, cytology and embryology for students of medical universities and academies of Ukraine. Its main purpose is to help students in self-preparing and in practical classes in studying microscopic slides of cells, tissues and organs, interpreting the obtained images and mastering specific histological and embryological terminology. The guideline was discussed and approved by Profile Methodological Commission for Medico-Biological Subjects. Protocol № 2, March 23, 2023.

Condensed bicyclic systems with thiadiazole core being annelated to other five-membered heterocycles such as 1,3-thiazole, imidazole or 1,2,4-triazole occupy prominent place in medicinal chemistry because of their broad spectrum of pharmacological activities. The combination of several heterocycles into a bicyclic system commonly provides much more interest in the enhanced activity profile of its analogs than their parent separate constituents. In this review, we summarized the literature data about the main approaches for obtaining and possible directions of structural modification of the most common 1,3,4-thiadiazole containing [5+5] annelated heterosystems as promising objects for modern medicinal chemistry.