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[Irritable bowel syndrome (IBS) is one of the most common gastrointestinal condition, which affects 10-15% of adults in developed countries. Recent observations have raised the possibility that disturbances in the gut microbiota and/or the accompanying low-grade inflammatory state might contribute to the etiology and symptomatology of irritable bowel syndrome. Some studies indicate that small intestinal bacterial overgrowth (SIBO), as confirmed by hydrogen breath tests (HBT), is more prevalent in patients with irritable bowel syndrome than in matched controls without IBS. Although the data are conflicting, this observation has led to the hypothesis that bacterial contamination was the primary cause of IBS. As a consequence of this hypothesis, a lot of therapeutic options have found their way into the armamentarium of those who treat patients with IBS. These agents include probiotics, prebiotics, antibiotics and anti-inflammatory agents. This paper describes the various mechanisms by which changes in the gut flora might contribute to IBS and also discusses the efficacy and safety of antibiotic therapies, especially rifaximin, for treating IBS/SIBO symptoms.]
[Diabetic foot syndrome is a characteristic late complication of diabetes mellitus. It can develop in patients with type 1 as well as type 2 diabetes mellitus, especially in case of a long duration of diabetes and sustained poor metabolic state. Diabetic neuropathy plays a pivotal role in the pathomechanism, but vascular symptoms might also contribute to the complex clinical picture. For making the diagnosis, evaluation of complaints, performing physical examination and using simple tests for identifying both distal, somatosensory neuropathy and potential angiopathy are of great importance. Therapeutic approaches aim to achieve proper glycaemic control, as well as to ameliorate symptoms of neuropathy, improve peripheral blood supply by medicines, angioplasty or intervention radiological methods, fight against infections and off-load the foot. Surgical intervention might also be necessary, and in severe cases, amputation might be needed. The diabetic foot syndrome increases mortality risk in patients with diabetes. Complaints related to diabetic foot syndrome are often resistant to treatment and tend to recur. Thus, prevention with long-term, good metabolic control and protection of the foot are of particular importance.]
[INTRODUCTION - Observational studies have verified that even in routine diabetes care, up to 1.3% reduction in HbA1c can be achieved with the initiation of a long-acting basal insulin analogue. We can get the same results in our patients using an insulin titration algorithm and close diabetological control. CASE REPORT - Metformin therapy of a 68-year old, moderately obese woman with type 2 diabetes was complemented by a long-acting basal insulin analogue (insulin glargine). Before initiation of insulin therapy, the patient received thorough dietetic and diabetic education by a qualified dietician and a diabetes nurse. The starting dose of insulin was 10 U, and then the patient was asked to increase the dose by 2 U every 3rd day depending on the mean of self-monitored fasting plasma glucose values in the previous 2 days. With the aid of a titration algorithm, optimal carbohydrate metabolism has been verified by laboratory parameters assessed 3 months later. CONCLUSION - Insulin self-titration based on appropriate patient education and close professional control makes a relatively simple therapeutic system the optimal decision in terms of a rapid and chronic normalisation of glucose control in a large patient group.]
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Clinical Neuroscience
[Headache registry in Szeged: Experiences regarding to migraine patients]2.
Clinical Neuroscience
[The new target population of stroke awareness campaign: Kindergarten students ]3.
Clinical Neuroscience
Is there any difference in mortality rates of atrial fibrillation detected before or after ischemic stroke?4.
Clinical Neuroscience
Factors influencing the level of stigma in Parkinson’s disease in western Turkey5.
Clinical Neuroscience
[The effects of demographic and clinical factors on the severity of poststroke aphasia]1.
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Clinical Oncology
[Pancreatic cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up]3.
Clinical Oncology
[Pharmacovigilance landscape – Lessons from the past and opportunities for future]4.
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