Azerbaijan Medical Journal

Nephropathy is considered a foremost cause of morbidity and mortality in patients with type 1 or type 2 diabetes mellitus. Hyperglycemia causes renal injury directly or via hemodynamic alterations. These alterations induce glomerular hyperfiltration, microalbuminuria, mesangial expansion, and GBM thickening and arteriolar hyalinosis. Risk determination has potential importance in the management of Diabetic Neuropathy advancement. In addition to the traditional approaches through albuminuria and glomerular filtration rate for the prediction and monitoring of the rate of damage among diabetic patients, various studies are enduring to identify biomarkers. Recent approaches to treat this disorder emphasize on increased control of glycemia and blood pressure using therapies based on renin-angiotensinaldosterone system blockade. Renal and pancreatic transplantation is considered the best modality. This review of literature focuses on pathogenic factors, risk factors, diagnosis and treatment of diabetic nephropathy.

This article explores the surprising finding that bariatric surgery can produce full and durable remission of the metabolic syndrome as well as other comorbidities of obesity including type II diabetes, hypertension, polycystic ovary syndrome, gastroesophageal reflux disease, nonalcoholic steatotic hepatitis, adult asthma and improvement in weightbearing arthropathy. Such an outcome was previously deemed impossible. One effect of the surgery is the correction of hyperinsulinemia, a common denominator in the various expressions of the metabolic syndrome. Basal insulin levels return to normal levels within a matter of days following surgery, allowing a return of the first phase of insulin secretion. This effect is ‘dose related’ to the extent of the reduction of contact between food and the gut. The resolution of the spectrum of diseases that comprise the metabolic syndrome following bariatric surgery suggests that hyperinsulinemia may be the common cause that is corrected by lowering contact between food and the gut. If this concept is true, then the cause of the syndrome, including diabetes, could be a diabetogenic signal from the gut that forces the islets to produce excessive and harmful levels of insulin, or the cause could be the removal of a signal that blocks exces-sive insulin secretion. If either of these mechanisms is proven correct, the current treatment of diabetes with long-term insulin administration deserves review.

Comparison of results DEXA and Ultrasonography of densitometry at patients in different groups. Comparative analysis x-ray densitometry of spine and ultrasound densitometry of the calcaneus were provided in 2 different clinical groups: postmenopausal osteoporosis(n=26), and type 2 diabetes mellitus (n=66). T-scores correlated poorly between the methods. No correlation was found between the results of ultrasound and X-ray densitometry in any of the examined groups of patients. It was determine that in postmenopausal women and in patients with diabetes mellitus should be determined bone density by X-ray densitometry. Ultrasound examination of the calcaneus in these groups of patients is uninformative. The most pronounced changes in postmenopausal osteoporosis are found in the vertebrae, but in senile osteoporosis and diabetes mellitus at the femoral neck. The ultrasound diagnostic method often determines the category of less severe violations than the X-ray densitometry of the axial skeleton. Only in senile osteoporosis determining hardness of the calcaneus can be used for screening the state of the skeleton.

The aim of the study was to evaluate the population mortality seasonal dynamics in the settings of emergency medical care availability. The study was conducted in Sumgait based on the medical certificates of death data analysis for 2013. The average daily number of deaths from all causes and from circulatory system diseases, the monthly number of death cases proportion in the structure of annual death cases, the proportion of deaths from circulatory system diseases among the total number of deaths were calculated. The average daily number of deaths from all causes was 4.42, including 2.72 cases - from circulatory system diseases. The average daily number of death cases from all causes below the annual average rate was observed in June, July, August and September, and when performing the seasonal analysis - in summer and autumn from circulatory system diseases - in January, June, September and December. The winter and spring increase in all-cause mortality rate was registered, whereas the mortality rate peak was characteristic for February and March. In the seasonality analysis the largest proportion of death cases number from circulatory system diseases in the structure of total annual mortality rate was in the spring. The proportion of deaths from circulatory diseases among the death causes of Sumgait population was 61.5±1.2%. In winter, the proportion of deaths from circulatory system diseases in the structure of causes of death from all causes was minimal (53.3±2.3%), and in the summer - the maximum (68.9±2.4%). The regularity of mortality seasonal dynamics in Sumgait is the winter-spring increase and summer decrease in all-cause mortality rate; distinctive feature of the mortality seasonal dynamics in Sumgait is associated with mortality risk increase in spring due to circulatory system diseases.

Unique gut microbial colonisation patterns are associated with the onset of allergic disease in infants; however, there is insufficient evidence to determine if aberrant microbial composition patterns persist in adult allergic rhinitis (AR) sufferers. To compare the gut microbiome composition between adult AR sufferers and controls. Gut microbial composition in stool samples was compared between 57 adult AR sufferers (39.06 ± 13.29 years) and 23 controls (CG; 36.55 ± 10.51 years) via next-generation sequencing of the V3–V4 hypervariable regions of the 16S rRNA gene. Taxonomic classification and identity assignment was performed using a reference-based approach with the NCBI database of 16S rRNA gene sequences. Species richness determined via the Shannon index was significantly reduced in the AR cohort compared to the CG (4.35 ± 0.59 in AR vs. 4.65 ± 0.55 in CG, p = 0.037); trends for reductions in operational taxonomic unit (OTU) counts, inverse Simpson, and CHAO1 diversity indices were also noted. Bacteroidetes (p = 0.014) was significantly more abundant in the AR group than in the CG. In contrast, the Firmicutes phylum was significantly less abundant in the AR group than in the CG (p = 0.006). An increased abundance of Parabacteroides (p = 0.008) and a reduced abundance of Oxalobacter (p = 0.001) and Clostridiales (p = 0.005) were also observed in the AR cohort compared to the CG. Adult AR sufferers have a distinct gut microbiome profile, marked by a reduced microbial diversity and altered abundance of certain microbes compared to controls. The results of this study provide evidence that unique gut microbial patterns occur in AR sufferers in adulthood and warrant further examination in the form of mechanistic studies.