Search

Copyright of Family Medicine Forum / Forum Medycyny Rodzinnej is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of General Practitioner / Lekarz POZ is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of General Practitioner / Lekarz POZ is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Disturbances in acid-base balance are one of the more frequent disorders in patients hospitalized in intensive care units. A case report. A 56-year-old patient admitted to the intensive care unit due to extremely severe lactic acidosis in the course of metformin poisoning (suicide attempt). Supportive and organ supporting functions as well as continuous renal replacement therapy for detoxification and acidosis were applied. Discussion. Lactic acidosis caused by metformin is very rare. It is an entity with high mortality. However, it is possible to get good treatment results with early treatment. [ABSTRACT FROM AUTHOR]

Diabetes and obesity are associated with an augmented manifestation of malignant tumors of various localizations. Metformin is commonly used in patients with diabetes type 2, particularly those classed as obese. It has been shown to reduce both incidence of malignant tumors and respective mortality. The action of metformin involves a pleiotropic mechanism: it activates the LKB1/AMP pathway (liver kinase B1/adenosine monophosphate) which inhibits the mTOR pathway and blocks cell division also by its effect on cyclins. Additionally, metformin promotes apoptosis and cellular autophagy, inhibits the activity of metalloproteinases and activates the immune system. Metformin reduces the incidence of lung, pancreas, liver and large intestine cancers. It also reduces the percentage of triple-negative breast cancers and improves response to neoadjuvant chemotherapy in this disease. In endometrial cancer, metformin increases the positive influence of gestagens, potentiates the effects of paclitaxel and improves survival. In cervical cancer, metformin extends time to relapse, and in ovarian cancer, it extends time to progression and improves overall survival. Studies indicate that a destructive effect on cancer stem cells may be its additional mechanism of action. [ABSTRACT FROM AUTHOR]

Metformin, currently recommended as the drug of first choice in type 2 diabetes mellitus (T2DM), is one of the few antihiperglycemic drugs to reduce cardiovascular risk. Nonetheless, due to the risk of lactic acidosis during metformin therapy, its usage in patients with diabetes and heart failure (HF) is still a matter of debate. The aim of this review is to present data supporting the possibility of using metformin in the treatment of diabetic patients with concomitant heart failure. In the failing heart, metformin through the mechanism related to AMP-activated protein kinase (AMPK) activity, improves free fatty acids (FFA) and glucose metabolism, mitochondrial biogenesis, as well as nitric oxide (NO)-NO synthase pathway. Metformin can also inhibit the generation and accumulation of advanced glycation end products (AGEs) and thereby prevents the development of the adverse structural and functional changes in myocardium. In summary, experimental and clinical data indicate the ability of metformin to prevent the development of the structural and functional changes in myocardium, although further basic research and clinical studies assessing benefits and safety of metformin therapy in patients with HF are required. [ABSTRACT FROM AUTHOR]

Copyright of Review of Medicine / Przeglad Lekarski is the property of Wydawnictwo Przegld Lekarski / Publisher Medicine Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lactic acidosis is a very rare but serious condition. Sepsis, shock, respiratory failure, liver failure, methanol/glycol or drug intoxication may cause lactic acidosis. It is potentially fatal and half of the patients die. In-hospital mortality in patients with liver or renal failure reaches up to 94%. In patients with metformin-associated lactic acidosis survival reaches 68%. We present a case of a man with severe lactic acidosis, which etiology was unknown. Nevertheless, diagnostic and therapeutic process has been completed successfully. [ABSTRACT FROM AUTHOR]

The results of recent studies suggest that metformin, in addition to its antihyperglycemic efficacy, may also attenuate neuroinflammation and directly act on the central nervous system. However, the molecular mechanisms by which metformin exerts its anti-inflammatory effects in the brain remain largely unknown. Adenosine-monophosphate-activated protein kinase (AMPK) activation is the most well-known mechanism of metformin action. However, some of the biological responses to metformin (e.g. the release of cytokines and the expression of arginase I or PGC-1α) are not limited to AMPK activation but also are mediated by AMPK-independent mechanisms. This article reviews current evidence supporting the hypothesis that the shift of microglia toward alternative activation may underlie the beneficial effects of metformin observed in animal models of neurological disorders. [ABSTRACT FROM AUTHOR]

The incidence of obesity and diabetes as well as metabolic syndrome gradually increases with age. In our consciousness, in women, menopause is directly related with a higher incidence of these abnormalities. Up to now there has been no evidence that menopause is the reason. Some studies documented that menopausal women had a higher amount of abdominal fat. This and abrupt decrease of estrogen levels appear to be the main reasons for a sudden rise in the incidence of cardio-vascular diseases in postmenopausal women. In most studies, behavioral intervention (i.e. diet with caloric restriction and physical activity) is the most effective prevention of obesity and diabetes. In early menopause, hormonal therapy may prevent the increase of central adiposity. In women in early menopause with central adiposity or BMI = 35 kg/m2 metformin may be helpful in diabetes prevention. In older age, behavioral therapy is the most effective. Hormonal therapy and metformin therapy may harmful rather than helpful. Polish and American Diabetes Associations recommended fast walking as a best method of exercise. In some studies, Tai Chi could be useful to prevent osteoporosis by strengthening the muscle of lower extremities as well as the sense of equilibrium. Below we present essential problems of obesity and diabetes in menopause as well as methods of their prevention. [ABSTRACT FROM AUTHOR]

Metformin is widely used for the treatment of type 2 diabetes mellitus. Although this biguanide derivative has been used for more than 50 years, its mechanism of action has not been fully elucidated. In this article we describe the latest achievements concerning the mechanisms of antihyperglycemic action of metformin. They include: decrease of glucose absorption in the small intestine, increase of glucose transport into cells, decrease in the plasma free fatty acid concentrations and inhibition of gluconeogenesis. Activation of AMP-activated protein kinase (AMPK) plays an important role in these processes. The latest discoveries have revealed mechanisms of antiatherosclerotic, hypotensive and anticancer action of metformin and its impact on vein endothelial function. The pleiotropic actions of metformin include impact on plasma lipid profile decrease of oxidative stress, and increase in plasma fibrinolytic activity. Although metformin is not metabolized, the latest research has shown that it is actively transported into hepatocytes and renal tubular epithelium, by OCT1 (organic cation transporter 1, encoded by the SLC22A1 gene) and OCT2 (organic cation transporter 2, encoded by the SLC22A2 gene), respectively. However, MATE1 transporter (multidrug and toxin extrusion 1 protein) is encoded by the SLC47A1 gene and facilitates metformin excretion from these cells into bile and urine. Metformin transporter gene polymorphisms may contribute to significant variation in drug response. Further studies of mechanisms of metformin action could contribute to its wider use for the prevention of type 2 diabetes mellitus, cancer, and Alzheimer's disease, and for the treatment of type 1 diabetes mellitus, and polycystic ovary syndrome (PCOS). [ABSTRACT FROM AUTHOR]