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Aims: In subjects with diabetes mellitus type 2 complicated with diabetic nephropathy, there is an increase of markers of inflammation, generated by multiple mechanisms. Chronical subclinical inflammation is a finding observed in diabetes mellitus type 2. This study was designed to establish the correlation between the level of inflammatory marker C-reactive protein (CRP) with the duration of diabetes, the degree of glycemic control and the stage of diabetic nephropathy. Method: The study was performed on four groups of subjects suffering from diabetes mellitus type 2 complicated with nephropathy and a control group. The first group included 47 patients with diabetes mellitus type 2 and normoalbuminuria (UAE < 30mg/d), the second group included 54 subjects with diabetes and microalbuminuria (UAE = 30 - 300mg/d), the third group had 49 subjects with diabetes type 2 and macroalbuminuria (UAE> 300mg/d). In the forth group were selected 45 patients with macroalbuminuria and chronic renal failure. In the control group were included 25 subjects. For all individuals included in the study we assessed the following parameters: glycemia, glycosylated hemoglobin A1c, creatinine, urea, uric acid, glomerular filtration rate, C reactive protein and urinary albumin excretion/day. Results: We obtained a significant increase of these elements in study groups by comparison with control group, except the glomerular filtration rate, which decreased. CRP was significant increased in experimental groups comparatively with the control group (p<0.001). We found a positive significant correlation between the level of CRP and UAE (r = 0.49, p< 0.001). The correlation of HbA1c with CRP was r = 0.25, p < 0.001 and the correlation between the concentration of CRP and the duration of diabetes r = 0.31, p<0.001, both positive and significant statisticaly. Conclusions: The level of CRP was significantly elevated in diabetic patients complicated with nephropathy and it correlates positively with the urinary excretion of albumin, the duration of diabetes mellitus and the degree of glycemic control. In addition to metabolic and hemodynamics factors, inflammation can play a role in pathogenesis of diabetes mellitus type 2, complicated with nephropathy. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is highly prevalent and presents a clinical challenge. Gelsectan is a medical device containing xyloglucan (XG), pea protein and tannins (PPT) from grape seed extract, and xylo-oligosaccharides (XOS), which act together to protect and reinforce the intestinal barrier., Objective: The objective of this study is to evaluate the efficacy and safety of XG + PPT + XOS in patients with diarrhoea-predominant IBS (IBS-D)., Methods: In this double-blind study, 60 patients were randomly assigned to receive XG + PPT + XOS or placebo for 28 days, then crossed over to the alternative treatment. Patients were followed for 60 days., Results: At Day 28, a significantly higher proportion of patients starting treatment with XG + PPT + XOS than placebo (87 vs 0%; p  = 0.0019) presented normal stools (Bristol Stool Form Scale type 3-4). At Day 56, a significantly higher proportion of patients who crossed over to XG + PPT + XOS than placebo (93% vs 23%; p  = 0.0001) presented normal stools. In the group allocated to receive XG + PPT + XOS after placebo, benefits of XG + PPT + XOS were maintained during follow-up. Subjective assessments of abdominal pain, bloating, quality of life and general health indicated significant improvement with XG + PPT + XOS over placebo. There were no related adverse events., Conclusion: XG + PPT + XOS effectively controlled diarrhoea and alleviated clinical symptoms in patients with IBS-D, and was well tolerated., (© Author(s) 2019.)

Background: Bloating is a common symptom reported by around 16% to 31% of the general population. Functional bloating is diagnosed in patients with recurrent symptoms of bloating who do not meet the diagnostic criteria of irritable bowel syndrome or other functional gastrointestinal disorders., Methods: This double-blind, multicentre, randomised study compared the safety and efficacy of APT036 (xyloglucan plus tyndallized Lactobacillus reuteri and Bifidobacterium brevis ; Aprotecol ® ) and simethicone in treating functional bloating in adults. APT036 or simethicone were administered orally (3 times/day) for 20 consecutive days, with evaluations at baseline, and on Days 2, 10, 20 (end of treatment) and 30 (follow-up visit). The main outcome measure was safety. Efficacy was assessed at each visit by patient-reported symptom severity (Likert scale) and abdominal girth measurement. A hydrogen breath test was performed at baseline and Day 20., Results: Both APT036 (n=54) and simethicone (n=54) were well tolerated by study subjects; no adverse effects were reported with either treatment. Compared with simethicone, APT036 significantly reduced abdominal distension (P=0.008) and flatulence (P=0.010) from baseline to Day 30. The baseline hydrogen breath test confirmed the presence of small intestinal bacterial overgrowth (SIBO) in all subjects. At Day 20, mean hydrogen gas elevation was below the threshold for a diagnosis of SIBO (<12 ppm above basal on glucose administration) in both study arms., Conclusions: Both APT036 and simethicone had good safety profiles but APT036 was superior to simethicone in relieving symptoms of functional bloating., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.