Background: In patients with chronic kidney disease (CKD), many metabolites of gut microbiota retain in the body as uremic toxins (UTs). However, the kinds of bacteria producing UTs are rarely discussed. Methods: We analyzed UT production and the composition of gut microbiota in CKD rats and cecectomized rats. AST-120, a spherical carbon adsorbent, was administrated to evaluate how the precursors of UT affect gut microbiota. Serum and urine levels of UTs were quantified by liquid chromatography/electrospray ionization-tandem mass spectrometry. Gut microbiota were analyzed using 454-pyrosequencing of the 16S rRNA gene. Operational taxonomic unit (OTU) clustering and UniFrac analysis were performed to compare gut microbiota among the groups. Results: Serum and urine levels of indoxyl sulfate and phenyl sulfate were higher in CKD versus control rats (p < 0.05). AST-120 administration decreased UT production (p < 0.01) and changed overall gut microbiota composition in CKD rats. UT urinary excretion and gut microbiota composition changed in cecectomized rats, with the relative abundance of Clostridia- and Bacteroidia-affiliated species being significantly reduced (p < 0.01). We identified candidate indole- and phenol-producing intestinal microbiota, 3 Clostridia, and 2 Bacteroidia. These OTUs have a tryptophanase/tyrosine phenol-lyase gene in the closest sequenced genome out of the OTUs declined following cecectomy. Conclusion: Our data suggest that UT production is correlated with a subset of indigenous gut microbiota. However, UT may be induced by other non-symbiotic microbiota that are influenced by factors other than microbiota populations. The relationship between specific microbiota and UTs in patients requires further clarification.

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Abstract

Esse trabalho teve por objetivo avaliar a temperatura e a qualidade sanitária de alimentos servidos nos balcões de distribuição em restaurantes self-service no município de Taubaté (SP), com vistas à discussão da segurança alimentar. MétodosForam coletadas quatro amostras, sendo dois alimentos quentes e dois alimentos frios de 16 restaurantes; antes da coleta mediu-se a temperatura dos alimentos expostos nos balcões de distribuição. As amostras foram analisadas quanto aos seguintes parâmetros: contagem de bactérias aeróbias mesófilas, determinação de coliformes a 35ºC e a 45ºC, contagem de Staphylococcus coagulase positiva e detecção de Salmonella. ResultadosCinquenta e seis (87,5%) alimentos estavam em temperaturas inadequadas, alimentos frios expostos em temperaturas acima de 10°C e alimentos quentes abaixo de 60°C. Bactérias aeróbias mesófilas em contagem acima de 10 6 UFC/g foram detectadas em 11% das amostras e coliformes a 35ºC e coliformes a 45ºC foram detectadas em 76,6% e 43,7% das amostras, respectivamente. Dois alimentos, sendo um frio e um quente, provenientes de um mesmo restaurante, apresentaram contagem de Staphylococcus coagulase positivo acima de 10 4 UFC/g. Todas as amostras apresentaram ausência de Salmonella. ConclusãoA manutenção dos alimentos servidos, nos balcões de distribuição, em temperaturas abusivas e a presença de microrganismos indicadores de qualidade sanitária em número elevado comprometem a segurança e podem colocar em risco a saúde dos consumidores, em restaurantes self-service. Os instrumentos utilizados demonstraram-se como ferramentas importantes de avaliação da segurança das refeições servidas. Termos de indexação:Inspeção de alimentos. Qualidade de alimentos. Restaurantes. Segurança alimentar.

Aims/IntroductionTo compare pregnancy outcomes between women with gestational diabetes mellitus (GDM) diagnosed early and late in pregnancy in Japan.Materials and MethodsWe examined women diagnosed with GDM in this multi‐institutional retrospective study. Women were divided into two groups by gestational age at diagnosis: <24 weeks of gestation (early group, 14.4 ± 4.2 weeks) and ≥24 weeks of gestation (late group, 29.6 ± 3.4 weeks). Dietary counseling with self‐monitoring of blood glucose with or without insulin therapy was initiated for both groups. Pregnancy outcomes were compared between the groups.ResultsData from 600 early and 881 late group participants from 40 institutions were included. Although pre‐pregnancy body mass index was higher in the early group than in the late group, gestational weight gain was lower in the early group. Hypertensive disorders of pregnancy and cesarean section were more prevalent in the early than in the late group (9.3% vs 4.8%, P < 0.001; 34.2% vs 32.0%, P < 0.001, respectively). The prevalence of large‐for‐gestational‐age infants was higher in the late than in the early group (24.6% vs 19.7%, respectively, P = 0.025). There was no significant difference in other neonatal adverse outcomes between the groups. Multiple logistic regression analysis showed that early group, nulliparity and pre‐pregnancy body mass index were associated with hypertensive disorders of pregnancy.ConclusionsThese results suggest that maternal complications, including hypertensive disorders of pregnancy and cesarean delivery, were higher in the early group than in the late group. Earlier intervention for GDM might be associated with a reduction in large‐for‐gestational‐age infants.