The rapid scientific interest in gut microbiota (GM) has coincided with a global increase in the prevalence of infectious and non-infectivous liver diseases. GM, which is also called “the new virtual metabolic organ”, makes axis with a number of extraintestinal organs, such as kidneys, brain, cardiovascular, and the bone system. The gut-liver axis has attracted greater attention in recent years. GM communication is bi-directional and involves endocrine and immunological mechanisms. In this way, gut-dysbiosis and composition of “ancient” microbiota could be linked to pathogenesis of numerous chronic liver diseases such as chronic hepatitis B (CHB), chronic hepatitis C (CHC), alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), development of liver cirrhosis, and hepatocellular carcinoma (HCC). In this paper, we discuss the current evidence supporting a GM role in the management of different chronic liver diseases and potential new therapeutic GM targets, like fecal transplantation, antibiotics, probiotics, prebiotics, and symbiotics. We conclude that population-level shifts in GM could play a regulatory role in the gut-liver axis and, consequently, etiopathogenesis of chronic liver diseases. This could have a positive impact on future therapeutic strategies.

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OBJECTIVE: To examine differences in lung function among sports that are of a similar nature and to determine which anthropometric/demographic characteristics correlate with lung volumes and flows. METHODS: This was a cross-sectional study involving elite male athletes (N = 150; mean age, 21 ± 4 years) engaging in one of four different sports, classified according to the type and intensity of exercise involved. All athletes underwent full anthropometric assessment and pulmonary function testing (spirometry). RESULTS: Across all age groups and sport types, the elite athletes showed spirometric values that were significantly higher than the reference values. We found that the values for FVC, FEV1, vital capacity, and maximal voluntary ventilation were higher in water polo players than in players of the other sports evaluated (p < 0.001). In addition, PEF was significantly higher in basketball players than in handball players (p < 0.001). Most anthropometric/demographic parameters correlated significantly with the spirometric parameters evaluated. We found that BMI correlated positively with all of the spirometric parameters evaluated (p < 0.001), the strongest of those correlations being between BMI and maximal voluntary ventilation (r = 0.46; p < 0.001). Conversely, the percentage of body fat correlated negatively with all of the spirometric parameters evaluated, correlating most significantly with FEV1 (r = −0.386; p < 0.001). CONCLUSIONS: Our results suggest that the type of sport played has a significant impact on the physiological adaptation of the respiratory system. That knowledge is particularly important when athletes present with respiratory symptoms such as dyspnea, cough, and wheezing. Because sports medicine physicians use predicted (reference) values for spirometric parameters, the risk that the severity of restrictive disease or airway obstruction will be underestimated might be greater for athletes.

Background/aimTo assess and compare measured ventilatory volumes (forced expiratory volume in 1 s (FEV1), peak expirium flow (PEF) and maximal voluntary ventilation (MVV)), ventilatory function capacities (forced vital capacity (FVC) and vital capacity (VC)) and FEV1/VC ratio in a sample of power and endurance elite athletes and their age-matched and sex-matched sedentary control group.MethodsA cross-sectional study was applied on male elite athletes (n=470) who were classified according to the type of the predominantly performed exercise in the following way: group 1: endurance group (EG=270), group 2: power athletes group (SG=200) and group 3: sedentary control group (CG=100). The lung VC, FVC, FEV1, FEV1/FVC ratio, PEF and MVV were measured in all of the observed subjects, who were also classified with regard to body mass index (BMI) and the percentage of the body fat (BF%).ResultsThe CG had the highest BF% value, while the endurance group had the lowest BMI and BF% value, which is significantly different from the other two groups (p<0.05). The observed values of VC, FVC and FEV1 in the EG were significantly higher than those from the other two groups (p<0.05). There were no differences concerning the observed FEV1/FVC ratio.ConclusionsA continued endurance physical activity leads to adaptive changes in spirometric parameters (VC, FVC and FEV1), highlighting the fact that there is a need for specific consideration of different respiratory ‘pattern’ development in different types of sport, which also has to be further evaluated.

Swimmers had statistically higher values of VC, FVC, FEV1 and FEV1/FVC when compared to both the football players and the controls, as the latter two showed no in-between differences. There was significant positive correlation between age, body weight and body height and each of the above named pulmonary parameters, when presented separately for swimmers, football players and the control group. When controlled for the anthropometric features, larger lung volumes in swimmers were not influenced by training period, age at the beginning of training and weekly extent of personal training. Further comprehensive longitudinal studies are needed to confirm these observations.

The impact of chronic, intense exercise, such as in elite athletes, on phospholipids fatty acids (FA) composition has not been studied in women so far. This study aimed to investigate FA profiles in plasma and erythrocytes phospholipids in elite female water polo (N = 15) and football (N = 19) players in comparison with sedentary women. In spite of similar dietary patterns, as assessed by a food frequency questionnaire, plasma FA profile in the football players showed significantly higher proportions of stearic acid, oleic acid, and monounsaturated FA (MUFA), and significantly lower proportions of total and n-6 polyunsaturated FA (PUFA) than in the water polo and control group. The water polo players had higher percentages of palmitoleic acid and arachidonic acid than the control subjects. Erythrocyte FA profile differed among groups. We found significantly higher proportion of oleic acid and MUFA in the football group than in the controls, and decreased stearic acid and elevated palmitic and palmitoleic acid in the water polo players than in the other 2 groups. Both groups of athletes had significantly lower percentages of n-6 dihomo-γ-linolenic acid, n-6 PUFA, and total PUFA compared with the controls. The estimated activities of elongase and desaturases in erythrocytes were also altered in the athletes. Our results indicate that long-term, intense physical training significantly affects FA status of plasma and erythrocyte phospholipids in women. The observed differences between the water polo and the football players suggest that the type of regular training may contribute to the altered metabolism of FA, although possible genetic differences among the 3 study groups cannot be ruled out.

Research on possible physiological changes as a consequence of a specific lifestyle and long-term strenuous exercise in boxing has been sparse. We determined plasma and erythrocyte phospholipid (PL) fatty acids (FA) profile of 16 elite amateur male boxers (22.4±3.3 years of age), and compared them with a control group composed of 19 sedentary (24.4±3.4) year-old men. The percentages of total saturated fatty acids (SFA) and monosaturated FA in plasma phospholipids were significantly higher (P <0.001) in boxers compared to the control group. On the other hand, all studied polyunsaturated fatty acids (PUFA) in plasma PL with the exception of eicosapentaenoic acid (EPA, 20:5, n-3) and docosatetraenoic acid (DTA, 22:4, n-6) were significantly lower in boxers than in sedentary men. Total PUFA, n-6 PUFA and n-3 PUFA were also significantly lower in boxers (P <0.001), whereas the n-6/n-3 ratio was higher in boxers than in control group (P <0.01). Boxers had significantly higher proportion of all SFA in erythrocyte PL compared to the control group (P <0.05). In addition, the percentage of linoleic acid was lower in boxers' erythrocyte PL than in the control group (P <0.05). The results show two potentially unfavourable main features of the FA profile of boxers, that is, a higher n-6/n-3 ratio in plasma PL and a higher percentage of SFA in both plasma and erythrocyte phospholipids compared to controls. As SFA correlates directly with the incidence of cardiovascular disease and high n-6/n-3 ratio has been shown to stimulate carcinogenesis and modulate inflammation and autoimmunity, this profile could be detrimental to the health of boxers. The mechanism underlying these differences requires further investigation; however the results suggest benefits of nutritional intervention.

The authors aimed to investigate right ventricular (RV) and left ventricular (LV) remodeling in patients with white-coat hypertension (WCH) and sustained arterial hypertension. This cross-sectional study included 153 untreated patients who underwent 24-hour ambulatory blood pressure (BP) monitoring and complete two-dimensional echocardiographic (2DE) examination. Results showed that LV and RV longitudinal mechanics gradually deteriorated from controls to patients with sustained hypertension. Endocardial RV longitudinal strain was lower in WCH and hypertensive patients than in controls. Midmyocardial RV longitudinal strain was decreased in hypertensive patients compared with the other two groups, whereas subepicardial RV longitudinal strain was similar between the observed groups. Twenty-four-hour systolic BP was associated with 2DE global longitudinal LV and subendocardial RV strain. This study demonstrates that myocardial deformation of both ventricles is significantly impaired in patients with WCH and sustained arterial hypertension, and 24-hour systolic BP is associated with LV and RV deformation independent of cardiac structure. J Clin Hypertens (Greenwich). 2016;18:617-622. ª 2016 Wiley Periodicals, Inc.The definition of white-coat hypertension (WCH) has been a subject of debate in the past two decades.1 A recent study showed that persistent WCH is associated with elevated long-term cardiovascular mortality.2 Furthermore, investigators showed that WCH was associated with significantly higher cardiovascular mortality risk than prehypertension, even after adjustment for demographic and clinical parameters (age, sex, body mass index [BMI], smoking, fasting plasma glucose, and total cholesterol/high-density lipoprotein cholesterol ratio). 3The influence of WCH on cardiac remodeling, and especially on left ventricular (LV) functional and structural alterations, has been previously demonstrated.4-6 Our recent meta-analysis that included 1705 WCH patients confirmed the unfavorable effect of WCH on LV structure and function.7 However, not all investigators agree about the impact of WCH on LV remodeling. 8Thus far, right ventricular (RV) structure and function has not been evaluated in WCH patients. Considering the importance of RV dysfunction in the prediction of mortality in patients with different conditions (heart failure with/without preserved LV function, pulmonary hypertension, cardiomyopathies, heart valve disease, congenital heart disease), [9][10][11][12] it is necessary to understand why RV remodeling represents a potentially important part in a complex puzzle of target organ damage in WCH patients. Moreover, our previous investigations have demonstrated the negative influence of arterial hypertension and high-normal blood pressure (BP) on RV structure, function, and mechanics. 13,14Based on our previous findings regarding the significant inverse relationship between BP level and RV remodeling, we hypothesized that WCH could impact RV function and mechanics.The aim of the present study was to investigate ...