[Clinical efficacy instant goat milk in the complex therapy and prevention of osteoporosis in patients with rheumatoid arthritis].

Osteoporosis (OP) in rheumatoid arthritis (RA) refers to a secondary immune-mediated metabolic osteopathy characterized by periarticular and systemic decreased bone mass, impaired bone strength and increased risk of fractures. According to some studies, adding milk in the diet helps to increase bone mineral density and to reduce the risk of osteoporosis and maintain normal levels of vitamin D. To study the state of mineral and bone metabolism in RA patients zeith osteopenic syndrome and to evaluate the effectiveness of treatment and prevention of OP by adding dry goat milk "Amalteya" in the diet. The study included 42 patients with a documented diagnosis of RA (ACR, 1987) - 23 men (mean age 59 years) and 19 postmenopausal women (mean age 62 years) with the presence of osteoporosis and osteopenia according to the dual-energy X-ray absorptiometry. 21 (50%) RA patients (main group) received standard antiosteoporotichesky (alendronate 70 mg/week + calcium 1000 mg/day + Vitamin D3 800 IU/day) therapy and milk powder Amalteya® (400 ml/day). The control group (21 patients with RA) received only standard antiosteoporotic therapy. Follow-up lasted for 6 months. The concentration of total calcium in the blood of RA patients was on average 2.33 mmol/l, ionized Ca - 1,18 mmol/l and inorganic P - 1,09 mmol/l, which corresponds to normal values. Vitamin D deficiency was found in 17,5% of patients, and failure - in 32,5% of patients with RA. After 6 months of the treatment it was found that b-CrossLaps levels tend to be reducing in both of the groups and with reduction of bone formation marker osteocalcin in the group not receiving goat milk. Also, due to the background of ongoing combinative therapy it was clear that concentrations of 1,25(OH)2D and 25(OH)D in the blood serum are increasing (by 18,5-28,2% at the main group and by 8,0-17,9% at the control group), however, inter-group differences was below the level of the reliable importance. It was strongly marked in the group who received goat's milk "Amalteya®". Reduced levels of vitamin D in the blood is typical for 50% of RA patients with osteopenic syndrome with normal values of calcium-phosphorus metabolism. Combination therapy and prevention of osteoporosis in patients with RA with an additional inclusion in the diet of the daily administration of 400 ml of goat's milk Amalthea® has a positive impact on bone metabolism.

[Defects of neutrophil function in chronic gastroduodenitis in children].

At present, chronic gastroduodenitis (CGD) occupies one ofthe leading places in the structure of diseases of the gastrointestinal tract in children. In the etiology of CGD, along with the leading pathogenic Helicobacterpylori (HP), the role of the fungal flora increased. The aim of the work was to evaluate the functional activity of neutrophils in children with the CGD, associated with HP and Candida albicans. Among 110 children in the age from 7 to 17 years with chronic gastroduodenitis, associated with Helicobacter pylory(HP), as well as the association of HP with Candida albicans and the markers of secondary immune insufficiency, a study of the phagocytic activity and immune phenotype of neutrophils by flow cytofluorimetry was conducted. Differentiated peculiarities of the phagocytic activity of neutrophils in association with bacterial pathogens (HP) and fungal flora were identified. The transformation of the immune phenotype was combined with a significant depression of the phagocytic and microbicidal functions, more pronounced with the association of HP and Candida albicans. Circulating mannano protein antigen of Candida albicans influenced on the surface of phenotype of neutrophils, increasing the expression of protopathic and HLADR-receptors, and decreasing the expression of adhesion receptors and cytolysis. Thus, in case of chronic gastroduodenitis in children, there was a considerable transformation of the phenotype of neutrophil with differentiated characteristics at the association with bacterial (HP) pathogens and fungal flora. The obtained data should be taken into account when carrying out medical activities, and the doctors should include in the composition of complex therapy of CGD, associated with Candida albicans, drugs, aimed at immunocorrection of the identified violations

[Prevalence and risk factors of gastroduodenal and biliary system diseases in infants and preschool children].

To study the prevalence and risk factors of digestive diseases in children performed continuous screening questionnaire 786 children from 1.5 to 7 years. Were Revealed that 47.1 +/- 3.5% of children have symptoms of diseases of the gastrointestinal tract and biliary system. This symptoms occur in children aged 4 to 7 years in 2.3 times more frequently than in children from 1.5 to 3 years. In-depth study was revealed that the frequency of biliary dyskinesia (BD) was 33 +/- 3.3%, chronic gastritis (CG) and gastroduodenitis (CGD)--6.2 +/- 1.8%, chronic cholecystitis--4.2 +/- 1.4%, functional disorders of the stomach (FSD)--2.8 +/- 1.2%, and peptic duodenal ulcer (DU)--0.3 + 0.4%. In the structure of digestive diseases in children from 1.5 to 7 years on the 1st place are BD--70% on the 2nd--CG and CGD--14.7% on the 3rd chronic cholecystitis--8.9%, on the 4th FSD-5.9% and 5th place DU-0.5%. For dispensary observation in the children's clinic with digestive diseases consist of only 7.9 +/- 1.9% of children, which is 5.9 times lower than according to the active diagnostics data. The leading medical and social risk factors and their complex influence on the formation of digestive disorders in infants and preschool children.

[Subpopulations and phagocytic activity of monocytes in chronic gastroduodenitis in children].

There was conducted a study of the phagocytic activity, immunophenotype and peripheral blood monocytes by flow cytometry in children with chronic gastroduodenitis associated with Helicobacter pylori, as well as the association of Helicobacter pylori with fungi of the genus Candida and markers of secondary immune deficiency. The differential changes in the structure of circulating profile of monocytes were revealed, that indicate the pathogenetic significance of these disorders in chronic gastroduodenitis with H. pylori etiology, as well as at association of Helicobacter pylori with fungi of the genus Candida. Violations of the phagocytic activity of monocytes in chronic gastroduodenitis in children are associated with depression of different stages of phagocytosis--capture functions, mobilization, killing, intracellular biocidity. A severe depression in phagocytic activity of monocytes occurs in CGD associated with Hp and fungi of the genus Candida.

[Prevalence and risk factors of gastroduodenal and biliary system diseases in infants and preschool children].

Gastroduodenal pathology, functional disorders and inflammatory diseases of the biliary tract take leading position among the diseases of the digestive system in children. Precisely these clinical forms are more intensive then other nosology. Continuous screening questionnaire of 786 children aged 1.5 to 7 years was carried out to study the prevalence and risk factors for diseases of the digestive system in children. Based on retrieved data was determined that 47,1 +/- 3,5% of children had symptoms of gastro-intestinal tract and biliary system diseases. They met 2.3 times more often in children aged 4 to 7 years, than in children from 1.5 to 3 years old. Immerced examination revealed that the incidence of dyskinesia of the biliary tract was 33 +/- 3,3%, chronic gastritis (CG) and gastroduodenitis (GDD)--6,2 +/- 1,8%, chronic cholecystitis--4,2 +/- 1,4%, functional disorders of the stomach (FGD)--2,8 +/- 1,2% and duodenal ulcer (DU)--0,3 +/- 0,4% of cases. In the structure of digestive diseases in children from 1.5 to 7 years in the first place were DBT--70%, the second--CGD and CG--14.7%--the third chronic cholecystitis--8.9%, the fourth--FGD--5.9% and in fifth place--DU-0.5% of cases. At the care record in the pediatric clinic with diseases of the digestive system were registered only 7,9 +/- 1,9% of children, which is 5.9 times lower accordinig to data of active diagnostic. The leading medical and social risk factors and their complex influence on the formation of digestive diseases in infants and preschool children.

[Peculiarities of diet therapy in children with duodenal ulcers associated with the genus Candida].

In children with relapsing DU in 50.8% cases there is a complicated disease course with Candida infection, as evidenced by the positive results of mycological examination of biopsy specimens of duodenal mucosa and detection of circulating Candida antigen in serum. The use in the complex therapy in children with DU associated with Candida species of instant New Zealand goat milk "Amalteya" leads to an overall therapeutic effect in 81.3% cases, which is manifested in the reduction of the duration of relapse 1.4 times prolongation of remission in 3 times and milder disease. Carried out in the dynamics fibrogastroduodenoscopy after treatment showed that 100% of the observed total endoscopic remission which is manifested in the disappearance of opalescent gray overlay on the bottom of the ulcer and ulcer epithelization.

[New way in dietotherapy of infants with food allergy]. / Novyi podkhod k dietoterapii detei s pishchevoi alergiei.

The authors followed up (in outpatient conditions) a total of fifty 1-to-9-mounth-old infants with the diagnosis of atopic dermatitis, disseminated form, of subacute course. The infants were followed up for 3-12 months, with 83% of the 113 examined patients 1-3 weeks after the beginning of treatment having shown clinical improvement of cutaneous inflammatory processes. Of the 172 infants subjected to immunological examination, in 100--the level of total IgE in blood serum was significantly elevated. These children also had elevated level of the specific IgE antibodies to cow's milk proteins. The outcomes of the carried out dietotherapy using mixture "Nanny" showed that this therapeutic product resulted in remission in the majority of the followed up infants suffering from allergy to cow's milk proteins.

[Vitamin B 6 metabolism in phenylketonuria]. / Osobennosti obmena vitamina B-6 pri fenilketonurii.

Based on the analysis of the dependence of 4-pyridoxic acid urinary excretion from pyridoxal-5'-phosphate blood plasma level and its statistic distribution it has been shown that vitamin B-6 metabolism in children suffering from phenylketonuria and therefore the criteria of the body saturation with this vitamin differ from those for healthy people. Increased pyridoxal-5'-phosphate blood plasma level has been demonstrated for PKU children. The concentration of 11 ng/ml should be considered as a bottom border of the adequate supply with vitamin B-6. The elevated vitamin B-2 intake approximates vitamin B-6 status indexes of sick children to those usually measured in healthy children. The necessity for the reevaluation of vitamin B-2 and B-6 optimal diet content under this disease and its biochemical validation are discussed.

[Metabolism of vitamins B1 and B2 during phenylketonuria]. / Obmen vitaminov B1 i B2 pri fenilketonurii.

Vitamin level in blood plasma and erythrocytes and a rate of urinary excretion of vitamin metabolites were analysed in children suffering from phenylketonuria. It has been shown that vitamin B1 metabolism and therefore the criteria of the adequate sufficiency with this vitamin does not differ from those for healthy people. Increased riboflavin urinary excretion under its decreased plasma and erythrocyte levels has been demonstrated for PKU children. In consequence of this the indexes of sufficiency significantly differ from those of the healthy adequately supplied with this vitamin children and are equal to 4 ng of riboflavin per 1 ml of blood plasma and its urinary excretion more than 50 mg/h. The necessity for the redetermination of vitamin B2 diet optimal content under this disease and its biochemical validation are discussed.

[Effects of vitamin D metabolites on indicators of protein, phosphorus and calcium metabolism in children with chronic renal failure]. / Vliianie metabolitov vitamina D na pokazateli belkovogo i fosforno-kal'tsevogo obmena u detei s khronicheskoi pochechnoi nedostatochnost'iu.

Amino acid analysis and investigation of nitrogen, calcium and phosphorus balance were done in two groups of patients with renal failure and osteodystrophy on vitamin D metabolites and analogues treatment. The results of the investigation confirm vitamin D metabolites influence on free amino acid metabolism and on nitrogen, calcium, phosphorus balance. We observed significant decreases of blood amino acids and good influence on renal osteodystrophy in patients treated with vitamin D metabolites. Vitamin D metabolites didn't influence retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure.

[Comparative study of special products "Tetraphen" and "Phenyl-free" in diet therapy of children with phenylketonuria]. / Sravnitel'naia otsenka ispol'zovaniia spetsializirovannykh produktov "Tetrafen" i "Fenil-fri" v dietoterapii detei, bol'nykh fenilketonuriei.

Basing on the comparative clinical and biochemical evaluation of the usage of the specialized product "Tetraphen" (Russia) and early utilized product "Phenyl-Free" (USA) it has been shown that "Tetraphen" does not yield to "Phenyl-Free", while some of its parameters (energy value, carbohydrate content) even in the higher degree correspond to the physiologic requirements of this aged children suffering from phenylketonuria. Intake of this product in smaller doses completely covers their requirements for the basic food ingredients. High frequency of carotenoids insufficiency in children received both "Tetraphen" and "Phenyl-Free" demonstrate necessity of the diet correction by means of beta-carotene additional supplementation.

[Effect of vitamin D metabolites on the markers of protein, calcium and phosphorus turnover in children with chronic renal failure]. / Vliianie metabolitov vitamina D na pokazatelibelkovogo i fosforno- kal'tsievogo obmena u detei s khronicheskoi pochechnoi nedostatochnost'iu.

Amino acid analysis and investigation of nitrogen, calcium and phosphorus balance were done in two groups of the patients with renal failure and osteodystrophy on the Vitamin D metabolites and analogues treatment. The results of the investigation confirm vitamin D metabolites influence on free amino acid turnover and on nitrogen, calcium, phosphorus balance. We observed significant decreases of blood amino acids and good influence on renal osteodystrophy in patients treated with the vitamin D metabolites. Vitamin D metabolites didn't influence on the retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure.

[Effects of vitamin D on protein turnover in children with renal osteopathy]. / Vliianie vitamina D na pokazateli belkovogo obmena u detei s renal'nymi osteopatiiami.

Amino acid analysis and investigation of nitrogen balance were done in 2 groups of the patients with renal failure and osteodystrophy on the diet and vitamin D treatment. The results of the investigations confirm vitamin D influence on free amino acid turnover. We observed significant elevations of plasma amino acids in patients treated with the diet and vitamin D in comparison with the patients without vitamin D supplementation. Vitamin D didn't influence on the retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure

[Standards of hourly excretion of B group vitamins with urine for children aged 9 to 13 years]. / Normy chasovoi ékskretsii s mochoi vitaminov gruppy V dlia detei 9-13 let.

Values of hour excretion of vitamins B1, B2, B6 and PP with urine in children of 9-13 years, studied under conditions of normal consumption of these vitamins, were estimated considering the correlation between the vitamins B concentration in blood and excretion of their metabolites with urine as well as using these parameters dependence on content of the vitamins in daily ration; for this purpose 35 adult persons and 31 children of both sexes were examined. Normal rate of riboflavin excretion with urine constituted 10-11 micrograms/h in children of this age, while of thiamine-11-12 micrograms/h. Under conditions of normal thiamine consumption, activity of erythrocyte transketolase, measured after preinactivation of transaldolase, exceeded 35 mumol/h/I ml of erythrocytes. Rates of excretion with urine of 4-pyridoxic acid and I-methyl nicotinamide were similar both in children and in adult persons and were equal to more than 40 micrograms/h and 400-600 micrograms/h, respectively.

[Calcium homeostasis and calcium-regulating hormones in young children with phenylketonuria]. / Sostoianie kaltsievogo gomeostaza i kaltsiireguliruiushchikh gormonov u detei rannego vozrasta, bolnykh fenilketonuriei.

Calcium and calcium-regulating hormones were investigated in 19 infants with phenylketonuria. Parathyroid hormone, osteocalcin, dehydrocholecalciferol were found elevated while calcitonin reduced in the serum of the infants prior to the diet. Total calcium and phosphorus remained stable in the course of the study. Element diet resulted in reduced serum parathormone levels though surpassing those of healthy subjects. This fact is attributed to primary metabolic disorders responsible for the onset of hyperparathyroidism. The conclusion is made that element diet is unable to change calcium homeostasis and that of calcium-regulating hormones in infants with phenylketonuria.

[The amino acid spectrum of plasma and erythrocytes in children with kidney diseases at the stage of chronic kidney insufficiency]. / Aminokislotnyi spektr plazmy i éritrotsitov pri bolezniakh pochek v stadii khronicheskoi pochechnoi nedostatochnosti u detei.

The effect of diets with varying protein restrictions on the amino-acid spectrum of plasma and erythrocytes was studied in 46 children with total chronic renal insufficiency (CRI), stages I and II, resultant from tubulo-interstitial diseases of the kidneys and glomerulonephritis. Qualitative and quantitative changes in the spectrum of blood amino acids are recorded at the initial stage of CRI and depend on the degree of protein restriction in the diet. The diet with a sharp protein restriction (Giordano-Giovanetti type) produces hypoazotemic effect and possesses anabolic properties. Disorders in amino-acid metabolism serve indications for using essential amino acids and their ketoanalogues in children with uremia.

[Exocrine function of the pancreas in children]. / Sostoianie vneshnesekretornoi funktsii podzheludochnoi zhelezy u detei.

Thirty-three children were followed up. There were 14 girls and 7 boys with constitutional-exogenous obesity and 12 normal children. To study proteolytic function of the pancreas, the activity of trypsin was determined by the Erlanger method modified by V.A. Shaternikov and that of its inhibitor in the blood serum by the Haverback et al. method modified by V.A. Shaternikov . Activation of trypsin and its inhibitor, depending on the degree of obesity was discovered. Activation of trypsin inhibitor points to the preservation of the compensatory possibilities of the pancreas in children with constitutional-exogenous obesity. Therefore, it is desirable that a complex of different measures should include wise dietetics promoting the normalization of disturbed processes in pathology under consideration.