[The natural course of chronic HBV+HCV infection in children].

At the present time there is a growth in the number of children suffering from chronic viral hepatitis (CVH). The most difficult group consists of patients with mixed-hepatitis, which is associated with a more rapid progression of the disease and the formation of cirrhosis of the liver. The paper presents the data of long-term monitoring of children with chronic hepatitis B+C (CH B+C); it demonstrates the features of a clinical course, the nature of the biochemical, immunologic, and morphologic changes in the natural course of the disease.

[A case report of Byler's syndrome].

The case report describes a progressive familial intrahepatic cholestasis II type Byler's syndrome with structural abnormality of the bile canalicular membrane. A child with a rare hereditary pathology,who is on the waiting list for liver transplantation, on the background of complex treatment, including diet therapy, drug therapy achieved a positive dynamics of clinical and laboratory parameters, acceleration of physical, psychomotor and intellectual development, that in general has improved the surgery prognosis and quality of life of the patient.

[Functional performance of the cardiovascular system in patients with overweight and obesity].

Was investigated 471 patients with obesity and cardiovascular diseases. Direct dependence between degree of expressiveness of obesity and the clinical status, severity of infringement of a functional condition of cardiovascular system, frequency of development of complications is revealed.

[Influence of a low-calorie diet with inclusion of probiotic product containing bacterias Lactobacillus plantarum Tensia DSM 21380 on clinical and metabolic characteristics in patients with obesity and arterial hypertension].

In a number of studies it is shown that regular use of the probiotic products containing Lactobacillus plantarum Tensia DSM 21380 in complex dietary treatment, not only modulates intestinal microflora, but also has a positive influence on a functional condition of cardiovascular system including levelels of systolic and diastolic blood pressure. The aim of this research was to study the influence of dietotherapy with inclusion of the probiotic product containing Lactobacillus plantarum Tensia DSM 21380, on clinical and metabolic characteristics in patients with obesity and accompanying arterial hypertension (AH).

[Elastography efficiency in the liver fibrosis determination in patients with nonalcoholic fatty liver disease].

INTRODUCTION: Liver stiffness measurement (LSM) is a noninvasive and reliable method for the indirect evaluation of liver fibrosis, but it may be less effective in case of nonalcoholic fatty liver disease (NAFLD). AIM. To evaluate the relation between LSM and antropometric measurements - waist-hip ratio (WHR), proportion of excess of fat in body composition (%EFM), body mass index (BMI), insulin resistance index (HOMA IR), serum cholesterol an activity of ALT and AST. METHODS: The antropometric sudies, bioimpedance analysis (ABC01-036, Medass, Russia), blood chemistry (Konelab 30i, Finland), and liver stiffness measurements using FibroScan (EchoSens, France) equipment were performed to 234 NAFLD patients. The availability of the LSM was estimated on the basis of calculation the proportion of patients with successive LSM (22 measurements, success rate no less then 30%). Correlation between LSM results and main studied parameters was evaluated by Spearman rank R correlation method. RESULTS: Availability of LSM in NAFLD patients was 52.56%. We found strong correlation between the availability of LSM and BMI (R = -0.28, p = 0.00002). In patients with NAFLD were found direct correlations between LSM and HOMA (R = 0.33, p = 0.0002) and %EFM (R = 0.2, p = 0.034). In patients with simple steatosis there was no correlation between LSM and studied parameters. In NASH patients the results of LSM correlated with HOMA-IR (R = 0.41, p = 0.0004), % EFM (R = 0.3, p = 0.01), WHR (R= 0.3, p = 0.01), and BMI (R = 0.32, p = 0.01). CONCLUSIONS: The diagnostic availability of liver stiffness measurement correlate with body mass index and goes up to 52.56%. In NAFLD patients there is strong correlation between LSM and results HOMA-IR (R = 0.33, p = 0.0002), and medium correlation with % EFM (R = 0,2, p = 0,034).

[Influence of hypocaloric diet with addition of a vitamin-mineral complex on status of patients with obesity 1st and 2nd degrees].

Addition of a vitamin-mineral complex (VMC) to a standard hypocaloric diet leads to a positive dynamics of antropometric characteristics in patients with obesity 1st and 2nd degrees which is comparable to effectiveness of standard dietotherapy (dietary treatment) traditionally used in complex treatment of obesity. Addition of 1,8 mg of vitamin B2 as part of VMC to a hypocaloric diet is shown to be inadequate in eradication of marginal provision of riboflavin when using diets reduced in calories.

[Definite of nutritional status in patients with metabolic syndrome with the use of modern methods of nutrimetabolomica].

A comprehensive assessment of nutritional status in 73 patients with metabolic syndrome was assessed. The consumption food pattern of the majority of examined patients have had increased energy intake with excessive fat consumption inadequate intake of complex carbohydrates. In patients with type 2 diabetes inadequate compensation of carbohydrate and lipid metabolism was marked. When assessing body composition method bioelectrical impedance analysis increased content of adipose tissue was revealed are positively correlated with insulin and tumor necrosis factor-alpha. According to indirect calorimetry, increase in the level of resting energy expenditure, reducing the rate of oxidation of fat, increase the rate of oxidation of protein and carbohydrates was noted.

[The efficacy of transient liver elastography overweight patients with chronic liver diseases].

UNLABELLED: Transient elastography (TE) allows evaluating the liver fibrosis stage indirectly and noninvasively. High correlation between results with liver fibrosis stage was shown previously. It was suggested that availability and reproducibility of the method is low in patients with excessive. AIM: To evaluate availability, reproducibility and diagnostic accuracy of transient elastography in patients with different body mass index (BMI) and liver fibrosis stage. MATERIALS AND METHODS: Two hundred patients with chronic liver diseases (predominantly with chronic hepatitis C, n = 135) were enrolled. Among them 100 were included to the group with BMI > or = 25 kg/m2 (M +/- m 29,58 +/- 3,7 kg/m2) and 100 patients with BMI < 25 kg/m2 (M +/- m 22,07 +/- 2,1 kg/m2). Liver stiffness measurements were performed using FibroScan (EchoSens, France), M-type probe. Metavir grading score was used to estimate liver fibrosis stage. Availability of TE was assessed by counting the proportion of patients with successful examination (22 measurements, success rate > 30%) per group. The reproducibility of TE was studied by counting intra-observer agreement (correlation between results of two series by 11 measurements obtained during examination of the patient) and inter-observer agreement between the results of examinations of the patient by two independent skilled operators obtained on the same day. Diagnostic accuracy was estimated using concordance of the results of liver histology and TE with following cut-off values: 5.8 kPa for F0, 7.2 kPa for F2, 9.5 kPa for F3 and 12.5 kPa for F4. RESULTS: Availability of TE was lower for patients with BMI > or = 25 kg/m2: 87,13% vs 99% (BMI < 25 kg/m2), p < 0,05. Intra-observer agreement was excellent and did not differ between both studied groups: 0.986595% CI [0.9794-0.9911] for the group with BMI > or = 25 kg/m2, and 0.990095% [0.9851 -0.9931] for patients with BMI < 25 kg/m2, p = 0.3122. Inter-observer agreement was higher for group with BMI > or = 25 kg/m2 (0.987, 95% CI [0.981 -0.990]) then in group with BMI < 25 kg/m2, p = 0.037. The diagnostic accuracy did not differ between groups with excessive weight compared to the BMI < 25 kg/m2 group related to liver fibrosis stage: 65.4% vs. 72.2%, p = 0.59 for F0, 68.1% vs. 70.5%, p = 0.84 for F1, 75.2% vs. 82.1%, p = 0.65 for F2, 84.1% vs. 88.8%, p = 0.76 for F3, 92.2 vs. 94.4, p = 0.85 for F4, accordingly. CONCLUSION: The availability of TE is lower for patients with an excessive weight. TE is highly reproducible method. The diagnostic accuracy of TE with taken cut-off values was fair and did not differ between both weight groups.

[Influence of vitamin and mineral complex on clinical and metabolic indexes and vitamin status of patients suffering from type 2 diabetes].

Provision of vitamins in patients with type 2 diabetes has been investigated. It has been shown that in substantial examined patients the decrease of vitamins C, B2 and beta-carotene provision has been observed. Inclusion of vitamin-mineral complex (300% of RDA) during 3 weeks was accompanied improvement of vitamins C and beta-carotene, as well as was prevented worsening B2 provision.

[Assessment of nutritional status of patients in the later period after renal transplantation].

This article summarizes the modern approach for estimation of nutritional status (medical history, anthropometric, clinical and biochemical measures) in patients in the late period after kidney transplantation. It is showed that main complications in the late posttransplant period (cardiovascular diseases, diabetes, obesity, malnutrition) determine the need of complex assessment of nutritional status in these patients with the object of improve outcomes after transplantation.

[Influence of specialized carbohydrate protein product enrich vitamins and minerals status of patients with gastrointestianals pathology and osteopenia].

It has been shown that inclusion of the specialized product containing 50% from recommended daily consumption of calcium, 20% of protein, 17-60% of 11 mineral substances and 11 vitamins in the diet of patients suffering from diseases of gastroenteric tract and osteopenia within 6 months lead to increasing of bone mineral density while it has not liquidated the existing vitamin B2 and vitamin D deficiency. The data obtained confirm the expediency of the development of specialized products of the set chemical composition intended for a concrete category of patients, and their inclusion in the diet.

[The system of multilevel diagnostics and corrections of nutrition status disorders in the patients with cardiovascular diseases].

As is known, the pathology of cardiovascular systems depends on nutrition and occupies leading positions in structure general morbidity and mortality of the population of Russian Federation. The system of nutritional and medical aids--"Nutritest" and "Nutricor", represent the technology of diagnostics of infringements the status of nutrition, estimations of risk of development of cardiovascular diseases, and ways of their high-grade correction.

[Influence of hypocaloric diet with supplemented biologically active substances with antioxidant activity on clinicometabolic parameters in type 2 diabetes mellitus patients].

It was investigated the influence of a diet with supplemented biologically active substances (catechins, flavanols and other) with antioxidant activity on dinamics clinicometabolic parameters in type 2 diabetes mellitus patients. It was shown that inclusion of biologically active addition as the source of catechins, flavanols and other polyphenols in complex of treatment in type 2 diabetes mellitus contributes to increase hypotensive, hypoglycemic, hypolipidemic and antioxidant efficacy dietary therapy.

[Alimentary risk factors of osteoporosis].

The data on of alimentary risk factors of osteoporosis have been observed. The frequency of decreased bone mineral density, vitamin and calcium diet content and sufficiency with vitamins evaluated by means of blood serum level determination among patients suffering from chronic diseases (of cardiovascular system, gastrointestinal tract, osteopenia and osteoporosis).

[Current views of nutritional therapy].

Epidemiologic studies in the Research Institute of Nutrition showed that dietary patterns of the Russian population are on the whole at variance with the balanced feeding formula largely due to excessive consumption of animal fat, insufficient consumption of proteins, vitamins, micro- and macroelements, polyunsaturated fatty acids, and dietary fibers. It is estimated that over 70% of total lethality in this country is due to diseases directly related to improper feeding (the so-called alimentary-dependent diseases), cardiovascular disorders, some neoplasms, diabetes mellitus, etc. Dietary therapy adjusted to specific pathogenetic features, clinical picture, stage of the disease, character of metabolic disorders in individual patients is an important factor having versatile beneficial effects on the patient's health, correcting metabolic problems, and improving quality of life. Decree No 330 of August 5, 2003 "On measures to improve nutritional therapy in medical institutions of the Russian Federation" introduced a new nomenclature of standard diets based on chemical composition of separate foods and the previously used system of numbered diets. Modern dietary therapy includes not only standard and special diets but also specific products to be used in concrete clinical conditions, enteral and parenteral nutrition, biologically active food additives, etc.

[Role of alimentary factor in correction of the main features of the metabolic syndrome. Modern approaches to dietary].

In review the role of alimentary factors in the correction of main features of the metabolic syndrome is presented. The data on influence of body weight reduction, lifestyle changes on such as the features of metabolic syndrome insulin resistance, arterial hypertension, abnormalities of carbohydrate meabolism are discussed. Also in the article describes the basic approaches to the dietary therapy in metabolic syndrome.

[Principles of dietotherapy in patients with long-term renal transplantation].

In this review role of clinical nutrition of the some components of dietotherapy in correction metabolic parameters and in decrease of complication risk (cardiovascular disease, type 2 diabetes, osteoporosis and other) in patients with long-term renal transplantation is discussed.

[Dietary correction of nutrition status in patients with metabolic syndrome].

Effectivity was studied of a low-caloric diet in patients with metabolic syndrome. Results of the study show that enrichment of a low-caloric diets in patients with metabolic syndrome improved clinic status, antropometric levels, metabolism and lipid spectrum of blood.

[Evaluation of inclusion of specialized carbohydrate-protein product with vitamins and mineral substances in the diet therapy of gastrointestinal and osteopenia diseases].

It has been shown that inclusion of the specialized product containing 50% from recommended daily consumption of calcium, 20%--of protein, 17-60%--of 11 mineral substances and 11 vitamins in the diet of patients suffering from diseases of gastroenteric tract and osteopenia within 6 months lead to increasing of bone mineral density while it has not liquidated the existing vitamin B2 and vitamin D deficiency. The data obtained confirm the expediency of the development of specialized products of the set chemical composition intended for a concrete category of patients, and their inclusion in the diet.

[Vitamin and beta-carotine sufficiency of patients suffering from type 2 diabetes].

Provision of vitamins in patients with type 2 diabetes has been investigated. It has been shown that in substantial examined patients the decrease of vitamins C, B2, beta-carotene provision has been observed. Obtained results are evidence about a need of the optimization of vitamin status in patients with type 2 diabetes.