[Immune status estimation algorithm in irritable bowel syndrome patients with food intolerance].

OBJECTIVE: To develop an algorithm for evaluation of the immune status in IBS patients with food intolerance. MATERIALS AND METHODS: 42 patients with IBS were observed. The diagnosis is based Rome III criteria. Determination of the concentration of serum allergen-IgG-antibodies to food allergens, IgG, IgA, IgM, IgE and immunoregulatory substances IL-5, TGF ß1, IL-10, IL-4 IL-2, IL-13 were determined by enzyme immunoassay. All the patients received rotational diet therapy based on immunoassay data in addition to medical treatment of the basis disease. The control group comprised 15 healthy individuals. RESULTS: Food intolerances basically to foods proteinaceous was diagnosed in 25 patients with IBS (59.5% of cases). The effectiveness of diet therapy was 68% (17 patients). Analysis of clinical and laboratory data revealed that the implementation of food intolerance in patients with IBS reducing the levels of IL-10 and TGFß1. An effective rotational diet of food intolerance in IBS patients had significantly (p < 0.05) increase IgA levels. CONCLUSION: Food intolerance in IBS patients characterized an increased synthesis of allergen-specific IgG antibodies, insufficient production of anti-inflammatory immunoregulatory substances IL-10 and TGFß1, and intact cytokines IL-2, - 4, - 5, - 13, IgG and IgM in serum. Efficiency rotary diet in patients with IBS is accompanied by positive clinical dynamics, increase levels of anti-inflammatory substances and serum IgA.

[Normal values for high-resolution anorectal manometry in a healthy women: effects of age and maternity].

BACKGROUND: High-resolution manometry (HRM) is increasingly used in the evaluation of anorectal disorders. However, the normal values of HRM have not been widely evaluated. Anorectal pressure patterns are known to be possibly influenced by maternity status in women, but the normal values of HRM in parous and non-parous asymptomatic women have not been studied. The aim of the present study was to evaluate, for the first time, the normal values HRM in asymptomatic parous and non-parous women. METHODS: Sixteen asymptomatic healthy females (age: 18-63 years) were enrolled into this study, and among them, 11 were parous women. HRM was performed using solid-state manometric assembly with 9 circumferential pressure sensors (MMS, Netherlands). Measurements of external and internal anal sphincter pressure at rest, during voluntary contraction and during rectal balloon distension were compared.. RESULTS: In asymptomatic parous women mean external anal sphincter resting pressure (69.9 ± 13.2) was significantly lower then anal pressure (101.2 ± 22.9) in healthy non-parous women. No differences were found between groups in internal sphincter pressure, voluntary contraction or during balloon distension. CONCLUSIONS: The found difference in resting external sphincter pressure between parous and non-parous women have to be taken in account when HRM is used for evaluation of functional defecatory disorders. Further studies for establishing of normal values of anorectal HRM in larger group of healthy controls are badly needed.

[Nutritional status in patients after gastrectomy due to gastric cancer].

UNLABELLED: Aim of the study was to evaluate nutritional status in patients after gastrectomy due to gastric cancer. METHODS: In 55 (26 males and 29 females) gastric cancer patients after gastrectomy body composition (bioimpedansometry method); resting energy expenditures and home actual nutrition (frequency analysis method) were evaluated. Blood levels of major nutrients and metabolites were assessed. RESULTS: Both men and women suffered from weight loss after gastrectomy (mean BMI was 19,8+/-4,7 kg/m2 in men and 20,5+/-1,9 in women). Higher BMI was positively correlated with age in women (R=0,45; p<0,03), but not in men, however there was no difference in mean age and mean time after gastrectomy between men and women. Mean body fat mass significantly decreased in men (7,4+/-5,0 kg) and in women (12,0+/-7,1 kg) in compare to normal values (18,2 and 22,5 correspondingly) (p<0,001). Resting energy expenditure variably decreased (for 13-53%) in half of the patients, mainly due to decrease in lipid oxidation rate. Mean daily energy intake was lower than normal in short-term (1359 kcal in period of 12 months) and long-term (1814 kcal in 1-5 years period) after gastrectomy, due to decrease consumption of proteins, carbohydrates and fat. Mean blood total protein, hemoglobin and hematocrit levels were lower than normal values in 40% of patients. CONCLUSION: In gastric cancer patients low BMI, low fat mass and energy consumption are observed even long period of time after gastrectomy. Dietary counseling and support are badly needed in patients short-term as well as long-term period after gastrectomy in men and younger women.

[Dietotherapy of patients with anorexia nervosa and eating disorders in inpatient clinic].

We assessed a nutritional status of patients with anorexia nervosa, theirs metabolical indicators and body structure with the use of bioimpedometry. Also we assessed a basal metabolic rate patients with anorexia nervosa with the use of indirect calorimethry method. We developed an algorithm of dietotherapy of patients with anorexia nervosa. In dependence of expressiveness degree of metabolical disorders of patients we suggested three different food allowance with different caloric content and different chemical compound of the food. The results show us the improvement of status of patients: their activity have risen up, mood have stabilized, anxiety have decreased, appetite have taken a turn for the better and their weight have stabilized too.

[Nutrition management of cancer patients after surgery on the esophagus and stomach: modern view on problem].

The review discusses the problem of cancer patients' nutrition, the data of the nutritional factors role in the restoring the normal functioning of the gastrointestinal tract, the basic principles of the diet after operations on the esophagus and stomach.

[Clinical significance of food antigens blotting capacity by patients with irritable bowel syndrome].

53 patients suffered from IBS (according to Rome III criteria) were included to the study with solid-phase immune-enzyme detection of the ovalbumin blood level after consumption of egg whites. Patient complaints and quality of life were assessed. The same blood samples were tested for content of the total IgE and specific to food IgE (13 food allergens); specific to food IgG (24 food allergens). The abnormal intestinal permeability was found in 38% IBS patients, also the degree of abdominal pain was significantly higher and quality of life was lower in this patients. The abnormal intestinal permeability was found more frequently in IBS-C patients High levels of IgE and IgG were detected in a few IBS patients.

[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.

[Efficacy of using inulin fortified fermented milk products in patients with functional constipation].

The research involved 76 patients with irritable bowel syndrome with constipation. Introduction of fermented milk products--inulin fortified spoon yoghurt, drinking, yoghurt, kefir drink--into a standard ration exerted influence upon dynamics of basis manifestations of illness and made for increase of indices, which characterize patients' quality of life. The biggest was marked upon use of spoon yoghurt and kefir drink. After use of drinking yoghurt, dyspeptic effects were observed in a third part of patients.

[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.

[Influence of tableted green tea on index the antioxidant status patients with disease digestion organs].

To assess the tolerance of tableted green tea and its effect on the antioxidant status indices. Twenty-five patients with different gastrointestinal pathology weere included in the study and divided into main and control groups. The tolerance of tableted green tea was good in main group patients. This group showed better dynamics of quality of life indices, especially in scales of body pain and social functioning. There were no significant differences in biochemical analysis of both groups--it can indicate on safety of this product. Analysis revealed that main group patients show decreased level of all antioxidant status indices, it is reflected in decreasing of the lipid peroxidation index from 4.63 to 4.14 (p<0.05).

[Vitamin status and bone mineral density at patients with diseases of gastroenteric tract].

It has been shown that among patients suffering from diseases of a gastroenteric tract and osteopenia the calcium insufficiency estimated on daily calcium urinary excretion and the lowered level of the transport form of vitamin D in blood serum take place more often, than among patients with the same pathologies, but without osteopenia. The most significant risk factors of bone mass decrease at the patients who have transferred operations on organs of digestion are insufficient supply with calcium and vitamin D and the body weight loss.

[Peculiarity mineralization of osteous tissue of patients wits cardiovascular and gastroenteric pathologic and provision with vitamins and calcium].

Two groups of patients were studied. Group 1: patients with cardiovascular diseases. Group 2: patients with diseases of a gastro-intestinal path. Half of group has weight less than 56 kg. The study reported that distinct changes of bone tissue (mineral density as well as a high rate of bone tissue resorption) expose more often by patient 2 group than patient 1 group. In the both groups, patients were sufficiently supplied with vitamin D; however, in group 1 the concentration of 25-OH D3 was 1.9 fold lower and was close to the lower norm bound.

[Using fat load with medium chain fatty acids as a test for assessing lipid metabolism and exocrine function of the pancreas in patients wits chronic pancreatitis].

An additional fat load, rich in medium chain acids was used to supplement a standard ration of 30 patients with chronic pancreatitis as a test for assessing assimilation and tolerance of lipids. Good tolerance of these acids as well as the lack of negative influence on the exocrine function of pancreas was revealed. This makes expedient to include the acids in ration of patients with chronic pancreatitis with the purpose to increase its energy value.

[Dietotherapy of the chronic pancreatitis].

A modern pahtogenetic and etiological classification of pancreatic diseases is observed in the review and the questions of dietotherapy concerning the main forms of the disease are under consideration. There are numerous sources given from literature where the question is discussed on the fiber level, quantitative and qualitative structure of the fatty part of the ration in case of chronic pancreatitis. The majority of native and foreign authors consider it inexpedient to reduce fiber lover than 120 g per day, however there is a number of works where it is recommended to increase in the ration the quantity of carbohydrates up to 400 g, reducing some fiber at the same time. There has appeared a number of works for the recent years, where it is recommended to include mixes for enteral nutrition into the diets recommended both for acute and chronic course of the disease. Such diets are emphasized to be well bearable and high effective during the treatment of this disease.

[The season changes of mineral and trace elements contents in blood patients with ulcer pathology gastric and intestinal duodenal].

There are two concepts of homeostasis microelements: a traditional one, considering homeostasis as a constancy of internal media of alive organisms, and an alternative, examining the change of structure of these media in time as a consequence of change of external factors. In the first concept the deviation of concentration of a microelement from norm in whey of blood is considered a diagnostic attribute of microelementose (deficiency or surplus). In the second concept, on the contrary, it is supposed, that such deviations can have the adaptive character assisting to an organism in struggle against illness. At three-year research of 436 patients by a stomach ulcer and duodenal we have revealed precise patterns of seasonal changes of homeostasis the basic seven elements of whey of blood--Na, K, Ca, Mg, Zn, Cu and Fe which differ from similar time functions for healthy people and can be explained only on the basis of the assumption about protective adaptations an organism at the given pathology. As functions of time it is considered two homeostasis parameters--a level of concentration and capacity homeostasis which are determined not by processes of absorption, deducing and depositions, but requirements of a cellular level of a feed.

[Selenium sufficiency in patients with malabsorption syndrome and its optimization with selenium enriched food supplements]. / Obespechennost' selenom bol'nykh s sindromom mal'absorbtsii i vozmozhnosti ee optimizatsii s pomoshch'iu selenosoderzhashchei BAD.

Selenium security was measured in 15 adult patients suffering from malabsorption syndrome, resulted from stomach and small intestine surgical resection consequences. In 7 of them (47%) marked deficiency of this essential trace element was revealed and in other 6 (40%)--suboptimal security. The indices of selenium security in observed patients markedly and significantly (p < 0.003) increased after a 3-week course of dietetic treatment including uptake of organic selenium enriched food supplement in amount equal to 90 mcg Se per day. This dietetic treatment had mild "physiologic" character that became apparent from the observation that the largest serum selenium increase was noticed in patients with largest degree of selenium insufficiency. It's concluded that there is certain testimony for selenium security correction in malabsorption patients by means of selenium enriched food supplement.

[Use of organic forms of selenium in nutrition of patients with gastrointestinal diseases]. / O primenenii organicheskoi formy selena v pitanii gastroénterologicheskikh bol'nykh.

Selenium level was determined in sera of 27 patients including 15 patients with chronic gastrointestinal diseases and 12 patients with intestinal malabsorption after some kinds of stomach or small intestine resection. Deficiency of this trace element was found in 5 patients and suboptimal concentration in 4 patients in the first group and in 3 and 5 patients of second group respectively. Supplementation of patients with 45 mg of selenium organic form based on autolysis extract of selenious baker's yeast resulted in increase of selenium level in 23 (85%) patients including all of them with selenium deficiency or suboptimal level. It was concluded about high bioavailability of selenium in supplement studied. Perturbed intestinal absorption after surgical resection of stomach or small intestine may be considered as an indication for prophylactic taking of organic selenium form preparation.

[Actual diet of patients with gastrointestinal diseases]. / Analiz fakticheskogo pitaniia bol'nykh gastroénterologiskogo profilia.

The study of actual nutrition of patients with erosive-ulcerative lesions in the gastroduodenal zone and of patients with operated ulcer has revealed defects in intake of essential nutrients by these patients: overeating of animal fat and refined carbohydrates, deficiency of oil, vitamins A, B2, C, D and food fibers.

[A study of lipid peroxidation in patients with chronic gastritis during administration of a food additive monosodium glutamate]. / Issledovanie perekisnogo okisleniia lipidov u bol'nykh khronicheskimi gastritami pri ispol'zovanii pishchevoi dobavki mononatriia glutamina.

The levels of diene conjugates (DC) and TBA-reactive substances (TBA-RS) were studied in serum blood of patients with gastritis before and after including in diet of monosodium glutamate (MSG). For investigation 15 patients were selected who had unacid or subacid signs determined by histamine test. It was shown that levels of DC and TBA-RS were increased in serum of patients. MSG increased the gastric secretion in patients but had no effect of levels of DC and TBA-RS in serum.

[Optimization of dietary fat composition in erosive and ulcerative diseases of the gastroduodenal area]. / Optimizatsiia zhirovoi chasti ratsiona pri érozivno-iazvennykh porazheniiakh gastroduodenal'noi zony.

Fish oil preparation "Polyen" was used for treatment 21 patients with ulcerative diseases of the stomach or duodenum. The cicatrization of ulcer was diagnosed in 85% of patients treated by "Polyen" and in 60% of those who did not take fish oil. "Polyen" influenced fatty acid composition of erythrocyte membranes and lipid peroxidation. Authors draw a conclusion that omega-3 PUFA's can stimulate the reparative processes.