Voprosy Detskoi Dietologii最新文献

{"title":"Autoimmune enteropathy","authors":"V. Novikova, N. E. Prokopyeva, A. Khavkin","doi":"10.20953/2224-5448-2021-1-25-32","DOIUrl":"https://doi.org/10.20953/2224-5448-2021-1-25-32","url":null,"abstract":"Autoimmune enteropathy (AIE) is a rare disease characterised by severe diarrhoea and immune-mediated damage of the intestinal mucosa. The objective: based on analysis of modern literature to describe the diagnostic criteria, etiology, pathogenesis, epidemiology, clinical features and treatment of AIE in children. Results. The diagnostic criteria of AIE include chronic diarrhoea (lasting more than 6 weeks), malabsorption syndrome, specific histological findings of small intestine biopsy when other causes of villous atrophy are excluded. An additional criterion is the presence of antibodies against enterocytes or goblet cells. The following types are singled out: (1) AIE associated with such syndromes as IPEX and APECED; (2) an isolated form of GI AIE with the presence of anti-enterocyte antibodies without diseases of the digestive system; and (3) any form of AIE in girls associated with any other autoimmune phenomena. At present, not less than five subtypes of AIE are known: Primary AIE (paediatric); Syndromal AIE (paediatric); Primary (sporadic) adult ОВОС AIE; Secondary (iatrogenic) adult AIE; Paraneoplastic AIE. Patients with AIE might have associated autoimmune diseases, including diabetes mellitus, autoimmune hepatitis, alopecia, hypothyroidism, and interstitial nephritis. AIE is a complex and potentially life-threatening disease, with the mortality rates reaching 30% in paediatric practice. The prognosis depends on the age of the disease onset, the severity of symptoms and histological lesions of the gastrointestinal tract. The use of therapy based on modern molecular biology technologies, along with nutritive support, immunosuppressive therapy, can help control the disease. Key words: autoimmune enteropathy, IPEX syndrome","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78834874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of TCF7L2 gene polymorphisms on the effectiveness of various variants of antihyperglycaemic therapy in patients with type 2 diabetes","authors":"О.V. Kondratyeva, K. Sharafetdinov, O. A. Plotnikova","doi":"10.20953/2224-5448-2021-2-11-20","DOIUrl":"https://doi.org/10.20953/2224-5448-2021-2-11-20","url":null,"abstract":"Single nucleotide polymorphisms of the TCF7L2 gene demonstrate the strongest association with the risk of developing type 2 diabetes, linking its effects to changes in insulin secretion. The mechanism of action of hypoglycaemic drugs used in treatment of type 2 diabetes is, to a certain extent, related to their influence on the function of β-cells, which implies that variants of the TCF7L2 gene will affect the therapeutic effect of certain anti-hyperglycaemic drugs, including the variability in the effects of incretin-based therapy, and sulphonylurea derivatives. Along with the direct influence of the TCF7L2 gene on the function of β-cells, there is evidence of the effects of TCF7L2 gene polymorphism on the susceptibility to external risk factors associated with the development of type 2 diabetes, including the alimentary factors. Pharmacogenetic studies in diabetology have at present the greatest potential in terms of selection of the optimal comprehensive anti-hyperglycaemic therapy based on preliminary genetic testing, which might improve the outcomes of treatment and the prognosis for the course of type 2 diabetes, reducing the number of life-threatening complications. Key words: GPP-1 agonists, TCF7L2 gene, metformin, nutrition, type 2 diabetes, sulphonylureas","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89649792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary specificity in women engaged in intellectual work with low physical activity","authors":"Е.N. Lobykina, L. Proskuryakova","doi":"10.20953/2224-5448-2021-1-5-13","DOIUrl":"https://doi.org/10.20953/2224-5448-2021-1-5-13","url":null,"abstract":"Objective. Unbalanced nutrition of women of different age is one of the risk factors for developing chronic non-infectious diseases at early working age. The aim of the work was to study the nutrition of working-age women living in a large industrial centre, whose work patterns are characterized by a low level of physical activity. Patients and methods. A retrospective cross-sectional study included 282 women with low physical activity: group 1 – 18–39-year-olds (n = 176), group 2 – 40 years and older (n = 108). The computer program «Analysis of the state of human nutrition» (version 1.2, Institute of Nutrition RAMS 2003–2005) assessed the actual nutrition. Inter-group comparison of parameters was performed using the Mann–Whitney (U) test with the Benjamini–Hochberg correction. Results. The calorific value of the diets exceeded the norms (in group 1 by 1.1 times, in group 2 by 1.6 times) due to consumption of proteins and fats. Cholesterol intake was reduced in both groups (by 0.6–0.9 times, respectively). The proportions of dietary mono- and disaccharides exceeded the norm by 2 and more times in both groups, deficiency of dietary fiber was found in group 1 – 26.5%, in group 2 – 45% of normal. In both groups, a higher intake of sodium (by 2–3.5 times) and phosphorus (by 1.4–2 times) was found. Group 1 had a lower intake of Ca (by 1.4 times), Mg (by 1.6 times), vitamins B1 (by 1.8 times), B2 (by 1.5 times) and PP (by 1.8 times). In group 2, mineral and vitamin intake was significantly higher but insufficient as well. Conclusion. Women's diets are imbalanced toward the excess of the total caloric intake, the amounts of consumed proteins and fats, sodium, potassium, phosphorus; insufficient intake of dietary fiber, Ca, Fe, and some vitamins, which is a serious risk factor for the development of chronic non-infectious diseases and should be taken into account in treatment and prevention programmes implemented at younger ages.","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74908207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of platelet count and platelet indices in assessing inflammatory bowel disease activity in children","authors":"E. Semikina, V. Tsvetkova, A. Potapov, A. Fisenko, E. A. Kopyl'tsova, S. Akulova, A. Surkov, M. Lokhmatov, T. N. Budkina, M. Vershinina","doi":"10.20953/1727-5784-2021-3-26-36","DOIUrl":"https://doi.org/10.20953/1727-5784-2021-3-26-36","url":null,"abstract":"Objective. To analyze the connection between the complex of platelet indices in complete blood count test with the clinical and endoscopic activity scores for Crohn's disease (CD) and ulcerative colitis (UC) in pediatric patients and to determine their most informative threshold values. Patients and methods. In this study, 370 children aged 5 to 18 years with diagnosed CD (n = 150) and UC (n = 220) were examined. The clinical activity of UC was assessed according to PUCAI, CD – according to PCDAI; the assessment of endoscopic activity in children with UC was carried out according to UCEIS and CD – according to SES-CD. The study included platelet indices of 630 complete blood count tests (270 in patients with CD and 360 in patients with UC): platelet count (PLT), mean platelet volume (MPV), platelet large cell ratio (P-LCR) and platelet distribution width (PDW). Results. Increased platelet count and decreased platelet indices were noted as the clinical and endoscopic activity of CD and UC in children increased. A positive correlation between the clinical and endoscopic activity indices in inflammatory bowel diseases and platelet count and negative correlations with platelet indices were revealed. ROC analysis showed that the informative value of platelet indices in assessing the endoscopic activity of CD and UC is higher than in assessing the clinical activity. The optimal threshold values for platelet count (cut-off) for determining the endoscopic activity of CD and UC were 340 × 109/L and 350 × 109/L (Se 77%, Sp 69% and Se 63%, Sp 67%, respectively). The specificity of determing the endoscopic activity of 99% was obtained for platelet count of 459 × 109/L and 390 × 109/L for CD and UC, respectively. In children with CD, the indicators MPV <7.8 fL, PDW <7.25 fL, P-LCR <15.2% characterized the presence of endoscopic disease activity with 99% specificity; in children with UC, the specificity of determining the endoscopic activity of 99% was obtained for MPV <9.25 fL, PDW <9.85 fL, P-LCR <17.5%. Conclusion. An increase in platelet count and a decrease in platelet indices (MPV, PDW and P-LCR) can be surrogate markers of endoscopic activity of these diseases. The established threshold values will improve the accuracy of diagnosing the activity of inflammatory bowel diseases in children. Key words: Crohn's disease, ulcerative colitis, platelets, platelet indices, clinical activity, endoscopic activity","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67713687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current state of celiac disease diagnosis in Uzbekistan: problems and solutions","authors":"A. Kamilova, G. Azizova, S. Geller","doi":"10.20953/1727-5784-2021-4-15-22","DOIUrl":"https://doi.org/10.20953/1727-5784-2021-4-15-22","url":null,"abstract":"Objective. To study the state of diagnosis, clinical manifestation and laboratory changes in children with celiac disease in the Republic of Uzbekistan. Patients and methods. The article presents a description of 64 newly diagnosed cases of celiac disease registered in the Republican Specialized Scientific and Practical Medical Center of Pediatrics. Celiac disease was diagnosed according to the ESPGHAN criteria. Results. Out of 64 patients, celiac disease was more frequently diagnosed among girls (69.6%), the median age at diagnosis was 5.3 ± 0.6 years. Classic symptoms were observed in 46 (71.9%) patients, the number of patients with extraintestinal manifestations was 18 (28.1%). In classical celiac disease, the most common intestinal symptoms were bloating, diarrhea, and severe protein-energy malnutrition (p ≤ 0.05; p ≤ 0.0001). Among the patients with extraintestinal manifestations, there were more often children with subnanism (p ≤ 0.05). Hemoglobin and calcium levels decreased with the same frequency in atypical and typical forms of celiac disease; there was an increase in the level of alkaline phosphatase in both groups, but higher amounts were found in typical forms of the disease. The majority of patients had a histological study of the intestinal mucosa according to Marsh III, most commonly – IIIc (total villous atrophy). Conclusion. The diagnosis of celiac disease in children living in Uzbekistan is established with a considerable delay. Most patients have classic symptoms accompanied by intestinal manifestations. It is essential to be alert to the diagnosis of celiac disease in patients with extraintestinal manifestations in the absence of diarrhea. In this regard, it is necessary to raise doctors’ awareness of the diagnosis of atypical forms of the disease, as well as to improve their knowledge about different manifestations of celiac disease. Key words: celiac disease, extraintestinal manifestations, children, diagnosis","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67713808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D deficiency: a pandemic of the 21st century. Problems of standardization of diagnosis of vitamin D deficiency","authors":"E. V. Kochneva, S. Kalinchenko, D. V. Makharoblishvili","doi":"10.20953/2224-5448-2021-1-33-43","DOIUrl":"https://doi.org/10.20953/2224-5448-2021-1-33-43","url":null,"abstract":"Vitamin D deficiency is a noninfectious pandemic of the 21st century. Vitamin D, apart from its role in phosphorus-calcium metabolism, is vital for functioning of all organs and systems, and its deficiency is a risk factor of developing aging-associated extraskeletal diseases. Vitamin D deficiency is a multifactor process related to a decreased synthesis of endogenous cholecalcipherol, insufficient intake of exogenous vitamin D and its disordered metabolism. Improvement of the effectiveness of therapeutic and preventive measures for management of vitamin D deficiency is impossible without accurate laboratory diagnosis. Immunochemical methods (radioactive, enzymatic and chemiluminescent) overestimate the 25(ОН)D levels, a benchmark test for vitamin D status assessment is a high performance liquid chromatography tandem–mass spectrometry. In order to reduce the risk of socially significant diseases the adequate 25(ОН)D levels should be not less than 40 ng/mL (100 nmol/L). Key words: vitamin D, vitamin D deficiency, liquid chromatography tandem–mass spectrometry","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73677628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xerostomia as a cause of impaired digestion","authors":"V. Afanasyev, S. Kalinchenko, N. Vinokurov, L. Vorslov, A. Fomin","doi":"10.20953/2224-5448-2021-2-56-58","DOIUrl":"https://doi.org/10.20953/2224-5448-2021-2-56-58","url":null,"abstract":"Xerostomia (dryness in the mouth) arises due to inadequate saliva secretion associated with various conditions of the body and, in particular, of the salivary glands. The diagnosis and treatment of xerostomia does not receive due attention in the Russian Federation, whereas saliva forms the food bolus and is responsible for the first stage of food digestion. The causes of xerostomia are varied, and therefore its treatment meets with considerable difficulties. One of the methods of treating xerostomia is replacement therapy, but it is rarely and insufficiently administered in RF. The authors give a detailed description of the clinical picture of a dry mouth in 80 patients, who received a multicomponent formulation «Xerostom » as substitution therapy. The study showed that the best results were obtained by using gel and spray. Key words:salivary glands, xerostomia, saliva substitutes","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89125479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enteropathic acrodermatitis in children","authors":"V. Novikova, A. A. Pokhlebkina, D. Zaslavsky, A. Khavkin","doi":"10.20953/2224-5448-2021-2-21-28","DOIUrl":"https://doi.org/10.20953/2224-5448-2021-2-21-28","url":null,"abstract":"Enteropathic acrodermatitis is a rare hereditary form of zinc deficiency, characterized by periorial and acral dermatitis, alopecia and diarrhea. Refers to congenital disorders of zinc metabolism, inherited as an autosomal recessive disease resulting from mutations in the gene for the zinc transporter SLC39A4. The prevalence ranges from 1 to 9:1,000,000, with an overall incidence of 1:500,000 newborns. The disease usually manifests itself in infancy, within a few weeks of stopping breastfeeding and switching the baby to a cow's milk-based formula, or in the first days of life if artificially fed from birth. The classical clinical manifestations of acrodermatitis enteropathic are characterized by the triad: acral and periofital dermatitis, alopecia and diarrhea, but all three signs together occur only in 20% of cases. Diarrhea may develop concurrently with skin symptoms, may precede or occur later. Characteristic signs of skin lesions include sharply demarcated, dry, scaly erythematous plaques or edematous foci with vesicles and pustules on the skin of the elbow and knee joints, distal extremities, genitals, in the inguinal folds, which are usually symmetrically distributed, have sharp boundaries and irregular outlines. The course of the skin syndrome is long, as it progresses, non-healing erosive and ulcerative areas appear. Plasma zinc deficiency is the gold standard for diagnosis. Most infants with AE have low plasma zinc concentrations (<500 mcg/L or <50 mcg/dl), but a level of less than 70 mcg/L on an empty stomach or less than 65 mcg/dl in older non-dieting children is considered diagnostically significant. Treatment for this disease usually includes enteral or parenteral zinc administration, at a dose of 1-3 mg/kg/day. for elemental zinc. A clinical response is observed within 5–10 days. Supportive zinc therapy is necessary throughout the patient's life, although periods of remission have been reported. Topical therapy is also used: Dexpanthenol in the form of a cream, applied 3 times a day in the area of dermatitis, can enhance re-epithelialization. There is no significant evidence of improvement with topical zinc application. No activity restrictions are required for patients with acrodermatitis enteropathic. Key words: zinc deficiency, enteropathic acrodermatitis, children","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"161 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86269762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D in Crohn’s disease: involvement in pathogenesis and application prospects","authors":"K. Ivashkin, V. R. Grechishnikova, M. Reshetova, O. Zol’nikova, V. Leschenko, A. Sedova, E. Bueverova, V. Ivashkin","doi":"10.20953/1727-5784-2021-1-24-31","DOIUrl":"https://doi.org/10.20953/1727-5784-2021-1-24-31","url":null,"abstract":"As many research works show, vitamin D has pleiotropic effects, including the immune regulation and pathogenesis of Crohn’s disease. Therefore, concentrations of the active vitamin D metabolite might be associated with the development, progression and severity of the disease. The skeletal and extraskeletal effects of vitamin D are realised through its active metabolite – 1.25(OH)2D, which is a steroid hormone. The objective of the work: to analyse the accumulated evidence demonstrative of a multiple contribution of vitamin D in the pathogenesis of Crohn’s disease, and to determine the possible perspectives of using the vitamin as part of comprehensive therapy of this disease. Despite the fact, that data of in vitro and animal studies are demonstrative of multiple effects of vitamin D in the pathogenesis of Crohn’s disease, the currently available evidence based on the underlying clinical trials are insufficient yet for including vitamin D in clinical guidelines on management of Crohn’s disease. Further research work is necessary. Key words: Crohn’s disease, vitamin D, calciferol, vitamin D axis, extraskeletal effects","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"19 1","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67713481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enteral nutrition for pediatric Crohn’s disease: significance and basic principles","authors":"T. Borovik, A. Potapov, E.A.Roslavtseva E.A.Roslavtseva, A. Khavkin","doi":"10.20953/1727-5784-2021-3-70-82","DOIUrl":"https://doi.org/10.20953/1727-5784-2021-3-70-82","url":null,"abstract":"The characteristics of the diet traditionally recommended for Crohn’s disease often reduce patients’ consumption of essential nutrients. Therefore, an important role belongs to nutritional support with specialized formulas, the effectiveness of which has been proven both for inducing remission and optimizing the parameters of physical development and puberty, bone mineralization. Nutritional support should be provided for patients with newly diagnosed Crohn’s disease in the form of full enteral nutrition, and subsequently in remission, exacerbation, in the pre- and postoperative periods as an addition to the standard diet. Of particular interest is the CDED ModuLife program, which is based on a combination of enteral nutrition with specially selected foods aimed at reducing the activity of intestinal inflammation in Crohn’s disease. Key words: inflammatory bowel disease, Crohn’s disease, full enteral nutrition, partial enteral nutrition, enteral nutrition formulas","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67713799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}