Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-1-32-41
A. Khavkin, V. Novikova, N. Evdokimova
This review focuses on the interaction between the microbiota and macroorganism in conditions of biological equilibrium, which is the basis of maintaining human homeostasis in general. Low-grade chronic inflammation (LGCI) is realized within this interaction in dysbiosis of various genesis. Bacterial endotoxins are normally the final effectors of LGCI, which are involved in the maturation of the immune system’s components, further determining its ability to neutralize and eliminate pathogens. However, altered intestinal permeability with subsequent microbial translocation to unrelated epitopes may cause LGCI. The review presents several possible options for affecting the gut microbiota and thus LGCI: through the use of probiotics, prebiotics, restrictive diets, and fermented probiotic food products. Key words: diet, probiotics, prebiotics, gut microbiota, low-grade chronic inflammation
{"title":"Dietary control of low-grade chronic inflammation by correcting gut microbiota","authors":"A. Khavkin, V. Novikova, N. Evdokimova","doi":"10.20953/1727-5784-2022-1-32-41","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-1-32-41","url":null,"abstract":"This review focuses on the interaction between the microbiota and macroorganism in conditions of biological equilibrium, which is the basis of maintaining human homeostasis in general. Low-grade chronic inflammation (LGCI) is realized within this interaction in dysbiosis of various genesis. Bacterial endotoxins are normally the final effectors of LGCI, which are involved in the maturation of the immune system’s components, further determining its ability to neutralize and eliminate pathogens. However, altered intestinal permeability with subsequent microbial translocation to unrelated epitopes may cause LGCI. The review presents several possible options for affecting the gut microbiota and thus LGCI: through the use of probiotics, prebiotics, restrictive diets, and fermented probiotic food products. Key words: diet, probiotics, prebiotics, gut microbiota, low-grade chronic inflammation","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67714995","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-1-42-51
A. Trukhmanov, D. Rumyantseva
The article describes the benefits of rebamipide and proton pump inhibitors combination therapy for acid-related diseases. It was shown that rebamipide have a positive effect on various parts of the protective barrier of the epithelium in gastroesophageal reflux disease, chronic gastritis, peptic ulcer disease, functional dyspepsia, NSAID-induced gastrointestinal erosive and ulcerative lesions, and in the treatment of Helicobacter pylori infection. Key words: gastroesophageal reflux disease, proton pump inhibitors, NSAID gastropathy, rebamipide, functional dyspepsia, peptic ulcer disease, Helicobacter pylori
{"title":"Rebamipide and proton pump inhibitors: benefits of combined use","authors":"A. Trukhmanov, D. Rumyantseva","doi":"10.20953/1727-5784-2022-1-42-51","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-1-42-51","url":null,"abstract":"The article describes the benefits of rebamipide and proton pump inhibitors combination therapy for acid-related diseases. It was shown that rebamipide have a positive effect on various parts of the protective barrier of the epithelium in gastroesophageal reflux disease, chronic gastritis, peptic ulcer disease, functional dyspepsia, NSAID-induced gastrointestinal erosive and ulcerative lesions, and in the treatment of Helicobacter pylori infection. Key words: gastroesophageal reflux disease, proton pump inhibitors, NSAID gastropathy, rebamipide, functional dyspepsia, peptic ulcer disease, Helicobacter pylori","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67715017","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-3-51-59
K. I. Grigoriev, L. Kharitonova, A. Grigoriev
This article presents a clinical presentation of the disease in children with Down syndrome, current data on inheritance pattern, prevalence, and diagnosis. Information necessary for health workers in the organization of feeding and care for such children and recommendations for conversations with their parents are given. Particular attention is paid to the rumination syndrome, which is the main manifestation of gastroesophageal reflux and gastroesophageal reflux disease, the leading causes of eating disorders in young children. The article focuses on feeding as one of the most common problems in providing care for this category of children, which is due to a combination of unfavorable factors. Key words: Down syndrome, maxillofacial anomalies, breastfeeding, gastroesophageal reflux disease, diagnosis
{"title":"Feeding difficulties in children with 22q11.2 deletion syndrome. Genetic and social challenges","authors":"K. I. Grigoriev, L. Kharitonova, A. Grigoriev","doi":"10.20953/1727-5784-2022-3-51-59","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-3-51-59","url":null,"abstract":"This article presents a clinical presentation of the disease in children with Down syndrome, current data on inheritance pattern, prevalence, and diagnosis. Information necessary for health workers in the organization of feeding and care for such children and recommendations for conversations with their parents are given. Particular attention is paid to the rumination syndrome, which is the main manifestation of gastroesophageal reflux and gastroesophageal reflux disease, the leading causes of eating disorders in young children. The article focuses on feeding as one of the most common problems in providing care for this category of children, which is due to a combination of unfavorable factors. Key words: Down syndrome, maxillofacial anomalies, breastfeeding, gastroesophageal reflux disease, diagnosis","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67716142","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-4-21-30
N. Esakova, I. Zakharova, I. Osmanov, D. Kolushkin, A. Pampura
Objective. To determine the frequency, range of triggers, features of clinical symptoms and treatment of anaphylaxis in children hospitalized with severe systemic allergic reactions in the pediatric department in Moscow. Patients and methods. We conducted a retrospective analysis of 1197 medical records of children admitted to the Z.A.Bashlyaeva Children's City Clinical Hospital with severe allergic reactions over the period from 2016 to 2020 to determine the clinical criteria for anaphylaxis. The diagnosis of anaphylaxis was made retrospectively in 86 patients based on corresponding reports of 2 independent allergy specialists. Results. The incidence of anaphylaxis among children hospitalized with severe allergic reactions was 7.18%. The use of the new WAOAG (2020) anaphylaxis criteria, compared with the previously adopted NIAID/FAAN (2006), slightly increased the coverage of patients diagnosed with anaphylaxis (7.18% vs 7.01%, respectively). Food allergens were the predominant cause of anaphylaxis in children (78%); the second most important trigger were medications (5%), and 7% of patients had idiopathic anaphylaxis. The main causes of food anaphylaxis were tree nuts (31%), cow's milk (19%), fish/seafood (16%), and chicken egg (9%); the frequency of anaphylactic reactions to peanuts did not exceed 4%. The incidence of anaphylaxis to cow's milk and chicken egg was higher in the group of children younger than 3 years (p = 0.003, p = 0.01, respectively), and the incidence of anaphylaxis to fruits was lower (p = 0.05) compared with patients aged 3-18 years. The proportion of anaphylaxis to tree nuts in children was highest and irrespective of patient age. In the development of anaphylaxis, skin/mucosal (98%) and respiratory (71%) symptoms were the most frequent, followed by gastrointestinal symptoms (29%) and laryngeal symptoms (26%). In hospital, anaphylaxis was diagnosed in 10 (12%) patients, and only 21% of children received epinephrine for the treatment of anaphylaxis. At discharge, epinephrine was recommended for 13% of patients. Conclusion. The diagnosis of anaphylaxis is to be excluded in patients with severe allergic reactions, since its incidence in this group of patients reaches 7.18%. Food allergens are the main trigger of anaphylaxis in children in the Russian Federation. The age-dependent spectrum of food anaphylaxis triggers in Russia suggests the use of diagnostic allergy panels in infants that include not only cow's milk, chicken egg, fish, but also tree nuts. Less than 1/4 of children receive epinephrine in the treatment of anaphylactic reactions; the rate of verification of the diagnosis of anaphylaxis and prescription of epinephrine is extremely low and does not exceed 13%. Key words: anaphylaxis, anaphylactic reaction, trigger, allergen, children, food allergy, infants
目标。目的确定莫斯科儿科重症全身性过敏反应住院儿童的过敏反应频率、触发因素范围、临床症状特征和治疗方法。患者和方法。回顾性分析2016 - 2020年在Z.A.Bashlyaeva儿童城市临床医院就诊的1197例严重过敏反应患儿病历，确定过敏反应的临床标准。根据2名独立过敏专家的相应报告，对86例患者进行回顾性诊断。结果。严重过敏反应住院患儿的过敏反应发生率为7.18%。与之前采用的NIAID/FAAN(2006)相比，使用新的WAOAG(2020)过敏反应标准略微增加了诊断为过敏反应的患者的覆盖率(分别为7.18%和7.01%)。食物过敏原是儿童过敏反应的主要原因(78%);第二个最重要的触发因素是药物(5%)，7%的患者有特发性过敏反应。食物过敏反应的主要原因是坚果(31%)、牛奶(19%)、鱼/海鲜(16%)和鸡蛋(9%);花生过敏反应发生率不超过4%。3岁以下儿童对牛奶和鸡蛋的过敏反应发生率高于3-18岁儿童(p = 0.003, p = 0.01)，对水果的过敏反应发生率低于3-18岁儿童(p = 0.05)。儿童对树坚果过敏反应的比例最高，与患者年龄无关。在过敏反应的发生过程中，皮肤/粘膜(98%)和呼吸道(71%)症状最为常见，其次是胃肠道症状(29%)和喉部症状(26%)。在医院，10例(12%)患者被诊断为过敏反应，只有21%的儿童接受肾上腺素治疗过敏反应。出院时，13%的患者推荐使用肾上腺素。结论。严重过敏反应的患者应排除过敏反应的诊断，因为其在该组患者中的发病率达到7.18%。食物过敏原是俄罗斯联邦儿童过敏反应的主要诱因。在俄罗斯，食物过敏反应触发因素的年龄依赖性谱建议对婴儿使用诊断过敏小组，不仅包括牛奶、鸡蛋、鱼，还包括树坚果。不到1/4的儿童接受肾上腺素治疗过敏性反应;对过敏反应诊断和肾上腺素处方的验证率极低，不超过13%。关键词:过敏反应，过敏反应，诱因，过敏原，儿童，食物过敏，婴儿
{"title":"Anaphylaxis among children hospitalized with severe allergic reactions: a 5-year retrospective analysis","authors":"N. Esakova, I. Zakharova, I. Osmanov, D. Kolushkin, A. Pampura","doi":"10.20953/1727-5784-2022-4-21-30","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-4-21-30","url":null,"abstract":"Objective. To determine the frequency, range of triggers, features of clinical symptoms and treatment of anaphylaxis in children hospitalized with severe systemic allergic reactions in the pediatric department in Moscow. Patients and methods. We conducted a retrospective analysis of 1197 medical records of children admitted to the Z.A.Bashlyaeva Children's City Clinical Hospital with severe allergic reactions over the period from 2016 to 2020 to determine the clinical criteria for anaphylaxis. The diagnosis of anaphylaxis was made retrospectively in 86 patients based on corresponding reports of 2 independent allergy specialists. Results. The incidence of anaphylaxis among children hospitalized with severe allergic reactions was 7.18%. The use of the new WAOAG (2020) anaphylaxis criteria, compared with the previously adopted NIAID/FAAN (2006), slightly increased the coverage of patients diagnosed with anaphylaxis (7.18% vs 7.01%, respectively). Food allergens were the predominant cause of anaphylaxis in children (78%); the second most important trigger were medications (5%), and 7% of patients had idiopathic anaphylaxis. The main causes of food anaphylaxis were tree nuts (31%), cow's milk (19%), fish/seafood (16%), and chicken egg (9%); the frequency of anaphylactic reactions to peanuts did not exceed 4%. The incidence of anaphylaxis to cow's milk and chicken egg was higher in the group of children younger than 3 years (p = 0.003, p = 0.01, respectively), and the incidence of anaphylaxis to fruits was lower (p = 0.05) compared with patients aged 3-18 years. The proportion of anaphylaxis to tree nuts in children was highest and irrespective of patient age. In the development of anaphylaxis, skin/mucosal (98%) and respiratory (71%) symptoms were the most frequent, followed by gastrointestinal symptoms (29%) and laryngeal symptoms (26%). In hospital, anaphylaxis was diagnosed in 10 (12%) patients, and only 21% of children received epinephrine for the treatment of anaphylaxis. At discharge, epinephrine was recommended for 13% of patients. Conclusion. The diagnosis of anaphylaxis is to be excluded in patients with severe allergic reactions, since its incidence in this group of patients reaches 7.18%. Food allergens are the main trigger of anaphylaxis in children in the Russian Federation. The age-dependent spectrum of food anaphylaxis triggers in Russia suggests the use of diagnostic allergy panels in infants that include not only cow's milk, chicken egg, fish, but also tree nuts. Less than 1/4 of children receive epinephrine in the treatment of anaphylactic reactions; the rate of verification of the diagnosis of anaphylaxis and prescription of epinephrine is extremely low and does not exceed 13%. Key words: anaphylaxis, anaphylactic reaction, trigger, allergen, children, food allergy, infants","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67716494","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-5-72-79
A. Efremova, V. Sherman, Y. Melyanovskaya, N. Bulatenko, T. Bukharova, D. Mokrousova, O. Makhnach, D. Goldshtein, E. Kondratyeva
Clinical manifestations of cystic fibrosis depend on the patient’s genotype since there are more than 2,000 variants of the CFTR gene. Main complications of the disease are expressed in a reduction or loss of pancreatic function and bacterial lung infection, leading to respiratory failure. The E92K (p.(Glu92Lys) and 4428insGA (p.(Ser1435Glyfs*14) mutations in the CFTR gene are accompanied by a high frequency of preserved pancreatic function. In a 3-year-old patient with recurrent pancreatitis and E92K/4428insGA genotype, the functional activity of the CFTR channel was studied using the intestinal current measurement method on rectal biopsy specimens and the forskolin-induced swelling assay in intestinal organoids. The personalized assessment of the action of CFTR modulators was also performed on organoid cultures obtained from the patient’s intestinal biopsies. In a 3-year-old child with cystic fibrosis and recurrent pancreatitis with frequent exacerbations, a high preservation of residual CFTR channel function was revealed. All the investigated targeted drugs were effective in increasing the functional activity of the CFTR chloride channel. Key words: cystic fibrosis, CFTR gene, targeted therapy, pancreatitis, intestinal organoids, intestinal current measurement, E92K, 4428insGA
{"title":"Study of CFTR channel functional activity in a patient with cystic fibrosis and E92K/4428insGA genotype","authors":"A. Efremova, V. Sherman, Y. Melyanovskaya, N. Bulatenko, T. Bukharova, D. Mokrousova, O. Makhnach, D. Goldshtein, E. Kondratyeva","doi":"10.20953/1727-5784-2022-5-72-79","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-5-72-79","url":null,"abstract":"Clinical manifestations of cystic fibrosis depend on the patient’s genotype since there are more than 2,000 variants of the CFTR gene. Main complications of the disease are expressed in a reduction or loss of pancreatic function and bacterial lung infection, leading to respiratory failure. The E92K (p.(Glu92Lys) and 4428insGA (p.(Ser1435Glyfs*14) mutations in the CFTR gene are accompanied by a high frequency of preserved pancreatic function. In a 3-year-old patient with recurrent pancreatitis and E92K/4428insGA genotype, the functional activity of the CFTR channel was studied using the intestinal current measurement method on rectal biopsy specimens and the forskolin-induced swelling assay in intestinal organoids. The personalized assessment of the action of CFTR modulators was also performed on organoid cultures obtained from the patient’s intestinal biopsies. In a 3-year-old child with cystic fibrosis and recurrent pancreatitis with frequent exacerbations, a high preservation of residual CFTR channel function was revealed. All the investigated targeted drugs were effective in increasing the functional activity of the CFTR chloride channel. Key words: cystic fibrosis, CFTR gene, targeted therapy, pancreatitis, intestinal organoids, intestinal current measurement, E92K, 4428insGA","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67717051","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-4-42-50
E. Pavlovskaya, O. Titova, M. Bagaeva, M. Shavkina, T. Strokova
Objective. To study the dynamics of body composition parameters in obese children against the background of hypocaloric diet in inpatient settings. Patients and methods. This study enrolled 89 children aged 5 to 17 (13 [12; 15]) years, of whom 44% were boys. The inpatient treatment program for obesity included a low-fat and low-carbohydrate diet with an energy value of 1668 kcal/day and therapeutic exercise. To assess the effectiveness of treatment, the clinical and anthropometric examination and body composition evaluation by bioelectrical impedance analysis (BIA) using the InBody 770 stationary analyzer (Biospace Co. Ltd., Korea) were performed at the beginning and at the end of inpatient treatment. Body fat mass (FM), fat-free mass (FFM), the amount of total body water, extracellular and intracellular fluid, protein, minerals, and the phase angle were determined. Results. At the beginning of the study, all children were found to have excess FM, and 47 (58%) had an increase in FFM due to muscle mass and intracellular fluid. By the end of treatment, there was a decrease in body weight, body mass index (BMI), BMI SDS, waist and hip circumference (p < 0.001) in all children. The amount of body fat decreased by 4.15% [2,6; 6,7]. Most children showed a statistically significant decrease in all FFM components by 2.4-2.7%. Protein loss during hospitalization was 0.3 kg [0.1; 0.4], mineral loss was 0.07 kg [0.01; 0.14]. The phase angle value at the beginning of the study was 5.5 [5.1; 6.1], at the end of the study – 5.4 [5.1; 5.9], p = 0.07. Conclusion. As a result of short-term adherence to the hypocaloric diet in inpatient settings, all children with obesity demonstrated a decrease in both FM and FFM against the background of a statistically significant decrease in BMI SDS. A comprehensive approach to treatment, combining the recommended calorie intake with the amount of protein according to the age group and structured physical activity, is necessary to preserve FFM in order to maintain resting energy expenditure. Body composition monitoring is required during the treatment of obesity. Key words: obesity, children, treatment, hypocaloric diet, fat-free mass, fat mass, body composition
目标。研究住院低热量饮食背景下肥胖儿童体成分参数的动态变化。患者和方法。本研究招募了89名5至17岁的儿童(13 [12;[15])岁，其中44%是男孩。肥胖症的住院治疗计划包括低脂肪和低碳水化合物饮食，能量值为1668千卡/天，以及治疗性运动。为了评估治疗的有效性，在住院治疗开始和结束时，使用InBody 770固定式分析仪(Biospace Co. Ltd.， Korea)进行临床和人体测量检查，并通过生物电阻抗分析(BIA)评估身体成分。测定体脂质量(FM)、无脂质量(FFM)、体内总水量、细胞外液和细胞内液、蛋白质、矿物质和相角。结果。在研究开始时，发现所有儿童都有过量的FM, 47例(58%)的FFM由于肌肉质量和细胞内液而增加。治疗结束时，所有儿童的体重、体重指数(BMI)、BMI SDS、腰围和臀围均下降(p < 0.001)。体脂量下降4.15% [2,6;6、7]。大多数儿童FFM各成分均有统计学意义上的下降，降幅为2.4-2.7%。住院期间蛋白质损失0.3 kg [0.1;0.4]，矿物质损失0.07 kg [0.01];0.14]。研究开始时相角值为5.5 [5.1;6.1]，研究结束时- 5.4 [5.1;5.9]， p = 0.07。结论。由于在住院环境中短期坚持低热量饮食，所有肥胖儿童的FM和FFM都有所下降，而BMI SDS有统计学意义上的显著下降。综合治疗方法，将推荐的卡路里摄入量与根据年龄组和有组织的身体活动的蛋白质量结合起来，是保持FFM以维持静息能量消耗所必需的。在治疗肥胖的过程中，需要监测身体成分。关键词:肥胖，儿童，治疗，低热量饮食，无脂量，脂肪量，身体成分
{"title":"Dynamics of body composition parameters in children with obesity against the background of hypocaloric diet in inpatient settings","authors":"E. Pavlovskaya, O. Titova, M. Bagaeva, M. Shavkina, T. Strokova","doi":"10.20953/1727-5784-2022-4-42-50","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-4-42-50","url":null,"abstract":"Objective. To study the dynamics of body composition parameters in obese children against the background of hypocaloric diet in inpatient settings. Patients and methods. This study enrolled 89 children aged 5 to 17 (13 [12; 15]) years, of whom 44% were boys. The inpatient treatment program for obesity included a low-fat and low-carbohydrate diet with an energy value of 1668 kcal/day and therapeutic exercise. To assess the effectiveness of treatment, the clinical and anthropometric examination and body composition evaluation by bioelectrical impedance analysis (BIA) using the InBody 770 stationary analyzer (Biospace Co. Ltd., Korea) were performed at the beginning and at the end of inpatient treatment. Body fat mass (FM), fat-free mass (FFM), the amount of total body water, extracellular and intracellular fluid, protein, minerals, and the phase angle were determined. Results. At the beginning of the study, all children were found to have excess FM, and 47 (58%) had an increase in FFM due to muscle mass and intracellular fluid. By the end of treatment, there was a decrease in body weight, body mass index (BMI), BMI SDS, waist and hip circumference (p < 0.001) in all children. The amount of body fat decreased by 4.15% [2,6; 6,7]. Most children showed a statistically significant decrease in all FFM components by 2.4-2.7%. Protein loss during hospitalization was 0.3 kg [0.1; 0.4], mineral loss was 0.07 kg [0.01; 0.14]. The phase angle value at the beginning of the study was 5.5 [5.1; 6.1], at the end of the study – 5.4 [5.1; 5.9], p = 0.07. Conclusion. As a result of short-term adherence to the hypocaloric diet in inpatient settings, all children with obesity demonstrated a decrease in both FM and FFM against the background of a statistically significant decrease in BMI SDS. A comprehensive approach to treatment, combining the recommended calorie intake with the amount of protein according to the age group and structured physical activity, is necessary to preserve FFM in order to maintain resting energy expenditure. Body composition monitoring is required during the treatment of obesity. Key words: obesity, children, treatment, hypocaloric diet, fat-free mass, fat mass, body composition","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67716570","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-6-5-13
P. Shumilov, A. Khavkin, Yu.A. Kucheryavy, D. Andreev, A. Gilmanov, R. Vasilyev, E.S. Kuchina, S.A. Marinchuk, O. V. Nazarova, N. G. Safonova, Ya.M. Stepkina, S.A. Tribunskaya, M. Chikunova, O.A. Shanava
Objective. To study the effect of esophagoprotector Alfasoxx on extraesophageal symptoms in children and adolescents with gastroesophageal reflux disease (GERD). Patients and methods. This article presents a prospective, open-label, multicenter, post-registration, observational study (the pediatric part of the EXTRASOXX protocol). The study enrolled 61 patients aged between 6 and 17 years (mean age: 12.5 ± 3.2 years) with a confirmed diagnosis of GERD who were prescribed a course of treatment with the esophagoprotector Alfasoxx (a combination of hyaluronic acid, chondroitin sulfate, and poloxamer 407) by their attending physician according to the instructions for medical use. The study consisted of two stages: a screening visit and two follow-up visits during administration of the esophagoprotector Alfasoxx. Screening was performed on the day of the patient’s visit. Visit 1 could take place on the same day as the screening visit, whereas visit 2 took place 4–5 weeks after visit 1 at the end of treatment. At each visit, the researcher completed a patient record form (RSI questionnaire, esophageal symptom frequency and severity assessment questionnaire, patient satisfaction questionnaire using a 5-point Likert scale). Results. By the end of the study, 70.5% (95% CI: 57.4–81.5) of patients had complete resolution of extraesophageal GERD symptoms (RSI score 0). When comparing mean RSI scores before and after treatment, a statistically significant regression was noted: from 13 points (95% CI: 11.5–14.5) at visit 1 to 0.5 points (95% CI: 0.2–0.7) at visit 2. Thus, the decrease in the total RSI score was significant and exceeded 90% of the baseline value. The proportion of patients taking antacid-containing medications decreased significantly: from 34.4% (95% CI: 21.7–47.2) at visit 1 to 4.9% (95% CI: 0.0–11.2) at visit 2. Mean treatment satisfaction score on the Likert scale was 4.9 (95% CI: 4.9–5.0), Alfasoxx’s ease of use was 4.9 (95% CI: 4.9–5.0). Conclusion. This prospective, observational, multicenter study demonstrated that adding Alfasoxx to standard therapy for GERD in children and adolescents contributes to a significant regression of both esophageal and extraesophageal symptoms and reduces the need for antacid-containing medications. Key words: gastroesophageal reflux disease, children, adolescents, extraesophageal symptoms, esophagoprotector, hyaluronic acid, chondroitin sulfate
{"title":"Evaluation of esophagoprotective therapy for gastroesophageal reflux disease with extraesophageal symptoms in children and adolescents: results of an open-label, multicenter, observational study","authors":"P. Shumilov, A. Khavkin, Yu.A. Kucheryavy, D. Andreev, A. Gilmanov, R. Vasilyev, E.S. Kuchina, S.A. Marinchuk, O. V. Nazarova, N. G. Safonova, Ya.M. Stepkina, S.A. Tribunskaya, M. Chikunova, O.A. Shanava","doi":"10.20953/1727-5784-2022-6-5-13","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-6-5-13","url":null,"abstract":"Objective. To study the effect of esophagoprotector Alfasoxx on extraesophageal symptoms in children and adolescents with gastroesophageal reflux disease (GERD). Patients and methods. This article presents a prospective, open-label, multicenter, post-registration, observational study (the pediatric part of the EXTRASOXX protocol). The study enrolled 61 patients aged between 6 and 17 years (mean age: 12.5 ± 3.2 years) with a confirmed diagnosis of GERD who were prescribed a course of treatment with the esophagoprotector Alfasoxx (a combination of hyaluronic acid, chondroitin sulfate, and poloxamer 407) by their attending physician according to the instructions for medical use. The study consisted of two stages: a screening visit and two follow-up visits during administration of the esophagoprotector Alfasoxx. Screening was performed on the day of the patient’s visit. Visit 1 could take place on the same day as the screening visit, whereas visit 2 took place 4–5 weeks after visit 1 at the end of treatment. At each visit, the researcher completed a patient record form (RSI questionnaire, esophageal symptom frequency and severity assessment questionnaire, patient satisfaction questionnaire using a 5-point Likert scale). Results. By the end of the study, 70.5% (95% CI: 57.4–81.5) of patients had complete resolution of extraesophageal GERD symptoms (RSI score 0). When comparing mean RSI scores before and after treatment, a statistically significant regression was noted: from 13 points (95% CI: 11.5–14.5) at visit 1 to 0.5 points (95% CI: 0.2–0.7) at visit 2. Thus, the decrease in the total RSI score was significant and exceeded 90% of the baseline value. The proportion of patients taking antacid-containing medications decreased significantly: from 34.4% (95% CI: 21.7–47.2) at visit 1 to 4.9% (95% CI: 0.0–11.2) at visit 2. Mean treatment satisfaction score on the Likert scale was 4.9 (95% CI: 4.9–5.0), Alfasoxx’s ease of use was 4.9 (95% CI: 4.9–5.0). Conclusion. This prospective, observational, multicenter study demonstrated that adding Alfasoxx to standard therapy for GERD in children and adolescents contributes to a significant regression of both esophageal and extraesophageal symptoms and reduces the need for antacid-containing medications. Key words: gastroesophageal reflux disease, children, adolescents, extraesophageal symptoms, esophagoprotector, hyaluronic acid, chondroitin sulfate","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67716763","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-1-12-20
E. Roslavtseva, T. Bushueva, T. Borovik, O. Simonova, N. Burkina, I. Sokolov, N. V. Lyabina, A. Fisenko
Objective. To study the clinical efficacy of hydrolyzed milk protein formulas “Peptamen Junior” and “Peptamen” (Nestlé, Switzerland) in nutrition therapy for children with cystic fibrosis. Patients and methods. Forty patients with cystic fibrosis aged from 1 year to 17 years 11 months who underwent treatment and rehabilitation at the pulmonology department of the National Medical Research Center for Children’s Health from October 2020 to August 2021 were examined. Patients were divided into two equal groups, each receiving one product. During dynamic observation, the patients’ general condition, nutritional status, including anthropometry, caliperometry, and bioimpedanceometry in older children, as well as biochemical parameters (albumin, prealbumin, transferrin, total protein, glucose), the biological and nutritional value of the diet were evaluated. Results. There was a significant improvement in the physical development of children, in some of whom the reduction of malnutrition was observed. This was evidenced by the positive dynamics of weight-for-length and BMI-for-age Z-scores, the complete elimination of malnutrition in 3 (3.8%) patients and reduction of malnutrition severity in 5 (6.3%) children, a significant increase in the average upper arm muscle circumference from 14.96 ± 0.93 to 15.9 ± 0.8 mm (p < 0.05) in children aged between 1 and 10 years, an increase in the number of children with normal lean body mass Z-score from 25 to 33%. Biochemical markers remained within reference values. The use of specialized formulas in the diet of children with cystic fibrosis enriched therapeutic nutrition with protein by 26-28% and energy by 22-24%. Conclusion. The inclusion of hydrolyzed milk protein formulas “Peptamen Junior” and “Peptamen” (Nestlé, Switzerland) in nutrition therapy for children with cystic fibrosis can maintain their nutritional status at a satisfactory level, provide a positive prognosis of the disease, and improve the quality of life of patients and their families. Key words: cystic fibrosis, children, nutritional status, hydrolyzed milk protein formulas
{"title":"Clinical study results for efficacy of using hydrolyzed milk protein formulas in children with cystic fibrosis","authors":"E. Roslavtseva, T. Bushueva, T. Borovik, O. Simonova, N. Burkina, I. Sokolov, N. V. Lyabina, A. Fisenko","doi":"10.20953/1727-5784-2022-1-12-20","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-1-12-20","url":null,"abstract":"Objective. To study the clinical efficacy of hydrolyzed milk protein formulas “Peptamen Junior” and “Peptamen” (Nestlé, Switzerland) in nutrition therapy for children with cystic fibrosis. Patients and methods. Forty patients with cystic fibrosis aged from 1 year to 17 years 11 months who underwent treatment and rehabilitation at the pulmonology department of the National Medical Research Center for Children’s Health from October 2020 to August 2021 were examined. Patients were divided into two equal groups, each receiving one product. During dynamic observation, the patients’ general condition, nutritional status, including anthropometry, caliperometry, and bioimpedanceometry in older children, as well as biochemical parameters (albumin, prealbumin, transferrin, total protein, glucose), the biological and nutritional value of the diet were evaluated. Results. There was a significant improvement in the physical development of children, in some of whom the reduction of malnutrition was observed. This was evidenced by the positive dynamics of weight-for-length and BMI-for-age Z-scores, the complete elimination of malnutrition in 3 (3.8%) patients and reduction of malnutrition severity in 5 (6.3%) children, a significant increase in the average upper arm muscle circumference from 14.96 ± 0.93 to 15.9 ± 0.8 mm (p < 0.05) in children aged between 1 and 10 years, an increase in the number of children with normal lean body mass Z-score from 25 to 33%. Biochemical markers remained within reference values. The use of specialized formulas in the diet of children with cystic fibrosis enriched therapeutic nutrition with protein by 26-28% and energy by 22-24%. Conclusion. The inclusion of hydrolyzed milk protein formulas “Peptamen Junior” and “Peptamen” (Nestlé, Switzerland) in nutrition therapy for children with cystic fibrosis can maintain their nutritional status at a satisfactory level, provide a positive prognosis of the disease, and improve the quality of life of patients and their families. Key words: cystic fibrosis, children, nutritional status, hydrolyzed milk protein formulas","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67715031","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-2-5-16
L. Khachatryan, E. V. Kasanave, N. Geppe, E. Tyurina, T.S. Kaminskaya, D.E. Vadiyan, A. V. Polyanskaya, S. Chebysheva, M. Manukyan
Objective. To justify the significance of using a gluten-free casein-free diet (GFCF diet) in children with delayed psycho-speech development (DPSD) and to study its effect on the somatic and neuropsychological status of these patients. Patients and methods. This randomized, open-label, prospective trial involved 105 children (71 boys and 34 girls) with DPSD between the ages of 1 year 6 months and 6 years 7 months. Children were divided into two groups: group 1 included 53 children who received the GFCF diet; group 2 – 52 children who ate regular meals. Children were examined at the beginning of observation, after 6 and 12 months. We used the Integrative Medicine Assessment Scale (IMAS) 1 and 2, Childhood Autism Rating Scale, Autism Treatment Evaluation Checklist (ATEC), Integrative Medicine Patients Parent Scale. Laboratory and instrumental examinations included blood tests for antibodies IgA, IgM, IgG, IgE, Anti-tTG IgA, Anti-tTG IgG, Anti-EMA, stool tests for calprotectin and zonulin, ultrasound imaging of the abdomen, kidney, heart, transcranial Doppler ultrasound of brain vessels, and magnetic resonance imaging of the brain if necessary. All children were examined by a neurologist, psychiatrist, geneticist, and surdologist. Results. A significant effectiveness of the GFCF diet in children with DPSD, including autism spectrum disorders, was justified. It was shown that the number of children without stereotypic movement disorders, as well as without digestive problems, increased by 1.5 and 2.3 times in the group of patients receiving diet therapy compared to the group without dietary correction after 6 and 12 months from the beginning of observation; the proportion of highly expressed stereotypies decreased by 2.3 times after 6 months. According to the ATEC scale, the number of children with severe disorders was 2.2 and 2.9 times lower after 6 and 12 months, respectively; according to the somatic status assessment scale (IMAS), the total score was 1.25 times lower. Conclusion. The GFCF diet has a positive effect on the neuropsychological and somatic status of children with DPSD. Children with DPSD have non-celiac gluten sensitivity, in which adherence to the diet allows to alleviate gastrointestinal and neurological manifestations. Key words: anti-tissue transglutaminase antibodies, autism, gluten-free diet, delayed psycho-speech development
{"title":"Comprehensive evaluation of the effectiveness of gluten-free casein-free diet in children with delayed psycho-speech development","authors":"L. Khachatryan, E. V. Kasanave, N. Geppe, E. Tyurina, T.S. Kaminskaya, D.E. Vadiyan, A. V. Polyanskaya, S. Chebysheva, M. Manukyan","doi":"10.20953/1727-5784-2022-2-5-16","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-2-5-16","url":null,"abstract":"Objective. To justify the significance of using a gluten-free casein-free diet (GFCF diet) in children with delayed psycho-speech development (DPSD) and to study its effect on the somatic and neuropsychological status of these patients. Patients and methods. This randomized, open-label, prospective trial involved 105 children (71 boys and 34 girls) with DPSD between the ages of 1 year 6 months and 6 years 7 months. Children were divided into two groups: group 1 included 53 children who received the GFCF diet; group 2 – 52 children who ate regular meals. Children were examined at the beginning of observation, after 6 and 12 months. We used the Integrative Medicine Assessment Scale (IMAS) 1 and 2, Childhood Autism Rating Scale, Autism Treatment Evaluation Checklist (ATEC), Integrative Medicine Patients Parent Scale. Laboratory and instrumental examinations included blood tests for antibodies IgA, IgM, IgG, IgE, Anti-tTG IgA, Anti-tTG IgG, Anti-EMA, stool tests for calprotectin and zonulin, ultrasound imaging of the abdomen, kidney, heart, transcranial Doppler ultrasound of brain vessels, and magnetic resonance imaging of the brain if necessary. All children were examined by a neurologist, psychiatrist, geneticist, and surdologist. Results. A significant effectiveness of the GFCF diet in children with DPSD, including autism spectrum disorders, was justified. It was shown that the number of children without stereotypic movement disorders, as well as without digestive problems, increased by 1.5 and 2.3 times in the group of patients receiving diet therapy compared to the group without dietary correction after 6 and 12 months from the beginning of observation; the proportion of highly expressed stereotypies decreased by 2.3 times after 6 months. According to the ATEC scale, the number of children with severe disorders was 2.2 and 2.9 times lower after 6 and 12 months, respectively; according to the somatic status assessment scale (IMAS), the total score was 1.25 times lower. Conclusion. The GFCF diet has a positive effect on the neuropsychological and somatic status of children with DPSD. Children with DPSD have non-celiac gluten sensitivity, in which adherence to the diet allows to alleviate gastrointestinal and neurological manifestations. Key words: anti-tissue transglutaminase antibodies, autism, gluten-free diet, delayed psycho-speech development","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67715404","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}
Pub Date : 2022-01-01DOI: 10.20953/1727-5784-2022-3-20-29
E. Sarkisyan, P. Shumilov, K. Nikoghosyan, O. Khandamirova, T.G. Demyanova
Necrotizing enterocolitis (NEC) is the most life-threatening disease of the gastrointestinal tract in newborns. Current strategies and methods of NEC prevention affect the pathogenetic mechanisms of the disease development. The promotion of breastfeeding and the use of early minimal enteral nutrition with native breast milk are the main links in prevention. Immunoglobulins, antiinflammatory cytokines, and other biologically active substances found in breast milk prevent the development of NEC. A change in diet and the use of donor milk lead to a decrease in the incidence of NEC. The use of antenatal steroids in women at risk of preterm birth, control of hypoxia and normalization of the respiratory parameters also reduce the risk of NEC development. For normal colonization of the intestine, the use of probiotics is recommended. The use of oral antibacterial drugs, which are recommended in some multicomponent methods of prevention, often leads to negative results. The use of oral antifungal drugs in modern neonatology is not excluded. The use of oral immunoglobulins is ineffective. Key words: necrotizing enterocolitis, breast milk, enteral antibiotics, oral antifungal drugs, probiotics
{"title":"Current approaches to prevention of necrotizing enterocolitis in premature newborns","authors":"E. Sarkisyan, P. Shumilov, K. Nikoghosyan, O. Khandamirova, T.G. Demyanova","doi":"10.20953/1727-5784-2022-3-20-29","DOIUrl":"https://doi.org/10.20953/1727-5784-2022-3-20-29","url":null,"abstract":"Necrotizing enterocolitis (NEC) is the most life-threatening disease of the gastrointestinal tract in newborns. Current strategies and methods of NEC prevention affect the pathogenetic mechanisms of the disease development. The promotion of breastfeeding and the use of early minimal enteral nutrition with native breast milk are the main links in prevention. Immunoglobulins, antiinflammatory cytokines, and other biologically active substances found in breast milk prevent the development of NEC. A change in diet and the use of donor milk lead to a decrease in the incidence of NEC. The use of antenatal steroids in women at risk of preterm birth, control of hypoxia and normalization of the respiratory parameters also reduce the risk of NEC development. For normal colonization of the intestine, the use of probiotics is recommended. The use of oral antibacterial drugs, which are recommended in some multicomponent methods of prevention, often leads to negative results. The use of oral antifungal drugs in modern neonatology is not excluded. The use of oral immunoglobulins is ineffective. Key words: necrotizing enterocolitis, breast milk, enteral antibiotics, oral antifungal drugs, probiotics","PeriodicalId":53444,"journal":{"name":"Voprosy Detskoi Dietologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67715840","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}
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