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Current nutritional strategies for preterm infants with very low and extremely low birth weight 极低和极低出生体重早产儿的当前营养策略
Q3 Medicine Pub Date : 2022-01-01 DOI: 10.20953/1727-5784-2022-2-58-73
E. Sarkisyan, P. Shumilov, K. V. Nikogosyan, O. Khandamirova, T.G. Demyanova
The growth rate of infants born preterm should match the growth rate of healthy fetuses of the same gestational age. However, despite many existing clinical guidelines and dietary protocols, preterm infants almost invariably experience postnatal growth restriction. To ensure optimal growth and development of preterm infants, it has become essential to revise nutritional strategies. For preterm infants with extremely low and very low birth weight, it is recommended to initiate parenteral nutrition within the first hours of life, as well as to initiate early enteral nutrition directly in the delivery room with mother’s colostrum using buccal and cotton swabs. If possible, to increase the volume of enteral nutrition, to enrich breast milk, preferably with liquid fortifiers and/or human milk-based fortifiers, and to optimize supplementation with additional minerals. This review presents the scientific rationale for nutrient requirements, practical recommendations and strategies for parenteral and enteral nutrition in preterm infants, current recommendations for initial and maximum macro- and micronutrient gestational requirements. Key words: parenteral nutrition, enteral nutrition, preterm infant, nutrients, micronutrients, breast milk fortifiers
早产婴儿的生长速度应与相同胎龄的健康胎儿的生长速度相匹配。然而,尽管有许多现有的临床指南和饮食方案,早产儿几乎总是经历出生后的生长限制。为了确保早产儿的最佳生长和发育,修改营养策略已成为必不可少的。对于极低和极低出生体重的早产儿,建议在出生后的最初几个小时内开始肠外营养,也可以在产房直接用口腔和棉签用母亲的初乳开始早期肠内营养。如果可能的话,增加肠内营养的量,丰富母乳,最好使用液体强化剂和/或人乳强化剂,并优化补充额外的矿物质。这篇综述介绍了营养需求的科学依据,早产儿肠外和肠内营养的实用建议和策略,目前对初始和最大的宏量和微量营养素的妊娠需求的建议。关键词:肠外营养,肠内营养,早产儿,营养素,微量营养素,母乳强化剂
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引用次数: 0
Educational programs: an effective mechanism for preventing and treating obesity 教育计划:预防和治疗肥胖的有效机制
Q3 Medicine Pub Date : 2022-01-01 DOI: 10.20953/2224-5448-2022-4-43-49
A. V. Pogozheva, I. Tarmaeva
The prevalence of obesity and the burden of associated diseases are constantly increasing in populations around the world. The treatment and prevention of obesity today include changes in lifestyle and dietary patterns to reduce body weight, as well as the risk of cardiovascular diseases. The development and implementation of educational programs are important means of preventing and treating obesity, aimed at promoting a healthy lifestyle and optimizing nutrition. The Federal State Budgetary Institution “Federal Research Centre of Nutrition and Biotechnology” has developed many educational programs in the field of healthy nutrition, including the prevention and treatment of obesity, both for specialists and for the public. Comprehensive educational programs that involve dietary and psychological aspects have demonstrated particularly high efficiency in correcting nutritional status and eating behavior in obese people. Key words: obesity, body mass index, nutrition, eating behavior, educational program
肥胖的流行率和相关疾病的负担在世界各地的人口中不断增加。今天,肥胖的治疗和预防包括改变生活方式和饮食模式,以减少体重,以及患心血管疾病的风险。制定和实施教育计划是预防和治疗肥胖的重要手段,旨在促进健康的生活方式和优化营养。联邦国家预算机构"联邦营养和生物技术研究中心"为专家和公众制定了许多健康营养领域的教育方案,包括预防和治疗肥胖。涉及饮食和心理方面的综合教育项目在纠正肥胖者的营养状况和饮食行为方面表现出特别高的效率。关键词:肥胖,体重指数,营养,饮食行为,教育计划
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引用次数: 1
“Gut microbiota universe” – diversity of functions: a modern view “肠道菌群宇宙”-功能多样性:现代观点
Q3 Medicine Pub Date : 2022-01-01 DOI: 10.20953/1727-5784-2022-2-30-39
E. Kornienko
This article is an up-to-date review of the literature describing the functions of the gut microbiota and its interaction with the host. The gut microbiota has an important metabolic function, including energetic. The main metabolites of the healthy microbiota are short-chain fatty acids, which play energetic, anti-inflammatory, tolerogenic and anticarcinogenic roles. Microbial metabolites of tryptophan contribute to the nervous system formation and immunological tolerance. The spectrum of vitamins synthesized by the gut microbiota depends on the host enterotype. The protective function of the gut microbiota includes colonization resistance, strengthening of the intestinal barrier and direct interaction with almost all components of innate and adaptive immunity with the ultimate goal to develop immunological tolerance. Understanding the functional role of the normal gut microbiota can underlie the prevention of many diseases in modern times. Key words: gut microbiota, metabolism, immunity
这篇文章是一篇最新的文献综述,描述了肠道微生物群的功能及其与宿主的相互作用。肠道菌群具有重要的代谢功能,包括能量。健康微生物群的主要代谢产物是短链脂肪酸,具有能量、抗炎、耐受性和抗癌作用。色氨酸的微生物代谢产物有助于神经系统的形成和免疫耐受。肠道菌群合成的维生素谱取决于宿主的肠道类型。肠道菌群的保护功能包括定植抵抗、加强肠道屏障以及与几乎所有先天免疫和适应性免疫成分的直接相互作用,最终目的是产生免疫耐受。了解正常肠道微生物群的功能作用可以在现代预防许多疾病。关键词:肠道菌群;代谢;免疫
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引用次数: 0
Hypocholesterolemia: an important symptom of rare diseases 低胆固醇血症:罕见病的重要症状
Q3 Medicine Pub Date : 2022-01-01 DOI: 10.20953/1727-5784-2022-4-70-80
S. Polyakova, P. Shumilov
Hypocholesterolemia is an important symptom that may indicate the presence of severe hereditary metabolic disease or acquired secondary pathology. This lecture discusses the criteria for hypocholesterolemia in children, issues of cholesterol metabolism and its disorders, and the most common causes of hypocholesteremia. Issues of pathogenesis, clinical picture, diagnosis, and treatment of cholesterol synthesis disorders (Smith–Lemli–Opitz syndrome) and abetalipoproteinemia are considered in detail, and clinical cases of patients with these diseases are presented. Key words: hereditary metabolic diseases, hypocholesterolemia, Smith–Lemli–Opitz syndrome, abetalipoproteinemia
低胆固醇血症是一个重要的症状,可能表明存在严重的遗传性代谢疾病或获得性继发性病理。本讲座讨论了儿童低胆固醇血症的标准,胆固醇代谢及其紊乱的问题,以及低胆固醇血症的最常见原因。本文详细讨论了胆固醇合成障碍(Smith-Lemli-Opitz综合征)和高脂蛋白血症的发病机制、临床表现、诊断和治疗问题,并介绍了这些疾病患者的临床病例。关键词:遗传性代谢性疾病;低胆固醇血症;Smith-Lemli-Opitz综合征
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引用次数: 0
Non-invasive markers of liver fibrosis and cirrhosis in children with biliary atresia 胆道闭锁儿童肝纤维化和肝硬化的非侵入性标志物
Q3 Medicine Pub Date : 2022-01-01 DOI: 10.20953/1727-5784-2022-4-31-41
M. Isaeva, А. Degtyareva, E. A. Filippova, A. Sugak, E. Tumanova, N. S. Korchagina, A. Razumovsky, N. Kulikova, E. A. Gordeeva, M. Albegova
Objective. To identify non-invasive laboratory and ultrasound markers of liver fibrosis and cirrhosis in children with biliary atresia. Patients and methods. This retrospective study enrolled 166 children who underwent the Kasai procedure for biliary atresia. Intraoperative liver biopsy followed by histological examination of the biopsy specimen was performed in all children. According to the results of morphological analysis, patients were divided into two groups: group I included 108 children with moderate fibrosis (F0–2), group II – 58 children with severe liver fibrosis/cirrhosis (F3–4). Prior to surgery, patients underwent a comprehensive examination, which included laboratory parameters (platelets, albumin, gamma-glutamyl transpeptidase, cholinesterase, cholesterol, alkaline phosphatase, total and direct bilirubin, alanine aminotransferase, aspartate aminotransferase, fibrinogen, international normalized ratio, thrombin time, prothrombin index, APRI and AAR indices), and Doppler ultrasound. Results. The correlation analysis revealed a statistically significant, direct, very strong correlation between the degree of fibrosis and patient age at the time of biopsy (ρ = 0.805; p < 0.001), APRI index (ρ = 0.827; p = 0.001), and the hepatic artery diameter (ρ = 0.794, p = 0.042). The correlation between the degree of liver fibrosis and spleen length was statistically significant, direct, and of marked strength (ρ = 0.686; p = 0.010). There was a statistically significant, direct, notably strong correlation between the hepatic artery resistive index (RI) (ρ = 0.639; p = 0.05) and hepatic artery diameter-to-portal vein diameter ratio (HAD-to-PVD ratio) (ρ = 0.683, p = 0.047). The dependence of the probability of liver fibrosis/cirrhosis severity on the values of APRI index was assessed using ROC curves. The AUC value was 0.792 ± 0.056 (95% CI: 0.76–0.88, p = 0.009). The APRI value at the cut-off point was 1.52: with an APRI >1.52 showing a high risk of severe liver fibrosis/cirrhosis, and with lower values, the risk of severe fibrosis/cirrhosis was considered low. The sensitivity and specificity of the model were 73.9 and 71.1%, respectively. Conclusion. The results of the study indicate the significance of biochemical, ultrasound and Doppler parameters in the diagnosis of liver fibrosis/cirrhosis in children with biliary atresia. Key words: biliary atresia, liver fibrosis, liver cirrhosis, APRI index
目标。目的:探讨胆道闭锁患儿肝纤维化和肝硬化的无创实验室和超声标志物。患者和方法。这项回顾性研究招募了166名接受Kasai手术治疗胆道闭锁的儿童。所有患儿均行术中肝活检,然后对活检标本进行组织学检查。根据形态学分析结果将患者分为两组:I组108例中度纤维化儿童(F0-2), II组58例重度肝纤维化/肝硬化儿童(F3-4)。术前对患者进行综合检查,包括实验室参数(血小板、白蛋白、γ -谷氨酰转肽酶、胆碱酯酶、胆固醇、碱性磷酸酶、总胆红素、直接胆红素、丙氨酸转氨酶、天冬氨酸转氨酶、纤维蛋白原、国际标准化比值、凝血酶时间、凝血酶原指数、APRI、AAR指数)、多普勒超声。结果。相关分析显示,纤维化程度与活检时患者年龄有统计学意义、直接、非常强的相关性(ρ = 0.805;p < 0.001), APRI指数(ρ = 0.827;P = 0.001),肝动脉直径(ρ = 0.794, P = 0.042)。肝纤维化程度与脾脏长度的相关性有统计学意义,且直接且强度显著(ρ = 0.686;P = 0.010)。肝动脉阻力指数(RI)之间有统计学意义、直接、显著的强相关性(ρ = 0.639;p = 0.05)、肝动脉直径与门静脉直径比值(hd -to- pvd ratio) (ρ = 0.683, p = 0.047)。采用ROC曲线评估肝纤维化/肝硬化严重程度概率与APRI指数值的依赖关系。AUC值为0.792±0.056 (95% CI: 0.76 ~ 0.88, p = 0.009)。分界点的APRI值为1.52,当APRI值为1.52时,表明发生严重肝纤维化/肝硬化的风险较高,当APRI值较低时,认为发生严重肝纤维化/肝硬化的风险较低。该模型的敏感性为73.9%,特异性为71.1%。结论。本研究结果提示生化、超声及多普勒参数对胆道闭锁患儿肝纤维化/肝硬化的诊断意义。关键词:胆道闭锁,肝纤维化,肝硬化,APRI指数
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引用次数: 0
Semantic analysis of terms in dietetics: nutritional status and nutritional condition 营养学术语的语义分析:营养状况和营养状况
Q3 Medicine Pub Date : 2022-01-01 DOI: 10.20953/2224-5448-2022-4-50-53
A. B. Petukhov, V. Novodranova, D. Nikityuk
The necessity of semantic analysis of the language of science is logically substantiated. The complexity and multi-level interpretation of definitions is demonstrated, as well as the need for linguistic description of terms in dietetics to achieve mutual understanding by specialists. Key words: language of science, nutritional science, dietetics, terminology, nutritional status, nutritional condition
对科学语言进行语义分析的必要性在逻辑上得到了证实。说明了定义的复杂性和多层次解释,以及营养学中术语的语言描述以实现专家相互理解的必要性。关键词:科学语言,营养科学,营养学,术语,营养状况,营养状况
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引用次数: 0
Flexitorianism: a tribute to fashion, a new dietary trend, or a perceived need? 弹性素食主义:对时尚的致敬,一种新的饮食趋势,还是一种被感知到的需求?
Q3 Medicine Pub Date : 2022-01-01 DOI: 10.20953/2224-5448-2022-4-32-42
A. Zavyalova, M.N. Kazikova, A.V. Masneva, D. Khranilova
An increasing number of people are becoming adherents of vegetarian diets, namely, such a modern trend as flexitorianism. The main idea of the Flexitorians is to reduce the consumption of red meat as a condition for maintaining health. Most of the supporters of this trend are environmentally friendly youth. The main reasons for switching to this type of diet are environmental and social. This movement is trying to reduce the negative impact of the livestock and meat industry on the environment. Also, some people are driven not only by moral ideas, but also by the desire to conform to fashion. A number of studies are presented in terms of the filling of the grocery basket and the frequency of choosing products of animal and plant origin, both for themselves and for their children. The study of stereotypes of nutrition of children and adolescents in modern conditions is described. Data from studies of the feces microbiome of Fleckitorians and omnivores have shown a positive effect on the saprophytic flora of the Flexitorian diet. Key words: flexitorianism, microbiome, nutritional stereotypes
越来越多的人成为素食的追随者,也就是像弹性素食这样的现代趋势。弹性素食者的主要思想是减少红肉的消费,以此作为保持健康的条件。这一趋势的大多数支持者是环保的年轻人。转向这种饮食的主要原因是环境和社会因素。这一运动试图减少畜牧业和肉类工业对环境的负面影响。此外,有些人不仅受道德观念的驱使,还受赶时髦的欲望的驱使。一些研究提出了关于食品篮子的填充和选择动物和植物来源的产品的频率,无论是为自己还是为他们的孩子。描述了在现代条件下对儿童和青少年营养的刻板印象的研究。对挠挠动物和杂食动物粪便微生物群的研究数据表明,挠挠动物饮食对腐生菌群有积极影响。关键词:弹性饮食,微生物群,营养刻板印象
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引用次数: 0
Chronic viral hepatitis and inflammatory bowel disease 慢性病毒性肝炎和炎症性肠病
Q3 Medicine Pub Date : 2021-12-25 DOI: 10.20953/2224-5448-2021-2-29-34
G. Volynets, A. Khavkin
The article presents the results of a literature review devoted to the study of the problems of the combined course of inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn's disease (CD), and chronic viral hepatitis (CVH) – chronic hepatitis B (CHB) and chronic hepatitis C (CHC). The frequency of occurrence of CHB and CHC in IBD in different countries is presented, which ranges from 1 to 9%. The clinical course of these combined diseases, the possibility of reactivation of hepatitis B virus (HBV) and hepatitis C virus (HCV) during immunosuppressive therapy are described. Recommendations on the specifics of examination and management of patients with combined pathology of IBD and CVH are presented. Conclusion. The combined pathology of IBD and CVH is a significant public health problem around the world that requires further large-scale study. The use of immunosuppressive therapy for IBD can be accompanied by the activation of HBV and HCV infection, therefore, the management of such patients should be individualized. Key words: inflammatory bowel disease, chronic hepatitis B, chronic hepatitis C, immunosuppressive therapy
本文介绍了一篇致力于研究炎症性肠病(IBD)联合病程问题的文献综述的结果,其中包括溃疡性结肠炎(UC)和克罗恩病(CD),以及慢性病毒性肝炎(CVH) -慢性乙型肝炎(CHB)和慢性丙型肝炎(CHC)。介绍了不同国家IBD中CHB和CHC的发生频率,其范围为1%至9%。本文描述了这些合并疾病的临床过程,以及免疫抑制治疗期间乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)再激活的可能性。提出了关于IBD和CVH合并病理患者的具体检查和管理的建议。结论。IBD和CVH的联合病理是世界范围内的一个重大公共卫生问题,需要进一步的大规模研究。使用免疫抑制治疗IBD可能伴随着HBV和HCV感染的激活,因此,这类患者的管理应个体化。关键词:炎症性肠病,慢性乙型肝炎,慢性丙型肝炎,免疫抑制治疗
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引用次数: 0
Probiotic fermented dairy products – food or medication? 益生菌发酵乳制品——食品还是药物?
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/1727-5784-2021-3-58-68
A. Khavkin, T. Kovtun, D. V. Makarkin, O. Fedotova
One of the main strategies for preventing chronic diseases is a balanced diet from early childhood, with the inclusion of functional ingredients: dietary fiber, vitamins and vitamin-like compounds, minerals, polyunsaturated fatty acids, prebiotics and probiotics. A combined enrichment of fermented dairy products with prebiotics and probiotics contributes to the summation of their positive effective influence. Adding prebiotics and probiotics to the diet leads to the change in the intestinal microbiota composition towards a more balanced structure, thereby increasing the intestinal barrier function and the formation of optimal immune interactions. The most commonly used in human nutrition is a combination of bifidobacteria or lactobacilli with fructo-oligosaccharides in synbiotic products. It is important that the microorganisms are safe, stable in storage and able to survive in the gastrointestinal tract. The use of probiotic fermented dairy products has a positive impact on child health: it has anti-infectious and immunomodulatory effects, helps to normalize the gastrointestinal motility. These statements are confirmed by controlled studies in which children aged 8 to 18 months, recovering from acute respiratory disease, for which antibiotic therapy was prescribed, included in the diet drinking yoghurts enriched with Bifidobacterium lactis BB12 and inulin for 3 months. The inclusion of yoghurts in the children’s diet helped to normalize the intestinal microbiota composition after antibiotic therapy, as well as to strengthen the immune system by stimulating the synthesis of protective factors – secretory immunoglobulin A and lysozyme. Key words: fermented dairy products, child nutrition, probiotics, prebiotics, synbiotics, inulin, microbiota, functional foods, immune system, Bifidobacterium lactis BB12
预防慢性疾病的主要策略之一是从幼儿时期开始均衡饮食,包括功能性成分:膳食纤维、维生素和维生素类化合物、矿物质、多不饱和脂肪酸、益生元和益生菌。益生元和益生菌在发酵乳制品中的联合富集有助于总结它们的积极有效影响。在日粮中添加益生元和益生菌,可以使肠道菌群的组成朝着更加平衡的结构变化,从而提高肠道屏障功能,形成最佳的免疫相互作用。在人类营养中最常用的是双歧杆菌或乳酸菌与低聚果糖的合成产品的组合。重要的是,微生物在储存中是安全的,稳定的,能够在胃肠道中生存。使用益生菌发酵乳制品对儿童健康有积极的影响:它具有抗感染和免疫调节作用,有助于胃肠运动的正常化。这些说法得到了对照研究的证实,在对照研究中,年龄在8至18个月的儿童,从急性呼吸道疾病中康复,并给予抗生素治疗,包括在饮食中饮用富含乳酸双歧杆菌BB12和菊粉的酸奶3个月。在儿童饮食中加入酸奶有助于使抗生素治疗后肠道微生物群组成正常化,并通过刺激保护性因子-分泌性免疫球蛋白A和溶菌酶的合成来增强免疫系统。关键词:发酵乳制品,儿童营养,益生菌,益生元,合成菌,菊粉,微生物群,功能食品,免疫系统,乳酸双歧杆菌BB12
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引用次数: 4
A case report of a patient with isolated Crohn’s disease of the stomach 一例孤立性胃克罗恩病患者的病例报告
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/1727-5784-2021-3-95-101
E. Trush, A. Ulyanin, A. Korolev, L.N. Androsova, P. Pavlov, O. Shifrin, A. Trukhmanov, E. Poluektova, A. S. Tertychnyy, S. S. Pirogov, V. Ivashkin
Crohn’s disease of the esophagus, stomach or duodenum is extremely rare and characterized by an aggressive disease course with a poor prognosis. Clinical symptoms of the upper gastrointestinal tract lesion are nonspecific, therefore esophagogastroduodenoscopy with biopsy is necessary for the differential diagnosis. Crohn’s disease of the stomach is characterized by a specific endoscopic finding – bamboo-joint-like appearance of gastric folds. Granulomatous inflammation in morphological examination of gastric biopsies in patients with Crohn’s disease is rare, therefore endoscopic finding is more pathognomonic. This article presents a clinical case of a patient with isolated Crohn’s disease of stomach, differential diagnosis and treatment approaches of the disease. Key words: Crohn’s disease, Crohn’s disease with lesions of the stomach, gastroprotective agents, proton pump inhibitors, endoscopic sonography
食道、胃或十二指肠的克罗恩病极为罕见,其特点是病程严重,预后差。上消化道病变的临床症状是非特异性的,因此需要食管胃十二指肠镜联合活检进行鉴别诊断。胃克罗恩病的特点是一种特殊的内镜发现-胃褶皱的竹关节样外观。克罗恩病患者胃活检形态学检查中的肉芽肿性炎症是罕见的,因此内镜下的发现更具有病理特征。本文报道1例孤立性胃克罗恩病的临床病例,介绍该病的鉴别诊断和治疗方法。关键词:克罗恩病,克罗恩病伴胃病变,胃保护剂,质子泵抑制剂,内镜超声检查
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引用次数: 0
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Voprosy Detskoi Dietologii
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