[Use of a controlled attenuation parameter for the diagnosis of non-alcoholic fatty liver disease]

AIM

To evaluate the efficacy of vibration-controlled transient elastography (VCTE) with a controlled attenuation parameter (CAP) in a population of patients with non-alcoholic fatty liver disease (NAFLD)and to compare to US and different non-invasive indices.

MATERIALS AND METHODS

Single center NAFLD patients' database of 2021-2023 years was retrospectively analysed. Data of VCTE evaluation with CAP (FibroScan 530® and FibroScan 630 Expert®) as well as liver US examination results and values of HSI, FLI, BAAT and NAFLD-LFS were extracted. AUROCs for all methods used were constructed and sensitivity and specificity analysis was performed.

RESULTS

The data of 1081 patients were available for analysis (385 with steatosis, 274 with NASH, 422 without NAFLD as a control). Ultrasound examination in the diagnosis of liver steatosis compared to VCTE with CAP showed sensitivity and specificity of 94.6 and 63.7%, respectively. Diagnosis of liver steatosis using indices and scales showed sensitivity and specificity of HSI: 97.9 and 60.1% (AUROC 0.90), FLI: 92.5 and 85.3% (AUROC 0.93), BAAT: 76.6 and 73.5% (AUROC 0.82), NAFLD-LFS: 56.7 and 81.8% (AUROC 0.85).

CONCLUSION

The sensitivity of the US of the liver was consistent with previous studies, but the specificity was low. The HSI index had the best indicators of sensitivity and specificity in relation to the diagnosis of liver steatosis. Combination of liver US and HSI can be used in screening of liver steatosis, however, for the complete diagnosis better tools which can simultaneously evaluate liver steatosis and fibrosis should be used.

[Prospects of dietary fibers food fortification for the treatment and prevention of gastrointestinal diseases: A review]

Epidemiological studies have proven the connection between high consumption of dietary fiber and a reduction in the risk of many diseases. In clinical trials, the possibility of functional regulation of the intestine and intestinal microbiome by dietary fibers has been revealed, which may be significant in certain diseases of the digestive system. This review provides information on the relationship between the physico-chemical properties and functional characteristics of dietary fibers, discusses evidence of the effectiveness of their use in the treatment of diseases of the digestive system, discusses the need to enrich food with dietary fibers.

[Spectrum of food diversity of megapolis' inhabitants obtained by the analysis of buying activity]

The food diversity is a significant indicator of a healthy diet. The aim of the study was to assess the indicators of food diversity in the metropolis (Moscow) based on the analysis of consumer activity in a large retail chain. Material and methods. 201 904 holders of loyalty cards of the retail network were selected from the depersonalized purchase data for 2016-2018 according to the following selection criteria: the presence of a dense segment of purchases (more than 4 weeks, where there was at least 1 purchase in 2 weeks), where the total cost of purchases was at least 4700 rubles and at least 4 different products were purchased. From of these, 111 136 buyers have data available by gender, 43 046 by age. The classification of a set of purchased products and dishes by food groups was carried out, and complex dishes were transformed into a set of their ingredients and the distribution of the unique values of the corresponding food groups was carried out. Counting the number of unique preferences (count base diversity) by the number of positions in each of the 6 food groups (cereals, fish and meat, fat products, dairy products, vegetables, fruits and berries) allowed us to estimate the amount of food diversity. The total number of food categories in all subgroups was also calculated. Results. The low value of food diversity in the category of cereals and cereals was found in 2/3 of buyers, in the category of vegetables and fruits in 60% of buyers, in the category of meat and fish products in half of buyers, in the category of fat-and-oil products in 63.7% and in 44.2% of buyers of dairy products. An acceptable total number of categories of purchased products (more than 20 per week) was achieved only in 14.5% of men and 16.7% of women from our sample. In general, lower indicators of dietary diversity are typical for men and young people (up to 45 years old). Conclusion. Thus, it can be concluded that the importance of food diversity as a factor of health protection is underestimated by the population, especially by young people, which can lead to an increase in the burden on healthcare due to the earlier debut of a wide range of chronic diseases.

[Clinical evaluation of the efficacy of innovative spread of a given fatty acid composition enriched by adaptogens]

Adaptogens are a group of substances capable to increase the nonspecific resistance of the organism to a wide range of harmful effects and stress. However, only limited data exist on their use in the composition of foods for special dietary uses. The aim of the study was to evaluate the effect of a diet that included vegetable-fat spread enriched with 5-hydroxytryptophan, L-theanine and γ-aminobutyric acid on memory, general well-being and emotional status of healthy volunteers. Material and methods. The single-center, single-blind randomized prospective trial that enrolled persons without signs of significant organic pathology have been performed. Participants were randomly allocated to receive either 45 g/day standard spread enriched with 5-hydroxytryptophan (0.67%), L-theanine (0.56%) and γ-aminobutyric acid (0.45%) (main group, MG) or 45 g/day standard spread (control group, CG) for 10 days. Beside this, all participants followed a standard diet. Initially, as well as on the 10th day after the start of using the diet, the emotional state was assessed using the HADS anxiety and depression scale and Beck's depression inventory (BDI), general well-being by SAN questionnaire, memory according to the Lurie method; reaction time and attention concentration were assessed using the Krepelin counting test and the Burdon correction test. A 5-point Likert visual-analogue scale was used to assess the palatability (pasting) of the product, the severity of feelings of hunger and satiety at the baseline and on the 10th day of the study. All tests were performed under the supervision of staff. During the study, daily monitoring of the presence of adverse events was performed. Results. There were 70 subjects in MG and 70 in CG. Lurie memory score significantly increased in the MG (59.9±6.7 vs 58.1±7.4 points at the baseline; p=0.001), but not in the CG (58.0±6.9 vs 57.3±7.3 points, p>0.05). According to the SAN questionnaire, significant increase of well-being values (46.9±13.4 vs 44.2±13.5 points; p=0.01) and mood (49.9±12.6 vs 47.4±12.9 points; p=0.01) was found in MG, while in CG there was an increase of the mood category only (54.4±10.8 vs 52.2±12.1, p=0.04). At the end of the study an increase of «Satiety» (60.3±22.8 vs 51.5±24.8, p=0.022) and decrease of «Hunger» score (24.1±19.8 vs 29.1±19.4, p=0.02) were revealed in CG but not in the CG. No significant change was found by the results of other tests, stool form and its frequency in both groups. Conclusion. Newly developed spread enriched with 5-hydroxytryptophan, L-theanine, γ-aminobutyric acid was well-tolerated, did not affect the feeling of hunger and satiety, and improved memory and well-being parameters.

[Food diversity analysis based on data of food purchasing in supermarket chain]

Diversity in nutrition is of fundamental importance for health. According to research in recent decades, the diversity of the population's diet has greatly decreased, which carries health risks. The aim of the study was to analyze food diversity in population based on their purchasing activity in large trading network. Material and methods. From the depersonalized data of 1 800 319 loyalty program unique members of the retail network in Moscow, 201 904 buyers were selected according to the following criteria: the presence of a dense segment of purchases (more than 4 weeks, where there was at least 1 purchase in 2 weeks), in which the total cost of purchases was not less than 4700 rubles and at least 4 different food groups were purchased. Data from the cashier's receipts for 12 months (median 124 days) as well as the food labels for extracting the data about ingredients were used. Food diversity was analyzed by using count-base score method in which absolute number of different foods in every of 6 food groups (grains, fish and meat, fats, dairy products, vegetables, fruits and berries) was calculated. Total score as a sum of all scores from all food groups was also calculated. Results. According to the food diversity analysis, 73.9% of buyers purchased 2 or less types of grains. Only 31.4% of buyers purchased more than 4 types of vegetables, only 36.2% purchased more than 2 types of fruits and berries, 41.9% purchased less than 2 types of meat and fish, 61.3% purchased only 1 type of fat, and at least 2 types of dairy products was purchased by 53,3% of buyers. Acceptable rate of food diversity of 20 different types of food per week was achieved only in 11.4% of buyers. Conclusion. Food diversity in buyers of trading network is low, with the lowest scores in buying different grains, vegetables, fruits and berries, meat and fish as well as fats. Better diversity was demonstrated in buying dairy products, as they traditionally are accounted as healthy by consumers.

[Food patterns in Russian patients with gastroesophageal reflux disease: the results of pilot comparative study]

AIM

To evaluate nutritional patterns in patients with gastroesophageal reflux disease (GERD) compared to the control group without GERD.

MATERIALS AND METHODS

The data of complex examination of patients referred to perform esophageal pH-impedance recording and who gave written informed consent to participate in the study served as a source data. All the participants underwent complex examination, including clinical data (presence of heartburn and acid regurgitation), symptom evaluation (GERD-Q questionnaire), esophagogastroscopy, esophageal pH-impedance recordings and food frequency questionnaire. Diagnosis of GERD was based on GERD-Q score 8, acid exposure time 6%, number of gastroesophageal refluxes 80/day by 24-hrs esophageal pH-impedance recordings. Nutritional patterns were assessed with the use of healthy eating pyramid principles.

RESULTS

Overall 165 patients were enrolled and the data of 150 of them (34 with confirmed GERD and 116 of the control group) were available for the final analysis. The patients of the both groups consumed lower compared to the recommended amounts of dairy and higher amounts of meat. Those with GERD consumed larger amounts of fruits (0.910.68 compared to the values of healthy eating pyramid vs 0.520.57 in the control group, p=0.001), and fats (0.690.55 vs 0.490.55, p=0.001). Compared to the controls, patients with GERD consumed lower amounts of vegetables (0.860.46 of the healthy eating pyramid vs 0.940.63 in the control group, р=0.004) and sugars confectionaries (0.380.39 vs 1.930.98, p=0.0001).

CONCLUSION

Nutritional patterns of patients with gastroesophageal reflux disease significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.

[Association of nutritional patterns and arterial hypertension in Russia: does it exist?]

AIM

To evaluate nutritional patterns in patient with arterial hypertension (AH) compared to the control group without elevated blood pressure.

MATERIALS AND METHODS

Retrospective search for unique records of the patients aged 1875 y.o. with complete data on usual nutrition with food frequency methods who had no mentions of diabetes mellitus, food intolerance or allergies, and history of major abdominal surgery, as well as signs of secondary reasons of AH. Nutritional patterns were assessed with the use of healthy eating pyramid principles. Ststistical analysis was performed with the use of SPSS 13.0 for Windows software (SPSS Inc., USA).

RESULTS

The data of 711 patients were available for the final analysis (595 of them in AH group). Both groups consumed lower compared to the recommended amounts of fruits, dairy and higher amounts of meat. Those with AH consumed larger amounts of vegetables (1.130.74 compared to the values of healthy eating pyramid vs 0.940.63 in the control group; p=0.004), fruits (0.800.66 vs 0.520.57; p=0.001), meat (1.851.05 vs 1.620.91; p=0.002) and fats (0.770.60 vs 0.490.55; p=0.001). On the other hand, there were lower rates of consumption of sugars, and confectionaries in the structure of nutritional patterns in patients with AH compared to the control group: (0.350.44 of the healthy eating pyramid in AH vs 1.930.98, in the control group; p=0.0001).

CONCLUSION

Nutritional patterns of patients with arterial hypertension significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.

[Innovative approaches to study food patterns in functional gastrointestinal disorders]

Dietary patterns play an important role in pathogenesis and treatment of functional gastrointestinal disorders. The aim - to perform literature review on modern approaches to perform nutritional assessment in functional gastrointestinal disorders and to summarize available data on its role in assessment of clinical manifestations and treatment of these conditions. Material and methods. A search was performed in the PubMed and Google scholar system with the use of keywords: "nutritional pattern", "dietary pattern", in combination with "methodology", "assessment", "functional gastrointestinal disorders", "GERD", "gastroesophageal reflux disease", "irritable bowel syndrome", "IBS", "small intestinal bacterial overgrowth", "treatment". The inclusion criteria were type of the paper (original study); they had to contain data on nutrition of patients with functional gastrointestinal disorders; main digital data should be present (sample size, design, diagnostic criteria, patients' eligibility criteria, control group characteristics, as well as results in quantitative characteristics and measure of dispersion of values). Results and discussion. Based on the data of 81 selected papers structured literature review was performed. We summarized the data on the methods of food patterns assessment, the knowledge on the food patterns in patients with functional gastrointestinal disorders (including gastroesophageal reflux disease and irritable bowel syndrome), clinical utility of the nutritional assessment with the use of food patterns. Assessment of nutritional patterns in patients with functional gastrointestinal disorders provides additional evidence that allows to correct the diet of these patients more effectively, to achieve better results of treatment in shorter time, to reduce the number of medications, and may be of use for the development of new functional foods.

[The role of dietary diversity in the formation of syndrome intestinal bacterial overgrowth]

Small intestinal bacterial overgrowth (SIBO) is a widespread disease characterized by a significant decrease of the quality of life. Antibiotic treatment of SIBO is usually effective, however, the recurrence rate is high. Microbiota is dependent on dietary pattern of the patient and specific nutrients, therefore the diversity of dietary patterns may be one of the major factor promoting SIBO or its relapses after treatment. The aim of the study was to compare nutritional diversity in patients with SIBО-H₂ and in healthy controls.

MATERIAL AND METHODS

Оne thousand twenty three patients with suspected SIBО were examined. Hydrogen-methane breath test with lactulose was performed in 973 patients, the results of which identified groups with SIBO-H₂ (n=522), with SIBO-CH₄ (n=340) and without signs of SIBO (n=108). Data on food intake was collected with 24 h recall from all participants. Dietary diversity was assessed using method of calculation of unique values (count base diversity) for 11 groups of food: cereals, meat and eggs, fish and non-fish seafood, fat containing products, dairy products, nuts, vegetables, fruits and berries, confectionery, drinks, sauces and spices. The pattern of food diversity for each patient was obtained by counting the items in each of the studied food groups. Comparison of the mean values of the number of items in each of the studied food groups was used to compare food diversity in patients with and without SIBО-H₂.

RESULTS AND DISCUSSION

A comparison of nutritional diversity in patients with SIBO-H₂ revealed a lower count base diversity in the groups of dairy products (2.70±1.37 vs 3.19±1.34, p<0.001), vegetables (5.50±2.22 vs 6.29±1.90, p<0.001), fruits (1.54± 1.38 vs 1.99±1.69, p=0.018) in compare with controls. Count base diversity in grains, meats, fishes, fat products, nuts and legumes and sweets did not demonstrate significant differences.

CONCLUSION

Significant differences in the diversity of dietary patterns in patients with SIBО were found in dairy products, vegetables and fruits and berries. The obtained data may be used to develop diet for SIBO patients additionally to the treatment and prevention of its relapses.

[Association of thermal food processing methods and small intestinal bacterial overgrowth syndrome]

Small intestinal bacterial overgrowth (SIBO) is a widespread disease which antibiotic therapy is not effective enough and the relapse rate is high. Microbiota is dependent on dietary pattern of the patient and specific nutrients, therefore the diversity of dietary patterns may be one of the major factor promoting SIBO or its relapses after treatment. The aim: to compare the patterns of thermal food processing methods in patients with and without SIBO. Material and methods. We performed retrospective single center database search to identify unique depersonalized records of patients with SIBO and the data of lactulose breath test and nutritional assessment with the use of 24-hours dietary recall. Inclusion criteria were complete data on patient's demography, adequate data of nutritional assessment and the lactulose breath test, absence of previous history of SIBO treatment in a special form of the database. In accordance with the results of lactulose breath test, patients were assigned into groups with the presence of SIBO with excess production of hydrogen (H₂), methane (CH₄), both gases (CH₄-H₂) or without SIBO (control group). According to the data of 24 h dietary recall, we divided all dishes and products consumed by a patient to 6 categories (Cat) depending on thermal food processing method: those that were not processed (raw) (Cat-r), boiled (Cat-bl), fried (Cat-f), stewed (Cat-s), baked in the oven (Cat-bk) or grilled (Cat-g). To analyze the structure of thermal food processing, we divided the weight of all products or dishes that underwent specific method of processing to the total weight of the food eaten. We did not take into the account the weight of thermally stable components like water and salt. The pattern of thermal food processing within each patients group was obtained as a quotient of the total percentage (by weight) of the food processed with the certain method by the number of patients in the group. Results and discussion. The data of 1108 patients were available for the final analysis: 602 patients in the SIBO-H₂ group, 140 in the SIBO-CH₄ group, 248 in the SIBO-CH₄-H₂ group, and 118 patients in the control group. The distribution of thermal food processing categories was in patients with SIBO-H₂ as follows: Cat-r - 45.8±17.3%, Cat-bl - 31.9±15.7%, Cat-s - 3.5±7.7%, Cat-f - 6.3±10.4%, Cat-bk - 12.2±10.2%, Cat-g - 0.3±3.3%); in patients with SIBO-CH4: Cat-r - 47.9±17.4%, Cat-bl - 29.6±15.6%, Cat-s - 4.4±7.6%, Cat-f - 5.8±9.8%, Cat-bk - 12.3±10.4%, Cat-g - 0,2±2,7%; in patients with SIBO-CH4-H2: Cat-r - 45.6±16.3%, Catbl - 31.5±16.2%, Cat-s - 4.0±8.0%, Cat-f - 5.1±9.3%, Cat-bk - 13.4±10.8%, Cat-g - 0.4±2.3%. Similar results were obtained in the control group (Cat-r - 44.7±17.0%, Cat-bl - 32.6±16.5%, Cat-s - 2.7±6.0%, Cat-f - 5.5±8.0%, Cat-bk - 14.2±10.6%, Cat-g - 0.3±2.0%). There were no significant differences between the SIBO and control groups by mean percentage of raw, boiled, stewed, fried, baked and grilled food intake. Conclusion. We found no association between thermal food processing patterns and SIBO. It seems that thermal food processing patterns has no influence on SIBO and its variants.

[Features of nutrition pattern of patients with small intestinal bacterial overgrowth resistant to therapy]

Small intestinal bacterial overgrowth (SIBO) is a widespread disease characterized by a significant decrease in the quality of life. Antibiotic treatment with SIBO is not effective enough and the recurrence rate is high. Long-term dietary patterns can shift the composition of the microbiota. The aim of the study was to compare the pattern of nutrition of patients with SIBО, resistant to therapy and cured patients. Materials and methods. SIBO H₂ has been identified in 458 patients using hydrogenmethane breath test with lactulose, and therapy with intestinal antiseptics and control breath test after 2 months was prescribed. 24 hour recalls or three-day food records were collected from all participants. The photographs were used to estimate the size of the portions eaten. According to food composition and portion all dishes in food diary were converted into constituent products by food groups, which were summed by weight per day and compared with the norms of consumption of the pyramid of healthy nutrition for a given caloric intake. The study compared dietary patterns of patients with resistance to the therapy of SIBO and those who had successful therapy. Results and discussion. Control of the hydrogen content in the exhaled air was performed only in 79 re-appeared patients, 38 (48.9%) of them in 2 months after therapy revealed the presence of SIBO H₂>20 ppm. A comparison of the nutrition of these patients showed that patients resistant to therapy had higher consumption of buckwheat (0.41±0.47 vs 0.14±0.35 relative to the rate of consumption of cereals, p<0.001) and millet (0.036±0.11 vs 0.007±0.021, p=0.047), poultry meat (0.80±0.64 vs 0.54±0.62, p=0.01) and butter (0.54±0.24 vs 0.39±0.22, p<0.01). The diet of patients with resistant to SIBO therapy was also сharacterized by a lower consumption of mono- and disaccharides (75.2±32.7 vs 95.5±41.5 g/day; p=0.015) and cottage cheese (0.07±0.08 vs 0.17±0.19, p=0.018). Consumption of fruits and vegetables did not have significant differences. Conclusion. Treatment is ineffective in roughly half the patients with SIBO H₂. According to the results of the study, significant differences in the nutrition pattern of patients resistant to SIBO therapy with respect to the consumption of cereals, poultry, butter, added sugars and cottage cheese were established. The obtained data may be used to develop dietetic maintenance of SIBO therapy and prevention of its relapses.

[Association of food patterns with different forms of small intestinal bacterial overgroth syndrome and treatment efficacy]

AIM

To assess food patterns in patients with different types of SIBO and their impact onto the course and treatment outcomes.

MATERIALS AND METHODS

The data of 988 patients who signed informed consent surved as a source data. On the basis of lactulose breath test (LBT; GastroCH4eck, Bedfont, UK), the patients were selected into one of the studied groups: SIBO-H2, SIBO-CH4, SIBO-CH4-H2 and control. Twenty - four hours food recall test was used to analyze nutritional habits. In patients with SIBO-H2, standard treatment with Tilichinol 100 mg/Tilbrochinol 200 mg (Intetrix, Beaufour-Ipsen International, France) 2 caps BID for 10 days) was provided. Efficacy of treatment was assessed on the bass of the result of LBT 2 month after treatment completion. Mann-Whitney T test (Statistica 10, StatSoft, USA) was used to compare nutritional patterns in patients with or without SIBO, in different types of SIBO and in accordance to the results of treatment.

RESULTS AND DISCUSSION

Nine hundred eighty eight patients were enrolled. On the basis of hydrogene breath test they were divided into 4 main groups: SIBO of hydrogen - producing flora (SIBO-H2, n=526), methane - producing flora (SIBO-CH4, n=129), SIBO with hyperproduction of methane and hydrogene (SIBO-CH4-H2, n=225). The control group consisted of 108 patients with no no excessive gas production on LBT. In contrast to controls, nutritional patterns of patients with SIBO were characterized by low dietary fiber and amount of red meat dishes in the rations. Those with SIBO-CH4 consumed more fruits (p=0.03), vegetables (p=0.003), and fish (p=0.026), compared to those with other variants of SIBO and the control group. Nutritional patterns of SIBO-H2 group were characterized by larger amount of poultry meat consumption (p=0.026) compared to other SIBO groups and controls. In SIBO-H2 "cured" group greater amounts of buckwheat (p.

[Methanobrevibacter smithii in irritable bowel syndrome: a clinical and molecular study]

AIM

To assess the role of Methanobrevibacter smithii in patients with irritable bowel syndrome associated with small intestinal bowel overgrowth.

MATERIALS AND METHODS

Sixty - seven patients with IBS according to Rome IV were enrolled into the study in whom hydrogen breath test was performed. Thirty - two healthy subjects with negative breath test was used as a control. All IBS symptoms assessed daily with 5 grade Lykert scale for 7 days, stool was assessed by Brystol stool scale. M. smithii was confirmed in stool samples by PCR.

RESULTS AND DISCUSSION

In 67 IBS patients CH4 overproduction was found in 32 (47.7%), H2 overproduction in 31 (46.2%) and normal values in 4 (5.9%) by hydrogen breath test. M. smithii was confirmed by stool PCR in all patients with CH4 overproduction. Severity and prevalence of main clinical features of IBS were similar in both SIBO groups but were significantly higher than in control (p.

[Assessment of clinical efficacy and tolerability of meat-containing canned food for enteral nutrition]

AIM OF STUDY

to evaluate the efficacy and tolerability of meat-containing canned food for enteral nutrition in clinical settings in patients with gastrectomy. The product was made from animal protein (beef) with the addition of vegetable oils, soy protein, maltodextrin, stabilizer, vitamins and minerals. 40 patients with gastrectomy were included to the study and randomly formed 2 groups of 20 persons: the main group (8 men and 12 women, mean age 64.4±12.4 years) on the background of standard mashed diet for 14 days received 2 portions of the tested product (240 ml), the control group (5 men and 15 women, mean age 64.8±12.9 years) was treated with standard diet. Daily registration of the symptoms was carried out filling the 5-point scale of the Likert (the presence and severity of abdominal pain, flatulence, heartburn, nausea, a feeling of heaviness after eating, incomplete evacuation of the intestine). The Bristol stool scale was used to assess the dynamics of the stool. Laboratory parameters (hemoglobin, blood serum level of total protein, albumin and iron) and body composition parameters were evaluated before and after treatment. Consumption of meat-containing canned food for enteral nutrition was accompanied by significant decrease in the severity of nausea (from 1.20±0.29 to 1.02±0.05 points of the Likert scale, p=0.017), a decrease in abdomen heaviness (from 1.8±0.8 to 1.4±0.6 points, p<0.05), contributed to an improvement in stool consistency, an increase in all body composition parameters, a positive dynamic of protein metabolism (increase of hemoglobin level from 119.2±9.6 to 122.6±6.8 g/l, p>0.05, blood serum protein and albumin). A tendency to increase the mental component of the quality of life (+4.2%) was found. Thus, meat-containing canned foods for enteral nutrition can be used in the diet of patients in the postoperative period, they are well tolerated in conditions with loss of appetite, are effective in patients with protein-energy malnutrition.

[Wasting syndrome in HIV-infected patients]

The review of literature analyzes scientific data on wasting syndrome in HIV-infected patients. It considers its etiology, diagnosis,and therapeutic approaches.

[Using a multicomponent functional food in IBS patients with constipation a comparative controlled study]

Irritable bowel syndrome (IBS) is highly prevalent functional gastrointestinal disorder associated with decrease in quality of life and a high social cost. Diet is one of several therapeutic options in IBS treatment; therefore the development and clinical evaluation of innovative functional food for IBS patients are actual. Instant drink containing 4 g inulin, 4 mg menthol and 2 mg of pyridoxine (in daily dose) has been evaluated. 49 patients 18-68 (41.5±16.5) years old fulfilling the Rome III criteria for IBS-C were randomly assigned into two groups: one received standard diet plus two drinks per day for 2 weeks and control group received standard diet. Response to therapy was recorded daily using Likert scale of abdominal pain, bloating and feeling of incomplete bowel emptying, frequency of bowel movement, Bristol stool scale, and quality of life was assessed by IBSQoL questionnaire before and after the treatment. The consumption of the drink with inulin and menthol contributed to a significant positive effect on the stool parameters (from 0.91±0.73 to 1.12±0.45 bowel movements per day in stool frequency, p=0.05, from 2.68±1.63 to 3.43±1.27 index Bristol scale, p=0.05), reduced the severity of abdominal pain (from 1.78±0.58 to 1.47?0.61 Likert scale points, p=0.05), bloating (from 2.22±0.83 to 1.53±0.71 points ofLikertscale,p= 0.01) and a sense of incomplete bowelemptying (from 2.22 ± 0.88 to 1.61± 0.81 points of Likert scale, p=0.001), as well as increased the quality of life (from 75.3± 12.0 to 83.3±6.7%, p=0.05), but a significant part of patients (10 of 25) complained the appearance of heartburn after the start of the treatment. In conclusion, the consumption of the functional drink containing inulin, menthol and pyridoxine is associated with improve in stool parameters, abdominal pain, Bristol scale index and increase in quality of life in patients with IBS-C, but produce noticeable heartburn. Changes in functional drink composition are needed to reduce adverse effects.

[Dry jelly concentrate with vitamins and dietary fiber in patients with IBS with constipation: a comparative controlled study]

Irritable bowel syndrome (IBS) is highly prevalent functional gastrointestinal disorder associated with decrease in quality of life and a high social cost. Diet is one of several therapeutic options in IBS treatment; therefore the development and clinical evaluation of innovative functional food for IBS patients is useful. Dry jelly concentrate containing 3 g inulin, 10 mg curcumin and 1.8 mg of pyridoxine was developed and clinically evaluated. Fifty patients fulfilling the Rome III criteria for IBS-C were randomly assigned into two groups: one received standard diet plus two jelly drinks a day for 2 weeks and control group received standard diet. Response to therapy was recorded on a daily basis using Likert scale of abdominal pain, bloating and feeling of incomplete bowel emptying, frequency of bowel movement, Bristol stool scale, and quality of life assessed by IBSQoL questionnaire before and after the treatment. Intake of functional food product (jelly) containing inulin and curcumin is associated with a significant positive effect on the stool parameters (from 0.6±0.24 to 1.15±0.65 t/d in stool frequency, p=0.001, from 2.62±1.23 to 3.99±1.27, index Bristol scale, p=0.001), a reduce of the severity of abdominal pain (from 1.69±0.71 to 1.36±0.44 Likert scale points, p=0.001), bloating (from 2.03±0.89 to 1.55±0.81 points of Likert scale, p=0.02) and a sense of incomplete bowel emptying (from 2.25±0.98 to 1.68±0.92 points of Likert scale, p=0.001), as well as an increase in quality of life (from 64.5±13.5 to 81.2±9.1%, р=0.05). Patients in control group have improvement in abdominal pain (from 2.16±0.58 to 1.8±0.61 Likert scale points, p=0.05) and bloating (from 2.42±0.83 to 2.16±0.71 Likert scale points, p=0.05) only. During the treatment period no significant adverse events were found. These results indicate that jelly concentrate containing inulin, curcumin and pyridoxine improves abdominal pain score, Bristol scale index and quality of life in patients with IBS-C.

[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.

[Contemporary dietotherapy of the irritable bowel syndrome]

Irritable bowel syndrome (IBS) is the most prevalent functional disease of the gastrointestinal tract. This highly prevalent condition is best diagnosed by assessing the constellation of symptoms with which patients present to their physicians. Because some critics have previously questioned whether irritable bowel syndrome and other functional gastrointestinal disorders truly exist because they do not have defining structural features, the Rome Foundation fostered the use of symptom-based criteria for universal use. In most cases treatment is reduced to symptomatic therapy because a lot of unknown in pathogenesis by irritable bowel syndrome. Irritable bowel syndrome leads to decrease of quality of life of the patients and could be one of the reasons of patients' disability. Food is believed by patients promotes symptoms and the diet or avoiding specific food can reduce symptoms. Possible role of different food and microbiota in the pathophysiology of irritable bowel syndrome, as well as the data from randomized, controlled clinical trials dedicated to the effects of diet in irritable bowel syndrome are summarized and discussed in this review. The efficacy of the diet, enriched by fiber, prebiotics, probiotics, peppermint oil, curcumin and vitamin B6 in irritable bowel syndrome patients was shown in numerous studies. In some studies restriction in consumption of fermented carbohydrates, coffee and alcohol, as well as diet with elimination IgG-sensed food was also shown to be effective in irritable bowel syndrome. Food intolerances, defined as non-toxic non-immune adverse reactions to food, include reactions to bioactive chemicals in foods and metabolic reactions to poorly absorbed dietary carbohydrates. New dietary approaches like polyunsaturated fatty acids intake correction and the low tryptophan intake are discussed.

[Effectiveness of cultured milk foods, enriched by bifidus bacteria and Lactobacillus rhamnosis GG (ATCC 53103, LGG) in patients with slackening of motility function of intestines]

In patients who consumed yogurt and kefir, enriched by bifidus bacteria and Lactobacillus rhamnosis GG, improvement of large intestine motor function was found.

[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.

[Campylobacter in stool of patients with irritable bowel syndrome]

AIMS

According to recent studies prevalence of IBS among patients suffered from of acute enteric infection (AEI) reaches 30%, and 25% of them were accounted to Campylobacter infection. We studied the prevalence of Campylobacter in a feces of Russian IBS patients.

METHODS

Fecal samples received from 39 patients with different types of IBS were studied. Campylobacter were detected by three different methods: culture, real time PCR with the C. jejuni-specific primers and ELISA.

RESULTS

Only 7 patients from 39 reported about AEI in the past. C. jejuni in a stool was found in 2 (5%) patients: in the first patient by all three methods and in second one by PCR only. The first patient noted that she suffered from AEI 30 years ago. After two weeks confirmatory testing was positive only in the first patients, in the second one the tests were negative.

CONCLUSIONS

C. jejuni in a stool was detected in 5% of patients with IBS. Further studies of a microbiota of an intestine in IBS patients using the combination of reliable microbiological and molecular techniques are badly needed.

[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.

[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).

[Comparative analysis of efficiency of the estimation of quality of life in patients with irritable bowel syndrome using questionnaires IBS-QOL and index BEST]

AIM

To examine the power of correlation between IBS-QOL Questionnare and BEST index in patients with irritable bowel syndrome.

METHODS

The IBS-QOL and BEST index were administered to 71 patients with IBS twice: before and after treatment. Statistical analysis to test the correlation between IBS-QOL and BEST index was performed using Spearman's rho coefficient.

RESULTS

The study cohort included 71 patients with Rome-III IBS evaluated at the State Research Institute of Nutrition of Russian Academy of Medical Sciences (mean age 41,4; mean IBS-QOL = 65,6; 76% women). The mean completion + scoring time for BEST was under 3 minutes vs 25 minutes for IBS-QOL. There was a striking correlation (r = - 0,8) between BEST and IBS-QOL results.

CONCLUSIONS

BEST is a concise, rapidly completed, point-of-care IBS severity index that demonstrates large correlation with well-validated instrument for assessing QOL (IBS-QOL) in IBS patients.