scholarly journals Exocrine pancreatic dysfunction in children with obesity: characteristics of clinical picture and diagnostics

2020 ◽  
pp. 36-41
Author(s):  
I. S. Lembryk ◽  
O. V. Tymoshchuk

Introduction. During the last twenty-five years the occurrence of obesity in children and teenagers has increased significantly. Materials and methods. 110 adolescents of 12–17 years old, with alimentary-constitutional obesity and involvement of pancreas and without its injury, as compared to the 30 healthy children of control group, were examined. The research provided determination of the sizes and elasticity of pancreas. The detection of the total cholesterol, high density lipoproteins and leptin level was carried out. Intensity of clinical symptoms (spastic pain in epigastrium and left subcostal arc; abdominal pain without localization, vomit without relief, general weakness) have been made accordingly to sum of points (from 0 to 3 points). If sum of points makes from 0 to 2 – intensive character of abdominal pain is low, from 3 to 5 points – it is high, from 5 to 10 points – it is very high. Normal level of amylase in a blood serum (Karavey’s method) is 12–32 g/(hour l), аnd diastase in urine – 20–160 g/(hour l). We made a screening test for elastase-I level by ELISA test. Normal activity of this enzyme in feces is 200 мkg/g. We have used sonographic method for detection of pancreatic diseases in obese children due to echo-structure of parotid gland. The analysis and statistical data processing were made by computer program "Statistica 7.0" and MS Excel XP. Research data. Physical inspection of our patients confirms prevalence of І degree over II degree obesity (52.7 % and 47.3 %, respectively; Р < 0.05). We have confirmed valid risk factor of pancreatic lesion in obese children – presence of diabetes mellitus type I in close relatives (80 % and 65 %, χ2 = 2,05; Р < 0.05). The changes of exocrine function of the pancreas in children with the stage II obesity were established. Echographic signs of the pancreas lesion in teenagers with obesity indicate the presence of functional changes: edema of head or entire edema, partial increase of parenchymal echogenicity, insufficient enlargement of the duct of Wirsung.

2017 ◽  
Vol 53 (1) ◽  
pp. 5-10
Author(s):  
Stanisław Pieczarkowski ◽  
Kinga Kowalska-Duplaga ◽  
Andrzej Wędrychowicz ◽  
Krzysztof Fyderek ◽  
Przemko Kwinta ◽  
...  

<i>Introduction:</i> Chronic abdominal pain in children is a very frequent and sometimes challenging diagnostic issue. Differential diagnosis in that cases is difficult and often connected with numerous, time-consuming, expensive, and frequently stressful diagnostic studies. The aim of the study was to establish whether fecal calprotectin concentration (FCC) and TNF-alpha may be useful in children with chronic abdominal pain to differentiate between inflammatory bowel disease (IBD), other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders. Methods. The study included patients (median age 13 years), who were assigned to functional gastrointestinal disorders group (n=33); inflammatory gastrointestinal disorders other than IBD (n=71), children with IBD (n=37) and 22 healthy children served as a control group. The concertation of FCC and TNF-alpha in stool samples was measured using ELISA. <i>Results:</i> In healthy children and in children with functional disorders FCCs were below 100 μg/g. In patients with IBD FCCs and TNF-alpha were markedly elevated as compare to children with functional gastrointestinal disorders, however using ROC discrimination of IBD patients was significantly better using FCC than TNF-alpha. <i>Conclusion:</i> FCC is better test for differentiation between IBD, other inflammatory gastrointestinal disorders, and functional gastrointestinal disorders as compare to TNF-alpha concentration in stool. FCC as screening test in patients with chronic abdominal pain should allow to diminish unnecessary diagnostic in cases of functional gastrointestinal disorders.


Author(s):  
Golikov A.V. ◽  
Epifanov S.Yu. ◽  
Reiza V.A.

Relevance. Dyslipidemia is considered one of the main risk factors for the development of recurrent myocardial infarction and early postinfarction angina. Aim. To evaluate the features of lipid metabolism in acute and subacute myocardial infarction in men under 60 years old with recurrent episodes of ischemia (recurrent myocardial infarction and/or early postinfarction angina) to search for new approaches to improve prevention measures. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 68 patients; II - control, without it - 427 patients. A comparative assessment of lipid metabolism parameters and their dynamics in selected groups were performed. Results. The study group differed in higher levels of total serum cholesterol (6.17±1.78 mmol/l) from the control group (5.56±1.28 mmol/l; p=0.02) at the end of the third week of disease, its dynamics during the observation period (I: 9.1%; p<0.0001; II: -1.8%; p<0.0001) and the dynamics of the atherogenic coefficient (I: -4.7.1; p=0.02; II: 6.3%; p<0.0001). In both groups, the group showed an increase in lipoproteins of low (I: 33.1; p=0.02; II: 45.5%; p<0.0001) and very low density (I: 275.8; p=0,0004; II: 233.4%; p<0.0001), atherogenic indices, decrease: triglycerides (I: -31.8%; p=0.02; II: -1.7%; p<0.0001) and high-density lipoproteins (I: -0.6%; p=0.02; II: -6.1%; p<0.0001). Conclusions. The group with recurrent ischemia is characterized by more pronounced hypercholesterolemia at the end of the subacute period of myocardial infarction in comparison with the control group due to an increase in the concentrations of atherogenic lipid metabolism fractions. The dynamics of indices and the coefficient of atherogenicity during this period is multidirectional, which requires additional study.


Pathogens ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 67 ◽  
Author(s):  
Tomoyoshi Doki ◽  
Tomoyo Tarusawa ◽  
Tsutomu Hohdatsu ◽  
Tomomi Takano

Background: The cationic amphiphilic drug U18666A inhibits the proliferation of type I FIPV in vitro. In this study, we evaluated the in vivo antiviral effects of U18666A by administering it to SPF cats challenged with type I FIPV. Methods: Ten SPF cats were randomly assigned to two experimental groups. FIPV KU-2 were inoculated intraperitoneally to cats. The control group was administered PBS, and the U18666A-treated group was administered U18666A subcutaneously at 2.5 mg/kg on day 0, and 1.25 mg/kg on days 2 and 4 after viral inoculation. Results: Two of the five control cats administered PBS alone developed FIP. Four of the five cats administered U18666A developed no signs of FIP. One cat that temporarily developed fever, had no other clinical symptoms, and no gross lesion was noted on an autopsy after the end of the experiment. The FIPV gene was detected intermittently in feces and saliva regardless of the development of FIP or administration of U18666A. Conclusions: When U18666A was administered to cats experimentally infected with type I FIPV, the development of FIP might be suppressed compared with the control group. However, the number of animals with FIP is too low to establish anti-viral effect of U18666A in cats.


Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1150 ◽  
Author(s):  
Hung-Hsiang Lai ◽  
Cheng-Hsun Chiu ◽  
Man-Shan Kong ◽  
Chee-Jen Chang ◽  
Chien-Chang Chen

Background: Acute diarrhea is a major cause of childhood morbidity and an economic burden for families. The aim of this study is to explore the effect of probiotics on clinical symptoms, intestinal microbiota, and inflammatory markers during childhood diarrhea. Methods: Children (n = 81) aged six months to six years (mean age 2.31 years) hospitalized for acute diarrhea were randomized to receive probiotics (Lactobacillus casei variety rhamnosus; n = 42) or no probiotics (n = 39) orally twice daily for seven days. Feces samples were also collected to evaluate microbial content using a traditional agar plate and next-generation sequencing. Immunoglobulin A (IgA), lactoferrin, and calprotectin were determined by enzyme-linked immunosorbent assay (ELISA) and compared in different groups. Other clinical symptoms or signs, including fever, vomiting, diarrhea, abdominal pain, bloated abdomen, daily intake, appetite, and body weight were also assessed. Results: Data were collected from 81 individuals across three different time points. Total fecal IgA levels in fecal extracts of the probiotics group were higher than those in the control group, reaching statistical significance (p < 0.05). Concentrations of fecal lactoferrin and calprotectin were significantly downregulated in patients with probiotic Lactobacillus casei variety rhamnosus (Lc) consumption compared to those of the control (p < 0.05). Probiotic Lc administration may be beneficial for gut-microbiota modulation, as shown by the data collected at one week after enrollment. Counts of Bifidobacteria and Lactobacillus species were elevated in stool culture of the probiotic group. Appetite and oral intake, body-weight gain, abdominal pain, bloating, as well as bowel habits (diarrhea) were much better in children receiving probiotics compared with those in the control group. Conclusion: Fecal IgA increased during acute diarrhea under Lc treatment; in contrast, fecal lactoferrin and calprotectin were downregulated during acute diarrhea under Lc treatment. Probiotic Lc may be a useful supplement for application in children during acute diarrhea to reduce clinical severity and intestinal inflammatory reaction.


2016 ◽  
Vol 94 (4) ◽  
pp. 285-289 ◽  
Author(s):  
Natalia G. Virstyuk ◽  
N. R. Senyutovich

The study involved 58 patients with chronic noncalculous cholecystitis (CNC) divided into two groups. Group I included 30 CNC patients with metabolic syndrome (MS), group II 28 CNC patients without MS. The control group consisted of 20 healthy people. MS was diagnosed according to International Diabetes Federation guidelines (2005). The following anthropometric parameters were determined: body mass index (BMI), waist to hip ratio, blood lipid profile (total cholesterol, triglycerides, high density lipoproteins (HDL), and low density lipoproteins (LDL)). Leptin and insulin levels were measured using commercial ELISA kits «Leptin ELISA» and «Insulin ELISA» (DRG International, Inc., USA) respectively. Insulin resistance index HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) was calculated. It was shown that leptin level in CNC patients with MS was 2.61 times that in healthy subjects (p <0.001) and 2.47 times higher than in CNC patients without MS (p <0.001). Significant direct correlations between leptin blood levels andBMI, HOMA-IR index, triglycerides, and cholesterol were documented. The relationships between blood levels of leptin and the thickness of the gallbladder (GB) wall, the amount of cholesterol crystals in bile, and decreased bile release rate from GB which suggests effect of leptin on the structural and functional changes in GB.


2011 ◽  
Vol 36 (2) ◽  
pp. 181-184 ◽  
Author(s):  
Kavita Rai ◽  
Amitha Hegde ◽  
Ananth Kamath ◽  
Suchetha Shetty

Insulin dependent diabetes mellitus is a severe disease that raises blood glucose levels because of hyperglycemia and insulinopenia. Fluctuations in water and electrolyte levels may result in xerostomia and other changes in the salivary composition. Since diabetes has an influence on oral health, it is important for the dentist to be aware of newer advances in the field of diabetes and to recognize specific oral problems related to diabetes. Thus, the dentist becomes an important part of the health care team for the patients with diabetes. Aim: The present study correlated salivary flow rate, salivary pH and total salivary antioxidant levels and dental caries in type I diabetic patients. Method: A total of 200 children that included 100 known diabetic children (study group) and 100 healthy children (controls) of both the sexes and from similar socioeconomic backgrounds formed the part of this study. Dental caries was assessed using DMFT index. The salivary total anti-oxidant level was estimated using phospho molybdic acid using spectrophotometric method. The salivary flow rate was recorded using the Zunt method and the salivary pH using the pH indicating paper. The results were statistically analyzed using t-test. Conclusions: The analyzed parameters showed increase in salivary anti-oxidant levels, reduced salivary flow rate, increase incidence of dental caries, salivary pH was decreased when compared to the control group.


2014 ◽  
Vol 34 (7) ◽  
pp. 698-705 ◽  
Author(s):  
Erika De Sousa ◽  
Gloria Del Peso ◽  
Laura Alvarez ◽  
Silvia Ros ◽  
Ana Mateus ◽  
...  

BackgroundUltrafiltration failure (UFF) is a serious complication of long-term peritoneal dialysis (PD). Peritoneal rest (PR) has been demonstrated as a valid treatment to reverse the functional changes that occur in UFF. The effects of PR on a normally functioning human peritoneum are unknown but are expected to be neutral. Our hypothesis was that PR positively modifies peritoneal function in patients with UFF, in contrast to the absence of effects when PR is applied under normal conditions.Patients and MethodsWe studied 84 PR periods, comparing 35 patients with UFF and 49 controls (resting for abdominal surgery with temporary discontinuation of PD). We analyzed peritoneal transport pre-PR and post-PR by calculating the mass transfer coefficients of creatinine (Cr-MTAC), the dialysate/plasma creatinine ratio (D/P Cr) and the ultrafiltration (UF).ResultsBaseline data was similar for the 2 groups, although the UFF group had a longer median time in PD (39 [18 – 60] vs 10 [5 – 23] months; p = 0.00001). Peritoneal rest induced a decrease in D/P Cr, Cr-MTAC and an increase in UF capacity in the UFF group ( p = 0.0001, p = 0.004 and p = 0.001, respectively), without causing changes in the control group. Peritoneal rest in patients with more than 6 months of UFF was not able to reduce peritoneal solute transport or improve UF capacity. Response to PR did not differ among UFF patients with or without a previous history of peritonitis. Peritoneal rest enabled patients with UFF to continue on PD for a median time of 23 months (range, 13 – 46 months).ConclusionsPeritoneal rest induces functional changes in patients with UFF but not in those with no functional abnormalities. This demonstrates that PR works only when abnormal but reversible functional conditions are present. However, the effect is highly dependent on how early PR is applied.


Author(s):  
Joanna Jaromin ◽  
Grażyna Markiewicz-Łoskot ◽  
Lesław Szydłowski ◽  
Agnieszka Kulawik

Background: The changes in the period of ventricular repolarization, i.e., QT interval, QTp (Q-Tpeak) and TpTe interval (Tpeak–Tend), make it possible to assess the electrical instability of the heart muscle, which may lead to the development of life-threatening ventricular arrhythmia. The aim of the study was to determine and evaluate the use of differences in T-wave morphology and durations of repolarization period parameters (QT, TpTe) in resting ECGs for children with ventricular arrhythmias. Methods: The retrospective analysis was made of the disease histories of 80 examined children with resting ECGs, which were admitted to the Children’s Cardiology Department. The study group consisted of 46 children aged 4 to 18 with ventricular arrhythmias and the control group consisted of 34 healthy children between 4 and 18 years of age, with no arrhythmias. Results: The duration of the TpTe interval was significantly (p < 0.001) longer in the group of children with ventricular arrhythmia with abnormal T-wave (bactrian/bifid, humid/biphasic) compared to the TpTe interval in children with ventricular arrhythmia with the normal repolarization period. The duration of the TpTe (p < 0.001), QTcB (p < 0.001) and QTcF (p < 0.001) intervals were significantly longer in the group of children with ventricular arrhythmias and with abnormal T-wave compared to the values of the TpTe, QTcB, and QTcF intervals of the control group with normal morphology of the repolarization period. Only the duration of the TpTe interval was significantly (p = 0.020) longer in the group of children with ventricular arrhythmia without clinical symptoms. Conclusions: Children with benign ventricular arrhythmias recorded on a standard ECG with prolonged TpTe and QT intervals and abnormal T-wave morphology require systematic and frequent cardiac check up with long term ECG recordings due to the possibility of future more severe ventricular arrhythmias. Further follow-up studies in even larger groups of patients are necessary to confirm the values of these repolarization parameters in clinical practice.


2020 ◽  
Author(s):  
Tut Galai ◽  
Hadar Moran-Lev ◽  
Shlomi Cohen ◽  
Amir Ben-Tov ◽  
Dina Levy ◽  
...  

Abstract Background Functional abdominal pain (FAP) disorders are one of the most common gastrointestinal disorders in children. We aimed to define the association between obesity and functional abdominal pain (FAP) disorders and to assess differences between overweight/obese children and normal weight children with FAP disorders.Methods We conducted a retrospective study of children (2-18 years old) with a clinical diagnosis of FAP who were followed-up in our pediatric gastroenterology unit between 1/2016-10/2018. FAP disorders were defined according to the ROME IV criteria. Body mass index (BMI) percentiles were defined by CDC standards. Patients with BMIs ≥85% were designated as being overweight/obese. A healthy control group was obtained from the 2015-2016 Israel national health survey.Results Data from 173 children with FAP disorders (median age 11.5 years, 114 females) were included. Seventy-one children (41%) were classified as having abdominal pain-NOS, 67 (38.7%) as having irritable bowel syndrome (IBS), and 35 (20.2%) has having functional dyspepsia. Fifty-three children (30.6%) were classified as being overweight/obese. Adolescents with FAP disorders had a significantly higher prevalence of overweight/obesity compared to controls (39.5% vs. 30%, respectively, p = 0.04). Overweight FAP children were older [12.4 (range 9.8-15.3) vs. 10.8 (7.4-14.1) years, p = 0.04] and had more hospitalizations due to FAP (20.8% vs. 7.6%, p = 0.01) compared to normal weight FAP children.Conclusions Children with FAP had higher prevalence of overweight/obesity compared to healthy controls. Future studies are warranted to raise awareness of weight issues in FAP and determine the effect of weight loss on FAP.


2021 ◽  
Vol 18 (7) ◽  
pp. 1553-1557
Author(s):  
Lu Zhijun ◽  
Chen Rongchun ◽  
Lin Feixiang ◽  
Wu Yaohong ◽  
Liu Ning ◽  
...  

Purpose: To study the therapeutic influence of meloxicam-glucosamine sulfate combination in patients with osteoarthritis and their effect on serum CTX-I, CTX-II, COMP and MMP-3. Methods: A total of 88 patients with osteoarthritis were assigned to control (n = 44) and treatment groups (n = 44), using the random number table method. Control group was given 7.5 mg of meloxicam, while treatment group received 0.5 g of glucosamine sulfate capsule in addition to meloxicam. Both groups were treated continuously for 8 weeks. Serum levels of C-terminal telopeptide of type I collagen (CTX-I), C-terminal telopeptide of type II collagen (CTX-II), cartilage oligomeric matrix protein (COMP) and matrix metalloproteinase-3 (MMP-3) were compared for the two groups after treatment. Results: Lysholm score significantly increased in the two groups after treatment. Serum CTX-I, CTX-II, COMP and MMP-3 in the two groups were significantly lower than before treatment, but the reductions were more pronounced in the treatment group (p < 0.05). During treatment, mild vomiting and pruritus of the skin appeared in both groups, but these were relieved after symptomatic treatment without any serious adverse reactions. Conclusion: Treatment with a combination of meloxicam and glucosamine sulfate produces significant beneficial effects in patients with osteoarthritis by reduction of clinical symptoms, pain relief and reduction of serum CTX-I, CTX-II, MMP-3 and COMP.


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