SECONDARY LACTASE INSUFFICIENCY DURING ROTAVIRUS INFECTION OF NURSELING CHILDREN
N.J.GULIYEV, S.S. JAFAROVA
Azerbaijan Medical University, Baku, AZERBAIJAN
Acute enteric infections (AEI) have one of the importance places in the structure of infectious morbidity in the modern period. While such known etiological causative agents as Salmonella and shigella cause only up to 10% of enteric infections, rotaviruses, discovered not more than 30 years ago, constitute the relatively frequent cause of acute diarrhea encountered throughout the world. Rotavirus infections (RI) ranges between 9-75% in the structure of AEI. The aim of the investigations is to determine occurrence rate of secondary lactase insufficiency during rotavirus infection of nurseling children, course and result of the infection process, as well as development of treatment and prophylactic measures necessary for the prevention of detected insufficiency. 109 nurseling children were examined: 45 (I group) (57,0▒5,6%) with rotavirus infection, 34 (II group) (43,0▒5,6%) with rotavirus-bacterial infection. The control group consists of 30 actually healthy children. To study hydrolysis and absorption of lactose in the examined children the level of hydrogen in the expired air was determined by EC-60 Gastrolyzer device, and the level of pH and excretion of carbohydrates in excrements was determined. As a result of conducted investigations, reduction of absorption in small intestine in children with rotavirus infection 53,3▒7,4% and with rotavirus-bacterial infection 38,2▒8,3% was determined.
During the study of the level of hydrogen in the expired air it was determined that the level of hydrogen in the expired air of the control group was not higher than 10 ppmH2 on an empty stomach and 30, 60 minutes later that meets the standard requirement. At the same time, significant increase of the level of hydrogen in the expired air of the I group children (9,98-12,03 mH2) (≤0,001) was observed, that conforms with clinical symptoms of secondary lactase insufficiency during rotavirus infection, in the II group children the indicators were higher (9,96-12,12 mH2). The indicators are directly proportional to the amount of carbohydrates not digested and not absorbed in the intestine. During the analysis of biochemical indicators of excrements it was determined that in I and II group children the level of pH was lower than 5 (4,58 and 4,38 respectively) (p≤0,001) and the level of excretion of carbohydrates with excrements was higher than 5gr/l (11,58 and 8,22 respectively) (p≤0,001). High excretion of carbohydrates and lowering of pH in the I and II group as compared to the control group conditions the prevalence of diarrhea syndrome in the clinics of secondary lactase insufficiency.
In 40,0▒7,3% children of the I group and 58,8▒8,4% of the II group of examined children there was determined the disorder of intestine biocoenosis. For the purpose of correction of disbacteriosis, high dose of probiotic bifidumbacterin was used (in the first half of the life 30 doses daily, in the second half - 45 doses daily). During the use of high doses of probiotics such clinical symptoms of intoxication, and pathologic mixtures in stool and improvement of biocoenosis were corrected more rapidly.EC-60 Gasrtolyzer device and hydrogen-breathing test conducted by means of the devices is a modern, highly-sensitive and exact, informative and noninvasive. During rotavirus infection in nurseling children the device makes it possible to detect secondary lactase insufficiency and can be used as express-diagnostics.
CHARACTERISTIC OF HEMODYNAMICS OF THE ORAL MUCOSA AND PARODENTIUM IN PATIENTS WITH ULCERATIVE COLITIS AND CROHN'S DISEASE
N.S. ROBAKIDZE, S.Y. TITYUK
St. Petersburg Medical Academy of Postgraduate Education, St. Petersburg, RUSSIA
Introduction: Etiology and pathogenesis of inflammatory bowel disease (IBD), which includes nonspecific ulcerative colitis (UC) and Crohn's disease (CD), has not yet been established. Etiology of concomitant IBD and manifestations of IBD considered in this case as extraintestinal manifestations of such dental lesions as chronic recurrent aphthous stomatitis (CRAS), catarrhal stomatitis (CS), cheilitis, inflammatory periodontal diseases, etc. study of the pathogenesis of the latter should bring researchers to the solution of IBD.
Materials and methods: There was carried out clinical examination of 28 patients with IBD aged between 16 - 69 years (12 patients with UC and 16 patients with CD). Hemodynamic status of periodontal tissues was examined by computer reoparodontography (RPG) by the tetrapolar method. The method of computer biomicroscopy (BMS) was used for the study of microcirculation of buccal mucosa (the depth of tissue examination up to 300 microns).
Results: 80% of patients with UC had chronic recurrent aphthous stomatitis (CRAS), 60% - chronic catarrhal stomatitis (CS). Periodontal disease in the form of gingivitis and mild periodontitis (in 20% and 80% of the total number of patients, respectively) was revealed in all the examined with UC. Patients with CD had CRAS in 77% of cases, and CS in 69%. Also, in 69% of cases there was observed gingivitis and in 23% - mild periodontal disease. According to the RPG, in patients with UC, the following indicators of periodontal hemodynamics: rheographic periodontal index (RI) - 0.57 ohm (norm - 0.69 ohms), peripheral resistance index (PRI) - in 96.3%, PTS - 16.3% , diastolic arterial index (DAI) - 113.8%, dicrotic arterial index (DicAI) - 70.6%. In patients with CD: RI - 0.37 ohms, the PRI - 104.7%, PTS - 17.8%, DAI - 108.7% DicAI - 71.6%. Average normal values of these indicators are as follows: RI - 0,69 ohms, the PRI - 87%, PTS - 15.4%, DAI - 70%, DicAI - 54%. According to BMS, diameter of arteriolar capillaries in patients with UC constituted average of 3.9 microns, venular - 6.2 microns, in patients with CD, these values constitute 4.1 microns and 6.8 microns. Average normal values for arteriolar part of the capillary - 7.3 microns, for venular - 10.0 microns.
Conclusion: 1. Certain types of dental disease on the background of IBD have a higher frequency of occurrence, include CRAS, CS, inflammatory parodontal lesions. 2. According to instrumental methods of investigation, changes in quantitative indicators of hemodynamics in IBD patients shows various levels its disorders. 3. The focus of hemodynamic shifts in patients with UC and CD in general is similar, the differences are expressed by the degree of severity, that may show the difference existing between the two forms of IBD, and requires their consideration in different aspects. 4. The high prevalence of dental disease may be associated with hemodynamic disturbances on the background of a system failure.