Features of the intestinal microbiota functional status in early-aged children with rotavirus infection

The aim is to assess the intestinal microflora functional and structural disorders in early-aged children in the dynamics of rotavirus infection by studying intestinal metabolites in faeces – short-chain fatty acids (SCFA). Materials and methods. The study included 60 breastfed children aged 1-24 months with rotavirus infection (the study group) and 30 healthy children, representative by age and sex (the comparison group). Determination of SCFA (acetate, propionate, butyrate) in faeces was carried out in all children of the study group three times in the dynamics of the disease (on the 3rd, 5th and 10th day) and in healthy children once. Results. The total concentration of SCFA in children with rotavirus infection was 3 and 2.2 times lower than in healthy children in the acute period of the disease (p<0.01 on the 3rd and 5th day, respectively), increasing on the 10th day (p<0.05), however, not reaching the normal level (p<0.01). The decrease in the total pool of SCFA occurred due to all volatile acids (C2, C3, C4), the concentrations of which were lower than in healthy children (p<0.01). Violation of the volatile acids ratio in their general pool was observed from the first days of rotavirus gastroenteritis in the form of an increase in the C2 relative concentration (p˂0.05) and a decrease in C3 and C4 profiles (p˂0.05). Correspondingly, a decrease in anaerobic index was noted. It was equal to 0.04 [0.01; 0.11] on the 3rd and 5th day of the disease, constituting only 1/5 of the healthy children values (p˂0,01), increasing on the 10th day to 0,09 [0,02; 0.17], however, remaining twice as lower than in children of the comparison group (p˂0,01). Conclusions. There is a violation of the intestinal microflora functional condition in early-aged children from the first days of rotavirus infection, which is expressed by depletion of the total pool of SCFA and concentrations of each of them, as well as structural disorders of intestinal microbiocinosis in the form of reducing its anaerobiosis. These changes are most pronounced during the first five days of rotavirus gastroenteritis and last up to 10th day of illness

Two-pronged attack: dual inhibition of Plasmodium falciparum M1 and M17 metalloaminopeptidases by a novel series of hydroxamic acid-based inhibitors

Plasmodium parasites, the causative agents of malaria, have developed resistance to most of our current antimalarial therapies, including artemisinin combination therapies which are widely described as our last line of defense. Antimalarial agents with a novel mode of action are urgently required. Two Plasmodium falciparum aminopeptidases, PfA-M1 and PfA-M17, play crucial roles in the erythrocytic stage of infection and have been validated as potential antimalarial targets. Using compound-bound crystal structures of both enzymes, we have used a structure-guided approach to develop a novel series of inhibitors capable of potent inhibition of both PfA-M1 and PfA-M17 activity and parasite growth in culture. Herein we describe the design, synthesis, and evaluation of a series of hydroxamic acid-based inhibitors and demonstrate the compounds to be exciting new leads for the development of novel antimalarial therapeutics

Place of lactase deficiency in the pathogenesis of rotavirus infection and possibilities of its correction

Rotavirus infection is one of the causes of the lactase deficiency. The pathogenesis of the lactase deficiency in this disease has been actively studied recently. But the dynamic changes of clinical and laboratory signs of the lactase deficiency in early age children on the background of rotavirus infection and methods of their correction are still not well investigated. The aim of research: tо enhance the effectiveness of treatment of rotavirus infection in early age children through the study of clinical and laboratory parameters of lactase deficiency gravity and development of the method of its correction. Materials and methods: the research bases on the results of examination of 40 children aged 1 to 18 months suffered with rotavirus infection, who were breastfed. 20 of them had been accepted basic and symptomatic therapy and were in the first group of observation. The second group consisted of another 20 at the same age patients with rotavirus infection, received drug lactase along with this therapy. All the children of the investigation groups had Benedict test (determining the content of carbohydrates in the faeces ) and pH-metry faeces and clinical, biochemical, immunochromatographic and bacteriological tests. Results: The most part of children had increased levels of carbohydrates in faeces on the day of hospitalization due the clinical manifestations of the disaccharidase deficiency (osmotic diarrhoea, flatulence, intestinal colic): on the day of hospitalization Benedict test result was 0,6±0,3%; increased to 1,0±0,3% on the third day and remained at the same level (0,9± 0,3%) on the fifth day of the observation. Strongly acidic faeces pH (5,3±0,2)was recorded on the day of hospitalization in absolute majority of patients (80% - 16 children). On the third day of the disease this rate was 5,3±0,2 and was strongly acidic in 75%, and only on the fifth day of the rotavirus infection there were observed the raising of the acidity of faeces to 5,6±0,3. The analysis of clinical and laboratory parameters of lactase deficiency in patients suffered with rotavirus depending on the type of treatment (with and without drug lactase) pointed to some differences between groups of observation. The duration of diarrhea in children from the second group was significantly lower (5,5±1,0 days) than the duration of the first patient group (7,7±1,2 days, p<0.05) as the duration of flatulence and rumbling gut 3,2±0,9 and 3,5±1 compared with 4,7±1,6 and 4,6±1,0 respectively (p<0.05). The levels of carbohydrates in the feces of children from the first and second groups were not statistically different with each other on the first day (0,6±0,3% and 0,7±0,4%, respectively) and on the third day of hospital stay (1,0±0,3% and 0,9±0,3% respectively). However, the indicators of the Benedict test had been decreased almost two times (0,5±0,1%) in children from the second group on the fifth day of treatment compared with patients of the first group (0,9±0,3%, p<0.05). Children of both groups had strongly acidic pH of the faeces (less than 5.5) on the day of hospitalization. There was a normalization of this indicator in 65% (13) patients of the second group and only in 35% (7 children) of the first group. On the fifth day of the observation 95% and 80% of children, respectively, had a normal acidity of the faeces (5,5-6,9). Conclusion: all infants, who were breastfed, on the background of rotavirus infection had clinical and laboratory signs of the secondary lactase deficiency of varying severity: diarrhea, flatulence, decreased pH of feces to 5,3±0,2, increased level of carbohydrates in the faeces to 1,0±0,1%. The additional purpose of the lactase in the therapy of rotavirus infection helps to reduce the manifestations of secondary lactase deficiency. The rapid acceleration of the leveling of diarrhea syndrome and flatulence occurs by the normalization of samples acidity and by reducing of the level of carbohydrates in the faeces (on the fifth day of illness)

Деякі елементи когнітивної технології навчання у викладанні дитячих інфекційних хвороб на V курсі

The elements of cognitive technologies in the teaching of clinical disciplines in higher school are discussed in the work.Обсуждаются элементы когнитивной технологии обучения в преподавании клинической дисциплины в высшем учебном заведении.Описано елементи когнітивної технології навчання у викладанні клінічної дисципліни у вищій школі

Some elements of cognitive technology in the teaching of children's infectious diseases on the V course

The elements of cognitive technologies in the teaching of clinical disciplines in higher school are discussed in the work

Місце лактазної недостатності в патогенезі ротавірусної інфекції та можливості її корекції

Rotavirus infection is one of the causes of the lactase deficiency. The pathogenesis of the lactase deficiency in this disease has been actively studied recently. But the dynamic changes of clinical and laboratory signs of the lactase deficiency in early age children on the background of rotavirus infection and methods of their correction are still not well investigated.The aim of research: tо enhance the effectiveness of treatment of rotavirus infection in early age children through the study of clinical and laboratory parameters of lactase deficiency gravity and development of the method of its correction.Materials and methods: the research bases on the results of examination of 40 children aged 1 to 18 months suffered with rotavirus infection, who were breastfed.  20 of them had been accepted basic and symptomatic therapy and were in the first group of observation. The second group consisted of another 20 at the same age patients with rotavirus infection, received drug lactase along with this therapy. All the children of the investigation groups had Benedict  test (determining the content of carbohydrates in the faeces ) and pH-metry faeces and clinical, biochemical, immunochromatographic and bacteriological tests.Results: The most part of children had increased levels of carbohydrates in faeces on the day of hospitalization due the clinical manifestations of the disaccharidase deficiency (osmotic diarrhoea, flatulence, intestinal colic): on the day of hospitalization Benedict test result was 0,6±0,3%;  increased to 1,0±0,3%  on the third day and remained at the same level (0,9± 0,3%) on the fifth day of the observation.Strongly acidic faeces pH (5,3±0,2)was recorded on the day of hospitalization in absolute majority of patients (80% - 16 children). On the third day of the disease this rate was 5,3±0,2 and   was strongly acidic in 75%, and only on the fifth day of the rotavirus infection there were observed the raising of the acidity of faeces to 5,6±0,3.The analysis of clinical and laboratory parameters of lactase deficiency in patients suffered with rotavirus depending on the type of treatment (with and without drug lactase) pointed to some differences between groups of observation. The duration of diarrhea in children from the second group was significantly lower (5,5±1,0 days) than the duration of the first patient group (7,7±1,2 days, p&lt;0.05) as the duration of flatulence and rumbling gut 3,2±0,9 and 3,5±1  compared with 4,7±1,6 and 4,6±1,0 respectively (p&lt;0.05).The levels of carbohydrates in the feces of children from the first and second groups were not statistically different with each other on the first day (0,6±0,3% and 0,7±0,4%, respectively) and on the third day of hospital stay (1,0±0,3% and 0,9±0,3% respectively). However, the indicators of the Benedict test had been decreased almost two times (0,5±0,1%) in children from the second group on the fifth day of treatment compared with patients of the first group  (0,9±0,3%, p&lt;0.05).Children of both groups had strongly acidic pH of the faeces (less than 5.5) on the day of hospitalization. There was a normalization of this indicator in 65% (13) patients of the second group and only in 35% (7 children) of the first group. On the fifth day of the observation 95% and 80% of children, respectively, had a normal acidity of the faeces (5,5-6,9).Conclusion: all  infants, who were breastfed, on the background of rotavirus infection had clinical and laboratory signs of the secondary lactase deficiency of varying severity: diarrhea, flatulence, decreased pH of feces to 5,3±0,2, increased level of carbohydrates in the faeces to 1,0±0,1%. The additional purpose of the lactase in the therapy of rotavirus infection helps to reduce the manifestations of secondary lactase deficiency. The rapid acceleration of the leveling of diarrhea syndrome and flatulence occurs by the normalization of samples acidity and by reducing of the level of carbohydrates in the faeces (on the fifth day of illness).  В последние годы активно изучают патогенез ротавирусной инфекции, тем не менее остаются не исследованными динамические изменения клинико-лабораторных признаков лактазной недостаточности на фоне этой болезни и методы ее коррекции. С целью повышения эффективности лечения ротавирусной инфекции у детей раннего возраста путем коррекции вторичной лактазной недостаточности проведен сравнительный анализ основных клинических и лабораторных ее проявлений в динамике ротавирусной инфекции в двух равных по количеству группах детей (по 20 детей в каждой группе) в зависимости от ввода в лечение препарата лактазы. Использовали общеклинические, биохимические методы, провели пробу Бенедикта и рН-метрию фекалий. Установлено, что у большинства детей раннего возраста на фоне ротавирусной инфекции регистрируют клинико-лабораторные признаки лактазной недостаточности с первых дней болезни. На фоне приема препарата лактазы происходит более быстрое нивелирование диарейного синдрома, ускорение нормализации показателей рН кала и пробы Бенедикта. Это свидетельствует о целесообразности включения препарата лактазы в комплексную терапию ротавирусной инфекции у детей раннего возраста на грудном вскармливании.В останні роки активно вивчають патогенез ротавірусної інфекції, але залишаються не дослідженими динамічні зміни клініко-лабораторних ознак лактазної недостатності у дітей раннього віку на фоні цієї хвороби та методи їх корекції. З метою підвищення ефективності лікування ротавірусної інфекції у дітей раннього віку шляхом корекції вторинної лактазної недостатності виконали порівняльний аналіз основних клінічних і лабораторних проявів лактазної недостатності в динаміці ротавірусної інфекції у двох рівних за кількістю групах дітей (по 20 дітей у кожній групі) залежно від включення до схеми лікування препарату лактази. Використали загальноклінічні, біохімічні методи, виконали пробу Бенедикта та рН-метрію фекалій. Визначили, що у більшості дітей раннього віку на тлі ротавірусної інфекції реєструють клініко-лабораторні ознаки лактазної недостатності від перших днів хвороби. На тлі приймання препарату лактази відбувається швидше нівелювання діарейного синдрому, прискорення нормалізації показників рН калу і проби Бенедикта. Це свідчить про доцільність включення препарату лактази в комплексну терапію ротавірусної інфекції у дітей раннього віку на грудному вигодовуванні

The role of carbohydrate malabsorption syndrome in the pathogenesis of rotavirus diarrhea (a literature review)

The aim – to summarize literature data on the pathogenetic mechanisms of the diarrheal syndrome development in children with rotavirus infection and to determine the role of carbohydrate malabsorption syndrome in it through a complex analysis of literature reviews and empirical studies. Rotavirus infection (RVI) remains the main cause of severe dehydrating gastroenteritis in children under five years of age. One of the most important pathogenetic links of rotavirus gastroenteritis is the development of osmotic diarrhea induced by carbohydrate malabsorption syndrome. Its development is associated with disaccharidase insufficiency and impaired absorption of monosaccharides in the small intestine. Carbohydrate malabsorption syndrome is found in 67.0–98.3 % of children with RVI. Its laboratory manifestations (an increase in levels of fecal carbohydrates and lactose) are observed starting from the first days of the disease, and the maximum indicators are recorded in the period from the fifth to the seventh day. Conclusions. Carbohydrate malabsorption syndrome is observed in the absolute majority of children with RVI, and its maximum severity is noted from the fifth to the seventh day of the disease, being realized mainly due to lactase deficiency. The severity of carbohydrate malabsorption syndrome can be influenced by concomitant pathological conditions, that lead to a decrease in the activity of disaccharidases in the small intestine, and the metabolic activity of the intestinal microbiota