Dietary fiber syndrome as the cause of disease in civilised societies.
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Biomedical subjects
Publications and source records attributed to F Matzkies.
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In a carbohydrate combination solution containing 12.5 mEq/1 calcium and 12 mmol/1 phosphate the concentrations of calcium and phosphate were kept constant during parenteral infusion therapy with carbohydrate, at a rate of 0.5 g/kg/h and amino acids at a rate of 0.1 g/kg/h. Balance for calcium and phosphate was positive. Calcium excretion was slightly above the levels determined in oral nutrition. A slight modification of calcium supplement by changing the concentration of the solution to 10 mEq/1 is suggested.
The water balance and the electrolyte balance were measured in 6 patients after 14 days of total starvation. After fasting a 600 calorie formula diet was given for the whole period. The potassium balance was +32 mval/day and that of sodium +120 mval/day. The total loss of potassium in 14 days was 488 mval and that of sodium only 126 mval. Sodium loss is replaced within one day of refeeding. No replacement of the potassium loss was noticed during the 4 day treatment.
Some therapeutic measures cause hyperuricemia, which may require treatment in certain cases. The following may induce hyperuricemia: cytostatic long-term treatment, weight reduction through fasting, antihypertensive treatment with different chlorothiazides but also furosemide and etacrynic acid, anti-tuberculostatic therapy and Parkinson long-term treatment.
Dietary therapy after gastrectomy demands a differentiated approach. In the immediate postoperative phase parenteral nutrition is indicated. If no complications occur, the transition to oral nutrition can soon be made, the basic principle of which is adherence to 6-8 small meals. Since, in our experience, after gastric resections numerous disorders can occur, a carefully controlled diet with the aid of nutrional anamnesis is to be recommended. At the same time substitution of vitamin B12, iron, calcium and pancreatic enzymes is absolutely essential.
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By treating 16 hyperuricemic patients each with 25 and 50 mg of Benzbromarone a significant decrease of the uric acid concentration in the serum into the normal range is achieved. On the 5th and 6th day after beginning the treatment the dosage of 25 mg of Benzbromarone renders a morning value of 5,3 +/- 1,0 and an evening value of 5,0 +/- 0,9 mg/100 ml. After administration of 50 mg of Benzbromarone there is also prevailing a steady-state behaviour on the 5th and 6th day for the uric acid concentration in the serum. Thereby the morning value is 3,7 +/- 0,8 mg/100 ml and th evening value 3,4 +/- 0,9 mg/100 ml. After both dosages an increased urate elimination occurs initially during the 1st, 2nd and 3rd day after beginning of the therapy. However, after having achieved therapeutically reduced uric acid levels, the uric acid elimination from the 4th, 5th and 6th day partially ranges below those values existing before beginning of the therapy. During a chronic treatment no hyperuraturia can be observed on account of the therapeutically reduced serum concentrations. Consequently an increased risk towards a formation of urate calculi is not given under the long-term treatment.
After oral application of 100mg of Benzbromarone a significant decrease of the uric acid concentration in the serum up to the 14th day after beginning of the treatment to a mean value of 1,7 mg/100 ml is achieved; while the application of 50 mg of Benzbromarone reduces the uric acid concentration only to a value of 3,4 mg/100 ml. Thereby the differences amounts to about 1,7 mg/100 ml. The urate elimination increases after 100 as well as after 50 mg of Benzbromarone. Only initially an increased uric acid elimination could be observed. In the further course the uric acid elimination remains increased despite reduced serum concentrations.
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Twenty patients, divided in two groups to ten were undergoing a fasting period for 14 days. One group received 80 mEq potassium per day. Despite of identical loss of body-weight, the application of potassium showed the following advantages: 1) The body is able to keep acid-base-balance. 2) The important loss of potassium, induced by starvation can be reduced to a minimum.
While age is increasing involutiones specific to age can be proofed at the gastrointestinal tract, which lead to a deceleration but quantitative unchanged adsorption. Wrong nutrition concerning to the take up of fat, carbohydrates, proteins and trace elements can be found in greater age very often. By watching a collective of healthy persons beyond the age of 90 years however it turns out that this group keeps a nearly faultless nutrition. The requirements of lysin, methionin and calcium is a little higher in old age than in younger. By intermitting starvation or addition of antioxidants life can be prolonged in experiments on animals, when this therapy starts already in younger age. Starvation in higher age, however, leads to a shortening of life in experiments on animals.
Report on two patients with endogenous hypertriglyceridemia. In both patients normal serum lipid values were reached in a comparatively short time under a diet with reduced carbohydrates and calories. In one diabetic patient who needed insulin at the beginning of the treatment the disease could be controlled by dietary measures alone after a few days. Different biological half-life periods of the various serum lipid fractions explain why, under a reducing diet, the rate of decrease of lipids is variable according to the respective component. Thus, the ratio of triglycerides and cholesterol can vary in the same patient within a few days and may change his classification under different types of hyperlipidemia according to Fredrickson. It would appear that in these cases a classification based on etiological considerations is more recommendable.
10 healthy men received an i.v. infusion of maltose at a dosage of 1.5 g/kg/h over a period of 1 h. No clinical side effects were observed. Total protein and albumin showed a significant drop. The glucose level remained constant. The concentration of maltose rose up to 495 +/- 77 mg/100 ml. The osmo-diuretic action of the solution was proven by a renal excretion of 289 +/- 57 ml water/h, 14.6 g maltose/h and 3.9 g glucose/h. The total carbohydrate elimination was 61.8 +/- 9.1 g/8 h, (44.5 +/- 13.5 maltose and 15.7 [+8.1--21,2] glucose). The specific action of maltose is an induction of glucosuria without hyperglycemia.
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In 2466 in-patients the blood cholesterol concentration was measured. Also age, height, weight, excretory liver function, glucose tolerance, the concentration of total lipids, uric acid and the clinical diagnosis were correlated with the cholesterol levels. Higher cholesterol levels were found in elderly patients and in patients with impairment of liver function, glucose tolerance and with overweight. With increasing hight cholesterol decreases. Patients with disorders of gallbladder and liver had significantly higher cholesterol levels compared with patients with hematological disorders, malignancies and pulmonary affections.
Three patients with gout and seven with hyperuricaemia, previously untreated, took a single dose of 100 mg allopurinol and 20 mg benzbromaron (as a combined preparation) each morning. There occurred a highly significant decrease in serum uric acid concentration from 430.7 mumol/l (72.4 mg/l) to 268.6 mumol/l (45.2 mg/l), without any significant increase in urinary excretion of uric acid.
In 106 healthy adults and 34 in-patients with diabetes mellitus the venous blood concentration of lactate, pyruvate, hydroxybutyrate and acetacetate was measured. In healthy men we found a lactate concentration of 7.7 mg/100 ml (7.11-8.15), a pyruvate level of 0.37 (0.34-0.44) mg/100 ml, a level of acetoacetate of 0.41 mg/100 ml(0.38-0.47) and a level of hydroxybutyrate of 0.47 mg/100 ml(0.29-0.70).