Biomedical subjects
Publications and source records attributed to J Kábrt.
The author gives an account on the effect of a number of nutrients prepared by the pharmaceutical industry and their use in enteral and parenteral nutrition. They are natural substances which promote the action of other pharmaceutical preparations. Their main importance is in prevention: they prevent a number of complications, have no side-effects and there is no risk of overdosage.
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For a period of two days, while maintaining compensation of diabetes mellitus type I (treated by insulin pump), the authors replaced the usual diabetic diet by a bland carbohydrate diet (2.6 +/- 0.6 MJ/24 h, practically without amino nitrogen). This resulted in a negative energy and nitrogen balance with an indicated adaptation reaction on the second day of administration--reduced amount of catabolic urinary nitrogen, concentration of non-esterified serum fatty acids suggested a slightly increased lipolysis. The insulin consumption per 24 h was significantly reduced, as compared with the control day. A low energy carbohydrate diet is, when administered for a short period under careful control of compensation of diabetes type I, relatively safe and can be used e. g. during intercurrent digestive diseases.
UNLABELLED: The authors investigated in 11 type diabetics the effect of omission of a meal on the compensation of diabetes during treatment with an insulin pump IP 1003. After stabilization of treatment by the pump, the patients were left on the 5th day without breakfast, while the basal operation of the pump was maintained and the patient received their insulin bolus in the morning. The test was terminated as planned after 180 mins. in 6 patients, in 5 it was terminated early because of typical signs of clinical hypoglycaemia. The course of the blood sugar curves revealed differences between patients from abrupt drops of hyperglycaemic values to hypoglycaemia to balanced low blood sugar levels. For the rest of the day till the following morning after the test the blood sugar was elevated, as compared with the control level of the 4th day. CONCLUSIONS: the tests revealed the relatively small drop of the blood sugar level after omission of the meal, hypoglycaemia develops in the majority of diabetics only after 120 to 180 mins. The danger of early hypoglycaemia within 60 minutes was recorded only in patients with a known history of severe hypoglycaemic states. Posthypoglycaemic hyperglycaemia influences the compensation of diabetics during the rest of the day.
The authors investigated 38 obese patients with a BMI above 35. The patients were divided into four groups. The first three groups were on a strict reducing diet, which differed as to the energy values (1.38 MJ to 2.75 MJ) and the amount of protein (5.58 g N to 17.91 g N) per 24 hours. The fourth group fasted. In the course of 16 days metabolic balances were made and the energy output at rest was assessed by indirect calorimetry. In all groups the body weight declined markedly on average by 8.2 to 10.5 kg. The energy consumption at rest declined only during the complete fast. The fasting patients were in a negative nitrogen balance. The nitrogen balance was positive in the patients who were given 11.2 g N and 17.91 g N/24 hours. In all groups the fat utilization increased and the sugar utilization declined. The protein catabolism declined markedly only in the fasting patients. It may be summarized that the low-energy protein diet is, as compared with the fast, a more physiological way to achieve weight reduction, in particular because despite weight reduction a positive nitrogen balance is achieved.
38 obese patients with BMI in excess of 35 were monitored, the patients were divided into four groups. The first three were on a strict slimming diet which different as to the energy values (1.38 MJ--2.75 MJ) and the amount of protein (5.58 g N--17.91 g N) per 24 hours. The fourth group was on a starvation diet. Metabolic balance values and resting energy cut put were measured by indirect calorimetry during 16 days of monitoring. In all groups the body weight declined markedly by an average of 8.2-10.5 kg. Resting energy consumption dropped only during absolute fasting. The starvation diet patients exhibited a negative nitrogen balance. Positive nitrogen balance was found in groups on 11.2 g N and 17.91 g N/24 hours. Fat utilization increased and sugar utilization declined in all groups. Protein catabolism declined markedly only in the fasting patients. Summed up, the low-energy protein diet is--in comparison with absolute diet--a more physiological way to achieving weight reduction, in particular, because, despite the loss of weight, a positive weight balance is achieved, too.
Parenteral nutrition (PN) was administered to 24 patients with chronic enteritis. Their mean age was 37 years (range 17 to 69 years). Seventeen times Crohn's disease was involved, five times ulcerative colitis and twice postprandial enteritis. The mean period of PN was 24.6 +/- 12.9 days and its energy value was 7.79 +/- 1.63 MJ/24 hours. Some patients had a restricted oral intake, on average 5 MJ/24 hours. The energy output at rest assessed by indirect calorimetry was 7.62 +/- 1.06 MJ/24 hours. Along with PN the patients had aimed antiinflammatory treatment. In the majority of patients clinical improvement was recorded. The nutritional status improved in 13 patients, was not affected in 9 and in two it deteriorated. The improvement of the nutritional status was not always associated with regression of manifestations of the local enteritis. In particular affections of the rectum in Crohn's disease were resistant to treatment and the position changed after a derivation stoma operation.
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