[Food poisonings and diabetes mellitus].
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Biomedical subjects
Publications and source records attributed to L E Brodov.
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The authors criticize the nosological principle of the diagnosis of toxic infections and believe that in a vast majority of cases such diagnosis must be based on syndromes. The only exceptions are cases of mass outbreaks and hospital infections. The definition of alimentary toxic infection is given, the difficulties of their clinical diagnosis and the ways to overcome these difficulties are indicated.
Therapeutic effectiveness of an oral rehydration solution of the second generation Super-ORS based on rice and salt has been tried in 28 patients with food poisoning. Administration of the solution produced a marked clinical effect superior to that of the first generation solutions Glucosalan, Citroglucosalan, Rehydron.
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The efficacy of the solutions of oral rehydration salts (ORS) of the first and second generations was estimated in the treatment of patients with acute intestinal infections. 150 patients with food toxicoinfections were examined. Two groups of the patients received the solutions of ORS of the first generation (glucosalan and citroglucosalan) and one group were given the second generation ORS solution based on the rice and salt, manufactured by Galactina (Switzerland). The clinical cases were analyzed. Some biochemical parameters that characterize certain aspects of homeostasis and bioenergetics were explored. The authors emphasize a greater effectiveness of the second generation solutions of ORS producing not only detoxification and rehydration but also serving as a food.
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The data are presented on an outbreak of salmonellosis induced by S. enteritidis. Gastrointestinal symptoms were recorded in 97.8% of 90 patients, 2.2% of them developed a generalized form. The disease ran a moderate course in 84.5% and a severe course in 2.2% of the patients majority of whom suffered from intoxication and dehydration. The therapeutic response was achieved upon rehydration treatment with crystalloid solutions.
The authors describe the data obtained by them during many years of pathogenetic treatment of patients with acute intestinal infections. Note the main errors made during treatment and giving rise to unfavourable outcomes. Give practical recommendations for carrying out pathogenetic therapy bearing in mind the age-associated characteristics and associated diseases. Draw the clinicians' attention to infusion therapy.
Ciprofloxacin (Bayer, FRG), a derivative of hydroxyquinolone acid, was used for the treatment of patients with shigellosis and salmonellosis and for the sanitation of Salmonella carriers. The drug turned out to exert a positive effect on bacteriological sanitation of the body. In order to treat patients with food toxinfection of unknown etiology, use was made of intetrix (Farmacos, Socialist Federal Republic of Yugoslavia). Inclusion of the drug into combined treatment of patients with food toxinfections did not show any material advantages.
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As many as 120 patients with food toxinfections were treated by intravenous injections of kvartasol solution and the oral solutions glucosolan and rehydron. The data obtained allow the conclusion that rehydration therapy is not only not inferior to intravenous treatment but also favours the quickest recovery of the disturbed parameters of homeostasis including most rapid elimination of intoxication. Rehydron solution should be regarded as the most effective one.
As a result of studying the clinical characteristics and paraclinical signs of intoxication in 420 patients with food toxinfections, markers of intoxication have been defined: concentration of citric acid and medium molecular metabolites in blood serum and the magnitude of the leukocytic index of intoxication.
A study of 45 patients with medium-severe toxic food infections demonstrated increased spontaneous NBT test results and altered pyrogenal-induced NBT test values, depending on the severity of intoxication and the clinical pattern of the disease.
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Interrelated alterations in metabolism were discovered in patients with acute intestinal infections of medium gravity. Alterations in homeostasis express the condition of the functional and adaptive processes that develop in the organs and systems in the course of an infectious disease. Oral rehydration therapy is an effective means of treating such category of patients.