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[Soluble milk protein concentrates, casecites, for infant and dietetic nutrition].

A soluble form of caseins, so-called casecites for an infant and dietetic nutrition, is obtained from separated milk by way of solving casein through using freshly precipitated lactic acid terment of 0.1 n HCl, mixed with solts-solvents. The lactoproteinic concentrates-casecites have an elevated biological value, called forth by the content of large amounts (80.0 per cent) of complete lactic protein, the presence of citrate-ions, forming as a physiologically active additive, balanced most important mineral elements. A minimal (not more than 2.0 per cent) of the lactose content in casecites enables the latter to be utilized for nutrition of persons suffering from lactose intolerance as well as to orientally regulate the carbohydrate composition of the products obtained on their basis.

Caseins

Staffing patterns in hospital clinical dietetics and nutrition support: a survey conducted by the Dietitians in Nutrition Support dietetic practice group.

The Dietitians in Nutrition Support dietetic practice group of The American Dietetic Association administered a questionnaire to evaluate changes in nutrition support services provided to hospitalized patients and home patients in 1989 and compared the results with results of a survey administered in 1986. The 1986 survey documented an increase in tube feeding to inpatients during 1984 to 1986 and greater dietitian staffing in tertiary care hospitals than in primary care hospitals and in larger hospitals in 1986. The 1989 questionnaire was mailed to clinical nutrition managers from a nationwide random sample of 1,000 hospitals from American Hospital Association members; 271 responses were received. Full-time equivalent (FTE) registered dietitians (RDs)--including clinical RDs, nutrition support service RDs, and clinical nutrition managers--decreased 11% from 1986 to 1989. FTE dietetic technicians decreased 22%. The number of FTE nutrition support service RDs and clinical nutrition managers decreased significantly (P less than .05). The mean number of FTE clinical dietitians per 100 beds decreased from 1.4 to 1.0 from 1986 to 1989. These decreases in dietetics staffing occurred despite an overall increase in total hospital FTE staff of 2.9%. Reported daily provision of nutrition support modalities to inpatients was 3.5% for parenteral nutrition, 4.9% for enteral tube feeding, and 9.6% for oral supplements. Decreased dietetics staffing was accompanied by other factors that negatively affect productivity (and therefore ability to provide adequate patient care), including inadequate delegation of technical tasks to dietetic technicians, limited availability of secretarial and computer support, and minimal provision of pocket pagers. These trends may be evidence of inadequacy of dietetics staffing to meet the needs of the US population for nutrition care.

Dietary Services

[Modern principles of assessing the effectiveness of dietetic nutrition in internal diseases].

Modern dietology is based on the metabolic principle. In all internal diseases it is composing a balanced diet adapted, above all, to metabolic disorders inherent in a given malady, that is envisaged. The range of current investigation methods permits it to ensure a strict control over the proportions of nutritional components in the dietary and to establish the limits of permissible increase or restriction of the content of each of them. Substance is given to dietetic approaches to various nosological forms of the disease that include the nutritional pattern, caloricity, qualitative and quantitative content of the nutrients.

Amino Acids

[New types of canned meats for infant and dietetic nutrition].

In line with the current concept for a balanced nutrition and physiological-biochemical peculiarities of the child's organism a raw meat was selected, formulations and technology of fabricating canned goods of meat and edible viscera of three degrees of communition for three age groups of children were elaborated. An approbation made in pediatric and medical establishments justified recommending inclusion of all the kinds of these canned meat in the ration of infants aged up to one year, and of the homogenized ones- also for dietetic consumption.

Amino Acids

[Economic aspects of therapy for lipid metabolism disorders].

The primary and secondary prevention of cardiovascular diseases and, therefore, the therapy of hyperlipidemia is essential in strategies to lower morbidity and mortality from coronary heart disease (CHD), the most relevant atherosclerosis-associated disease. These programs imply not only a medical but also an economic challenge to our health system. That is why all therapeutic measures have to be evaluated regarding their cost-effectiveness. A cost-effectiveness profile was calculated for all the therapies of hyperlipidemia (nutritional therapy, dietetic nutritionals, drugs and LDL-apheresis) with respect to the following parameters: total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides. The daily costs of all interventional measures are compared to the success rate, whereby an index of daily therapy costs and 1% change per lipid parameter was calculated. Nutritional therapy is by far the cheapest, and LDL-apheresis the most expensive but also the most effective and reliable therapeutic measure. It has to be considered, however, that dietary intervention can be very successful in overnutrition while in rare cases of severe homozygous familial hypercholesterolemia there is no therapeutic alternative to LDL-apheresis. Life-style modifications, such as changing nutritional habits, may contribute towards reducing or removing one or more risk factor(s) (e.g. malnutrition is associated with overweight, hyperlipoproteinemia (HLP), hyperinsulinemia (syndrome X), hyperfibrinogenemia and hypertension). But neither health politicians nor the population seem to be conscious of the fact that life-style changes help to reduce medical expenditure. Considering the fact that nearly every medical service is getting more and more expensive, the need to introduce financial regulations is evident.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholesterol

[Questioning of diabetic patients on their knowledge of nutrition and dietetics as well as on their smoking habits].

100 diabetics were asked questions referring to the knowledge of nutrition to smoking habits. Most of the diabetics controlled their body weight regularly and were convinced that overweight may be dangerous to health. Despite this knowledge, more than half of the patients were overweight and did not know their individual ideal weight. Between the quality of dietary consultation and dietary behaviour of the patients a similar discrepancy existed: More than half of the questioned persons - especially males - had to be regarded as dietary failures. Patients with relatively low educational level came off worse. Fortunately, most of the patients were non-smokers. However, the dietary consultation practised at the moment seemed to have had no influence on the number of smokers. Consequently, for the training of the patients the following results: More than ever, the patients must be incited to normalize their body weight and they must be positively motivated in this regard as well as with regard to nicotine abuse. Behaviour therapy would certainly be desirable. Moreover, the patients should have a dietary consultation at least every second year. A dietary filled in for the patient personally must serve as the basis for the observance of the diet. Persons in whom diabetes mellitus was diagnosticated should receive consultation more quickly than up to now. Moreover, it would be useful to free the diet from the odium of an annoying and unimportant supplementation to medicamentous diabetes therapy. The study showed that continuous self-control of the own educational work is indispensable to guarantee a high standard of therapeutic efforts.

Adult