Experience in the use of biostator in the treatment of diabetes mellitus in children of the pubertal age

The authors discuss the possibilities of the use of the apparatus "artificial pancreas biostator" in multiple modality treatment of patients suffering from type I diabetes. The own research data are provided. They are based on the use of the apparatus "biostator" in 62 children aged 9-15 years with diabetes mellitus in order to improve insulin therapy. After treatment sessions with the aid of the apparatus all the patients noted improvement of the well-being and abatement of the signs of diabetes mellitus lability. In some cases, the treatment using the apparatus promoted a more rapid attainment of disease compensation as compared to the application of conventional treatment methods. It has been shown that high insulin requirement of pubertal children with diabetes decompensation is determined in many respects by activation of the hypothalamus-pituitary-adrenal system.     

Advances in the modulation of the microbial ecology of the gut in early infancy

It is now generally accepted that the microbiota of the human gut may influence health and well-being. Lactic acid bacteria are the most important microorganisms associated with these beneficial effects and the elevated bifidobacterial count may be one of the greatest advantages that breastfed infants have over infants fed with milk formulas. Several studies relative to the selective growth stimulation of bifidobacteria, both in vitro and in vivo , are reported in this review. Over the years, diverse human milk components have been identified as the specific factors able to modulate the growth of bifidobacteria. Even if there is a certain agreement that the bifidogenic activity of human milk may be based not on single growth substances, but on a complex set of interacting factors, the present state of knowledge indicates that the use of non-digestible but fermentable carbohydrates may be an easy and reliable method to influence the growth of lactic acid bacteria. In this context, some of the characteristics of the major physiological effects of inulin-type fructans, of galacto-oligosaccharides, but also of lactoferrin, a milk whey protein fraction with purported bifidogenic activity, are briefly examined.     

Advances in the modulation of the microbial ecology of the gut in early infancy

It is now generally accepted that the microbiota of the human gut may influence health and well-being. Lactic acid bacteria are the most important microorganisms associated with these beneficial effects and the elevated bifidobacterial count may be one of the greatest advantages that breastfed infants have over infants fed with milk formulas. Several studies relative to the selective growth stimulation of bifidobacteria, both in vitro and in vivo, are reported in this review. Over the years, diverse human milk components have been identified as the specific factors able to modulate the growth of bifidobacteria. Even if there is a certain agreement that the bifidogenic activity of human milk may be based not on single growth substances, but on a complex set of interacting factors, the present state of knowledge indicates that the use of non-digestible but fermentable carbohydrates may be an easy and reliable method to influence the growth of lactic acid bacteria. In this context, some of the characteristics of the major physiological effects of inulin-type fructans, of galacto-oligosaccharides, but also of lactoferrin, a milk whey protein fraction with purported bifidogenic activity, are briefly examined.     

Metabolic effects of the delay in obliteration of the umbilical cord in the newborn rat

The effect of delay in obliteration of the umbilical cord on the time-courses of liver glycogen, blood glucose and lactate concentrations and blood PO2, PCO2 and pH during the first 6 h of extrauterine life were studied. Obliteration of the umbilical cord 2 h after delivery resulted in an increase in liver glycogenolysis without significantly affecting the other parameters studied. A 6-hour delay in obliteration of the umbilical cord increased lactiacidemia and decreased blood PO2 and pH without significantly affecting the other parameters studied. A supply of pure oxygen to the newborns decreased lactiacidemia and increased PO2, although the differences between obliterated and nonobliterated newborns remained. These results suggest that hypoxia due to the persistence of placental circulation results in an increase in lactiacidemia as a consequence of a decrease in lactate utilization.     

Controversies in the management of hyperglycemia in the ELBW infant

Hyperglycemia is a common problem in newborns undergoing intensive care, especially extremely low birth weight (ELBW) infants. There is a lack of consensus with regard to various aspects of management of neonatal hyperglycemia including definition, optimal management strategy as well as short and long term implications. We reviewed the current evidence in this regard. Recent studies suggest that adequate control of hyperglycemia may be beneficial but long-term implications of hyperglycemia and insulin therapy in the ELBW infants are not known. Awaiting further research, it may be pragmatic to use a more operational definition of hyperglycemia and limit insulin therapy to neonates with high risk of osmolar derangement as per the proposed guideline.