AIM: To investigate whether semi-vegetarian diet (SVD) has a preventive effect against relapse of Crohn’s disease (CD) in patients who have achieved remission,who are a high-risk group for relapse.METHODS: A prospect...AIM: To investigate whether semi-vegetarian diet (SVD) has a preventive effect against relapse of Crohn’s disease (CD) in patients who have achieved remission,who are a high-risk group for relapse.METHODS: A prospective,single center,2-year clinical trial was conducted.Twenty-two adult CD patients who achieved clinical remission either medically (n = 17) or surgically (n = 5) and consumed an SVD during hospitalization were advised to continue with an SVD and avoid known high-risk foods for inflammatory bowel disease.The primary endpoint was clinical relapse defi ned as the appearance of active symptoms of CD.Kaplan-Meier survival analysis was used to calculate the cumulative proportion of patients who had a relapse.A 2-year analysis of relapse rates of patients who followed an SVD and those who did not (an omnivorous diet group) was undertaken.RESULTS: SVD was continued by 16 patients (compliance 73%).Remission was maintained in 15 of 16 patients (94%) in the SVD group vs two of six (33%)in the omnivorous group.Remission rate with SVD was 100% at 1 year and 92% at 2 years.SVD showed signif icant prevention in the time to relapse compared to that in the omnivorous group (P = 0.0003,log rank test).The concentration of C-reactive protein was normal at the f inal visit in more than half of the patients in remission who were taking an SVD,who maintained remission during the study (9/15;60%),who terminated follow-up (8/12;67%),and who completed 2 years follow-up (7/10;70%).There was no untoward effect of SVD.CONCLUSION: SVD was highly effective in preventing relapse in CD.展开更多
Primary sclerosing cholangitis (PSC) is commonly associated with ulcerative colitis (UC). PSC progresses independently of UC ultimately resulting in liver failure. There is no established medical treatment to improve ...Primary sclerosing cholangitis (PSC) is commonly associated with ulcerative colitis (UC). PSC progresses independently of UC ultimately resulting in liver failure. There is no established medical treatment to improve the natural course of PSC. Normalization of serum alkaline phosphatase (ALP) in early stage might delay the progress of PSC. A 20-year-old female, had a sudden attack of right hypochondralgia with high fever and abnormal liver function tests without elevation of bilirubin: ALP 478 IU/L, aspartate aminotransferase 360 IU/L, alanine aminotransferase 174 IU/L. Abnormal liver function tests returned to normal after the attacks. Morphological examinations initially indicated then confirmed a diagnosis of PSC. One month after displaying PSC symptoms administration of ursodeoxycholic acid was initiated. Similar attacks of cholangitis were repeated several times over the following two years. Even in the absence of these attacks, she always suffered postprandial hypochondralgia. There was no acute cholangitis in the year prior to the last hospitalization due to abdominal pain and bloody diarrhea. Findings were consistent with UC in the form of entire colitis. Sulfasalazine, metronidazole and semi-vegetarian diet (SVD) were initiated. Metronidazole is routinely used in inflammatory bowel disease (IBD) in our practice with the expectation of elimination of any potentially pathogenic bacteria. SVD was designed for IBD hoping to increase beneficial bacteria. A remission of UC was ascertained during hospitalization. Elevated ALP, in the absence of clinical cholangitis, was decreased to normal after the therapy for UC.展开更多
Among 18 patients diagnosed as posthepatitic cirrhosis of the liver at compen-sated stage, 12 were treated for 2 months with a vegetarian diet which provided a dailyintake of 2263 Kcal and 95g protein with 68g of it v...Among 18 patients diagnosed as posthepatitic cirrhosis of the liver at compen-sated stage, 12 were treated for 2 months with a vegetarian diet which provided a dailyintake of 2263 Kcal and 95g protein with 68g of it vegetable in origin, while the re-maining 6 patients were given a routine hospital diet and served as controls. After 2months of dietary treatment, there was a marked increase in the value of serum albuminand transferrin, an increase in 24 h urinary creatinine output and creatinine height indexwith a decrease in 24 h urinary output of urea nitrogen. The reverted A/G ratio was cor-rected and the negative nitrogen balance became positive. The protein synthetic rate turnedto become greater than the catabolic rate and the body protein flux decreased as mea-sured by the <sup>15</sup>N-glycine tracer kinetic study. The paper concludes that a high caloric vege-tarian diet can influence favorably the whole body protein turnover in cirrhotic patientsand should thus be used at least as an adjuvant therapy in the management of these patients.展开更多
Chronic kidney disease (CKD) is a common health problem worldwide. CKD staging or classification, together with patients’ prognosis and treatment plan depend on the patients’ kidney function which is assessed by mea...Chronic kidney disease (CKD) is a common health problem worldwide. CKD staging or classification, together with patients’ prognosis and treatment plan depend on the patients’ kidney function which is assessed by measurement of glomerular filtration rate (GFR). Estimated GFR can be obtained using serum or plasma creatinine as a main variable in equations or formulae such as Cockcroft-Gault equation, MDRD equation (Modification of Diet in Renal Disease), the Schwartz and Counahan-Barratt formulae. These equations, though widely accepted, still have to be adjusted or validated among different groups of patients according to the variation in some factors such as race, diet, and genetic heterogenicity. Diet, especially the high protein load, can affect GFR representing the renal functional reserve. A high protein diet can cause an increase in GFR that lasts for many hours. Long-term consumption of vegetarian diet which is low in protein and contains only protein from plant sources can cause a low baseline GFR while the renal functional reserve is still preserved. This paper aims to remind of the role of protein diet effect on GFR measurement especially when assessing the renal function in vegetarians or individuals on long-term low-protein intake.展开更多
文摘AIM: To investigate whether semi-vegetarian diet (SVD) has a preventive effect against relapse of Crohn’s disease (CD) in patients who have achieved remission,who are a high-risk group for relapse.METHODS: A prospective,single center,2-year clinical trial was conducted.Twenty-two adult CD patients who achieved clinical remission either medically (n = 17) or surgically (n = 5) and consumed an SVD during hospitalization were advised to continue with an SVD and avoid known high-risk foods for inflammatory bowel disease.The primary endpoint was clinical relapse defi ned as the appearance of active symptoms of CD.Kaplan-Meier survival analysis was used to calculate the cumulative proportion of patients who had a relapse.A 2-year analysis of relapse rates of patients who followed an SVD and those who did not (an omnivorous diet group) was undertaken.RESULTS: SVD was continued by 16 patients (compliance 73%).Remission was maintained in 15 of 16 patients (94%) in the SVD group vs two of six (33%)in the omnivorous group.Remission rate with SVD was 100% at 1 year and 92% at 2 years.SVD showed signif icant prevention in the time to relapse compared to that in the omnivorous group (P = 0.0003,log rank test).The concentration of C-reactive protein was normal at the f inal visit in more than half of the patients in remission who were taking an SVD,who maintained remission during the study (9/15;60%),who terminated follow-up (8/12;67%),and who completed 2 years follow-up (7/10;70%).There was no untoward effect of SVD.CONCLUSION: SVD was highly effective in preventing relapse in CD.
文摘Primary sclerosing cholangitis (PSC) is commonly associated with ulcerative colitis (UC). PSC progresses independently of UC ultimately resulting in liver failure. There is no established medical treatment to improve the natural course of PSC. Normalization of serum alkaline phosphatase (ALP) in early stage might delay the progress of PSC. A 20-year-old female, had a sudden attack of right hypochondralgia with high fever and abnormal liver function tests without elevation of bilirubin: ALP 478 IU/L, aspartate aminotransferase 360 IU/L, alanine aminotransferase 174 IU/L. Abnormal liver function tests returned to normal after the attacks. Morphological examinations initially indicated then confirmed a diagnosis of PSC. One month after displaying PSC symptoms administration of ursodeoxycholic acid was initiated. Similar attacks of cholangitis were repeated several times over the following two years. Even in the absence of these attacks, she always suffered postprandial hypochondralgia. There was no acute cholangitis in the year prior to the last hospitalization due to abdominal pain and bloody diarrhea. Findings were consistent with UC in the form of entire colitis. Sulfasalazine, metronidazole and semi-vegetarian diet (SVD) were initiated. Metronidazole is routinely used in inflammatory bowel disease (IBD) in our practice with the expectation of elimination of any potentially pathogenic bacteria. SVD was designed for IBD hoping to increase beneficial bacteria. A remission of UC was ascertained during hospitalization. Elevated ALP, in the absence of clinical cholangitis, was decreased to normal after the therapy for UC.
文摘Among 18 patients diagnosed as posthepatitic cirrhosis of the liver at compen-sated stage, 12 were treated for 2 months with a vegetarian diet which provided a dailyintake of 2263 Kcal and 95g protein with 68g of it vegetable in origin, while the re-maining 6 patients were given a routine hospital diet and served as controls. After 2months of dietary treatment, there was a marked increase in the value of serum albuminand transferrin, an increase in 24 h urinary creatinine output and creatinine height indexwith a decrease in 24 h urinary output of urea nitrogen. The reverted A/G ratio was cor-rected and the negative nitrogen balance became positive. The protein synthetic rate turnedto become greater than the catabolic rate and the body protein flux decreased as mea-sured by the <sup>15</sup>N-glycine tracer kinetic study. The paper concludes that a high caloric vege-tarian diet can influence favorably the whole body protein turnover in cirrhotic patientsand should thus be used at least as an adjuvant therapy in the management of these patients.
文摘Chronic kidney disease (CKD) is a common health problem worldwide. CKD staging or classification, together with patients’ prognosis and treatment plan depend on the patients’ kidney function which is assessed by measurement of glomerular filtration rate (GFR). Estimated GFR can be obtained using serum or plasma creatinine as a main variable in equations or formulae such as Cockcroft-Gault equation, MDRD equation (Modification of Diet in Renal Disease), the Schwartz and Counahan-Barratt formulae. These equations, though widely accepted, still have to be adjusted or validated among different groups of patients according to the variation in some factors such as race, diet, and genetic heterogenicity. Diet, especially the high protein load, can affect GFR representing the renal functional reserve. A high protein diet can cause an increase in GFR that lasts for many hours. Long-term consumption of vegetarian diet which is low in protein and contains only protein from plant sources can cause a low baseline GFR while the renal functional reserve is still preserved. This paper aims to remind of the role of protein diet effect on GFR measurement especially when assessing the renal function in vegetarians or individuals on long-term low-protein intake.
