Сучасні уявлення про значущість забезпечення цинком при інфекційній патології в дітей

Aim. Give a comparative characteristic of the course of infectious diarrhea in young children, residents of the Zaporizhzhia region (Ukraine), depending on their provision of zinc (Zn). Materials and methods. The study included 99 children aged 1 to 36 months with manifestations of infectious diarrhea. On the day of hospitalization, immunochromatographic and bacteriological examination of feces was performed. Also, on the first, third and fifth days of hospitalization, a general blood test and the level of Zn in the blood were determined for each patient. Results. It was found that among the examined patients with infectious diarrhea at the onset of the disease, 22 children (22.2 %) had a reduced concentration of Zn in blood serum. In these children, the zinc level ranged from 7.63 to 9.17 μmol/l. It was also noted that the level of Zn in these patients on the 5th day of inpatient treatment rose to the norm of reference indicators. After studying the anamnesis, it was found that 40.9% of children with low Zn content had episodes of acute intestinal infection before this disease. During a comparative analysis of the clinical and laboratory data of patients, it was found that the tendency to more frequent vomiting occurred in patients with Zn deficiency (p = 0.05), that Zn availability had the most significant effect on the expressiveness of the diarrheal syndrome at the onset of the disease and more than a third (n = 8, 36.4 %) of children with Zn deficiency had more than 5 episodes of diarrhea per day, among which every second had more than 10. We did not determine significant differences between the frequency of viral and bacterial causes of diarrhea in the comparison groups. As for complete blood count, patients with Zn deficiency more often had a tendency to blood neutrophilia with a reliably frequent shift of the leukocyte formula to the left (p = 0.003). At the same time, children with a reduced content of Zn in blood serum significantly more often had lymphopenia at the onset of diarrheal disease (p = 0.006). When investigating the effect of Zn deficiency on the course of the disease, we found that in children with reduced Zn, the duration of diarrhea was almost twice as long (8 [6; 9] days vs. 5 [4; 6] in children with normal Zn indicators; p = 0.0001 according to the Mann–Whitney test) and in patients with infectious diarrhea who had Zn deficiency at the onset of the disease, on the seventh day of treatment diarrhea persisted significantly more often (p = 0.03). Such symptoms were accompanied by the persistence of signs of anemia (p = 0.06 on the 5th day) and a shift of the leukocyte formula to the left (p = 0.007) without leukocytosis. Conclusions. Almost 25 % of young children with infectious diarrhea in the Zaporizhzhia region had Zn deficiency. Most likely, Zn deficiency is caused by the peculiarities of its supply with food and its metabolism. In the debut of a diarrheal disease, insufficient supply of Zn is associated with lymphopenia and a shift of the leukocyte formula to the left. Zn deficiency in infectious diarrhea leads to a long (more than 5 days) course of the disease due to prolongation of the diarrheal syndrome.

Zinc: An Essential Trace Element for Parenteral Nutrition

Background: Zinc is an essential trace element that is crucial for numerous biological processes, including protein synthesis, antioxidant activity, and bone calcification. Preterm infants are at high risk of zinc deficiency owing to inadequate zinc stores at birth and the rapid decline in zinc concentration in breast milk. This study aimed to evaluate the relationship between zinc concentrations in breast milk and zinc supplementation in preterm infants. Methods: A prospective observational study was conducted at Showa University Hospital, enrolling preterm infants born at less than 32 weeks of gestation or with a birth weight of less than 1800 g. Serum zinc levels, breast milk zinc concentrations, and zinc acetate supplementation were analyzed. Results: The results indicated an inverse correlation between breast milk zinc concentration and the required zinc supplementation dose. Infants receiving high-dose zinc supplementation (≥3 mg/kg/day) had significantly lower breast milk zinc concentrations at 2, 4, and 5 weeks postpartum. Conclusions: These findings highlight the need for individualized zinc monitoring and supplementation strategies to prevent zinc deficiency in preterm infants. Considering the absence of zinc in human milk fortifiers in Japan, aggressive zinc supplementation may be necessary to ensure optimal growth and development.

Zinc

Association of Zinc Deficiency and Depression in the Patients With End-stage Renal Disease on Hemodialysis

Background: In sub-Saharan Africa, infectious diarrhoea is a major cause of childhood morbidity and mortality. A cross-sectional study was undertaken to document the pathogens potentially involved in community-acquired childhood diarrhoea in Dakar, the capital of Senegal.Methods: Between September 2007 and March 2008, 176 children aged 1 month to 5 years were recruited consecutively from a primary health care institution in an urban area. Clinical data were recorded and stool samples were collected. Bacterial pathogens were identified using conventional methods and/or PCR assays. Rotaviruses and adenoviruses were detected by a rapid immunochromatographic test. Intestinal parasites were diagnosed by microscopy.Results: Rotavirus was the most common enteric pathogen, detected in 27% of patients, followed by Shigella (12%), diarrhoeagenic Escherichia coli (8%), enteric adenovirus (8%), Salmonella (4%), Campylobacter jejuni (3%) and Plesiomonas shigelloides (2%). Mixed bacterial/viral infections were detected in 6% of cases. Parasites, mostly protozoa, were detected in 14% of children. Using ipaH PCR, 30% of samples were positive for Shigella/entero-invasive E. coli. Detection of rotavirus was more frequently associated with younger age groups (<24 months), whereas bacterial diarrhoea was isolated more often in children over 1 year of age. Detection of bacterial pathogens was significantly associated with malnutrition. Antibiotics were prescribed for 77% of children who attended for consultation. No pathogen was found in 36% of them, whereas a virus was detected without any other associated bacterial or parasitic pathogen in 23% of patients.Conclusion: In developing countries, there is a need to develop reliable, easy-to-use, inexpensive rapid diagnostic tests to guide the management of diarrhoea in infants and children and thereby prevent over-use of antimicrobial agents.

ABSTRACTEarlier, we demonstrated that transcript levels of METAL TOLERANCE PROTEIN2 (MTP2) and of HEAVY METAL ATPase2 (HMA2) increase strongly in roots of Arabidopsis upon prolonged zinc (Zn) deficiency and respond to shoot physiological Zn status, and not to the local Zn status in roots. This provided evidence for shoot-to-root communication in the acclimation of plants to Zn deficiency. Zn-deficient soils limit both the yield and quality of agricultural crops and can result in clinically relevant nutritional Zn deficiency in human populations. Implementing Zn deficiency during cultivation of the model plant Arabidopsis thaliana on agar-solidified media is difficult because trace element contaminations are present in almost all commercially available agars. Here, we demonstrate root morphological acclimations to Zn deficiency on agar-solidified medium following the effective removal of contaminants. These advancements allow reproducible phenotyping toward understanding fundamental plant responses to deficiencies of Zn and other essential trace elements.

Development of a Plasma Zinc Concentration Cutoff to Identify Individuals with Severe Zinc Deficiency Based on Results from Adults Undergoing Experimental Severe Dietary Zinc Restriction and Individuals with Acrodermatitis Enteropathica

The effect of Trypanosoma brucei brucei infection on rabbit plasma iron and zinc concentrations

Objective To assess the prevalence of Campylobacter in the children with acute bacterial diarrhea in Shanghai. Methods Epidemiological survey.Totally 6 641 children with acute bacterial infectious diarrhea from outpatients and inpatients in Children′s Hospital of Fudan University were submitted to the investigation during January 2011 to December 2012.The Campylobacter was isolated from stool samples collected from subjects in micro aerobic environment and identified by both multi-PCR and matrix-assisted laser desorption ionization-time-of-flight mass spectrometry （MALDI-TOF MS）.Antimicrobial susceptibility tests were assayed by disk-diffusion method according to EUCAST standard.The isolates molecular typing was done by PFGE.SPSS16.0 was used to analyze the results. Results A total number of 6 641 subjects were enrolled, among them, 305 patients were infected with Campylobacter.The prevalence rate was 4.6% (305/6 641).Among the infected patients, 240 patients were infected with Campylobacter jejuni and 65 patients were infected with Campylobacter coli, the infectious rates of these two pathogenic bacteria were 3.6% and 1.0%, respectively.The peak infectious rate in patients older than 1 year of age was 6.2%（209／3 385) which was higher than that in children under 1 year of age （2.9％， 96／3 256)，χ2=35.98，P<0.001.The infectious rate in winter and spring (6.8%, 138/2 040) was higher than that in the other seasons (3.6%,167/4 601)，χ2=28.59，P<0.001.Antimicrobial susceptibility test results showed that 91.5%(279/305) isolates were resistant to ciprofloxacin and 11.8%（36/305） isolates were resistant to erythromycin.A total of 9 genotypes of Campylobacter were found by PFGE cluster analysis.The similarity were ranged from 65.1%-100.0% for type A, 67.6%-100.0% for type B, 61.7%-100.0% for type C, 59.0%-100.0% for type D, 71.4% for type F, 80.0% for type H, 54.4%-90.9% for type I, and only one strain was classified as type E and G. Conclusions Campylobacter is a major pathogenic bacteria associated with acute bacterial infectious diarrhea in children especially in children older than 1 year of age in Shanghai.The prevalent pattern of this pathogen was sporadic and the sharp peak was in winter and spring.The isolates are highly resistant to ciprofloxacin but still sensitive to erythromycin.（Chin J Lab Med,2014,37:743-747） Key words: Campylobacter infections; Diarrhea; Epidemiology; Microbial sensitivity tests; Electrophoresis, gel, pulsed-field

Trace elements play an important role in human health. They are involved in growth, development, reproduction, and other physiological functions. Among them, special attention is paid to zinc, which is an essential trace element required for the normal functioning of many organ systems. Experimental data have been accumulated indicating a significant role of zinc in the functioning of the male reproductive system and the spermatogenesis. Zinc concentration in seminal plasma is considerably higher compared to those in other body fluids. In contrast to its serum concentration, seminal zinc level is associated with the sperm concentration, motility and morphology. Under dietary deficiency, Zinc supplementation can significantly increase the ejaculate volume, sperm motility and morphology and improves overall sperm quality in infertile patients. Zinc, being a structural element of a large number of different macromolecules and enzymes, shows antioxidant, antibacterial and antiapoptotic properties in the testes. It should be considered as one of the trace elements with great potential for the prevention and treatment of male infertility and subfertility. The aim of this review is to analyze current publications and summarize information about the effect of zinc on male fertility and its properties related to sperm quality and successful fertilization.

Diarrhoea is second only to malaria as a cause of death in under five children in Nigeria. Episodes of acute diarrhoea tend to resolve within a few days in healthy children but persist longer in children with malnutrition, impaired cellular immunity and recurrent diarrhoea. Diarrhoea is very common in severe zinc deficient children and has been reported to respond to zinc supplementation as an adjunct to the combined use of oral rehydration therapy and early continued feeding. We study the effect of Zinc supplementation on the severity, duration and recurrence of acute diarrhoea in children in a hospital-based randomized placebo controlled clinical trial at JUTH in Jos. Seventy children 2-24 months of age who were reported to have passed at least 3 or more unformed stools in the previous 24 hours and have had diarrhoea for 7 days or less were randomized to receive Zinc (20mg/day n= 35) or placebo (n= 35) for 14 days. Each patient also had the low osmolar UNICEF-ORS at 75mls/kg. and the child's usual feeds. Weekly follow-up visits were conducted for 12 weeks after the diarrhea episode. Incidence and prevalence of diarrhea were compared between the groups. Neither the attending clinician nor the patient nor the data analyst was aware of who was on the Zinc or the Placebo. 57 children completed 14 days zinc supplementation, however only 54 children completed the three months post zinc supplementation follow-up. Zinc reduces the average number of watery stools by 37% and the mean duration of diarrhea by 39%. zxeZinc supplementation significantly reduced the risk of recurrence of acute diarrhoea by 38%. Supplementing the treatment of acute watery diarrhea with Zinc in just 2 cases will prevent recurrence of diarrhea in one of the children in the following 12 weeks. Fourteen days supplementation of Zinc in the treatment of acute diarrhea in children significantly reduced the average number of watery stools and duration of acute diarrhea. It also reduces the recurrence of diarrhea within three months of completion of supplementation. Zinc supplementation of acute diarrhea management in just two children will prevent diarrhea recurrence in the next three months in at least one child. Keywords : Acute watery Diarrhoea in Children; Zinc supplementation

ObjectivesThe objectives of this study is to find out the prevalence of copper and zinc deficiency among paediatrics population who are on jejunal feeding and to find out risk factors...

This study aimed to describe the pattern of prescription and laboratory use in the management of infectious acute gastroenteritis (AGE) in children seen in a rural service delivery network (SDN) and to determine their adherence to the 2019 Clinical Practice Guidelines on the Management of Acute Infectious Diarrhea in Children and Adults from the Department of Health (DOH). A descriptive retrospective study was done using the electronic medical records (EMR) of patients less than 19 years old seen by the rural SDN from April 2019-2021 and diagnosed with infectious AGE. Data were extracted on diagnostic and therapeutic management. Adherence to strong CPG recommendations focusing on rehydration, zinc supplementation, rational laboratory use, and antibiotic prescription was chosen as indicator of quality of care. Adherence of less than 70% was defined as low. There were 227 infectious AGE cases, with 72% diagnosed under non-specific infectious AGE. Fifty two percent (52%) were prescribed with low-osmolarity oral rehydration solutions (ORS), while 74% were given zinc. Stool analysis was done in 25% of cases while CBC was done in 20%. Top antibiotics given were metronidazole at 44% and cotrimoxazole at 33%. There was low adherence to prescribing low-osmolarity ORS for rehydration (52%) and to deferring routine antibiotic prescription for non-specific infectious AGE cases (24%). Adherence to deferring routine stool analysis and CBC were relatively high at 73% and 70%, respectively while adherence to antibiotic use for indicated cases was high at 95%. Frequency of diagnostics ordered were low resulting to high adherence rates to recommendations concerning judicious laboratory use. Prescription frequency of appropriate antibiotics and interventions for AGE were low, leading to low adherence rates to recommendations concerning rational antibiotic use and prescription of cornerstone therapies for infectious AGE.

The purpose of this study was to identify the effect of oral zinc supplementation in patients with type 1 diabetes (T1DM) on metabolic control and zinc blood concentrations. The sample consisted of 20 patients with T1DM and a control group (n=17). Metabolic control was evaluated by glycemia at fast, 24 h glycosuria, and HbA1c. Zinc concentrations were measured in plasma and erythrocytes. After the first collection of biological material, oral zinc supplementation was initiated and continued for 4 mo in T1MD patients (T1). Daily dosages were established based on Dietary Recommended Intakes (DRIs), considering zinc intake based on data from other studies previously performed with this population. All analyses were repeated after supplementation (T2). Metabolic control was unsatisfactory, with an HbA1c increase at T2. There was no difference in zinc concentrations in plasma and erythrocytes between patients with T1DM and control. Zinc concentrations in plasma were within the normal range in T1MD before and after supplementation and the control. Zinc concentrations in erythrocyte presented lower than normal values for all groups. A zinc increase in erythrocyte after supplementation was observed in T1DM patients, although without statistical significance. More studies are needed to confirm oral zinc supplementation as nutritional management in diabetes.