BRIEF DESCRIPTION OF THE DRAWINGS

The invention will now be illustrated by examples only with reference to the accompanying drawing in which FIGS. 1 (a) and 1 (b) to show the effects of a diet containing a guanidino group containing polymer on the levels of serum phosphate, and baking in normal rats. EXAMPLES Example 1 Preparing GUANIDINO group containing resins made from polyvinyl A aminated resin is reacted in methanol under reflux with an excess of (a) 3.5-dimethylpyrazole-1-carboxamidine nitrate (b) S-methylisothiouronium sulfate or (c) O-methylpseudourea hydrogen sulphate to convert the amino groups attached the Polymer backbone into guanidino groups. The extent of the reaction can be followed by trials for each product so that reagent (a), it may be followed by extraction with ether to determine the amount of 3,5-dimethylpyrazole formed. The resin is purified by sequential washing, methanol and water until the eluate is free of inorganic ions. Resin raw materials (A) A commercially available poly (acrylonitrile-butadiene - styrene) resin has been reduced with an excess of lithium hydride, aluminum in ether or tetrahydrofuran under reflux or by catalytic hydrogenation of PtO2 (60 psi, 20 ° C) acetic acid containing sulfuric acid. The result aminated resin is purified by successive washing with dilute hydrochloric acid aqueous and then water until the eluates are free of chloride ions and inorganic cations. The Cl-form of the resin was converted to the form of free base by treatment with 1M aqueous sodium hydroxide followed by washing with water. (B) A commercially available poly (chloromethylstyrene) resin was treated with an excess of methanol solution of ammonia saturated at 20 ° C for 48 hours, then wash with water depth until the eluate is free of ammonia. Example 2 Studies in vitro determination of phosphate binding capacity of the various GUANINIDINO group containing resins made from polyvinyl The three resins were compared. (Amberlite is a trademark). A poly (styrylmethylguanidinium) chloride resin prepared as in Example 1 (B). A poly (allylguanidinium) chloride resin prepared as in Example 1 (A). Amberlite 1R410 (Cl-) as a material control. The theoretical capacity of the polymer was determined by elemental analysis. The binding capacity of the resin was determined by ion-exchange chromatography using 32 P-labeled phosphate. The columns were prepared from 5 g of dry resin. Binding experiments were performed at pH 7.4, both in the absence of competition and the presence of chloride anions. The concentrations of chloride and phosphate were 10 and 150 mM, respectively. The results are presented in Table 1. TABLE 1 ______________________________________ Phosphate Binding Capacity (mEq g 1) In the absence In the presence Theory From chloride From chloride ______________________________________ In poly (styrylmethyl - 3.8 1.02 0.47 Guanidinium) chloride In poly (allylguanidinium) 2.3 -- 1.41 Chloride Amberlite IR410 (Cl-) 4.9 -- 0.26 ______________________________________ Although poly (allylguanidinium) chloride resin has a capacity lower binding judged by binding functions, a larger proportion is bioavailable judged by the binding of 32 P-phosphate. Chloride no rival for the phosphate-binding site of polyguanidine resins, but it does so with a low yield. Thus, even when the chloride was present in 15 molar excess, phosphate binding has been reduced by 50%. It was also shown that poly (allylguanidinium) chloride resin is selective for phosphate in the presence of 150 molar excess chloride. Amberlite IR410 (Cl-) are also bound phosphate, but unless new polyguanidine resins. Example 3 In vivo studies on the ability A GUANIDINO group containing based resin polyvinyl lowering levels of serum phosphate in rats Experimental Protocol Polyvinyl based resin used was a poly (allylguanidinium) chloride resin prepared as in Example 1, which is identified as follows PVG resin. This resin composed of a cross-linked polyethylene backbone by divinyl benzene. This frame was highly substituted 2-guanidino methyl groups. The study was conducted in two stages: A) The effectiveness of the resin binder in normal rats Six rats (strain original Wistar, male, 145-160 g) were bled by the tail (0.5 ml) and fed for 7 days with (powder) rat Chow (CRM food, SDS , Essex) mixed with powder-PVG matrix (0.5 g resin/15 g diet). The rats were given 15 grams of food daily. Thereafter, the animals were bled as above, and analyzed for serum urea, creatinine and electrolytes. B) The effectiveness of the resin binder in chronic renal failure The chronic renal failure was induced in a group of 11 men, Wistar rats (weight = 160-190 g) by making a total nephrectomy (NX) in two stages: the upper and lower pole of the left kidney been abducted, then after 9-10 days by a total nephrectomy right. The control group (n = 6) included rats in which sham operations (SO) was conducted. One week after the second operation sham operated and nephrectomised rats were bled (approximately 0.5 ml peak through tail clipping). One group (n = 3 SO; N = 6 NX) was then given for 1 week, the diet of rats powder + resin (31 g / rat / day; 0.5 g resin/15 g regime). The other group (n = 3 SO; N = 5 NX) for 7 days powder rats Chow (31 g / rat / day), followed by a further week by the rat Chow + resin. Rats were bled at the end of each stage. All serum samples were then analyzed for urea, creatinine and electrolytes. Bleeding of rats was conducted at roughly the same time of day to minimize any possibility of diurnal variations. The hemoglobin data for rats used in this study was SO group (n = 5) = 17.52 ± 1.83 g / dl NX group (n = 11) = 15.32 ± 3.02 g / dl Results An efficiency of resin binder in normal rats Rats were found to eat all PVG containing food provided on a daily basis. Weight gain during the week ranged from 7-18 g Initial serum phosphate levels were significantly higher than men (3.81 ± 0.33 (6) mmol / l mean ± SD), and declined in all cases next feeding rats containing Chow PVG (Fig. 1, which shows the plots in serum phosphate and bicarbonate levels of the individual rat). The mean percentage decrease in phosphate was 15.9% (± 5.3 SD). Such a decrease of serum bicarbonate (19.7 ± 17.2% (6)) was also evident on the PVG-feeding. Calcémie levels showed no change. The data show that the resin PVG has the ability to lower levels of phosphate. B) The effectiveness of the resin binder in chronic renal failure Sub-total nephrectomy led to the emergence of chronic renal failure (CRF), as reflected by significant increases in serum creatinine and urea levels and a decrease in hemoglobin content (Table 2). The calcium levels, although slightly higher in the NX group, have failed to reach statistical significance (P = 0.052). The levels of phosphate on the other hand showed no significant alteration following sub-total nephrectomy (Table 2). TABLE 2 ______________________________________ Comparison of various biochemical parameters in Sham-Operated (SO) and Nephrectomised (NX) Rats Parameter so NX-p ______________________________________ Creatinine (μ M) 51.0 ± 2.1 78.9 ± 7.6 <0.001> 0.05 K + (mM) 5.8 ± 0.5 6.0 ± 0.3 > 0.05 Ca (mM) 2.58 ± 0.08 2.72 ± 0.15 > 0.05 Phosphate (mM) 3.49 ± 0.18 3.37 ± 0.31 > 0.05 ______________________________________ Results: Mean ± SD for animals (n). N = 6 and 11 for SO and NX Groups, respectively. The NX group of rats fed diet PVG-appear to have somewhat improved renal function, as reflected in a significant decrease in urea treatment (p = 0.013) and a small decrease in serum creatinine (Table 3). Phosphatémie were also slightly reduced (3.37 ± 0.26 (6) of 3.18 ± 0.24, p> 0.05). Kept unchanged. TABLE 3 ______________________________________ Sham operated (N = 3) Nephrectomised (N = 4) Group after PVG-After-PVG Parameter Initial for 1 wk initial 1 week ______________________________________ Na + (mM) 142.3 ± 1.15 142.7 ± 1.16 144.2 ± 5.85 142.3 ± 2.58 K + (mM) 5.6 ± 0.35 5.87 ± 0.42 6.03 ± 0.19 * 5.98 ± 0.57 Urea 5.13 ± 0.49 5.23 ± 0.15 13.25 ± 0.99 ** 11.77 ± 0.69 + + (MM de) Cre-52.0 ± 2.00 53.67 ± 2.52 77.33 ± 6.59 ** 76.17 ± 4.07 Atinine (Μ M) Ca2 + 2.53 ± 0.095 2.62 ± 0.09 2.73 ± 0.20 2.76 ± 0.085 (MM de) PO43 3.58 ± 0.01 3.38 ± 0.04 + 3.37 ± 0.26 3.18 ± 0.24 (MM de) ______________________________________ Data: mean ± SD Statistics: * P <0.05;> 0.05 in all cases). Phosphatémie SO fell in the group (3.27 ± 0.5 (3) to 2.80 ± 0.08 (3), p> 0.05), but remained unchanged in the NX group (3.11 ± 0 .15 (5) against 3.27 ± 0.35). The 2-step surgical procedure resulted in the appearance of the CRF as evidenced by the increase of urea and creatinine and a drop in hemoglobin. However, the rats were found eating well and gaining weight (comparable increases in both groups). Levels of calcium in the NX group were slightly elevated, while levels of phosphate TABLE 4 __________________________________________________ ________________________ Sham operated (N = 3) Nephrectoinised (N = 5) Group Diet-PVG Diet Diet + PVG - PVG Diet + PVG Parameter Initial For 1 week For 1 week Initial For 1 week For 1 week __________________________________________________ ________________________ Na + (mM) 141.7 ± 0.58 142.0 ± 0 141.3 ± 0.58 142.0 ± 2.00 143.4 ± 2.07 141.2 ± 0.45 K + 6.0 ± 0.56 5.93 ± 0.67 5.4 ± 0.52 5.86 ± 0.47 6.02 ± 0.13 5.96 ± 0.54 Urea (mM) 6.57 ± 0.75 6.7 ± 0.36 5.97 ± 0.32 13.16 ± 2.04 13.76 ± 2.53 11.82 ± 1.41 Creatinine (μ M) 50.0 ± 2.00 57.7 ± 2.08 ** 56.7 ± 5.69 80.8 ± 9.09 86.2 ± 9.2 81.4 ± 6.43 Ca2 + (mM) 2.63 ± 0.03 2.68 ± 0.1 2.57 ± 0.02 2.71 ± 0.06 2.78 ± 0.08 2.67 ± 0.09 PO43 - (mM) 3.41 ± 0.21 3.27 ± 0.5 2.8 ± 0.08 3.36 ± 0.39 3.11 ± 0.15 3.27 ± 0.35 __________________________________________________ ________________________ Data: mean ± SD Statistics: * P <0.05;> 3 mol / l), the low degree of renal impairment, a low-phosphate food, rats were more active and phosphate accumulation in the bones, etc., cash or a differential response to nephrectomy. Phosphate levels decreased as a result of the introduction of food in both PVG control and nephrectomised animals. It was surprisingly shown improvement in renal function after feeding rats with diet-PVG (refer to the urea and creatinine values, tables 3 and 4). Example 4 Chemical analysis of the resin polyvinyl GUANIDINO PVG The resin polymer tested consisted of a cross-linked polyethylene backbone by divinyl benzene. This frame was highly substituted 2-guanidino methyl groups. This is the resin PVG mentioned in the previous examples. (A) An analysis of the resin Capacity -- This has been determined by (I), and elemental analysis (Ii) Binding of 32 p. At pH 8.0 (I) Elemental Analysis Équilibration of the resin with HCl (1M), and then washed with distilled water and drying to constant weight of the analysis include: ______________________________________ (A) (b) ______________________________________ C 43.12 44.60 H 7.37 7.5 N 20.20 20.10 Cl 10.60 10.15 P 0 0 ______________________________________ This corresponds to a capacity of 5.3 mEq Cl-per gram of dry resin. Équilibration of the resin with H3 PO4 (1M), and then washed with distilled water and drying to constant weight of the analysis include: ______________________________________ (A) (b) ______________________________________ C 37.6 35.9 H 7.1 6.8 N 16.5 16.1 Cl 0.2 0.7 P 9.2 9.3 (PO4) 27.6 27.6 ______________________________________ This corresponds to a capacity of 2.88 mEq phosphate per gram of dry resin. Thus, the capacity of the polymer for both anions chloride and phosphate is high and compares favorably with other Dowex resins. 32 P-phosphates Resin (400 mg) was added to a narrow column containing a fine sintered glass filter. The flow through the column was adjusted to 1 ml min-1 by a peristaltic pump. The resin is washed successively with NaOH (1M, 10 mL) H2 O (20 ml) HCl (1M, 10 ml) and H2 O (20 mL). In this state of the column was completely responsible for the anion Cl. The column was then eluted with 32 phosphate (100 mM pH 8.0) to 1.0 ml, registration, the percentage of phosphate binding to each addition. The date is shown in Table 5. TABLE 5 ______________________________________ Phosphate binding capacity of the resin (pH 8.0) Fraction # Percentage of phosphate Amount of phosphate Binds (%) linked meq g-1 ______________________________________ 1 98.4 0.246 2 95.9 0.240 3 93.7 0.234 4 85.3 0.213 5 75.0 0.188 6 55.1 0.137 7 31.5 0.079 8 14.2 0.036 9 0.0 0.00 Total 1.37 ______________________________________ Each aliquot added to the column of 1 ml of Na2 HPO4 (pH 8.0, 100 mM). Thus, at pH 8.0 the ability of phosphate has been somewhat reduced to 1.37 mEq g-1 resin. It was 50% of the value obtained when phosphoric acid was used to balance the column at pH 1.0. This difference may refers to the ionic state of phosphate at the two pH values. (B) The competition between the anions for binding sites polymer Two experimental procedures were adopted: one, competition, in the absence of phosphates added and the second, competition, in the presence of phosphate (1 mM). The competition in the absence of phosphate The competition with anions was investigated following: Chloride Bicarbonate Sulfate Taurocholate Glycocholate The column (400 mg resin) was charged with 32 P-phosphates to over 80% of its capacity and balanced with Tris.HCl (pH 8.0, 5 mM). The column was then eluted with various anions competitors in 50 ml of Tris.HCl (pH 8.0, 5 mM). The results are shown in Table 6. TABLE 6 __________________________________________________ ________________________ Moving phosphate resin By various anions at pH 8.0 Na Na NaCl NaCl Na2 SO4 NaHCO3 Taurocholate Glycocholate Fraction # (10 mM) (25 mM) (10 mM) (10 mM) (10 mM) (10 mM) __________________________________________________ ________________________ 1 8.8 14.4 32.4 11.0 1.9 2.1 2 6.5 9.3 31.3 11.6 0.7 1.0 3 5.6 7.2 22.1 14.3 1.0 1.4 Total 20.9% 30.9 85.8 36.9 3.6 4.5 __________________________________________________ ________________________ Each part consisted of 50 ml column effluents. Column buffered to pH 8.0 throughout the study. Table 6 shows that the sulfate was the only reflecting the anion effective displacement activity. This is probably because SO42-can interact with guanidino functions in a manner similar to that of phosphates. The monobasic anions Cl-and HCO3 - are much less effective by moving phosphate anions. If large volumes of liquid are then used to high concentrations, Cl - eventually oust phosphate anions. This is illustrated below in Table 7. Anioniques bile salts are extremely inefficient movement of phosphate, which means they have only very low affinity for the resin. It is likely that they were unable to penetrate the resin matrix. TABLE 7 ______________________________________ Moving phosphate from the chloride resin at pH 8.0 Percent Fraction # [NaCl] mM phosphate displaced ______________________________________ 1 5 9 2 10 10.3 3 50 23 4 100 19 5 100 10.9 6 100 6.6 Total Displacement 78.8% ______________________________________ Each part consisted of 50 ml column effluents. The competition in the presence of phosphate In this investigation, the column was eluted with Tris-HCl (pH 8.0, 5 mM) containing Na2 HPO4 (1 mM) of the specific radioactivity identical to the burden of phosphate used in the resin column. In those circumstances, if the phosphate moves phosphate, radioactivity on the column will remain unchanged. In these circumstances, the move did chloride phosphate, but only with low efficiency. This is shown in Table 8 below. So no detectable phosphates has been moved in the presence of 10 mM NaCl,; However, it began to be displaced and 50 mM largest concentrations of NaCl. Resin.sym. - HPO32 - Cl - Resin.sym. - Cl - + HPO32 - All experiments were reported repeated at least twice independent. TABLE 8 ______________________________________ Moving phosphate from the chloride resin In the presence of phosphate (1 mM) pH 8.0 Percent Fraction # [NaCl] mM phosphate eluted ______________________________________ 1 5 0 2 5 0 3 5 0 4 10 0 5 50 16% 6 100 19% ______________________________________ Each fraction eluted from the column = 50 mg. Conclusions The guanidino containing resin used in this preliminary investigation is remarkably selective for phosphate anions. Monobasique anions and bile salts only phosphate move slowly. When he studied in the presence of phosphate (1 mM), only high concentrations of NaCl (50-100 mM) cause displacement of phosphates (eg <20%>

Description

This invention relates to polymer containing guanidino groups who are capable of specifically binding phosphate. Kidney disorders are very common and can, if treatment is delayed or inadequate, progress through renal conditions in the terminal phase, the patient subsequently requiring dialysis treatment. Renal Dialysis patients suffer from high levels of serum phosphate. In addition, patients who have often ineffective Reins develop "kidney" composed of two extremely insoluble salts, calcium phosphate and calcium oxalate. Both anions cause toxic effects in these patients. The development of high levels of phosphate is minimized in these patients by the addition of aluminum hydroxide, magnesium hydroxide or calcium hydroxide or mixtures of any of these compounds in the diet. However the use of magnesium hydroxide or calcium can lead to serious side effects, which is aluminum hydroxide compound, which is the most commonly used. The presence of aluminum ions in the intestine patient reduces the absorption of phosphate from the diet, thereby reducing the concentration of phosphate in the cavity. The result is a concentration gradient of phosphate from a high level in the blood at a low level in the cavity. Phosphate moves therefore blood on the concentration gradient and into the light. Continuation of treatment with aluminum hydroxide or related preparations led to the gradual accumulation of aluminum ions in the tissues of the body, which must then be disposed of by the administration of the compound desferrioxamine. Desferrioxamine, an iron chelator, is known to have side effects, especially in people who are not "heavy iron" (eg as a result of a blood transfusion). Sick kidneys are not overloaded with iron, hence the constant use of the concession desferrioxamine to reduce levels of aluminum may cause undesirable side effects. Description of Invention It is therefore an object of the present invention to provide a practical way to reduce the absorption of phosphate from the diet in the kidneys of patients and reduce levels of phosphate in the blood of kidney patients. It was noted that this goal can be achieved through the incorporation into the composition pharmaceutical or food for a polymer composed of a backbone and guanidino groups said attached to the spine. Phosphate ions are known to bind to guanidino groups. This attraction is so strong connections involving two electrostatic and two stereochemically favorable hydrogen bonds. However, the incorporation of guanidino groups in a polymer structure and the therapeutic application of guanidino groups and structures of polymers containing guanidino groups has not been previously suggested. Accordingly, the present invention provides a physiologically acceptable polymer composed of a backbone that are directly or indirectly tied guanidino groups, the polymer having a minimum molecular weight of 10,000. The present invention extends to the use of polymer compounds of the invention in therapy, for example, in pharmaceutical compositions and foodstuffs as described below. The invention is of particular interest for the treatment of kidney patients for the control of phosphate from the diet and the elimination of excess phosphate in the blood of these individuals. The polymeric material on which the guanidino groups are attached can be essentially a polymer structure, because the nature of the polymer backbone is not of primary importance in phosphate binding, this effect is rather due to the presence in the polymer of the guanidino groups. However, preferably, the polymer is pharmaceutically acceptable and appropriate molecular weight of these not to be absorbed by patients when taken orally, but to stay in the intestine. The molecular weight of the guanidino group polymer containing at least 10,000. The guanidino group containing polymers of the invention must be physiologically acceptable. As is known to those skilled in the art, polymers are large molecules consisting of small units chemical simple. In some cases, the repetition is linear, and a chain is built up of these units. In other cases, or branched chains are interconnected to form 3-dimensional networks. These 3-dimensional networks can also be formed by cross-linking polymer chains. Types of polymer that can be used, including those with a skeleton staff, in particular the polymers in which the spine is made of carbon atoms, such as polyvinyl alcohol polymer derivatives, and polymethacrylic polyacrylic acid polymer derivatives, and other polvinyl, and polyisobutylene polyisoprene polymers, but also organic polymers in which the backbone includes hetero such as oxygen or nitrogen and the carbon atoms. Polymers of particular interest in the present context of the invention include polymers forming a 3-dimensional network structure, for example because of a new cross-linking of the polymer. The degree of crosslinking control of the porosity of the polymer matrix, which in turn can influence both the capacity and selectivity of the molecular weight of the matrix. Preferred polymers of this type include polymers having a backbone Crosslinked polyethylene with divinyl benzene. Also of interest are some of polymers with inorganic base, eg polyphosphazene polymers. The polymers can be sequenced from two or more different types of monomer. Since the preferred route of administration is oral, and they remain in the intestine and is not absorbed into the bloodstream of the patient, polymers of the invention are preferably more acceptable to consumers. Examples of such polymers include cellulose polymers in carbohydrates and agarose. The carbohydrate polymers are particularly advantageous since many kidney patients to take carbohydrates bulk up their food. Based on this way we are providing food in bulk and at the same time prevent the absorption of phosphate from the diet and make its excretion in feces and not via the bloodstream and kidneys, and thus reducing toxic side effects . The guanidino groups are attached to the polymer backbone through chemical bonding through the terminal NH group of the guanidino group (NH2 -- C (. Dbd.NH) -- NH --). The chemical bonding of the guanidino groups at the base of polymers may be either directly or through some form of association acting as a "space" through which it is attached to the base polymer. Various forms of attachment can be used, the forms vary depending on the type of base polymer. For example, alkylene groups of 1-4 carbon atoms, amide groups, groups ether or a combination thereof, may be used. The method of fixing guanidino groups at the base polymer will obviously depend on the nature of the backbone, but for the simplicity of direct liaison between the atoms of the backbone and the NH group of guanidino group is preferable to the extent possible. The amount of polymer to be administered to the patient is an important consideration bearing on the number of guanidino groups in the polymer. Preferably, the proportion of guanidino groups for the remainder of the polymer is in the range of 1 part by weight of guanidino groups at 1 part by the weight of the rest of the polymer and 1 part by weight of guanidino groups at 100 parts by weight Rest of the polymer. Preferably the range is between 1 part by weight of guanidino groups at 1 part by the weight of the rest of the polymer and 1 part by weight of guanidino groups of 10 parts by weight of the end of the polymer, such as 1 part to 10 parts . Methods of preparing the guanidino containing polymers will be apparent to a person skilled in the art, but for example, they may be prepared following the teachings of Schnaar, L. And R. Lee, Y. C., 1975, Biochemistry 14, 1535 -1.541 Who describes a method for linking biologicaly active ligands in a polymer matrix, polymers or can alternatively be determined by the reaction with a polymer containing amino groups attached the spine polymer (a) 3.5-dimethylpyrazole-1-Carboxamidine nitrate (b) S-methylthiouronium sulfate or (c) O-methylpseudourea hydrogen sulphate. It was found that the polymers of the invention are able to specifically bind phosphate anions in vitro and in vivo. The polymers of the invention have a particular use for the prevention of phosphate from the diet and also the removal of excess phosphate in the blood of these patients with a deficit since the kidneys of phosphate binding in the intestine the diet disrupts the balance of the body and the effects of the movement of phosphate blood flow in the intestine. The polymers of the invention can be administered to patients orally as food or as a complement to a food, pharmaceutical or a song. According to a second aspect of the invention, there is provided a food or a supplement to a foodstuff physiologically acceptable composed of a polymer of the invention. These foods can take various forms, for example by taking the conventional form of the human diet. According to a third aspect of the invention, it is anticipated pharmaceutical composition suitable for oral administration physiologically acceptable composed of a polymer of the invention in combination with a diluent or pharmaceutically acceptable carrier. The guanidino group containing polymer can be made in a pharmaceutical composition by a variety of methods. The pharmaceutical composition normally be administered orally, as it should be present in the patient's intestine rather than in the blood. Although the compositions incorporating a liquid solvent can be used for oral administration, it is preferable to use compositions comprising a solid carrier such as starch, lactose, dextrin or magnesium stearate. Such compositions sound should be composed of a kind, for example in the form of tablets, capsules, etc. The compositions of pharmaceuticals, food products or more for food can be made in unit dose, ie in the form of discrete parts containing a unit dose, or a multiple or sub-unit of a unit of dose. The mix of guanidino group containing polymer will of course depend on the circumstances and severity of kidney disease in the patient, as well as the chemical structure of the guanidino group containing polymer. As an orientation daily dose in terms of guanidine be in the range of 1 g to 10 g and therefore the amount of polymer can be calculated accordingly. According to another aspect of the invention is a method for treating a patient who understands the administration said the patient a guanidino group containing polymer described above to control phosphate from the diet and to eliminate excess phosphate in the bloodstream. According to another aspect of the invention, it is planned to use a guanidino containing polymer described above for the manufacture of a drug for the treatment of a patient with the aim of controlling phosphate from the diet and to remove excess phosphate in the bloodstream.

Excess weight in childhood and adolescence: prevention and treatment

Therefore, the prevention and treatment of childhood obesity is a public health priority. What is the current status information on the methods and results? In theory, the prevention and treatment of any excess weight is easy. If the energy inputs of the organization is less than the output, the burden falls; If the contribution is greater, then increases body weight. Easy in theory, but difficult in practice, in part because: For thousands of years, human genes have encouraged those stored in the fat many times to help the survival in times of food shortage; In developed countries, there is a glut of attractive foods energy-dense (that is a change in eating habits); There is now little need or incentive to expend energy and a great attraction in sedentary recreation (ie a change in lifestyle). While it is widely recognized that the prevention of childhood obesity is a public health priority, there is a misunderstanding of how it can best be achieved. Analysis of the currently available strategies for prevention and treatment have been taken recently by several researchers2-5. Most of the programs used to be a school or an approach based on the family. Interventions focused on the school have been geared toward the prevention, targeting all students in selected classes to prevent the stigmatization of obese children. These programs include not only health promotion and initiatives alone physical activity, but also multifaceted interventions. These concerned: Class-based programs to promote healthy eating and higher levels of physical games, Practical demonstration of the principles by changing school meals more healthy habits with the reduced fat intake and more vegetables and fruit, School action plans to increase the time devoted to physical activity within the school day. These initiatives are based on the school, by their very nature, take advantage of their success to the enthusiasm of teachers, coupled with adequate training of these officers in the principles and practice of maintaining a healthy lifestyle. Interventions focused on the family. As its name indicates, the focus here is on the family farm, in the conviction that, unless the family as a whole can be encouraged to adopt a healthier lifestyle, the children are not likely to continue with any improvement in behavior. The majority of these studies are participating, directly or indirectly, either health or welfare professionals to provide the necessary impetus and competence. The aim was to change attitudes within the family in order to ensure that a healthy lifestyle have persisted long after the period of activity is over. Both at home and in school-based approaches receive exemplary stories or models. Challenge to current approaches So far, schools and intervention programs have generally not succeeded in reducing the prevalence of obesity. In some studies of family therapy, the changes favorable long-term weight loss were observed, but only to individuals motivated. A possible explanation for why long-term weight loss is so difficult to achieve is that the diet and physical activity used in both the family and prescription programs based on the school risk not to be particularly effective. A second possibility is that environmental factors (eg increased sedentary pursuits including TV, video games, computers; Deficit of urban and suburban environments that encourage active lifestyles, such as sidewalks and bike paths; Increase eating away from the home, and the increase in portion size) clearly tipped the balance in favor of weight.