Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology最新文献

Introduction: Model for End-Stage Liver Disease (MELD) is a scoring system used to estimate the severity of chronic liver disease. Score is based on objective variables and predicts survival among different populations of patients. Study Aim. The aim of the study was to retrospectively analyze potential connection between MELD score and laboratory findings and complications of hepatitis C caused liver cirrhosis.

Materials and methods: A retrospective cross-sectional study based on data from Riga East Clinical University Hospital from the time period of 2010 to 2014 was performed. Original protocol and database were developed with consequential data statistical analysis using IBM SPSS Statistics ver.20.0.

Results: In total 221 cirrhosis cases were enrolled in the study. 128 (58%) cases were male and 93 (42%) female. Mean age was 52.7 ± 13.4 years. Statistically significant correlation was found between leukocytes (r = 0.4, p < 0.001), blood urea (r = 0.4, p < 0.001), serum albumin (r = -0.4, p < 0.001), C-reactive protein (r = 0.4, p < 0.001) and MELD score. Higher leukocytes, higher urea, C-reactive protein and lower serum albumin rates give higher MELD score. At the time of hospitalization 208 (94%) of the patients had different complications of liver cirrhosis. Correlation between MELD score varied significantly with esophageal varices (r = 0.2, p < 0.05) and esophageal vein bleeding (r = 0.2, p < 0.05). Results show, if patient is present with esophageal varices and esophageal vein bleeding, MELD score is higher.

Conclusion: Patients with higher leukocytes, blood urea nitrogen and lower serum albumin level are presenting higher MELD score. In patients who presented with esophageal varices and esophageal vein bleeding, higher MELD score was observed.

Aim: The aim of this study was to investigate the frequency of polymorphic variants of genes CYP2E1 and GSTA1 in patients with pathology of the hepatobiliary system (PHS) and healthy individuals in the Republic of Bashkortostan, as well as an analysis of possible associations of genotypes of this gene with the development of PHS.

Materials and methods: There were examined 81 patients with pathology of the hepatobiliary system. Was studied association analysis of polymorphic loci of genes CYP2E1 and GSTA1.

Results: The study demonstrated that a marker of risk of developing the disease is AA genotype (OR = 2,09; 95% CI 1,07-4,10) polymorphic locus gene rs3957357 GSTA1.

Aim of investigation: The aim of the research is to study the clinical course of hepatitis C in children with different variants of the gene polymorphism of IL-28B.

Materials and methods: We observed 94 children (46 girls and 48 boys) with chronic hepatitis C (CHC) in age from 3 to 17 years (mean age 10 years). There were significant differences in the distribution of allele frequencies in children with chronic hepatitis C and in the population. In children with chronic hepatitis C significantly increased the incidence of the T allele at the locus of the gene IL-28B rs12979860 C>T, which makes it possible to consider it as a predictor of antiviral therapy ineffective.

Results: When analyzing the frequency of occurrence of a polymorphic variant T>G [rs8099917] IL-28B gene in children with chronic hepatitis C and healthy children revealed no differences in the distribution of alleles.

Conclusion: Personalized approach to the appointment of HCV antiviral therapy in children is to carry out genetic studies to determine on the basis of predictive features of the course of HCV in children during the treatment.

Objective: To optimize the diagnostic and therapeutic approaches in polymorbid patients with fatty hepatosis in the practice of general practitioner. The medical tactics of treatment of polymorbidit patient with fatty liver, is considered in regards of the course of concomitant diseases, especially the cardiovascular system. Substantiates the necessity of determination of, in relation to the patient's prognosis, not only the degree of steatosis, but also the liver fibrosis stage changes, developing due to apoptosis of hepatocytes that leads to the progression of endothelial dysfunction A working version of the treatment of hepatic steatosis, designed to reduce progression of fatty degeneration, reducing the risk of steatohepatitis and fibrosis body changes is proposed in the paper. Ursodeoxycholic acid and glycyrrhizin are the most promising medication.

The purpose: To present the history of surgical gastroenterology in Perm krai.

Materials and methods: Narrative, historical, genetic, comparative and structural.

Results: In the early 20th century the main method of surgical treatment of peptic ulcer was gastroenteroanastomosis. A significant number of recurrences resulted to distal gastrectomy implementation in the 30s in the Clinic of hospital surgery of Perm medical institute, led by professor M.V. Shats. It was also performed in major cities of the region: Lysva, Kungur, Berezniki, Kizel, Osa. Treatment of ulcer perforation and bleeding was accomplished at the department of surgical diseases of pediatric faculty, led by Professor V. N. Repin. He also developed vagotomy and methods of diagnostics and treatment of diseases of operated stomach. Comorbidity was also researched. The combination of liver and biliary tract diseases was re- searched in the Hospital surgical clinic of Perm, initially led by Professor S. Yu. Minkin and then by academician E. A. Wagner (L. F. Palatova). The results of surgical treatment of cholelithiasis, depending on morphological and biochemical abnormali- ties in liver and chemical composition of gallstones were studied (L. P. Kotelnikova). Indications for surgery in cholelithiasis in conjunction with pathology of stomach, duodenum and liver were defined (A.V. Popov). The results of surgical treatment of biliary pancreatitis and cholangitis (L. B. Guschensky), and diseases of stomach, duodenum and pancreas with cholelithiasis were obtained (D.V. Shvarev).

Conclusion: The priority trends of research of Perm scientists were treatment of post-resection syndrome, arteriomesen- terial obstruction, pathogenesis of gallstone disease and its combination with other disorders of the digestive system.

This review covers the epidemiology, pathogenesis, risk factors, classification, clinical manifestations of candidiasis gastrointestinal, diagnosis and therapies.

The article presents a clinical case of observation of the course of pregnancy and delivery in women with a rare manifestation of Crohn's disease with a primary lesion of the anal canal with extraintestinal manifestations (perianal region and external genitalia). Prospective clinical observation demonstrates the possibility of work with adequate outpatient and inpatient obstetric services in collaboration with relevant specialists, a favorable course and outcome of pregnancy in women with Crohn's disease of moderate severity with extraintestinal manifestations in the phase of incomplete remission and the birth of healthy full-term newborns, It should be noted that the use of drugs for the treatment of Crohns disease and related complications (anemia) had no teratogenic effects on the growth and development of the fetus, and on and on the health of the newborn Joint management of these patients by the obstetrician-gynecologist, gastro-enterology and a proctologist in the form ofjoint inspections and allows councils, in a timely manner to verify diagnosis of the disease and its complications, and provide adequate correction treatment patient to obtain a favorable pregnancy outcome, birth and the postnatal period.

Objective: To improve the diagnosis of the diseases of the pylorus and prepyloric region in patients with duodenal peptic ulcer based on the study of the mucous membrane folds

Materials and methods: Endoscopic examination of 208 patients without diseases of the gastroduodenal transition (healthy) and 112 patients with duodenal peptic ulcer of three age groups from 35 to 90 years. Men were 72 and 61, women - 136 and 51 respectively groups. Endoscopic examinations were performed by endoscopes EVIS GIF-130, XP-150 N, GIF H-180 and instruments of the company «Olympus» (Japan).

Results: Individual differences were revealed in the formation of mucous membrane folds of the pylorus and prepyloric region, in the frequency of participation of the walls in healthy people and patients with duodenal peptic ulcer. Age differences were revealed. Gender differences were not revealed. The clinical case of the patient with duodenal peptic ulcer and maltoma in prepyloric region was presented.

Conclusion: The features of the formation of mucous membrane folds, the relief of the mucous membrane of the pylorus and prepyloric region in healthy people and patients with peptic ulcer of the duodenum are necessary to consider. It is important to perform a biopsy, histological, c.

Aim: The aim of the study was to assess the effectiveness of the inclusion in the scheme remaxol treatment of metabolic syndrome in patients with nonalcoholic steatohepatitis and diabetes mellitus 2 type.

Materials and methods: Data of 76 patients with metabolic syndrome in a non-alcoholic steatohepatitis and type 2 diabetes were analyzed. Patients were randomized by gender and age, and are divided into 2 groups according to the scheme of therapy: patients in group I (major - 38) conducted a basic therapy in combination with remaxol: intravenous infusion of 400 ml of 1 times a day for 10 days, group II patients (comparison - 38) combined basic therapy with intravenous ademetionine: 400 mg, in a solution diluted NaCL 0,9% 400 ml 1 time per day for 10 days. In addition to standard clinical and laboratory tests were studied biochemical parameters of liver activity, lipid and carbohydrate metabolism in the dynamics: before therapy and after its completion.

Results: It was found that the inclusion in the scheme of drugs from the group of succinates (remaxol) reduces the severity of metabolic syndrome by reducing the manifestations of cholestasis and cytolysis, and improving lipid and glucose metabolism. As a result, significantly reduced the severity of the main clinical syndromes: asthenovegetative 46% and dyspeptic syndromes - 46% and 15%, respectively.

It is the data of literature on existing classifications and systems of assessment and prognosis of hepatocellular carcinoma (HCC). In some classifications takes into account only the characteristics of the tumor tissue, in others are used biochemical and clinical characteristics in addition. Some systems allow to predict the survival of patients regardless of the stage of the disease, while others are most effective for the individual stages. The international TNM classification is generally accepted for the development of treatment methods and determining the forecast mainly for resectable HCC forms. The Japanese staging system (JIS) is mainly recommended for operable patients. Italian scale (CLIP), on the contrary, is intended to analyze HCC, which is not subject to surgical treatment. The Barcelona classification of liver cancer (BCLC) is considered the most universal, because it takes into account the stage of disease, the condition of the liver parenchyma and does not depend on the method of treatment and the patient’s place of residence. Therefore, the choice of staging system and assessment of disease prognosis should be based on the clinical and morphological features of the disease, taking into account features of application of various scales.