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

The purpose of the study: to study the nature of the changes of the microbiota of the stomach after total colectomy.

Materials and methods: The research was conducted on 50 outbred white male rats by means of microbiological and electron microscopic methods with statistical data processing.

Conclusion: In adaptive-adaptive changes of the microbiota of the stomach after total colectomy clearly stages, where it is possible to allocate two periods - the period of early post-operative changes (7-30 days) and the adaptation period 160-go days). Changes of the microbiota was characterized by a significant decrease in anaerobic non-sporulating Bacillus, lactic acid bacteria and staphylococci and the increase of yeast and yeast-like fungi of the genus Candida, pathogens, enterococci, Escherichia coil, and Bacillus Proteus.

Long-term experience of using irifliximab in patients with inflammatory bowel disease (IBD) have shown that 20-30% of patients couldn't achieve clinical improvement (primary failure) or have developed acquired drug resistance (secondary failure). The frequency of antibody formation to infliximab is to 28-61%, for adalimumab 4-12%, to certolizumab the guests to 12.3%, for etanercept to 2.5%. The ways to overcome the primary and secondary inefficiency of anti-cytokine the(apy (loss of response to therapy) at the present time are: increasing the dose, shortening the interval between infusions of genetically engineered biological drugs, additional immunosuppressive agents, as well as switching to another biologic drug. Search of primary and secondary inefficiency of anti-cytokine therapy in patients with IBD currently remains topical and requires new approaches to the solution of this problem.

Purpose of the study: medico-social factors, influencing upon the date of visiting the doctor for the patients with ulcerative colitis manifestation have been analyzed.

Materials and methods: under observation there were 38 patients with ulcerative colitis. The diagnosis was made on the availability of the typical symptoms and was confirmed by the endoscopy of the colon and histological biopsy of the mucosa samples.

Conclusion: light and moderately severe colitis is still remaining not identified for a long time due to the lack of population's awareness about that disease as well as insufficient attention of the doctors to such problems. The belated visit to a doctor is more common for mail patients up to 30.,years old with high education.

The renin-angiotensin system (RAS) is the universal multiple-factor regulator of many vital processes at the organismal, tissue and cellular levels. Classical (circulating) RAS provides maintenance of arterial pressure, a water and salt balance, lipid and glucose homeostasis. Local tissue RAS are functioning independently and participating in metabolic processes and protective reactions. Local RAS of a small intestine mucosa is presented practically by a complete rangeof the components (renin, angiotensinogen, angiotensin-converting enzymes, angiotensin receptors) localized, mainly, in an intestinal epithehum, lamina propria and muscularis mucosa. Local RAS participates in regulation of the most levels of activity ofa small intestine, influencing on an intestinal motility, secretory-transport processes, adaptation and protective reactions. The experimental data presented in this review are very promising for the detection of possible complications when using drugs that alter the activity of the RAS-related unexplored effects of the interaction of these drugs with their potential targets, localized not only in the blood vessels, but also directly to the niucosa of the gastrointestinal tract. This is especially important in connection with the extensive use of drugs that modulate the activity of the RAS in the practice of the treatment of cardiovascular diseases such as hypertension, atherosclerosis, endothelial dysfunction, and others.

Complex studying of functional condition of small intestine at bile stone disease and analyzing connection of small intestine functional disorders with formation of lithogenic bile. 123 patients with Bile stone disease were examined at pre-stone stage. Examinations done include ultrasonic exam of gallbladder, biochemical examination of bile, studying of bile acids in the bile by method of mass-spectrometry, morphological examination of duodenal mucous membrane, functional examination of small intestine with loading test.

Results: As the survey showed, a biliary sludge was found at 86,2% of the patients at ultrasonic examination of gallbladder In the patients' bile there were noticed changes of both general pool of bile acids and of ratio of their separate fractions. 82% of patients with bile stone disease at pre-stone stage had disorders of digestive and absorbing functions of small intestine, connected with reducing of general pool of bile acids in bile.

Lymphangloectasia intestinal Disease (Gordon disease, hypoprotein exudative enteropathy) is a disease in which develops the extension of lymphatic vessels (lymphangioectasia), located in the small intestine, resulting in signi1~cant intestinal protein loss. The article presents a clinical case of primary small intestinal lymphangloectasia in the 17-year old girl, which was admitted to the Morozov hospital Department of gastroenterology and Nephrology with complaints of weakness, widespread swelling on the face, legs and stomach, diarrhea. During a comprehensive clinical and instrumental examinations (including histology) the disease was diagnosed and treatment strategy was developed.

Existing methods of clustering of gut microbiota (enterotypes, clusters, gradients), as well as the term 'phylogenetic core' do not reflect its functional activity. The authors propose to describe the key microbiora using term 'phylometabolic core of intestinal microbioca which more accurately reflects the functional importance of metabolically active microbiota. Phylometabolic core includes functional groups of microorganisms that perform similar metabolic functions: butyrate-producing bacteria, propionate-producing bacteria, acetate-produc- ing bacteria (acerogens), hydrogenosrophic microorganisms (reductive acetogens, sulfate-reducing bacteria, methanogens), lactate-producing and lactate-utilizing bacteria, bacteria involved in bile acids metabolism, bacteria that metabolize proteins and amino acids, vitamin-producing microorganisms, oxalate-degrading bacteria and others. The hypothesis that disturbance of microbial metabolism is the root of many human diseases is discussed. The microbial dysmexabo- lism leads to the metabolic dysbiosis (a particular form of dysbiosis) that is primarily characterized by metabolic abnormalities (e.g. serum, urinary, fetal or exhaled air). Metabolic dysbiosis is not necessarily accompanied by appreciable quantitative and/or qualitative changes in microbiora composition that called taxonomic dysbiosis. Since in the metabolic dysbiosis metabolic pathways can be switched only, it means the need for completely different approaches to its assessment using metabolomics (metabolic fingerprinting, metabolic profiling, meta-metabolomics). Metabolites concentrations in colon (feces, biopsy samples), blood (serum, plasma), urine or exhaled air, as well as metabolic profiles of examined substrates can serve as biomarkers. The main clinical variants of metabolic dysbiosis are due to the disturbances in microbial synthesis of short-chain fatty acids (primarily butyrate and propionate) and due to increasing bacterial production of hydrogen sulfide, ammonia and secondary bile acids (particularly deoxycholic acid). These kinds of metabolic dysbiosis can eventually lead to inflammatory bowel disease (IBD) or colorectal cancer (CRC). The metabolic dysbiosis due to bacterial choline dysmetabolism followed by overproduction of trimethylamine (TMA), arherogenic precursor of trimethylamine N-oxide (TMAO), is associated with atherogenesis and increased risk of cardiovascular disease. Dysmetabolism of aromatic amino acids leads to changes in the microbial production of phenylalanine and tyrosine derivatives (phenyl carboxylic acid, p-cresol) and tryptophan indole derivatives (indole carboxylic acid, indole) and contributes to pathogenesis in lBS. IBD, CRC, chronic liver and kidney diseases, cardiovascular diseases, autism and schizophrenia. Metabiotics, a new class of therapeutic agents, e.g. based on microbial metabolites, can correct metabolic dysbiosis, prevent diet- and microbiota-relared diseases and increase the effectivenes

Aim: To evaluate the effectiveness of Native-complex functional food to correct nutritional disorders and to normalize gastrointestinal motor activity in celiac disease (CD).

Methods: 20 CD patients with constipation and metabolic disorders were included in the study (age 31.8?9.5 years, male to female ratio 1:5.3). The diagnosis of CD was confirmed by clinical and anamnestic data, endoscopy, histopathology of duodenal biopsy specimens, HLA-DQ2 and HLA-DQS typing. All patients received Native-complex Fucus jelly (Kelp jelly) within 2 months.

Results: At the beginning of the study45% of patients had stools corresponding to the Bristol Stool Form ScaleType 1,40% of patients had Type 2 stools and 15% of patient had Type 3 stools. 15 patients (75%) showed a decrease in fat mass and 13 patients (65%) showed a decrease in fat-free mass indicated by bloimpedance measurement. All patients had low values of total bacterial counts and increased abundance of pathobionts including fungi and viruses in fecal microbiota. Supple- mentary nutrition significantly improved symptoms, intestinal circadian rhythms and stool consistency in CD patients. At the end of the study 70% of patients had daily bowel movements, 30% of patients had stools every other day. The average stool frequency was 5,95 ? 1,80 per week. 80% of patients had Type 4 or Type 5 stools,20% of patients had Type 3 stools according to the Bristol Scale. Supplementary nutrition significantly improved gut microbiota profile.

Conclusion: Long-term gluten-free diet in celiac disease leads to a decrease in dietary fiber and polysaccharides consumption and promotes intestinal dysbiosis. Functional foods improve symptoms; stool consistency and gut microbiota profile in adult celiac patients on gluten-free diet.

The goal of this study is to investigate the pathological physiology of superior mesenteric artery syndrome (SMAS).

Materials and methods: We selected 35 articles devoted to SMAS, which were published from 1990 to 2014, and performed radiometric analysis of X-rays, CT scans and MRI slices found in these articles. In pictures the narrowing in the third part of the duodenum was measured from the boundary of the expanded segment to the level of the superior mesenteric artery (SMA).

Results: Only in 6 (17%) of. 35 cases the narrowing portion of duodenum was located directly between aorta and SMA, and its length was about 1cm. In the remaining 29 cases, the beginning of the narrow segment was 2.5-4.6 cm (average 3.30 ±0.15 cm) proximal to SMA, ie, most of the narrowed duodenum was out of aortomesenteric angle. Location and length of the narrowed segment of duodenum corresponded to the location and length (3.2 ± 0.15 cm) (P> 0.2) of the functional Ochsner sphincter.

Conclusion: These data indicate that in most cases of SMAS the sphincter Ochsner dyskinesia causes the disease. It is likely that the disease is triggered by heavy stressful conditions that cause a sharp and sustained reduction in the pH of gastric secretions, which in turn leads to the spasms of the sphincter Ochsner. With time this condition progresses to hypertrophy of the contracted wall of the duodenum with subsequent replacement of the muscle fibers by connective tissue. This can lead to the rigidity of the wall.