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

Diarrhea refers to one of the most common syndromes encountered in practice therapist, general practitioner, pediatrician, gastroenterologist and infectious disease. The article describes the main diseases and conditions in which there is a clinical syndrome of diarrhea.

A clinical case of severe ulcerative colitis vvith extraintestinal manifestations, development of steroid dependence and inefficiency of basic therapy is presented. A good effect of therapy with golimumabis demonstrated.

Based on the results of a comprehensive study of 35 people aged from 19 to 52 years, among them 20 women and 15 men with celiac disease features of their physiological status were studied, reflecting the severity of the disease and quality of life. The diagnosis was based on the clinical and anamnestic data, endoscopy, histomorphological, immunological and genetic exams. Psychophysiological analysis showed that in celiac disease is characterized by the formation reactions with anxiety, anxiety-phobic, neurotic, affective, and hypochondriacal symptoms. The results of the study emphasized the importance of adaptive physiological capacity of the body to build tolerance to the development of psycho-vegetative, hypochondriacaldepressive and other disorders.

Objective: Analysis of the complexities of diagnosis of atypical celiac disease in elderly patients.

Key points: A clinical observation of the patient 63 years with atypical form of celiac disease, have flowed mainly from edematous and anemic syndrome. High titers of antibodies to gliadin, tissue transglutaminase, histological changes of the mucous membrane of the small intestine (Marsh II), the presence DQA1*0501 of the alleles have confirmed diagnosis. Against the background of strict gluten-free diet and a half years I have come persistent clinical remission with normalization of serum indicators.

Conclusion: Inclusion in the plan of diagnostic screening for celiac disease in patients 'vith edematous and anemic syndrome possible to establish the correct diagnosis and to reduce the risk of complications (including malignancies) in this patient.

The purpose of the study is to examine the situation and to ascertain the features of incidence and mortality of colorectal cancer (CRC) in Kazakhstan in 2004-2013 and to give a forecast until 2020.

Materials and methods: The data of new cases and deaths, which are available in the Cancer Registry of Research Institute of Oncology and Radiology of the Republic of Kazakhstan, were applied. in the analyzes the modern methods of variation statistics were applied to determine the average relative number, the study of time series, standard errors of means and other indicators.

Results: The average 10-year CRR incidence was 15.5?0.31 cases per 100 000 population, and the rate of increase reached 2.04% per year where higher rates (+2.28%) were typical for colon cancer. Age is one of the most important factors in the development of CRC. In 30-39 years, the incidence rate increased 11.5 times relative to the age grouping up to 30 years, in 50-59 and 60-69 years, the incidence increases 3.2 and 2.5 times respectively, relative to the previous level. In the group older than 70 years the incidence is 121.1?4.04. On the average during the study period the CRR incidence among females is 1.2 times higher than among males.

Conclusion: The high correlation of developing CRC by age and sex was determined. The death rate from CRC was 9.6?0.25 cases per 100 000. According to the forecast for 2020 the CRC incidence will increase by 11%, and the mortality will not significantly change.

Intestinal microbiota produces many carboxylic acids, especially short chain fatty acids (SCFA) as a result of carbohydrates, fats and proteins fermentation and which are intermediates in the interaction of the microbiota and the host. SCFA (formate, acetate, propionate, butyrate) are formed by the anaerobic carbohydrates fermentation and branched-chain fatty acids (BCFA), such as isobutyric and isovaleric acids, are derived from amino acids valine and leucine. Phenylcarboxylic acids (PCA), such as phenylacetic acid (PAA), phenyipropionic acid (PPA), phenyllactic acid (PLA) and some other acids, are metabolites of amino acids phenylalanine and tyrosine involved in host adaptation and regulation. ma unique experiment, the authors first examined effect of the carboxylic acids on host cell proliferation in organotypic tissue cultures (rat spleen explants). The study showed that almost all biogenic aliphatic carboxylic acids have a positive effect on cell proliferation in rat spleen tissue. This fundamentally distinguishes them from amino acids, many of which have an inhibitory effect at the same concentrations. These findings suggest that SCFA, including hydrox~ and oxo derivatives, can act as positive regulators of host immune tissues. Some SCFA (for example, butyric acid), stimulate proliferation of normal host cells (immune tissue, intestinal epithelium), but inhibit growth and induce apoptosis in colorectal cancer cells ('butyrate paradox'). Unlike SCFA, phenylcarboxylic acids have a negative effect on host immune tissues explants and induce apoptosis. These data confirm the potential contribution of phenylcarboxylic acids in the pathogenesis of chronic disorders associated with impaired immune response, including autoimmune diseases. The authors suggest that PCA may serve as early metabolic markers of sepsis, immune-related diseases and chronic inflammation, such as inflammatory bowel disease (iBD), colorectal cancer, chronic kidney disease and liver, secondary imrnunodeficiency. It can be assumed that carboxylic acids are evolutionary precursors of amino acids that have a wide variety of functions and able to modulate not only proliferation but also apoptosis. The results agree well with the data obtained in the study of Actoflor-C (microbial metabolites complex) and can be used to study mechanisms of action of probiotic strains and metabiotics (e.g. butyrate and propionate-containing formulations), as well as for the development of innovative medicines.

Aim: Determine qualitative and quantitative parameters of mouth and intestines microbiocenosis of healthy people in the age aspect to assess the status of the digestive tract microbiota, as an indicator of human health.

Materials and methods: We examined 74 healthy subjects aged 12-18 years who have a comparative aspect investigated qualitative and quantitative composition of the oral fluid and feces microflora.

Results: The mouth and intestines microbiota of healthy people has a number of interrelated characteristics defined microbiota of the entire digestive tract The first time were described three variants of the mouth and intestines microbiota, characterized by a certain combination of obligate and facultasive microflora, depending on the age and livelihoods.

Conclusion: Definition ofmouth and intestines microbiocenosis can be used to assess the status of the digestive tract microbiora as an indicator of health and correction of outlined features through a rational manner of life, balanced diet, pre-and probiorics administration.

Aimlo observe the qualitative and quantitative composition of the luminal and mucosal microflora in the functional departments of digestive tract, determine its participation in the fermentation of food ingredients and place of symbiotic digestion in the digestive conveyor.

Materials and methods: The study involved 107 healthy volunteers aged 18-36 years. The qualitative and quantitative composition, enzymatic activity of the oral fluid on the surface of the cheeks and tongue, and the contents of the biopsies of the esophagus, stomach, duodenum,jejunum, ileum and colon have been studied.

Results: Symbiotic digestion is carried out by luminal and mucosal microflora provided cavitary and parietal bacterial dilestion in all parts of the digestive tract. Symbiotic digestion included in the own digestion takes place in the fermentation of food ingredients, complementing and extending the assimilation processes. gondusion. The obtained data allowed to expand understanding of the digestive, process in humans, the first describe four phases of enteric digestion, propose a scheme of digestive convey or that includes mechanisms of the own and symbiotic digestion in all its departments.

Aim of the study: To investigate the effect of generation of tumor necrosis factor-alpha (TNFα) and the importance of TNFα(rs1 800629) gene polymorphism in the progression of chronic hepatitis C (CHC) and ulcerative colitis (UC).

Material and methods: The study involved 90 patients with chronic hepatitis C, 50 patients with UC and 50 healthy donors. The blood concentrations TNFα and TNFα gene polymorphism (rs1800629) were evaluated.

Results: TNFα levels in the blood in patients with chronic hepatitis C were increased compared with the control group and correlated with the severity of Cytolysis and fibrosis (r = 0.34, p = 0.02). At slow speed the formation of liver fibrosis TNFα amounted to 1.5 (0.9-2.8) pg/mI, with a fast speed--2.3(1.4-8.2) pg/mI (p = 0.006). Patients with UC at 3-4 degrees endo- scopic activity production of TNFα reached 6.5 (7-9) pg/mI, which was significantly higher than the value obtained at 1-2 degrees endoscopic activity--0.25(0-0.8) pg/ml (p = 0.001). The allelic variations of TNFα in groups of patients with CHC at different rates forming LF statistically differences were not found. The allele, associated with severe progressive course of UC and increased production of TNFα--A risk allele and genotype GA TNFα, associated with a slow progression of UC- "protective" G allele and genotype GG TNFα gene were determined.

Conclusion: Determining the level of TNFα allows to evaluate the severity of liver disease, heaviness and progression of liver fibrosis speed in CHC, and the severity of inflammation in the intestinal mucosa in UC. The presence of the allele A of TNFo(rs1800629) is a predictor of severe and progression of UC. Determining genetic polymorphism TNFα in patients with UC may be an additional factor to assess the prognosis of the disease.