Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-219-11-67-74
M. A. Butov, M. Msakni, V. M. Butova
Parietal cell proton pump inhibitors (PPIs) have become firmly established in clinician practice. When discussing the features of their action, as a rule, researchers focus on their antisecretory effect. In the available literature, we found only a single report on the effect of PPIs on the motor-evacuation function of the gastrointestinal tract (GIT). We have found that the PPI rabeprazole not only has an antisecretory effect, but also normalizes the motor-evacuation function of all parts of the gastrointestinal tract. In this regard, it can be used in patients with gastric hypersecretion in functional gastrointestinal disorders (FGID) with impaired motor-evacuation function. Aim. To study the effect of the antisecretory drug rabeprazole on the state of gastrointestinal motility in patients suffering from FGID of the gastrointestinal tract and overlap syndrome (overlap syndrome) with functional dyspepsia (FD) with gastric hypersecretion and irritable bowel syndrome (IBS). Material and methods. We examined 30 patients suffering from FGID of the gastrointestinal tract and cross syndrome - FD with gastric hypersecretion and IBS. To relieve clinical symptoms of FD, the drug rabeprazole 20 mg was prescribed once a day for 14 days. Before and after the start of treatment, patients were examined with VAS and SF-36 tests, intragastric pH-metry and peripheral electrogastroenterocolography (EGECG) were performed. Results. In all 30 patients with FGID of the gastrointestinal tract with FD and overlap syndrome with IBS, gastric hypersecretion was eliminated within 3 hours after taking 20 mg of rabeprazole. 2 weeks after the start of treatment, abdominal pain and heartburn were completely eliminated in 28 (93.3%) patients. In all (100%) patients with FGID of the gastrointestinal tract with gastric hypersecretion and overlap syndrome, after two weeks of treatment, sour belching disappeared, and nausea disappeared in 23 (77%) patients. Rabeprazole therapy in the examined individuals was accompanied by a marked improvement in the quality of life in all assessed SF-36 parameters. 2 weeks after starting rabeprazole, in patients with FGID of the gastrointestinal tract and overlap syndrome of FD and IBS, the frequency of bowel movements and stool quality were normalized, and according to the results of EGECG, the relative myoelectric activity (P(i)/PS) of the gastrointestinal tract and the rhythmicity coefficient (Kritm) were normalized. Conclusion. Rabeprazole quickly neutralizes gastric secretion and helps eliminate symptoms of FD. It also has a beneficial effect on the motor-evacuation function of all parts of the gastrointestinal tract, normalizing the frequency of bowel movements, stool quality and myoelectric activity of all parts of the gastrointestinal tract according to EGECG. Rabeprazole can be used in patients with FGID with FD with gastric hypersecretion and overlap syndrome with IBS.
{"title":"The effect of rabeprazole on the secretory and motor function of the gastrointestinal tract","authors":"M. A. Butov, M. Msakni, V. M. Butova","doi":"10.31146/1682-8658-ecg-219-11-67-74","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-219-11-67-74","url":null,"abstract":"Parietal cell proton pump inhibitors (PPIs) have become firmly established in clinician practice. When discussing the features of their action, as a rule, researchers focus on their antisecretory effect. In the available literature, we found only a single report on the effect of PPIs on the motor-evacuation function of the gastrointestinal tract (GIT). We have found that the PPI rabeprazole not only has an antisecretory effect, but also normalizes the motor-evacuation function of all parts of the gastrointestinal tract. In this regard, it can be used in patients with gastric hypersecretion in functional gastrointestinal disorders (FGID) with impaired motor-evacuation function. Aim. To study the effect of the antisecretory drug rabeprazole on the state of gastrointestinal motility in patients suffering from FGID of the gastrointestinal tract and overlap syndrome (overlap syndrome) with functional dyspepsia (FD) with gastric hypersecretion and irritable bowel syndrome (IBS). Material and methods. We examined 30 patients suffering from FGID of the gastrointestinal tract and cross syndrome - FD with gastric hypersecretion and IBS. To relieve clinical symptoms of FD, the drug rabeprazole 20 mg was prescribed once a day for 14 days. Before and after the start of treatment, patients were examined with VAS and SF-36 tests, intragastric pH-metry and peripheral electrogastroenterocolography (EGECG) were performed. Results. In all 30 patients with FGID of the gastrointestinal tract with FD and overlap syndrome with IBS, gastric hypersecretion was eliminated within 3 hours after taking 20 mg of rabeprazole. 2 weeks after the start of treatment, abdominal pain and heartburn were completely eliminated in 28 (93.3%) patients. In all (100%) patients with FGID of the gastrointestinal tract with gastric hypersecretion and overlap syndrome, after two weeks of treatment, sour belching disappeared, and nausea disappeared in 23 (77%) patients. Rabeprazole therapy in the examined individuals was accompanied by a marked improvement in the quality of life in all assessed SF-36 parameters. 2 weeks after starting rabeprazole, in patients with FGID of the gastrointestinal tract and overlap syndrome of FD and IBS, the frequency of bowel movements and stool quality were normalized, and according to the results of EGECG, the relative myoelectric activity (P(i)/PS) of the gastrointestinal tract and the rhythmicity coefficient (Kritm) were normalized. Conclusion. Rabeprazole quickly neutralizes gastric secretion and helps eliminate symptoms of FD. It also has a beneficial effect on the motor-evacuation function of all parts of the gastrointestinal tract, normalizing the frequency of bowel movements, stool quality and myoelectric activity of all parts of the gastrointestinal tract according to EGECG. Rabeprazole can be used in patients with FGID with FD with gastric hypersecretion and overlap syndrome with IBS.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"109 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-222-2-22-30
N. Pervyshin, S. Bulgakova, V. Vasilkova, L. A. Sharonova, R. Galkin, E. Lebedeva
Objective: to study and clinically substantiate the relationship between overweight and the dynamics of CKD progression in patients with type 2 diabetes of different age groups using the diagnostic parameter Index of glomerular filtration rate reduction. Material and methods: a single-stage cross-sectional observational study of clinical indicators in a population sample of patients with type 2 diabetes of different age groups was performed, patterns of relationships, significance of differences in mean values and measures of influence (OR (95%CI)) were studied between the indicators of BMI, the stage of obesity and the presence of a diagnosis of obesity in the anamnesis and the original calculated diagnostic parameter, the Index of glomerular filtration rate reduction (RI_GFR), which allows to give an objective quantitative characteristic of the rate of progression of CKD. Results: significant correlations were established between RI_GFR and indicators of age, BMI, DM experience and duration of insulin therapy, a significant inverse relationship with BMI was noted only in the older group; when analyzing differences in the average values of clinical indicators in the groups of rapid and slow progression of CKD, divided by the threshold value of RI_GFR, significant factors affecting the rate of progression were determined CKD: DM experience, duration of insulin therapy, BMI; the logistic regression analysis determined the measure of the influence of the above factors on the dynamics of GFR reduction, confirmed its significance; when analyzing the factors of drug treatment in the elderly group, it was revealed that an integrated approach to the appointment of antihypertensive therapy (prescribing drugs of three or more groups) significantly reduces the risk of rapid progression of CKD. Conclusions: the most significant risk factors for the high rate of progression of CKD in patients with type 2 diabetes and overweight in the general sample and in patients of the older age group are the length of diabetes and duration of insulin therapy; the dynamics of GFR reduction in patients with type 2 diabetes of different age groups is interrelated with BMI, and in patients with overweight CKD progresses more slowly; an integrated approach to prescribing antihypertensive therapy (prescribing drugs of three or more groups) in elderly patients with type 2 diabetes significantly reduces the risk of rapid progression of CKD.
{"title":"Excess body weight, duration of insulin and antihypertensive therapy slow down the rate of progression of chronic kidney disease in type 2 diabetes","authors":"N. Pervyshin, S. Bulgakova, V. Vasilkova, L. A. Sharonova, R. Galkin, E. Lebedeva","doi":"10.31146/1682-8658-ecg-222-2-22-30","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-222-2-22-30","url":null,"abstract":"Objective: to study and clinically substantiate the relationship between overweight and the dynamics of CKD progression in patients with type 2 diabetes of different age groups using the diagnostic parameter Index of glomerular filtration rate reduction. Material and methods: a single-stage cross-sectional observational study of clinical indicators in a population sample of patients with type 2 diabetes of different age groups was performed, patterns of relationships, significance of differences in mean values and measures of influence (OR (95%CI)) were studied between the indicators of BMI, the stage of obesity and the presence of a diagnosis of obesity in the anamnesis and the original calculated diagnostic parameter, the Index of glomerular filtration rate reduction (RI_GFR), which allows to give an objective quantitative characteristic of the rate of progression of CKD. Results: significant correlations were established between RI_GFR and indicators of age, BMI, DM experience and duration of insulin therapy, a significant inverse relationship with BMI was noted only in the older group; when analyzing differences in the average values of clinical indicators in the groups of rapid and slow progression of CKD, divided by the threshold value of RI_GFR, significant factors affecting the rate of progression were determined CKD: DM experience, duration of insulin therapy, BMI; the logistic regression analysis determined the measure of the influence of the above factors on the dynamics of GFR reduction, confirmed its significance; when analyzing the factors of drug treatment in the elderly group, it was revealed that an integrated approach to the appointment of antihypertensive therapy (prescribing drugs of three or more groups) significantly reduces the risk of rapid progression of CKD. Conclusions: the most significant risk factors for the high rate of progression of CKD in patients with type 2 diabetes and overweight in the general sample and in patients of the older age group are the length of diabetes and duration of insulin therapy; the dynamics of GFR reduction in patients with type 2 diabetes of different age groups is interrelated with BMI, and in patients with overweight CKD progresses more slowly; an integrated approach to prescribing antihypertensive therapy (prescribing drugs of three or more groups) in elderly patients with type 2 diabetes significantly reduces the risk of rapid progression of CKD.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"108 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-219-11-47-51
A. V. Tegai
The use of organ-preserving interventions for cholelithiasis is not widely used in modern medicine, although there are publications in the literature about the implementation of such interventions in some clinics. In the period 2004-2006 in the Republican Center for Functional Surgical Gastroenterology (Krasnodar), 12 surgical interventions were performed for cholelithiasis with preservation of the gallbladder (laparoscopic cholecystolithoextraction). From 2009 to 2011 the patients were called and examined (the first follow-up examination, on average 2.2 years after the operation). There were no signs of recurrence in 9 operated patients (of which 4 had an echogenic homogeneous suspension), in 3 patients a recurrence of stone formation was detected. Due to the reorganization and subsequent closure of the center, communication with patients was terminated. In 2023 (on average 15.5 years after surgery), patients who did not have a relapse at the first follow-up examination were examined. It was found that 3 out of 9 patients had no gallbladder stones, 3 patients underwent laparoscopic cholecystectomy due to relapse after the first follow-up examination, with 3 patients the relationship could not be established. The results of laparoscopic cholecystolithoextraction were analyzed depending on the clinical situation.
{"title":"Immediate and long-term consequences of the treatment of cholelithiasis by laparoscopic cholecystolithoextraction","authors":"A. V. Tegai","doi":"10.31146/1682-8658-ecg-219-11-47-51","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-219-11-47-51","url":null,"abstract":"The use of organ-preserving interventions for cholelithiasis is not widely used in modern medicine, although there are publications in the literature about the implementation of such interventions in some clinics. In the period 2004-2006 in the Republican Center for Functional Surgical Gastroenterology (Krasnodar), 12 surgical interventions were performed for cholelithiasis with preservation of the gallbladder (laparoscopic cholecystolithoextraction). From 2009 to 2011 the patients were called and examined (the first follow-up examination, on average 2.2 years after the operation). There were no signs of recurrence in 9 operated patients (of which 4 had an echogenic homogeneous suspension), in 3 patients a recurrence of stone formation was detected. Due to the reorganization and subsequent closure of the center, communication with patients was terminated. In 2023 (on average 15.5 years after surgery), patients who did not have a relapse at the first follow-up examination were examined. It was found that 3 out of 9 patients had no gallbladder stones, 3 patients underwent laparoscopic cholecystectomy due to relapse after the first follow-up examination, with 3 patients the relationship could not be established. The results of laparoscopic cholecystolithoextraction were analyzed depending on the clinical situation.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"103 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-219-11-19-26
Y. M. Vakhrushev, M. S. Busygina
{"title":"The evaluation of the digestive and suction function of the duodenum in chronic duodenal insufficiency","authors":"Y. M. Vakhrushev, M. S. Busygina","doi":"10.31146/1682-8658-ecg-219-11-19-26","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-219-11-19-26","url":null,"abstract":"","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"122 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-222-2-101-110
L. A. Sharonova, S. Bulgakova, Y. Dolgikh, O. Kosareva, E. Treneva, D. P. Kurmaev
Obesity is an important medical and social problem, it occupies one of the leading places among cardiovascular risk factors. Obesity is a major component of the metabolic syndrome. It has a close pathogenetic relationship with its other manifestations, as a result of which a portrait of a comorbid patient is formed. The article presents data on the prevalence, criteria for diagnosing obesity, the relationship of obesity with other components of the metabolic syndrome is shown. The role of adipose tissue dysfunction in obesity on the development and progression of insulin resistance, atherosclerosis, as well as its relationship with non-alcoholic fatty liver disease and arterial hypertension is discussed. It is shown that obesity is a comorbidity factor and the basis of the metabolic syndrome, the leading pathogenetic mechanism in the formation and progression of its components, preceding their occurrence. This allows us to conclude that weight loss can reduce cardiovascular risks, reduce the manifestations of the metabolic syndrome, and in some cases even eliminate them completely.
{"title":"Obesity as a main component of metabolic syndrome and a risk factor for comorbidity","authors":"L. A. Sharonova, S. Bulgakova, Y. Dolgikh, O. Kosareva, E. Treneva, D. P. Kurmaev","doi":"10.31146/1682-8658-ecg-222-2-101-110","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-222-2-101-110","url":null,"abstract":"Obesity is an important medical and social problem, it occupies one of the leading places among cardiovascular risk factors. Obesity is a major component of the metabolic syndrome. It has a close pathogenetic relationship with its other manifestations, as a result of which a portrait of a comorbid patient is formed. The article presents data on the prevalence, criteria for diagnosing obesity, the relationship of obesity with other components of the metabolic syndrome is shown. The role of adipose tissue dysfunction in obesity on the development and progression of insulin resistance, atherosclerosis, as well as its relationship with non-alcoholic fatty liver disease and arterial hypertension is discussed. It is shown that obesity is a comorbidity factor and the basis of the metabolic syndrome, the leading pathogenetic mechanism in the formation and progression of its components, preceding their occurrence. This allows us to conclude that weight loss can reduce cardiovascular risks, reduce the manifestations of the metabolic syndrome, and in some cases even eliminate them completely.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"117 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-219-11-52-61
L. B. Lasebnik, L. N. Chikhireva, O. A. Chikhirev, E. D. Li
Metabolic dysfunction associated steatatotic liver disease (MASLD) and hypertension are two chronic progressive diseases that require a comprehensive approach. The article discusses approaches to the appointment of hypotensive and hypolipidemic therapy in patients with MASLD, depending on the stage of the disease.
{"title":"Choice of antihyprtensive therapy at varios stages of metabolically associated lever disease","authors":"L. B. Lasebnik, L. N. Chikhireva, O. A. Chikhirev, E. D. Li","doi":"10.31146/1682-8658-ecg-219-11-52-61","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-219-11-52-61","url":null,"abstract":"Metabolic dysfunction associated steatatotic liver disease (MASLD) and hypertension are two chronic progressive diseases that require a comprehensive approach. The article discusses approaches to the appointment of hypotensive and hypolipidemic therapy in patients with MASLD, depending on the stage of the disease.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"115 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-219-11-102-111
L. N. Ivanov, M. L. Kolotilova
The purpose of the study. Improvement of the author's Neurogenic-genetic theory of the etiology of the pathogenesis of peptic ulcer disease. Materials and methods: To develop the author's view on the etiology and pathogenesis of peptic ulcer disease, about 50 different publications were processed and the results of their own research were analyzed. Results. Consequently, the neurogenic-genetic theory of the etiology and pathogenesis of gastric and duodenal ulcer very optimally explains the cause-and-effect relationships in a patient with ULCER, allowing for variants of the prevalence of neurosis factor or local genetic factors in one case or another. However, another thing is obvious, that only a combination of a neurogenic factor with a genetically altered reactivity of the gastroduodenal system (the presence of a target organ) causes the chronic ulcers. The theory of peptic ulcer disease developed by us, as a disease related to psychosomatic pathology, allows us to develop effective therapy, including drugs with a psychocorregulating effect.
{"title":"Neurogenic-genetic theory of etiology peptic ulcer disease","authors":"L. N. Ivanov, M. L. Kolotilova","doi":"10.31146/1682-8658-ecg-219-11-102-111","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-219-11-102-111","url":null,"abstract":"The purpose of the study. Improvement of the author's Neurogenic-genetic theory of the etiology of the pathogenesis of peptic ulcer disease. Materials and methods: To develop the author's view on the etiology and pathogenesis of peptic ulcer disease, about 50 different publications were processed and the results of their own research were analyzed. Results. Consequently, the neurogenic-genetic theory of the etiology and pathogenesis of gastric and duodenal ulcer very optimally explains the cause-and-effect relationships in a patient with ULCER, allowing for variants of the prevalence of neurosis factor or local genetic factors in one case or another. However, another thing is obvious, that only a combination of a neurogenic factor with a genetically altered reactivity of the gastroduodenal system (the presence of a target organ) causes the chronic ulcers. The theory of peptic ulcer disease developed by us, as a disease related to psychosomatic pathology, allows us to develop effective therapy, including drugs with a psychocorregulating effect.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"124 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-219-11-33-39
M. Zarivchatskiy, E. Kamenskikh, I. Mugatarov, D. G. Amarantov
The purpose of the study. To study the coagulation profile of patients undergoing liver resections using laboratory tests and thromboelastography. Materials and methods. The results of observation of coagulological changes in 45 patients were studied: with colorectal liver metastases - 24 (53.3%) cases, with hepatocellular cancer - 14 (31.1%), with cholangiocellular cancer - 7 (15.6%). Right-sided hemihepatectomy was performed in 22 (48.9%) patients, right-sided extended hemihepatectomy - in 7 (15.6%), left-sided hemihepatectomy - in 8 (17.8%), resection of the left sector - in 8 (17.8%). Laboratory diagnostics included standard conventional coagulation tests and thromboelastography. Results. The concentrations of total bilirubin and alkaline phosphatase significantly increased up to 3 days of the postoperative period inclusive. The international normalized ratio increased significantly after liver resection immediately after surgery, as well as after 1, 3 and 5 days of observation. The level of fibrinogen in the first day after surgery decreases, and then increased to the initial value. Thromboelastometric parameters indicated a stable and normal coagulation function with a short ability to hypercoagulate immediately after liver resection. Conclusion. Although standard routine laboratory tests such as activated partial thromboplastin time and international normalized ratio may remain within normal limits or indicate hypocoagulation, the patient may be at risk for thrombosis. Thromboelastography measures the rate of formation, stabilization, and lysis of a clot using whole blood, which gives a more complete picture of coagulation status. Thus, routine laboratory parameters alone should not be used to decide whether to delay thromboembolic prophylaxis after liver resection.
{"title":"Coagulological disorders during liver resections in patients with malignant tumors","authors":"M. Zarivchatskiy, E. Kamenskikh, I. Mugatarov, D. G. Amarantov","doi":"10.31146/1682-8658-ecg-219-11-33-39","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-219-11-33-39","url":null,"abstract":"The purpose of the study. To study the coagulation profile of patients undergoing liver resections using laboratory tests and thromboelastography. Materials and methods. The results of observation of coagulological changes in 45 patients were studied: with colorectal liver metastases - 24 (53.3%) cases, with hepatocellular cancer - 14 (31.1%), with cholangiocellular cancer - 7 (15.6%). Right-sided hemihepatectomy was performed in 22 (48.9%) patients, right-sided extended hemihepatectomy - in 7 (15.6%), left-sided hemihepatectomy - in 8 (17.8%), resection of the left sector - in 8 (17.8%). Laboratory diagnostics included standard conventional coagulation tests and thromboelastography. Results. The concentrations of total bilirubin and alkaline phosphatase significantly increased up to 3 days of the postoperative period inclusive. The international normalized ratio increased significantly after liver resection immediately after surgery, as well as after 1, 3 and 5 days of observation. The level of fibrinogen in the first day after surgery decreases, and then increased to the initial value. Thromboelastometric parameters indicated a stable and normal coagulation function with a short ability to hypercoagulate immediately after liver resection. Conclusion. Although standard routine laboratory tests such as activated partial thromboplastin time and international normalized ratio may remain within normal limits or indicate hypocoagulation, the patient may be at risk for thrombosis. Thromboelastography measures the rate of formation, stabilization, and lysis of a clot using whole blood, which gives a more complete picture of coagulation status. Thus, routine laboratory parameters alone should not be used to decide whether to delay thromboembolic prophylaxis after liver resection.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"88 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-219-11-112-119
F. Yusupov, A. A. Yuldashev
The vagus nerve is an essential connection between the body and the brain that controls vital aspects of autonomic physiology such as respiration, heart rate, blood pressure and intestinal motility, reflexes such as coughing and swallowing, and survival behaviors such as eating, drinking and response to nausea. The stomach has a complex nervous apparatus. The innervation of the stomach is provided by both the somatic and the autonomic nervous system. The stomach receives innervation from the vagus nerve and derivatives of the celiac plexus (superior mesenteric, gastric, splenic, hepatic). The vagus nerve has the greatest influence on the work of the stomach and intestines. The vagus nerve is the longest splanchnic nerve, literally wandering throughout the body. The vagus nerves play a dominant role in stimulating gastric secretion. The basal or continuous secretion of gastric juice in normal humans is entirely due to tonic impulses in the vagus nerves. The purpose of our review was to identify the pathogenetic role of the vagus nerve in gastric and duodenal ulcers.
{"title":"Modern aspects of vagus-induced gastroprotection and ulcerogenesis in gastric and duodenal ulcers","authors":"F. Yusupov, A. A. Yuldashev","doi":"10.31146/1682-8658-ecg-219-11-112-119","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-219-11-112-119","url":null,"abstract":"The vagus nerve is an essential connection between the body and the brain that controls vital aspects of autonomic physiology such as respiration, heart rate, blood pressure and intestinal motility, reflexes such as coughing and swallowing, and survival behaviors such as eating, drinking and response to nausea. The stomach has a complex nervous apparatus. The innervation of the stomach is provided by both the somatic and the autonomic nervous system. The stomach receives innervation from the vagus nerve and derivatives of the celiac plexus (superior mesenteric, gastric, splenic, hepatic). The vagus nerve has the greatest influence on the work of the stomach and intestines. The vagus nerve is the longest splanchnic nerve, literally wandering throughout the body. The vagus nerves play a dominant role in stimulating gastric secretion. The basal or continuous secretion of gastric juice in normal humans is entirely due to tonic impulses in the vagus nerves. The purpose of our review was to identify the pathogenetic role of the vagus nerve in gastric and duodenal ulcers.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"115 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-26DOI: 10.31146/1682-8658-ecg-219-11-81-101
A. Kaplina, E. Kayumova, E. Y. Vasil'eva, E. Vasichkina, T. Pervunina, O. O. Shemyakina, N. A. Guryanova, N. S. Kiseleva, Yu. V. Skorobogatova, E. V. Pelevina, E. V. Efimova, E. V. Novik, O. N. Valeeva, A. N. Malorodova, N. A. Petrova
The development of necrotizing enterocolitis (NEC) in neonates with duct-dependent congenital heart defects (CHD) who underwent cardiac surgery is accompanied by high mortality. Analysis of predictors is necessary for understanding the pathophysiology of NEC and development of approaches for prevention to achieve favorable outcomes of cardiac surgery. The purpose of the study was to develop a prognostic model for predicting the development of NEC after cardiac surgery in neonates with duct-dependent CHD. Methods. A prognostic cohort study was performed that included full-term neonates with duct-dependent CHD who underwent cardiac surgery at the Almazov National Medical Research Center from January 2021 to September 2023. The outcome was the development/absence of stage IB-III NEC in the postoperative period. Biomarkers of NEC (intestinal fatty acid binding protein (i-FABP, ng/ml), claudin-3 (CLDN3, ng/ml), calprotectin (CALPR, ng/ml), ischemia modified albumin (IMA, ng/ml), vascular endothelial growth factor A (VEGF A, pg/ml)) were measured by ELISA in the blood serum before cardiac surgery and 12-14 hours after surgery. We also analyzed clinical characteristics of neonates, C-reactive protein levels, complete blood count, abdominal ultrasound, ejection fraction (EF, Teicholtz) in the preoperative and postoperative periods, surgical parameters, P(v-a)CO2/C(a-v)O2 upon arrival from the operating room, vasoactive inotropic score (VIS) and arterial blood lactate levels in the first 24 hours after surgery. The association between predictors and the development of NEC after cardiac surgery was assessed using univariate and multivariate logistic regression analysis. Internal validation of the model was performed using 10-fold cross-validation. Results. During the observation period, 187 neonates underwent surgical treatment of duct-dependent CHD, of which 32 children developed stage IB-III NEC in the postoperative period (17.1%), two neonates required surgical treatment of NEC (6.3%). After meeting the non-inclusion and exclusion criteria, two groups of patients were formed: a main group (30 neonates who developed stages IB-III NEC in the postoperative period, of which stage III NEC was in one neonate) and a comparison group (40 neonates without NEC). Groups were comparable by types of CHD. Predictors associated with NEC (univariate analysis): intrauterine growth retardation (IUGR), formula feeding before surgery, high levels of IMA before on the first postoperative day (POD), procedures performed before surgery (Rashkind procedure/valvuloplasty/stenting), lower EF in in the early postoperative period, a higher maximum level of VIS in the first 24 hours after surgery, as well as a higher level of IR in the superior mesenteric artery (SMA) and thickening of the intestinal wall on the first postoperative day (POD) Independent preoperative predictors of NEC (AUC of model 0.885, specificity 0.867): IUGR (OR 32.2 (1.4-730.3), p=0.029), formula feeding (OR 1
患有导管依赖性先天性心脏缺陷（CHD）并接受心脏手术的新生儿发生坏死性小肠结肠炎（NEC）的死亡率很高。分析预测因素对于了解 NEC 的病理生理学和制定预防方法以获得良好的心脏手术效果非常必要。本研究的目的是建立一个预后模型，用于预测导管依赖性先天性心脏病新生儿心脏手术后发生 NEC 的情况。方法。该研究纳入了 2021 年 1 月至 2023 年 9 月期间在阿尔马佐夫国立医学研究中心接受心脏手术的导管依赖性先天性心脏病足月新生儿。研究结果为术后发生/不发生 IB-III 期 NEC。在心脏手术前和手术后12-14小时，通过ELISA法测定血清中的NEC生物标记物（肠脂肪酸结合蛋白（i-FABP，纳克/毫升）、Claudin-3（CLDN3，纳克/毫升）、钙保护蛋白（CALPR，纳克/毫升）、缺血修饰白蛋白（IMA，纳克/毫升）、血管内皮生长因子A（VEGF A，皮克/毫升））。我们还分析了新生儿的临床特征、C 反应蛋白水平、全血细胞计数、腹部超声波、术前和术后的射血分数（EF，Teicholtz）、手术参数、到达手术室后的 P(v-a)CO2/C(a-v)O2 值、血管活性肌力评分（VIS）以及术后 24 小时内的动脉血乳酸水平。采用单变量和多变量逻辑回归分析评估了预测因素与心脏手术后发生 NEC 之间的关系。使用 10 倍交叉验证对模型进行了内部验证。结果。在观察期间，有187名新生儿接受了管道依赖性CHD手术治疗，其中32名患儿在术后出现IB-III期NEC（17.1%），2名新生儿需要手术治疗NEC（6.3%）。在符合非纳入和排除标准后，患者分为两组：主组（30 名在术后出现 IB-III 期 NEC 的新生儿，其中一名新生儿出现 III 期 NEC）和对比组（40 名未出现 NEC 的新生儿）。各组的CHD类型具有可比性。与 NEC 相关的预测因素（单变量分析）：宫内发育迟缓（IUGR）、术前配方奶喂养、术后第一天（POD）前 IMA 水平较高、术前进行的手术（Rashkind 手术/瓣膜成形术/支架植入术）、术后早期 EF 较低、术后 24 小时内 VIS 的最高水平较高，以及术后第一天（POD）肠系膜上动脉（SMA）的 IR 水平较高和肠壁增厚（模型的 AUC 为 0.885，特异性 0.867）：IUGR（OR 32.2 (1.4-730.3)，p=0.029）、配方奶喂养（OR 12.6 (2.6-60.2)，p=0.002）、术前 IMA 水平（OR 1.03 (1.01-1.04)，p=0.004）、术前 CLDN3 水平（OR 0.5 (0.3-0.9)，p=0.013）。术后早期 NEC 的独立预测因素：术后 12-14 小时的 IMA 水平（OR 1.02 (1.01-1.03)，P=0.030），术后即刻的 P(v-a)CO2/C(a-v)O2 （OR 2.3 (1.2-4.4)，p=0.008）、SMA中IR>0.93（OR 7.2 (1.6-32.4)，p=0.011）和POD 1时超声检查肠壁厚度（OR 4.9 (1.3-19.2)，p=0.021）。在模型中加入血管内皮生长因子 A 水平（术后 12-14 小时，与 NEC 负相关）可提高特异性，但预测效果不显著。术后模型的 AUC 为 0.862，特异性为 0.800。最终模型包括术前预测因子（IUGR、配方喂养）和术后预测因子（IMA、P(v-a)CO2/C(a-v)O2、SMA IR>0.93、肠壁厚度），AUC=0.921，特异性为 0.83。结论已确定的预测因子间接表明，缺氧在患有导管依赖性先天性心脏病的足月新生儿 NEC 的病理生理学中起着重要作用。术前母乳喂养/混合喂养有助于降低术后发生 NEC 的风险。术前低水平的CLDN3与NEC的发生有关，但对这一结果的解释还存在争议。
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