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Training of pediatricians in pediatric gastroenterology. To the 35th anniversary of the Department of Pediatrics with Infectious Diseases in Children of the Faculty of Additional Professional Education of the N. I. Pirogov’s Russian National Research Medical University 对儿科医生进行小儿肠胃病学培训。为 N. I. Pirogov's 俄罗斯国立研究医科大学补充专业教育学院儿童传染病儿科系成立 35 周年献礼。Pirogov's 俄罗斯国立研究医科大学儿科与儿童传染病系成立 35 周年
Pub Date : 2024-03-07 DOI: 10.31146/1682-8658-ecg-215-7-5-12
L. A. Kharitonova, K. I. Grigoryev
The article is devoted to the results of the training of pediatricians in pediatric gastroenterology based on the experience of the Department of Pediatrics with Infectious Diseases in Children (Head of the Department - prof. L. A. Kharitonova) N. I. Pirogov’s Russian National Research University of the Ministry of Health of Russia. The stages of development of the department are presented in detail. Since diseases of the digestive system have been and remain the main scientific direction of the work of the department staff, the issues of teaching gastroenterology and training both specialist doctors and pediatricians in this area influenced the goal-setting of the pedagogical process. Convincing evidence of the effectiveness of the rapid introduction of scientific and research achievements in practical health care. Fragments of the article highlight how, within the framework of training, joint medical work with organizations of health authorities in various regions of Russia, with which the department closely cooperates, they help spread knowledge. The prospects for the work of the department in the field of age-related non-infectious, infectious gastroenterology, biliary pathology and nutrition, further improvement of scientific and pedagogical activities, the quality of training of specialists in the field of pediatric gastroenterology are outlined. The article is dedicated to the 35th anniversary of the department.
文章主要介绍了根据俄罗斯卫生部俄罗斯国立皮罗戈夫研究大学儿童传染病儿科系(系主任:Л.А. Kharitonova教授)的经验对儿科医生进行小儿肠胃病学培训的结果。Pirogov's Russian National Research University of the Ministry of Health of Russia.详细介绍了该系的发展阶段。由于消化系统疾病一直是科室人员工作的主要科学方向,因此在这一领域的胃肠病学教学和专科医生与儿科医生的培训问题影响着教学过程的目标设定。令人信服的证据表明,在实际医疗保健工作中迅速引进科研成果是行之有效的。文章中的一些片段强调了在培训框架内,与俄罗斯各地区卫生当局组织的联合医疗工作是如何帮助传播知识的。文章概述了科室在与年龄相关的非感染性、感染性胃肠病学、胆道病理学和营养学领域的工作前景,进一步改进科学和教学活动,提高小儿胃肠病学领域专家的培训质量。文章献给科室成立 35 周年。
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引用次数: 0
Cardiovascular diseases: pathophysiological role of gut microbiota and new targets for treatment and prevention 心血管疾病:肠道微生物群的病理生理作用以及治疗和预防的新目标
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-201-208
K. Aitbaev, I. Murkamilov, Z. Murkamilova, V. V. Fomin, I. Kudaibergenova, T. Yusupova, F. Yusupov
Despite certain success achieved in therapy and prevention, cardiovascular diseases (CVD) continue to be the leading cause of death of the population worldwide. One of the main reasons for this is that the pathophysiological mechanisms of the development of atherosclerosis, a disease that underlies most clinical forms of CVD, have not been fully understood yet, and therapy based on well-known concepts of pathogenesis, including lipid, does not provide the desired results. In this regard, search and identification of new molecular targets and therapeutic approaches is an important objective of modern medical science. In this direction, a completely new metabolic pathway identified by researchers, that links lipid consumption, gut microbiota (GM) and development of atherosclerosis, deserves interest. Thus, for the first time it was shown that GM uses food choline, as well as carnitine (found in red meat) for synthesis of trimethylamine (TMA), which, in turn, is rapidly oxidized by liver flavin monooxidases (FMO) to trimethylamine oxide (TMAO), that causes the development of atherosclerosis. Mechanisms of proatherogenic effect of TMAO, which, taken together, involve stimulation of inflow and suppression of outflow of cholesterol from the cell, have also been established. Another pathway of GM influence on the development or progression of atherosclerosis, that links the presence of bacterial infection and the degree of atherosclerosis development, has also been identified. It is believed that in this case, bacterial liposaccharides (LPS) interact with low-density lipoproteins (LDL), as a result of which LDL turn into atherogenic oxidized LDL. The article discusses possible therapeutic strategies for prevention and treatment of coronary atherosclerosis associated with both decreased production of TMAO and elimination of TMA from the intestines, and regulation of microbial metabolism (inhibition of microbial enzymes that produce TMA), as well as change in the structure of GM towards increase in the proportion of microorganisms beneficial to the human body (unable to produce TMA).
尽管在治疗和预防方面取得了一定的成就,心血管疾病(CVD)仍然是全球人口死亡的主要原因。造成这种情况的主要原因之一是,人们尚未完全了解大多数临床形式的心血管疾病(CVD)的病理生理机制--动脉粥样硬化的发病机制,而基于众所周知的发病机制概念(包括脂质)的治疗并不能达到预期效果。因此,寻找和确定新的分子靶点和治疗方法是现代医学的一个重要目标。在这方面,研究人员发现的一条全新的代谢途径值得关注,它将脂质消耗、肠道微生物群(GM)和动脉粥样硬化的发展联系在一起。因此,研究首次表明,转基因利用食物中的胆碱和肉碱(存在于红肉中)合成三甲胺(TMA),而三甲胺又会被肝脏黄素单氧化酶(FMO)迅速氧化成氧化三甲胺(TMAO),从而导致动脉粥样硬化的发生。TMAO 的致动脉粥样硬化作用机制也已确立,其中包括刺激胆固醇从细胞中流入和抑制胆固醇从细胞中流出。全球机制对动脉粥样硬化的发展或恶化产生影响的另一个途径也已确定,即细菌感染的存在与动脉粥样硬化的发展程度有关。据认为,在这种情况下,细菌脂糖(LPS)与低密度脂蛋白(LDL)相互作用,导致低密度脂蛋白变成致动脉粥样硬化的氧化低密度脂蛋白。文章讨论了预防和治疗冠状动脉粥样硬化的可能治疗策略,包括减少肠道中 TMAO 的产生和 TMA 的排出,调节微生物的新陈代谢(抑制产生 TMA 的微生物酶),以及改变基因改造的结构,增加对人体有益的微生物(不能产生 TMA)的比例。
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引用次数: 0
The concept of enzymatic disintegration of nutrients in the upper gastrointestinal tract 上消化道营养素酶解概念
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-56-67
V. Aleynik, S. Babich
The aim of the study was to study the effect of salivary amylase on improving gastric protein digestion, as well as the effect of gastric protein hydrolysis on improving fat digestion. The work consisted of two parts, in the first part, in two series, the hydrolysis of proteins under the influence of gastric juice in the presence of starch and the effect of saliva amylase on the change in the total proteolytic activity of gastric juice when using substrates of a mixture of starch and proteins were investigated. In the second part of the work, the lipolytic activity of pancreatic juice with the studied proteins was studied in the presence and absence of bile. From the data obtained, it was found that the use of a mixture of starch with proteins helps to reduce the hydrolysis of proteins by gastric juice. The use of salivary amylase promotes an increase in protein hydrolysis by reducing the formation of starch-protein complexes that prevent the digestion of proteins by gastric juice. All the studied proteins, except gelatin, have an inhibitory effect on lipase in the pancreatic juice; the degree of inhibitory effect of each protein is expressed differently. It depends on their degree of digestion in gastric juice. Thus, the preliminary hydrolysis of proteins by pepsins in the stomach contributes not only to the further improvement of their hydrolysis under the influence of proteolytic enzymes of pancreatic juice, but also to the hydrolysis of fats under the influence of pancreatic lipase. It is concluded that the sequence of nutrient breakdown by enzymes of saliva, stomach and pancreas is primarily aimed at enzymatic disintegration between polysaccharides and proteins, as well as proteins and fats, in order to reduce their interaction and the formation of physical complexes. Thus, secondarily, improve the digestibility of nutrients in the upper gastrointestinal tract. The conceptual assumption of enzymatic disintegration of nutrients in the upper gastrointestinal tract allows us to substantiate the existing sequence of initial digestion of polysaccharides by saliva, as well as the initial digestion of proteins by gastric juice.
这项研究的目的是研究唾液淀粉酶对改善胃蛋白质消化的影响,以及胃蛋白质水解对改善脂肪消化的影响。这项工作由两部分组成,第一部分分两个系列,分别研究了在有淀粉存在的情况下,胃液对蛋白质的水解作用,以及在使用淀粉和蛋白质混合物为底物时,唾液淀粉酶对胃液总蛋白水解活性变化的影响。在工作的第二部分,研究了在有胆汁和无胆汁的情况下胰液与所研究蛋白质的脂肪分解活性。从获得的数据中发现,使用淀粉与蛋白质的混合物有助于减少胃液对蛋白质的水解。使用唾液淀粉酶可以减少淀粉-蛋白质复合物的形成,从而阻止胃液对蛋白质的消化,从而促进蛋白质水解的增加。除明胶外,所有研究的蛋白质都对胰液中的脂肪酶有抑制作用;每种蛋白质的抑制作用程度表现不同。这取决于它们在胃液中的消化程度。因此,胃蛋白酶对蛋白质的初步水解不仅有助于在胰液蛋白水解酶的影响下进一步改善蛋白质的水解,而且有助于在胰脂肪酶的影响下水解脂肪。结论是,唾液、胃和胰腺中的酶对营养物质的分解顺序主要是在多糖和蛋白质以及蛋白质和脂肪之间进行酶解,以减少它们之间的相互作用和物理复合物的形成。其次,提高营养物质在上消化道的消化率。营养物质在上消化道酶解的概念假设,使我们能够证实现有的唾液对多糖的初步消化顺序,以及胃液对蛋白质的初步消化顺序。
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引用次数: 0
The concept of the development of inflammatory bowel diseases as a consequence of intestinal metabolic dysbiosis 炎症性肠病的发生是肠道代谢失调的结果这一概念
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-162-167
L. V. Tarasova, Yu. V. Tsyganova, S. I. Pavlova, N. Y. Kucherova
The article discusses the high relevance of the problem of inflammatory bowel diseases (IBD). First of all, attention is drawn to the annual increase in the incidence of ulcerative colitis and Crohn’s disease. Factors that can influence the development of IBD are assessed. A diagram of the pathogenetic cascade of dysbiotic disorders is presented, manifested by an increase in the blood serum of metabolic products of the intestinal microflora, microvascular, metabolic and immune changes leading to the triggering of inflammation in the intestinal wall.
文章讨论了炎症性肠病(IBD)问题的高度相关性。首先,文章关注了溃疡性结肠炎和克罗恩病发病率的逐年上升。对影响 IBD 发病的因素进行了评估。图中展示了菌群失调的致病级联,表现为血清中肠道微生物区系的代谢产物增加、微血管、代谢和免疫变化导致肠壁发炎。
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引用次数: 0
A case of multifocal atherosclerosis complicated by acute myocardial infarction in a young woman with ulcerative colitis 一名患有溃疡性结肠炎的年轻女性并发急性心肌梗死的多灶性动脉粥样硬化病例
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-247-252
L. V. Tarasova, N. Y. Kucherova, Yu. V. Tsyganova
Coronary artery thrombosis in ulcerative colitis is a serious condition and can occur in the young population. The authors report a case of multifocal atherosclerosis complicated by acute myocardial infarction due to atherosclerotic coronary thrombosis in a young woman with ulcerative colitis.
溃疡性结肠炎冠状动脉血栓是一种严重的疾病,可发生在年轻人群中。作者报告了一例患有溃疡性结肠炎的年轻女性因冠状动脉粥样硬化性血栓形成而并发多灶性动脉粥样硬化和急性心肌梗死的病例。
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引用次数: 0
Prediction of life-threatening complications of inflammatory bowel disease using neural networks: a practical tool for health care professionals 利用神经网络预测炎症性肠病危及生命的并发症:医护人员的实用工具
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-20-33
Y. Uspenskiy, S. V. Ivanov, Yu. A. Fominykh, A. N. Narkevich, A. M. Segal’, A. Grjibovski
Introduction. Inflammatory Bowel Disease (IBD) including Crohn’s Disease (CD) and Ulcerative Colitis (UC) representsis a challenge for gastroenterologists worldwide, due to its potential to cause life-threatening complications and lead to disability in patients. Aim: to develop a tool that can be used in clinical practice to predict the development of life-threatening complications of IBD through mathematical modeling. Methods. A historical cohort of 291 adult patients with a verified diagnosis of IBD (48% - CD, 52% - UC) who sought medical care from 2020 to 2022 comprised the study base. The outcomes were life-threatening complications including a subgroup of conditions that required urgent surgical intervention. Logistic regression, classification trees and neural network analysis were used to predict the studied outcomes. Results. Life-threatening complications occurred in 22.3% of CD- and in 9.9% of UC patients. The corresponding numbers for urgent surgical complications were 16.5% and 1.3%. Among the constructed mathematical models for both types of outcomes, neural network models demonstrated the highest sensitivity and specificity. Based on the neural network models, two software products named “IBD prognosis: risk of life-threatening complications” and “ IBD prognosis: risk of urgent surgical complications” were developed. For the former, the positive predictive value was 65.0% (95% CI 52.4-75.8) while the negative predictive value was 97.0% (95% CI: 93.9-98.5). For the latter, the corresponding numbers were 77.4% (95% CI: 60.2-87.4) and 99.2% (95% CI: 97.2-99.8). Conclusions. Two tools have been developed for use in clinical practice by gastroenterologists, therapists, and general practitioners to manage IBD patients. Identifying a high-risk IBD patient for developing a life-threatening complication can be used as a foundation for optimizing the therapy used in the treatment of a given patient, potentially saving lives.
导言。炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),是全世界胃肠病学家面临的一项挑战,因为它可能引起危及生命的并发症,导致患者残疾。目的:开发一种可用于临床实践的工具,通过数学建模预测危及生命的 IBD 并发症的发生。方法。以 2020 年至 2022 年期间就诊的 291 名经确诊为 IBD(48% 为 CD,52% 为 UC)的成年患者为研究对象。研究结果为危及生命的并发症,包括需要紧急手术干预的亚组病症。研究采用逻辑回归、分类树和神经网络分析来预测研究结果。研究结果22.3%的 CD- 和 9.9% 的 UC 患者出现了危及生命的并发症。紧急手术并发症的相应比例分别为 16.5%和 1.3%。在针对这两类结果构建的数学模型中,神经网络模型的灵敏度和特异性最高。在神经网络模型的基础上,开发了名为 "IBD 预后:危及生命的并发症风险 "和 "IBD 预后:紧急手术并发症风险 "的两个软件产品。前者的阳性预测值为 65.0%(95% CI 52.4-75.8),阴性预测值为 97.0%(95% CI:93.9-98.5)。后者的预测值分别为 77.4% (95% CI: 60.2-87.4) 和 99.2% (95% CI: 97.2-99.8)。结论我们开发了两种工具,供消化科医生、治疗师和全科医生在临床实践中使用,以管理 IBD 患者。识别IBD患者发生危及生命的并发症的高风险,可作为优化治疗特定患者的疗法的基础,从而有可能挽救生命。
{"title":"Prediction of life-threatening complications of inflammatory bowel disease using neural networks: a practical tool for health care professionals","authors":"Y. Uspenskiy, S. V. Ivanov, Yu. A. Fominykh, A. N. Narkevich, A. M. Segal’, A. Grjibovski","doi":"10.31146/1682-8658-ecg-217-9-20-33","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-20-33","url":null,"abstract":"Introduction. Inflammatory Bowel Disease (IBD) including Crohn’s Disease (CD) and Ulcerative Colitis (UC) representsis a challenge for gastroenterologists worldwide, due to its potential to cause life-threatening complications and lead to disability in patients. Aim: to develop a tool that can be used in clinical practice to predict the development of life-threatening complications of IBD through mathematical modeling. Methods. A historical cohort of 291 adult patients with a verified diagnosis of IBD (48% - CD, 52% - UC) who sought medical care from 2020 to 2022 comprised the study base. The outcomes were life-threatening complications including a subgroup of conditions that required urgent surgical intervention. Logistic regression, classification trees and neural network analysis were used to predict the studied outcomes. Results. Life-threatening complications occurred in 22.3% of CD- and in 9.9% of UC patients. The corresponding numbers for urgent surgical complications were 16.5% and 1.3%. Among the constructed mathematical models for both types of outcomes, neural network models demonstrated the highest sensitivity and specificity. Based on the neural network models, two software products named “IBD prognosis: risk of life-threatening complications” and “ IBD prognosis: risk of urgent surgical complications” were developed. For the former, the positive predictive value was 65.0% (95% CI 52.4-75.8) while the negative predictive value was 97.0% (95% CI: 93.9-98.5). For the latter, the corresponding numbers were 77.4% (95% CI: 60.2-87.4) and 99.2% (95% CI: 97.2-99.8). Conclusions. Two tools have been developed for use in clinical practice by gastroenterologists, therapists, and general practitioners to manage IBD patients. Identifying a high-risk IBD patient for developing a life-threatening complication can be used as a foundation for optimizing the therapy used in the treatment of a given patient, potentially saving lives.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"193 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140504746","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}
引用次数: 0
Pyoderma gangrenosum in a patient with onset of inflammatory bowel diseases 一名炎症性肠病患者的脓皮病
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-261-273
Y. Uspensky, Yu. A. Fominykh, O. A. Kizimova, A. Gnutov, E. Kalinina, E. P. Fedotova, R. A. Nasyrov, A. A. Kozobin, R. A. Guchapshev
The course of inflammatory bowel diseases can be complicated by damage to almost all organs and systems, including the eyes, skin, lungs, kidneys, liver, as well as hematopoietic organs and the cardiovascular system. In this case, skin diseases are most often affected, and skin extraintestinal manifestations occur in more than 10% of patients with inflammatory bowel disease. Among the cutaneous extraintestinal manifestations, the second place in prevalence after erythema nodosum is occupied by pyoderma gangrenosum - neutrophilic dermatosis, an idiopathic disease, most often associated with systemic immune-inflammatory conditions, such as rheumatoid arthritis, hemoblastoses or intestinal diseases. Also, this disease is one of the components of such genetically determined syndromes as PAPA, PASH, PAPASH and SAPHO. Difficulties in diagnosing and detecting this condition are due to the lack of a standardized approach to the appointment of these patients, the achievement of the results of randomized trials, and the identification of the reliability of the reliability of drug therapy for pyoderma gangrenosum. This article presents a review of the literature and, as a clinical manifestation, an observation in patients with the onset of inflammatory bowel disease complicated by pyoderma gangrenosum was identified.
几乎所有器官和系统,包括眼睛、皮肤、肺、肾脏、肝脏以及造血器官和心血管系统都会受到损害,从而使炎症性肠病的病程复杂化。在这种情况下,皮肤病最常受到影响,10% 以上的炎症性肠病患者会出现皮肤肠外表现。在皮肤肠外表现中,发病率仅次于结节性红斑的是脓疱疮--嗜中性粒细胞皮肤病,这是一种特发性疾病,多与全身免疫炎症有关,如类风湿性关节炎、血细胞增多症或肠道疾病。此外,这种疾病也是由基因决定的综合征(如 PAPA、PASH、PAPASH 和 SAPHO)的组成部分之一。诊断和检测这种疾病的困难在于缺乏对这些患者的标准化诊治方法、随机试验结果的实现以及脓皮病药物治疗可靠性的鉴定。本文对文献进行了综述,作为临床表现,确定了对脓毒症并发炎症性肠病发病患者的观察结果。
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引用次数: 0
Clinical and morphological characteristics of patients with chronic gastritis and high risk of gastric cancer 慢性胃炎和胃癌高危患者的临床和形态特征
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-107-116
A. Tertychnyy, D. D. Protsenko, N. Pachuashvili, D. P. Nagornaya, P. V. Pavlov, A. P. Kiruhin, A. A. Fedorenko
The purpose of this study is to conduct a clinical and morphological analysis of cases of chronic gastritis with a high risk of gastric cancer (GC). Materials and methods. The study included 26 cases of chronic atrophic gastritis of stages 3 and 4 with a high risk of developing GC according to the assessment using the OLGA system (Operative Link for Gastritis Assessment). The cases were diagnosed on material of gastric tissue biopsy in 2022. In total, 678 histological studies were performed during the year. Cases of chronic gastritis with a high risk of developing GC accounted for 3.8% of all chronic gastritis. Results. Cases of chronic gastritis with a high risk of developing GC were more often observed in older men (average age 67±12 years, ratio 2.25:1). Multifocal atrophic gastritis was in the first place in frequency of occurrence (61.5%), the connection with helicobacter infection was confirmed only in a third of cases (34.6%). Morphological changes were characterized by a predominant lesion of the antrum of the stomach and mixed complete and incomplete intestinal metaplasia. With the exception of one case in which pseudopancreatic metaplasia was detected in the antrum of the stomach, all cases of autoimmune gastritis (n=26) were assigned to stage 2 with a low risk of developing GC, which seems controversial to us. Conclusion. The results of our study showed a high percentage of pre-existing tumor lesions of the stomach in the group of chronic gastritis with a high risk of developing GC. Dysplasia was diagnosed in 5 out of 26 cases, GC with previously performed mucosectomy in 3 out of 26 cases. In addition, the patients had other tumor and precancerous lesions of the gastrointestinal tract. These data show the validity and practical value of using the OLGA system to identify high-risk groups for the development of tumors not only of the stomach, but also of gastrointestinal tumors of other localizations.
本研究旨在对具有胃癌(GC)高风险的慢性胃炎病例进行临床和形态学分析。材料和方法。本研究纳入了 26 例慢性萎缩性胃炎 3 期和 4 期病例,根据 OLGA 系统(胃炎评估手术链接)进行评估,这些病例具有患胃癌的高风险。这些病例是根据 2022 年的胃组织活检材料确诊的。这一年共进行了 678 次组织学研究。慢性胃炎高危病例占所有慢性胃炎病例的3.8%。研究结果高危慢性胃炎病例多见于老年男性(平均年龄为 67±12 岁,比例为 2.25:1)。多灶性萎缩性胃炎的发病率居首位(61.5%),只有三分之一的病例(34.6%)证实与螺旋杆菌感染有关。形态学变化的特征是胃窦部的主要病变以及混合性完全和不完全肠化生。除一例在胃窦部发现假性胰腺化生外,所有自身免疫性胃炎病例(26 例)均被归入第二阶段,发展为 GC 的风险较低,这在我们看来是有争议的。结论我们的研究结果表明,在慢性胃炎组中,胃部原有肿瘤病变的比例较高,患 GC 的风险也较高。在 26 个病例中,有 5 个病例被诊断为增生异常;在 26 个病例中,有 3 个病例被诊断为曾进行过粘液切除术的 GC。此外,患者还伴有其他胃肠道肿瘤和癌前病变。这些数据表明,使用OLGA系统识别高危人群的有效性和实用价值,不仅可以识别胃部肿瘤,还可以识别其他部位的胃肠道肿瘤。
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引用次数: 0
Whipple’s disease: etiology, pathogenesis, clinic, diagnosis and treatment 惠普尔病:病因、发病机制、临床、诊断和治疗
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-238-246
I. N. Kupriyanova, M. V. Stafilova
Whipple’s disease is an infectious, systemic and recurrent disease caused by the gram-positive bacterium Tropheryma whipplei. The disease proceeds with a heterogeneous clinical picture, presenting difficulties of timely diagnosis and in the absence of antibacterial therapy can lethal outcome. This review is devoted to the etiology, pathogenesis, epidemiology, clinical picture, modern diagnosis and therapy of Whipple’s disease.
惠普尔病是由革兰氏阳性细菌惠普尔氏菌(Tropheryma whipplei)引起的一种传染性、全身性和复发性疾病。该病的临床表现多种多样,难以及时诊断,在缺乏抗菌治疗的情况下可导致死亡。本综述主要介绍惠普尔病的病因、发病机制、流行病学、临床表现、现代诊断和治疗。
{"title":"Whipple’s disease: etiology, pathogenesis, clinic, diagnosis and treatment","authors":"I. N. Kupriyanova, M. V. Stafilova","doi":"10.31146/1682-8658-ecg-217-9-238-246","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-238-246","url":null,"abstract":"Whipple’s disease is an infectious, systemic and recurrent disease caused by the gram-positive bacterium Tropheryma whipplei. The disease proceeds with a heterogeneous clinical picture, presenting difficulties of timely diagnosis and in the absence of antibacterial therapy can lethal outcome. This review is devoted to the etiology, pathogenesis, epidemiology, clinical picture, modern diagnosis and therapy of Whipple’s disease.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"211 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140504744","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}
引用次数: 0
Transabdominal ultrasound of the intestine in the diagnosis of inflammatory bowel diseases: a modern view 经腹肠道超声诊断炎症性肠病:现代视角
Pub Date : 2024-01-17 DOI: 10.31146/1682-8658-ecg-217-9-150-161
D. Mukhametova, I. M. Minnemullin, N. Savushkina, E. R. Kirillova, K. A. Zigangirova, D. Abdulganieva
Ultrasound of the intestine is a highly informative, accessible, harmless, mobile, common method of diagnosing inflammatory bowel diseases that does not require special training, has high specificity (95.6%) and sensitivity (89.7%) (depend on the examined area). In recent years, standardized methods have been developed to quantify the results of intestinal ultrasound in inflammatory bowel diseases, the most common of which are the Milan ultrasound criteria for ulcerative colitis, as well as the Sonographic Lesion Index for Crohn’s disease (SLIC), the International Bowel Ultrasound Segmental Activity Score (IBUS-SAS), A simple Ultrasound Activity Score for Crohn’s Disease (SUS-CD) with a satisfactory correlation and an area under the curve. The use of echocontrast drugs (both oral - polyethylene glycol and intravenous - Sonovue) improves the visualization of a number of structures. Purpose: consider the current position of ultrasound for the diagnosis of inflammatory bowel diseases, research technique, specificity and sensitivity of the method, quantitative methods of evaluating indicators, applicability for monitoring the activity of the disease, the presence of complications and the effectiveness of therapy. Materials and methods: in February-June 2023, articles were searched in the databases PubMed, Cyberleninka, Wiley, Oxford University Press, Science Direct with the following keywords: inflammatory bowel disease (IBD), ultrasound, Crohn’s disease, ulcerative colitis, disease activity, ultrasonographic parameters, index, abdominal ultrasonography, sonovue, gastrointestinal Ultrasound (GIUS), Contrast-enhanced ultrasonography (CEUS), epidemiology. Practical guidelines on ultrasound diagnostics, clinical recommendations on Crohn’s disease [regional enteritis] and ulcerative colitis, guidelines of international medical associations, communities, etc. were also used. The search was not limited to years or languages. After reviewing the abstracts of articles or full texts, a decision was made on the suitability of the articles for inclusion in the review. The graphs, diagrams, figures of interest were used as a source for creating own illustrations. Conclusion: ultrasound methods of intestinal examination have a number of advantages, which include high information content, no need for preparation, high availability, prevalence, low cost and harmlessness. Of particular clinical importance is the possibility of evaluation at the patient’s bedside, the use of ultrasound criteria for assessing the activity of IBD and monitoring in dynamics.
肠道超声是诊断炎症性肠病的一种信息量大、简便易行、无害、可移动的常用方法,无需特殊培训,具有较高的特异性(95.6%)和敏感性(89.7%)(取决于检查部位)。近年来,已开发出标准化方法来量化炎症性肠病的肠道超声检查结果,其中最常用的是米兰溃疡性结肠炎超声检查标准、克罗恩病超声病变指数(SLIC)、国际肠道超声节段活动度评分(IBUS-SAS)、克罗恩病简易超声活动度评分(SUS-CD),其相关性和曲线下面积均令人满意。使用回声对比剂(口服聚乙二醇和静脉注射 Sonovue)可改善一些结构的可视化。目的:探讨超声诊断炎症性肠病的现状、研究技术、方法的特异性和敏感性、评价指标的定量方法、监测疾病活动的适用性、并发症的存在和治疗效果。材料与方法:2023 年 2 月至 6 月,在 PubMed、Cyberleninka、Wiley、牛津大学出版社、Science Direct 等数据库中以下列关键词检索文章:炎症性肠病(IBD)、超声、克罗恩病、溃疡性结肠炎、疾病活动、超声参数、指数、腹部超声、sonovue、胃肠超声(GIUS)、对比增强超声(CEUS)、流行病学。此外,还使用了超声诊断实用指南、克罗恩病[区域性肠炎]和溃疡性结肠炎临床建议、国际医学协会和社区指南等。搜索不限年份或语言。在审阅文章摘要或全文后,决定是否将文章纳入综述。感兴趣的图形、图表和数字被用作创建自己插图的来源。结论:超声波肠道检查方法有许多优点,包括信息含量高、无需准备、可用性高、普遍、成本低和无害。特别重要的临床意义在于可以在病人床边进行评估,使用超声标准评估 IBD 的活动性并进行动态监测。
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Experimental and Clinical Gastroenterology
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