Pub Date : 2023-02-28DOI: 10.22416/1382-4376-2022-32-5-31-42
K. Dudina, P. A. Belyy, I. Maev, N. Safiullina, E. Klimova, S. A. Shutko, O. Znoyko, N. D. Yushchuk
Aim: to analyze the dynamics of fibrosis and steatosis of the liver according to fibroelastometry in patients with chronic hep-atitis C (CHC) after ≥ 6 months from transient elastometry (TE) achieving a sustained virologic response (SVR) to antiviral therapy.Materials and methods. At baseline, a prospective observational study included 628 CHC patients with known stage of liver fibrosis (F) before AVT, some of whom were phased out due to non-compliance with the inclusion criteria. The final analysis included 297 patients who had transient elastometry (TE) data with CAP™ technology on the severity of liver fibrosis (± steatosis) before treatment and after ≥ 6 months after reaching SVR (67 % – interferonfree regimens of therapy). Median follow-up from the moment SVR was confirmed was 3 years [2; 6].Results. At the end of the study, the average age of patients was 49 ± 12 years, of which 53 % were men. In the long-term period after reaching SVR, regression of liver fibrosis was diagnosed in 80 % of cases (including in patients with cirrhosis), and the progression of fibrosis was in 3 % of patient. At the same time, regression of liver steatosis was detected only in 31 % of the patient, worsening of the results was in 23 % (26 % of them had the appearance of steatosis (S) of the liver of 1–3 degrees in persons with no fatty liver before the start of AVT). In the group of patients with liver steatosis, the proportion of men was significantly higher (p = 0.004). Clinically significant stages of fibrosis F3–F4 were significantly more often recorded in patients with hepatic steatosis, both before treatment (46 % S1–S3 and 22 % S0, p < 0.001) and after ≥ 6 months after reaching SVR (19 % S1–S3 and 9 % S0, p = 0.023).Conclusion. In patients with chronic hepatitis C with SVR achieved in the long term, despite a significant regression of liver fibrosis, a high prevalence of hepatic steatosis remains. The data obtained indicate the feasibility of routine diagnosis of both fibrosis and steatosis of the liver in the management of patients with chronic HCV infection before and after successful antiviral therapy.
目的:根据纤维弹性测量分析慢性丙型肝炎(CHC)患者在短暂弹性测量(TE)达到抗病毒治疗持续病毒学应答(SVR)≥6个月后肝脏纤维化和脂肪变性的动态。材料和方法。在基线时，一项前瞻性观察性研究纳入了628例AVT前已知肝纤维化分期(F)的CHC患者，其中一些患者因不符合纳入标准而被淘汰。最终分析纳入了297例患者，他们在治疗前和达到SVR(67% -无干扰素治疗方案)≥6个月后，使用CAP™技术获得了肝纤维化(±脂肪变性)严重程度的瞬时弹性测量(TE)数据。SVR确诊后的中位随访时间为3年[2;6) .Results。研究结束时，患者的平均年龄为49±12岁，其中男性占53%。在达到SVR后的长期内，80%的病例(包括肝硬化患者)诊断为肝纤维化消退，3%的患者诊断为肝纤维化进展。同时，只有31%的患者出现肝脂肪变性消退，23%的患者出现肝脂肪变性恶化(其中26%的患者在AVT开始前出现1-3度的肝脂肪变性(S))。在肝脂肪变性患者组中，男性所占比例显著高于男性(p = 0.004)。肝脂肪变性患者在治疗前(46% S1-S3和22% S0, p < 0.001)和达到SVR后≥6个月(19% S1-S3和9% S0, p = 0.023)均记录有临床意义的纤维化F3-F4阶段。在长期实现SVR的慢性丙型肝炎患者中，尽管肝纤维化显著消退，但肝脂肪变性的患病率仍然很高。获得的数据表明，在成功的抗病毒治疗前后，对慢性HCV感染患者进行肝纤维化和肝脂肪变性的常规诊断是可行的。
{"title":"Long-Term Monitoring of Liver Fibrosis and Steatosis in Patients with Chronic Hepatitis C after Achieving a Sustained Virologic Response to Antiviral Therapy","authors":"K. Dudina, P. A. Belyy, I. Maev, N. Safiullina, E. Klimova, S. A. Shutko, O. Znoyko, N. D. Yushchuk","doi":"10.22416/1382-4376-2022-32-5-31-42","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-31-42","url":null,"abstract":"Aim: to analyze the dynamics of fibrosis and steatosis of the liver according to fibroelastometry in patients with chronic hep-atitis C (CHC) after ≥ 6 months from transient elastometry (TE) achieving a sustained virologic response (SVR) to antiviral therapy.Materials and methods. At baseline, a prospective observational study included 628 CHC patients with known stage of liver fibrosis (F) before AVT, some of whom were phased out due to non-compliance with the inclusion criteria. The final analysis included 297 patients who had transient elastometry (TE) data with CAP™ technology on the severity of liver fibrosis (± steatosis) before treatment and after ≥ 6 months after reaching SVR (67 % – interferonfree regimens of therapy). Median follow-up from the moment SVR was confirmed was 3 years [2; 6].Results. At the end of the study, the average age of patients was 49 ± 12 years, of which 53 % were men. In the long-term period after reaching SVR, regression of liver fibrosis was diagnosed in 80 % of cases (including in patients with cirrhosis), and the progression of fibrosis was in 3 % of patient. At the same time, regression of liver steatosis was detected only in 31 % of the patient, worsening of the results was in 23 % (26 % of them had the appearance of steatosis (S) of the liver of 1–3 degrees in persons with no fatty liver before the start of AVT). In the group of patients with liver steatosis, the proportion of men was significantly higher (p = 0.004). Clinically significant stages of fibrosis F3–F4 were significantly more often recorded in patients with hepatic steatosis, both before treatment (46 % S1–S3 and 22 % S0, p < 0.001) and after ≥ 6 months after reaching SVR (19 % S1–S3 and 9 % S0, p = 0.023).Conclusion. In patients with chronic hepatitis C with SVR achieved in the long term, despite a significant regression of liver fibrosis, a high prevalence of hepatic steatosis remains. The data obtained indicate the feasibility of routine diagnosis of both fibrosis and steatosis of the liver in the management of patients with chronic HCV infection before and after successful antiviral therapy.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84442083","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 : 2023-02-12DOI: 10.22416/1382-4376-2022-32-5-95-102
E. Trush, E. Poluektova, A. Beniashvili, O. Shifrin
Aim: to demonstrate the management of a patient with somatization disorder and irritable bowel syndrome.Key points. A 41-yo female patient was admitted with complains of spastic lower abdomen pain, hard stool once every 1–2 days under laxative treatment (macrogol), bloating, anxiety, waiting for confirmation of a life threatening illness, internal stress, difficulty in falling asleep, shallow sleep. Has a long history of disease, characterized by the appearance of a variety of somatic symptoms (headache, tachycardia, joint pain, stool disorders, abdominal pain, etc.) during periods of emotional tension, lack of data suggesting organic disease. No abnormal changes were detected in examination at the clinic (complete blood count, serum chemistry tests, urinalysis or fecal tests, hydrogen and methane breath tests with lactulose, abdominal ultrasound, esophagogastroduodenoscopy, colonoscopy). With the prior agreement of patient, she was consulted by a psychiatrist and diagnosed with somatization disorder and mild anxiety disorder. On discharge from hospital recommended cognitive-behavioral therapy, continue taking macrogol, as well as treatment with Kolofort. After 3 months of complex treatment, there was a significant decrease in the severity of both the symptoms of irritable bowel syndrome and anxiety disorder.Conclusion. For patients whose complaints meet the diagnostic criteria for IBS, a two-stage differential diagnosis may be justified: at the first stage, differentiation of IBS and organic diseases of the gastrointestinal tract is carried out; at the second stage - IBS and somatization disorder. Kolofort can be the drug of choice both in patients with IBS and the pharmacological part of therapy in patients with somatization disorder.
{"title":"Management of a Female Patient with Irritable Bowel Syndrome and Somatoform Disorder","authors":"E. Trush, E. Poluektova, A. Beniashvili, O. Shifrin","doi":"10.22416/1382-4376-2022-32-5-95-102","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-95-102","url":null,"abstract":"Aim: to demonstrate the management of a patient with somatization disorder and irritable bowel syndrome.Key points. A 41-yo female patient was admitted with complains of spastic lower abdomen pain, hard stool once every 1–2 days under laxative treatment (macrogol), bloating, anxiety, waiting for confirmation of a life threatening illness, internal stress, difficulty in falling asleep, shallow sleep. Has a long history of disease, characterized by the appearance of a variety of somatic symptoms (headache, tachycardia, joint pain, stool disorders, abdominal pain, etc.) during periods of emotional tension, lack of data suggesting organic disease. No abnormal changes were detected in examination at the clinic (complete blood count, serum chemistry tests, urinalysis or fecal tests, hydrogen and methane breath tests with lactulose, abdominal ultrasound, esophagogastroduodenoscopy, colonoscopy). With the prior agreement of patient, she was consulted by a psychiatrist and diagnosed with somatization disorder and mild anxiety disorder. On discharge from hospital recommended cognitive-behavioral therapy, continue taking macrogol, as well as treatment with Kolofort. After 3 months of complex treatment, there was a significant decrease in the severity of both the symptoms of irritable bowel syndrome and anxiety disorder.Conclusion. For patients whose complaints meet the diagnostic criteria for IBS, a two-stage differential diagnosis may be justified: at the first stage, differentiation of IBS and organic diseases of the gastrointestinal tract is carried out; at the second stage - IBS and somatization disorder. Kolofort can be the drug of choice both in patients with IBS and the pharmacological part of therapy in patients with somatization disorder.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82609995","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 : 2023-02-01DOI: 10.22416/1382-4376-2022-32-5-51-62
E. Stepanov, V. Ivashkin
Aim: to compare the results of 13C-UBT with the data of morphological analysis of the gastric and duodenal mucosa obtained during gastroduodenoscopy in gastritis and peptic ulcer. To analyze the dependence of the results of diode laser spectroscopy (DLS) based 13C-UBT on age, nosology, activity and severity of the inflammatory process, the degree of atrophy and metaplasia.Materials and methods. The 13C-UBT DLS was performed in 525 patients before the start of eradication therapy and in 196 patients 10–12 weeks after its completion. The breath test was carried out according to a standard protocol using the BSIA patent kit (Great Britain). During endoscopy, 134 patients underwent a biopsy from the upper third of the body of the stomach, the antrum (within 5 cm from the pylorus along the greater curvature) and the duodenal bulb with histological examination with hematoxylin-eosin staining, PAS-reaction and Giemsa. Histological assessment of the state of the gastric mucosa was carried out according to a modified Sydney system with an assessment of morphological changes according to a 4-point visual analog scale (0 to 3+).Results. A total of 525 patients (301 men and 224 women) aged 15–80 years (median 39.8 ± 15.1 years) were examined. 239 (45.5 %) patients were diagnosed with chronic gastritis, chronic duodenitis (including erosive forms). In 286 (54.5 %) patients, peptic ulcer was diagnosed with localization in the stomach — in 42 (8 %), in the duodenum – in 238 (45.3 %), combined lesions — in 9 (1.7 %) cases. Based on the results of 13C-UDT DLS, H. рylori infection was detected in 447 patients. H. рylori was not found in erosive gastritis in 15 %, erosive duodenitis in 21 % and chronic non-erosive gastritis in 23 %. In peptic ulcer of the stomach and duodenum, H. pylori was detected in 93 % and 97 %.A direct linear relationship between the results of the breath test and the quantitative content of H. рylori on the surface of the gastric mucosa was obtained. The parameters of laser 13C-UBT clearly correlate with the degree of severity of mononuclear infiltration of the mucosa (the strength of the connection is 0.78). When comparing the average values of laser 13C-UBT with the total assessment of the degree of mucosal neutrophilic infiltration, no significant relationship was found. With a slight severity of mucosal atrophy, the result of laser based 13C-UBT practically does not change; there is a tendency of a decrease in the breath test with an increase in atrophic changes.Conclusion. Indicators of 13C-UBT correlate with the quantitative content of H. pylori bacteria in the gastric mucosa, the severity of mononuclear infiltration of the gastroduodenal mucous, the severity of atrophic changes.
{"title":"Laser Based 13C-urea Breath Test in Quantitative Assessment of Bacterial Colonization, Severity of Inflammation and Atrophy in Gastric Mucosa","authors":"E. Stepanov, V. Ivashkin","doi":"10.22416/1382-4376-2022-32-5-51-62","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-51-62","url":null,"abstract":"Aim: to compare the results of 13C-UBT with the data of morphological analysis of the gastric and duodenal mucosa obtained during gastroduodenoscopy in gastritis and peptic ulcer. To analyze the dependence of the results of diode laser spectroscopy (DLS) based 13C-UBT on age, nosology, activity and severity of the inflammatory process, the degree of atrophy and metaplasia.Materials and methods. The 13C-UBT DLS was performed in 525 patients before the start of eradication therapy and in 196 patients 10–12 weeks after its completion. The breath test was carried out according to a standard protocol using the BSIA patent kit (Great Britain). During endoscopy, 134 patients underwent a biopsy from the upper third of the body of the stomach, the antrum (within 5 cm from the pylorus along the greater curvature) and the duodenal bulb with histological examination with hematoxylin-eosin staining, PAS-reaction and Giemsa. Histological assessment of the state of the gastric mucosa was carried out according to a modified Sydney system with an assessment of morphological changes according to a 4-point visual analog scale (0 to 3+).Results. A total of 525 patients (301 men and 224 women) aged 15–80 years (median 39.8 ± 15.1 years) were examined. 239 (45.5 %) patients were diagnosed with chronic gastritis, chronic duodenitis (including erosive forms). In 286 (54.5 %) patients, peptic ulcer was diagnosed with localization in the stomach — in 42 (8 %), in the duodenum – in 238 (45.3 %), combined lesions — in 9 (1.7 %) cases. Based on the results of 13C-UDT DLS, H. рylori infection was detected in 447 patients. H. рylori was not found in erosive gastritis in 15 %, erosive duodenitis in 21 % and chronic non-erosive gastritis in 23 %. In peptic ulcer of the stomach and duodenum, H. pylori was detected in 93 % and 97 %.A direct linear relationship between the results of the breath test and the quantitative content of H. рylori on the surface of the gastric mucosa was obtained. The parameters of laser 13C-UBT clearly correlate with the degree of severity of mononuclear infiltration of the mucosa (the strength of the connection is 0.78). When comparing the average values of laser 13C-UBT with the total assessment of the degree of mucosal neutrophilic infiltration, no significant relationship was found. With a slight severity of mucosal atrophy, the result of laser based 13C-UBT practically does not change; there is a tendency of a decrease in the breath test with an increase in atrophic changes.Conclusion. Indicators of 13C-UBT correlate with the quantitative content of H. pylori bacteria in the gastric mucosa, the severity of mononuclear infiltration of the gastroduodenal mucous, the severity of atrophic changes. ","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78399066","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 : 2023-01-30DOI: 10.22416/1382-4376-2022-32-5-70-74
A. Sheptulin
Aim: to present an analysis of the published materials of the consensus “Maastricht-VI” on the management of patients with Helicobacter pylori (H. рylori) infection.Key points. The content of the new consensus “Maastricht-VI” largely corresponds to that of the previous “Maastricht-V” consensus. This refers to the methods of diagnostics of this infection, indications for eradication. The introduction of eradication schemes of the 3rd and 4th lines, as well as a double scheme with increased doses of proton pump inhibitors (PPI) and amoxicillin can be considered new. The important role of measures that increase the effectiveness of eradication (14-day duration of the course, increasing the dose of PPI, the use of probiotics) is emphasized.Conclusion. The publication of materials of the new consensus “Maastricht-VI” will contribute to improving the results of H. рylori eradication therapy.
{"title":"The Main Statements of the Consensus “Maastricht-VI” (2022) on the Diagnostics and Treatment of Helicobacter pylori Infection","authors":"A. Sheptulin","doi":"10.22416/1382-4376-2022-32-5-70-74","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-70-74","url":null,"abstract":"Aim: to present an analysis of the published materials of the consensus “Maastricht-VI” on the management of patients with Helicobacter pylori (H. рylori) infection.Key points. The content of the new consensus “Maastricht-VI” largely corresponds to that of the previous “Maastricht-V” consensus. This refers to the methods of diagnostics of this infection, indications for eradication. The introduction of eradication schemes of the 3rd and 4th lines, as well as a double scheme with increased doses of proton pump inhibitors (PPI) and amoxicillin can be considered new. The important role of measures that increase the effectiveness of eradication (14-day duration of the course, increasing the dose of PPI, the use of probiotics) is emphasized.Conclusion. The publication of materials of the new consensus “Maastricht-VI” will contribute to improving the results of H. рylori eradication therapy.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82707053","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 : 2023-01-12DOI: 10.22416/1382-4376-2022-32-5-89-94
D. A. Semenov, S. Shapovalyants, D. Seleznev, O. Yudin, S. Korolev, N. A. Gracheva, L. Mikhaleva, K. S. Paramonenko
Aim: to present a clinical case of a patient with a complicated course of acute pancreatitis.Key points. A 31-year-old patient was admitted to the surgical department with a clinical picture of acute alcoholic pancreatitis. Signs of anemia were regarded as a consequence of gastrointestinal bleeding. Computed tomography with contrast enhancement, along with an increase in the size of the pancreas, the presence of foci of pancreatic necrosis with multiple fluid accumulations in the parapancreatic space, revealed smoothed gaustration and thickening of the walls of the predominantly transverse colon. During colonoscopy, ischemic changes of the colon mucosa were detected in a timely manner. Negative results of analysis for toxins A and B of Clostridioides difficile and pathogenic intestinal flora were obtained. By the means of intensive care, it was possible to achieve complete stabilization of the patient's condition, normalization of laboratory blood parameters and relief of ischemic processes in the colon wall.Conclusion. Ischemic changes of the colon can serve as a complication of acute pancreatitis. A thorough analysis of the results of computed tomography at the first signs of colon lesion and colonoscopy contributed to the rapid detection of complications and prevention of irreversible colon ischemia.
{"title":"Ischemic Changes in the Mucous Membrane of the Transverse Colon as a Complication of Acute Pancreatitis","authors":"D. A. Semenov, S. Shapovalyants, D. Seleznev, O. Yudin, S. Korolev, N. A. Gracheva, L. Mikhaleva, K. S. Paramonenko","doi":"10.22416/1382-4376-2022-32-5-89-94","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-89-94","url":null,"abstract":"Aim: to present a clinical case of a patient with a complicated course of acute pancreatitis.Key points. A 31-year-old patient was admitted to the surgical department with a clinical picture of acute alcoholic pancreatitis. Signs of anemia were regarded as a consequence of gastrointestinal bleeding. Computed tomography with contrast enhancement, along with an increase in the size of the pancreas, the presence of foci of pancreatic necrosis with multiple fluid accumulations in the parapancreatic space, revealed smoothed gaustration and thickening of the walls of the predominantly transverse colon. During colonoscopy, ischemic changes of the colon mucosa were detected in a timely manner. Negative results of analysis for toxins A and B of Clostridioides difficile and pathogenic intestinal flora were obtained. By the means of intensive care, it was possible to achieve complete stabilization of the patient's condition, normalization of laboratory blood parameters and relief of ischemic processes in the colon wall.Conclusion. Ischemic changes of the colon can serve as a complication of acute pancreatitis. A thorough analysis of the results of computed tomography at the first signs of colon lesion and colonoscopy contributed to the rapid detection of complications and prevention of irreversible colon ischemia.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88238697","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 : 2023-01-12DOI: 10.22416/1382-4376-2022-32-5-43-50
A. Dolgushina, A. Selyanina, V. V. Dubrovina, G. A. Isyangildina, E. R. Olevskaya
Aim: to study the significance of prognostic scales in a target group of patients with primary sclerosing cholangitis (PSC) living in the Chelyabinsk region.Materials and methods. The study included 21 patients with a confirmed diagnosis of primary sclerosing cholangitis (PSC) and a disease duration of at least two years. The primary endpoint studied was death. The MELD, Mayo Risk Score, Amsterdam-Oxford PSC Score, PREsTo score, and UK-PSC Score scales were calculated based on the medical records. Statistical processing was carried out using the SPSS Statistics v.22 application.Results. A retrospective assessment of the risk of mortality using the MELD, Mayo Risk Score and Amsterdam-Oxford PSC Score did not reveal a statistically significant difference between deceased and surviving patients. The UK-PSC Score scale showed the highest predictive value (p = 0.046).Conclusion. The new predictive model UK-PSC Score showed advantages in predicting death in PSC patients compared to other scales.
{"title":"Prognostic Models of Primary Sclerosing Cholangitis","authors":"A. Dolgushina, A. Selyanina, V. V. Dubrovina, G. A. Isyangildina, E. R. Olevskaya","doi":"10.22416/1382-4376-2022-32-5-43-50","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-43-50","url":null,"abstract":"Aim: to study the significance of prognostic scales in a target group of patients with primary sclerosing cholangitis (PSC) living in the Chelyabinsk region.Materials and methods. The study included 21 patients with a confirmed diagnosis of primary sclerosing cholangitis (PSC) and a disease duration of at least two years. The primary endpoint studied was death. The MELD, Mayo Risk Score, Amsterdam-Oxford PSC Score, PREsTo score, and UK-PSC Score scales were calculated based on the medical records. Statistical processing was carried out using the SPSS Statistics v.22 application.Results. A retrospective assessment of the risk of mortality using the MELD, Mayo Risk Score and Amsterdam-Oxford PSC Score did not reveal a statistically significant difference between deceased and surviving patients. The UK-PSC Score scale showed the highest predictive value (p = 0.046).Conclusion. The new predictive model UK-PSC Score showed advantages in predicting death in PSC patients compared to other scales.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83206070","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 : 2023-01-09DOI: 10.22416/1382-4376-2022-32-5-24-30
I. A. Baranova, A. V. Baranov
Aim. To present data of Russian and foreign studies on the prevalence, pathogenesis and clinical picture of gastrointestinal tract (GIT) pathology in patients with primary hyperparathyroidism (PHPT).Key point. At the beginning of the 20th century PHPT was considered a severe endocrine disease with specific bone and kidney complications, however in 1957 W.T. St Goar proposed a mnemonic triad to recognize this pathology as “diseases of stones, bones and abdominal groans”. A high frequency of gastrointestinal complaints, peptic ulcer, pancreatitis, cholelithiasis in patients with PHPT has been reported. Hyperparathyroidism has been shown to cause smooth muscle atony with specific upper and lower GI symptoms such as nausea, heartburn and constipation. The prevalence of peptic ulcer in patients with PHPT, according to studies of the 50s–60s of the last century, ranged from 10 to 25 %. However, studies linking PHPT to peptic ulcer development were performed before the advent of proton 1). On the other hand, the development of pancreatitis in PHPT is one of the most studied pathologies. In developing countries its frequency can reach 10–20 % due to the absence of routine screening for blood calcium. Some authors report the impact of elevated parathyroid hormone levels on the formation of gallbladder stones by inhibiting of gallbladder emptying, hepatic bile secretion and mobility of the sphincter Oddi, and changing of the bile composition. A number of studies have found an increased risk of developing malignant neoplasms of the intestine, especially the colon, in patients with PHPT.Conclusion. The digestive manifestations of parathyroid dysfunction in patients can often be overlooked, and serum calcium levels should be included in the routine examination in the presence of abdominal symptoms.
的目标。介绍国内外关于原发性甲状旁腺功能亢进(PHPT)患者胃肠道(GIT)病理的患病率、发病机制及临床资料。关键。在20世纪初，PHPT被认为是一种严重的内分泌疾病，伴有特定的骨骼和肾脏并发症，然而在1957年，W.T. St Goar提出了一种记忆三联症，将这种病理识别为“结石、骨骼和腹部呻吟的疾病”。据报道，PHPT患者的胃肠道主诉、消化性溃疡、胰腺炎、胆石症的发生率很高。甲状旁腺功能亢进已被证明会引起平滑肌张力失调，并伴有特定的上消化道和下消化道症状，如恶心、胃灼热和便秘。根据上世纪50 - 60年代的研究，PHPT患者中消化性溃疡的患病率从10%到25%不等。然而，将PHPT与消化性溃疡发展联系起来的研究是在质子(1)出现之前进行的。另一方面，PHPT中胰腺炎的发展是研究最多的病理之一。在发展中国家，由于缺乏血钙常规筛查，其发病率可达10 - 20%。一些作者报道了甲状旁腺激素水平升高通过抑制胆囊排空、肝胆汁分泌和Oddi括约肌的运动以及改变胆汁成分对胆囊结石形成的影响。许多研究发现，phpt患者发生肠道恶性肿瘤的风险增加，尤其是结肠恶性肿瘤。甲状旁腺功能障碍患者的消化表现常被忽视，在出现腹部症状时应将血钙水平纳入常规检查。
{"title":"Pathology of the Gastrointestinal Tract in Patients with Primary Hyperparathyroidism","authors":"I. A. Baranova, A. V. Baranov","doi":"10.22416/1382-4376-2022-32-5-24-30","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-24-30","url":null,"abstract":"Aim. To present data of Russian and foreign studies on the prevalence, pathogenesis and clinical picture of gastrointestinal tract (GIT) pathology in patients with primary hyperparathyroidism (PHPT).Key point. At the beginning of the 20th century PHPT was considered a severe endocrine disease with specific bone and kidney complications, however in 1957 W.T. St Goar proposed a mnemonic triad to recognize this pathology as “diseases of stones, bones and abdominal groans”. A high frequency of gastrointestinal complaints, peptic ulcer, pancreatitis, cholelithiasis in patients with PHPT has been reported. Hyperparathyroidism has been shown to cause smooth muscle atony with specific upper and lower GI symptoms such as nausea, heartburn and constipation. The prevalence of peptic ulcer in patients with PHPT, according to studies of the 50s–60s of the last century, ranged from 10 to 25 %. However, studies linking PHPT to peptic ulcer development were performed before the advent of proton 1). On the other hand, the development of pancreatitis in PHPT is one of the most studied pathologies. In developing countries its frequency can reach 10–20 % due to the absence of routine screening for blood calcium. Some authors report the impact of elevated parathyroid hormone levels on the formation of gallbladder stones by inhibiting of gallbladder emptying, hepatic bile secretion and mobility of the sphincter Oddi, and changing of the bile composition. A number of studies have found an increased risk of developing malignant neoplasms of the intestine, especially the colon, in patients with PHPT.Conclusion. The digestive manifestations of parathyroid dysfunction in patients can often be overlooked, and serum calcium levels should be included in the routine examination in the presence of abdominal symptoms.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"264 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76310897","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 : 2023-01-08DOI: 10.22416/1382-4376-2022-32-5-75-88
M. Reshetova, O. Zolnikova, V. Ivashkin, K. Ivashkin, S. Appolonova, T. Lapina
Aim: to provide information on the results of recent scientific research in the field of non-alcoholic fatty liver disease (NAFLD) metabolomic profiling.Key points. Metabolites of microbial origin are important biological molecules involved in many specific reactions of the human body. This literature review presents the results of recent studies in the field of metabolomics in patients with NAFLD. A more detailed understanding of the role of individual metabolites or their combinations in the NAFLD pathogenesis will allow us to determine the vector of further diagnostic and therapeutic approaches for this nosology. The research results of the probiotics effect on the levels of certain metabolites are currently being discussed.Conclusion. New research data in the field of studying the human metabolomic profile are presented. The results allow us to summarize the effects of microbial agents and their metabolites in the formation of changes in the liver parenchyma in the context of NAFLD. Changes in the level of endogenous ethanol, secondary bile acids, aromatic amino acids, branched chain amino acids, etc. have been described. Correlation between metabolites and certain bacterial strains has been established. A correlation between the ratio of bacteria types and clinical/laboratory parameters was noted in patients taking prebiotics.
{"title":"Gut Microbiota and its Metabolites in Pathogenesis of NAFLD","authors":"M. Reshetova, O. Zolnikova, V. Ivashkin, K. Ivashkin, S. Appolonova, T. Lapina","doi":"10.22416/1382-4376-2022-32-5-75-88","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-75-88","url":null,"abstract":"Aim: to provide information on the results of recent scientific research in the field of non-alcoholic fatty liver disease (NAFLD) metabolomic profiling.Key points. Metabolites of microbial origin are important biological molecules involved in many specific reactions of the human body. This literature review presents the results of recent studies in the field of metabolomics in patients with NAFLD. A more detailed understanding of the role of individual metabolites or their combinations in the NAFLD pathogenesis will allow us to determine the vector of further diagnostic and therapeutic approaches for this nosology. The research results of the probiotics effect on the levels of certain metabolites are currently being discussed.Conclusion. New research data in the field of studying the human metabolomic profile are presented. The results allow us to summarize the effects of microbial agents and their metabolites in the formation of changes in the liver parenchyma in the context of NAFLD. Changes in the level of endogenous ethanol, secondary bile acids, aromatic amino acids, branched chain amino acids, etc. have been described. Correlation between metabolites and certain bacterial strains has been established. A correlation between the ratio of bacteria types and clinical/laboratory parameters was noted in patients taking prebiotics.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89009715","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 : 2023-01-08DOI: 10.22416/1382-4376-2022-32-5-103-108
A. Sheptulin
Aim: to present an analysis of the Russian abstracts published in the materials of the 30th. United European Gastroenterology Week (UEGW).Key points. In the materials of 30 UEGW, 17 abstracts of Russian authors from Moscow, St. Petersburg, Novosibirsk, Kazan and other cities were published. The abstracts were devoted to topical issues of pathogenesis, diagnosis and treatment of intestinal liver and pancreatic diseases.Conclusion. Analysis of the published abstracts testifies to the high scientific level and large practical significance of the conducted research.
{"title":"Review of Russian Abstracts Accepted for United European Gastroenterology Week (2022)","authors":"A. Sheptulin","doi":"10.22416/1382-4376-2022-32-5-103-108","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-103-108","url":null,"abstract":"Aim: to present an analysis of the Russian abstracts published in the materials of the 30th. United European Gastroenterology Week (UEGW).Key points. In the materials of 30 UEGW, 17 abstracts of Russian authors from Moscow, St. Petersburg, Novosibirsk, Kazan and other cities were published. The abstracts were devoted to topical issues of pathogenesis, diagnosis and treatment of intestinal liver and pancreatic diseases.Conclusion. Analysis of the published abstracts testifies to the high scientific level and large practical significance of the conducted research.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88506831","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 : 2022-12-30DOI: 10.22416/1382-4376-2022-32-6-60-64
R. Sayfutdinov, R. R. Saifutdinov, R. R. Akhunova, T. V. Saifutdinova, G. Absalyamova, T. V. Dvoryankina, G. R. Akhunova
Aim: to present a clinical case of antiphospholipid syndrome (APS) manifested as recurrent portal vein thrombosis in a man with a medical history of other thromboses.Key points. APS is a syndrome that includes venous and/or arterial thrombosis, various forms of obstetric pathology, thrombocytopenia, as well as a variety of neurological, skin, cardiovascular and hematological disorders. The article presents a clinical case of a male patient with several episodes of vascular thrombosis, two of which (thrombophlebitis of the veins of the lower extremities and stroke) developed at the age of 39 years, and recurrent thrombosis of the portal vein since 2018. For several years, the patient had the diagnosis of cirrhosis based on the presence of signs of portal hypertension. However, the patient's liver function remained practically intact all the time. During the current examination, APS was suspected, and the result of a blood test for antibodies against phospholipids was positive.Conclusion. This clinical case of APS reflects the difficulties in diagnosing this disease. It should be remembered that cases of thrombosis at a young age may be due to APS.
{"title":"Antiphospholipid Syndrome as a Cause of Recurrent Portal Vein Thrombosis in a Man with a Medical History of other Thrombosis","authors":"R. Sayfutdinov, R. R. Saifutdinov, R. R. Akhunova, T. V. Saifutdinova, G. Absalyamova, T. V. Dvoryankina, G. R. Akhunova","doi":"10.22416/1382-4376-2022-32-6-60-64","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-6-60-64","url":null,"abstract":"Aim: to present a clinical case of antiphospholipid syndrome (APS) manifested as recurrent portal vein thrombosis in a man with a medical history of other thromboses.Key points. APS is a syndrome that includes venous and/or arterial thrombosis, various forms of obstetric pathology, thrombocytopenia, as well as a variety of neurological, skin, cardiovascular and hematological disorders. The article presents a clinical case of a male patient with several episodes of vascular thrombosis, two of which (thrombophlebitis of the veins of the lower extremities and stroke) developed at the age of 39 years, and recurrent thrombosis of the portal vein since 2018. For several years, the patient had the diagnosis of cirrhosis based on the presence of signs of portal hypertension. However, the patient's liver function remained practically intact all the time. During the current examination, APS was suspected, and the result of a blood test for antibodies against phospholipids was positive.Conclusion. This clinical case of APS reflects the difficulties in diagnosing this disease. It should be remembered that cases of thrombosis at a young age may be due to APS.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81533699","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}
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