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Treatment of Functional Dyspepsia in Outpatients after COVID-19 Infection COVID-19感染后门诊患者功能性消化不良的治疗
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-47-52
M. S. Turchina, Yu. M. Morozov, T. I. Obolenskaya
Aim: to compare the efficacy of different therapeutic regimens for managing functional dyspepsia in outpatients after COVID-19 infection.Materials and methods. 42 post-COVID-19 outpatients (age: 26–47 years) diagnosed with functional dyspepsia (FD) according to the Rome IV Criteria were enrolled in two parallel groups. All patients were divided in 2 groups by randomization: Group 1 received omeprazole at a dose of 80 mg/day, Group 2 received a combination of omeprazole and Kolofort® (a combined action drug product containing technologically processed antibodies to S100, TNF-alpha, and histamine) at a dose of 80 mg/day. At baseline and after treatment, a 10-point VAS was used to measure symptoms and an SF-36 questionnaire to evaluate the quality of life.Results. By Day 28 of the treatment, the intensity of epigastric pain (VAS score) in the group receiving proton-pump inhibitor (PPI) + Kolofort® was significantly lower. In both groups, fully resolved dyspeptic syndrome was observed in up to 90 % of patients, without significant differences (p < 0.06). According to the SF-36 data, a combination treatment resulted in higher scores (pain and general health subscales) as compared to the PPI alone.Conclusion. Kolofort® relieves symptoms and improves the quality of life when added to the treatment regimen against functional dyspepsia in post-COVID-19 patients.
目的:比较不同治疗方案对新型冠状病毒感染后门诊患者功能性消化不良的治疗效果。材料和方法。42例根据Rome IV标准诊断为功能性消化不良(FD)的covid -19后门诊患者(年龄:26-47岁)被纳入两个平行组。所有患者被随机分为两组:第一组接受奥美拉唑治疗,剂量为80 mg/天;第二组接受奥美拉唑联合Kolofort®(一种含有S100、tnf - α和组胺抗体的联合作用药物)治疗,剂量为80 mg/天。在基线和治疗后,使用10分VAS来测量症状,并使用SF-36问卷来评估生活质量。治疗第28天,质子泵抑制剂(PPI) + Kolofort®治疗组胃脘痛强度(VAS评分)明显降低。在两组中,高达90%的患者完全缓解消化不良综合征,差异无统计学意义(p < 0.06)。根据SF-36数据,与单独使用PPI相比,联合治疗可获得更高的评分(疼痛和一般健康亚量表)。在covid -19后患者的功能性消化不良治疗方案中加入Kolofort®可缓解症状并改善生活质量。
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引用次数: 0
Diagnostic Possibilities of Determining the Level of Faecal Calprotectin in Clinical Practice 测定粪便钙保护蛋白水平在临床中的诊断价值
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-53-59
A. Sheptulin, S. Kardasheva, A. A. Kurbatova
Aim: to analyze the publications devoted to the modern possibilities of determining the level of faecal calprotectin (FCP) in the diagnosis of various diseases.Key points. In patients with already established diagnosis of inflammatory bowel diseases (IBD), dynamic monitoring of the level of FCP allows to assess the course and prognosis of the disease, as well as the effectiveness of treatment. The determining of FCP helps in the primary diagnosis of IBD (ulcerative colitis, Crohn's disease, microscopic colitis), contributing to their differentiation from functional bowel disorders, as well as in assessing the course of diverticular intestinal disease and celiac disease. The possibility of using FCP as a marker of colorectal cancer (CRC) and adenomatous polyps of the colon is also discussed.Conclusion. Determining the level of FCP plays an important role in the diagnosis and assessment of the course of a number of gastroenterological diseases (primarily IBD). The significance of FCP as a marker of CRC requires further research.
目的:分析有关测定粪便钙保护蛋白(FCP)水平在各种疾病诊断中的现代可能性的出版物。要点。对于已经确诊为炎症性肠病(IBD)的患者,动态监测FCP水平可以评估疾病的病程和预后,以及治疗的有效性。FCP的测定有助于IBD(溃疡性结肠炎、克罗恩病、显微镜下结肠炎)的初步诊断,有助于将其与功能性肠道疾病区分开来,也有助于评估肠憩室病和乳糜泻的病程。本文还讨论了FCP作为结直肠癌和结肠腺瘤性息肉标志物的可能性。测定FCP水平在许多胃肠疾病(主要是IBD)的诊断和评估过程中起着重要作用。FCP作为结直肠癌标志物的意义有待进一步研究。
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引用次数: 0
Successful Combined Treatment of a Patient with Borderline Resectable Liver Metastasis of Colorectal Cancer 结直肠癌交界性可切除肝转移患者的成功联合治疗
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-65-71
O. Stukalova, A. Polikarpov, A. Moiseenko, D. A. Granov
Aim: to present the value of interventional radiology techniques in the treatment of a patient with liver metastasis of colorectal cancer.Key points. In 2013, a 60-year-old patient with stage IIIB sigmoid colon cancer, pT3N2M0 underwent resection of the sigmoid colon with the formation of hardware rectosigmoanastomosis, 6 courses of adjuvant chemotherapy were performed. In 2015, a control examination revealed metastatic liver damage. Liver resection could not be performed due to the small future residual volume, and systemic chemotherapy was not effective. The patient underwent 3 cycles of regional chemotherapy. Taking into account the pronounced positive dynamics, in the form of a decrease in tumor size and a decrease in cancer markers, the patient managed to perform an extended right-sided hemihepatectomy. No progression of the tumor process was detected during the follow-up.Conclusion. Modern possibilities of X-ray endovascular methods allow to achieve results in the treatment of patients with colorectal cancer metastases in the liver such as a decrease in metastases in size, that make liver resection possible.
目的:探讨介入放射技术在大肠癌肝转移患者治疗中的应用价值。要点。2013年,60岁乙状结肠IIIB期pT3N2M0患者行乙状结肠切除术,形成硬直肠-乙状结肠吻合,辅助化疗6个疗程。2015年,对照检查显示转移性肝损伤。术后残余体积小,不能行肝切除,全身化疗无效。患者接受了3个周期的局部化疗。考虑到明显的积极动态,以肿瘤大小减少和癌症标志物减少的形式,患者成功地进行了扩展的右侧半肝切除术。随访期间未见肿瘤进展。现代x线血管内方法的可能性使得治疗肝转移的结直肠癌患者的效果得以实现,例如转移灶的缩小,这使得肝切除术成为可能。
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引用次数: 0
First Russian Gastroenterology Olympiad 首届俄罗斯胃肠病学奥林匹克竞赛
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-94-98
V. Ivashkin, E. Baranskaya, Y. Shulpekova, S. Kardasheva, N. Dzhakhaya
On October 21, 22, 23, 2022, within the framework of the 122nd International Session of the National School of Gastroenterology, Hepatology (NSGH) of the Russian Gastroenterological Association (RGA), the First Russian Gastroenterology Olympiad was held.
2022年10月21日、22日、23日,在俄罗斯胃肠病学协会(RGA)国家胃肠病学、肝病学院(NSGH)第122届国际会议框架内,首届俄罗斯胃肠病学奥林匹克竞赛举行。
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引用次数: 1
Factors of Organizing Surgical Treatment of Upper Gastrointestinal Cancers and Patient Survival: Real-World Data 组织上消化道肿瘤手术治疗与患者生存的因素:真实世界数据
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-20-30
D. Andreev, A. Zavyalov
Aim: to analyze the safety and effectiveness of the method of cold snaring resection with preliminary hydropreparation when removing superficially colorectal epithelial neoplasms with a diameter of 5 to 25 mm.Material and methods. The number of complications and disease recurrence after endoscopic excisions by “cold” snaring resection with preliminary hydropreparation of superficially neoplasms with a diameter of 5 to 25 mm was assessed.Results. Neoplasms were removed in a single block in 89/122 (72.95 %) cases. Neoplasms with a diameter of 5 to 9 mm were excisions in a single block in 100 % of cases, with a diameter of 9 to 14 mm in 28/30 (93.33 %) cases, with a diameter of 15 to 19 mm in 12/38 (31.57 %) cases. According to the results of a lifetime pathoanatomic examination of the removed material, serrated dysplasia (serrated dysplasia, low grade) was detected in 76 cases; micro vesicular hyperplastic polyps (Hyperplastic polyp, micro vesicular type MVHP) were established in 9 cases; hyperplastic polyps containing goblet cells (Hyperplastic polyp, goblet cell GCHP) were in 5 cases; tubular adenoma with dysplasia (Tubular adenoma, low grade) was in 32 cases. Delayed bleeding and perforation of the intestinal wall, both at the time of resection, and in the delayed period was not observed. No local recurrence was detected in the groups of patients with neoplasms diameters of 5-9 and 10-14 mm. One case of local recurrence was detected in a group of patients with a neoplasms diameter from 15 to 19 mm (1/38 = 2.63 %) and one case in a group with a neoplasms diameter of 20-25 mm (1/5 = 20 %).Conclusions. Cold endoscopic snaring resection of colorectal epithelial neoplasms with preliminary hydropreparation in the submucosa is a safe and effective method of excisions superficially epithelial neoplasms of the colon with a diameter of 5 to 19 mm.
目的:探讨冷捕术加预备水切除直径为5 ~ 25mm的浅表结直肠上皮性肿瘤的安全性和有效性。对5 ~ 25mm浅表肿瘤进行初步水处理的“冷”陷阱内镜切除后的并发症和疾病复发率进行了评估。89/122(72.95%)的肿瘤被单个切除。直径5 ~ 9mm的肿瘤100%为单块切除,直径9 ~ 14mm的28/30(93.33%),直径15 ~ 19mm的12/38(31.57%)。根据对切除材料的终身病理解剖检查结果,76例检出锯齿状发育不良(低分级);微泡型增生性息肉(hyperplastic polyp, microvesicular type MVHP) 9例;含杯状细胞的增生性息肉(hyperplastic polyp, goblet cell GCHP) 5例;管状腺瘤伴不典型增生(低级别管状腺瘤)32例。未观察到在切除时和延迟期间的肠壁延迟出血和穿孔。肿瘤直径5 ~ 9 mm和10 ~ 14 mm两组均未见局部复发。肿瘤直径15 ~ 19mm组局部复发1例(1/38 = 2.63%),肿瘤直径20 ~ 25mm组局部复发1例(1/5 = 20%)。冷内镜下粘膜下层预备水切除结直肠上皮性肿瘤是一种安全有效的结肠浅表上皮性肿瘤切除方法,直径为5 ~ 19mm。
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引用次数: 0
Evaluation of the Clinical Efficacy of Prednisolone in the Treatment of Inflammatory Bowel Diseases with Different Dosage Methods 强的松龙不同剂量法治疗炎症性肠病的临床疗效评价
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-40-46
O. P. Alekseeva, S. V. Krishtopenko, A. Alekseeva
Aim: to investigate the clinical efficacy of two methods of oral dosing of prednisolone (in mg and mg/kg) for the induction of remission for patients with ulcerative colitis (UC) and Crohn's disease (CD) using the technology of constructing and evaluating the effectiveness function (dose-effect relationship).Material and methods. In this study were included 86 patients aged from 18 to 65 years with moderate or severe active inflammatory bowel disease (61 — UC, 25 — CD). All patients were treated with prednisolone at an initial daily dose from 30 to 60 mg with a subsequent tapering of dose. The clinical response to treatment was evaluated at the time of complete withdrawal of prednisolone using the generally accepted criteria. Two efficiency functions were constructed, compared and analyzed: the first — at the initial dosage of prednisolone in mg and the second calculating the dose in mg/kg of patient weight. The patients' body weight ranged from 41 to 98 kg. The “dose-effect” relationship for prednisolone was constructed with statistical transformation of the baseline clinical data and a quantitative expression of the actual doses and alternative responses into a graph of the effectiveness function. The mean value at each point was estimated based on the regression kernel scoring method.Results. Two graphs of the “dose-effect” of prednisolone in mg and mg/kg of patient weight were constructed. The optimal clinically effective dose (OCED) when calculated in mg/kg of weight was 0.70 ± 0.01 (0.68 + 0.72) mg/kg with the corresponding effect 79.25 ± 6.26 (66.62 91.88) %. When two graphs in mg and mg / kg of weight were superimposed, it is shown that when an initial dose of 40 mg is prescribed without taking into account the patient's weight, the effect of therapy will be 25 % lower. Prescribing a dose of 60 mg per day without weight will be optimal for patients with a body weight of 85-90 kg. With a lower body weight, the clinical effect will not decrease, but the likelihood of recognized side effects of prednisolone should be expected in proportion to the decrease in body weight.Conclusion. The clinical efficacy of two methods of prednisolone dosing (mg and mg/kg) for patients with IBD during the first induction course was compared.Using a new technology for constructing and evaluating the effectiveness function (dose-effect relationship) allowed us to prove a reliable relationship between the body weight of patients with the clinical effect of prednisolone in patients with UC and CD. Based on the analysis of the dose-effect relationship, the optimal clinically effective dose of prednisolone for patients with UC and CD during the first induction course was established, equal to 0.70 mg/kg, which can be recommended for use in clinical practice for calculating individual doses.
目的:采用构建和评价疗效函数(量效关系)的技术,探讨两种口服给药强的松龙(mg/kg和mg/kg)诱导溃疡性结肠炎(UC)和克罗恩病(CD)患者缓解的临床疗效。材料和方法。本研究纳入了86例年龄在18 - 65岁的中重度炎症性肠病患者(61 - UC, 25 - CD)。所有患者接受泼尼松龙治疗,初始日剂量为30 - 60mg,随后逐渐减少剂量。在完全停用强的松龙时,使用普遍接受的标准评估对治疗的临床反应。构建了两个效率函数,并对其进行了比较和分析:第一个效率函数以强的松龙初始剂量mg为单位计算,第二个效率函数以患者体重mg/kg为单位计算。患者体重为41 ~ 98 kg。强的松龙的“剂量-效应”关系是通过对基线临床数据进行统计转换,并将实际剂量和替代反应定量表达为有效性函数图来构建的。采用回归核评分法对各点的均值进行估计。构建了两张强的松龙在mg和mg/kg患者体重中的“剂量效应”图。最佳临床有效剂量(OCED)(以mg/kg体重计算)为0.70±0.01 (0.68 + 0.72)mg/kg,相应的有效率为79.25±6.26(66.62 91.88)%。当两张以mg和mg / kg重量表示的图表叠加在一起时,可以看出,如果在不考虑患者体重的情况下开出40 mg的初始剂量,治疗效果会降低25%。对于体重为85-90公斤的患者,处方剂量为每天60毫克,不加体重。体重降低时,临床效果不会降低,但预期泼尼松龙出现已知副作用的可能性应与体重降低成比例。比较两种泼尼松龙给药方式(mg和mg/kg)对IBD患者首次诱导疗程的临床疗效。我们采用了一种新的构建和评价疗效函数(剂量效应关系)的技术,证明了UC和CD患者的体重与强的松龙临床疗效之间存在可靠的关系。在对剂量效应关系分析的基础上,确定了UC和CD患者第一诱导疗程中强的松龙的最佳临床有效剂量为0.70 mg/kg。可以推荐用于临床实践中计算个体剂量。
{"title":"Evaluation of the Clinical Efficacy of Prednisolone in the Treatment of Inflammatory Bowel Diseases with Different Dosage Methods","authors":"O. P. Alekseeva, S. V. Krishtopenko, A. Alekseeva","doi":"10.22416/1382-4376-2022-32-6-40-46","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-6-40-46","url":null,"abstract":"Aim: to investigate the clinical efficacy of two methods of oral dosing of prednisolone (in mg and mg/kg) for the induction of remission for patients with ulcerative colitis (UC) and Crohn's disease (CD) using the technology of constructing and evaluating the effectiveness function (dose-effect relationship).Material and methods. In this study were included 86 patients aged from 18 to 65 years with moderate or severe active inflammatory bowel disease (61 — UC, 25 — CD). All patients were treated with prednisolone at an initial daily dose from 30 to 60 mg with a subsequent tapering of dose. The clinical response to treatment was evaluated at the time of complete withdrawal of prednisolone using the generally accepted criteria. Two efficiency functions were constructed, compared and analyzed: the first — at the initial dosage of prednisolone in mg and the second calculating the dose in mg/kg of patient weight. The patients' body weight ranged from 41 to 98 kg. The “dose-effect” relationship for prednisolone was constructed with statistical transformation of the baseline clinical data and a quantitative expression of the actual doses and alternative responses into a graph of the effectiveness function. The mean value at each point was estimated based on the regression kernel scoring method.Results. Two graphs of the “dose-effect” of prednisolone in mg and mg/kg of patient weight were constructed. The optimal clinically effective dose (OCED) when calculated in mg/kg of weight was 0.70 ± 0.01 (0.68 + 0.72) mg/kg with the corresponding effect 79.25 ± 6.26 (66.62 91.88) %. When two graphs in mg and mg / kg of weight were superimposed, it is shown that when an initial dose of 40 mg is prescribed without taking into account the patient's weight, the effect of therapy will be 25 % lower. Prescribing a dose of 60 mg per day without weight will be optimal for patients with a body weight of 85-90 kg. With a lower body weight, the clinical effect will not decrease, but the likelihood of recognized side effects of prednisolone should be expected in proportion to the decrease in body weight.Conclusion. The clinical efficacy of two methods of prednisolone dosing (mg and mg/kg) for patients with IBD during the first induction course was compared.Using a new technology for constructing and evaluating the effectiveness function (dose-effect relationship) allowed us to prove a reliable relationship between the body weight of patients with the clinical effect of prednisolone in patients with UC and CD. Based on the analysis of the dose-effect relationship, the optimal clinically effective dose of prednisolone for patients with UC and CD during the first induction course was established, equal to 0.70 mg/kg, which can be recommended for use in clinical practice for calculating individual doses.","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":"77582117","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
Modern Approaches to H. pylori Eradication Therapy in Adults (Literature Review and Resolution of Experts Council) 成人幽门螺杆菌根除治疗的现代方法(文献综述及专家委员会决议)
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-7-19
V. Ivashkin, A. Ulyanin, I. V. Mayev, R. S. Kozlov, M. Livzan, S. Abdulkhakov, O. P. Alekseyeva, S. A. Alekseyenko, D. S. Bordin, N. Dekhnich, N. V. Korochyanskaya, T. Lapina, E. Poluektova, V. Simanenkov, A. Trukhmanov, I. Khlynov, V. Tsukanov, A. Sheptulin
Aim: to analyze current approaches to H. pylori eradication therapy in adults and present the materials of Experts Council held on December 9, 2022 in Moscow.General statements. H. pylori infection is the main etiological factor of gastritis, peptic ulcer, and gastric cancer. Eradication of H. pylori is recognized as a necessary measure to reduce the incidence of these diseases. The approaches to selecting an eradication regimen should be optimized to take into account epidemiological trends and achieve better treatment outcomes. The updated Maastricht VI Consensus Report presents the means to overcome the difficulties in selecting an approach to the treatment of H. pylori infection. However, eradication therapy remains challenging due to adverse events (primarily antibiotic-associated diarrhea), poor treatment tolerance and patient compliance. Eradication therapy can be optimized by supplementing treatment regimens with strain-specific probiotics that reduce adverse events, improve patient compliance and eradication rates, such as Saccharomyces boulardii CNCM I-745 strain with established efficacy.Conclusion. The inclusion of certain probiotics in eradication regimens improves treatment tolerance, reduces the risk of adverse events, improves patient compliance and eradication rates.
目的:分析目前成人幽门螺杆菌根除治疗的方法,并介绍2022年12月9日在莫斯科举行的专家委员会的材料。一般的语句。幽门螺旋杆菌感染是胃炎、消化性溃疡和胃癌的主要病因。根除幽门螺杆菌被认为是减少这些疾病发病率的必要措施。应优化选择根除方案的方法,以考虑流行病学趋势并取得更好的治疗结果。最新的马斯特里赫特六共识报告提出了克服选择治疗幽门螺旋杆菌感染的方法的困难的方法。然而,由于不良事件(主要是抗生素相关性腹泻)、治疗耐受性差和患者依从性差,根除治疗仍然具有挑战性。可以通过在治疗方案中补充菌株特异性益生菌来优化根除治疗,以减少不良事件,提高患者的依从性和根除率,例如具有既定疗效的博氏酵母菌CNCM I-745。在根除方案中加入某些益生菌可以提高治疗耐受性,降低不良事件的风险,提高患者的依从性和根除率。
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引用次数: 0
The Method of “Cold” Snaring Mucosa Resection with Preliminary Hydro-Preparation for the Removal of Colorectal Epithelial Neoplasms through an Endoscope 经内窥镜“冷”诱捕粘膜预备水切除结肠上皮肿瘤的方法
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-31-39
Yu. S. Sigaeva, E. V. Tokarenko, A. Y. Bulatov, A. S. Borisov, E. D. Fedorov
Aim: to analyze the safety and effectiveness of the method of cold snaring resection with preliminary hydropreparation when removing superficially colorectal epithelial neoplasms with a diameter of 5 to 25 mm.Material and methods. The number of complications and disease recurrence after endoscopic excisions by “cold” snaring resection with preliminary hydropreparation of superficially neoplasms with a diameter of 5 to 25 mm was assessed.Results. Neoplasms were removed in a single block in 89/122 (72.95 %) cases. Neoplasms with a diameter of 5 to 9 mm were excisions in a single block in 100 % of cases, with a diameter of 9 to 14 mm in 28/30 (93.33 %) cases, with a diameter of 15 to 19 mm in 12/38 (31.57 %) cases. According to the results of a lifetime pathoanatomic examination of the removed material, serrated dysplasia (serrated dysplasia, low grade) was detected in 76 cases; micro vesicular hyperplastic polyps (Hyperplastic polyp, micro vesicular type MVHP) were established in 9 cases; hyperplastic polyps containing goblet cells (Hyperplastic polyp, goblet cell GCHP) were in 5 cases; tubular adenoma with dysplasia (Tubular adenoma, low grade) was in 32 cases. Delayed bleeding and perforation of the intestinal wall, both at the time of resection, and in the delayed period was not observed. No local recurrence was detected in the groups of patients with neoplasms diameters of 5-9 and 10-14 mm. One case of local recurrence was detected in a group of patients with a neoplasms diameter from 15 to 19 mm (1/38 = 2.63 %) and one case in a group with a neoplasms diameter of 20-25 mm (1/5 = 20 %).Conclusions. Cold endoscopic snaring resection of colorectal epithelial neoplasms with preliminary hydropreparation in the submucosa is a safe and effective method of excisions superficially epithelial neoplasms of the colon with a diameter of 5 to 19 mm.
目的:探讨冷捕术加预备水切除直径为5 ~ 25mm的浅表结直肠上皮性肿瘤的安全性和有效性。对5 ~ 25mm浅表肿瘤进行初步水处理的“冷”陷阱内镜切除后的并发症和疾病复发率进行了评估。89/122(72.95%)的肿瘤被单个切除。直径5 ~ 9mm的肿瘤100%为单块切除,直径9 ~ 14mm的28/30(93.33%),直径15 ~ 19mm的12/38(31.57%)。根据对切除材料的终身病理解剖检查结果,76例检出锯齿状发育不良(低分级);微泡型增生性息肉(hyperplastic polyp, microvesicular type MVHP) 9例;含杯状细胞的增生性息肉(hyperplastic polyp, goblet cell GCHP) 5例;管状腺瘤伴不典型增生(低级别管状腺瘤)32例。未观察到在切除时和延迟期间的肠壁延迟出血和穿孔。肿瘤直径5 ~ 9 mm和10 ~ 14 mm两组均未见局部复发。肿瘤直径15 ~ 19mm组局部复发1例(1/38 = 2.63%),肿瘤直径20 ~ 25mm组局部复发1例(1/5 = 20%)。冷内镜下粘膜下层预备水切除结直肠上皮性肿瘤是一种安全有效的结肠浅表上皮性肿瘤切除方法,直径为5 ~ 19mm。
{"title":"The Method of “Cold” Snaring Mucosa Resection with Preliminary Hydro-Preparation for the Removal of Colorectal Epithelial Neoplasms through an Endoscope","authors":"Yu. S. Sigaeva, E. V. Tokarenko, A. Y. Bulatov, A. S. Borisov, E. D. Fedorov","doi":"10.22416/1382-4376-2022-32-6-31-39","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-6-31-39","url":null,"abstract":"Aim: to analyze the safety and effectiveness of the method of cold snaring resection with preliminary hydropreparation when removing superficially colorectal epithelial neoplasms with a diameter of 5 to 25 mm.Material and methods. The number of complications and disease recurrence after endoscopic excisions by “cold” snaring resection with preliminary hydropreparation of superficially neoplasms with a diameter of 5 to 25 mm was assessed.Results. Neoplasms were removed in a single block in 89/122 (72.95 %) cases. Neoplasms with a diameter of 5 to 9 mm were excisions in a single block in 100 % of cases, with a diameter of 9 to 14 mm in 28/30 (93.33 %) cases, with a diameter of 15 to 19 mm in 12/38 (31.57 %) cases. According to the results of a lifetime pathoanatomic examination of the removed material, serrated dysplasia (serrated dysplasia, low grade) was detected in 76 cases; micro vesicular hyperplastic polyps (Hyperplastic polyp, micro vesicular type MVHP) were established in 9 cases; hyperplastic polyps containing goblet cells (Hyperplastic polyp, goblet cell GCHP) were in 5 cases; tubular adenoma with dysplasia (Tubular adenoma, low grade) was in 32 cases. Delayed bleeding and perforation of the intestinal wall, both at the time of resection, and in the delayed period was not observed. No local recurrence was detected in the groups of patients with neoplasms diameters of 5-9 and 10-14 mm. One case of local recurrence was detected in a group of patients with a neoplasms diameter from 15 to 19 mm (1/38 = 2.63 %) and one case in a group with a neoplasms diameter of 20-25 mm (1/5 = 20 %).Conclusions. Cold endoscopic snaring resection of colorectal epithelial neoplasms with preliminary hydropreparation in the submucosa is a safe and effective method of excisions superficially epithelial neoplasms of the colon with a diameter of 5 to 19 mm.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"458 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83029802","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
Clinical Practice Guidelines of Russian Gastroenterological Association, Scientific Society for the Clinical Study of Human Microbiome, Russian Society for the Prevention of Non-Communicable Diseases, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy for H. pylori Di 俄罗斯胃肠病学协会、人类微生物组临床研究科学学会、俄罗斯预防非传染性疾病学会、临床微生物学和幽门螺杆菌抗微生物化疗区域间协会的临床实践指南
Q3 Medicine Pub Date : 2022-12-30 DOI: 10.22416/1382-4376-2022-32-6-72-93
V. Ivashkin, T. Lapina, I. Maev, O. Drapkina, R. S. Kozlov, A. Sheptulin, A. Trukhmanov, S. Abdulkhakov, O. P. Alekseeva, S. Alekseenko, D. Andreev, D. S. Bordin, N. Dekhnich, I. Klyaritskaya, N. Korochanskaya, M. Osipenko, E. Poluektova, A. S. Sarsenbaeva, V. Simanenkov, A. V. Tkachev, A. Ulyanin, I. Khlynov, V. Tsukanov
Aim: bring to the attention of practitioners indications for anti-Helicobacter therapy, methods and procedure for diagnostics and eradication therapy of Н. pylori infection.Key points. Chronic gastritis caused by Н. pylori infection, including asymptomatic persons, may be considered as an indication for eradication therapy of Н. pylori as etiological therapy and opportunistic screening for gastric cancer prevention. Indications, for obligatory anti-Helicobacter therapy include peptic ulcer, gastric MALT lymphoma, early gastric cancer (EGC) with endoscopic resection. H. pylori primary diagnostics methods include 13C-urea breath test, H. pylori stool antigen lab test, rapid urease test and serological method. The serological method cannot be used after anti-Helicobacter therapy.In Russia H. pylori strains' resistance to clarithromycin does not exceed 15 % in most regional studies. The first line therapy for Н. pylori infection eradication is the standard triple therapy including a proton pump inhibitor (PPI), clarithromycin and amoxicillin, enhanced with bismuthate tripotassium dicitrate. A classic four-component therapy based on bismuthate tripotassium dicitrate or quadrotherapy without bismuth drug products which includes PPI, amoxicillin, clarithromycin and metronidazole, may be used as alternative to the first line eradication therapy. The standard triple therapy may be prescribed for 14 days only in those regions, where it has been proven to be effective. Quadrotherapy with bismuthate tripotassium dicitrate is also used as main second line therapy in case of standard triple therapy, bismuth enhanced standard triple therapy or combined therapy failure. Another second line therapy includes PPI, levofloxacin and amoxicillin, to which a bismuth-containing drug product may be added. The third line therapy is selected individually based on previously used treatment settings.Conclusion. In each case of H. pylori infection the decision for eradication therapy should be made, which is especially relevant as eradication of H. pylori has been recognized as an effective measure for the prevention of gastric cancer.
目的:提醒从业人员注意抗幽门螺杆菌治疗的适应症,Н的诊断和根除治疗的方法和程序。螺杆菌感染。要点。Н引起的慢性胃炎。幽门螺杆菌感染,包括无症状的人,可能被认为是根除治疗Н的指征。幽门螺杆菌作为病因治疗和胃癌预防的机会性筛查。适应症,强制性抗幽门螺杆菌治疗包括消化性溃疡,胃MALT淋巴瘤,早期胃癌(EGC)内镜切除。幽门螺杆菌的主要诊断方法包括13c -尿素呼气试验、幽门螺杆菌粪便抗原实验室试验、快速脲酶试验和血清学方法。抗幽门螺杆菌治疗后不能采用血清学方法。在俄罗斯的大多数区域研究中,幽门螺杆菌菌株对克拉霉素的耐药性不超过15%。Н的一线治疗。根除幽门螺杆菌感染是标准的三联疗法,包括质子泵抑制剂(PPI)、克拉霉素和阿莫西林,并辅以二硝酸三钾铋。基于铋酸三钾的经典四组份治疗或不含铋药物产品的四组份治疗,包括PPI、阿莫西林、克拉霉素和甲硝唑,可作为一线根除治疗的替代方案。标准的三联疗法只有在那些已被证明有效的地区才能开14天的处方。在标准三联治疗、铋强化标准三联治疗或联合治疗失败的情况下,用二硝酸三钾铋的四方疗法也被用作主要的二线治疗。另一种二线治疗包括质子泵抑制剂、左氧氟沙星和阿莫西林,其中可能添加含铋的药物产品。根据以前使用的治疗设置单独选择第三线治疗。对于每一例幽门螺杆菌感染,都应作出根除治疗的决定,这一点尤其重要,因为根除幽门螺杆菌已被认为是预防胃癌的有效措施。
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引用次数: 1
Age-related and Gender Aspects of Inflammatory Bowel Diseases in the Republic of Dagestan 达吉斯坦共和国炎症性肠病的年龄相关和性别方面
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.22416/1382-4376-2022-32-4-68-74
S. S. Akhmedkhanov, G. Abakarova, A. T. Beibalayeva, B. S. Abdullayeva, Z. Saidova
Aim: Creation of a patient registry in the Republic of Dagestan to study various aspects of the course and outcomes of IBD, depending on the age and gender of patients.Materials and methods. We have created a register of IBD patients in the Republic of Dagestan. It included 168 IBD patients aged 17 to 70 years, 69 males and 99 females, the average age of patients with IBD was 38.1 ± 2.5 years with an average duration of illness of 6.19 ± 0.71 years. The diagnosis of IBD was established on the basis of the characteristic clinical picture of the disease, objective status, results of laboratory, endoscopic, X-ray and morphological research in accordance with Russian Clinical GuidelinesResults. The prevalence of IBD in the Republic of Dagestan is 5.41 cases per 100,000 population. The progression of IBD is more often observed in women, aged 30 to 39 years, residents of rural areas. Anemia (mainly chronic iron deficiency) was registered in 66.1 %, more often in women, its maximum frequency was noted in patients aged 20–29 years (80 %). Disability due to IBD was registered in 55.4 % of patients.Conclusions. The creation of a register of IBD patients in the Republic of Dagestan is aimed at monitoring the state of health, timely monitoring of the effectiveness of therapy and improving the quality of medical care.
目的:在达吉斯坦共和国建立一个患者登记处,根据患者的年龄和性别研究IBD病程和结果的各个方面。材料和方法。我们在达吉斯坦共和国建立了一个IBD患者登记册。纳入IBD患者168例,年龄17 ~ 70岁,男性69例,女性99例。IBD患者平均年龄38.1±2.5岁,平均病程6.19±0.71年。IBD的诊断是根据疾病的特征性临床表现,客观状态,实验室,内镜,x线和形态学研究结果,根据俄罗斯临床指南结果建立的。达吉斯坦共和国的IBD患病率为每10万人5.41例。IBD的进展更常见于30至39岁的农村妇女。贫血(主要是慢性缺铁)的发生率为66.1%,多见于女性,20-29岁的患者发生率最高(80%)。55.4%的患者因IBD致残。在达吉斯坦共和国建立IBD患者登记册的目的是监测健康状况,及时监测治疗效果,提高医疗质量。
{"title":"Age-related and Gender Aspects of Inflammatory Bowel Diseases in the Republic of Dagestan","authors":"S. S. Akhmedkhanov, G. Abakarova, A. T. Beibalayeva, B. S. Abdullayeva, Z. Saidova","doi":"10.22416/1382-4376-2022-32-4-68-74","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-4-68-74","url":null,"abstract":"Aim: Creation of a patient registry in the Republic of Dagestan to study various aspects of the course and outcomes of IBD, depending on the age and gender of patients.Materials and methods. We have created a register of IBD patients in the Republic of Dagestan. It included 168 IBD patients aged 17 to 70 years, 69 males and 99 females, the average age of patients with IBD was 38.1 ± 2.5 years with an average duration of illness of 6.19 ± 0.71 years. The diagnosis of IBD was established on the basis of the characteristic clinical picture of the disease, objective status, results of laboratory, endoscopic, X-ray and morphological research in accordance with Russian Clinical GuidelinesResults. The prevalence of IBD in the Republic of Dagestan is 5.41 cases per 100,000 population. The progression of IBD is more often observed in women, aged 30 to 39 years, residents of rural areas. Anemia (mainly chronic iron deficiency) was registered in 66.1 %, more often in women, its maximum frequency was noted in patients aged 20–29 years (80 %). Disability due to IBD was registered in 55.4 % of patients.Conclusions. The creation of a register of IBD patients in the Republic of Dagestan is aimed at monitoring the state of health, timely monitoring of the effectiveness of therapy and improving the quality of medical care.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74148395","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
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Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii
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