- Issues
- About the Journal
- News
- Cooperation
- Contact Info
Issue. Articles
¹1(87) // 2016
1. Original researches
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Peculiarities of the nitric oxide exchange in patients withgastroesophageal reflux disease, combined with arterial hypertensionO. Ye. GridnevSI «L.T. Mala National Therapy Institute of NAMS of Ukraine», Kharkiv |
|---|
Objective — to evaluate the peculiarities of metabolism of nitric oxide in patients with gastroesofageal reflux disease (GERD) combined with arterial hypertension.
Materials and methods. The study included 126 patients with arterial hypertension stage 2, 1 — 3 degrees and GERD. The control group consisted of 20 healthy individuals. Determining the stage and grade of hypertension and risk stratification for prognosis was carried out according to the clinical guidelines for hypertension ESH/ESC 2013. Diagnosis of GERD was established according to the Montreal Consensus (2006). In the study, patients were selected having heartburn symptoms two times a week or more. Blood pressure monitoring, echocardiography, daily intraesophageal pH meter was performed by standard methods. Nitric oxide metabolism was determined by the content of its stable metabolites, nitrites and nitrates in plasma and daily urinary excretion (day and night) by reaction Gris. To assess lipid peroxidation and antioxidant system, serum malondialdehyde and SH-groups levels in the blood hemolysate — glutathione peroxidase were determined according to standard methods.
Results. Indicators of nitrites in the blood plasma of patients with the combined course of GERD and arterial hypertension had no significant (p > 0.05) differences with the control group, and urinary nitrite levels were significantly (p < 0.001) higher than in the control group. Increased urinary nitrite excretion in patients with concomitant GERD and arterial hypertension and occurred mainly at night. The levels of nitrites in the blood plasma had gender differences — performance in males (24.99 ± 0.07 mmol/L) was significantly (p < 0.01) higher than that of female (24.66 ± 0.09 mmol/l). In the daylight hours in patients in the age group 30 — 39 years, nitrite excretion figures were significantly higher than those in older age groups. This excretion of nitrites in the night hours was significantly lower in patients in the age groups 40 — 49 and 50 — 59 years, compared with patients in the older age group — 60 — 69 years. A significant inverse correlation between the plasmanitritelevelsand average systolic blood pressure (r = –0.22) has been revealed. Moreover, the results showed the direct correlation between urinary nitrite diurnal and nocturnal urinary pH and the percentage of time of less than 4 (r = 0.22 and r = 0.27 respectively), the number of reflux with a pH of less than 4 (r = 0.19 and r = 0.28 respectively) DeMeester index (r = 0.19 and r = 0.23 respectively). The inverse correlation has been found between the level of glutathione peroxidase (GPO) and in the daily nitrite excretion (r = –0.26) and night urine (r = –0.25). The level of nitrite in urine had a relationship with clinical manifestations of GERD: with increasing severity of heartburn there was a significant (p < 0.05) increased excretion of nitrites in the night hours.
Conclusions. The level of nitrite in the blood plasma of patients with both GERD and arterial hypertension has no significant differences with the control group, indicating that the expression of mutual leveling levels of nitric oxide for the isolation inherent in proceeding GERD and arterial hypertension. In males with concomitant GERD and arterial hypertension level nitrite in blood plasma was significantly (p < 0.01) higher than that of the female. There was an inverse correlation between the level of nitrites in the blood plasma and the average systolic blood pressure (r = –0.22), and between the GPO and nitrite in the daily excretion (r = –0.26) and in the night urine (r = –0.25), suggesting a direct effect of the level of nitric oxide in the regulation of blood pressure and blood antioxidant system in patients with comorbidity GERD and arterial hypertension. Identification of a direct correlation between the levels of nitrite excretion in the urine daily and night and indicators esophageal pH monitoring confirming the link metabolism of nitric oxide and the formation of abnormal gastroesophageal reflux in patients with combined GERD and arterial hypertension.
Materials and methods. The study included 126 patients with arterial hypertension stage 2, 1 — 3 degrees and GERD. The control group consisted of 20 healthy individuals. Determining the stage and grade of hypertension and risk stratification for prognosis was carried out according to the clinical guidelines for hypertension ESH/ESC 2013. Diagnosis of GERD was established according to the Montreal Consensus (2006). In the study, patients were selected having heartburn symptoms two times a week or more. Blood pressure monitoring, echocardiography, daily intraesophageal pH meter was performed by standard methods. Nitric oxide metabolism was determined by the content of its stable metabolites, nitrites and nitrates in plasma and daily urinary excretion (day and night) by reaction Gris. To assess lipid peroxidation and antioxidant system, serum malondialdehyde and SH-groups levels in the blood hemolysate — glutathione peroxidase were determined according to standard methods.
Results. Indicators of nitrites in the blood plasma of patients with the combined course of GERD and arterial hypertension had no significant (p > 0.05) differences with the control group, and urinary nitrite levels were significantly (p < 0.001) higher than in the control group. Increased urinary nitrite excretion in patients with concomitant GERD and arterial hypertension and occurred mainly at night. The levels of nitrites in the blood plasma had gender differences — performance in males (24.99 ± 0.07 mmol/L) was significantly (p < 0.01) higher than that of female (24.66 ± 0.09 mmol/l). In the daylight hours in patients in the age group 30 — 39 years, nitrite excretion figures were significantly higher than those in older age groups. This excretion of nitrites in the night hours was significantly lower in patients in the age groups 40 — 49 and 50 — 59 years, compared with patients in the older age group — 60 — 69 years. A significant inverse correlation between the plasmanitritelevelsand average systolic blood pressure (r = –0.22) has been revealed. Moreover, the results showed the direct correlation between urinary nitrite diurnal and nocturnal urinary pH and the percentage of time of less than 4 (r = 0.22 and r = 0.27 respectively), the number of reflux with a pH of less than 4 (r = 0.19 and r = 0.28 respectively) DeMeester index (r = 0.19 and r = 0.23 respectively). The inverse correlation has been found between the level of glutathione peroxidase (GPO) and in the daily nitrite excretion (r = –0.26) and night urine (r = –0.25). The level of nitrite in urine had a relationship with clinical manifestations of GERD: with increasing severity of heartburn there was a significant (p < 0.05) increased excretion of nitrites in the night hours.
Conclusions. The level of nitrite in the blood plasma of patients with both GERD and arterial hypertension has no significant differences with the control group, indicating that the expression of mutual leveling levels of nitric oxide for the isolation inherent in proceeding GERD and arterial hypertension. In males with concomitant GERD and arterial hypertension level nitrite in blood plasma was significantly (p < 0.01) higher than that of the female. There was an inverse correlation between the level of nitrites in the blood plasma and the average systolic blood pressure (r = –0.22), and between the GPO and nitrite in the daily excretion (r = –0.26) and in the night urine (r = –0.25), suggesting a direct effect of the level of nitric oxide in the regulation of blood pressure and blood antioxidant system in patients with comorbidity GERD and arterial hypertension. Identification of a direct correlation between the levels of nitrite excretion in the urine daily and night and indicators esophageal pH monitoring confirming the link metabolism of nitric oxide and the formation of abnormal gastroesophageal reflux in patients with combined GERD and arterial hypertension.
Keywords: gastroesophageal reflux disease, arterial hypertension, nitric oxide, comorbidity.
To download
full version need login
Original language: Russian
2. Original researches
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Gastrointestinal aspects of lung cancerYu. V. Dumanskyy1, O. Yu. Stolyarova2, O. V. Syniachenko1, Ya. V. Kmetiuk3, V. A. Stepko11 Donetsk National Medical University of Maxim Gorky, Lyman |
|---|
Objective — to study the incidence of metastatic lesions of lung cancer (LC) in various gastrointestinal parts, the character of the relationship between the clinical signs of disease (localization, shape, histopathologic variant, degree of differentiation, staging of tumor), their dependence from concomitant gastroenterological diseases; gastroenterological complications of the radio-chemotherapy, as well as evaluate survival of this group of patients.
Materials and methods. Observations involved 1071 patients with LC aged 24 to 86 years (mean age — (59.2 ± 0.31) years). Male subjects prevailed in this group: 887 patients (82.8 %). None of these patients has undergone previous LC surgery. All patients received radio therapy after the diagnosis establishment, and 73.1 % of subjects were administered the combined radio chemotherapy.
Results. The ratio of distribution of LC invasion into esophagus, metastases into pancreas, mesenteric and inguinal lymph nodes, the abdominal wall and the intestines was established as 3 : 2 : 2 : 1 : 1 : 1, and it had gender-specific features. The duration of the disease, a form of tumor (central, peripheral), its histological variant (smallcell, adenocarcinoma) affected the injury of the gastroenterological areas at LC. The parameters of transforming growth factor β1 had the prognostic significance. The following complications of radio-chemotherapy have been established in patients with LC: acute post irradiation esophagitis, intractable vomiting, acute pancreatitis, diarrhea, gastrointestinal bleeding, peritonitis, mesenteric ischemia in ratio 10 : 8 : 4 : 4 : 3 : 2 : 1. They closely correlated with the powerfulness of radiation effects (postirradiation esophagitis) and the presence of concomitant disease of the digestive system (gastroduodenitis, peptic ulcers of the stomach and duodenum, chronic cholecystitis).
Conclusions. Tumor and iatrogenic radio-chemotherapeutic damage of gastroenterological area significantly determine the clinical course of LC, and results in the reduction of the survival of these patients.
Materials and methods. Observations involved 1071 patients with LC aged 24 to 86 years (mean age — (59.2 ± 0.31) years). Male subjects prevailed in this group: 887 patients (82.8 %). None of these patients has undergone previous LC surgery. All patients received radio therapy after the diagnosis establishment, and 73.1 % of subjects were administered the combined radio chemotherapy.
Results. The ratio of distribution of LC invasion into esophagus, metastases into pancreas, mesenteric and inguinal lymph nodes, the abdominal wall and the intestines was established as 3 : 2 : 2 : 1 : 1 : 1, and it had gender-specific features. The duration of the disease, a form of tumor (central, peripheral), its histological variant (smallcell, adenocarcinoma) affected the injury of the gastroenterological areas at LC. The parameters of transforming growth factor β1 had the prognostic significance. The following complications of radio-chemotherapy have been established in patients with LC: acute post irradiation esophagitis, intractable vomiting, acute pancreatitis, diarrhea, gastrointestinal bleeding, peritonitis, mesenteric ischemia in ratio 10 : 8 : 4 : 4 : 3 : 2 : 1. They closely correlated with the powerfulness of radiation effects (postirradiation esophagitis) and the presence of concomitant disease of the digestive system (gastroduodenitis, peptic ulcers of the stomach and duodenum, chronic cholecystitis).
Conclusions. Tumor and iatrogenic radio-chemotherapeutic damage of gastroenterological area significantly determine the clinical course of LC, and results in the reduction of the survival of these patients.
Keywords: cancer, lung metastases, radio-chemotherapy, complications, gastroenterological area.
To download
full version need login
Original language: Russian
3. Original researches
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Gastroesophageal reflux in infants: differential diagnosis and treatmentO. L. LychkovskaDanylo Halytsk³y Lviv National Medical University |
|---|
Objective — to evaluate the peculiarities of the clinical manifestations of physiological and pathological Gastroesophageal reflux GER in infants, possibilities of its differential diagnostics and treatment.
Materials and methods. We examined 108 children aged from one to seven months, which were referred to the medical attention for the first time due to frequent regurgitations. Control group was comprised of children with the signs of physiological GER. The investigations and treatment was performed in accordance with the clinical protocols pf the Ministry of Health of Ukraine (MoH) and ESPGHAN recommendations. Physical examination, clinical assessment of the regurgitation syndrome course was performed at admission, and on the days 3 — 5, 7 — 10, 14, and 30.
Results. Among the studied population boys were slightly more prevalent. The majority of children were below 6 months of age and presented with mild and moderately severe degree of regurgitations. Forty eight children (44.4 %) were breast-fed, while the rest 60 (55.6) were on artificial or on mixed feeding. Family history of gastroesophageal reflux disease (GERD) was established in 47 families (43.5 %). In 25 children (23.1 %) frequent regurgitation were accompanied by agitation and cry, in two of them KISS syndrome was diagnosed. In 38 children with history of allergy regurgitation was eliminated or significantly reduced after administration of hypoallergenic diet (elimination of cow milk).
Conclusions. Syndrome of regurgitation in infants, even if it is consistent with the criteria of physiological GER, has heterogeneous nature and can accompany various disorders. Special attention should be paid to children with history of allergy, in whom regurgitation may develop as the first nonspecific sign of allergy to cow milk. Stepwise therapy of GER and GERD in infants, recommended by MoH and ESPGHAN, proved to be effective in the majority of cases but the heterogeneity of these disorders should be taken into account.
Materials and methods. We examined 108 children aged from one to seven months, which were referred to the medical attention for the first time due to frequent regurgitations. Control group was comprised of children with the signs of physiological GER. The investigations and treatment was performed in accordance with the clinical protocols pf the Ministry of Health of Ukraine (MoH) and ESPGHAN recommendations. Physical examination, clinical assessment of the regurgitation syndrome course was performed at admission, and on the days 3 — 5, 7 — 10, 14, and 30.
Results. Among the studied population boys were slightly more prevalent. The majority of children were below 6 months of age and presented with mild and moderately severe degree of regurgitations. Forty eight children (44.4 %) were breast-fed, while the rest 60 (55.6) were on artificial or on mixed feeding. Family history of gastroesophageal reflux disease (GERD) was established in 47 families (43.5 %). In 25 children (23.1 %) frequent regurgitation were accompanied by agitation and cry, in two of them KISS syndrome was diagnosed. In 38 children with history of allergy regurgitation was eliminated or significantly reduced after administration of hypoallergenic diet (elimination of cow milk).
Conclusions. Syndrome of regurgitation in infants, even if it is consistent with the criteria of physiological GER, has heterogeneous nature and can accompany various disorders. Special attention should be paid to children with history of allergy, in whom regurgitation may develop as the first nonspecific sign of allergy to cow milk. Stepwise therapy of GER and GERD in infants, recommended by MoH and ESPGHAN, proved to be effective in the majority of cases but the heterogeneity of these disorders should be taken into account.
Keywords: gastroesophageal reflux, infants, differential diagnostics.
To download
full version need login
Original language: Ukrainian
4. Original researches
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 The use of complex of essential, conditionally nonessential and nonessential amino acids in the treatment of patients with a combination of chronic pancreatitis and alcoholic liver cirrhosisK. M. SkoropadIvano-Frankivsk National Medical University |
|---|
Objective — to study the effects of medicine, containing8 essential, 2 conditionally nonessential and 5 nonessential amino acids, on the functional status of the pancreas, liverproteinsynthetic function, trophological status in patients with a combination of chronic alcoholic pancreatitis (CAP) and liver cirrhosis (LC) class A, B by Child — Pugh.
Materials and methods. The study involved 38 patients with chronic pancreatitis and 40 subjects with CAP and LC. Each group was divided into two subgroups depending on the method of treatment. Patients with CAP of the first subgroup (20 subjects) received standard therapy for 2 weeks, and the second subgroup (18 patients), in addition to the basic therapy, received 8 % solution of Hepasol Neo 500 ml intravenous for 5 times.
Patients of the second groupwere also divided into two subgroups, the first of which (20 patients) got ademethionine (Heptral) 400 mg intravenously, twice a day for 5 days, and then 400 mg orally up to 2 weeks, Duphalac 30 ml orally twice a day for 2 weeks, Verospiron 100 — 200 mg depending on the class of the cirrhosis, in addition to the treatment of CAP, and such therapy was considered as the basic. Patients of the second subgroup also got 8 % solution of Hepasol Neo 500 ml intravenously every other day, 5 times, besides basic therapy. The evaluation included clinical manifestations, the state of pancreas and liver, trophological status. Coprological test, determination of chymotrypsin activity in feces, level of phospholipase A2 type IIA, blood serum levels of total protein, albumin, cholinesterase.
Results. More significant improvement of pancreas functional status has been established: decrease of exocrine insufficiency by clinical data, slightly increased chymotrypsin activity in feces (p < 0.05), intensifying of the protein-synthetic liver function (increasing of levels of total protein, albumin, cholinesterase, p < 0.05), and improvement trophological status.
Conclusions. Proposed scheme of treatment has provided more pronounced positive effects on the functional state of liver and pancreas in patients with chronic alcoholic pancreatitis, combined with alcoholic liver cirrhosis.
Materials and methods. The study involved 38 patients with chronic pancreatitis and 40 subjects with CAP and LC. Each group was divided into two subgroups depending on the method of treatment. Patients with CAP of the first subgroup (20 subjects) received standard therapy for 2 weeks, and the second subgroup (18 patients), in addition to the basic therapy, received 8 % solution of Hepasol Neo 500 ml intravenous for 5 times.
Patients of the second groupwere also divided into two subgroups, the first of which (20 patients) got ademethionine (Heptral) 400 mg intravenously, twice a day for 5 days, and then 400 mg orally up to 2 weeks, Duphalac 30 ml orally twice a day for 2 weeks, Verospiron 100 — 200 mg depending on the class of the cirrhosis, in addition to the treatment of CAP, and such therapy was considered as the basic. Patients of the second subgroup also got 8 % solution of Hepasol Neo 500 ml intravenously every other day, 5 times, besides basic therapy. The evaluation included clinical manifestations, the state of pancreas and liver, trophological status. Coprological test, determination of chymotrypsin activity in feces, level of phospholipase A2 type IIA, blood serum levels of total protein, albumin, cholinesterase.
Results. More significant improvement of pancreas functional status has been established: decrease of exocrine insufficiency by clinical data, slightly increased chymotrypsin activity in feces (p < 0.05), intensifying of the protein-synthetic liver function (increasing of levels of total protein, albumin, cholinesterase, p < 0.05), and improvement trophological status.
Conclusions. Proposed scheme of treatment has provided more pronounced positive effects on the functional state of liver and pancreas in patients with chronic alcoholic pancreatitis, combined with alcoholic liver cirrhosis.
Keywords: chronic alcoholic pancreatitis, alcoholic liver cirrhosis, amino acid mixture.
To download
full version need login
Original language: Ukrainian
5. MEDICINES
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Gastroesophageal multichannel impedance-pH-monitoring in rationalization of diagnostics and treatment of biliary reflux with ursodeoxycholic acidV. M. Chernobrovyó, S. G. Melashchenko, O. O. KsenchynNational Pirogov Memorial Medical University, Vinnytsóa |
|---|
The article presents the recent data about biliary reflux diagnostics. A wide prevalence of duodenogastroesophageal syndrome associated with different gastroenterological diseases has been emphasized. The significance of the gastroesophageal intraluminal impedancepHmonitoring and conventional multichannel pHmonitoring in the identification of biliary reflux, including application of the original techniques and approaches, has been considered. The pathogenetic role of the subacid bile reflux (ðÍ = 4.0 - 6.99), containing toxic bile acids with the damaging properties, has been outlined. In the case of bile reflux, a positive therapeutic effect of UDCA was demonstrated due to its hydrophilic properties, choleretic action and elimination of the cytotoxic effect of bile acids.
Keywords: gastroesophageal intraluminal multichannel impedancepHmonitoring, bile reflux, ursodeoxycholic acid.
To download
full version need login
Original language: Ukrainian
6. MEDICINES
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Rational choice of proton pump inhibitor for the treatment of chronic pancreatitis combined with drug-induced liver lesions. Part 1. Original state of the pancreas and liver, metabolic homeostasis. Quality of life of patients with comorbidityN. B. Gubergrits, P. G. Fomenko, O. Î. Golubova, N. V. ByelyayevaDonetsk National Medical University of Maxim Gorky, Lyman |
|---|
The article represents a literature review on drugs’ metabolism in the liver. Peculiar attention is paid to the role of P450 cytochrome system in this metabolism. It has been proved that pantoprazol (Nolpaza) affected the activity of P450 cytochrome system enzymes in a less degree than other proton pump inhibitors.
The authors conducted their own research, examining 328 patients with comorbidity. The investigation confirmed that patients had substantial disturbances of liver and pancreas function, the metabolic intoxication was developing, the activity of lipid peroxidation was increased, and antioxidant protection decreased. The blood lipid profile became pathological, and quality of life worsened.
The authors conducted their own research, examining 328 patients with comorbidity. The investigation confirmed that patients had substantial disturbances of liver and pancreas function, the metabolic intoxication was developing, the activity of lipid peroxidation was increased, and antioxidant protection decreased. The blood lipid profile became pathological, and quality of life worsened.
Keywords: chronic pancreatitis, druginduced hepatitis, functional state of liver and pancreas, blood lipid profile, metabolic intoxication, quality of life.
To download
full version need login
Original language: Ukrainian
7. MEDICINES
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Mesalasine and psyllium in the treatment of irritable bowel syndrome with constipationsÀ. E. Dorofeyev1, Ì. Ì. Rudenko1, Î. Î. Kirijan2, I. À. Dårkach3, À.Yu. Butova31 O. O. Bogomolets National Medical University, Kyiv |
|---|
Objective — to investigate efficacy of psyllium and mesalasine in the combined treatment of patients with irritable bowel syndrome (IBS) with constipations (C).
Materials and methods. The observations involved 100 patients, 32 male and 68 female, mean age 38.2 ± 4.2 years, for whom the modification of life style was ineffective. IBSC diagnosis was established in accordance with Rome criteria III. The study was open-labeled.
Results. The high the efficacy (94.0 %) of combination of Mucofalk and Salofalk has been established in the treatment of patients with IBSC. The defecation frequency was increased almost twice. The normalization of stool consistency (up to 3 —5th type according to Bristol scale) was accompanied with the reduction of both duration of the straining and feeling of the incomplete bowel emptying.
Conclusions. Combination of Mucofalk and Salofalk demonstrated advantages in terms of reduction of clinical symptoms (abdominal pain, discomfort, bloating) and safety. Combination of these preparations can be recommended for the treatment of patients with IBSC.
Materials and methods. The observations involved 100 patients, 32 male and 68 female, mean age 38.2 ± 4.2 years, for whom the modification of life style was ineffective. IBSC diagnosis was established in accordance with Rome criteria III. The study was open-labeled.
Results. The high the efficacy (94.0 %) of combination of Mucofalk and Salofalk has been established in the treatment of patients with IBSC. The defecation frequency was increased almost twice. The normalization of stool consistency (up to 3 —5th type according to Bristol scale) was accompanied with the reduction of both duration of the straining and feeling of the incomplete bowel emptying.
Conclusions. Combination of Mucofalk and Salofalk demonstrated advantages in terms of reduction of clinical symptoms (abdominal pain, discomfort, bloating) and safety. Combination of these preparations can be recommended for the treatment of patients with IBSC.
Keywords: irritable bowel syndrome, symptoms, treatment.
To download
full version need login
Original language: Russian
8. MEDICINES
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Clinical efficacy of pancreatic enzyme replacement therapy for pancreatic exocrine insufficiency in chronic pancreatitis: the results of multicenter studyO. V. Shvets1, Î. Ì. Agibalov2, O. O. Bondarenko3, V. M. Gedrazhko4, |
|---|
Objective — to study the dynamics of clinical, anthropometrical and biochemical signs of pancreatic malabsorption as result of the pancreatic enzyme replacement therapy (PERT) in patients with verified diagnosis of chronic pancreatitis (CP) with pancreatic exocrine insufficiency (PEI).
Materials and methods. Forty-one patient with confirmed diagnosis of CH with PEI were included in multicenter study. All patients received consultation with recommendations designed to stop smoking and cease alcohol consumption, to personalized diet’s improvement. The patients received medicine Ermital 25 000 with every meal and Ermital 10 000 with snacks. The efficacy of therapeutic interventions evaluated by dynamics of clinical symptoms (abdominal pain, discomfort, bloating, flatulence and diarrhea), BMI and laboratory parameters (albumin, HbA1C, transferrin and magnesium level).
Results. The significant positive trend in clinical and laboratory parametershas been registeredafter 31 day of PERT with use of Ermital: thedecrease of symptoms’ severity, increase of BMI, albumin, transferrin and magnesium levels, and decrease of HbA1C level in patients’ blood.
Conclusions. Well-balanced and adequate by calories diet together with effective PERT (Ermital 25 000 with every meal and Ermital 10 000 with snacks) leads to compensation of PEI confirmed by positive dynamics of clinical and laboratory parameters.
Materials and methods. Forty-one patient with confirmed diagnosis of CH with PEI were included in multicenter study. All patients received consultation with recommendations designed to stop smoking and cease alcohol consumption, to personalized diet’s improvement. The patients received medicine Ermital 25 000 with every meal and Ermital 10 000 with snacks. The efficacy of therapeutic interventions evaluated by dynamics of clinical symptoms (abdominal pain, discomfort, bloating, flatulence and diarrhea), BMI and laboratory parameters (albumin, HbA1C, transferrin and magnesium level).
Results. The significant positive trend in clinical and laboratory parametershas been registeredafter 31 day of PERT with use of Ermital: thedecrease of symptoms’ severity, increase of BMI, albumin, transferrin and magnesium levels, and decrease of HbA1C level in patients’ blood.
Conclusions. Well-balanced and adequate by calories diet together with effective PERT (Ermital 25 000 with every meal and Ermital 10 000 with snacks) leads to compensation of PEI confirmed by positive dynamics of clinical and laboratory parameters.
Keywords: Chronic pancreatitis, pancreatic exocrine insufficiency, pancreatic enzyme replacement therapy, nutritional status, pancreatic malabsorption.
List of references: 1 O. O. Bogomolets National Medical University, Kyiv
2 Multispecialty Hospital Vitacenter, Zaporizhia
3 Danylo Halytskiy Lviv National Medical University
4 Medical Center «²nto-Sana», Odesa
5 Odessa National Medical University
6 SI «Institute of Gastroenterology of NAMS of Ukraine», Dnipropetrovsk
7 Military Medical Clinical Center of the Central Region, Vinnytsóa
To download
full version need login
Original language: Russian
9. MEDICINES
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Posteradication gastritis — terra incognita of the modern gastroenterologyN. B. Gubergrits, I. V. Vasilenko, N. V. Byelyayeva, Î. Ye. Klochkov, P. G. Fomenko, Î. Ì. Agibalov, K. Yu. LinevskaDonetsk National Medical University of Maxim Gorky, Lyman |
|---|
The authors conducted the detailed analysis of the literature data on pathogenesis, clinical and morphological manifestations of the posteradication period of gastroduodenal pathology associated with Helicobacter pylori. The pathogenetic substantiation has been provided for the differentiated inclusion of Doktovit and Pangast preparations in the treatment of posteradication gastritis depending on the morphological peculiarities of the gastric mucosa and clinical manifestations.
Keywords: Helicobacter pylori, chronic gastritis, posteradication syndrome, risk factors, treatment.
To download
full version need login
Original language: Russian
10. MEDICINES
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 The role of rifaximin in the treatment of postinfectious irritable bowel syndromeÀ. Å. Dorofeyev1, Ì. Ì. Rudenko1, Ò. Î. Êînovalova-Êushnir2, ². À. Derkach31 O. O. Bogomolets National Medical University, Kyiv |
|---|
Objective — to study the prevalence of postinfectious irritable bowel syndrome (IBS) in the population of Ukrainian patients and to evaluate the effectiveness of rifaximin (Alpha Normix) in the treatment of these patients.
Materials and methods. The examinations involved 242 patients with IBS, hospitalized in the gastroenterology departments of Eastern, Central and Western Ukraine. IBS diagnosis was established on the basis of the Rome criteria III, with the allocation based on the stool abnormalities subtypes with diarrhea, constipation, mixed and undifferentiated.
Results. In the Ukrainian patients’ cohort, postinfectious IBS was established in 13.6 % of subjects, from them in 64 % IBS was with diarrhea, and other cases it was of mixed subtype. No cases of IBS with constipation and undifferentiated subtype were registered. The mean age in this population was 37.8 ± 6.1 years, and the women proportion (63.6 %) were slightly less than the average at IBS.
Conclusions. Alpha Normix application for 2 weeks resulted in the significant reduction of symptoms, including pain andfeeling ofbloating. In majority of patients demonstrated stool normalization, decreased incidence and severity of bacterial overgrowth syndrome. Moreover, the bifidobacteria and lactobacilli number increased, and opportunistic microorganisms’ level decreased.
Materials and methods. The examinations involved 242 patients with IBS, hospitalized in the gastroenterology departments of Eastern, Central and Western Ukraine. IBS diagnosis was established on the basis of the Rome criteria III, with the allocation based on the stool abnormalities subtypes with diarrhea, constipation, mixed and undifferentiated.
Results. In the Ukrainian patients’ cohort, postinfectious IBS was established in 13.6 % of subjects, from them in 64 % IBS was with diarrhea, and other cases it was of mixed subtype. No cases of IBS with constipation and undifferentiated subtype were registered. The mean age in this population was 37.8 ± 6.1 years, and the women proportion (63.6 %) were slightly less than the average at IBS.
Conclusions. Alpha Normix application for 2 weeks resulted in the significant reduction of symptoms, including pain andfeeling ofbloating. In majority of patients demonstrated stool normalization, decreased incidence and severity of bacterial overgrowth syndrome. Moreover, the bifidobacteria and lactobacilli number increased, and opportunistic microorganisms’ level decreased.
Keywords: enteric infection, irritable bowel syndrome, treatment.
To download
full version need login
Original language: Russian
11. MEDICINES
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 New approaches to the classification, diagnosis and management of patients with chronic gastritis in the view of global Kyoto’s consensusS. Ì. TkachUkrainian Research and Practical Centre of Endocrine Surgery, |
|---|
The review provides considerations of the basic provisions of the new global Kyoto’s consensus on the diagnosis and management of patients with H. pyloripositive gastritis and functional dyspepsia, and gastric cancer prevention. In particular, the new international etiologic classification of chronic gastritis is presented, and recommendations have been given to consider H. pyloriinduced gastritis as chronic infectious disease that needs treatment not only for symptoms’ relief, but for prevention of such complicationsas peptic ulcers and stomach cancer. The H. pylori eradication is strongly recommended to all infected chronic gastritis patientsas afirstlinetherapy, which promotes elimination of inflammation in gastric mucosa, healing of peptic ulcers, reducing the risk of serious complications and may be accompanied by complete and normal resumption of the gastric mucosa. Though this approach doesn’t guarantee total elimination of the risk of stomach cancer developments, but significantly reduces it. Patients with precancerous changes after of H. pylorieradicationshould be under programs of endoscopic and histomorphological observation.
Keywords: chronic gastritis, functional dyspepsia, H. pylori infection, diagnosis and treatment.
To download
full version need login
Original language: Russian
12. Reviews
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 Chronic pancreatitis combined with obesity, metabolic syndrome: possible common mechanisms of developmentD. Î. Gontsaryuk, T. Ì. Hristich, Y. M. TelekiBukovinian State Medical University, Chernivtsi |
|---|
The authors elucidated the importance of chronic generalized lowgrade inflammation in the development of such polymorbidity as chronic pancreatitis, obesity, type 2 diabetes mellitus. Moreover, the mechanisms of development and progression of chronic lowgrade inflammation in the course of all three diseases have been described, as well as participation of oxidative stress, antioxidant defense system, cytokine system, including adipokines, pancreatic peptide, a number of intestinal regulatory peptides in the development of lipid and carbohydrate metabolism in patients with this polymorbidity. The necessity has been outlined for further investigations aimed on the working out recommendations for the clinical practice.
Keywords: chronic pancreatitis, type 2 diabetes, obesity, chronic lowgrade inflammation, adipokines, intestinal regulatory peptides.
To download
full version need login
Original language: Russian
13. Reviews
|
Notice: Undefined index: pict in /home/vitapol/sgastro.vitapol.com.ua/en/svizhij_nomer.php on line 74 The role of eradication of Helicobacter pylori infection in Prevention of NSAID-induced gastropathyS. Ì. Tkach1, L. Î. Onischuk21 Ukrainian Research and Practical Centre of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kyiv |
|---|
The article presents the modern data regarding relationship of Helicobacter pylori infection and longterm use of NSAIDs, as well as regarding the role of eradication of Helicobacter pylori infection in prevention of NSAID-induced gastropathy. It has been concluded, that in the primary NSAIDs-users, H. pylori eradication should be considered as an effective strategy of primary prevention of ulcerogenesis and ulcer bleeding.
Keywords: NSAID-induced gastropathy, H. pylori eradication.
To download
full version need login
Original language: Ukrainian
Current Issue Highlights
¹6(98) // 2017
Chronic inflammatory bowel disease and viral infections
E. I. Sergienko
The phenomenon of Helicobacter pylori-negative ulcer and its place in clinical practice
V. ². Vdovychenko 1, Ya. B. Shvydkyi 1, A. V. Ostroglyad 2
Log In
Notice: Undefined variable: err in /home/vitapol/sgastro.vitapol.com.ua/blocks/news.php on line 51
Publisher
Services
Partners
Advertisers
Subscribe
© VIT-A-POL