Vol 17, No 8 (2015)


Possibilities of increasing the effectiveness of Helicobacter pylorieradication

Kazyulin A.N.


Article type overview, dedicated one of the leading problems of gastroenterology - improve the effectiveness of eradication therapy (ET). Based on the analysis of the results of randomized clinical trials, meta-analyses of these works, expert advice of Maastricht IV and Russian gastroenterological community the authors have identified a number of ways to optimize the ET, including: accounting resistant Helicobacter pylori to antibiotics in a particular region, extension ET administration of drugs bismuth fourth component in the standard scheme ET, using sequential circuit ET, ET levofloxacin triple, double doses of more potent proton pump inhibitors, probiotics and in particular, Saccharomyces boulardii during ET allows not only significantly reduce the incidence of adverse events, but also to increase the efficiency of standard circuits.
Consilium Medicum. 2015;17(8):8-14
pages 8-14 views

The use of proton pump inhibitors in patients with gastroesophageal reflux disease to ischemic heart disease

Komissarenko I.A., Levchenko S.V., Mikheeva O.M.


The article provides an overview of the literature on the problem of polymorbidity treatment of comorbidity: coronary heart disease and gastroesophageal reflux disease, the selection of the optimal therapy. Emphasis is placed on the use of proton pump inhibitors as the primary method of treatment of gastroesophageal reflux disease.
Consilium Medicum. 2015;17(8):15-19
pages 15-19 views

Current and future approaches to the diagnosis of non-alcoholic fatty liver disease

Maev I.V., Kuznetsova E.I., Andreev D.N., Dicheva D.T.


Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver disease, are prone to a progressive flow. NAFLD is a diagnosis of exclusion, and therefore rational diagnosis of this disease is based on a combination of clinical, laboratory and instrumental data. The article provides an overvi ew of current and prospective methods of diagnosis of NAFLD. We present the histological criteria of the disease, based on the scale NAS (2005) and SAF (2012). The role of biomarkers as a promising non-invasive diagnostic tools for assessing the severity of necroinflammatory and hepatic fibrosis in patients with NAFLD.
Consilium Medicum. 2015;17(8):20-27
pages 20-27 views

Herbal preparations in the treatment of diseases of the hepatobiliary system

Kaziulin A.N.


This paper describes the mechanisms of action of the two phyto-medications most commonly used in the treatment of diseases of the hepatobiliary system, standardized extract of flavonoids thistle and herbal extract (Fumitory based) medication. The data of studies of varying degrees of evidence demonstrating the efficacy and safety of these phyto-medications described insufficiently judging by the studied aspects of their application. Presents the possibility of using the combined phyto-preparation Gepabene for the treatment of diseases of the hepatobiliary system.
Consilium Medicum. 2015;17(8):28-34
pages 28-34 views

Treatment of hepatotoxic reactions to chemotherapy in patients with colorectal cancer

Varlan G.V., Galtsova S.E.


In 2013, in Russia were found 15.0% more cases of malignancies as compared to 2003. In the overall structure of the incidence of colorectal cancer is the 5th place and revealed often already at common forms of the disease, for which chemotherapy (CT) is necessary stage of treatment. Hepatotoxicity - one of the most common side effects of chemotherapy. The article assesses the effectiveness ademetionine in the treatment of liver toxicity in patients with colorectal cancer on the background of chemotherapy. According to the results of our study and literature data ademetionine is an effective hepatoprotector.
Consilium Medicum. 2015;17(8):35-37
pages 35-37 views

Some aspects of the treatment of patients after surgery on the pancreas

Vinokurova L.V., Bordin D.S., Dubtsova E.A., Nikolskaia K.A., Smirnova A.V., Varvanina G.G.


Objective: to investigate the functional state of the pancreas (P) in patients after resection of pancreas operations for complications of chronic pancreatitis calcification (CPC), and tumors of the pancreas.The study included 52 patients: 30 CPC patients, 16 of which were subjected to surgical treatment, and 22 patients after resection surgery for tumors of the pancreas. The control group consisted of 20 people, not suffering from diseases of the digestive system.The level of C-peptide in CPC patients in all studied groups was significantly reduced in comparison with the control value. No significant difference between the groups treated with conservative and surgical treatment (14 and 16 patients, respectively) was noted. And the difference was not as the whole group with surgery and between subgroups with different types of surgical treatment (draining, resection, resection-draining operation). Similar results were obtained in studies of exocrine pancreatic (fecal elastase 1).The level of C-peptide for surgery for pancreatic cancer was 0,9 ± 0,3 mg/g and 1,9±0,3 mg/g for the control group, that is, there was a significant decrease in C-peptide (p=0.0005). However, this study was limited and required further expansion.It is concluded that the CPC on the background of complicated surgeries and developing functional insufficiency of the pancreas (exocrine like and endocrine). This surgery does not affect the development of functional pancreatic insufficiency.
Consilium Medicum. 2015;17(8):38-41
pages 38-41 views

Malnutrition in chronic pancreatitis: mechanisms of pathogenesis

Kucheryavy Y.A.


Nutritional deficiency (malnutrition) is the principal marker of distress in case of chronic pancreatitis (CP) due to a loss of the main pancreatic function during digestion. The knowledge of the mechanisms of syndrome development can help clinician to understand the most justified surveillance of CP patients to avoid the occurrence and progression of malnutrition, affecting the long-term prognosis of patients.
Consilium Medicum. 2015;17(8):42-46
pages 42-46 views

Long-term infliximab therapy for ulcerative colitis

Parfenov A.I., Knyazev O.V., Ruchkina I.N.


The aim of the study is to retrospectively evaluate the efficacy of long-term infliximab treatment for patients with refractory ulcerative colitis (UC). Materials and methods. The study included 48 patients with refractory UC who had been receivinginfliximab treatment from 2008 to 2014. Steroid-associated or steroid-refractory UC was diagnosed in 40 (83.3%) patients. Eight (16.7%) patients were resistant to azathioprineor 6-merkatopurinetherapy. We used induction therapy with infliximab in a regimen of 5 mg/kg at 0.2 and 6 weeks, and continued the supportive therapy every 8 weeks.Results. After induction courses, 3 (6.3%) patients did notdemonstrate the clinical response to infliximab induction therapy and were excluded from the study. 25 (55.5%) patients in state of clinical remission up to the present day continued to receive infliximab in a regimen of 5 mg/kg every 8 weeks among 45 patients responded to therapy. 4 (8.8%) patients after 18 months therapy became non-responder, and we had to use its intensification. We increased the dose of infliximab in 2 times (to 10 mg/kg of body weight) in 2 patients and we shortened the time between the regimens from 8 to 4 weeks in other 2 patients. The changing in the therapy was successful: all 4 patients had been staying in state of clinical remission up to the present day. Asa result the maintenance infliximab therapy was successful during 64 months in 29 (64.4%) patientsamong 45 providing to increase its intensity if necessary.Conclusion. The results of long-term usage of infliximab in patients with UC study confirmed the international data concerningthe high efficiency in terms of achieving clinical response, the induction of the clinical remission, the ability to heal the mucous membranes lining the colon and decrease the frequency of relapses.
Consilium Medicum. 2015;17(8):47-50
pages 47-50 views

Crossing the clinical symptoms of functional dyspepsia and irritable bowel syndrome, and their dynamics in the combined therapy prokineticand probiotics

Samsonov A.A., Karaulov S.A., Uliankina E.V., Yashina A.V.


Currently the subject of discussion and research is the relationship between PD and other diseases of the digestive system. The combination of FD and IBS is not uncommon, it does create some problems, since the abdominal pain is the main symptom, and PD, and IBS. Search for the best ways of correction of multiple dyspeptic phenomena remains relevant to this day. We have carried out a study, which aims - to compare the efficacy and safety of monotherapy and combined therapy trimebutin trimebutin and lineksom patients' chiasm syndrome functional dyspepsia and irritable bowel syndrome. By the end of treatment, patients in both groups reported an improvement in health, side effects, intolerance reactions were observed. When combined with the effects on the pathogenetic mechanisms of functional disorders of the positive therapeutic effect is achieved faster and is more durable character than monotherapy. Key words: functional dyspepsia, irritable bowel syndrome, crossed symptoms.
Consilium Medicum. 2015;17(8):51-54
pages 51-54 views

Barrett's esophagus is a complication of gastroesophageal reflux disease: diagnosis and modern treatment methods (look surgeon)

Allakhverdian A.S., Prazdnikov E.N.


The article discusses the surgical treatment of reflux esophagitis and hiatal hernia, complicated by Barrett's esophagus.
Consilium Medicum. 2015;17(8):55-61
pages 55-61 views

The role of bile acids in the maintenance enterohepatic circulation during nutritional rehabilitation after extensive resection of the bowel

Kostyuchenko L.N., Kuzmina T.N., Smirnova O.A.


Questions of nutritional support in the event of dysfunction in the enterohepatic circulation is actively debated. We evaluated the efficacy of administration of bile acids in the structure of alimentation in violation of their metabolism as a result of the extensive intestinal resections.We describe the metabolic changes of protein and energy metabolism in the early postoperative period and one year after undergoing surgery in contingent consideration. It is shown that in the long term after extensive resection of the bowel pharmaconutrient feasibility of introducing additives in the form of offsets enterohepatic circulation.
Consilium Medicum. 2015;17(8):62-65
pages 62-65 views

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