Vol 19, No 8-2 (2017)


Pathogenetic features of contamination of the esophagus mucosa in gastroesophageal reflux disease

Tarasova G.N., Smirnova E.A.


Objective - to study the proteome pattern and the expression of E-cadherin in the esophageal mucosa, depending on the composition of pathological gastroesophageal refluxate in patients with gastroesophageal reflux disease (GERD). Materials and methods. This parallel group prospective study included patients with GERD - 39 patients with acidic and slightly acidic nature of reflux and 25 - with alkaline and slightly alkaline reflux. The diagnosis of GERD is verified in accordance with the standard survey protocol. Proteomic and immunohistochemical studies of biopsy from the distal esophagus were conducted. Mass spectra were obtained using a tandem MALDI-TOF/TOF Ultraflex II (Bruker Daltonics, Germany) mass spectrometer. Identification of proteins and peptides was carried out by searching for relevant candidates in the NCBI (National Center for Biotechnology Information) and Swiss-Prot/UniProt databases. Immunohistochemical study of biopsies was carried out by labeled streptavidin-biotin method using monoclonal mouse antibodies to E-cadherin (Dako, the USA). For statistical data analysis, the Statistis 10.0 for Windows (StatSoft, the USA) program package was used. Results. Nine proteins responsible for the formation of the cytoskeleton and the proliferation of epithelial cells are identified and typed in patients with GERD. These proteins are involved in complicated cascades of inflammatory processes in the esophageal mucosa. In the group of patients with acidic character of refluxate were differentially expressed vinculin, calponin-1, cystatin C; with alkaline character - protein-1, which is stimulated by hypoxia, prihibitin-2, thioredoxin. The tendency to decrease of E-cadherin expression in patients with alkaline character of refluxate was revealed. Conclusion. Differences in the protein profile and E-cadherin expression pathogenetically substantiate the content of GERD therapy, especially taking into account the damaging nature of pathological character of refluxate.
Consilium Medicum. 2017;19(8-2):7-12
pages 7-12 views

Bismuth-containing drugs in the treatment of patients with peptic ulcer and eradication therapy, according to the Management of Helicobacter pylori infection - the Maastricht V

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Peptic ulcer is one of the most common diseases of the digestive system, that is why every doctor should know the latest diagnostic recommendations and treatment regimens for this disease. We interviewed O.N.Minushkin, prof., MD, PhD, Head of the Department of Therapy and Gastroenterology of Central State Medical Academy of Administration of the President of Russian Federation about the recent recommendations in the treatment of Helicobacter pylori and his own research.
Consilium Medicum. 2017;19(8-2):13-16
pages 13-16 views

Modern approaches to the treatment of the functional gastrointestinal disorder and overlap syndrome

Samsonov A.A., Lobanova E.G., Mikheeva O.M., Yashina A.V., Axelrod A.G.


Aim - to analyze the modern view on pathogenesis, clinical symptoms and therapy of functional gastrointestinal diseases (FGID) and overlap syndrome. FGID include a number of separate gastrointestinal disorders, characterized by alterations in motility, visceral sensation, and mucus function, that are not associated with structural alterations. The pathogenesis of FGID seems to imply disturbance in brain-gut interactions. The most common functional disorders are irritable bowel syndrome (IBS) and functional dyspepsia (FD). As defined by Rome IV criteria overlap syndrome is one of the modern problem in therapy of FGID. The estimated prevalence of IBS and FD overlap is 42-87%. Since FGID has a huge impact on patient’s psychological condition and the quality of life it is important to treat symptoms of FGID effectively. Symptomatic treatment (antispasmodics, laxative, prokinetics, herbal extracts) has either short-term effect or low impact on patient's improvement. Thus pathogenetic therapy should be the therapy of choice for FGID and overlap syndrome treatment. The aim of FGID therapy is to reduce symptoms effectively, to avoid the symptom recurrence and overlap syndrome. Kolofort with pathogenetic action is safe and effective in FGID treatment and provide high level of patient’s compliance.
Consilium Medicum. 2017;19(8-2):17-26
pages 17-26 views

Noninvasive and laboratory methods of diagnosis alcoholic liver disease: literature review

Kuzma F., Pavlov C.S., Usanova A.A., Glushenkov D.V., Kuznetsova E.A., Semenistaya M.C.


The purpose of this review is systematization of the information regarding the diagnostic tools for alcoholic liver disease, in particular the noninvasive methods as a component of the diagnostic process for this disease.
Consilium Medicum. 2017;19(8-2):27-32
pages 27-32 views

The first experience of using ultrasound with multimodal imaging technology for the diagnosis of pancreatic insulinoma. Clinical case

Yukina M.Y., Soldatova T.V., Troshina E.A., Kuznetsov N.S., Latkina N.V., Abdulova L.I., Nuralieva N.F., Vorontsov A.V., Vladimirova V.P., Izmaylova N.S.


Insulinoma is an insulin-producing pancreatic tumor. Hyperproduction of insulin leads to hypoglycemic syndrome - an extremely life-threatening condition in consequence of the high risk of hypoglycemic coma and death. This article presents a clinical case of verification of the diagnosis of insulinoma. Along with laboratory tests were used visualizing diagnostic methods including S-Fusion. This is the first experience of applying the technology which combine ultrasound and magnetic resonance imaging (Fusion) in topical insulinoma diagnosis. S-Fusion allows us to expand the amount of diagnostic information obtained by combining the information of two diagnostic modalities in one image.
Consilium Medicum. 2017;19(8-2):33-36
pages 33-36 views

Complex therapy of irritable bowel syndrome

Simanenkov V.I., Sundukova Z.R., Solovyeva O.I.


The article presents modern view on the complex therapy of irritable bowel syndrome (IBS), which includes the use of miotropic spasmolytics, bulk laxatives, antimotility agents and psychotropic drugs. The features of pathogenetic treatment of patients with IBS. It is emphasized that the use of drugs correcting intestinal microflora - intestinal antiseptics, probiotics, prebiotics, including anti-inflammatory, regulating tone and motility of the gastrointestinal tract Iberogast®.
Consilium Medicum. 2017;19(8-2):37-44
pages 37-44 views

Skin manifestations of coeliac disease: what practicing gastroenterologist needs to know?

Zhuchkov M.V., Kotlyarov S.N.


The article discusses the most frequent dermatological manifestations of gluten enteropathy, prompt diagnosis of which plays a significant role for practicing gastroenterologists in disease management. The authors report their own clinical observations and analyze the published literature on clinical relevance of specific skin manifestationsas diagnostic markers for coeliac disease. The article provides simple description of skin manifestations of coeliac disease that will be useful for practicing physicians and gastroenterologists.
Consilium Medicum. 2017;19(8-2):45-51
pages 45-51 views

Application of the combination of polyethyleneglycol and symeticone preparations in the preparation for the route diagnostic and medical colonoscopy

Pyrkh A.V., Ivinskaya O.V., Shirokov I.I.


Goal. The study of quality of preparation of the colon for diagnostic and therapeutic colonoscopy with a combination of drugs polyethylene glycol (Fortrans) 4 litres two-stage method (2+2) and antifoam SAB Simplex 10 ml with an individual approach to preparation of patients. Materials and methods. The study involved 53 patients. All patients prepared by drug Fortrans 4 litres two-stage method (2+2) with the addition of the last liter 10 ml of simethicone SAB Symplex (time drugs have to be specified individually based on the time of the study). Used video endoscopy system of the company Olimpus Exera II Exera III, the Boston rating scale of quality of preparation of the colon. Results. According to the analysis, 90.6% of patients considered the tolerability of the preparation of satisfactory or good and fully complies with guidelines for training. 26% of patients reported reducing or stopping unwanted effects after taking the last liter of Fortrans in combination with SAB Simplex. The rate of intubation of the dome of the cecum was 92.6%. In the course of the study and 52.8% of the revealed surface epithelial formations in different parts of the colon removed 18 entities. Conclusion. Patient compliance with recommendations for diet, two-step preparation with polyethylene glycol (Fortrans), individual approach in the appointment of preparation time depending on the time of the study, observance of the time interval between the end of preparation and the inspection of 3-5 hours, the indispensable use of antifoaming agent (SAB Simplex) provide high quality training to the study
Consilium Medicum. 2017;19(8-2):52-54
pages 52-54 views

Influence of preparation Resalut® on lipid peroxidation, antioxidant status, a marker of cytolysis and cholestasis in patients with nonalcoholic fatty liver disease

Myazin R.G.


Purpose: evaluate the influence of preparation Resalut® on the dynamics of lipid peroxidation, antioxidant status, cytolysis syndrome, cholestasis, cholesterol level in patients with nonalcoholic fatty liver disease (NAFLD). Materials and methods: 70 patients with NAFLD were treated with preparation Resalut® and comparing the drug from a group of essential phospholipids. Levels of lipid peroxidation, antioxidant status, markers of cytolysis and cholestasis were determined before and after therapy course. Results: after the therapy in group of patients, threated by Resalut®, revealed a valuable positive dynamics of all indexes, improvement of the general status of patients after therapy. Conclusion: therapy with preparation Resalut® is an effective method of treatment nonalcoholic fatty liver disease.
Consilium Medicum. 2017;19(8-2):55-58
pages 55-58 views

Diabetes mellitus after liver transplantation: pathogenesis, risk factors, verification, impact on prognosis

Kosmacheva E.D., Babich A.E.


Post-transplant diabetes mellitus (PTDM) is associated with increased morbidity and mortality after liver transplantation. The review presents literature data on current views on the pathogenesis, risk factors and verification of DM in the early and late posttransplant period. Particular attention is paid to the mechanisms of the diabetogenic action of cytostatics and immunosuppressants. The understanding of the mechanisms of occurrence, management of risk factors and early diagnosis of PTDM will contribute to prevention and the timely beginning of treatment.
Consilium Medicum. 2017;19(8-2):59-63
pages 59-63 views

Differences in the effectiveness of treatment of cholelithiasis and biliary sludge with various drugs of ursodeoxycholic acid

Vyalov S.S.


Purpose: comparative analysis of clinical efficacy of ursodeoxycholic acid drugs for treatment of cholelithiasis and biliary sludge. Materials and methods. A retrospective multicenter study of 5 thousand patients was conducted, in which the actual occurrence of various stages of cholelithiasis in clinical practice was assessed. The effectiveness of treatment of cholelithiasis and biliary sludge in 210 patients receiving ursodeoxycholic acid therapy was evaluated. Results. Analysis of the patients structure on an outpatient visit revealed a frequency of cholelithiasis morbidity 15.5%. The prevalence of mild forms of cholelithiasis was 9.3%. The greatest effectiveness of reducing the size of gallstones and biliary sludge symptoms according to the results of the study was noted in the group whose participants took Ursosan. Conclusion. Сhoosing a treatment it is necessary to take into account the peculiarities of ursodeoxycholic acid preparations, the quality of production and substance. Ursosan may be a drug of choice for therapy of cholelithiasis.
Consilium Medicum. 2017;19(8-2):64-68
pages 64-68 views

Differential diagnosis of hepatic syndromes in primary care physicians’ practice

Makarova M.A., Baranova I.A.


The article concerns clinical and biochemical syndromes of diffuse liver lesions that most frequently occur in everyday primary care physicians’ practice.
Consilium Medicum. 2017;19(8-2):69-73
pages 69-73 views

Non-alcoholic fatty liver disease, hyperlipidemia and cardiovascular risks

Shirokova E.N.


Non-alcoholic fatty liver disease (NAFLD) is the main cause of morbidity and mortality associated with liver disease. The mortality of patients with NAFLD is due mainly to mortality from cardiovascular diseases, and not to the progression of liver disease with the development of liver failure, complications of portal hypertension and hepatocellular carcinoma. Most studies indicate that NAFLD is associated with an increase in cardiovascular disease, and the risk of their development increases with the progression of liver disease.
Consilium Medicum. 2017;19(8-2):74-76
pages 74-76 views

Gallstone disease: correct tactic is the key to successful litholysis

Vyalov S.S.


The article deals with data analysis on the tactic of uncomplicated cholelithiasis treatment, taking into account the features of the diagnostic search. Actual studies of methods of cholelithiasis treatment are discussed, including selection of patients - candidates for therapy, using of various drugs of ursodeoxycholic acid, aspects of costs for treatment. It is necessary to fulfill the requirements for diagnosis and selection of patients for oral litholysis, which ensures the success of therapy. Choosing a treatment it is necessary to take into account the characteristics of the drugs, the quality of production and the substance. For illustration, we analyze the clinical case.
Consilium Medicum. 2017;19(8-2):77-82
pages 77-82 views

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