[Multicenter study of gastroesophageal reflux disease symptoms prevalence in outpatients in Russia].

BACKGROUND: Recently, there has been an increase in the prevalence of gastroesophageal reflux disease (GERD) in Northern Europe, North America and East Asia. However data on GERD prevalence in Russian population are very limited. AIM: To determine the prevalence of GERD among the population of Russia, the clinical spectrum of GERD symptoms, the main drugs used for GERD treatment, and the rate of their administration. MATERIALS AND METHODS: The study was conducted from November 2015 to January 2017 in 8 cities of Russia. A survey of patients over the age of 18 years old visiting outpatient medical institutions for any reason, including patients without gastrointestinal complaints was carried out using a short version of the Mayo Clinic questionnaire. RESULTS: In total, 6132 questionnaires of patients aged 1890 years were analyzed [2456 men (40.1%) and 3676 women (59.9%), mean age 46.615.4 years]. The GERD prevalence among the interviewed patients was 34.2%. The incidence of GERD increased depending on body mass index and the age of the patients. Medications used by the patients for heartburn relief included proton pump inhibitors 59.96%, antacids 67.92%, H2-histamine receptor blockers 11.42%, alginates 18.41% of patients. CONCLUSION: The results of this study indicate a high prevalence of GERD among residents of Russian cities applying for primary health care (34.2%). In comparison with previous studies, an increase in the proportion of GERD patients taking proton pump inhibitors was noted; in most cases the regimen of their intake was in accordance with the recommendations.

[Metabolic characteristics, nutritional status and behavior factors in people with obesity, working at industrial plant].

An obesity is the topical problem worldwide, because excessive weight is the reason of metabolic changes that lead to development of serious chronic non-communicable diseases. The examination was aimed to assess clinical and metabolic health, nutritional status and behavior risk factors of obesity in people, working at the industrial plant. Material and methods. In 348 workers of the industrial plant (210 males, 138 females) examination was performed including anthropometry: body mass index (BMI), waist and hip circumferences and their ratio, blood pressure level detection, laboratory blood tests (glucose and cholesterol levels), and questionnaire on nutritional habits and physical activity. All examined were divided in three groups depending on BMI: 1st group - 151 (43.3%) persons with normal body mass, 2nd group - 125 (36%) working people with overweight and 3rd group - 72 (20.7%) people with obesity. Results. More than half of examined workers (mostly females) had overweight or obesity with predominantly abdominal type of fat distribution and I degree. Arterial hypertension was diagnosed in 41% of all working people (predominantly I degree), more frequently observed in obese (62.5%) and in males (45%). Each fourth man and woman had elevated total cholesterol level, which increased depending on BMI raise. Postprandial hyperglycemia was observed in 5.5% of cases, with the same frequency in both genders, predominantly in obesity. A significant part of responded with obesity, especially females, confirmed, that the reasons of excessive weight were stresses and somatic diseases (37%), and they preferred chocolate from confectionery. It was noted a correlation of BMI with egg consumption in males and with the consumption frequency of nuts, seeds and chocolate in females. Physical activity less than 3 times a month or never was observed in most of responded workers with overweight and obesity (73%), especially in males, as well as in females during the last month before the survey (57%). Conclusion. Preventive examination detected not only high prevalence of abdominal obesity, arterial hypertension and fat metabolism disturbances in people, working at the industrial plant, but also allowed to detect the most significant alimentary and behavioral risk factors of obesity.

[The lipids of the erythrocyte stroma and myocardial ischemia in patients with iron-deficiency anemia]. / Lipidy stromy éritrotsitov i ishemiia miokarda u bol'nykh zhelezodefitsitnoi anemiei.

Red cell stromal lipid fractions (total lipids and phospholipids, triglycerides, free fatty acids, cholesterol and its esters, lisophospholipids, sphyngomyelins, phosphatidylserines, phosphatidylcholines, phosphatidylethanolamines, cardiolipins, phosphatide acids) were measured and ECG A leads at rest analyzed in 29 patients with iron-deficiency anemia to detect myocardial ischemia. Significant changes in red cell stroma lipid composition were revealed, particularly marked in women with myocardial ischemia. Measures aimed at normalization of red cell stromal lipid composition in patients with iron-deficiency anemia may be regarded as one of the factors inhibiting the development of myocardial ischemia.

[Iron reserves in the female body and susceptibility to colds]. / Zapasy zheleza v organizme zhenshchin i vospriimchivost' k zabolevaniiam.

Levels of temporary invalidity because of catching cold were analyzed in 101 working women over two years and these women's levels of serum iron, total iron-binding capacity of the serum, transferrin saturation with iron, serum ferritin, and red cell ferritin measured. Women with stable iron reserves in the body virtually have no sick leaves because of catching cold, whereas in those with iron deficiency susceptibility to catching cold is increased, and if iron metabolism intensity in the body grows, invalidity periods are much longer. Normalization of not only iron reserves in the body, but correction of iron metabolism as well should be regarded as a factor exerting a favorable effect on body resistance to catching cold.

[Stromal lipids of peripheral blood erythrocytes and myocardial dystrophy in patients with iron deficiency anemia]. / Lipidy stromy éritrotsitov perifericheskoi krovi i distrofiia miokarda u bol'nykh zhelezodefitsitnoi anemiei.

Lipid fractions (total lipids and phospholipids, triglycerides, free fatty acids, cholesterol, lysophospholipids, sphingomyelins, phosphatidylserines, phosphatidylcholines, phosphatidylethanolamines, cardiolipins, phosphatidic acids) were assessed in stromal red cells of 41 patients with iron deficiency anemia (IDA). The values obtained were correlated with wave T height at rest ECG. It was found that IDA patients have abnormalities in the lipid spectrum of red cell stroma promoting myocardiodystrophy. Therapeutic measures to normalize relevant lipid spectrum may become one of the factors preventing further dystrophic developments in the myocardium.

[Phospholipid and glycerol levels in women's erythrocytes depending on body iron reserves]. / Soderzhanie fosfolipidov i glitserolov v éritrotsitakh zhenshchin v zavisimosti ot zapasov zheleza v organizme.

Red cell phospholipids and glycerols were measured in 18 normal by peripheral blood hemoglobin, 19 iron deficient (latent deficiency) and in 20 hypoferric anemia females. Latent and manifest iron deficiency caused a pronounced elevation in the levels of glycerols, lysophosphatidylinositols, lysophosphatidylcholines, lysophosphatidylethanolamines, phosphatidylinositol diphosphates and a drop in the phosphatidylserines in erythrocytes. This provokes serious structural and functional alterations in erythrocytic membranes of iron deficient subjects.

[The erythrocyte lipids of the peripheral blood and myocardial dystrophy in patients with iron-deficiency anemia]. / Lipidy éritrotsitov perifericheskoi krovi i distrofiia miokarda u bol'nykh zhelezodefitsitnoi anemiei.

Lipids of peripheral blood red cells (total lipids and phospholipids, triglycerides, free fatty acids, cholesterol, cholesterol ethers, lysophospholipids, sphingomyelins, phosphatidylserins, phosphatidylethanolamines, phosphatidylcholines, cardiolipins, phosphatid acids) were assessed in correlation with wave T height on resting ECG. It is shown that iron deficiency anemia patients develop shifts in red blood cell lipid composition contributing to the onset of myocardiodystrophy. The correction of the lipid composition defects is an additional factor decreasing dystrophic processes in the myocardium.

[The postviral asthenia syndrome in the practice of the district therapist]. / Sindrom poslevirusnoi astenii v praktike uchastkovogo terapevta.

The examination of 76 patients recovering after acute respiratory viral disease for somatic and vegetative neurologic condition revealed postinfluenzal asthenia in nearly half of them. Three degrees of the asthenia severity have been recognized. A differential approach to patients with postinfluenzal asthenia helps in more accurate evaluation of the treatment required and temporary disability grade.

[Erythrocyte membrane lipid composition in patient with iron deficiency anemia during treatment]. / Lipidnyi sostav membran éritrotsitov u bol'nykh zhelezodefitsitnoi anemiei v protsesse lecheniia.

Red blood cell membrane lipid composition was studied in 51 iron deficiency anemia patients, in 10 of them during ferro-therapy. It was noted that red blood cell membranes contained increased total levels of lipids, phospholipids and significantly decreased levels of cholesterol esters and lysophospholipids. During the treatment, in the presence of a distinct process of the recovery of disturbed lipid composition of red blood cell membranes, a significant increase was recorded in the content of triglycerides, phosphatidyl amines, while phosphatidyl and cardiolipin levels were significantly lowered. Red blood cell membrane lipid content in iron deficiency anemia patients and its dynamics in the process of their treatment might serve as an additional criteria of the body saturation with iron.

[Changes in heart volume in patients with iron-deficiency anemia (based on data from teleroentgenocardiography)]. / Izmeneniia ob''ema serdtsa u bol'nykh zhelezodefitsitnoi anemiei (po dannym telerentgenokardiografii).

Teleroentgenocardiography was employed in 96 patients with iron deficiency anemia with the purpose of evaluating the cardiac volume. This volume increased with advance of the disease. The number of women with cardiomegaly increased as well. Cardiomegaly showed a tendency to normalization in the course of treatment. These findings are of importance for the treatment and rehabilitation of patients with iron deficiency anemia.

[Combined evaluation of iron reserves in women]. / Kompleknaia otsenka zapasov zheleza v organizme u zhenshchin.

Peripheral blood hemoglobin levels, serum iron, general serum iron-binding capacity, transferrin saturation with iron, transferrin, serum ferritin and erythrocytic ferritin were studied in 101 clinically normal women. Apparent and latent iron deficiency was rather frequently detected among them. Information on transferrin saturation with iron, erythrocytic ferritins and, particularly, serum ferritin, was most valuable in the estimation of iron deficiency. The combined evaluation of erythrocytic and serum ferritins has permitted the authors to distinguish 5 variants of iron reserves in the body and to avoid discrepancy arising in their individual estimations.

[Painless myocardial ischemia in patients with iron deficiency anemia]. / Bezbolevaia ishemiia miokarda u bol'nykh zhelezodefitsitnoi anemiei.

Resting and bicycle ergometric ECGs were examined in 159 patients with iron deficiency anemia, including 100 treated with iron-containing drugs. ST segment depression in the patients undergoing exercise was regarded as a sign of silent myocardial ischemia which is common in anemic patients, its detection rate increases as the disease progresses. In patients with iron deficiency anemia, silent myocardial ischemia results in a substantial decrease of threshold intensity, has a negative effect on cardiac output both at rest and during exercise, and significantly slows down the recovery of cardiac performance during therapy. This should be borne in mind while solving problems in medial labour examinations and making rehabilitative measures in patients with the above abnormality.

[The autonomic regulation of the heart rhythm in patients with iron-deficiency anemia]. / O vegetativnoi reguliatsii serdechnogo ritma u bol'nykh s zhelezodefitsitnoi anemiei.

Overall 155 patients suffering from iron deficiency anemia were subjected to bicycle ergometry to estimate autonomic regulation of cardiac rhythm using variation pulsometry readings. The changes in vegetative regulation proceed by the type of sympathicotonia which increases clearly as the disease gravity rises. Moderate sympathicotonia is an adequate compensatory mechanism that favours adaptation of the body to anemia. On the contrary, excessive sympathicotonia is an unfavourable factor producing an adverse effect on work fitness of anemic patients. This requires the elaboration of measures aimed at eliminating in necessary cases the excessive activation of the sympathetic nervous system in patients suffering from iron deficiency anemia.

[Lipid composition of erythrocytes in iron deficiency anemia]. / Lipidnyi sostav éritrotsitov pri zhelezodefitsitnykh anemiiakh.

The assay of lipid composition in red blood cells of 51 patients with iron-deficiency anemia (IDA) was conducted with the use of horizontal thin-layer chromatography, and the state of the end blood flow was studied with the ai of conjunctival biomicroscopy. It was found that in IDA patients the content of total lipids, phospholipids, free fatty acids, cholesterol, sphingomyelins, cardiolipins and phosphatidic acids increased and that of triglycerides decreased. The content of the rest fractions of total lipids in IDA patients was practically not changed. Variations in lipid composition of red blood cells lead to disorders in their functional activity. In IDA patients it is clinically expressed in the development of the sludge phenomenon that aggravates tissue hypoxia in women with this disease.

[Compensatory changes in the microcirculatory system and their clinical significance in patients with iron deficiency anemia]. / O kompensatornykh izmeneniiakh sistemy mikrotsirkuliatsii i ikh klinicheskom znachenii u bol'nykh zhelezodefitsitnoi anemiei.

The interrelationship of the microcirculatory state with compensatory changes in central hemodynamics and exercise testing was studied in 212 patients with iron deficiency anemia using conjunctival biomicroscopy, mechanocardiography and bicycle ergometry. Alongside with general pathological disorders of terminal nature the patients with iron deficiency anemia developed compensatory changes (a decrease in the linear density of venules and an increase in their diameter) aimed at ensuring of appropriate high circulation volume and physical working capacity. Registration of compensatory deviations in the microcirculation of the anemic patients enables a physician to estimate in detail not only their general status but also the problems of medical labor examination in a more reasonable fashion.