RESUMEN
AIM: To study the activity of neutrophilic granulocytes in patients with opisthorchiasis, depending on the severity of liver fibrosis. MATERIALS AND METHODS: A total of 74 patients with chronic opisthorchiasis (39 men and 35 women, average age 42.3 years) and 32 practically healthy patients (17 men and 15 women, average age 41.5 years) aged 24 to 60 years were examined. Diagnosis of opisthorchiasis was carried out by two methods: coprooscopy and identification of eggs or bodies of adult parasites in duodenal content. Liver fibrosis was determined by the method of elastometry according to the METAVIR scale in all 74 patients with opisthorchiasis. The study of the functional activity of neutrophils in the blood was performed to all 74 patients with opisthorchiasis and 32 healthy individuals from the control group by chemiluminescent analysis with measurement of the reactive oxygen species (ROS) production intensity in a spontaneous and zymosan-induced reaction in lucigenin and luminol-dependent processes. RESULTS: Liver fibrosis F2 by METAVIR was registered in 20.3% of the examined individuals, liver fibrosis F3F4 by METAVIR was detected in 17.6% of patients with opisthorchiasis. In patients with opisthorchiasis with liver fibrosis F3F4 by METAVIR, a significant decrease in the functional activity of neutrophilic granulocytes was registered in comparison with individuals with liver fibrosis F0F1 by METAVIR, as evidenced by a significant decrease in the maximum intensity of ROS production (Imax) and the area under the curve (S) chemiluminescence in lucigenin and luminol-dependent processes both in the spontaneous and zymosan-induced reaction. CONCLUSION: These results provide new information to explain the mechanisms of liver fibrosis in patients opisthorchiasis and create opportunities for the development of diagnostics and preventive technologies.
Asunto(s)
Opistorquiasis , Adulto , Masculino , Humanos , Femenino , Opistorquiasis/complicaciones , Opistorquiasis/diagnóstico , Opistorquiasis/parasitología , Especies Reactivas de Oxígeno , Luminol , Zimosan/farmacología , Granulocitos , Cirrosis Hepática/diagnóstico , HígadoRESUMEN
AIM: to determine the efficacy and safety of Kolofort in the treatment of patients with irritable bowel syndrome (IBS). SUBJECTS AND METHODS: 52 patients (16 men and 36 women) aged 26 to 59 years were examined over 4 months to rule out organic disease. The diagnosis of IBS was established on the basis of the Rome III diagnostic criteria (2006). Seven patients were diagnosed as having IBS with a preponderance of constipation; 3 had IBS with a preponderance of diarrhea, and 42 had mixed IBS. Thereafter they were given Kolofort, a combination release-active antibody drug having anxiolytic, anti-inflammatory, and spasmolytic effects. Kolofort affects the ligand-receptor interactions of the brain-specific protein S-100 with serotonin receptors and σ1-receptors in the central nervous system and that of histamine with histamine H4 receptors in the gastrointestinal tract and modifies (regulates) the functional activity of tumor necrosis factor-α (TNF-α). The regulatory action of the drug at the level of the central and autonomic nervous system and the immune system manifests itself as spasmolytic, anti-inflammatory, and sedative effects, which as a whole effectively normalizes gastrointestinal motility. For 3 months, the patients took sublingual Kolofort in a dose of 2 tablets thrice daily for 2 weeks, then 2 tablets twice daily for 2.5 months. Control was made 2 weeks, 1, 2, and 3 months after treatment initiation. The investigators assessed abdominal pain syndrome, defecation disorders, abdominal distension, and flatulence by the visual analogue scale (VAS-IBS questionnaire), visceral sensitivity index (VSI questionnaire), quality of life (QL) in patients with IBS (IBS-QoL questionnaire), and stool form according to the Bristol Stool Chart and measured the levels of TNF-α and interleukin (IL)-1ß and IL-10 before and after treatment. RESULTS: The efficacy of Kolofort showed itself within 2 weeks of its administration against all the study functional parameters (pain, defecation disorder, and flatulence). After one month of therapy, the efficacy of Kolofort achieved meaningful statistical significance against abdominal pain, complaints of flatulence, visceral sensitivity index, and QL. The statistically significant restoration of a stool form was achieved 2 months after treatment and 3-month Kolofort treatment showed a clear-cut positive clinical effect that appeared as reductions in pain syndrome (214±0.22; Ñ < 0.001) and visceral hypersensitivity symptoms (from 30.33±2.9 to 67.76±6.5; Ñ < 0.001), improvements in subjective sensations associated with defecation disorders (from 6.95±0.71 to 2.74±0.28; Ñ < 0.001), stool form, and QL indicators (from 103.48±9.06 to 44.95±5.4; Ñ < 0.001), and a decrease in blood TNF-α levels after treatment termination (from 9.16 to 7.02 pg/ml; Ñ < 0.026). A Kolofort treatment cycle for IBS produced no clinically relevant side effects. CONCLUSION: Kolofort was highly effective in relieving symptoms, in normalizing the psychological status, and in lowering the levels of TNF-α in the treatment of IBS. The efficacy of the drug was achieved because of its combined effect on the main components of the pathogenesis of IBS.
Asunto(s)
Anticuerpos/administración & dosificación , Fármacos Gastrointestinales , Motilidad Gastrointestinal/efectos de los fármacos , Síndrome del Colon Irritable/tratamiento farmacológico , Receptores Histamínicos/inmunología , Proteínas S100/inmunología , Factor de Necrosis Tumoral alfa/inmunología , Adulto , Ansiolíticos/farmacología , Antiinflamatorios/farmacología , Combinación de Medicamentos , Monitoreo de Drogas , Fármacos Gastrointestinales/administración & dosificación , Fármacos Gastrointestinales/efectos adversos , Humanos , Factores Inmunológicos/administración & dosificación , Síndrome del Colon Irritable/diagnóstico , Síndrome del Colon Irritable/inmunología , Síndrome del Colon Irritable/fisiopatología , Síndrome del Colon Irritable/psicología , Masculino , Persona de Mediana Edad , Parasimpatolíticos/farmacología , Resultado del TratamientoRESUMEN
AIM: To study prevalence and risk factors of gastroesophageal reflux disease in different age-gender groups. MATERIAL AND METHODS: 506 men of military age, in 375 men in age 40-60 years old, 296 women in age 18-30 years old were investigated. The research included clinical examination with standard questionnaires filling and endoscopy. RESULTS: Prevalence of heartburn in men of military age was 30.4%; in men in age 40-60 years old--46.9%, (p(1-2) < 0.001), in women--24.6% (p(1-3) = 0.8). Prevalence of esophagitis in men of military age was 2.4%; in men in age 40-60 years old--4.3%, (p(1-2) = 0.1), in women--0.7% (p(1-3) = 0.07). CONCLUSION: Features of clinical manifestations and risk factors action in three different age-gender groups were established.