[Liver cirrhosis of alcoholic etiology complicated by the spontaneous bacterial peritonitis].

The case of spontaneous bacterial peritonitis (SBP) in the patient, with alcoholic cirrhosis, is presented in the article. Clinical observation demonstrates diagnostic hardships of latent clinical course of alcoholic cirrhosis, complicated SBP. Clinical observation demonstrated diagnostic consequence of ultrasound elastometry.

[HCV infection in the elderly].

AIM: To investigate prevalence, clinical picture and course of hepatitis C virus (HCV) infection in elderly patients. MATERIAL AND METHODS: A total of 1045 patients aged 60- 74 years with chronic diseases of the liver (CDL) were examined for hepatitis. RESULTS: HCV monoinfection was detected in 210 (20.1%) patients. Alcohol-viral etiology of HCV was revealed in 22% cases. HCV RNA was identified in 117 (76%) out of 154 elderly patients. All the HCV infected patients had 1b genotype, high viremia. Pain and asthenic syndromes were main clinical manifestations of HCV infection. Most often the activity of HCV infection in the elderly patients was low (88.6%), progression was slow (94.7%). The latter was registered in 22.8% patients. HCV infection in the elderly entails higher inflammation activity and incidence of HCV RNA. CONCLUSION: Complex examination of elderly patients for early detection of HCV, early diagnosis and treatment slows down progression of CDL, reduces the rate of development of severe complications and lethality.

[Clinical-functional and morphological changes in the large intestine in patients with chronic abdominal ischemia]. / Kliniko-funktsional'nye i morfologicheskie izmeneninia tolstoi kishki u bol'nykh s khronicheskoi abdominal'noi ishemiei

The article presents a study of clinical variants of ischemic lesions of the large intestine (ILLI) in patients with the chronic abdominal ischemia (CAI) syndrome. There was an examination of 42 patients with putative ILLI, who had a cardiovascular pathology at the background, which led to significant hemodynamic disorders of the blood flow in unpaired visceral branches of the abdominal aorta. The authors performed a complex diagnostics of ILLI including anamnestic and clinical data, laboratory and morphological assessment of the large intestine and vessels providing its blood supply. Based on the data collected, other functional and organic diseases of the large intestine (LI) were excluded. It was revealed that the final result of ILLI differed depending on the ischemia degree--from reversible functional disorders to high-grade organic lesions of the LI. Each clinical variant of ILLI has its own clinical manifestations as well as functional, organic and morphological peculiarities of changes in the LI revealed by a laboratory and histological examination of the LI.

[Changes in the liver in glutenic enteropathy]. / Izmeneniia pecheni pri gliutenovoi énteropatii.

AIM: To evaluate frequency of clinical manifestations, biochemical and morphological alterations characteristic of liver affection in patients with glutenic enteropathy (GEP) in correlation with GE duration and severity of malabsorption syndrome (MAS). MATERIAL AND METHODS: 116 GEP patients have undergone clinico-laboratory examination, intestinoscopy with biopsy of jejunal mucosa, puncture biopsy of the liver with morphological examination of the specimens, ultrasonography of the liver. In addition, the immune status was assessed and tests for markers of hepatotropic viruses B and C were made. RESULTS: Clinical symptoms, typical for hepatic lesion in GEP patients, such as yellowness of the skin and scleras, palmar erythema, vascular stella and hepatomegaly were found in 7.2% cases. Hyperaminotransferasemia was detected in 48.4% of new cases of celiac disease, in 18.1% of patients on strict aglutenic diet. Aminotransferase hyperactivity detection was associated with severity of MAS. Morphological alterations in the liver in celiac disease are characterized by fat dystrophy, portal and periportal hepatitis, steatohepatitis or fibrosis. Combined therapy of celiac disease including strict aglutenic diet, correction of metabolic disturbances was not always effective in correction of metabolic processes in the liver. In new GEP cases early adequate therapy was most effective. CONCLUSION: The course of glutenic enteropathy is accompanied with clinicomorphological alterations in the liver. This necessitates use of drugs improving liver function.

[Use of heptral in chronic liver diseases]. / Primenenie geptrala pri khronicheskikh zabolevaniiakh pecheni.

Geptral (ademetionine) has a hepatoprotective, antidepressant, disintoxication, regenerating, antioxidant, and neuroprotective action. It compensates for the deficiency in ademetionine and stimulates its production in the organism, first of all in the liver and brain.

[Chronic abdominal ischemia: clinical manifestations, diagnostic potential and treatment policy]. / Khronicheskaia abdominal'naia ishemia: klinicheskie proiavleniia, diagnosticheskie vozmozhnosti i taktika lecheniia.

AIM: To define variants of clinical course of chronic abdominal ischemia (CAI) and treatment policy depending on functional class of the disease. MATERIALS AND METHODS: The examination of 236 patients with CAI included clinicolaboratory, endoscopic, x-ray and ultrasonic investigations, ultrasonic dopplerography, x-ray contrast aortoarteriography, histological analysis of gastric, duodenal and colon mucosa biopsies. RESULTS: 6 variants of CAI clinical course were distinguished. Most frequent CAI manifestations were erosive-ulcerative gastroduodenal lesions, primarily in men, which combined with ischemic heart disease and atherosclerosis of lower limb vessels. Women often presented with pseudopancreatic variant which was associated with hypertension and dyslipoproteinemia. By severity of clinical symptoms, 3 functional classes of the diseases were recognized. They are decisive for the treatment policy. Biopsy specimens of the mucosa exhibited dystrophy in weak inflammation. CONCLUSION: Today's diagnostic techniques and recognition of functional classes of the disease contribute to correct decision on the treatment policy.