[Functional activity of blood neutrophilic granulocytes in patients with opisthorchiasis, depending on the severity of liver fibrosis].

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.

[European registry Helicobacter pylori (Hp-EuReg): how has clinical practice changed in Russia from 2013 to 2018 years].

The multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group (EHMSG) is conducted in 27 countries in Europe. The data from the Russian part of the European registry for the management of Helicobacter pylori infection (European Registry on the management of Helicobacter pylori infection, protocol: "Hp-EuReg") allows us to analyze the real clinical practice of diagnosis and treatment of H. pylori and compare it with international recommendations. MATERIALS AND METHODS: A comparative analysis of the data entered in the register by the Russian research centers "Hp-EuReg", in the period from 2013 to 2018, was conducted. RESULTS AND DISCUSSION: Invasive diagnostic methods prevail for the primary diagnosis of H. pylori [histology - 20.3% (in 2013 year) - 43.9% (in 2018 year), rapid urease test - 31.7% and 47.8% respectively]. The most popular mode of eradication therapy is a 10-day triple therapy (62.8-76.2%), the effectiveness of which does not exceed 79% (per protocol). Invasive tests (histology) are the leading method for control the effectiveness of therapy, however, there is a tendency towards a wider use of non-invasive methods (H. pylori stool antigen - from 17% in 2013 to 29.3% in 2018 and urea breath test from 6.9 to 18.3%, respectively). Serological test to control the effectiveness of eradication is still used from 8.2% (2013) to 6.1% (2018). Eradication therapy was not performed in 28% of patients throughout the entire observation period. CONCLUSION: In Russia, despite approved domestic and international recommendations, deviations in clinical practice persist, both during eradication therapy and in monitoring the effectiveness of eradication therapy.

Russian consensus on exo- and endocrine pancreatic insufficiency after surgical treatment.

The Russian consensus on exo- and endocrine pancreatic insufficiency after surgical treatment was prepared on the initiative of the Russian "Pancreatic Club" on the Delphi method. His goal was to clarify and consolidate the opinions of specialists on the most relevant issues of diagnosis and treatment of exo- and endocrine insufficiency after surgical interventions on the pancreas. An interdisciplinary approach is provided by the participation of leading gastroenterologists and surgeons.

Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program "odyssey".

AIM: To assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. MATERIALS AND METHODS: 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. RESULTS: All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course ("prolonged population"). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore 'symptoms'. CONCLUSION: The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.

Changes in the indices of prooxidant and antioxidant systems in blood plasma in men with atrophic gastritis and gastric cancer.

AIM: To study changes in the indices of prooxidant and antioxidant systems in plasma in men with atrophic gastritis and gastric cancer. MATERIALS AND METHODS: The study included 60 healthy men, 42 patients with atrophic gastritis and 50 men, nicardipine patients with gastric cancer stage II according to TNM. All patients underwent serological diagnosis of diffuse atrophic gastritis (definition of pepsinogens and gas- trin-17) and Helicobacter pylori infection. The diagnosis of "atrophic gastritis" was verified by morphological examination of biopsy speci- mens obtained during fibroesophagogastroduodenoscopy. Diagnosis of gastric cancer was carried out in the Krasnoyarsk regional oncologic dispensary on the basis of a comprehensive instrumental and morphological examination. All patients spectrophotometric methods in plasma was determined the content of diene conjugates (DC), malonic dialdehyde (MDA), glutathione-S-transferase (GST), glutathione peroxidase (GPO), superoxide dismutase (SOD) and catalase. RESULTS: The concentration of SOD, GST, GPO and catalase had no significant differences in patients with atrophic gastritis and gastric cancer and prevailed in comparison with healthy persons. Patients with cancer of the stomach content in the blood plasma DK 2.7 times and MDA at 35.2 times higher than healthy individuals, indicating severe oxidative stress in patients with cancer. In patients with atrophic gastritis was ob- served similar but less pronounced pattern. CONCLUSION: The results indicate the presence of oxidative stress in men with atrophic gastritis and gastric cancer.

European Registry on the management of Helicobacter pylori infection (Hp-EuReg): analysis of 2360 patients receiving first-line therapy in Russia.

AIM: European Registry on the management of Helicobacter pylori infection («Hp-EuReg¼) - a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group, conducted in 27 European countries in order to evaluate the real clinical practice of diagnosis and treatment of H. pylori and its comparison with international recommendations. MATERIALS AND METHODS: The analysis of 2360 patients entered in the register by the Russian centres of «Hp-EuReg¼ in 2013-2017, who were underwent 1st line eradication therapy. RESULTS: The most common methods of primary diagnosis of H. pylori are histological (37.7%), rapid urease test (29.2%) and serology (29.7%). The duration of eradication therapy in 9.4% of cases was 7 days, in 65.3% - 10 days, and in 25.3% - 14 days. To control the effec- tiveness of treatment, H. pylori antigen in feces (31.3%), urea breath test (23.4%) and histological method (23.3%) were used. In 3.6% cases was used serology by mistake. In 17.3% of patients control was not carried out. The effectiveness of triple therapy with a PPI, amoxicillin, clar- ithromycin (per protocol) was 67.6%, with 7-day course, 81.1% at 10-day and 86.7% at 14-day course. Eradication rate of triple therapy with addition of bismuth (per protocol) reached 90,6% in the group receiving 10-day scheme and 93.6% in the group receiving the 14-day treatment. CONCLUSION: Significant deviations of clinical practice from expert recommendations, most pronounced at the stage of monitoring the effectiveness of therapy, were noted. The suboptimal efficacy of triple therapy is shown.

[The Russian consensus on the diagnosis and treatment of chronic pancreatitis: Enzyme replacement therapy]. / Rossiiskii konsensus po diagnostike i lecheniiu khronicheskogo pankreatita: zamestitel'naia fermentnaia terapiia.

Pancreatology Club Professional Medical Community, 1A.S. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow; 2A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow; 3Kazan State Medical University, Ministry of Health of Russia, Kazan; 4Kazan (Volga) Federal University, Kazan; 5Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk; 6Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow; 7I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg; 8Siberian State Medical University, Ministry of Health of Russia, Tomsk; 9M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow; 10Maimonides State Classical Academy, Moscow; 11V.I. Razumovsky State Medical University, Ministry of Health of Russia, Saratov; 12I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow; 13S.M. Kirov Military Medical Academy, Ministry of Defense of Russia, Saint Petersburg; 14Surgut State Medical University, Ministry of Health of Russia, Surgut; 15City Clinical Hospital Five, Moscow Healthcare Department, Moscow; 16Nizhny Novgorod Medical Academy, Ministry of Health of Russia, Nizhny Novgorod; 17Territorial Clinical Hospital Two, Ministry of Health of the Krasnodar Territory, Krasnodar; 18Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg; 19Rostov State Medical University, Ministry of Health of Russia, Rostov-on-Don; 20Omsk Medical University, Ministry of Health of Russia, Omsk; 21Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow; 22Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk; 23Stavropol State Medical University, Ministry of Health of Russia, Stavropol; 24Kemerovo State Medical University, Ministry of Health of Russia, Kemerovo; 25N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow; 26A.M. Nikiforov All-Russian Center of Emergency and Radiation Medicine, Russian Ministry for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters, Saint Petersburg; 27Research Institute for Medical Problems of the North, Siberian Branch, Russian Academy of Sciences, Krasnoyarsk; 28S.P. Botkin City Clinical Hospital, Moscow Healthcare Department, Moscow; 29Tver State Medical University, Ministry of Health of Russia, Tver The Russian consensus on the diagnosis and treatment of chronic pancreatitis has been prepared on the initiative of the Russian Pancreatology Club to clarify and consolidate the opinions of Russian specialists (gastroenterologists, surgeons, and pediatricians) on the most significant problems of diagnosis and treatment of chronic pancreatitis. This article continues a series of publications explaining the most significant interdisciplinary consensus statements and deals with enzyme replacement therapy.

[Change in the ratio of blood saturated to unsaturated fatty acids is a universal marker of lipid metabolic disorder in patients with cholelithiasis]. / Izmenenie sootnosheniya nasyshchennykh i nenasyshchennykh zhirnykh kislot v krovi ­ universal'nyi marker narusheniya lipidnogo obmena u bol'nykh kholelitiazom.

AIM: To study the spectrum of serum fatty acids (SSFA) and the composition of blood lipids in cholelithiasis (CL) in various ethnic groups of East Siberia. SUBJECTS AND METHODS: A clinical and epidemiological study was conducted, during which ultrasonography and oral cholecystography were used to examine 991 Khakases and 934 Europoids in Khakassia and 652 Evenks and 996 Europoids in Evenkia. Biochemical tests were performed to determine serum lipids in 20% of the random sample. Gas liquid chromatography was applied to investigate ASSFA in 220 patients in Khakassia and 157 people in Evenkia. RESULTS: The manifestations of hyperlipidemia were detected in the Europoids with CL in Evenkia and Khakassia. These changes were less pronounced in the Evenks with CL and absent in the Khakases with CL. In all populations, the blood levels of saturated FAs and ratios of saturated to unsaturated FAs were considerably higher in the patients with CL than in the healthy individuals. CONCLUSION: The higher levels of saturated FAs and the lower proportion of serum unsaturated FAs are a universal marker of lipid metabolic disturbances in patients with CL in genetically different populations.

[Efficacy of Kolofort for the treatment of patients with irritable bowel syndrome]. / Effektivnost' Koloforta v lechenii bol'nykh s sindromom razdrazhennogo kishechnika.

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; р < 0.001) and visceral hypersensitivity symptoms (from 30.33±2.9 to 67.76±6.5; р < 0.001), improvements in subjective sensations associated with defecation disorders (from 6.95±0.71 to 2.74±0.28; р < 0.001), stool form, and QL indicators (from 103.48±9.06 to 44.95±5.4; р < 0.001), and a decrease in blood TNF-α levels after treatment termination (from 9.16 to 7.02 pg/ml; р < 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.

[The frequency and clinical aspects of extraesophageal syndromes in elderly patients with gastroesophageal reflux disease].

AIM: To investigate the frequency of extraesophageal syndromes in elderly patients with gastroesophageal reflux disease (GERD). MATERIALS AND METHODS: This cross-sectional study was conducted to compare the clinical manifestations of GERD in 1100 patients aged 60 to 75 years and in 453 patients aged 36 to 60 years. A control group consisted of 154 elderly patients without GERD and 178 mature-aged patients without this condition. GERD was diagnosed via analysis of its symptoms, esophagogastroduodenoscopy, and 24-hour pH monitoring on the basis of the Montreal consensus guidelines. Extraesophageal syndromes were detected actively using the current methods accepted to treat lung, heart, and ENT diseases and a simultaneous gastroesophageal examination. RESULTS: Chronic cough, asthma, chronic laryngitis, cardialgias and cardiac arrhythmias were much more common in elderly patients with GERD than in those without this condition and prevalent in patients with erosive esophagitis and Barrett's esophagus as compared with those with non-erosive reflux disease. The mature-aged patients were recorded to have similar but less pronounced trends. The authors proposed an algorithm for the management of patients with extraesophageal manifestations of GERD, the important aspect of which was two-month acid-suppressive therapy used as both diagnostic testing and empirical treatment for this pathology. CONCLUSION: The extraesophageal manifestations of GERD in elderly patients are a serious clinical problem calling for considerable attention.

[European Registry on the management of Helicobacter pylori infection (Hp-EuReg protocol): The first results of Russian centers].

AIM: To assess the clinical practice of diagnosis and treatment in patients with Helicobacter pylori infection and to compare this practice with the international guidelines in the European Registry on the management of Helicobacter pylori infection, Hp-EuReg protocol), a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group. MATERIALs AND METHODS: The data of 813 patients infected with H. pylori and entered in the Hp-EuReg register by the Russian centers in 2013-2015 were analyzed. RESULTS: The most common methods for the primary diagnosis of H. pylori infection are histology (40.3%), rapid urease test (35.7%), and serology (17.2%). The duration of H. pylori eradication therapy was 7, 10, and 14 days in 18.0, 49.3, and 25.1%, respectively. To monitor the effectiveness of treatment, the investigators used a histological examination (34%), a urea breath test (27.3%), H. pylori stool antigen (22.8%), and a rapid urease test (16.3%). A serological test was carried out in 2.5% of the cases. No monitoring was done in 13.5% of the patients. The average eradication efficiency was 82.6%. If the therapy was ineffective, 80% of physicians did not intend to prescribe a new cycle of treatment. CONCLUSION: Significant differences were found between clinical practice and the current guidelines.

[ESOPHAGITIS, CAUSED BY HERPES SIMPLEX VIRUS: CASE REPORT].

The clinical observation of the patient at the age of 56 years, with lesions of the esophagus by the herpes simplex virus has been presented. The patient complained of odynophagia and dysphagia. Treatment with proton pump inhibitors in outpatient stage was not effective. On endoscopic examination revealed multiple ulcers in all parts of the esophagus. Herpes simplex virus has been detected in biopsy specimens of esophageal mucosa by the PCR method. Treatment with acyclovir led to rapid and complete clinical recovery. Analysis of the literature allowed making the conclusion about the importance and actuality this demonstration.

[THE ROLE OF OXIDATIVE STRESS IN THE PATHOGENESIS OF GASTROESOPHAGEAL REFLUX DISEASE].

AIM: To study features of lipid peroxidation in patients with different types of gastroesophageal reflux disease (GERD). METHODS: We examined 120 patients with different clinical variants of GERD and 25 healthy individuals. It was determined the concentration of diene conjugates (DC) ketodienes (KD), conjugated trienes (CT) by biochemical methods in serum and mucosal biopsies of the lower third of the esophagus. RESULTS: In biopsies of esophagus mucosa the content of DK, CD, CT was increased in patients with complications of GERD (ulcerative esophagitis and Barrett's esophagus) in 2,2-5,3 times compared with healthy individuals. In blood serum registered similar but less pronounced regularities. CONCLUSION: It was revealed a significant intensification of free radical oxidation in the tissues of the esophagus and the blood of patients with GERD, which was exacerbated in proportion to the severity of the disease.

[Indicators of apoptosis in the gastric mucosa in patients with atrophic gastritis among the indigenous and nonindigenous dwellers of Evenkia].

AIM: To study the indicators of apoptosis in the gastric mucosa (GM) in relation to atrophy and the presence of CagA gene- containing Helicobacter pylori strains in the indigenous and nonindigenous dwellers of Evenkia. SUBJECTS AND METHODS: Clinical and morphological examinations and fibrogastroscopy of GM were performed in 159 Caucasians and 136 Mongoloids (Evenks). The TUNEL assay was used to determine GM apoptosis in 24 Caucasians and 22 Evenks and the H. pylori strains containing the CagA gene were detected in all the 295 patients. RESULTS: The extent of atrophic gastritis in the gastric antrum and body was higher in the Caucasians than in the Evenks. The total indicator of GM apoptosis in the gastric antrum was 5.19 ± 0.26% in the newcomers and 4.04 ± 0.28% in the aboriginals (p = 0.01). Apoptosis in both populations was associated with GM atrophy and the presence of H. pylori strains containing CagA gene. CONCLUSION: There were ethnic differences in the extent of atrophic gastritis, which may be attributable to differences in the rate of GM apoptosis and the spread of H. pylori strains containing CagA gene in the indigenous and non-indigenous dwellers of Evenkia.

Parameters of proliferation and apoptosis of epithelial cells in the gastric mucosa in indigenous and non-indigenous residents of Khakassia with Helicobacter pylori positive duodenal ulcer disease.

We evaluated parameters of apoptosis in the mucosa of the gastric antrum and body of indigenous and non-indigenous residents of Khakassia with duodenal ulcer disease associated with Helicobacter pylori infection. In the gastric antrum, apoptotic index was significantly increased in patients with ulcer disease in comparison with healthy individuals in both populations. The ratio of proliferation index to apoptotic index was lower in patients with ulcer disease in comparison with healthy individuals in both populations. Similar, but less pronounced processes were recorded in the body of the stomach. Significant changes in the parameters of proliferation and apoptosis were noted in the gastric antrum and body of the stomach in both populations, but they were more pronounced in Caucasians in comparison with Khakasses.

[Role of Helicobacter pylori eradication in the prevention of gastric cancer].

The review deals with the current aspects of prevention of non-cardia gastric cancer (GC). Helicobacter pylori is the most common cause of non-cardia GC. The Correa cascade remains a major pattern of the pathogenesis of non-cardia GC as before. The key moments in gastric carcinogenesis are H. pylori infection; genes associated with cell recognition of bacteria; an immune response and the activation of an inflammatory response. The prevention of GC requires H. pylori eradication as primary prevention in combination with screening for this pathology as secondary prevention of gastric malignancies. Standard three-component therapy is a first-line major regimen for H. pylori eradication.

[Clinical aspects of gastroesophageal reflux disease in elderly patients: results of a 5-year prospective study].

AIM: To evaluate the clinical manifestations and changes of non-erosive reflux disease, erosive reflux disease, and Barrett's esophagus (BE) in a cohort of elderly patients during a 5-year follow-up. SUBJECTS AND METHODS: A continuous method was used to compare the clinical manifestations of gastroesophageal reflux disease (GERD) in 950 patients aged 60 to 75 years and 453 patients aged 36 to 60 years. All the patients underwent clinical examination using the Mayo clinic questionnaire and fibroesophagogastroduodenoscopy. A prospective cohort study was performed in 950 patients aged 60 to 75 years for an average of 5 years. GERD was diagnosed on the basis of the Montreal Consensus guidelines (2006); the degree of esophageal mucosal injury was evaluated according to the Los-Angeles classification (1999). The diagnosis of BE was morphologically verified. RESULTS: The frequency of weekly heartburn was 10% higher in the mature-aged patients; but that of nocturnal heartburn, belching, and BE prevailed in the elderly patients. The 5-year prospective follow-up revealed a significant increase in the rate of erosive esophagitis and BE in the elderly patients with GERD. The risk factors of the latter were no maintenance therapy with proton pump inhibitors, as well as obesity and hiatal hernia. CONCLUSION: GERD shows clinical features and progression in the elderly patients.

[Helicobacter pylori eradication: current status].

The paper gives an update on the efficiency of Helicobacter pylori eradication. Triple therapy (a proton pump inhibitor + clarithromycin + amoxicillin) therapy is shown to hold top positions as first-line therapy for H. pylori eradication as before. The leading second-line therapy regimens are quadruple and 10-day triple schemes including levofloxacin. This point of view is supported by the Russian Gastroenterology Association. To reduce an increase in H. pylori resistance to clarithromycin, it is advisable to use Klacid (generic name: clarithromycin) in the eradication schemes.

[The prevalence and clinical aspects of Barrett's esophagus in the population of Eastern Siberia].

AIM: To study the prevalence and clinical aspects of Barrett's esophagus (BE) in natives and newcomers in East Siberia. SUBJECTS AND METHODS: Clinical examinations and esophagogastroduodenoscopy were performed in 12975 Caucasoids and 1489 Khakases in Abakan (Khakasia), 1861 Caucasoids and 5829 Tuvinians in Kyzyl (Republic of Tuva), and 1177 Caucasoids in Dudinka (Taimyr). The diagnosis of BE was verified by morphological study. RESULTS: Among the Caucasoids, the total prevalence of BE was 1.6% (2.4% in men and 0.8% in women; odds ratio (OR) was 3.21 with 95% CI 2.40-4.29; p < 0.001); among the Mongoloids, that was 3.1% (4.5% in men and 2% in women; OR, 2.3 with 95% CI 1.75-3.04; p < 0.001). Heartburn and other typical symptoms was more prevalent in patients with BE. The risk factors of BE in all the examined populations were male sex, age over 40 years, smoking more than 20 cigarettes a day for 10 years or more in men, and obesity. CONCLUSION: There were ethnic differences in the prevalence of BE, which were prevalent in East Siberia in the Mongoloids as compared to the Caucasoids.

[Peculiarities of relationship between atrophic gastritis and stomach cancer in the population of Eastern Siberia].

The authors studied the prevalence of atrophic gastritis, H.pylori strains carrying the CagA gene, seeding and apoptosis indices of gastric mucosa in indigenous and newcomer residents of Evenkia. A total of 136 Evenks and 159 newcomers were examined using fibrogastroscopy and biopsy of antral gastric mucosa. Morphological study included light microscopy of hematoxylin and eosin-stained biopsies and their analysis using a visual-analog scale to reveal signs of inflammation, apoptosis, intestinal metaplasia and the degree of insemination by P. pylori. Urease and morphological tests were used to identify H. pylori and the TUNEL technique (Mebstain Apoptosis kit direct, France) to determine apoptosis index; serum anti-Helicobacter and CagA antibodies were detected by an immunoenzyme assay in 22 Evenks and 24 newcomers with chronic H. pylori-associated gastritis. The prevalence of atrophic gastritis in these groups was estimated at 13.2 and 23.9% respectively, seeding density 45.37 +/- 2.01 and 214 +/- 8.75 (p < 0.001). H. pylori strains carrying the CagA gene were identified in 59.6 and 43.6% of the newcomers and Evenks (p = 0.01), total apoptosis index in greater curvature mucosa was 4.99 +/- 0.23 and 3.19 +/- 0.28 (p < 0.01) respectively. These ethnic difference in the prevalence of atrophic gastritis appear to be attributable to different intensity of apoptosis in greater curvature mucosa.