[The role of mycoplasma infection (M. hominis and U. urealyticum) in inflammatory diseases of the genitourinary system the debate continues].

The article presents current views on urogenital diseases caused by M. hominis and U. urealyticum. Particular attention is paid to concurrent (co-occurring) urogenital infections. The review reports the data from epidemiological studies and outlines recent Russian and international guidelines and consensuses on managing patients with urogenital inflammatory diseases. The importance of adequate diagnosis and rational therapy of urogenital infections is discussed.

Pancreatic cancer (data of the Registry in Novosibirsk, risk factors, prevention options).

Dynamics of morbidity and mortality from pancreatic cancer in the population of Novosibirsk according to the Population-based Cancer Registry and the Registry of total mortality for 25 years (1988-2012) were analyzed. The morbidity and mortality for the studied period decreased slightly. Incidence rates in middle-aged males are higher than in females but this difference is leveled after 75 years. Possible risk factors for pancreatic cancer as well as issues of screening and prevention are discussed.

[25-year trends of incidence and mortality from liver cancer and viral hepatitis in Novosibirsk].

The article presents data of Cancer Registry in Novosibirsk for the period 1988-2012 concerning primary liver cancer. Over the period studied the incidence and mortality have declined significantly (2,5 and 2,1 times, respectively). Both figures fall in line for men and women being generally twice as high in men. The long-term trends of main etiologic risk factor for liver cancer (prevalence of hepatitis viruses B and C in the population) are shown. The issues of screening and prevention are discussed.

[Combination therapy of chronic bacterial prostatitis].

The article discusses the possible etiological factors in the development of chronic bacterial prostatitis. The authors presented a comparative long-term analysis of morbidity from non-viral sexually transmitted infections (STIs) in Russia. Against the background of general decline in STIs incidence, a significant percentage of them is made up by urogenital trichomoniasis. The findings substantiated the advantages of combination therapy (ornidazole and ofloxacin) for bacterial urinary tract infections.

PREVALENCE AND PECULIARITY OF CORPUS ATROPHIC GASTRITIS IN POPULATION WITH HIGH LEVEL OF HELICOBACTER PYLORI INFECTION.

BACKGROUND: Corpus atrophic gastritis (CAG) maybe the outcome of Helicobocterpylori (U pylon) - infection or autoimmune damage of the parietal system, affecting the risk of gastric cancer and requiring different approaches in the treatment and observation. AIM: To study the prevalence and peculiarity of CAG in population with, high prevalence of H.pylori infection. MATERIALS AND METHODS: Prevalence of CAG was studied in the representative group of Novosibirsk citizens (246 subjects aged 45-69,117 males and 129 females) using serology for noninvasive testing of gastritis phenotype Gastro-Panel. Pepsinogen I (Pgl) level < 30 pg/I and/or Pgl/Pgil ratio c 3.0 were interpreted as sever atrophy. In addition, a clinical group with serologically proven corpus atrophy was studied: 39 females and 8 males aged 38-79. Upper endoscopy and morpholojical examination was performed in 38 patients. As a pilot project, in 19 patients with suspicion on autoimmune gastritis (AIG) (low Pgl + high Gastrin-17) parietal cells antibodies (PCA) and vitamin B12 level were determined. CONCLUSION: In Novosibirsk population prevalence of both H.pylori infection and CAG (10.2%) is high. AIG is often associated with H.pylori infection (in 47.4% of cases); however, its role demands a further evaluation. Autoimmune phenotype of gastritis which was found using noninvasive diagnostic was confIrmed with the presence of PCA. In all cases ofAIG atrophy was confirmed morphologically with the presence of intestinal metaplasia in 52.6% and ~ysplasia in 10.5% of cases.

PREVALENCE AND RISK FACTORS OF GERD IN ADOLESCENTS IN NOVOSIBIRSK: TEN-YEAR TRENDS.

The aim of the study was the study of ten-year trends (1999-2009) of GERD symptoms and risk factors in schoolchildren in Novosibirsk from 14 to 17 years. MATERIALS AND METHODS: The comparison of the results of the screenings performed at 1999 and 2009 was analyzed. Anthropometry, the survey to identify the symptoms of GERD and eating habits, smoking and alcohol consumption, determination of lgG and CagA antibodies to Helicobacterpylori were included at the program of screenings. RESULTS: No significant dynamics of GER symptoms in adolescents, except weekly heartburn among boys. Among the factors associated with dyspepsia and GER, there have been some mixed changes: the frequency of smoking significantly reduced, but the proportion adolescents with excess body weight have increased. Violations of the regime and diet, and Helicobocrerpylori-infection has not changed significantly. CONCLUSION: The frequency of GERD in adolescents remains high but does not reach the prevalence of GERD in adults.

[Toxoplasmosis: Epidemiology, Diagnosis, Treatment].

The up-to-date literature and original data on the epidemiology, diagnosis and treatment of toxoplasmosis are presented. Particular attention is paid to the parasite infection during pregnancy. Spiramycin is the drug of choice for acute toxoplasmosis in pregnant women.

[EPIDEMIOLOGICAL STUDIES IN GASTROENTEROLOGY: LONG-TERM SIBERIAN EXPERIENCE OF HELICOBACTER PYLORI AND RELATED DISEASES].

The paper presents the long-term experience of Siberian epidemiological studies in the field of gastroenterology (cross-sectional and prospective). High prevalence of Helicobacterpylori infection (75-85%) in the adult population of Siberia, and the association with dyspeptic symptoms in different age groups are shown. The dynamics of infection in children and adolescents, the high detection rates of CagA-positive strains, the prevalence of the different phenotypes of gastritis and the predictive value of gastric atrophy biomarkers in relation to gastric cancer were studied. The importance of epidemiological studies for the formation of groups at risk for a number of diseases and the development of prevention programs is demonstrated.

[Physiological and clinical implications of gastric pepsinogens].

This review deals with pepsinogen metabolism, physiological role, and clinical implications. Effects of various factors, e.g H. pylori, on pepsinogen levels are considered. It is concluded that non-invasive screening of gastric precancer conditions provides a cost-effective and efficacious approach to the prevention of this pathology.

Spontaneous and mitogen-induced cytokine production in lymphoproliferative diseases.

The levels of spontaneous and mitogen-induced production of pro- and anti-inflammatory cytokines were studied in patients with chronic lymphoid leukemia, non-Hodgkin's lymphocytic lymphomas, and multiple myeloma during the course of chemotherapy. Cytokine concentrations varied within a great range and did not conform to the normal distribution law. The levels of granulocyte and granulocyte-macrophage CSF were high during the debut, progress, and remission of the lymphoproliferative diseases. Imbalance of a wide spectrum of pro- and anti-inflammatory cytokines was observed during the debut and progress of the lymphoproliferative diseases, more often in chronic lymphoid leukemia and non-Hodgkin's lymphocytic lymphomas than in multiple myeloma.

[Symptoms of gastroesophageal reflux disease and associated factors in adolescents: population survey].

OBJECTIVES: Gastroesophageal reflux (GER) is frequent among the general population affecting 10-20% of adults. However, there is a notable lack of epidemiological data describing prevalence of GER in children. The aims of the present study were to assess the prevalence of GER symptoms (GERS) in adolescents and to evaluate factors associated with GERS including markers of H. pylori infection. METHODS: All school students in grades 9-11 in four randomly selected secondary schools in Novosibirsk participated (449 adolescents, 189 boys, 260 girls aged 14-17). They completed the Bowel Disease Questionnaire, life-style questionnaire, and sera were tested for antibodies against Helicobacter pylori infection. RESULTS: Overall, 60% of adolescents experienced GERS (heartburn and/or acid regurgitation) over the previous year. GER symptoms on a monthly basis were reported by 22% of students, weekly GERS were reported by 9% of adolescents with the same frequency in both genders. GERS were related to family history of dyspepsia or GER, mother's lower educational attainment, overweight, unhealthy eating patterns, alcohol consumption, smoking, and H. pylori infection, as well as concomitant dyspepsia and irritable bowel syndrome. The majority of associations were more prominent in girls. Visiting a physician, endoscopic study, and school absenteeism were reported in the last year more frequently by adolescents with GERS vs those without GERS. CONCLUSIONS: Gastroesophageal reflux symptoms are frequent among the adolescent population and result in frequent use of health care resources. Some precipitated factors found in this study are modifiable and may be corrected in adolescent population.

[Use of immunoenzyme assay to detect the level of pepsinogen in blood].

Determining the level of blood pepsinogens has important clinical significance in the formation of risk groups for gastric cancer and erosive/ulcerative lesions of the gastric mucosa. A comparison of imported and domestic kits for testing the level of pepsinogens was performed. Russian diagnostic kits in comparison with foreign ones proved to show similar sensitivity and specificity.

[Impact of exogenous proteolytic enzymes on immunogenesis in patients with urogenital infections].

The use of systemic enzyme therapy in combination with antibiotics in the treatment of urogenital chlamydia infection in patients of both sexes proved to improve the therapeutic efficacy and to reduce the risk of the side effects.

[Efficacy of azithromycin and its impact on cytokine system in urogenital infections].

Seventy five patients with urogenital chlamydial and mycoplasmic infections were enrolled in the trial. In the etiotropic therapy azithromycin was used in the standard dosage (1.0-1.5 g) depending on the infection. The treatment with azithromycin, in addition to the high eradication rates, was also evident of its effect on the cytokine levels in the patients, that was characteristic of a significant increase of the IFN-gamma level and a decrease of the IL-1beta and IL-6 levels in the blood.

[Risk of gastric cancer dependent on serological markers of atrophic gastritis: cohort study].

In a prospective study the risk of subsequent gastric cancer (GC) was assessed in persons aged 45-69 over 5 years after the initial testing with a set of serological tests (pepsinogen I, pepsinogen II, gastrin-17, antibodies to Helicobacter pylori). The presence of gastric atrophy markers was a significant predictor of GC in the forthcoming years. Non-invasive techniques may be used in the formation of high-risk groups, followed by GC active surveillance.

[Use of macrolides in pregnancy and lactation according to evidence-based medicine: pro et contra].

The use of macrolides in the treatment of chlamydial infection during pregnancy and breast feeding is reviewed from the viewpoint of evidence-based medicine. The clinical experience and research data suggest azithromycin to be safe and effective in the obstetric practice.

[Mode of dieting as a risk factor for dyspeptic symptoms: a two-year prospective study].

A random representative sample of adolescents has been questioned about gastrointestinal symptoms and mode of dieting habits. Four hundred fifty schoolchildren participated primarily and over two years. Irregular meals, hasty meals, long period between meals were associated with symptoms of dyspepsia and gastroesophageal reflux. Moreover, symptoms developed over 2 years were related to newly reported changes in dieting habits.

[The level of serum cytokines in children infected with various strains of Helicobacter pylori].

Serum contents of 7 cytokines (IL-1, IL-1beta, IL-6, IL-8, TNF-alpha, INF-gamma, INF-alpha) were examined in 87 children aged 14-17 years according to presence of antibodies against Helicobacter pylori and cytotoxic CagA protein. There was a lack of difference in cytokine levels between infected and non-infected children. Thus H. pylori infection in children in contrast to adults does not cause changes in systemic cytokine secretion.

[Quality of life at dyspepsia and irritable bowel syndrome: population-based studies].

The aims of the study were to examine the prevalence of dyspepsia and irritable bowel syndrome (IBS) in the unselected population and to assess the quality of life (QOL) in these syndromes and their combination. The study involved 1,040 people, representing a random sample of adults aged 45-70 years (492 men, 548 women). To identify gastrointestinal symptoms using validated questionnaire, dyspepsia and IBS were diagnosed by Rome I criteria. QOL was assessed using a questionnaire SF-36. Dyspepsia was reported by 37.5% (30.1% men and 44.2% women, p < 0.001). The prevalence of IBS was 18.8% (12.0% men and 25,0% in women, p < 0.001). The combination of dyspepsia and IBS was noted in 12.0% (6.5% in men and 17.0% in women). Both dyspepsia and IBS cause significant decrease in QOL on most scales of the questionnaire SF-36 compared with those without these disorders. Their combination reduced QOL even more in comparison with isolated dyspepsia or IBS. Finally, high prevalence of dyspepsia and IBS was stated among the population, both conditions more frequently observed in women. QOL is significantly reduced in subjects with dyspepsia and IBS, especially if these syndromes combine.

[Gastrointestinal symptoms in adult population of Novosibirsk city: prevalence and risk factors].

AIM: To study prevalence of dyspepsia symptoms, gastroesophageal reflux (GER) and irritable bowel syndrome (ICS) in city population and to detect relevant risk factors. MATERIAL AND METHODS: Gastrointestinal symptoms were investigated with a validated questionnaire Bowel Disease Questionnaire and dyspepsia, GER, ICS syndromes were identified in a representative sample of adult Novosibirsk population (1040 patients, 492 males and 548 females aged 45-69 years). Risk factors were studied by social-demographic and antropometric parameters, smoking, drinking and administration of nonsteroidal anti-inflammatory drugs (NSAD). Depression was assessed by CESD questionnaire. Helicobacter pylori infection and the level of pepsinogen I were studied with enzyme immunoassay Biohit GastroPanel (Biohit, Finland). RESULTS: Incidence of dyspepsia was 38%, GER--30%, ICS--19%. One of the illnesses was found in 56% cases, combination of the conditions--in 24%. Females had dyspepsia and ICS much more frequently. Social-demographic parameters (age, marital status, education, labor activity), alcohol consumption, intake of NSAD, Helicobacter pylori infection had no significant effect on the incidence of gastrointestinal symptoms. GER occurred more frequently in smoking males. Overweight was characteristic both for GER males and females. Severe depression was associated with the risk of dyspepsia and ICS both in females and males. Hyperpepsinogenemia increased the rate of GER detection in males and dyspepsia in females. CONCLUSION: Dyspepsia, GER and ICS were seen in 50% adult population and often combine, but the risk factors differ. Some of the latter can be modified and prevented.