RESUMEN
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.
Asunto(s)
Consenso , Insuficiencia Pancreática Exocrina , Páncreas/cirugía , Glucemia/análisis , Insuficiencia Pancreática Exocrina/diagnóstico , Insuficiencia Pancreática Exocrina/etiología , Insuficiencia Pancreática Exocrina/terapia , Heces/química , Hemoglobina Glucada/análisis , Terapia de Reemplazo de Hormonas/métodos , Lipasa/uso terapéutico , Estado Nutricional , Páncreas/enzimología , Páncreas/fisiopatología , Pancreatectomía , Elastasa Pancreática/análisis , Federación de RusiaRESUMEN
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.
Asunto(s)
Terapia de Reemplazo Enzimático/métodos , Pancreatitis Crónica , Manejo de la Enfermedad , Humanos , Moscú , Pancreatitis Crónica/diagnóstico , Pancreatitis Crónica/terapiaRESUMEN
AIM: to study relationship between parameters of intracardiac hemodynamics assessed by Doppler echocardiography and functional activity of endothelium, hepatic blood flow and severity of portal hypertension in patients with cirrhosis of the liver (CL) of different etiology. RESULTS: We found that changes of structural and functional parameters of the heart in LC depended on the stage of compensation of portal hypertension and were accompanied by rearrangement of parameters of intracardiac hemodynamics. Pulmonary arterial hypertension (PAH) was found in 11.1% of patients with LC. PAH was moderate and was more frequent in patients with end-stage disease (Child-Pugh class C) compared with those with initial stage of LC (21.4% and 6.3%, p<0.05, respectively). CONCLUSION: Disorders of vasoregulating endothelial function in patients with CL were related to parameters of cardiopulmonary hemodynamics and functional state of the right ventricle and were more pronounced in patients with PAH.
Asunto(s)
Endotelio Vascular/fisiopatología , Corazón/fisiopatología , Hipertensión Pulmonar/etiología , Cirrosis Hepática/fisiopatología , Circulación Pulmonar , Adulto , Anciano , Ecocardiografía Doppler , Femenino , Humanos , Hipertensión Portal/complicaciones , Hipertensión Portal/fisiopatología , Cirrosis Hepática/complicaciones , Masculino , Persona de Mediana EdadRESUMEN
AIM OF INVESTIGATION: To explore and describe the endoscopic picture of HP--associated atrophic gastritis and to analyze the specificity of endoscopic markers indicating the presence of atrophic gastritis, intestinal metaplasia and dysplasia using high-tech methods of endoscopy in comparison with morphological characteristics of atrophic gastritis defining the degree of activity and stage of atrophic gastritis according to the system OLGA. MATERIALS AND METHODS: 40 people: males and females aged 40 to 70 years with a reduced level of pepsinogen I and a positive titre of antibodies to H. pylori in serum--were included into the study. THE RESULTS: Risk groups with atrophic gastritis based on indicators of pepsinogen 1 were formed. Endoscopic picture of H. Pylori--associated atrophic gastritis in patients with reduced level of pepsinogen I in serum is studied and described. Analysis of the specificity of endoscopic markers indicating the presence of AG, intestinal metaplasia and dysplasia using high-tech methods of endoscopy (endoscopy with high resolution, magnifying endoscopy, chromoendoscopy and narrow band imaging endoscopy (NBI) is made. Analysis of their sensitivity in comparison with the results of morphological studies of biopsy material is made. CONCLUSION: Thus, these studies show that high-resolution endoscopy in combination with magnification and chromoendoscopy allows accurately identify areas of atrophy, intestinal.Narrow band imaging endoscopy (NBI) provides a detailed picture of the vascular pattern of tissues, pattern changes typical for pathological areas of inflammatory genesis, as well as for precancers and early cancers. All these methods have high sensitivity and specificity in the diagnosis of HP-associated atrophic gastritis in comparison with the results of morphological studies of biopsy materials of stomach mucosa.
Asunto(s)
Mucosa Gástrica/patología , Gastritis Atrófica/patología , Gastroscopía/métodos , Infecciones por Helicobacter/patología , Helicobacter pylori/aislamiento & purificación , Pepsinógeno A/sangre , Adulto , Anciano , Ciudades , Femenino , Mucosa Gástrica/microbiología , Gastritis Atrófica/sangre , Gastritis Atrófica/epidemiología , Gastritis Atrófica/microbiología , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/microbiología , Humanos , Masculino , Tamizaje Masivo , Metaplasia , Persona de Mediana Edad , Federación de Rusia/epidemiología , Sensibilidad y Especificidad , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/patologíaRESUMEN
AIM OF INVESTIGATION: To estimate the role of polymorphic variants of genes IL4 (C-590T), IL4RA (I50V), TNF (G-308A) and SLC1IAI (D543N) in chronic viral hepatitis progression. MATERIAL AND METHODS: Overall 121 patients with chronic viral hepatitis C and B. RESULTS: Study results have demonstrated, that of all investigated polymorphic variants of genes IL4 (C-590T), IL4RA (150V), TNF (G-308A) and SLC11A1 (D543N) in patients with chronic liver diseases of various etiology the <
Asunto(s)
Proteínas de Transporte de Catión , Hepatitis B Crónica , Hepatitis C Crónica , Subunidad alfa del Receptor de Interleucina-4 , Interleucina-4 , Polimorfismo Genético/inmunología , Factor de Necrosis Tumoral alfa , Adolescente , Adulto , Anciano , Proteínas de Transporte de Catión/genética , Proteínas de Transporte de Catión/inmunología , Femenino , Hepatitis B Crónica/genética , Hepatitis B Crónica/inmunología , Hepatitis C Crónica/genética , Hepatitis C Crónica/inmunología , Humanos , Interleucina-4/genética , Interleucina-4/inmunología , Subunidad alfa del Receptor de Interleucina-4/genética , Subunidad alfa del Receptor de Interleucina-4/inmunología , Masculino , Persona de Mediana Edad , Células TH1/inmunología , Células Th2/inmunología , Factor de Necrosis Tumoral alfa/genética , Factor de Necrosis Tumoral alfa/inmunologíaRESUMEN
A case of thoracic actinomycosis manifest as round shadow in the lung is described. Diagnosis was based on the presence of actinomycetes in a transthoracic lung biopsy sample. Treatment for 3 months resulted in recovery. No relapse was documented during 1 year follow-up period.
Asunto(s)
Actinomyces/patogenicidad , Actinomicosis/diagnóstico , Antibacterianos/farmacología , Neumonía Bacteriana/diagnóstico , Actinomicosis/tratamiento farmacológico , Actinomicosis/patología , Combinación Amoxicilina-Clavulanato de Potasio/administración & dosificación , Combinación Amoxicilina-Clavulanato de Potasio/farmacología , Antibacterianos/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Neumonía Bacteriana/tratamiento farmacológico , Neumonía Bacteriana/patología , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/patología , Sulbactam/administración & dosificación , Sulbactam/farmacología , Resultado del TratamientoRESUMEN
Association of deletion polymorphism in GSTT1 and GSTM1 genes and polymorphic variant A313G of GSTP1 gene with cirrhosis diseases and 4-year survival rate for the Tomsk region (West Siberia) patients were tested. Homozygous deletion of GSTM1 gene (null genotype) was a protective factor for alcoholic and mixed (HCV, HBV and alcohol) liver cirrhosis development. The patients from the joint group (all etiology forms) as well as having alcoholic and mixed cirrhosis had lower frequency of GSTM1 null genotype (39.2, 39.0, and 34.2%, respectively) in comparison with the control group (64.6%). The GSTM1 null genotype and GSTP1 gene A313G polymorphic variant correlated with the patients' survival rate. The patients survived in comparison with the dead had higher frequency of a GSTM1 null genotype (46.6 vs. 30.2%) and GSTP1 AA genotype (63.1 vs. 40.5%), and lower frequency of GSTP1 AG (A313G) genotype (31.1 vs. 51.2%). A survival rate was 2.5 times higher for patients having GSTP1 AA genotype in comparison with the GG and AG genotype carriers and 2 times higher for patients having GSTM1 null genotype than the gene carriers. A 4-year fatal case probability was 2.3 times higher among the patients having heterozygous AG GSTP1 genotype in comparison with homozygous AA and GG genotype carriers.
Asunto(s)
Secuencia de Bases/genética , Glutatión Transferasa/genética , Cirrosis Hepática/genética , Polimorfismo Genético , Eliminación de Secuencia , Citogenética , Femenino , Genotipo , Humanos , Cirrosis Hepática/enzimología , Cirrosis Hepática/mortalidad , Cirrosis Hepática/patología , Masculino , Siberia/epidemiología , Tasa de SupervivenciaRESUMEN
AIM: to estimate quality of life (QL) indices in patients with chronic viral hepatitis (CVH) and their relationships to the clinical characteristics of the disease. SUBJECTS AND METHODS: One hundred and ten patients with chronic viral hepatitis (CVH), including 58 patients with chronic hepatitis C (CHC), 27 with chronic hepatitis B, and 25 with CHC + HBCor, were examined. The personality psychological profile, reaction and personality anxiety were evaluated; the Beck inventory was used to identify borderline mental disorders. The test developed by the Karelian Research Center, Russian Academy of Medical Sciences, modified by Ya. M. Rutgaizer, and the Nottingham Health Profile were applied to estimate QL indices. RESULTS: Parameters characterizing the social and personality indices of life, such as qualitative performance of paid work, participation in social life, impossibility of adequate rest, and sexual life are most frequently influenced. The main indicators of worse QL were diminished vitality (vital energy), sleep disorders, and emergence of emotional reactions. This was largely seen in patients with active CVH infection and in those who had isolated HBcor antibodies. CONCLUSION: QL is directly related to the duration of viral infection.
Asunto(s)
Hepatitis B Crónica/psicología , Hepatitis C Crónica/psicología , Calidad de Vida , Adulto , Trastorno Depresivo/psicología , Emociones , Femenino , Hepatitis B Crónica/patología , Hepatitis B Crónica/virología , Hepatitis C Crónica/patología , Hepatitis C Crónica/virología , Humanos , Hipocondriasis/psicología , Masculino , Pruebas Psicológicas , Índice de Severidad de la Enfermedad , Aislamiento Social , Encuestas y CuestionariosRESUMEN
AIM: To study a relationship of the plasma activity of elastase-like and collagenase-like proteinases and their inhibitors to hepatic collagen metabolism and to detect the serum markers of fibrosis severity. SUBJECTS AND METHODS: Three hundred and fifty-nine patients with chronic liver diseases (CLD), including 118 patients with chronic viral hepatitis (CVH), 113 with CVH concurrent with alcoholic liver disease (ALD), 109 with ALD, and 19 with CLD in the presence of opiomania were examined. The activities of alpha1-proteinase inhibitor and alpha2-macroglobulin (alpha2-MG) were determined by the unified spectrophometric assay from the inhibition of N-benzoyl-arginine ethyl ester hydrolysis. The activity of elastase-like proteinases was determined by enzymatic assay from the hydrolysis of the synthetic substrate N-butyloxycarbonyl-L-alanine-para-nitrophenyl ester. That of collagenase-like proteinases was determined, by using a collagen type 1 substrate and expressed in terms of micromoles of the resultant hydroxyproline. The content of hydroxyproline was determined by a color reaction with demethylbenzaldehyde, a free, peptide- and protein-bound hydroxyproline; their fraction was obtained under various conditions of plasma protein isolation and hydrolysis. Plasma fibronectin levels were measured by solid-phase immunoassay. Liver biopsy specimens were morphologically studied in the majority of patients to determine the histological hepatitis activity index and the stage of fibrosis. RESULTS: Fibrois formation in the liver in its chronic diseases was attended by a significant reduction in the activity of collagenase-like proteinases hydrolyzing collagen and by the lower activity of alpha2-MG, an inhibitor limiting collagen formation. CONCLUSION: The identified changes make themselves evident just in early fibrosis, which suggests the rapid onset of imbalance in the mechanisms responsible for regulation of connective tissue synthesis and promotes intensified fibrosis formation.
Asunto(s)
Enfermedad Hepática Crónica Inducida por Sustancias y Drogas/metabolismo , Colágeno/metabolismo , Fibronectinas/metabolismo , Hepatitis Viral Humana/metabolismo , Hígado/metabolismo , Péptido Hidrolasas/metabolismo , alfa 1-Antitripsina/metabolismo , Biomarcadores/metabolismo , Biopsia , Enfermedad Hepática Crónica Inducida por Sustancias y Drogas/patología , Progresión de la Enfermedad , Hepatitis Viral Humana/patología , Humanos , Hidroxiprolina/metabolismo , Hígado/patología , Pronóstico , Índice de Severidad de la EnfermedadRESUMEN
The aim of the work was to study somatopsychic manifestations in patients with chronic viral hepatitis (CVH). MMPI profiles, state and trait anxiety were assessed in 110 patients. Boundary psychic problems were evaluated using the Beck scale. It was shown that mean MMPI T-score in patients with CVH was above 50; half of them developed "neurotic triad"; hypochondria occurred in 37.3%, depression in 42.7%, and hysteria in 37.1%. The highest level of state anxiety was documented in patients with HCV infection and isolated HBCor At. The CVH-1b genotype was associated with enhanced occurrence of depression in patients having virus-positive blood for 1-5 years. The level of state and trait anxiety in them was lower than in patients with duration of viremia over 5 years.
Asunto(s)
Hepatitis Crónica/psicología , Hepatitis Viral Humana/psicología , Trastornos Psicofisiológicos/diagnóstico , Hepatitis Viral Humana/sangre , Hepatitis Viral Humana/virología , Humanos , MMPIRESUMEN
The aim of the investigation was to study the myocardium in patients with chronic viral hepatitis concurrent with chronic opisthorchiasis. Ninety patients with chronic viral hepatitis, including 52 patients with this disease concurrent with chronic opisthorchiasis, were examined. Doppler echocardiography indicated a statistically significant increase in left ventricular mass regardless of the presence of Opisthorchis infestation. Analysis of left ventricular diastolic dysfunction showed its great degree in chronic hepatitis C. Single-photon emission computed tomography with 99mTc-pyrophosphate revealed focal tracer incorporation in the myocardium of most patients with Opisthorchis infestation. A third of patients with chronic viral hepatitis showed moderate diffuse trace accumulation that was significantly more frequently found in chronic hepatitis C. Single photon-emission tomography with labeled leukocytes demonstrated abnormal accumulation in none of the patients; troponin T levels were in the normal allowable range. Myocardial lesion was detected in the chronic course of viral hepatitis C concurrent with chronic opisthorchiasis that was unattended by cardiomyocyte necrosis and that was dystrophic.
Asunto(s)
Corazón/fisiopatología , Hepatitis B Crónica/complicaciones , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/fisiopatología , Miocardio/patología , Opistorquiasis/fisiopatología , Enfermedad Crónica , Hepatitis B Crónica/patología , Hepatitis B Crónica/fisiopatología , Hepatitis C Crónica/patología , Humanos , Opistorquiasis/complicaciones , Opistorquiasis/patología , Disfunción Ventricular Izquierda/patología , Disfunción Ventricular Izquierda/fisiopatologíaRESUMEN
Association study was performed for genetic polymorphisms IL4 C(-590)T, IL4RA Ile50Val, TNF G(-308)A, to estimate their effect on quantitative features which are pathogenetically important for chronic viral hepatitis course, i.e. levels of IL4, IL10, IL12, tumor necrosis factor alpha, fibronectin, collagenase, protease inhibitors, macroglobulines, elastases, free and protein-bound hydroxyproline. It has been shown that A allele of TNF G(-308)A polymorphism is associated with decreased TNF-alpha, increased IL4 and IL12, as well as with low level of protein-bound hydroxyproline. In addition, association of CT genotype of IL4 C(-590)T polymorphism and high level of protein-bound hydroxyproline has been identified.
Asunto(s)
Citocinas/genética , Hepatitis B Crónica/genética , Hepatitis C Crónica/genética , Polimorfismo de Nucleótido Simple , Biomarcadores/sangre , Proteínas Sanguíneas/análisis , Proteínas Sanguíneas/genética , Citocinas/sangre , Citocinas/inmunología , Femenino , Genotipo , Hepatitis B Crónica/sangre , Hepatitis B Crónica/inmunología , Hepatitis C Crónica/sangre , Hepatitis C Crónica/inmunología , Humanos , Hidroxiprolina/sangre , MasculinoRESUMEN
Polymorphic variants of several genes IL4 C(-590)T, IL4RA Ile50Val, TNF G(-308)A were studied for their association with extent of the disease chronization which is marked by hepatic fibrosis stage. Gradual decrease in A allele frequency of polymorphic marker G(-308)A in TNF gene, from patients with weak fibrosis to patients with cirrhosis. Group of patients with weak fibrosis was characterized by higher frequency of A allele (24.5%) comparing with patients with moderate and pronounced fibrosis (13.4%) and cirrhosis (8.7%). Differences in heterozygous genotype frequencies of IL4 C(-590)T were found between patients with cirrhosis (68.2%) and groups of patients with moderate and marked fibrosis (39.1%).
Asunto(s)
Predisposición Genética a la Enfermedad , Hepatitis B Crónica/genética , Hepatitis C Crónica/genética , Subunidad alfa del Receptor de Interleucina-4/genética , Interleucina-4/genética , Cirrosis Hepática/genética , Polimorfismo de Nucleótido Simple , Factor de Necrosis Tumoral alfa/genética , Alelos , Femenino , Frecuencia de los Genes/genética , Hepatitis B Crónica/complicaciones , Hepatitis C Crónica/complicaciones , Humanos , Cirrosis Hepática/etiología , MasculinoRESUMEN
81 patients with confirmed HCV-infection and 48 healthy volunteers were examined. In healthy Caucasian participants living in Siberian region significant predominance of C/T genotype in promoter region C-590T of interleukin-4 (IL-4) gene and Q/Q and Ile/Val genotypes in points -50 and -576 of IL-4RA gene that codes alpha-chains of IL-4 receptor were revealed. In patients with HCV-infection predominance of C/T genotype in C-590T region in IL-4 gene (OR = 1.86), R/R genotype in Q-576R region of IL-4RA gene (OR=7.86), and Val/Val genotype in point Ile-50Val (OR = 2.6) of the same gene. Summary predictive coefficient of hepatitis C development in carriers of these genotypes approached to 95%. During analysis of role of allelic polymorphism of IL-4 genes in predisposition to hepatitis C development it is necessary to consider not only presence of allelic variants of promoter regions of the IL-4 genes, but also the polymorphism of genes coding molecules binding with this cytokine on target cells membranes and in its soluble form.
Asunto(s)
Alelos , Hepatitis C/genética , Interleucina-4/genética , Regiones Promotoras Genéticas , Receptores de Interleucina-4/genética , Adulto , Femenino , Frecuencia de los Genes , Genotipo , Hepatitis C/inmunología , Humanos , Masculino , Polimorfismo GenéticoRESUMEN
The diagnostic significance of serum markers of fibrosis was investigated in 92 patients with chronic viral hepatitis (CVH) by studying the collagenolythic activity of blood, proteasic inhibitor activity, collagen metabolism products (oxyproline fraction), and fibronectin. At the same time, the patients underwent puncture biopsy of the liver, which made it possible to determine the degree of process activity and the stage of its chronization. As the degree of fibrosis grew, the collagenase serum activity increased significantly, while the alpha1-proteinase inhibitor activity fell, the content of oxyproline (its fractions) increased, and the fibronectin level decreased. Hence, the measurement of the noted parameters allows for noninvasive diagnostics of CVH stages.
Asunto(s)
Biomarcadores/sangre , Colagenasas/sangre , Hepatitis Viral Humana/sangre , Adolescente , Adulto , Biopsia , Enfermedad Crónica , Progresión de la Enfermedad , Femenino , Hepatitis Viral Humana/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , PronósticoRESUMEN
A complex clinico-instrumental, laboratory and psychological examination of 122 patients with chronic non-calculous cholecystitis (CNCC), 63 of who had chronic opisthorchosis (CO), was conducted. The controls were 33 healthy individuals. Patients with CNCC and CO had hypomotoric dyskinesia, Oddi's sphincter dysfunction, higher levels of personal anxiety and depression more often than others.
Asunto(s)
Ansiedad/etiología , Colecistitis/complicaciones , Depresión/etiología , Opistorquiasis/complicaciones , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Colecistitis/psicología , Enfermedad Crónica , Depresión/epidemiología , Depresión/psicología , Humanos , Incidencia , Opistorquiasis/psicología , Pronóstico , Pruebas PsicológicasRESUMEN
The study was performed to estimate association of the Ile50Val polymorphism in IL4RA and clinical characteristics of chronic viral hepatitis including course of disease manifestation which is determined by degree of hepatic fibrosis. The group under investigation included 61 patient diagnosed with chronic viral hepatitis. Control group consisted of 128 randomly selected inhabitants of Tomsk city. Genotyping of Ile50Val polymorphism in the groups was performed by RFLP (restriction fragment length polymorphism) analysis. There was no significant differences in genotypes and alleles frequencies between cases and controls. However differences in genotype distribution depend on fibrosis stage were detected. Ile/Val heterozygote frequency in subgroup of patients without hepatic fibrosis was lower (7.1%) than in controls (51.6%) (p = 0.002) due to increase of both homozygote classes. Subgroup of patients without hepatic fibrosis differed by genotype frequencies both from patients with moderate and severe disease stage (p = 0.035; p = 0.004).
Asunto(s)
Sustitución de Aminoácidos/genética , Predisposición Genética a la Enfermedad , Hepatitis B Crónica/genética , Hepatitis C Crónica/genética , Polimorfismo de Longitud del Fragmento de Restricción , Receptores de Interleucina-4/genética , Adolescente , Adulto , Femenino , Fibrosis/genética , Fibrosis/patología , Hepatitis B Crónica/patología , Hepatitis C Crónica/patología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
AIM: To examine clinical efficacy of combined therapy with reaferon and iodantipirin in patients with chronic hepatitis B and C of moderate activity. MATERIAL AND METHODS: 100 patients with confirmed diagnosis of chronic viral hepatitis (CVH) at the stage of replication. All the patients have undergone puncture biopsy of the liver with estimation of index of histological activity Knodell and index of fibrosis Desmeth. RESULTS: Comparative evaluation was made of clinical efficacy of combined therapy reaferon + iodantipirin and monotherapy with reaferon in 100 patients with moderate activity CHB and C. CONCLUSION: Conventional scheme with reaferon turned out less effective than the above combination therapy.
Asunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Hepatitis B Crónica/tratamiento farmacológico , Hepatitis C Crónica/tratamiento farmacológico , Interferón Tipo I/uso terapéutico , Compuestos de Yodo/uso terapéutico , Pirazolonas/uso terapéutico , Adulto , Biopsia con Aguja , Quimioterapia Combinada , Femenino , Hepatitis B Crónica/patología , Hepatitis C Crónica/patología , Humanos , Interferón alfa-2 , Interferón-alfa , Hígado/patología , Masculino , Proteínas Recombinantes , Índice de Severidad de la EnfermedadRESUMEN
The study demonstrates significant changes of cytokine-producing ability of mononuclear blood leucocytes in type 'hepatitis, correlating with the degree of hepatic lesion. The results showed that various morphologic types of chronic virus type C hepatitis were associated with disbalance in production of pro- and antiinflammatory cytokines, i.e. decrease of tumor necrosis factor (TNF)-alpha concentration and a significant rise of interleukin (IL)-4 and IL-10 concentations, which were the most prominent in cases of severe hepatic fibrosis and high histologic activity of hepatitis. The study established a direct correlation between increase of the ability of mononuclear blood leucocytes to synthesize IL-4, and the progress of the pathologic process.
Asunto(s)
Hepatitis C Crónica/inmunología , Hepatitis C Crónica/fisiopatología , Interleucina-10/inmunología , Interleucina-2/inmunología , Interleucina-4/inmunología , Adolescente , Adulto , Endoscopía del Sistema Digestivo/métodos , Femenino , Hepatitis C Crónica/diagnóstico , Humanos , Masculino , Persona de Mediana EdadRESUMEN
AIM: To reveal the structural features of the red blood cell membrane in patients with prolonged persistence of hepatitis B virus (HBV) and hepatitis C virus (HCV). MATERIALS AND METHODS: 61 patients with moderate and mild chronic viral hepatitis B and C were examined. A control group comprised 22 healthy donors. Fluorescence of the red blood cell membrane was performed, by using the following probes: pyrene, phenylnaphthylamine, 1-anilinonaphthalene-8-sulfonate. The activity of the ion-transporting enzyme Na+, K(+)-ATPase was determined. RESULTS: Increases in the microviscosity of the lipid bilayer, periprotein lipid environment, as well as the structural modification of the surface layers of the membrane were found in patients with chronic hepatitis B and C. The activity of the membrane-bound enzyme Na+, K(+)-ATPase was statistically significantly decreased as compared with that in healthy donors. CONCLUSION: In HBV and HCV infection, the impairments of the red blood system are highly diversified: they involve bone marrow compartment of an erythron, as earlier shown, and its peripheral one. Molecular disorganization of the red blood cell membrane fails to present with obvious red blood cell dysfunctions. Despite the multifactorial property of their occurrence, impairments of the red blood system are mediated and corrected by many regulatory mechanisms at different organizational levels and may be compensated.