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.

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.

[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.

[NONINVASIVE DIAGNOSTICS OF THE PHENOTYPE OF GASTRITIS: ANALISIS OF THE FIRST THOUSAND OF CASES].

The analysis of noninvasive diagnostics of a phenotype of gastritis among 1050 people aged from 18 till 80 years which consistently addressed to policlinic is presented in the article. The instrument of diagnostics was a <>, including a complex of biomarkers - so-called <> (pepsinogen I, pepsinogen II, gastrin-17 and IgG- antibodies to Helicobacter Pylori). High frequency of different variants of atrophic gastritis (25%) with a gastric cancer risk and conditions with a risk of erosive and ulcer damages of the stomach mucous (26 %) was shown. Clinical and economical expediency of noninvasive screening of a phenotype of gastritis is postulated.

[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.

[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.

[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.

[Prevalence of atrophic gastritis in different populations in Siberia on medical evidence of the serological survey].

Prevalence of atrophic gastritis in various population of Siberia with serological tests was studied. Representative samples of Novosibirsk adult population and also urban and rural population of Yakutia were examined. 348 persons at the age more than 45 years (180 males and 168 females) were studied. Concentration of pepsinogen I, gastrin 17 and antibodies to Helicobacter pilori in blood serum was estimated with immune-enzyme analysis ("Biohit GastroPanel", "Biohit", Finland). In addition, domestic test-systems were used for detection cytotoxic (expressing CagA-protein) strains H. pylori. Level of markers (pepsinogen, gastrin, antibodies to Helicobacter pilori and antibodies to CagA H. pilori) in observing populations had no difference between males and females, and also did not depend on age. Occurrence of atrophy in body of stomach in Novosibirsk population, urban and rural population of Yakutia was 10.1, 16.7 and 25.6% respectively, and in antral part--10.7, 25.6 and 8.9% respectively. Total atrophy was registered in 1% in all groups. Helicobacter infection was detected in 78-88% of population. Domestic immune-enzyme test-systems were comparable with data of histological examination and demonstrated greater sensitivity at H. pylori detection vs. foreign. High prevalence of atrophic gastritis in various groups of Siberia population was noticed, which must be was bounded with great level of H. pylori infection in population.

[Dyspepsia and gastroesophageal reflux in adolescents]. / Dispepsiia i gastroézofageal'nyi refliuks u podrostkov.

AIM: To study the prevalence and risk factors for dyspepsia and gastroesophageal reflux (GER) among adolescents. MATERIAL AND METHODS: Senior schoolchildren (forms 9-11) of four randomly selected secondary schools of Novosibirsk participated in the study (189 boys and 260 girls aged 14-17 years). They filled in the Bowel Disease Questionnaire, and sera were tested for antibodies against Helicobacter pylori infection. RESULTS: Dyspepsia was reported by 21% of the schoolchildren, being more frequent in girls (25%) than boys (14%, p = 0.004). GER occurred in 22% of adolescents with the same frequency in both genders. The combination of dyspepsia with GER was found in 8%. The prevalence of H. pylori infection was 56%. No association was found between the infection and abdominal symptoms, except heartburn. Among factors associated with dyspepsia were female gender, irregular meals, family history of dyspepsia. GER was related to H. pylori infection, obesity, smoking and irregular meals, 46% of adolescents with dyspepsia and 36% of those with GER have consulted a physician, and school absenteeism was reported by 55 and 40%, respectively. CONCLUSION: Dyspepsia and gastroesophageal reflux are widespread among the adolescent population and result in frequent use of health care resources.

[Prevalence and risk factors of the development of irritable bowel syndrome in adolescents: a population study]. / Rasprostranennost' i faktory riska razvitiia sindroma razdrazhennogo kishechnika u podrostkov: populiatsionnoe issledovanie.

AIM: To determine prevalence of irritable bowel syndrome (IBS) and associated factors in a community-based population of adolescents. MATERIAL AND METHODS: 189 schoolboys and 250 schoolgirls aged 14-17 years from four randomly chosen schools of Novosibirsk participated in the study. RESULTS: The prevalence of IBS defined according to Rome criteria was higher in girls (24 vs 14% in boys, p = 0.01). Colonic pain frequency was similar in both genders (11% in girls vs 9% in boys, p = 0.46), however disturbed defecation occurred significantly more often in girls than in boys (16 vs 7%, p = 0.003). Half of the subjects who reported IBS had also dyspeptic symptoms. Fiber-rich diet and/or laxatives to prevent constipation were used by 2% of boys and 7% of girls (p = 0.012). However, only one third of those having less than 3 stools a week thought it abnormal. IBS is associated with the age over 15-16 years, female gender, abdominal pain in childhood, appendectomy, irregular meals and smoking (in girls). No association was found with other socio-demographic factors and serological markers of some infections and invasions (H. pylori, G. lamblia, O. felineus, hepatitis viruses B and C). Of the persons with diagnosable IBS, 49% have consulted a physician about it, 21% have undergone upper endoscopy. School absenteeism was reported by 62% of the IBS sufferers. CONCLUSION: IBS is common among adolescents (especially girls) with the prevalence rates similar to those described in adults from West Europe and USA. These disorders are associated with significant disability and health care costs.

[Prevalence of and risk factors for gallstones in female population of Novosibirsk]. / Rasprostranennost' i faktory riksa razvitiia zhelchnokamennoi bolezni v zhenskoi populiatsii Novosibirska.

AIM: To investigate the prevalence of gallstones and associated factors in female population of Novosibirsk (Western Siberia). MATERIALS AND METHODS: A representative sample of 870 women aged 25-64 years was drawn from general population according to WHO "MONICA" protocol. The subjects were screened for the presence of gallstones by gallbladder ultrasonography, completed a questionnaire relating to food and alcohol consumption, smoking, gastrointestinal symptoms and obstetric history. They also underwent physical examination and blood chemistry tests. Age-adjusted prevalence of cholelithiasis was 9.5%. Increasing age, obesity, diabetes mellitus, consumption of animal fat, pregnancies and opisthorchiasis positively correlated with gallstones in univariate analysis. Serum lipids, family history of gallstones, consumption of alcohol and tobacco were not predictors of gallstones. Only association with age and obesity was significant in multivariate analysis. Among subjects with cholelithiasis 52.1% were not aware of having gallstones. Subjects with gallstones more frequently suffered from biliary colics and non-specific dyspeptic symptoms. However, their predictive value was poor. Cholecystectomized patients revealed more often upper abdominal pain and dyspeptic symptoms. CONCLUSION: Prevalence and risk factors for gallstones in female population of Novosibirsk are similar to those reported in Western European countries. Cholecystectomy is not recommended in patients with symptomless disease.

[The clinical and morphofunctional characteristics of different types of stomach ulcer]. / Klinicheskie i morfofunktsional'nye osobennosti razlichnykh tipov iazvy zheludka.

AIM: The study of a complex of anamnestic, clinicoendoscopic and functional-morphological characteristics in type I and II (according to Johnson) gastric ulcer. MATERIALS AND METHODS: Esophagogastroduodenoscopy, gastric secretion tests, determination of blood group and Rh factor were performed in 91 patients (52 patients with ulcer type I and 39 with ulcer type II). RESULTS: Ulcers type I have arisen in the presence of long-term chronic gastritis. They were associated with marked changes in the mucosa of gastric body, its atrophy and intestinal metaplasia, persistent recurrences in the same gastric zone. Ulcers type II are characterized by hereditary loading, 0(I) blood group, combination with gastroduodenal erosions, season occurrence, trend to migration and recurrence in different gastric or duodenal zones, HCl hypersecretion, high occurrence of Helicobacter pylori infection. CONCLUSION: It is thought valid to include types of gastric ulcer in current classification of ulcer.

Helicobacter pylori in a Chukotka Native male population.

Helicobacter pylori (HP) is a widespread human pathogen closely associated with gastroduodenal diseases. Thirty-four males from one of the settlements of coastal Chukotka (72% of total adult male population, mean age 31.6 years) underwent upper endoscopy, and HP was examined histologically in antral biopsies (Giemsa stain). Histology revealed normal mucosa in 16%, antral superficial gastritis in 29%, and atrophic gastritis in 55%. HP was found in 40% of histological specimens of normal mucosa, in 100% of superficial gastritis, and in 77% of atrophic gastritis. Correlation was found between the degree of bacterial contamination and both the activity of gastritis and grade of mononuclear infiltration. Data indicate a high prevalence of HP among Chukotka Natives (77%) which may partly explain the significant frequency of antral gastritis in this population.