[Effectiveness of empirical Helicobacter pylori eradication therapy with furazolidone in Russia: results from the European Registry on Helicobacter pylori Management (Hp-EuReg)].

BACKGROUND: First-line therapy does not always provide a high level of Helicobacter pylori eradication due to the increase of H. pylori resistance to antibiotics; therefore, it remains necessary to identify the most effective rescue treatments. The purpose of this study was to evaluate the efficacy and safety of empirical H. pylori furazolidone-containing regimens. MATERIALS AND METHODS: Adult H. pylori infected patients empirically treated with furazolidone-containing eradication regimens were registered in an international, prospective, multicenter non-intervention European registry on H. pylori management (Hp-EuReg). Data were collected at AEG-REDCap e-CRF from 2013 to 2021 and the quality was reviewed. Modified intention-to-treat (mITT) effectiveness analyses were performed. RESULTS: Overall 106 patients received empirical furazolidone-containing therapy in Russia. Furazolidone was prescribed in a sequential scheme along with amoxicillin, clarithromycin and a proton pump inhibitor in 68 (64%) cases, triple regimens were prescribed in 28 (26%) patients and quadruple regimens in 10 (9.4%). Treatment duration of 7 days was assigned to 2 (1.9%) patients, 10-day eradication therapy in case of 80 (75%) and 14 days - in 24 (23%) patients. Furazolidone was mainly used in first- (79%) and second-line (21%) regimens. The methods used to diagnose H. pylori infection were: histology (81%), stool antigen test (64%), 13C-urea breath test (6.6%), and rapid urease test (1.9%). The mITT effectiveness of sequential therapy was 100%; 93% with the triple therapy and 75.5% with quadruple therapy. Compliance was reported in 98% of cases. Adverse events were revealed in 5.7% of patients, mostly nausea (3.8%). No serious adverse events were reported. CONCLUSION: Furazolidone containing eradication regimens appear to be an effective and safe empirical therapy in Russia.

[Intestinal microbiota, nutrients and probiotics viewed from the «gut-lung¼ axis].

Disturbance of the bronchopulmonary system are among the most common and socially significant diseases, so, the prevention and treatment of these disorders are the priority tasks of practical health care. Being based on the accumulated literature data on the interaction of the intestinal microflora and respiratory tract, the role of symbiotic bacteria of the intestinal biotope has been discussed in the respiratory diseases' pathogenesis. The aim of the work was to analyze the results of experimental and clinical studies confirming the effect of intestinal microflora on the development and progression of respiratory diseases. The analysis of the available data on the risk reducing of occurrence, duration and severity of symptoms of bronchial asthma when taking probiotics, both in childhood and in the adult population, has been carried out. The effectiveness of the probiotic microorganisms' intake for the treatment of chronic obstructive pulmonary disease, pneumonia, viral infection, cystic fibrosis, and lung cancer has been analyzed. The main possible molecular mechanisms of the symbiotic bacteria prevention of the bronchopulmonary diseases development have been discussed in the article. Conclusion. The probiotics usage in the complex treatment of bronchopulmonary diseases demonstrates encouraging results. Its potential may be useful in the treatment of various lung diseases. However, a number of questions have been related to the individual selection of specific strains, the dosage and duration of use to achieve sustained remission for a patient.

[Ursodeoxycholic acid: A therapeutic niche in an internist's practice].

The paper shows more than 40 years' experience with ursodeoxycholic acid (UDCA) used as a drug; during this period it has demonstrated its rather high clinical efficacy. Due to the range of its inherent pleiotropic (choleretic, cytoprotective, immunomodulatory, antiapoptotic, hypocholesterolemic, and litholytic) properties, UDCA has a broad spectrum of therapeutic activity. The paper considers the issues associated with the mechanism of action and with the clinical effects of this bile acid. It gives the results of the most important randomized controlled trials determining currently the evidence base for the efficiency and safety of using UDCA in the clinical picture of visceral diseases.