[Predicting side effects of the treatment of chronic hepatitis with peginterferon alpha-2A with ribaverin].

The aim of the study was to monitor the commonest side effects of the treatment of chronic hepatitis with peginterferon alpha-2A (PEG-IFN) and ribaverin (RBV) and the influence of various factors on their development. The work was done in the Department of Infectious Disease, Erevan State Medical University. Monitoring 16 adverse reactions was carried out with the use of special tables within 1, 2, 4 and 6 months after the onset of therapy in patients with genotypes 2 and 3 and in addition after 8, 10 and 12 months in patients with genotype 1. The influence of independent prognostic factors was estimated by logistic regression analysis. The commonest side effects of PEG-IFN plus RBV therapy were leukopenia, thrombocytopenia, weight loss, depression, fatigue, and insomnia that occurred at one time or another in more than half of the patients. Weight loss during therapy amounted to 8.36 kg (95% CI 6.7-10) (maximum 21 kg). Myalgia, anorexia, arthralgia, headache, alopecia, and vomiting were documented in 20-50% of the cases. Anemia, pruritis, eruption, erythema, and hair shedding at injection sites occurred in 1/4 of the patients. It is concluded that logistic regression analysis with matching selected prognostic factors permits to estimate the probability of such side effects as weight loss, flu-like syndrome, and myalgia.

[Psychosomatic events in patients with digestive system disorders].

A total of 167 patients (92 men and 75 women) at the age of 45-65 (mean 47.4 +/- 4.2) years with different digestive system disorders were examined in this study. One group included 48 patients with chronic non-atrophic (largely antral) gastritis associated with helicobacterial infection, the second one comprised 46 patients with intestinal irritation syndrome, the third consisted of 36 patients with gastro-oesophageal reflux disease at the stage of unstable remission in the absence of symptoms of oesophagitis, and the forth group included 38 patients with chronic recurring duodenal ulcer. The Spielberger State-Trait Anxiety Inventory (STAI-i) test and Toronto Alexithymia Scale (TAS) test were used for the assessment. Correlation was estimated using the Spearman coefficient and multiple regression analysis based on the Statistica 6.0 and GraphhPad Prism 4 statistical programs. It was shown that the overall alexithymia rate averaged 66.8%. Taken together with the high occurrence of the reactive anxiety response (74.1%), it suggests a high degree of personality psychosomatization among the examined patients with different digestive system disorders. Patients of groups 1 and 2 are characterized by significant positive correlation between the occurrence of the alexithymic personality type and the reactive anxiety response (r = 0.592, r = 0.593, p > 0.0001). This correlation was weak and insignificant in patients of groups 3 and 4 (r = 0.245, r = 0.190, p > 0.05).

[Electrophoresis with the mulberry leave extract and officinal peat for the rehabilitative treatment of chronic non-calculous cholecystitis].

Electrophoresis using a 5% aqueous extract of mulberry leaves and a 5% aqueous extract of Tavish peat at the right hypochondrium of patients included in the study had beneficial effect on the clinical picture of chronic non-calculous cholecystitis. Specifically, the state of the hepatobiliary system improved judging by the results of staged chromatic duodenal probing, ultrasonographic examination of biliary ducts, and bioresonance diagnostics. Also, positive changes were recorded in energy metabolism. It is recommended that electrophoresis using an aqueous mulberry leaf extract be prescribed to patients with a short duration of the disease and hyperkinetic biliary ducts and intestines. In case of an inflammatory process in these organs or hypomotor dyskinesia of biliary ducts, good results can be obtained using electrophoresis with Tavish peat extracts having a wide spectrum of action. They are indicated for the rehabilitative treatment of digestive organ pathology.

[Surgical treatment of patients with acute pancreatitis].

Results of treatment of patients with acute pancreatitis are analyzed. Efficacy of staged treatment of patients with acute destructive pancreatitis is demonstrated. The ineffective conservative therapy during 1-3 days is regarded as indication for half-open surgical method (median laparotomy, necrsecvestrectomy, omentopancreatobursostoma and lumbostoma formation). General purulent peritonitis is indication for open method (laparostoma formation). Unitized surgical tactics permitted to reduce lethality from 4.2 to 2.5%.

[Effectiveness of using immunomodulators in combined treatment of patients with chronic gastritis and ulcer disease]. / Effektivnost' primeneniia immunomoduliatorov v kompleksnom lechenii bol'nykh khronicheskim gastritom i iazvennoi bolezn'iu.

Clinical and instrumental-laboratory investigations have been conducted in 372 patients with chronic antral gastritis (CAG, n = 131), diffuse gastritis (DG, n = 108) and ulcer disease (UD, n = 135). Immunomodulators tactivin and levamisol were added to standard treatment of 75 CAG, 63 DG and 85 UD patients. Healing of the lesions was observed, on the average, on the treatment day 24.3 +/- 0.5 and 18.4 +/- 0.6 in the standard treatment and with the added immunomodulator, respectively. Adjuvant levamisol diminished the number of recurrences of chronic gastritis and UD.

[Somatic vascular and psycho-emotional disorders in some gastrointestinal diseases and the correction with physical factors]. / Vegetativno-sosudistye i psikhoémotsional'nye narusheniia pri nekotorykh zabolevaniiakh organov pishchevareniia i ikh korrektsiia fizicheskimi faktorami.

Vegetovascular disorders are obligatory and even leading clinical manifestations of chronic gastrointestinal diseases. Physiotherapy in combination with psychotherapy produce a normalizing effect on functional-morphological condition of the gastrointestinal organs, correct alterations in the neuropsychic sphere and autonomic nervous system.

[Effectiveness of the combined treatment of patients with the exogenous constitutional form of obesity at sanatoria and health resorts]. / Effektivnost' kompleksnogo lecheniia bol'nyhk s ékzogenno--konstitutsional'noi formoi ozhireniia v statsionarnykh i kurortnykh usloviiakh.

The treatment of patients with exogenous-constitutional obesity with the dietetics (low caloric diet, fasting days) coupled with health resort and physical factors, especially at the hospital-health resort Dzhermuk stage, ensures a positive time course of changes in the laboratory indicators. The function of the hepatobiliary system and pancreas involved into the pathogenesis of obesity improves. The increased compensatory possibilities of these organs promote the attainment of favourable results.