RESUMO
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.
Assuntos
Infecções por Helicobacter , Helicobacter pylori , Adulto , Humanos , Furazolidona/efeitos adversos , Estudos Prospectivos , Quimioterapia Combinada , Antibacterianos/efeitos adversos , Amoxicilina/efeitos adversos , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/diagnóstico , Inibidores da Bomba de Prótons/efeitos adversos , Resultado do Tratamento , Federação Russa/epidemiologia , Sistema de RegistrosRESUMO
BACKGROUND: Recently, there has been an increase in the prevalence of gastroesophageal reflux disease (GERD) in Northern Europe, North America and East Asia. However data on GERD prevalence in Russian population are very limited. AIM: To determine the prevalence of GERD among the population of Russia, the clinical spectrum of GERD symptoms, the main drugs used for GERD treatment, and the rate of their administration. MATERIALS AND METHODS: The study was conducted from November 2015 to January 2017 in 8 cities of Russia. A survey of patients over the age of 18 years old visiting outpatient medical institutions for any reason, including patients without gastrointestinal complaints was carried out using a short version of the Mayo Clinic questionnaire. RESULTS: In total, 6132 questionnaires of patients aged 1890 years were analyzed [2456 men (40.1%) and 3676 women (59.9%), mean age 46.615.4 years]. The GERD prevalence among the interviewed patients was 34.2%. The incidence of GERD increased depending on body mass index and the age of the patients. Medications used by the patients for heartburn relief included proton pump inhibitors 59.96%, antacids 67.92%, H2-histamine receptor blockers 11.42%, alginates 18.41% of patients. CONCLUSION: The results of this study indicate a high prevalence of GERD among residents of Russian cities applying for primary health care (34.2%). In comparison with previous studies, an increase in the proportion of GERD patients taking proton pump inhibitors was noted; in most cases the regimen of their intake was in accordance with the recommendations.
Assuntos
Antiácidos , Refluxo Gastroesofágico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antiácidos/uso terapêutico , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/diagnóstico , Pacientes Ambulatoriais , Prevalência , Inibidores da Bomba de Prótons/uso terapêutico , Bombas de Próton/uso terapêutico , Receptores Histamínicos , Federação Russa/epidemiologia , Inquéritos e QuestionáriosRESUMO
The multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group (EHMSG) is conducted in 27 countries in Europe. The data from the Russian part of the European registry for the management of Helicobacter pylori infection (European Registry on the management of Helicobacter pylori infection, protocol: "Hp-EuReg") allows us to analyze the real clinical practice of diagnosis and treatment of H. pylori and compare it with international recommendations. MATERIALS AND METHODS: A comparative analysis of the data entered in the register by the Russian research centers "Hp-EuReg", in the period from 2013 to 2018, was conducted. RESULTS AND DISCUSSION: Invasive diagnostic methods prevail for the primary diagnosis of H. pylori [histology - 20.3% (in 2013 year) - 43.9% (in 2018 year), rapid urease test - 31.7% and 47.8% respectively]. The most popular mode of eradication therapy is a 10-day triple therapy (62.8-76.2%), the effectiveness of which does not exceed 79% (per protocol). Invasive tests (histology) are the leading method for control the effectiveness of therapy, however, there is a tendency towards a wider use of non-invasive methods (H. pylori stool antigen - from 17% in 2013 to 29.3% in 2018 and urea breath test from 6.9 to 18.3%, respectively). Serological test to control the effectiveness of eradication is still used from 8.2% (2013) to 6.1% (2018). Eradication therapy was not performed in 28% of patients throughout the entire observation period. CONCLUSION: In Russia, despite approved domestic and international recommendations, deviations in clinical practice persist, both during eradication therapy and in monitoring the effectiveness of eradication therapy.
Assuntos
Antibacterianos/uso terapêutico , Antiulcerosos/uso terapêutico , Antígenos de Bactérias/análise , Testes Respiratórios/métodos , Quimioterapia Combinada/métodos , Fezes/microbiologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/isolamento & purificação , Antibacterianos/administração & dosagem , Antiulcerosos/administração & dosagem , Quimioterapia Combinada/efeitos adversos , Europa (Continente) , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/imunologia , Humanos , Estudos Prospectivos , Sistema de Registros , Federação Russa/epidemiologiaRESUMO
The iron overload syndrome can be associated with various acquired states and hereditary factors. Hereditary hemochromatosis is the most common genetic disorder. Without therapeutic intervention the disease can lead to the development of life-threatening complications such as cirrhosis, hepatocellular carcinoma. The article presents data on pathogenesis, diagnosis and treatment of hereditary hemochromatosis. Own clinical observation is given.
Assuntos
Hemocromatose , Carcinoma Hepatocelular/etiologia , Hemocromatose/complicações , Hemocromatose/diagnóstico , Hemocromatose/terapia , Humanos , Cirrose Hepática/etiologia , Neoplasias Hepáticas/etiologia , SíndromeRESUMO
AIM: To assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. MATERIALS AND METHODS: 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. RESULTS: All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course ("prolonged population"). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore 'symptoms'. CONCLUSION: The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.
Assuntos
Dor Abdominal/tratamento farmacológico , Parassimpatolíticos/uso terapêutico , Fenetilaminas/uso terapêutico , Síndrome Pós-Colecistectomia/tratamento farmacológico , Espasmo/tratamento farmacológico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Parassimpatolíticos/administração & dosagem , Fenetilaminas/administração & dosagem , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento , Adulto JovemRESUMO
AIM: European Registry on the management of Helicobacter pylori infection («Hp-EuReg¼) - a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group, conducted in 27 European countries in order to evaluate the real clinical practice of diagnosis and treatment of H. pylori and its comparison with international recommendations. MATERIALS AND METHODS: The analysis of 2360 patients entered in the register by the Russian centres of «Hp-EuReg¼ in 2013-2017, who were underwent 1st line eradication therapy. RESULTS: The most common methods of primary diagnosis of H. pylori are histological (37.7%), rapid urease test (29.2%) and serology (29.7%). The duration of eradication therapy in 9.4% of cases was 7 days, in 65.3% - 10 days, and in 25.3% - 14 days. To control the effec- tiveness of treatment, H. pylori antigen in feces (31.3%), urea breath test (23.4%) and histological method (23.3%) were used. In 3.6% cases was used serology by mistake. In 17.3% of patients control was not carried out. The effectiveness of triple therapy with a PPI, amoxicillin, clar- ithromycin (per protocol) was 67.6%, with 7-day course, 81.1% at 10-day and 86.7% at 14-day course. Eradication rate of triple therapy with addition of bismuth (per protocol) reached 90,6% in the group receiving 10-day scheme and 93.6% in the group receiving the 14-day treatment. CONCLUSION: Significant deviations of clinical practice from expert recommendations, most pronounced at the stage of monitoring the effectiveness of therapy, were noted. The suboptimal efficacy of triple therapy is shown.
Assuntos
Antibacterianos , Infecções por Helicobacter , Inibidores da Bomba de Prótons , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Claritromicina , Quimioterapia Combinada , Europa (Continente) , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Humanos , Estudos Prospectivos , Inibidores da Bomba de Prótons/uso terapêutico , Sistema de RegistrosRESUMO
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.
Assuntos
Consenso , Insuficiência Pancreática Exócrina , Pâncreas/cirurgia , Glicemia/análise , Insuficiência Pancreática Exócrina/diagnóstico , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/terapia , Fezes/química , Hemoglobinas Glicadas/análise , Terapia de Reposição Hormonal/métodos , Lipase/uso terapêutico , Estado Nutricional , Pâncreas/enzimologia , Pâncreas/fisiopatologia , Pancreatectomia , Elastase Pancreática/análise , Federação RussaRESUMO
AIM: To assess the prevalence of bacterial overgrowth syndrome (BOS) and its risk factors in patients with inflammatory bowel diseases (IBD). SUBJECTS AND METHODS: The patients from the Novosibirsk IBD registry, who had undergone a hydrogen breath test (HBT) using a Gastro+ device, were examined. RESULTS: In 93 IBD patients who had undergone a HBD, the prevalence of BOS was 48% (46.2% for ulcerative colitis and 51.2% for Crohn's disease). There was a strong correlation between abdominal bloating, abdominal rumbling, and positive HBT results in both patient groups. During the HBT, the patients with BOS frequently complained of diarrhea, borborygmi, belching, and anxiety. CONCLUSION: The findings suggest that BOS is highly prevalent among patients with IBD. BOS is associated with clinical symptoms, such as abdominal bloating, abdominal rumbling, tearfulness, and irritability.
Assuntos
Síndrome da Alça Cega/epidemiologia , Síndrome da Alça Cega/fisiopatologia , Doenças Inflamatórias Intestinais/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adulto , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Sibéria/epidemiologiaRESUMO
AIM: To estimate the incidence of abdominal pain syndrome (APS) and to assess quality of life (QOL) in patients within 10 years after cholecystectomy (CE). SUBJECTS AND METHODS: This investigation is part of a long-term prospective follow-up study of patients after CE for cholelithiasis (CL). It enrolled 145 people: 30 (21.5%) patients with baseline asymptomatic CL and 115 (80.7%) with its clinical manifestations. The time course of changes in APS and QOL were analyzed. RESULTS: Over 10 years, all the patients showed a decrease in the incidence of APS from 84.1% (n=95) to 66.4% (n=75; p=0.004). In Group 1 (n=89), APS was at baseline detected in all the patients; 10 years later, its incidence declined to 67.4% (n=60; p < 0.001). Biliary pains were predominant; these had been identified significantly less frequently over the 10-year period in 47 (52.8%) patients; p<0.001). In Group 2 (n=24), pre-CE APS was generally detected in 6 (25%) patients; following 10 years, the incidence rates of pain significantly increased to 62.5% (n=15; p=0.035), among which there were predominant biliary pains (in 54.2%; p<0.001) and dyspepsia from 33.3% (n=8) up to 66.7% (n=16; p=0.039). QOL in the physical and mental health domains was found to decrease in both groups. CONCLUSION: Ten years after CE, the group with the baseline clinical manifestations of CL and poorer QOL showed a lower incidence of APS mainly due to the reduced incidence of biliary pains and the baseline asymptomatic group exhibited a rise in the incidence of APS due to the appearance of biliary pains and dyspepsia.
Assuntos
Dor Abdominal/etiologia , Colecistectomia/efeitos adversos , Colelitíase/cirurgia , Dispepsia/etiologia , Complicações Pós-Operatórias/etiologia , Qualidade de Vida , Idoso , Colecistectomia/estatística & dados numéricos , Dispepsia/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologiaRESUMO
The paper presents the All-Russian consensus on the diagnosis and treatment of celiac disease in children and adults, which has been elaborated by leading experts, such as gastroenterologists and pediatricians of Russia on the basis of the existing Russian and international guidelines. The consensus approved at the 42nd Annual Scientific Session of the Central Research Institute of Gastroenterology on Principles of Evidence-Based Medicine into Clinical Practice (March 2-3, 2016). The consensus is intended for practitioners engaged in the management and treatment of patients with celiac disease. Evidence for the main provisions of the consensus was sought in electronic databases. In making recommendations, the main source was the publications included in the Cochrane Library, EMBASE, MEDLINE, and PubMed. The search depth was 10 years. Recommendations in the preliminary version were reviewed by independent experts. Voting was done by the Delphic polling system.
Assuntos
Doença Celíaca , Gerenciamento Clínico , Adulto , Doença Celíaca/classificação , Doença Celíaca/diagnóstico , Doença Celíaca/terapia , Criança , Medicina Baseada em Evidências , Humanos , Federação RussaRESUMO
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.
Assuntos
Terapia de Reposição de Enzimas/métodos , Pancreatite Crônica , Gerenciamento Clínico , Humanos , Moscou , Pancreatite Crônica/diagnóstico , Pancreatite Crônica/terapiaRESUMO
The review gives current views on the problem of celiac disease (gluten enteropathy). It presents the pathogenetic components of pathology development, associations with the specific features of the microflora in different parts of the gastrointestinal tract, as well as groups at risk for this pathology. The idea on other types of gluten intolerance is briefly given. Current elaborated approaches to gluten enteropathy therapy are provided.
Assuntos
Doença Celíaca , Dieta Livre de Glúten/métodos , Trato Gastrointestinal , Fatores Imunológicos/uso terapêutico , Doença Celíaca/diagnóstico , Doença Celíaca/etiologia , Doença Celíaca/imunologia , Doença Celíaca/fisiopatologia , Doença Celíaca/terapia , Gerenciamento Clínico , Trato Gastrointestinal/microbiologia , Trato Gastrointestinal/patologia , Trato Gastrointestinal/fisiopatologia , Glutens/imunologia , HumanosRESUMO
AIM: To assess the clinical practice of diagnosis and treatment in patients with Helicobacter pylori infection and to compare this practice with the international guidelines in the European Registry on the management of Helicobacter pylori infection, Hp-EuReg protocol), a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group. MATERIALs AND METHODS: The data of 813 patients infected with H. pylori and entered in the Hp-EuReg register by the Russian centers in 2013-2015 were analyzed. RESULTS: The most common methods for the primary diagnosis of H. pylori infection are histology (40.3%), rapid urease test (35.7%), and serology (17.2%). The duration of H. pylori eradication therapy was 7, 10, and 14 days in 18.0, 49.3, and 25.1%, respectively. To monitor the effectiveness of treatment, the investigators used a histological examination (34%), a urea breath test (27.3%), H. pylori stool antigen (22.8%), and a rapid urease test (16.3%). A serological test was carried out in 2.5% of the cases. No monitoring was done in 13.5% of the patients. The average eradication efficiency was 82.6%. If the therapy was ineffective, 80% of physicians did not intend to prescribe a new cycle of treatment. CONCLUSION: Significant differences were found between clinical practice and the current guidelines.
Assuntos
Antibacterianos/uso terapêutico , Gastroenteropatias , Infecções por Helicobacter , Helicobacter pylori , Inibidores da Bomba de Prótons/uso terapêutico , Adulto , Testes Respiratórios/métodos , Protocolos Clínicos , Europa (Continente)/epidemiologia , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Gastroenteropatias/terapia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/fisiopatologia , Infecções por Helicobacter/terapia , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Sistema de Registros/estatística & dados numéricos , Federação Russa/epidemiologia , Sensibilidade e Especificidade , Urease/análiseRESUMO
Sarcoidosis is a multisystemic disease of unknown origin characterized by the formation of non caseating granulomas. Thoracic involvement is the most common presentation; however, sarcoidosis can involve almost any other organ. Liver is one of the most frequently affected organs after lungs and lymph nodes. Microscopic hepatic involvement is common in these patients but is mostly clinically silent. specific symptoms include jaundice and pruritus, mostly from chronic cholestasis. In a significant portion of these patients, macroscopic findings can be detected by ultrasound examination ,abdominal CT or magnetic resonance imaging and these findings may easily be confused with other benign and malignant conditions of the liver. Liver biopsy is usually required to confirm the diagnosis. Not all cases of hepatic sarcoidosis require treatment. For symptomatic patients, the first line treatment includes corticosteroids or ursodeoxycholic acid.
Assuntos
Corticosteroides/uso terapêutico , Hepatopatias , Sarcoidose , Ácido Ursodesoxicólico/uso terapêutico , Humanos , Hepatopatias/diagnóstico , Hepatopatias/tratamento farmacológico , Hepatopatias/metabolismo , Hepatopatias/mortalidade , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico , Sarcoidose/metabolismo , Sarcoidose/patologiaRESUMO
This article describes a clinical case of fulminant paracetamoly hepatitis a young woman of 33 years. Fulminant hepatitis has developed as a consequence of uncontrolled reception paracetamol-containing medicines for acute viral infection. Paracetamol poisoning conlirmed at autopsy.
Assuntos
Acetaminofen/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas , Falência Hepática Aguda , Acetaminofen/administração & dosagem , Adulto , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/patologia , Evolução Fatal , Feminino , Humanos , Falência Hepática Aguda/induzido quimicamente , Falência Hepática Aguda/metabolismo , Falência Hepática Aguda/patologia , Viroses/tratamento farmacológico , Viroses/metabolismo , Viroses/patologiaRESUMO
According the background of increasing consumption of gluten-containing products by the population increase in the prevalence and expanding the range of gluten-related diseases was marked. Gluten proteins and other cereals have been recognized as a possible cause of allergies to wheat, and non-celiac gluten sensitivity has been described as a new syndrome (NCGS). The article presents a modern view on the problem of gluten-related diseases, deiThition of NCGS, approaches to the diagnosis and recommendations for management of patients with this pathology.
Assuntos
Glutens/toxicidade , Síndromes de Malabsorção/diagnóstico , Hipersensibilidade a Trigo/diagnóstico , Humanos , Síndromes de Malabsorção/metabolismo , Síndromes de Malabsorção/patologia , Hipersensibilidade a Trigo/metabolismo , Hipersensibilidade a Trigo/patologiaRESUMO
AIM: To evaluate gastrointestinal symptoms during 10 years after cholecystectomy in patients with symptomatic and asymptomatic gallstone disease and to identify predictors of them. MATERIALS AND METHODS: The work is the part of a prospective long-term monitoring of patients with symptomatic (1) and asymptomatic (2) gallstone disease after cholecystectomy (CE). The study included 145 patients: 115 (80.7%) with initially symptomatic disease (1) and 30(21.5%) asymptomatic (2) disease. RESULTS: The frequency of heartburn increased from 15.9% to 63.7% during 10 years (p = 0.015) after CE especially in the group (1) (from 2.24% to 68.53% (p 0.037). The frequency of "bitter taste in the mouth" raised from 46.9% before the CE to 69.02% after CE (p < 0.001). The frequency of diarrhea increased from 0.88% to 38.2% in both groups. (p = 0.046). CONCLUSION: The frequency of heartburn, "bitter taste in the mouth", diarrhea increased in patients after 10 years in patients with symptomatic and asymptomatic gallstone disease after CE. A common risk factors are presence symptomps at baseline and the presence of these symptoms at the 6rst years after CE.
Assuntos
Colecistectomia/efeitos adversos , Diarreia/epidemiologia , Dispepsia/epidemiologia , Azia/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Diarreia/etiologia , Diarreia/fisiopatologia , Dispepsia/etiologia , Dispepsia/fisiopatologia , Feminino , Cálculos Biliares/epidemiologia , Cálculos Biliares/cirurgia , Azia/etiologia , Azia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/fisiopatologiaRESUMO
Inflammatory bowel diseases (IBD) are chronic recurrent immune-mediated inflammation of the gastrointestinal tract. Now it is not unified system of monitoring patients with IBD in Russia, but there is information from different regions about the prevalence of disease. There are the registers in few big cities. From 2003 the registers of IBO have been done in Novosibirsk. The register data can give us the possibility to estimate the various real-time data of the disease, to analyze the effect of the treatment, to evaluate risk factors for the disease in real clinical practice. Among the patients with ulcerative colitis decreased the number ofpatients with recurrent and continuous increase in the number of patients with distal forms, which is probably due to the more skillful conduct of patients. in general, it decreased the number of patients with Crohns disease with continuously relapsing course option, reflecting, perhaps, improved treatment. Decline in the proportion of persons with the localization process, only in the colon, which is associated with greater availability of diagnostic methods for destruction of the small intestine. The registry was created in April 2012 and includes patients registered up to October 2015.
Assuntos
Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/terapia , Sistema de Registros , Adulto , Feminino , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Masculino , Sibéria/epidemiologiaRESUMO
AIM: To estimate the informative value of a noninvasive fecal (calprotectin) test in the differential diagnosis of bowel diseases. SUBJECTS AND METHODS: One hundred and forty-two patients who had visited their physicians with intestinal disorders (a change in stool frequency and patterns, abdominal pain) were examined in an open-label multicenter cross-sectional study. The examinees' mean age was 35 ± 2.43 years. Gender- and age-matched comparison groups consisted of healthy individuals and patients with irritable bowel syndrome. Fecal calprotectin (FCP) was determined using a BUHLMANN Calprotectin ELISA kit. All the patients underwent colonoscopy. RESULTS: In the patients with organic bowel diseases (ulcerative colitis, Crohn's disease, lymphocytic colitis, colonic diverticular disease, colonic adenomas, celiac disease), the concentration of FCP was found to be substantially higher than that in the healthy individuals and patients with irritable bowel syndrome. The highest calprotectin levels were noted in the patients with inflammatory bowel diseases. CONCLUSION: This study demonstrated the high diagnostic value of the calprotectin test for the differential diagnosis of organic and functional bowel diseases.
Assuntos
Fezes/química , Síndrome do Intestino Irritável/diagnóstico , Complexo Antígeno L1 Leucocitário , Adulto , Diagnóstico Diferencial , Feminino , Humanos , MasculinoRESUMO
The data of the literature and own data on the frequency and mechanisms of gastrointestinal symptoms in patients with diabetes mellitus type 2 are discussed. Changes in the gastrointestinal tract with diabetes mellitus type 2 are detected over its entire length and occur more frequently than in the general population. Among the reasons of it the presence of autonomic neuropathy, factor of hyperglycemia, increased anxiety and depression in patients are discussed.