[The Russian consensus on the diagnosis and treatment of chronic pancreatitis: Enzyme replacement therapy]. / Rossiiskii konsensus po diagnostike i lecheniiu khronicheskogo pankreatita: zamestitel'naia fermentnaia terapiia.

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.

[All-Russian Consensus on Diagnosis and Treatment of Celiac Disease in Children and Adults]. / Vserossiiskii konsensus po diagnostike i lecheniyu tseliakii u detei i vzroslykh.

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.

BASIC BIOCHEMICAL AND CLINICAL ASPECTS OF NONINVASIVE TESTS HELIC.

Biochemical process that lay in the core of non-invasive detection of Helico ho cter pylod with the help of HELIC Ammonia breath test, manufactured by AMA Co Ltd., St.Petersburg, is shown. Patents from various countries, describing ammonia as H.pyiori diagnostic marker, are reviewed. Approaches for evaluation of efficacy of the test-system are analyzed, validation and verification data is provided. High diagnostic characteristics are confirmed by the results of comparative studies on patients of different age groups, reaching 97% sensitivity and 96% specificity.

[NONALCOHOLIC FATTY LIVER DISEASE: DIAGNOSTIC, SYMPTOMS, TREATMENT. GUIDELINES WERE APPROVED BY THE XV GASTROENTEROLOGICAL SCIENTIFIC SOCIETY OF RUSSIA IN 2015].

According to the World Health Organization, it is recorded steady growth of the number of chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD), in recent years. As an independent nosological entity, NAFLD is one of the risk factors for cardiovascular diseases, associated with abdominal-visceral obesity, peripheral insulin resistance (IR), and is regarded as the hepatic component of Metabolic syndrome (MS). Nowadays there are no generally accepted national standards for diagnosis and treatment of NAFLD for physicians, gen- eral practitioners, gastroenterologists in Russia. This was the essential reason in their development. The main reason of The guidelines development is the absence of generally accepted national standards for diagnosis and treatment of NAFLD for physicians, general practitioners, gastroenterologists in Russia. These guidelines are based on the global and local data of treatment experience of NAFLD, recently published in reviews, analytical studies in the literature. Guidelines are intended for physicians, general practitioners, gastroenterologists and contain the description of the preferred approaches to the provision of diagnostic, curative and preventive care of patients NAFLD. The quality of recommendations was grading according to the GRADE approach.

[Sympathetic block as a part of the treatment of coronary heart disease (Literature review)].

The given literature review is devoted to the urgent problem of improving the effectiveness of conservative treatment of patients with coronary heart disease through the use of sympathetic blockade. The authors highlight the. current understanding of the morbid physiology of cardiac angina, in particular, pain syndrome, of the state of analgesia in cardiology. Considered in detail the use of thoracic epidural block in case of coronary heart disease, shows the mechanism of action of epidural blockade, clinical features, its antiischemic effect on the myocardium, the impact on hemodynamic. Also described are the possible side effects and complications of epidural blockade. In conclusion, the authors emphasize the prospect of a wide practical application of regional blockade of local anaesthetics and narcotic analgesics in cardiac patients.

[Heterogeneity of chronic esophagitis in childhood].

Chronic esophagitis in children etiologically are heterogeneous. Was observed 83 patients aged from 3 to 17 years with histologically defined chronic esophagitis, 58 of them suffered from food and respiratory allergies. All children underwented endoscopy, morphological and immunohistochemical study of the esophagus biopsies with the definition IgE, IgA herpes simplex virus (HSV), cytomegalovirus (CMV) and Epstein - Barr virus (EBV) in the mucous membrane. The presence of chronic infection was established in 77 out of 83 (92.8%) children. All the patients underwented daily pH meters. GERD was diagnosed in 33 children. GERD was characterized by typical symptoms, combined with gastroduodenal pathology, usually Hp-associated, and increased gastric secretion. Morphologically at 15% of the patients with gastric metaplasia was found moderate inflammation. During examination of patients with allergic esophagitis was neither clinical nor explicit endoscopic manifestations, eosinophilic infiltration was observed in some patients, but inflammatory activity was lower than at GERD and infections. Esophagitis in chronic viral infections was characterized by a higher frequency of erosive changes, higher activity of inflammation. The combination of the three etiological factors were associated with more severe lesions of the esophagus.

[Results of child observation during 3 years after the eradication treatment]. / Rezul'taty trekhletnego nabliudeniia za det'mi posle éradikatsionnoi terapii.

Comparative evaluation of clinical, endoscopic and morphological stomach mucosa changes dynamics was performed in 100 patients with presence and absence of HP eradication during 3 years. Improvement of clinical, endoscopic and disease morphological sings, sometimes the complete its normalization, but never worsening were observed in the most patients with HP eradication. The main pathomorphological indexes were for certain decreased after 1 year of eradication. The same indexes were not changed in the patients with still presence of HP infection. The complete normalization of stomach mucosa morphology was revealed in 28% of children during 3 years after HP eradication. New HP infection and recurrence of complains and increase of inflammatory and dystrophic stomach mucosa changes were revealed in 43% of children.

[Various problems of small-intestinal pathology in children with food allergy]. / Nekotorye voprosy patologii tonkoi kishki pri pishchevoi allergii u detei.

Altogether 54 children with food allergy characterized clinically by concomitant lesion of the skin and alimentary tract were examined. The results obtained attest to the involvement into the pathological process of the small intestine, to the combination of cow's milk protein and lactose intolerance as well as to the advisability of correcting intestinal dysbiocenosis in order to reduce the disease progress.