[METHOD FOR DETERMINING EROSIVE LESIONS OF THE GASTRIC MUCOUSA IN CHILDREN WITH JUVENILE ARTHRITIS].

To detect the clinical diagnostic criteria for non-invasive diagnosis of erosive gastritis in children with juvenile arthritis have been studied the 92 children aged 9 to 16 years (mean age-13,9 ± 2,3 years) with verified diagnosis of juvenile arthritis, of whom 10 had erosive gastritis (group 1) and 82 without erosions (group 2). A comparison of the groups on 23 grounds by analysis of contingency tables and the subsequent discriminant analysis, has developed a new non-invasive method for determining the erosive lesions of the mucous membrane of the stomach in children with juvenile arthritis, including a score of history, complaints and the results of laboratory studies the level of the G-17, pepsinogen I, pepsinogen II, and the ratio of pepsinogen I to pepsinogen II, the presence of autoantibodies to the H+, K+/ATPase of the parietal cells of the stomach, the test for occult blood "Colon View Hb and Hb/Hp". Developed a diagnostic table, including 11 features with scores each. The total score 27 or higher allows a high degree of probability to determine the erosive lesions of the gastric mucosa in children with juvenile arthritis.

[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.

[Biliary dysfunction in obese children].

To examine the state of the biliary system, a study of properties of bile "case-control") 100 children and adolescents aged 8 to 18 years, held checkup in consultative and diagnostic center for chronic gastroduodenitis. BMI children were divided into 2 groups: group 1-60 children with obesity (BMI of 30 to 40) and group 2-40 children with normal anthropometric indices. Survey methods included clinical examination pediatrician, endocrinologist, biochemical parameters (ALT, AST, alkaline phosphatase level, total protein, bilirubin, lipidogram, glucose, insulin, HOMA-index), ultrasound of the abdomen and retroperitoneum, EGD with aspiration of gallbladder bile. Crystallography bile produced by crystallization of biological substrates micromethods modification Prima AV, 1992. Obese children with chronic gastroduodenita more likely than children of normal weight, had complaints and objective laboratory and instrumental evidence of insulin resistance and motor disorders of the upper gastrointestinal and biliary tract, liver enlargement and biliary "sludge". Biochemical parameters of obese children indicate initial metabolic changes in carbohydrate and fat metabolism and cholestasis, as compared to control children. Colloidal properties of bile in obese children with chronic gastroduodenita reduced, as indicated by the nature of the crystallographic pattern. Conclusions: Obese children with chronic gastroduodenitis often identified enlarged liver, cholestasis and biliary dysfunction, including with the presence of sludge in the gallbladder; most often--hypertonic bile dysfunction. Biochemical features of carbohydrate and fat metabolism reflect the features of the metabolic profile of obese children. Crystallography bile in obese children reveals the instability of the colloidal structure of bile, predisposing children to biliary sludge, which is a risk factor for gallstones.

[Hepatic steatosis and fatty pancreas--2 targets of metabolic syndrom in children].

OBJECTIVES: This study aimed to assess frequency of association between hepatic steatosis and pancreatic steatosis in obese children and find out common chains of pathogenesis. METHODS: This study was conducted among 100 children aged 12-17 years, consisted 2 groups: 60 overweight children (BMI from 30,1 to 42,87-1st group) and 40 children with normal BMI (2nd group). Diagnosis of the hepatic steatosis and pancreatic steatosis was based on sonographic findings. Were investigated peculiarities of carbohydrates and lipid metabolism and pancreatic exocrine function. RESULTS: Sonographic findings compatible with pancreatic steatosis in obese children were found with frequency- 70%, whereas sonographic findings compatible with hepatic steatosis were found with frequency- 46.6%. These findings were associated with BMI, parameters of metabolic syndrome: waist circumference, insulinresistancy, disturbances of the carbohydrates and lipid metabolism. Was found decreasing level of the elastase-1 in children with obesity. CONCLUSION: In 70% obese children was found pancreatic steatosis. The presence of fatty pancreas represents a meaningful manifestation of metabolic syndrome together with obesity and hepatic steatosis.

[Bactericidal effect of lysozyme].

Isolation of lysozyme from hemolymph of Alveonasus lahorensis (Acari: Parasitiformes, Argasidae) and Hyalomma marginatum (Acari: Parasitiformes, Ixodidae) with using ultrasound is described. It was shown that the bactericidal effect of the ultrasound-extracted lysozyme against Staphylococcus aureus and Micrococcus luteus significantly exceeded that of the chicken egg lysozyme and lysozyme from ticks without ultrasound exposure. Disintegration of the hemolymph cells increased lysozyme production.

[Morpho-functional peculiarities of autoimmune gastritis in different age groups].

In 98 patients with chronic gastritis clinical-morphologic analysis was performed. The analysis included: the examination of gastric biopsy specimens, determination of HP-status by means of a group of methods, determination of antibodies to H+/K+ -ATPase of parietal cells of the gastric wall, IgG-EA-EBV and IgM-NA-EBN antibodies in the blood serum by means of IFA method, pepsinogene I, pepsinogene II, gastrin and antibodies to Hp with the use of Biohit gastric panel, 24-hour monitoring of intragastric pH with the use of Gastroscan-24 machine. Comparison of all parameters was performed in 4 groups: 27 children aged 6-17 with non-autoimmune gastritis and 119 children with gastritis of other etiology, 34 patients aged 18-80 with autoimmune gastritis and 43 patients of the same age group with non-autoimmune gastritis were described. Age-specific peculiarities of autoimmune gastritis in children were determined; and a diagnostic algorithm for its early diagnosis in the latter was developed.

[Chronic gastritis and herpetic infections in subjects of different ages].

Gastric mucosal biopsy specimens were immunohistochemically studied to detect the antigens of herpes simplex virus, cytomegalovirus, and Epstein-Barr virus (EB ) in 103 children aged 7-17 years and 49 adults aged 18-78 years who suffered from morphologically verified chronic gastritis. Gastric mucosal virus antigens were found in 70% of the children (including EBV in 44.8%; herpes simplex virus in 34.9%, cytomegalovirus in 16.5%; concurrence of two and three infections in 22.3 and 1.9%, respectively) and in 65.3% of the adults (EBV in 408%; herpes simplex virus in 26.5%, cytomegalovirus in 18.4%; concurrence of two and three infections in 26.3 and 2%, respectively). It was shown that herpes viruses may play an etiological role in the development of chronic gastritis in children and adults.

[Association of the morphological features of gastric parietal cells with the concentration of H+/K+/ATPase autoantibodies in chronic gastrititis].

Chronic gastritis was morphologically verified in 119 patients. The count of parietal cells per 100 epitheliocytes of fundic glands was estimated. The sizes of parietal cells were measured by the morphometric computer program Videotest. For the diagnosis of autoimmune chronic gastritis (ACG), the level of antibodies to H+K+ATPase of gastric parietal cells in the patients' serum was determined by enzyme immunoassay. Childhood ACG has been found to be characterized by hyperplasia and structural changes of parietal cells with their preserved total count. The specific features of adult ACG include a significant reduction in the number of parietal cells, their sizes depending on the level of antiparietal autoantibodies, and marked ultrastructural changes as impairments in the differentiation and destruction of cytoplasm, organelles, and cell membrane.

[Gas analyzer "HelicoSense" as a new device for diagnosis of the Helicobacter infection].

According to recommendations of the European Health Committee, noninvasive methods should be preferred for diagnosis of Helicobacter pylori (HP) infection in children. Equipment and reagents for respiration diagnostic tests available from foreign manufacturers have rather high cost, which hinders their use in domestic medical institutions. A new noninvasive electrochemical technique for HP detection is based on the use of HelicoSense gas analyzer. 150 patients (100 children 6-17 years old and 50 adults 18-78 years old) participated in mulicenter testing of the developed technique. Chronic gastritis was previously diagnosed by endoscopic and morphological examination in all patients. HP status was studied using bacteriological, serological, and cytological methods, as well as the Helpil test. The obtained results were compared to the results of examination with HelicoSense gas analyzer. Our study showed that HelicoSense gas analyzer provides easy use, patient's safety, and possibility of rapid testing. Its application does not require specially trained medical personnel. The device provides high specificity (86.7%) and high sensitivity (93.7%).

[Chronic EBV-infection in children with a high level of anti-H+/K+-ATPhase antibodies in gastric parietal].

We examined 50 children at the age of 4-17 suffering from chronic gastritis. AntiH+/K+-ATPhase antibodies of gastric parietal cells, anti-EBV antibodies IgG EA and IgM VCA were determined with the help of immune-enzyme analysis methods. The first group comprised 28 children with a high level of antiparietal antibodies in the blood serum, and 22 children with a normal level of antiparietal antibodies made up the second group. The HP identification was carried out for all children. Anti-EBV antibodies IgG EA were found in 72% of children, and there were no statistical differences in the frequency and level of antibodies IgG EA. IgM VCA were not found in any of the patients. However, HP-infection was revealed in 64.3% in the first group vs. 22.7% in the second group (p < 0,05); the combination of HB and chronic EBV infection was also more frequent in the first group than in the second group (42.8% and 18.1%, respectively, p < 0,05).

[Ixodes ticks of the town of Cherkessk and its environs].

The paper presents the results of the studies made in 2002-2004 to examine the species-specific composition of Ixodes ticks. The ticks were gathered for a flag (155km routes being covered and 405 ticks being gathered); 48 dogs were examined, 320 ticks being gathered; 212 ticks were collected from human beings. The town dwellers' visit rates were grouped by ages and months. In the republic, Borreliae, the causative agents of Lyme borreliosis, were first isolated from Ixodes ricinus by darkground microscopy. Thus, there is one more available Lyme borreliosis focus. Enzyme immunoassay was used to study the sera from the dwellers bitten by ticks. Anti-M and anti-G antibodies were isolated. The paper presents the distribution of Ixodes ticks gathered for the flag and taken from dogs in accordance with the biotopes, establishes seasonal variations, and provides calculations of the abundance index on the dogs.

[Chronic gastritis in children with concomitant diseases of the thyroid gland]. / Khronicheskii gastrit u detei s sopustvuiushchimi zabolevaniiami shchitovidnoi zhelezy.

We examined: 1 group--16 children with chronic gastritis (CG) and autoimmune thyroiditis (AT); 2 group--41 children with functional thyroidal pathologies; 3 group--23 children with CG only. The average age in all groups was 11.17 +/- 2.98. HP (68%) was revealed equally frequently in all the groups. Antibodies to H+/K(+)-ATPase of parietal cells were revealed in the first and second groups only (31-36%), p < 0.05 as compared to the third group. CG of the stomach body was more frequently revealed in the first group using endoscopic and histological tests. The second group had more frequent and more apparent lesions of the antral part. Thus, in case of concomitant diseases of the thyroid gland CG has an autoimmune nature of an inflammation of the mucous coat of the stomach.

[Antibodies to H+/K+-ATPase of gastric parietal cells in children with Helicobacter pylori associated chronic gastritis]. / Antitela k H+/K+-ATFaze parietal'nykh kletok zheludka u detei s HP-assotsirovannym khronicheskim gastritom.

54 children at the age of 3-15 suffering from HP-associated CG were examined. Antibodies to H+/K(+)-ATPase of gastric parietal cells were determined with the help of the immune-enzyme analysis method. It was discovered that antibodies to H+/K(+)-ATPase are found in 27.7% of children. Concomitant autoimmune diseases, pangastritis, morphologic symptoms of the pre-atrophic stage of autoimmune gastritis as well as the drop of secretion at the fasting phase were discovered more often in antibody-positive patients. The successful eradication of HP in two children resulted in the disappearance of anti-parietal autoantibodies.

[Classification of amyotrophic lateral sclerosis (clinico-electromyographic study)]. / K voprosu o klassifikatsii bokovogo amiotroficheskogo skleroza (kliniko-élektromiograficheskoe issledovanie).

On the basis of the clinical electromyographic examination of 117 patients with lateral amyotrophic sclerosis, the relationship was ascertained between the manifestations of this illness and the primary localization of amyotrophies in the distal or proximal regions of the extremities. The first group was characterized by rapid generalization of the pathological process and by the presence of marked symptoms of the involvement of the segmento-nuclear motoneurons and the pyramidal tracts whilst the second group largely manifested impairment of the anterior cornual motor cells and the spinal localization of the process throughout the course of the disease. It is suggested that cervicothoracic and lumbosacral forms of the illness be subdivided into distinctive variants in relation to the primary localization of amyotrophies in the distal or proximal regions of the extremities.

[State of mechanisms regulating muscle tone in amyotrophic lateral sclerosis (clinico-electromyographic study)]. / Sostoianie mekhanizmov reguliatsii myshechnogo tonusa pri bokovom amiotroficheskom skleroze (kliniko-élektromiograficheskoe issledovanie).

For studying the mechanisms of spasticity electromyographic examinations were carried out in 54 patients suffering from lateral amyotrophic sclerosis at various stages of the disease. At the beginning of the spasticity formation disturbances of the functions of the checking spinal mechanisms and the gamma-system were revealed, while those of alpha-mononeurons (tested by the H-reflex) showed no statistically significant changes. In the late period (pronounced spasticity) disturbances of all the motor systems mentioned were noted. The role of various mechanisms in the development of muscular hypertonicity in lateral amyotrophic sclerosis is discussed.