[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.

[Multicenter study of gastroesophageal reflux disease symptoms prevalence in outpatients in Russia].

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.

[Epithelial protective therapy in comorbid diseases. Practical Guidelines for Physicians].

This document was produced with the support of the National Medical Association for the Study of Comorbidities (NASС). In 2021 the first multidisciplinary National Consensus on the pathophysiological and clinical aspects of Increased Epithelial Permeability Syndrome was published. The proposed guidelines are developed on the basis of this Consensus, by the same team of experts. Twenty-eight Practical Guidelines for Physicians statements were adopted by the Expert Council using the "delphic" method. Such main groups of epithelial protective drugs as proton pump inhibitors, bismuth drugs and probiotics are discussed in these Guidelines from the positions of evidence-based medicine. The clinical and pharmacological characteristics of such a universal epithelial protector as rebamipide, acting at the preepithelial, epithelial and subepithelial levels, throughout gastrointestinal tract, are presented in detail.

[Prevalence of nonalcoholic fatty liver disease in outpatients in Rostov-on-Don: Regional results of the DIREG-2 study]. / Rasprostranennost' nealkogol'noi zhirovoi bolezni pecheni u patsientov ambulatorno-poliklinicheskoi praktiki v Rostove-na-Donu: regional'nye rezul'taty issledovaniya DIREG-2.

AIM: to analyze and summarize the data of the DIREG-2 study of the nonalcoholic fatty liver disease (NAFLD) register in Rostov-on-Don versus those in Russia. MATERIAL AND METHODS: The prospective disease registry study encompasses an epidemiologic, observational, cross-sectional, multicenter study estimating the prevalence of NAFLD in outpatients in Rostov-on-Don. A total of 3200 patients participated in this study. The investigators were 65 outpatient physicians. Epidemiological data were obtained during two patient visits to the research centers. RESULTS: The key result obtained from this study was the significantly higher prevalence of NAFLD in Rostov-on-Don than that in the general population (40.4 and 37.3%). In addition to the higher prevalence of NAFLD, there was also a higher spread of risk factors (RFs), such as abdominal obesity, female age of 45-55 years, and hyperlipidemia. CONCLUSION: The prevalence of NAFLD in the outpatients of Rostov-on-Don was 3.1% greater than that in Russia; this might be due to the significantly higher spread of some RFs (abdominal obesity, female age of 45-55 years, hyperlipidemia). The findings are undoubtedly necessary for the elaboration of measures for the primary and secondary prevention of NAFLD in Rostov-on-Don.

EVOLUTION OF VIEWS ON THE PATHOGENESIS OF INFLAMMATORY BOWEL DISEASE.

Based on the literature overview and summarizing of practical experience we provides a current review of data regarding the epidemiology, etiology and pathogenesis of IBD. In this review authors focuse their attention on different links of the immune system, including the components of the innate immune system (macrophages, monocytes, neutrophils, dendritic cells), adaptive or acquired immunity (T and B cells), secreted mediators (cytokines and chemokines), as well as the cells of the intestinal epithelium and congenital limphoid cells, because according to modern concepts, elements of this system are the key factors of understanding the pathogenesis of IBD.

POST-GENOMIC MEDICINE: THE DIAGNOSTIC VALUE OF PROTEOMIC ANALYSIS IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE.

PURPOSE: Study the characteristics of proteomic profile of esophageal mucosa in different forms and gradations of gastro-esophageal reflux disease (GERD). MATERIALS AND METHODS: The study included 68 patients with verified GERD. Studied the proteomic profile of a gullet a method of tandem time-of-flight MALDI mass spectrometry using bioinformation algorithms. RESULTS: The identified proteins are involved in the regulation of inflammation, apoptosis, adhesion and transport of ions and other important biological processes. The data obtained allow to expand the understanding of the molecular mechanisms of this pathology development. Identified proteins in the esophagus can be used as informative markers of the complicated course of GERD.

[Clinical usefulness of alpha-and beta-defensins in biological environments in patients with ulcerative colitis].

OBJECTIVE: To determine the dependence of alpha-and beta-defensins in biological environments and prevalence of inflammatory process, activity bei patienten ulcerative colitis (UC). MATERIALIEN UND METHODEN: The study was conducted on 63 patients with moderate activity UC and 25 practically healthy people. Depending on the extent of the gut was isolated by the three groups of patients: group 1 (n = 18)--distal form, group 2 (n = 24)--left-hand localization of pathological process and group 3 (n = 21)--total form UC. Content of beta-defensins in the stool and alpha-defensins in blood by method of the immune-enzyme analysis. RESULTS: In the control group the level of beta-defensins in the stool was 3.7 +/- 3.2 ng/g, alpha-defensins in blood--71.7 +/- 3.8 ng/ml. In patients of group 1 the concentration of beta-defensins in the stool was 218.5 +/- 8.2 ng/g in 2 group--210.8 +/- 4.3 ng/g and in group 3--261.7 +/- 9.2 ng/g. Intermediate level a-defensins in blood match in group 1--471.8 g 9.9 ng/ml in group 2--853.5 g 9.5 ng/ml and in group 3--479.3 +/- 6.8 ng/ ml. Regardless of the localization of lesions in the gut, not including beta-defensin in the stool at 2 under, the concentration of antimicrobial peptides in remission. CONCLUSION: Proven association increased expression of alpha-and beta-defensins with activity and a length of inflammation in the intestine at UC.