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1.
Ter Arkh ; 93(2): 174-178, 2021 Feb 15.
Artículo en Ruso | MEDLINE | ID: mdl-36286632

RESUMEN

The occurrence of chronic diarrhea after cholecystectomy (CCY) has been described by many researchers. However, the main mechanisms of the development of this diarrhea are not fully understood. Supposed that dysregulation of the bile acids (ВA) absorption in the ileum is played a significant role in the development of diarrhea syndrome. AIM: To determine the role of the fibroblast growth factor 19 (FGF19) level in the serum and BA concentration in feces in pathogenesis of bile acid diarrhea (ВАD) in patients after CCY. MATERIALS AND METHODS: Sixty-one patients were examined at various times after CCY: 30 patients with chronic diarrhea that appeared after CCY (group 1) and 31 patients with normal stools (group 2). In all patients, the level of FGF19 in the blood serum, and the daily excretion of BA in the feces were studied. The control group consisted of 28 healthy individuals. RESULTS: In the 1st group we found lower concentrations of FGF19 in the blood serum 86.2 ng/ml (67.8; 117.8) compared with concentrations in the 2nd group 259 ng/ml (170.6; 318.8), p0.001. The daily excretion of bile acids with feces in the 1st group was 657.4 mg/day (524.6; 830.1), which was twice more than in the 2nd group and the control group. It was established an inverse correlation between serum concentration of the FGF19 and the BA excretion in the feces in all examined patients. It indicates a possible relationship between the low concentration of FGF19 in blood serum and malabsorption of the BA. CONCLUSION: Low level of FGF19 in the blood serum and a high excretion of BA in the feces may be one of the causes of BAD in patients undergoing cholecystectomy. Our results indicate the important role of FGF19 in the development of chronic diarrhea, which can be considered as one of the variants of postcholecystectomy syndrome.

2.
Ter Arkh ; 90(10): 84-88, 2018 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-30701801

RESUMEN

AIM: In order to optimize the therapy, the functional state of the pancreas (P) and the peculiarities of metabolic activity of intestinal microbiota in adults with cystic fibrosis (CF) were assessed. MATERIALS AND METHODS: 14 CF patients (20-34 years, 7 men, 7 women) were enrolled. In 8 patients, the diagnosis was confirmed in the first year of life on the basis of clinical data, positive sweat test, 5 had genetic confirmation. In 4 patients, the diagnosis was confirmed at the age of 8-13 years and 2 patients aged 18, 27 years. In this group, genetic confirmation was in 4 subjects. In addition to general clinical studies, the level of C-peptide in blood, elastase and the concentration of short chain fatty acids in feces was determined. RESULTS: Of elastase feces in 9 patients was 5.5±4.7 icg/g, that is revealed severe exocrine insufficiency of the pancreas and in 5 patients the elastase level was normal and amounted to 402±124 icg/g. Deployed the clinical picture of diabetes mellitus was observed in 3 patients. Metabolic activity of the colon microflora as a whole was reduced, the sum of the concentration of short-chain fatty acids (ΣCn) was 6.03±4.11 mg/g at a rate of 10.61±5.11 (p<0.05). At the same time, in some patients (group 1, n=9), who were at the time of the study on antibiotic therapy, the value of ΣCn was 3.32±0.33 mg/g, and in patients receiving probiotic drugs (group 2, n=5), the activity of microflora did not differ from the norm ((ΣCn=11.03±2.01 mg/g). The correlation dependence of the ratio of the total iso-acids fraction in patients with MV to the normal values and the level of fecal elastase (r= -0.46, p=0.049) was revealed. CONCLUSION: Most patients with CF (64%) diagnosed with exocrine pancreatic insufficiency severe according elastase stool. The activity of faecal elastase correlated with parameters of microbiocenosis, which indicates the necessity of correction is not only functional insufficiency of the pancreas, but also the state of the microbiota.


Asunto(s)
Fibrosis Quística , Insuficiencia Pancreática Exocrina , Microbiota , Páncreas , Adulto , Fibrosis Quística/complicaciones , Heces , Femenino , Humanos , Masculino , Páncreas/fisiopatología , Elastasa Pancreática
3.
Ter Arkh ; 88(2): 39-43, 2016.
Artículo en Ruso | MEDLINE | ID: mdl-27030182

RESUMEN

AIM: To determine celiac disease detection rate in patients with digestive disease. SUBJECTS AND METHODS: A total of 318 gastroenterological patients admitted to be treated at the Central Research Institute of Gastroenterology in September to October 2012 were examined. The patients' age was 18 to 74 years (mean 51.5±16.4 years). Immunoglobulin A (IgA) and immunoglobulin G (IgG) anti-gliadin antibodies (AGA), IgA anti-tissue transglutaminase (anti-tTG) antibodies and IgG anti-tTG antibodies were determined. When the antibodies were elevated, esophagogastroduodenoscopy with duodenal biopsy was performed. RESULTS: Forty-one of the 318 patients were found to have higher AGA (12.9%); out of them IgA AGA were in 17 (5.35%) patients and IgG AGA were also in 17 (5.35%). Elevated levels of both antibodies (IgA AGA and IgG AGA) were seen in 7 (2.2%) patients. Overall, the detection rate of increased AGA levels was 12.9%. The antibodies were more commonly higher in patients with liver diseases (21.8%) and in those with inflammatory bowel diseases (21.6%). Both IgA anti-tTG, IgG anti-tTG and IgA AGA, IgG AGA were detected in 6 (1.9%) of the 318 patients. The diagnosis of celiac disease was verified by duodenal histological examination in 3 (0.94%) of the 318 patients. CONCLUSION: The celiac disease detection rate in gastroenterological patients was 0.94%.


Asunto(s)
Enfermedad Celíaca , Duodeno/patología , Enfermedades Gastrointestinales , Adulto , Anciano , Autoanticuerpos/sangre , Biopsia , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/epidemiología , Enfermedad Celíaca/inmunología , Comorbilidad , Endoscopía del Sistema Digestivo/métodos , Femenino , Proteínas de Unión al GTP/inmunología , Enfermedades Gastrointestinales/sangre , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/epidemiología , Gliadina/inmunología , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Masculino , Persona de Mediana Edad , Proteína Glutamina Gamma Glutamiltransferasa 2 , Factores de Riesgo , Federación de Rusia/epidemiología , Transglutaminasas/inmunología
4.
Eksp Klin Gastroenterol ; (11): 31-34, 2016.
Artículo en Inglés, Ruso | MEDLINE | ID: mdl-29889442

RESUMEN

Bile acids regulate glucose and lipid metabolism. Aim -determination of total serum bile acids in patients with NAFLD and in combination with type 2 diabetes. To determine the inflammatory markers (nitric oxide, endotoxin, phospholipase A2, malondialdehyde) effects role for the synthesis and transport of bile acids. NAFLD patients with type 2 diabetes observed decrease in synthesis and disruption of transport of bile acids, which is associated with the cell membrane damage by inhibition of enzyme systems, and inflammation.


Asunto(s)
Ácidos y Sales Biliares/metabolismo , Metabolismo de los Hidratos de Carbono , Diabetes Mellitus Tipo 2/metabolismo , Metabolismo de los Lípidos , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Biomarcadores/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad
5.
Ter Arkh ; 87(2): 70-76, 2015.
Artículo en Ruso | MEDLINE | ID: mdl-25864353

RESUMEN

AIM: To investigate the impact of bariatric surgery (BS) on the level of vitamins in obese patients. SUBJECTS AND METHODS: One hundred obese patients (78 women and 22 men) aged 19 to 61 years were examined. Controlled gastric banding (CGB) was carried out in 20 patients (mean body mass index (BMI), 41.3 ± 8.2 kg/m2); gastric sleeve resection (GSR) in 40 patients, and gastric shunting (GS) in 40 (the mean BMI in these groups were 41.1 ± 17.8 and 45.9 ± 6.2 kg/m2, respectively). A control group consisted of 10 apparently healthy individuals (BMI, 24.9 ± 3.2 kg/m2). An enzyme immunoassay was used to determine the serum concentrations of vitamins B1, B2, B5, B6, B9, B12, C, and D, niacin, biotin, and retinol-binding protein (RBP) before and 1 year after surgery. RESULTS: All the three groups showed a considerable decrease in the levels of vitamins C, B5, B6, and D, and RBP both prior to and following BS. More than 50% of the patients who had undergone GSR had also a lower baseline niacin level. A year after CGB, GSR, and GS, the number of patents with deficiency of these vitamins remained the same or increased. The majority of patients with the same level of vitamin B2, niacin, and folic acid (FA) were observed to have its decrease a year postsurgery. The concentration of the other test vitamins was also reduced a year after all operations; however, it remained within the normal range. GS had no substantial impact on the concentrations of FA, vitamins B2, B12, B1, and biotin. The lower serum vitamin levels were not accompanied by clinical symptoms in most patients following BS. CONCLUSION: In 80% of the patients with obesity, the levels of vitamins C, B6, and D were decreased to a variable degree. After BS, there was a rise in the number of patients with low serum vitamin C, D, B6, B5, niacin, FA, and RBP concentrations, at the same time the number of patients with FA deficiency increased by more than twice. BS did not significantly affect the metabolism of vitamins B1 B2 B12, and biotin.


Asunto(s)
Avitaminosis/etiología , Cirugía Bariátrica/efectos adversos , Obesidad/cirugía , Vitaminas/sangre , Adulto , Avitaminosis/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
6.
Klin Med (Mosk) ; 93(12): 28-31, 2015.
Artículo en Ruso | MEDLINE | ID: mdl-27149810

RESUMEN

AIM: to study the concentration of vitamins in obese patients after bariatric surgery (BS). MATERIAL AND METHODS: A total of 100 obese patients aged 19 to 61 years (78 women, 22 men). 20 patients (mean body mass index (BMI)--41.3 ± 8.2 kg/m²) had adjustable gastric banding (AGB), 40 patients--sleeve gastrectomy (SG) and 40--gastric bypass (GB) (mean BMI Group 41.1 ± 17.8 kg/m², and 45.9 ± 6.2 kg/m², respectively). The control group consisted of 10 healthy subjects (BMI--24.9 ± 3.2 kg/m²). We determined the serum level of vitamins B1, B2, B5, B6, B9, B12, C, D, niacin, biotin, and retinol-binding protein (RBP) before surgery and 1 year after it. RESULTS: There was a significant reduction ofvitamins C, B6, B5, D and RBP both before and after BS. More than half of patients after SG, also had initial reduction of niacin. A year after BS (AGB, SG, GB) the number of patients with deficiency of these vitamins remained the same or increased. Most patients with normal or even elevated levels ofvitamin B2, niacin and folic acid, has been declining a year after BO. The concentration of the rest of the vitamins also significantly decreased a year after all operations, but their performance remained within normal limits. CONCLUSION: Levels of vitamins C, B6 and D were reduced in more than 70% patients with obesity. The number of patients with low levels of vitamin C D, B6, B5, niacin, folic acid and RBP increased after BS. BS does not have a significant effect on the metabolism ofvitamins B1, B2, B12 and biotin.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Síndromes de Malabsorción/sangre , Vitaminas/sangre , Adulto , Femenino , Humanos , Síndromes de Malabsorción/etiología , Masculino , Persona de Mediana Edad , Adulto Joven
7.
Ter Arkh ; 85(2): 27-31, 2013.
Artículo en Ruso | MEDLINE | ID: mdl-23653935

RESUMEN

AIM: To estimate the diagnostic value (DV) of direct markers of liver fibrosis, such as type IV collagen (C-IV), hyaluronic acid (HA), tissue inhibitor of metalloproteinases-1 (TIMP-1) in combination with indirect markers of fibrosis, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (gamma-GTP), alkaline phosphatase (ALP), platelets, tumor necrosis factor-alpha (TNF-alpha) in evaluating liver fibrosis. SUBJECTS AND METHODS: Sixty-seven patients with chronic diffuse liver diseases were examined. ALT, AST, gamma-GTP, and ALP were determined as indirect indicators of fibrosis. The levels of TIMP-1, HA, C-IV, and TNF-alpha were estimated by ELISA; the stage of fibrosis was determined by the results of indirect liver ultrasound fibroelastography (FE). RESULTS: According to the results of FE, the patients were divided into 2 groups: 1) (n = 25) F < or = 2 METAVIR and 2) (n = 42) F3-F4. While estimating DV of severe fibrosis stages (F3-F4), the area under the ROC curve (AUC) increased for platelets, HA, and C-IV. DV of ALT, AST declined with the higher degree of fibrosis. The highest ratio of test specificity and sensitivity (TSp and TSen) and AUC were observed for AST and HA. ALT and platelets showed low TSen, and TNF-alpha and TIMP-1 had no TSp. For evaluation of fibrosis (F4), a HA increase of over 57.7 ng/ml had 92.6% TSen and 67.5% TSp; for a C-IV elevation of above 133.1mkg/l, TSen was 85.2%, TSp was 57.5%; for a TIMP-1 rise from 24.4 ng/ml, TSen was 74.1% and TSp was 62.5%. For the diagnosis of fibrosis (F4) with a HA rise of more than 57.7 ng/ml, DV of a positive test was 65.8 (48.65-80.4; 95% CI) and that of a negative test was 93.1 (76.8-99.2; 95% CI). Thus, the negative rather than positive test results are of great diagnostic value for evaluation of the degree of fibrosis. CONCLUSION: The results of the investigation convincingly suggest that examination of the serum markers of fibrosis allows one to estimate with a high probability its presence and severity in patients with hepatic cirrhosis. The so-called direct markers (substances reflecting the biochemistry and regulation of fibrogenesis) are undoubtedly of great diagnostic value.


Asunto(s)
Cirrosis Hepática/sangre , Cirrosis Hepática/diagnóstico , Área Bajo la Curva , Biomarcadores/sangre , Enfermedad Crónica , Diagnóstico por Imagen de Elasticidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
8.
Ter Arkh ; 84(12): 54-7, 2012.
Artículo en Ruso | MEDLINE | ID: mdl-23479990

RESUMEN

AIM: To reveal the specific features of pancreatogenic diabetes mellitus (DM) and to discuss the principles of its medical therapy. SUBJECTS AND METHODS: Sixty-six patients (55 men and 11 women) aged 30 to 65 years with chronic pancreatitis (CP) were examined. The disease was accompanied with pancreatic calcification and cyst formation in 22 and 13 patients, respectively; 5 patients were found to have a pseudotumorous form of CP and 10 had clinically and laboratorily verified DM. 14 resections and 11 drainages for complicated CP were performed. Its diagnosis was established on the basis of clinical, instrumental, and laboratory findings. Pancreatic exocrine function was evaluated from the results of the 13C-trioctanain breath test (BT) that is designed for its in vivo diagnosis. The level of C-peptide was studied by an enzyme immunoassay. RESULTS: The findings suggest that pancreatic exocrine function is diminished in CP patients both with and without complications as compared with the normal value in 44% (24.3 +/- 1.7 and 26.6 +/- 1.3%, respectively), as shown by BT. According to the results of BT, a substantial decrease in the total proportion of a released label was noted in patients with CP and pancreatic calcification, diabetes mellitus, after resection operations for complications of CP and there were also significant differences, as compared to a group of CP patients without complications. In these patient groups, the level of C-peptide fell to a larger extent than that in CP patients without complications and in patients with CP and DM it was decreased to 0.11 +/- 0.02 ng/ml, the normal level being 0.7-1.9 ng/ml. There was a direct correlation between C-peptide levels and BT results in the patients with CP after resection operations. Insulin antibodies were absent in all the examined patients with CP, which proves the specific type of DM in CP. These are detectable only in type 1 DM. Seven patients with CP and DM were found to have calcification, 5 underwent resection operations, 3 had calcification and underwent pancreatic resection operations. CONCLUSION: The development of DM may be predicted in CP patients with formation of pancreatic calcification and resections. In these patients, pancreatic exocrine dysfunction achieves a severe degree.


Asunto(s)
Péptido C/metabolismo , Diabetes Mellitus , Glucosa/metabolismo , Insulina , Pancreatectomía/efectos adversos , Pancreatitis Crónica , Adulto , Pruebas Respiratorias/métodos , Calcinosis/patología , Calcinosis/fisiopatología , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/etiología , Diabetes Mellitus/metabolismo , Femenino , Humanos , Insulina/metabolismo , Insulina/uso terapéutico , Islotes Pancreáticos/patología , Islotes Pancreáticos/fisiopatología , Masculino , Persona de Mediana Edad , Pancreatectomía/métodos , Pancreatitis Crónica/complicaciones , Pancreatitis Crónica/metabolismo , Pancreatitis Crónica/patología , Pancreatitis Crónica/fisiopatología , Pancreatitis Crónica/cirugía
9.
Eksp Klin Gastroenterol ; (4): 60-9, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-21916204

RESUMEN

UNLABELLED: The state of dynamic equilibrium between the host micro-organisms, it settled, and the environment called "eubiosis" in which human health is at an optimum level. The development of the gastrointestinal tract requiring surgical intervention was determined not only by the degree of pathological process activity, endotoxemia level dysbiotic bowel disturbances, but also disturbances in the patient's immune system. The aim of our study was to examine the influence of gut microbiota and endotoxemia on the development of comorbidity and functional status of the liver in patients after hemicolectomy. Were studied a total of 365 patients after undergoing surgery hemicolectomy (right-and left-handed). RESULTS: violations in microbiocenosis intestine, which is most frequently observed in patients after left-sided hemicolectomy, leads to the development of endotoxemia, its toxic effects on the liver, were realized in the development of liver steatosis and steatohepatitis. Thus, the left-sided hemicolectomy increases the risk of steatohepatitis in the late period, which may affect the core functions of the liver and the development of other metabolic disorders. Hyperendotoxemia that was developed in patients as a result of violations of microbiota after left-sided hemicolectomy, increases the risk of developing diseases pancreat-duodenal zone and cardiovascular changes. Certainly, the pathogenesis of these diseases was not determined by left-sided hemicolectomy, but her conduct contributed to the development and progression of these diseases.


Asunto(s)
Colectomía , Endotoxemia/metabolismo , Endotoxemia/microbiología , Mucosa Intestinal/metabolismo , Intestinos/microbiología , Hígado/metabolismo , Hígado/microbiología , Adulto , Anciano , Anciano de 80 o más Años , Endotoxemia/complicaciones , Endotoxemia/patología , Hígado Graso/etiología , Hígado Graso/metabolismo , Hígado Graso/microbiología , Hígado Graso/patología , Femenino , Humanos , Técnicas In Vitro , Intestinos/patología , Intestinos/cirugía , Hígado/patología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/metabolismo , Complicaciones Posoperatorias/microbiología , Complicaciones Posoperatorias/patología , Factores de Riesgo
10.
Eksp Klin Gastroenterol ; (5): 35-7, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-21916233

RESUMEN

The article presents literature data on the diagnostic value of the new indicator of the epithelial damage of the small intestine--I-FABP (protein binding fatty acids) and the results of our investigation of this indicator in 63 patients with functional bowel disease, and 20--the control group presented patients with erosive gastritis. Also presented diagnostic value of this indicator and defined the boundaries of normal values for this indicator.


Asunto(s)
Proteínas de Unión a Ácidos Grasos/sangre , Intestino Delgado/metabolismo , Síndrome del Colon Irritable/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Intestino Delgado/patología , Síndrome del Colon Irritable/sangre , Síndrome del Colon Irritable/patología , Masculino , Persona de Mediana Edad , Adulto Joven
11.
Eksp Klin Gastroenterol ; (3): 74-8, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-21698812

RESUMEN

UNLABELLED: The normal intestinal microflora important for maintaining the optimum level of metabolic processes in the human body, the immune system, as well as to create a high colonization resistance against the pathogenic microbes. With aging, changes microbiocaenosis intestine, resulting in an increase in the total number of microbes in the gut and profound changes in the functional properties of microorganisms. Under physiological conditions, the main reservoir of endotoxin in the human body is the intestine. Endotoxins, penetrating through the intestinal mucosa, arrive first at the local (intestinal), and then through the portal system in the liver, are able to initiate it various lesions, including fatty degeneration of the parenchyma. OBJECTIVE: Based on clinical and laboratory studies to determine changes in gut microbiota and the level of endotoxemia in elderly patients in the remote period after undergoing surgery--hemicolectomy. RESULTS OF THE STUDY: Metabolic activity of microflora in the colon according to the concentrations of short chain fatty acids in the feces of elderly patients in distant periods after hemicolectomy revealed in various degrees of violation of the microbiota of the colon. Violation of gut microbiota leads to endotoxaemia, which has a toxic effect on liver function, level of endotoxin and protein that binds to endotoxin was significantly higher in patients who underwent left-sided hemicolectomy.


Asunto(s)
Colectomía/métodos , Endotoxemia/microbiología , Intestinos/microbiología , Complicaciones Posoperatorias/microbiología , Anciano , Enfermedades del Colon/microbiología , Enfermedades del Colon/cirugía , Endotoxemia/sangre , Endotoxemia/etiología , Endotoxinas/sangre , Ácidos Grasos Volátiles/metabolismo , Heces/química , Heces/microbiología , Femenino , Humanos , Masculino , Proteínas de la Membrana/sangre , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/etiología
12.
Eksp Klin Gastroenterol ; (2): 27-30, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-21563360

RESUMEN

This article summarizes results of numerous experimental and clinical studies conducted in the laboratory of gastrointestinal hormones CSRIG that was made to examine the endocrine status and metabolic changes in the digestive system with its physiological and pathological conditions.


Asunto(s)
Enfermedades Gastrointestinales/etiología , Hormonas Gastrointestinales/metabolismo , Prostaglandinas/metabolismo , Enfermedades Gastrointestinales/diagnóstico , Enfermedades Gastrointestinales/metabolismo , Humanos
13.
Eksp Klin Gastroenterol ; (2): 117-20, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-21560651

RESUMEN

We studied the effect of NSAIDs on the stomach lining and intestines. Animals received the selective and nonselective NSAIDs. Revision of the abdominal cavity was performed after 24 hours and 14 days. In the mucosa was determined by the levels of prostaglandins and measured the index of damage. Lowering the synthesis of PG in the mucosa of the gastrointestinal tract contributes to the formation damage. After 24 hours when receiving non-selective COX inhibitors and selective inhibitors of COX-2 revealed the presence of mucous membrane lesions that are smaller than in groups of animals treated with selective NSAIDs. After 14 days of reception remains a low level of GHGs in the group of animals treated with nonselective NSAIDs. Visually mucosal damage are insignificant, but in the submucosal layer preserved microcirculatory blood flow disturbances.


Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Mucosa Gástrica/efectos de los fármacos , Mucosa Intestinal/efectos de los fármacos , Úlcera Péptica/inducido químicamente , Animales , Modelos Animales de Enfermedad , Femenino , Mucosa Gástrica/enzimología , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patología , Mucosa Intestinal/enzimología , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Intestino Grueso/efectos de los fármacos , Intestino Grueso/enzimología , Intestino Grueso/metabolismo , Intestino Grueso/patología , Intestino Delgado/efectos de los fármacos , Intestino Delgado/enzimología , Intestino Delgado/metabolismo , Intestino Delgado/patología , Masculino , Úlcera Péptica/enzimología , Úlcera Péptica/metabolismo , Úlcera Péptica/patología , Prostaglandinas/biosíntesis , Ratas
14.
Eksp Klin Gastroenterol ; (7): 59-63, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-22364001

RESUMEN

In order to identify features of the course pancreatic diabetes and discussion of the principles of conservative therapy were examined 66 patients with CP in age of 30 to 65 years (55 men, 11 women). Among them in 22 cases disease was followed with formation of calcification of pancreas, 13 - pancreatic cysts, and 5 revealed pseudo tumor form of CP, 10 patients had clinical and laboratory evidence of diabetes. Concerning CP complicated course were performed 14 resection and 11 draining operations on the pancreas. Based on clinical, instrumental and laboratory data was made the diagnosis of CP. Exocrine pancreatic function was assessed on the results of the breath test, using 13C-trioktanaine, which is applied for exocrine pancreatic function in vivo test. The content of C-peptide was investigated by enzyme-linked immunosorbent assay (ELISA). The data indicate pancreatic exocrine function decrease in patients with CP with complications and without complications in compare with the norm of 44% (24,3 +/- 1,7, 26,6 +/- 1,3%, respectively) according to the breath test. Significant decrease of the cumulative output tags based on the test data of patients with CP and pancreatic calcification, diabetes mellitus, after resection surgery with CP complications, and there were significant differences in compare with a group of patients with CP without complications (p = 0.5). The level of C-peptide in these groups of patients decreased significantly in compare with a group of patients with CP without complications, and patients with CP and Diabetes was reduced to 0,11 +/- 0,02 ng/ml, at a rate range of 0.7-1.9 ng/ml, ie below the minimum values of norm. Obtained a direct correlation between the level of C-peptide and indicators breath test in patients after resection HP (r = 0,84, p = 0,03). Antibodies to insulin in the whole group of studied patients CPs were negative, which proves the specific type of Diabetes at HP. Antibodies to insulin can be detected only at diabetes type 1. In 7 patients with CP and CD detected calcification, 5 patients performed resection surgery, 3 patients had calcification and conducted the pancreas resection. Thus, we can conclude that in patients with CP and formation of pancreas calcification, pancreas resections may predict the development of diabetes.


Asunto(s)
Diabetes Mellitus/etiología , Pancreatitis Crónica/complicaciones , Adulto , Anciano , Glucemia/análisis , Pruebas Respiratorias , Péptido C/sangre , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/tratamiento farmacológico , Femenino , Fármacos Gastrointestinales/administración & dosificación , Fármacos Gastrointestinales/uso terapéutico , Humanos , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/uso terapéutico , Insulina/administración & dosificación , Insulina/uso terapéutico , Masculino , Persona de Mediana Edad , Pruebas de Función Pancreática , Pancreatina/administración & dosificación , Pancreatina/uso terapéutico , Pancreatitis Crónica/diagnóstico , Pancreatitis Crónica/tratamiento farmacológico , Pancreatitis Crónica/metabolismo , Pancreatitis Crónica/cirugía
15.
Eksp Klin Gastroenterol ; (10): 12-7, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-22629693

RESUMEN

Anemia in IBD is the result of a combination of iron deficiency and anemia of chronic disease. Therapy of IBD is relief of inflammation, but the drugs usage may cause the development hemolytic anemia and myelodysplastic syndrome. We studied the effect of basic therapy on the incidence of anemia and assess the impact of modern biological therapies on the main markers of AHZ. A total of 153 patients with ulcerative colitis (UC) and 53 patients with Crohn's disease (CD), which at the time of the study received basic anti-inflammatory therapy for at least 1 year. All patients underwent blood tests, iron metabolism parameters were determined by the level of erythropoietin and G-gepsidina C reactive protein. Modern biological therapy increases the effectiveness of the treatment of anemia in patients with IBD. The use of Remicade gives a quick positive response, which is due to the decrease of gepsidin negative influence on iron metabolism and unlocking the synthesis of erythropoietin. The use of MSCs does not inhibit the synthesis of erythropoietin, and is likely to stimulate erythropoiesis at the erythroblast precursors.


Asunto(s)
Anemia Hemolítica/sangre , Anemia Hemolítica/tratamiento farmacológico , Anemia Ferropénica/sangre , Anemia Ferropénica/tratamiento farmacológico , Antiinflamatorios/administración & dosificación , Anticuerpos Monoclonales/administración & dosificación , Colitis Ulcerosa/sangre , Enfermedad de Crohn/sangre , Anemia Hemolítica/epidemiología , Anemia Hemolítica/etiología , Anemia Ferropénica/epidemiología , Anemia Ferropénica/etiología , Péptidos Catiónicos Antimicrobianos/sangre , Proteína C-Reactiva/metabolismo , Colitis Ulcerosa/complicaciones , Colitis Ulcerosa/epidemiología , Colitis Ulcerosa/terapia , Enfermedad de Crohn/complicaciones , Enfermedad de Crohn/epidemiología , Enfermedad de Crohn/terapia , Eritroblastos/metabolismo , Eritropoyesis/efectos de los fármacos , Eritropoyetina/sangre , Hepcidinas , Humanos , Técnicas In Vitro , Incidencia , Infliximab , Masculino , Síndromes Mielodisplásicos/sangre , Síndromes Mielodisplásicos/tratamiento farmacológico , Síndromes Mielodisplásicos/epidemiología , Síndromes Mielodisplásicos/etiología , Factores de Riesgo , Factores de Tiempo
16.
Eksp Klin Gastroenterol ; (10): 18-22, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-22629694

RESUMEN

UNLABELLED: Gepsidin is an iron regulatory protein that inhibits ferroportin, limiting the transport of iron into the cell of the small intestine villi and blocking the exit of iron from macrophages, that often leads to disruption of iron homeostasis, iron deficiency and the development of anemia. The Aim was to study the levels of gepsidin in patients with IBD and determine its prognostic significance for the development of anemia. We examined 80 patients with IBD, 45 (56%) men and 35 (44%) women with the average age of 39,0 +/- 15,8 years. In 40 patients with anemia and 40 patients with IBD without anemia syndrome, studies were conducted in the status of iron metabolism, the level of gepsidin, TNF, C-reactive protein. CONCLUSION: IBD with systemic inflammatory response leads to increased levels gepsidina and increases the risk of anemia in IBD. Determination of gepsidin in IBD patients enables identify patients at risk for anemia and to clarify the effectiveness of the basic treatment of the disease.


Asunto(s)
Anemia/sangre , Péptidos Catiónicos Antimicrobianos/sangre , Enfermedades Inflamatorias del Intestino/sangre , Adulto , Anemia/etiología , Proteína C-Reactiva/metabolismo , Femenino , Hepcidinas , Humanos , Enfermedades Inflamatorias del Intestino/etiología , Enfermedades Inflamatorias del Intestino/terapia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factor de Necrosis Tumoral alfa/sangre
17.
Eksp Klin Gastroenterol ; (10): 26-30, 2011.
Artículo en Ruso | MEDLINE | ID: mdl-22629696

RESUMEN

The paper presents the results of a study of iron metabolism in 185 patients with cirrhosis of different etiologies. The frequency of iron deficiency in 28.6% of patients and the syndrome of iron overload - 18.9%. The gender and etiology of cirrhosis role in the frequency of occurrence of the syndrome of iron overload and iron deficiency. The iron metabolism disorders in relationship with the frequency of complicated cirrhosis, the severity of liver cirrhosis, according to Child-Pugh's grade of severity of liver disease, the severity of cytolytic syndrome.


Asunto(s)
Sobrecarga de Hierro/epidemiología , Sobrecarga de Hierro/etiología , Cirrosis Hepática/complicaciones , Cirrosis Hepática/epidemiología , Adulto , Femenino , Humanos , Sobrecarga de Hierro/sangre , Cirrosis Hepática/sangre , Masculino , Persona de Mediana Edad , Factores de Riesgo , Índice de Severidad de la Enfermedad , Síndrome
18.
Eksp Klin Gastroenterol ; (7): 12-9, 2010.
Artículo en Ruso | MEDLINE | ID: mdl-21033078

RESUMEN

THE AIM: To investigate the role of hormones and the types of FB in the development of morbid obesity (MO), to develop a treatment policy for MO to examine the diagnostic predictive value of the FB hormones and FB modifications. MATERIALS AND METHODS: Were investigated 67 patients: 28 (42%) males and 39 (58%) female aged 18 to 60 years under the scheme: medical history, questionnaire on the questionnaire SF-36, score types of FB, the study of the anthropometric data (OT/OB, BMI), the definition of the FB hormones with subsequent control of BMI, OT/OB dynamics, types and FB hormones. RESULTS: In patients older than 50 years were dominated abdominal FB, in patients younger than 50 years - all three types of FB in approximately equal proportions. After the decline in MT was observed pattern between the FB modification and age of the patient. There was an increase of leptin and ghrelin and decrease in serotonin at all three types of FB. After weight correction was a decreased leptin, ghrelin, and increased serotonin, but the achievement of normal numbers are not marked. The paradoxical result is related to a violation of reciprocal relations of hormones. CONCLUSIONS: In patients with MO FB hormone levels (Leptin, Ghrelin) elevated to normal values, reduced levels of serotonin, there is an infringement of their reciprocal correlations. The approach to patients should be lengthy and complex, involving multidisciplinary team aimed at FB correcting the with the rejection of improper food stereotype. In the treatment of MO must used different methods: reducing diet, physiotherapy effects, drug therapy and their combination with the selection of individual programs, taking into contraindications account. For the above techniques inefficiency is necessary to use surgical treatment. Correction of FB in patients older than 50 years is the most difficult task (due to the presence of concomitant diseases). Necessary to draw attention and to start treatment at a young age.


Asunto(s)
Conducta Alimentaria , Ghrelina/sangre , Leptina/sangre , Síndrome Metabólico , Serotonina/sangre , Adolescente , Adulto , Factores de Edad , Femenino , Humanos , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/patología , Síndrome Metabólico/fisiopatología , Síndrome Metabólico/terapia , Persona de Mediana Edad
19.
Eksp Klin Gastroenterol ; (4): 28-32, 2010.
Artículo en Ruso | MEDLINE | ID: mdl-20623949

RESUMEN

The level of cholecystokinin and secretin in 50 patients after cholecystectomy (from 1 to 10 years ago) was analyzed to study connection between cholecystectomy and gastrointestinal hormones concentration. 30 patients with gall bladder stone disease were included into the group of comparison. Cholecystokinin and secretin concentration in the groups of research was compared with indicated hormones concentration in the group of control formed of healthy volunteers. After anamnestical clinical and diagnostical features in every group had been studied we concluded, that cholecystokinin level changes depending on period after operation and outflow of bile conditions.


Asunto(s)
Colecistectomía , Colecistoquinina/sangre , Colelitiasis/sangre , Colelitiasis/cirugía , Síndrome Poscolecistectomía/sangre , Adaptación Fisiológica , Estudios de Casos y Controles , Humanos , Secretina/sangre , Factores de Tiempo
20.
Eksp Klin Gastroenterol ; (3): 71-3, 2010.
Artículo en Ruso | MEDLINE | ID: mdl-20496793

RESUMEN

In the experiment on white rats reproduced the damage to the intestinal mucosa after administration of selective and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) within 24 hours and for 14 days. After the autopsy was measured the index injury (II), the content of prostaglandins (PGs) and cytokines in extracts of intestinal mucosa. Was established that the reduction of PGs was combined with an increase in II. Long reception of NSAIDs (14 days) causes greater damage to the submucous layer, without visible macroscopic changes.


Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Citocinas/metabolismo , Mucosa Intestinal , Prostaglandinas/metabolismo , Flujo Sanguíneo Regional/efectos de los fármacos , Animales , Antiinflamatorios no Esteroideos/farmacología , Femenino , Mucosa Intestinal/irrigación sanguínea , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Masculino , Ratas , Factores de Tiempo
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