[Gastroenterological symptoms in COVID-19 patients with mild severity of the disease: opportunities to optimize antidiarrheal therapy].

BACKGROUND: The novel coronavirus infection COVID-19 can be manifested by damage to the organs of the gastrointestinal tract (GIT). Damage to the gastrointestinal tract by the SARS-CoV-2 virus leads to a violation of the microbial-tissue complex of the mucous membrane of the digestive tract. A common gastroenterological manifestation of COVID-19 is diarrhea. AIM: Study of the clinical features of gastroenterological disorders and the possibility of optimizing the treatment of diarrheal syndrome in patients with COVID-19 with a mild form of viral infection. MATERIALS AND METHODS: The observation group consisted of 230 patients with mild COVID-19: K-group (n=115) with respiratory symptoms, I group (n=115) with gastrointestinal manifestations in combination and without signs of respiratory damage. In order to compare the effectiveness of treatment of diarrheal syndrome, patients of group I are randomized into 2 subgroups: Ia (n=58) prebiotic treatment (Zacofalk) and Ib (n=57) enterosorbents. RESULTS: The development of gastrointestinal symptoms with SARS-CoV-2 infection is significantly more often noted in comorbid patients (67%). Gastrointestinal symptoms were dominated by diarrhea (93.9%) and flatulence (76.5%), in 1/3 of patients they were the first manifestos of infection. It was established that in 98.4% of patients of group I (against 42.6% of the K-group) signs of infectious intoxication were detected. In patients with gastrointestinal lesions, an elongation of the febrile period by 91.5 days was noted, a later (6 days) verification of the viral etiology of the disease. It was found that in patients of group I, the regression of clinical symptoms, the duration of viral disease, the dynamics of antibody formation, the prognosis for the development of IBS-like disorders in the post-infectious period depended on the treatment. In patients taking (Zacofalk), these indicators were significantly better. CONCLUSION: In mild cases, to reduce the severity of viral intestinal damage, for effective relief of intestinal symptoms, to reduce the risk of IBS-like symptoms, it is advisable to prescribe (Zacofalk) in an initial dose of 3 tablets per day.

[Comparative effectiveness of ursodeoxycholic acid preparations in the treatment of biliary sludge].

In the clinical classification of cholelithiasis, biliary sludge (BS) is distinguished as the pre-stone stage. Ursodeoxycholic acid (UDCA) is a drug with an evidence base for effective and safe effects on BS. The therapeutic equivalence of various UDCA drugs remains an important issue for clinical practice. AIM: To conduct a comparative analysis of the effectiveness of the use of UDCA: Ursofalk with other UDCA drugs for the treatment of BS in a fixed dose of 10 mg/kg of body weight. MATERIAL AND METHODS: The observation group consisted of 225 patients with various types of BS. In randomized groups, the comparison of the effectiveness of UDCA drugs in the dissolution of BS was determined by the data of ultrasound of the gallbladder. Dynamic ultrasound cholecystography using a standardized technique was performed to study the effect of the compared drugs on the contractile function of the liver. When analyzing the impact of ursotherapy on the clinical manifestations of BS, the dynamics of biliary pain syndrome and dyspeptic disorders were evaluated. RESULTS: A comparative analysis of the effectiveness of UDCA drugs for BS lysis with a high degree of confidence established the advantage of Ursofalk: after 3 months in 80%, and after 6 months of therapy in 95.65% of patients, a regression of BS was detected. In the group of patients who took other UDCA, the corresponding indicators were 46.36% and 67.27%. The greatest effectiveness of ursotherapy was demonstrated in the BS variant by the type of suspension of hyperechogenic particles, the lowest in the variant by the type of putty-like bile in the form of mobile or fixed clots. In the last variant of BS, the relationship between the success of lysis with the extension of the UDCA intake period to 6 months and the preferred choice of Ursofalk was traced. Normalization of the contractile function of the gallbladder was noted in patients who took Ursofalk. CONCLUSION: From the standpoint of therapeutic effectiveness, the drug of choice for the treatment of BS, regardless of its type, is Ursofalk, which has proven the best dynamics of BS litolysis, recovery of the contractile function of the gastrointestinal tract, and relief of clinical symptoms.

[Comparison of clinical-metabolic efficacy of pre- and probiotics in the conducted optimized protocols of eradication therapy of Helicobacter pylori infection].

Low patient compliance due to the development of adverse events in the form of antibiotic-associated diarrhea (AAD) is considered as the main reason for the failure of the eradication of optimized anti-Helicobacter therapy regimens. A key mechanism for the development of AAD is to reduce the number and species diversity of bacteria that form butyric acid. AIM: The purpose of this study was to study the comparative effect on the clinical effectiveness of eradication therapy (ET) of Helicobacter pylori infection and metabolic changes in the colon microbiota of additional inclusion in the optimized treatment regimen of the combined prebiotic Zakofalk (inulin + butyrate) with probiotics (lacto- and bifidobacteria in an amount of at least 1017 СFU). MATERIALS AND METHODS: 120 patients with chronic gastroduodenal diseases and infected H. pylori were еxamined. A comparative analysis of the effect of a combined prebiotic and lacto-bifid-containing probiotics on improving the effectiveness of the optimized ET scheme and improving its tolerability, as well as on the quantitative and qualitative content of short-chain fatty acids (SFA) in feces. The success of eradication was controlled by a 13C urease breath test. RESULTS: According to the results of the study in randomized groups of patients, an excellent percentage of eradication (95%) was achieved in patients who performed ET with the addition of the prebiotic Zakofalk. In the same group of patients, there was an increase in the absolute content of SFA and a significant increase in the concentration of butyric acid. In the group of patients who received ET with the addition of probiotics, an acceptable level of eradication was achieved (85.7%), but no changes in SFA were found indicating an increase in the number or activity of the butyrate-producing flora. Patients who performed ET without the addition of pre-probiotics did not achieve the target percentage of successful eradication (83.3%), and a significant quantitative decrease in SFA was found with a significant decrease in the proportion of butyric acid. CONCLUSION: The inclusion of Zakofalk in the ET scheme, in comparison with probiotics, significantly increases the probability of successful eradication, more effectively restores the metabolic potential of the microbiota, and prevents the development of AAD.

["HELICARB" - the first Russian breath test kit with 99 % C-urea for Helicobacter pylori: from idea to registration].

The present study was aimed to develop and introduce in medical practice the first Russian kit for the C-urea breath test of Helicobacter pylori. The newly created kit was given the commercial name «HELICARB¼ and successfully passed technical, toxicological, clinical, and laboratory testing. The optimal dose of 13C-urea was determined and various devices needed to perform the test were compared. The results were approved by the Federal Service for Supervision in the health sector Roszdravnadzor) that issued the Registration certificate № RZN 2016/3773 (order № 1641 of 02.29.2016), which gives the right to manufacture and use the «HELICARB¼ test kit at the territory of the Russian Federation.

[COMPARATIVE ASSESSMENT OF MASS-SPECTROMETRY AND INFRARED SPECRTROMETRY USED IN 13C-UREA BREATH TEST FOR HELICOBACTER PYLORI].

At present, mass-spectrometry is the most accurate and efficient method for measuring carbon isotope ratio in 13C-urea breath test for H. pylori infection but its wide application is restricted by the high cost of equipment and operational complexity. IR spectrometry is one of the less expensive techniques recently proposedfor the purpose. To compare the effectiveness of the two methods, we undertook a study including 20 volunteers (6 men and 14 women) aged 18-60 years with parallel measurements by IR and mass-spectrometry. IR spectrometry was shown to be highly accurate (94-96%), sensitive (up to 100%), and specific (87.5%) which makes it a promising alternative to mass-spectrometry to be used in urea breath test for mass examination especially in outpatient facilities.

[Blood cell catecholamines during different methods of postoperative analgesia]. / Katekholaminy kletok krovi pri raznykh metodakh posleoperatsionnogo obezbolivaniia.

Blood cell catecholamine levels were measured in the patients over the course of the postoperative period administered various types of analgesia, the standard mode with narcotic analgetics and the method suggested by the authors, consisting in blocking of the afferent nervous painful pulsation via the anterior abdominal wall. The blocking is carried out with a micro-irrigator placed in the muscular layer of the anterior abdominal wall during surgery. Procaine solution was employed for anesthesia. Postoperative analgesia efficacy was assessed from blood catecholamine levels. Analysis has shown the efficacy of the suggested analgesia mode.

[Study of the characteristics of the oxygen supply of suppurative wounds after two-stage active surgical treatment by transcutaneous measurement of oxygen pressure]. / Osobennosti kislorodnogo snabzheniia gnoinykh ran pri dvukhétapnom aktivnom khirurgicheskom lechenii po dannym chreskozhnogo opredeleniia napriazheniia kisloroda.

PO2 in the tissues surrounding a purulent wound was measured by the percutaneous method in 30 patients with purulent-inflammatory diseases of the soft tissues. It was established, that with transition of purulent-necrotic phase of the wound process into the reparative one, PO2 increased 2-4 fold. In primary healing of a wound after debridement, PO2 also increased. The low PO2 indices at day 2-4 after the operation are the unfavourable prognostic sign.