RESUMO
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.
Assuntos
Doença Celíaca , Gerenciamento Clínico , Adulto , Doença Celíaca/classificação , Doença Celíaca/diagnóstico , Doença Celíaca/terapia , Criança , Medicina Baseada em Evidências , Humanos , Federação RussaRESUMO
Animal Helicobacter species other than Helicobacter pylori are also able to cause human gastritis, gastric ulcers, and MALT lymphomas. Animal Helicobacter species are presented with typical spiral fastidious microorganisms colonizing the gastric mucosa of different animals. Bacteria initially received their provisional name Helicobacter heilmannii, and out of them at least five species colonizing the gastric mucosa of pigs, cats, and dogs were isolated later on. A high proportion of these diseases are shown to be zoonotic. Transmission of pathogens occurs by contact. The factors of bacterial pathogenicity remain little studied.
Assuntos
Gastroenteropatias/microbiologia , Infecções por Helicobacter/patologia , Infecções por Helicobacter/transmissão , Helicobacter/patogenicidade , Animais , Gatos/microbiologia , Cães/microbiologia , Humanos , Suínos/microbiologiaRESUMO
The article presents the results of a survey of 72 patients who underwent cholecystectomy in 2008-2010. 5 years after cholecystectomy were revealed the changes in the organs of the gastrointestinal tract caused by loss of the physiological function of the gallbladder: half of patients--had increasing fasting blood sugar and duodenal reflux, in 46% of patients--were reduction of pancreatic elastase-1 in stools. According to the fractional duodenal intubation prevails hypersecretory type of bile, 35%--hypotonia, in 45%-- hypertonicity of the sphincter of Oddi. Definition "postcholecystectomical syndrome" should not be limited only to the sphincter of Oddi dysfunction.
Assuntos
Colecistectomia , Vesícula Biliar/patologia , Vesícula Biliar/fisiopatologia , Pâncreas/patologia , Pâncreas/fisiopatologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In article the data on interrelation between gallbladder contractility and a level of hormones of a thyroid gland (threeiodethyronine, thyroxine, thyrotropin hormone (TTH) and antibodies to thyreoperoxidase (AT to TPO)) in plasma of blood at 470 healthy persons and 540 patients with gallstone disease are submitted. The contractility function of a gallbladder on ultrasonic at persons with gallstone disease is authentic less, than at healthy persons. Dysfunction of a thyroid gland is found out in women with gallstone disease: increase TTH and AT to TPO. Among men hormonal shifts are not revealed. Contact chemical litholysis with methyl tert butyl ether of cholesterol stones in gallbladder except for their dissolution, improves its contractility activity.
Assuntos
Colelitíase/fisiopatologia , Vesícula Biliar/fisiopatologia , Contração Muscular/fisiologia , Hormônios Tireóideos/sangue , Estudos de Casos e Controles , Colelitíase/sangue , Colelitíase/diagnóstico por imagem , Colelitíase/terapia , Feminino , Vesícula Biliar/diagnóstico por imagem , Humanos , Masculino , Éteres Metílicos/administração & dosagem , Pessoa de Meia-Idade , Fatores Sexuais , Solventes/administração & dosagem , Resultado do Tratamento , UltrassonografiaRESUMO
PURPOSE OF INVESTIGATION: There has been conducted comparison of the most wide-spread methods of diagnosis of Helicobacter pylori infection: histologic, cytologic, method of polymerase chain reaction (PMCR) and respiratory urease Xelic-test on the method of AMA firm. MATERIALS AND METHODS: 1118 patients participated in the investigation, 403 patients were investigated by urease test and 50 ones were investigated by method of PMCR. The results of investigations were compared by means of correlative and variational analysis. RESULTS: There has been shown fine comprison of histologic, cytologic methods of Helicobacter pylori revealing and PMCR method both between them (coefficients of correlation 0.79, 0.34 and 0.53 accordingly), and with indices of gastritis activity (coefficients of correlation 0.49, 0.52 and 0.37 accordingly). On the other hand the results of respiratory urease Xelic-test did not correspond to any of investigated indices (coefficients of correlation 0.02, 0.05 and 0.09). The possible causes of such discrepancy, based on features of chemical properties of ammonia have been defined. Except known reaction of neutralization with hydrochloric acid, ammonia able to show donor-acceptor interactions and form various compounds with organic substances. CONCLUSION: Urease respiratory Xelic-test on the method of AMA firm can not be used for definition of Helicobacter pylori infection.
Assuntos
Mucosa Gástrica/microbiologia , Gastrite/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Úlcera Gástrica/microbiologia , Adolescente , Adulto , Idoso , Testes Respiratórios , DNA Bacteriano/genética , Mucosa Gástrica/patologia , Gastrite/patologia , Infecções por Helicobacter/patologia , Helicobacter pylori/enzimologia , Helicobacter pylori/genética , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Análise de Regressão , Úlcera Gástrica/patologia , Urease/análise , Adulto JovemRESUMO
INTRODUCTION: Methyl-tert-butyl ether (MTBE) is used at contact chemical dissolution (CCD) of cholesterol gallstones since 1981. However no abroad, no in Russia on MTBE the sanction as on a medical product is not received. AIM: to determine parameters of common toxicity MTBE at white mice. MATERIALS AND METHODS: MTBE entered per se to white mice intrastomach (Litchfield-Wilcocson). Calculations of average lethal dozes carried out. Batching carried out on weight of substance, taking into account its density of 0.74 g/sm2, and expressed in mg/kg of weight of a body of animals. Research carried out together with Institute of toxicology (Saint Petersburg, Russia). RESULTS: The period of supervision was 14 days. Lethal, time of destruction, semiology of a poisoning carried out before introduction, for 7 and 14 days of supervision, opening and macroscopical research of all perishing and survived animals--at the end of research. The death of animals at intrastomach introduction of fatal dozes MTBE (more than 5 g/kg) was observed within 1.5-5 hours from the moment of introduction at the phenomena of slackness, devocalization and a paralysis. Semiology was of the deep narcotic intoxication. Opening of the died animals has revealed: attributes venous full bloods of the internal bodies, subpleural haemorrhages, fine haemorrhages in an oblong brain and the big hemispheres of a bark. At the animals receiving less 5 g/kg, in the first day block, slackness, drowsiness, decrease of consumption of a forage and water were marked. In other days they did not differ from those at animals of control group. CONCLUSION: Sharp intrastomach introduction MTBE does not cause macroscopical changes internal and glandulars bodies, a brain, and also mucous of a stomach and an intestines.
Assuntos
Carcinógenos/farmacologia , Vesícula Biliar/patologia , Cálculos Biliares/tratamento farmacológico , Cálculos Biliares/patologia , Éteres Metílicos/efeitos adversos , Éteres Metílicos/farmacologia , Animais , Colesterol/metabolismo , Vesícula Biliar/metabolismo , Camundongos , Camundongos Endogâmicos CBARESUMO
The purpose of the work is to estimate the efficiency and follow-ups of the contact chemical litholysis (CCL) of gallstones with methyl-tert-butyl ether (MTBE). The CCL has been carried to 5 women with plural (10-15) radiolucent gallstones, who refused from cholecystectomy. The percutaneous transhepatic puncture of the gallbladder has been executed to them under X-ray and ultrasonic control. Laboratory (general blood analysis, urine analysis, biochemical parameters of blood and bile) and tool (ultrasonic control, cholecystography) researches were carried out before the procedure, during dissolution, 2, 6, 9 months after the CCL. High litholytic activity of MTBE has been revealed by dissolution of cholesterol stones of the gallbladder with use of the above-mentioned agent. Local irritation, allergenic actions and essential collateral reactions were not observed. After the CCL, contractility function of the gallbladder has increased (before the procedure - 23,8 +/- 0,4%, after it - 37,5 +/- 0,8%, p < 0,001).
Assuntos
Vesícula Biliar/diagnóstico por imagem , Cálculos Biliares/terapia , Éteres Metílicos/uso terapêutico , Solventes/uso terapêutico , Adulto , Cateterismo , Colecistografia , Feminino , Cálculos Biliares/sangue , Cálculos Biliares/diagnóstico por imagem , Humanos , Éteres Metílicos/administração & dosagem , Solventes/administração & dosagem , Resultado do Tratamento , UltrassonografiaAssuntos
Úlcera Duodenal , Veículos Automotores , Doenças Profissionais , Úlcera Gástrica , Adulto , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Progressão da Doença , Úlcera Duodenal/diagnóstico , Úlcera Duodenal/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Prevalência , Federação Russa , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/epidemiologiaRESUMO
The article summarizes the data of the national and foreign literature on methods of conservative managements of patients with cholelithiasis. The article also discloses modern points of view (indications, contra-indications, efficacy, etc.) on the application of the litholytic therapy with peroral bile acids and extracorporal shock-wave lithotripsy at cholecystolithiasis. Special attention was paid to contact chemical dissolution of stones in the gall bladder. A number of works devoted to the prevention of gallstone recurrence are generalized.
Assuntos
Colecistolitíase/terapia , Colecistolitíase/tratamento farmacológico , Colecistolitíase/cirurgia , Terapia Combinada , Humanos , LitotripsiaRESUMO
AIM: To study paramagnetic centers (PMC) of some biological media in cholecystitis patients. MATERIALS AND METHODS: PMC of 81 patients with chronic acalculous cholecystitis and 29 patients with acute calculous cholecystitis were examined using 3-cm radiospectrometer "Rubin" employing low-temperature fixation of biological tissues (77K). RESULTS: Most informative for diagnosis of cholecystitis exacerbation were the following PMC: in plasma--transferrin Fe3+ and free radicals; in duodenal portion B--Cu2+, free radicals and Mn2+. CONCLUSION: Electronic paramagnetic resonance is a perspective method in diagnosis of chronic cholecystitis exacerbation and in investigations of its pathogenesis.
Assuntos
Bile/química , Líquidos Corporais/química , Colecistite/diagnóstico , Espectroscopia de Ressonância de Spin Eletrônica , Eritrócitos/química , Biomarcadores/análise , Colecistite/metabolismo , Doença Crônica , Cobre/análise , Diagnóstico Diferencial , Duodeno/metabolismo , Feminino , Radicais Livres/análise , Humanos , Ferro/análise , Masculino , Manganês/análise , Pessoa de Meia-Idade , Transferrina/químicaRESUMO
Paramagnetic centers of the blood were investigated in 75 patients with chronic uremia (Electron Spin Resonance, 77 K). The analysis of hemodialysis action on paramagnetic centers in the blood showed that this procedure provokes gradual depression of antioxidant defense.
Assuntos
Antioxidantes , Falência Renal Crônica/enzimologia , Falência Renal Crônica/terapia , Diálise Renal , Espectroscopia de Ressonância de Spin Eletrônica , Eritrócitos/química , Eritrócitos/enzimologia , HumanosRESUMO
New data are presented indicating that the electron paramagnetic resonance technique can be used to study nasal secretion paramagnetic centers. In the study 53 subjects, who were not exposed to industrial aerosols during their professional activities, were examined. It was demonstrated that nasal secretion contained paramagnetic centers bound with iron- and copper-containing proteins in the concentrations which were significantly lower than plasma had. It is postulated that metal-containing complexes may be involved in defence systems of the upper airways.
Assuntos
Espectroscopia de Ressonância Magnética , Mucosa Nasal/metabolismo , Adulto , Cobre/análise , Feminino , Humanos , Ferro/análise , Masculino , Mucosa Nasal/imunologia , Proteínas/análiseRESUMO
The electron-spin resonance (ESR) was applied to examine human plasma and red cell lipids. In the lipids, the signal of ESR of alpha-tocopherylquinone was recorded. The concentration of the latter in the lipids was found to be elevated in coronary heart disease. Intramuscular injection of 30% oily solution of alpha-tocopherylquinone in a dose of 2 ml two times a day over three days entailed an increase in the concentration of alpha-tocopherylquinone in plasma and red cell lipids.
Assuntos
Doença das Coronárias/sangue , Lipídeos/sangue , Vitamina E/análogos & derivados , Vitamina E/farmacologia , Eritrócitos/metabolismo , Humanos , Vitamina E/sangueRESUMO
The electron-spin resonance method was applied to examine human plasma and red cells at a temperature of 77 degrees K and variation in the level of free radicals (FR) under the effect of adrenaline. In plasma, the signals of transferrin (g approximately 4.26), ceruloplasmin (g approximately 2.05), and FR (g approximately 2.0024-2.0029 and delta H 6-8 Oe) were registered, while in red cells, the signals of hemoglobin (g approximately 6.00), superoxide dismutase (g approximately 2.063), and flavosemiquinone (g approximately 2.0030-2.0040 and delta H 12-15 Oe). Addition of adrenaline entailed an increase in the level of FR and a lowering of the ceruloplasmin signal intensity in plasma. The level of FR in red cells was found to be elevated. The mechanisms of the phenomena described are discussed.