[Disease as a phenomenon of human nature: toward understanding and developing of V. Kh.Vasilenko's philosophical legacy. Part 1].

V.Kh.Vasilenko paid much attention to the development of philosophical aspects of the concept of disease and left the rich intellectual legacy and a number of advisory instructions that allow the main challenge in modern medicine (the definition of the notion of disease) to be addressed. One of his principal messages is the necessity of generalization and synthesis of facts. Following Vasilenko's instructions, Part 1 of this review is devoted to systematization of modern views of general features of pathogenesis of internal diseases for obtaining a deeper insight into the essence of the disease.

[Disease as a phenomenon of human nature: toward understanding and developing of V.Kh.Vasilenko's philosophical legacy. Part 2].

Empirical data on the nature of disease were systematized and summarized in Part 1. In Part 2 the same problem is addressed by the deductive method from the general biological and philosophical standpoint. Methodological assessment of the most popular definitions of the disease is undertaken along with expanded medico-philosophical interpretation of the notion of disease as an anthropological phenomenon including its applied aspects.

[Irritated bowel syndrome: what is its real nature?].

The author discusses definition of irritated bowel syndrome (IBS), the history of this problem and terminological issues. Current views of IBS etiology and pathogenesis are presented with special reference to the biopsychosocial concept of this condition. Clinical variants of IBS are described along with its intestinal and extraintestinal symptoms and their classification. Modern methods of laboratory, instrumental, and differential diagnostics of IBS are considered alongside with the "anxiety symptoms" excluding diagnosis of IBS. The review is concluded by the description of methods for psychotherapeutic and pharmacotherapeutic treatment of the disease. Much attention is given to the meaning of the term irritated bowel syndrome, impermissibility of "nosologization" of syndromes and impossibility of functional disorders without their morphological equivalent as illustrated by the latest data on the IBS-associated inflammatory process in the colon.

[Etiology of internal organ diseases].

The authors discuss I.V. Davydovsky's views expounded in his book "Problems of causality in medicine, Etiology" (1962) where the philosophical method was applied for the first time for the solution of fundamental problems of medicine, such as etiology and pathogenesis. The main provisions of Davydovsky's concept of etiology of internal organ diseases are considered, an attempt is undertaken to develop and apply them in the present-day context.

[Comparative estimation of diagnostic tests for helicobacter pylori and the spectrum of gastric mucosal microflora in gastritis and ulcer disease].

We estimated specificity and sensitivity of diagnostic tests for H. pylori (HP) infection in patients with gastroduodenal problems and studied species composition of gastric mucosal microflora in gastritis and ulcer disease. The following characteristics have been determined as the most informative signs of HP infection: HP fecal antigen, plasma total antibodies (IgG, IgA, IgM) against CagA, histological (cytological) findings confirming the presence of HP antigens in biopsies, rapid urease test, the presence of bent rods morphologically resembling HP in gastric mucosa biopsies cultured in the glycol medium for sterility control. The use of these signs (at least three) in combination ensures efficacious diagnostics of HP infection for the substantiation of its traditional therapy. The study of the spectrum and occurrence of gastric mucosal microflora revealed the predominance of Streptococcus, Staphylococcus, Candida fungi, and HP in patients with gastritis and Streptococcus, HP and Candida in those with ulcer disease at a mean concentration of microbial cells 3.41 and 2.71 CF/gg respectively. Significant differences were documented only in the occurrence of HP and Candida.

[Syndrome of functional dyspepsia and/or chronic gastritis?].

Definition and prevalence of syndrome of functional dyspepsia (SFD) are discussed along with the brief history of the problem, priority works of V.P. Obraztsov and other authors, current views of SFD etiology and pathogenesis with reference to the role of H. pylori infections. Clinical variants of SFD, their diagnostic criteria and principals of differential diagnostics are described. Special attention is given to the debatable relationship between CFD and chronic gastritis. Nosological and syndromal diagnostics, structure-function relationship, goals and methods of SFD treatment and other matters of dispute are considered.

[Eubiosis and dysbiosis of gastrointestinal tract: myths and reality].

Current data on eubiosis and dysbiosis of gastrointestinal tract are discussed along with the role of its microflora in human body under normal and pathological conditions. Certain debatable problems are discussed. Classification of colonic dysbiosis is presented with reference to its stages, functions of normal flora, "myths" related to the science of eubiosis and dysbiosis, the authors views of the problem. Diagnostic methods and their informative value are described. The main diseases and syndromes associated with intestinal dysbiosis are discussed. In conjunction with approaches to its correction.

[The problem of growing resistance of microorganisms to antibiotic therapy and prospects for Helicobacter pylori eradication].

The problem of growing resistance of microorganisms to antibiotic therapy acquires increasingly greater significance as threatening the loss of endosymbiotic bacteria. The causes, mechanisms, and consequences of this phenomenon are considered. Several groups of modern antibiotic drugs are characterized along with the methods for improving their efficacy and preventing side effects. The schemes for Helicobacter pylori eradication as recommended by the Maastricht consensus are discussed in conjunction with major mistakes accounting for marked reduction of their effectiveness. Terminological issues are briefly considered.

[Has the discovery of Helicobacter pylori actually made a revolution in gastroenterology?].

Part 1 of this paper presents a brief description of the results of 25 year investigations of H. pylori infection and its contribution to the development of gastroduodenal pathology (chronic hepatitis, ulcer disease, stomach cancer, gastric maltoma) with reference to its diagnostics, strategy and efficacy of eradication therapy. Part 2 contains arguments and facts that contradict opinions in favour of the leading role of H. pylori infection in pathogenesis of major gastro-duodenal disorders as well as results of the studies of normal and anomalous gastric mucosal microflora comprising numerous bacteria, besides H. pylori, exhibiting such properties as adhesiveness, invasiveness (unlike H. pylori), virulence, and urease activity. The causes behind the failure of eradication therapy are discussed with reference to the decrease of its effectiveness to the critical level attributable largely to misjudgements of the authors of Maastricht recommendations.

[Ulcerative colitis and Crohn's disease. Part 1. Definition, terminology, prevalence, etiology and patogenesis, clinical features, complications, classification].

Definitions of ulcerative colitis (UC) and Crohn's disease (CD) are given, related terminological problems are discussed, the prevalence of UC and CD in the population is considered along with their etiology pathogenesis, clinical symptoms, complications and extraintestinal (systemic) lesions. Classification and diagnostics of UC and CD are discussed with special reference to current international recommendations on their diagnostics and differential treatment.

[Ulcerative colitis and Crohn's disease. Modern views. Part 2. Diagnostics and differential therapy].

Definitions of ulcerative colitis (UC) and Crohn's disease (CD) are given, related terminological problems are discussed, the prevalence of UC and CD in the population is considered along with their etiology, pathogenesis, clinical symptoms, complications and extraintestinal (systemic) lesions. Classification and diagnostics of UC and CD are discussed with special reference to current international recommendations on their diagnostics and differential treatment, rejuvenation and extraintestinal lesions.

[Maastricht consensus-4 (2011). Main provisions and comments].

The author reviews the main articles and statements of the newly adopted Maastricht Consensus-4 (2011) on diagnostics and treatment of gastroduodenal diseases associated with H. pylori infection. Each statement is commented taking account of the author's experience and results of Russian and foreign researchers obtained by methods and techniques of evidence-based medicine. Corrected recommendations for diagnostics, therapeutic indications, and strategy of management of H. pylori-dependent diseases are proposed.

[Ulcer disease: challenging problems of etiology, pathogenesis, differential treatment].

This review summarizes the data of Russian and foreign authors as well as the results of original studies on etiology pathogenesis, and differential treatment of ulcer disease (UD). The author's original concepts of UD pathogenesis and relations between man and Helicobacter pylori are discussed. The pathogenetic role of disturbances in the system of gastroduodental self-regulatory function and psychosomatic mechanisms as well as immune deficiency and impaired antioxidatve protection is considered. Peculiarities and results of UD eradication therapy intended to eliminate H. pylori infection are described. The importance of the choice of the UD treatment strategy on an individual basis is emphasized as opposed to the use of universal standards and therapeutic modalities influencing only local pathogenic factors, such as acidopeptic ones and H. pylori infection.

[Cutaneous symptoms and syndromes in pathology of digestive organs].

Changes of skin characteristics accompanying various diseases of the gastrointestinal tract, hepatobiliary system, and pancreas having diagnostic implications are considered. Possible mechanisms of their development are discussed with reference to the underlying gastroenetrologic diseases.

[Gastroduodenal erosion: state-of-the-art].

The author proposes the definition of gastroduoduodenal erosions (GDE), discusses their prevalence, debatable and unresolved problems related to this pathology including terminological issues. Etiology, pathogenesis, clinical manifestations and methods of diagnostics of GDE are considered. An original classification of GDE has been developed along with the methods for differential treatment of their specific forms taking into account peculiarities of their etiology and pathogenesis.

[Microflora of gastric mucosa, its properties and role in the development of acute and chronic gastritis].

Gastric microflora was studied in 28 patients suffering acute and chronic gastritis with reference to the factors of pathogenicity and sensitivity to antibacterial preparations. A total of 55 bacterial species were isolated The microflora was dominated by streptoccoci while Helicobacter pylori occurred rather rarely 27.3 +/- 6.5% of the isolated strains showed urease activity 36.3 +/- 6.5% natural or acquired virulence, 45.5 +/- 6.7% resistance to eradication therapy.

[Hirschsprung's disease in adults].

Up-to-date information about Hirschsprung's disease in children and adults is presented including definition of this pathology, data on its prevalence, and debatable questions of terminology. Etiology and pathogenesis of Hirschsprung"s disease, the role of hereditary factors in its development and clinico-anatomic classification are considered. Clinical variants of Hirschsprung's disease in children and adults are discussed along with its complications and combinations with other congenital malformations. Diagnostic and informative value of clinical and instrumental tools is assessed. Modern methods of conservative and surgical treatment are described.