[Of the article intraliver pregnancy cholestasis].

The article includes the contemporary information about prevalence, clinical history, the methods of diagnostics and treatment of the intraliver pregnancy cholestasis, and about the tactics of the supervision of the pregnant women with intraliver cholestasis.

[Results of a multicenter trial "Epidemiology of Gastroesophageal Reflux Disease in Russia" (MEGRE)].

AIM: To assess prevalence of gastroesophageal reflux disease (GERD) in Russia in MEGRE trial in 6 cities of the Russian Federatiion (Kazan, Kemerovo, Krasnoyarsk, Ryazan, St-Petersburg, Saransk). MATERIAL AND METHODS: Mayo Clinic questionnaire (USA) adapted for Russia was used to question 7812 people over 18 years of age from of random population sample. The symptoms (heartburn and regurgitation) were classified as frequent if they arose once a week and more often for the last 12 months, rare symptoms arose less often than once a week. The responders with frequent heartburn and/or regurgitation were regarded as persons with epidemiological quantitative criteria of GERD. RESULTS: Heartburn occurred in 47.5% responders: frequent in 9%, rare in 38.5%. Regurgitation occurred in 42.9%: frequent in 7.6%, rare in 35.3%. GERD prevalence was 13.3% (city range 11.3-14.3%). Frequent GERD symptoms are associated with frequent gaseous eructation (24.3%), chronic cough (22.9%), chest pain (15.1%), dysphonia (11.4%.). To stop heartburn, 88% responders took antacids, 32%--blockers of histamine H2-receptors and only 23%--inhibitors of proton pump. Only 52.8% responders with frequent chest pain and 29.3% those with frequent heartburn visited a doctor. CONCLUSION: The population-based trial MEGRE conducted by international methodology in 6 cities of Russia demonstrated that GERD prevalence is 13.3%. Most of the patients pay little attention to the symptoms, do not seek medical advice and, therefore, receive no adequate treatment.

[Use of serum tumor markers in the diagnosis of malignant tumors of the digestive system].

The article is devoted to the main OncoMarkers, which are used in the case of malignant growth in digestal organs, their efficient administration in the medical practise and diagnostic importance.

[Restoration of the quality of life by eliminating and prevention of heartburn by alginate: results of multicenter study "VIA APIA"].

Was conducted a muIticenter study VIA APIA, in which the impact of gaviscon forte (suspension) on symptoms, general state and quality of life of 148 patients (male 53, female 95, age 42.9 +/- 15.6) with gastroesophageal reflux disease (GERD) were investigated. The patients had undergone clinical evaluation of dynamics of GERD symptoms (Likert scale), general state (Visual Analogue Scale, questionnaire SAN) and quality of life (SF-36). It was shown that 14-days treatment with gaviscon forte provided symptoms relief in 84.5% patients and conducted improvement of general state and quality of life. Gaviscon forte recommended as drug of choice in initial treatment for the first time visited patient with heartburn before endoscopy and for pathogenetic treatment of typical reflux syndrome.

[Multicentre study "Epidemiology of gastroesophageal reflux disease in Russia"(MEGRE): first results].

We aimed to determine the prevalence and clinical spectrum of GERD in the urban population of 6 cities in different parts of Russia (St. Petersburg, Ryazan, Kazan, Kemerovo, Krasnoyarsk and Saransk). A previously validated reflux questionnaire developed at the Mayo Clinic was translated into Russian, culturally adapted and administered. Data was collected from 7812 randomly selected subjects greater than 18 years old with the assistance of the yellow pages. 'Frequent symptoms' were defined as a major symptom (heartburn and/or regurgitation) occurring at least once a week or more. "Occasional symptoms" were defined as an episode of one of the major symptoms occurring less than once a week within the past 12 months. Patients were defined as having GERD if they reported frequent heartburn and/or regurgitation. The average prevalence of frequent and occasional GERD symptoms in Russia was 9% and 38.5% for heartburn and 7.6% and 35.3% for regurgitation respectively within the last 12 months. The average prevalence of GERD in Russia was 13.3% (11.3-14.3%). The prevalence of frequent heartburn decreased with age (r = -0.3); however, frequent regurgitation increased (r = 0.7) with age. As a result, we found that prevalence of GERD increased with age. The average prevalence of GERD was statistically the same in men (12.5%) and in women (13.9%). This prevalence didn't change with age in men but did increase with age in elderly women to 24%. Frequent heartburn and regurgitation (GERD) were significantly associated with frequent belching (24.3%), chronic cough (22.9%), dyspepsia (19.8%), non-cardiac chest pain (15.1%), nausea (14.9%), hoarseness (11.4%), dysphagia (8.1%), odynophagia (7.3%) and constipation (37.8%). Alcohol consumption (prevalence of 60.4% among respondents) and smoking (prevalence of 25.4% among respondents) didn't yield any significant difference in subjects with frequent symptoms. Importantly, we also found that only 52.8% of subjects with frequent chest pain and 29.3% of respondents with frequent heartburn had seen a physician for these symptoms.

[Intestinal digestion in patients with chronic pancreatitis].

Clinical signs of a lesion of a small bowel at a chronic pancreatitis are caused by disturbance first of all a membranous stage of intestinal digestion, observed at early stages of disease and progress in process of augmentation of duration of disease. Expression of enzymatic disorders correlated with a lesion of elements of a brush border.

[Prevention of intestinal dysbiosis in patients after anti-Helicobacter therapy].

This article presents a literature review of side effects of antihelikobakter therapy, as well as survey data, whose goal was to determine the efficacy and safety of normoflorins at patients after eradication therapy of peptic ulcer. It was shown that the frequency of occurrence of side effects during antihelikobakter therapy varies widely and can reach, according to different authors, from 30 to 50% of patients. In addition to allergic and toxic PE, with antibacterial agents allocate their influence on the microflora of the colon, which often leads to development of a scarce and dysbacteriosis of antibioticassociated colitis. Appointment of biodiesel of normoflorin after eradication therapy effectively suppresses clinical signs of dyspepsia as a side effect of antihelikobakter therapy enhances the effectiveness of treatment of patients and improve their quality of life.

[Dysbiotic manifestations during eradication therapy of Helicobacter pylori and their corrections].

Forty-eight patients with duodenal peptic ulcer disease infected with Helicobacter pylori were examined. All patients undergo conventional 1-week eradication therapy. After its ending the patients were randomized to two groups: those who will be treated by synbiotics or control group. Normoflorin B and Normoflorin L, which contain bifidobacteria or lactobacilli in complex with different microelements, vitamins, aminoacids, organic acids, and antioxidants, were used as synbiotics. Morphologic study of biopsy samples of small intestine mucosa were performed in patients from both groups. It was determined that eradication therapy worsened existing symptoms of dyspepsia in 80.9% of cases or lead to their emergence, connected with dysbiotic manifestations, in 55.5% of patients. Inclusion of synbiotics in complex therapy resulted in rapid and effective elimination of dyspeptic symptoms, promoted recovery of affected morphologic and functional states of small intestine mucosal epithelium, and optimized metabolic processes important for the digestion.

[Risk factors for progressing of chronic hepatitis and liver cirrhoses].

The paper presents the material of long-term monitoring and analysis of the virus hepatitises and heparocirrhosises chronicity characteristics, the most significant risk factors of the diseases progress are defined in it. The role of various anhepatogenous manifestations and the immunity rate in the capacity of the chronic virus hepatitises and hepatocirrhosises course prognostic criterion is also determined here.

[The functional and reserve potentials of the absorption processes in the small intestine in a nutritional disorder]. / Funktsional'nye i rezervnye vozmozhnosti protsessov vsasyvaniia v tonkoi kishke pri narushenii pitaniia.

The absorbing function of the small intestine was studied in healthy subjects and those patients with chronic gastritis presenting with lower than the normal body mass, than of above normal, and normal, with the aid of the D-xylose test alone and in combination with atropine, lactose, amino acids, intralipid. The data obtained suggest functional and reserve inadequacy in those individuals with nutritional disorders presenting as deficit in respect of body mass of alimentary- and-constitutional genesis.

[Blood plasma cyclic nucleotides and compensatory-restorative processes in duodenal peptic ulcer]. / Tsiklicheskie nukleotidy plazmy krovi i kompensatorno-prisposobitel'nye protsessy pri iazvennoi bolezni dvenadtsatiperstnoi kishki.

Contents of cAMP and cGMP in blood plasma as well as ratio cAMP/cGMP were studied by radioimmunoassay in 56 patients with duodenal ulcer of various severity. The examination was performed twice: before the treatment and 4 weeks after the treatment in a hospital. The analysis carried out with regard to the treatment efficacy in every variant of the clinical course of the disease showed that poor treatment results are associated with the dynamics of cyclic nucleotide (CN) plasma levels, especially with the increased ratio cAMP/cGMP, regardless of the disease severity which is characteristic of blood plasma CN taking part in compensatory-adaptive mechanisms in duodenal ulcer and evidences the necessity of differentiated approach to the treatment in accordance with developed adaptive reactions.

[The characteristics of prostaglandin and cyclic nucleotide biosynthesis in patients with peptic ulcer and chronic atrophic gastritis during digestion]. / Osobennosti sinteza prostaglandinov i tsiklicheskikh nukleotidov u bol'nykh iazvennoi bolezn'iu i khronicheskim atroficheskim gastritom v protsesse pishchevareniia.

Prostaglandins (PG) and cyclic nucleotides (CN) were assessed radioimmunologically in the blood plasma under basal conditions and after a standard breakfast in 20 patients with duodenal ulcer, 16--with gastric body ulcer and 18 patients with atrophic gastritis. It was established that the patients showed an increased PG level, cAMP-dependent processes. Neurohumoral mechanisms of regulation of gastric secretion were abnormal.

[Effect of food on blood levels of insulin, glucagon and C-peptide in gastroduodenal pathology]. / Vozdeistvie pishchi na soderzhanie v krovi insulina, gliukagona i C-peptida pri patologii gastroduodenal'noi zony.

Insulin, glucagon and C-peptide content in the blood was assayed with the use of commercial radioimmune kits (Diagnostic, USA, and Oris, France). A total of 93 peptic ulcer patients (35 with duodenal peptic ulcer, 28 with gastric ulcer, 16 after Billroth-I resection, and 14 after Billroth-II resection) and 25 patients with chronic gastritis attended by secretory insufficiency were investigated. The study was conducted on empty stomach and after a test breakfast containing 57 g of protein, 63 g of fat, 103 g of carbohydrates that comprised 1212 kcal. The highest changes in hormone incretion were recorded in patients with peptic ulcer disease after Billroth-I and Billroth-II resection, the lowest--in patients with chronic gastritis attended by secretory insufficiency.

[The effect of food intake on the content of proteolytic enzymes and gastrin in the blood of patients with peptic ulcer and chronic atrophic gastritis]. / Vliianie pishchevoi nagruzki na soderzhanie proteoliticheskikh fermentov i gastrina v krovi bol'nykh iazvennoi bolezn'iu i khronicheskim atroficheskim gastritom.

Radioimmunoassay was used to determine trypsin, pepsinogen and gastrin content in the blood serum with the use of kits produced by the firm "Oris" (France). A total of 43 patients with peptic ulcer (25 with duodenal ulcer and 18 with gastric ulcer), 20 patients with chronic gastritis and 10 normal subjects were investigated. The study was conducted on an empty stomach and after a test breakfast consisting of 2 boiled eggs, 100 g of cheese, 100 g of white bread, 25 g of butter, 50 g of sugar and 200 g of tea (57 g of proteins, 63 g of fats, 103 g of carbohydrates; calorie value comprised 1212 kcal). It has been shown that food intake is a regulator of gastrin, pepsinogen and trypsin production that permits evaluating functional possibilities of gastrin-producing cells, the main gastric cells and acinar cells of the pancreas. The investigation conducted has evidenced that compensatory shifts in the levels of gastrin, pepsinogen and trypsin taking place in gastroduodenal disease are directed to the improvement of digestive processes.

[Gastrin, insulin and glucagon secretion after cimetidine and sodium hydrocarbonate intake in patients with duodenal ulcer]. / Sekretsia gastrina, insulina i gliukagona posle priema tsimetidina i gidrokarbonata natria u bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

The response of serum gastrin, insulin and glucagon to administration of sodium bicarbonate (SB) followed by cimetidine was studied in 35 duodenal ulcer patients. Relevant measurements were made using radioimmunoassay kits "Diagnostic" (USA) and "Oris" (France). It was established that SB administration induced a significant rise in gastrin levels while those of insulin, glucagon and gastrin lowered significantly following cimetidine treatment (gastrin levels progressed to baselines). This marked effect of cimetidine on the gut hormone production is not always due to its adverse action being rather of compensatory nature and directed at enhancement of cytoprotection and normalization of gastric secretion.

[Pancreatic hormonal function and proteolytic activity in peptic ulcer]. / Gormonal'naia funktsiia podzheludochnoi zhelezy i aktivnost' proteoliticheskikh fermentov pri iazvennoi bolezni.

Blood serum insulin, glucagon, pepsinogen, trypsin was studied by radioimmunological methods in 95 patients with ulcer disease. Fasting values and values 1 and 2 hours after a standard breakfast (1212 kcal) were evaluated. It was established that all patients showed a statistically valid increase of the basal level of glucagon while patients with gastric ulcer showed an increase of the basal insulin level. Use of a test breakfast showed reserve and compensatory capacities of the hormonal pancreatic function. Patients with gastric and duodenal ulcer revealed an increase of the pepsinogen level under conditions of basal secretion and after a test breakfast.

[Pancreatic insular function in peptic ulcer patients]. / Insuliarnaia funktsiia podzheludochnoi zhelezy u bol'nykh iazvennoi bolezn'iu.

Radioimmunological assay was used to study the content of insulin and C-peptide in the blood bath in conditions of basal incretion and 1 and 2 hours after a test breakfast in 12 healthy subjects, 36 patients with duodenal ulcer and 20 patients with chronic atrophic gastritis. It was found that patients with duodenal ulcer showed an increased hormonal activity of the pancreas leading to exhaustion of its reserve capacities. In patients with chronic atrophic gastritis reserve hormonal capacities of the pancreas were maintained and somewhat elevated.