[The outpatient treatment possibilities for patients with exacerbated peptic ulcer]. / Vozmozhnosti ambulatornogo lecheniia bol'nykh s obostreniem iazvennoi bolezni.

The efficacy of hospital and ambulatory treatment of patients with peptic ulcer exacerbation was compared. 209 patients were treated in the hospital and 116 on an ambulatory basis. No appreciable differences were found in the times of the removal of the painful syndrome or gastroduodenal ulcer healing. At the same time early relapses were recorded in 26.4% of the inpatients and in 14.9% of the outpatients. Indications for the treatment of outpatients with gastroduodenal ulcers were developed: rare relapses, lack of complications, moderate painful syndrome, small ulcer dimensions, a possibility of arranging good treatment and control over ulcer healing, favourable living conditions, and being in a positive mood for outpatient treatment.

[The procedure of the therapist in newly detected and recurrent stomach ulcer]. / Taktika terapevta pri vpervye vyiavlennoi i retsidiviruiushchei iazve zheludka.

Over 5 years the authors followed up 320 patients with gastric ulcer receiving conservative treatment at hospitals or as outpatients, 86 patients operated on before for gastric ulcer, and 58 patients admitted to the surgical hospital for hemorrhage from gastric ulcer. The primary ulcerous form of carcinoma accounted for 9.1% of all gastric ulcers, carcinoma of the gastric stump was diagnosed in 10.4% of patients subjected to resection of the stomach for assumed malignant ulcer. The conservative treatment carried out at hospitals or as outpatients ensured healing of gastric ulcer within a month in 61.8 and 55.1% of the patients, respectively. Nevertheless early relapses (a month after the healing) were recorded in the appropriate groups in 26.4 and 14.9% of the patients. Among gastric ulcer patients followed up for 5 years and receiving the conservative treatment, perforation was recorded in 2.6% and hemorrhage in 4.5% of the patients. The lethality due to resection of the stomach in patients with assumed malignant gastric ulcer amounted to 4-7%. It is evident that there are no serious reasons for supporting the positions of high surgical activity champions in gastric ulcer.

[General mechanisms of regulation of the activity of the stomach and pancreas in peptic ulcer and chronic pancreatitis]. / Obshchie mekhanizmy reguliatsii sekretornoi aktivnosti zheludka i podzheludochnoi zhelezy pri iazvennoi bolezni i khronicheskom pankreatite.

Altogether 25 patients with peptic ulcer and 26 patients with chronic pancreatitis were examined for gastric and pancreatic secretion. Histamine dihydrochloride (0.008-0.024 mg/kg) was employed to stimulate gastric secretion whereas cholecystokinin (2U/kg/h) and calcium gluconate (16 mg/kg) were used to stimulate pancreatic secretion. Lidocain (1.2 mg/kg), a blocker of Ca2+-channels, and lithium hydroxybutyrate (12 mg/kg), a blocker of phosphatidylinositol transformations, were employed for suppression of gastric and pancreatic secretion. The content of HCl, pepsinogen, fucose, cAMP and cGMP was measured in gastric juice, that of bicarbonates, amylase, lipase, trypsin, cAMP and cGMP in pancreatic juice. It has been shown that mechanisms dependent on cAMP and on extra- and intracellular Ca2+ are involved in the initiation and maintenance of gastric and pancreatic secretion. However, the contribution of those mechanisms is different as applied to the regulation of ions and enzymes, on the one hand, and to various enzymes, on the other.

[Randomized double-blind placebo-controlled study of drugs with anti-ulcer action and their use in associated pathology]. / Randomizirovannoe dvoinoe slepoe platsebo-kontroliruemoe ispytanie lekarstvennykh preparatov s protivoiazvennoi aktivnost'iu i ikh promenenie pri sochetannoi patologii.

The effect of lithium preparations (lithium carbonate, lithium oxybutyrate), calcium channel blocking agents (verapamil, nifedipine), beta 2-adrenoagonist (salbutamol), cromolyn sodium and cimetidine on clinical efficacy and frequency of ulcer cicatrization was assessed in 201 patients (33 women, 168 men) with endoscopically verified stomach ulcer (52 patients) and duodenal ulcer (166 patients) during treatment for 4 weeks as compared to placebo and standard antiulcerative therapy (cholinolytics, antacids and reparents). All the tested drugs (excluding cromolyn sodium) significantly increased as compared to placebo the frequency of ulcer cicatrization (p less than 0.001 in the use of lithium preparations and cimetidine; p less than 0.01 in the use of salbutamol and verapamil; p less than 0.05 in the use of nifedipine). The effect of lithium preparations and cimetidine exceeded that of standard antiulcerative multimodality therapy.