[The Russian consensus on the diagnosis and treatment of chronic pancreatitis: Enzyme replacement therapy]. / Rossiiskii konsensus po diagnostike i lecheniiu khronicheskogo pankreatita: zamestitel'naia fermentnaia terapiia.

Pancreatology Club Professional Medical Community, 1A.S. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow; 2A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow; 3Kazan State Medical University, Ministry of Health of Russia, Kazan; 4Kazan (Volga) Federal University, Kazan; 5Far Eastern State Medical University, Ministry of Health of Russia, Khabarovsk; 6Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow; 7I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg; 8Siberian State Medical University, Ministry of Health of Russia, Tomsk; 9M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow; 10Maimonides State Classical Academy, Moscow; 11V.I. Razumovsky State Medical University, Ministry of Health of Russia, Saratov; 12I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow; 13S.M. Kirov Military Medical Academy, Ministry of Defense of Russia, Saint Petersburg; 14Surgut State Medical University, Ministry of Health of Russia, Surgut; 15City Clinical Hospital Five, Moscow Healthcare Department, Moscow; 16Nizhny Novgorod Medical Academy, Ministry of Health of Russia, Nizhny Novgorod; 17Territorial Clinical Hospital Two, Ministry of Health of the Krasnodar Territory, Krasnodar; 18Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg; 19Rostov State Medical University, Ministry of Health of Russia, Rostov-on-Don; 20Omsk Medical University, Ministry of Health of Russia, Omsk; 21Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow; 22Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk; 23Stavropol State Medical University, Ministry of Health of Russia, Stavropol; 24Kemerovo State Medical University, Ministry of Health of Russia, Kemerovo; 25N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow; 26A.M. Nikiforov All-Russian Center of Emergency and Radiation Medicine, Russian Ministry for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters, Saint Petersburg; 27Research Institute for Medical Problems of the North, Siberian Branch, Russian Academy of Sciences, Krasnoyarsk; 28S.P. Botkin City Clinical Hospital, Moscow Healthcare Department, Moscow; 29Tver State Medical University, Ministry of Health of Russia, Tver The Russian consensus on the diagnosis and treatment of chronic pancreatitis has been prepared on the initiative of the Russian Pancreatology Club to clarify and consolidate the opinions of Russian specialists (gastroenterologists, surgeons, and pediatricians) on the most significant problems of diagnosis and treatment of chronic pancreatitis. This article continues a series of publications explaining the most significant interdisciplinary consensus statements and deals with enzyme replacement therapy.

[Autoimmune Diseases of Digestive System].

Autoimmune diseases of digestive system refer to pathological conditions, caused by autoimmune mechanisms, and their etiology remains unknown. This is a group of relatively rare diseases, however, during the last years a marked tendency towards the raise in incidence andprevalence is observed, which led to an increase in number of clinical investigations on etiology, pathogenesis, and, accordingly, development of new diagnostic methods and therapies. Results of such trials shown, for example, that the pathogenesis of chronic cholestatic liver diseases is associated with nuclear receptors function, while the main etiological and pathogenic factor of inflammatory bowel diseases represents gut microbiota. Despite new achievements in autoinmune diseases of digestive system research, therapies are low effective and are accompanied by a huge number of adverse events. The fact that these diseases may lead to malignant tumors is also worth noting. For example, patients with primary sclerosing cholangitis have a 160 times higher risk of cholangiocellular carcinoma, while 10-14% ofpatients with celiac disease may develop malignancies of esophagus, small and large intestine. Thus, these diseases require further investigation with a purpose of more accurate diagnostic methods for the detection of disease at early stages and new effective and safe therapies development.

[Role of 24 hour intraesophageal pH monitoring in diagnosis of gastroesophageal reflux and assessment of drug effectiveness]. / Znachenie sutochnogo monitorirovaniia vnutripishchevodnogo pH v diagnostike gastroézofageal'noi refliuksnoi bolezni i otsemke éffektivnosti lekarstvennykh preparatov.

58 patients with gastroesophageal reflux (GER) and 18 patients with chronic gastroduodenitis (CGD) were examined using 24-h monitoring of intraesophageal pH. GER patients exhibited changes in all the readings of 24-h pH-gram of the esophagus which strongly correlated with severity of clinical symptoms (heartburn, metasternal pain), reflux-esophagitis (endoscopical picture), data of esophagotonocimography. 24-h monitoring of intraesophageal pH provided an adequate estimation of the drugs used to treat GER. As to effect on intraesophageal pH, domperidon had no effect, famotidine had a moderate positive effect, omeprasol returned pH to normal.

[Comparative assessment of antacid agents with intragastric ph-metry]. / Sravnitel'naia otsenka éffektivnosti antatsidnykh preparatov s pomoshch'iu vnutrizheludochnoi ph-metrii.

Alkalizing effects of maalox, renni and tams were compared in 63 patients (27 males and 36 females) aged 19-56 with endoscopically confirmed superficial gastroduodenitis using intragastric pH-metry. Liquid antacids (maalox) began their action quicker (1.3-1.7 times) than tablets (renni and tams) but the tablets had longer alkalizing effects. Maximal and minimal alkalizing effects were achieved with maalox and renni, respectively. It is inferred that rapid intragastric pH-metry can be used for comparative assessment of different antacid drugs. Of the drugs studied the highest antiacid effect was exhibited by maalox.

[Enzyme preparations in conservative treatment of chronic pancreatitis]. / Fermentnye preparaty pri konservativnom lechenii khronicheskogo pankreatita.

AIM: To study effectiveness of enzyme medicine pancitrate 25,000 in the treatment of chronic pancreatitis (CP). MATERIALS AND METHODS: Pain, stool, creato- and steatorea, other signs of CP were examined before and after pancitrate treatment of 17 patients with chronic pancreatitis aged from 28 to 62 years. RESULTS: Pancitrate 25,000 reduced stomach pains in 16 of 17 patients. Stool returned to normal in 8 of 13 patients. Creato- and steatorea decreased. CONCLUSION: New dosage forms of the enzyme preparations (pancitrate 25,000, in particular) are highly effective both in deficiency of pancreatic external secretion and pain relief in exacerbation of CP.

[Antisecretory effects of quamatel and gastrocepin in duodenal ulcer: comparison with intragastric pH-metry]. / Sravnitel'naia otsenka antisekretornogo deistviia kvamatela i gastrotsepina u bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki s pomoshch'iu vnutrizheludochnoi pH-metrii.

Antisecretory effect of intravenous quamatel (Q) and gastrocepin (G) was studied in 59 patients with duodenal ulcer. Mean maximal pH and delta-pH in antral portion of the stomach and its body were similar for Q and G, but pH responded to Q administration faster. The antisecretory effect of Q was more pronounced in males and young patients and was inversely proportional to initial acidity.

[A comparative evaluation of the antacid properties of the preparations Maalox and Almagel]. / Sravnitel'naia otsenka antatsidnykh svoistv preparatov "Maaloks" i "Al'magel'".

Basic modes of action and indications for aluminium and magnesium-containing antacids are reviewed. Antacid properties of Maalox were studied versus those of Almagel in 24 duodenal ulcer patients by the following indices of pH-metry: time of pH response onset, "alkaline time", alkalification area and index. All the features were significantly different when assessed in the body of the stomach. Regular Maalox intake as a main medicine provided good results in the treatment of duodenal ulcer (25 responders), gastric ulcer (14 responders), erosive gastroduodenitis (14 responders), erosive reflux-esophagitis (9 responders). Maalox displayed high symptomatic efficacy, safety, insignificant side effects.