[About the prevalence of diseases of pancreas in the Udmurt Republic].

UNLABELLED: THE AIM OF OUR INVESTIGATION: To study the dynamic of morbidity level of pancreas in Udmurt Republic (UR) and to prognose it for nearest years. MATERIALS AND METHODS: We used the official statistic materials of Republic medical information-analytic center for 2001-2011 yy. In analyses of received data we used trend models and statistic method. THE RESULTS: We found that during analyzing period (2001-2011) common morbidity of pancreas in UR increased as well as primary--on 246% and 92% correspondently, especially in rural population. Morbidity of adult urban population is significantly higher than. By trend model method we can prognose raising of pancreas for nearest 5 years till the level of Russian one and higher. CONCLUSION: The tendency to increasing of pancreas diseases morbidity in UR was revealed for last 10 years. Prognosing rise of morbidity, more in rural population, requires to organize active prophylactic measures.

[Clinical and pathogenetic significance of collagen metabolism disorder in children with gastroesophageal reflux disease].

In 62 children with gastroesophageal reflux disease (GERD) and 32 with gastroduodenitis (DG) aged 9-17 years, the peculiarities of metabolism of collagen were studied. High levels of fractions of sialic acids were set, that was associated with the protein fructose, fractions of hydroxyproline in children with GERD compared with the patients with DG, which testify to the process of degradation of collagen and may be one of the factors contributing to the local inflammation of the esophagus and gastroduodenal zone of the digestive tract. The prevalence of Helicobacter pylori, as well as violations of diet, play an important role in maintaining the inflammatory process.

[The study of hormonal status in children with gastroesophageal reflux disease].

UNLABELLED: The aim of this work is to study the level of some hormones and their role in the pathogenesis of gastroesophagal reflux disease (GERD) in children. MATERIALS AND METHODS: 40 children with GERD at the age 9 till 17 years of them 17 boys (42.5%) and 23 girls (57.5%) were examined. Content of somatostatin, gastrin, insulin, cortisol in the blood was studied by immunofermental method. Motor function of the sthomach was studied using the apparatus EGC-4M. RESULTS: The investigations which were performed revealed the fact that children with GERD have different concentration of somatostatin and gastrin depending on their age. In disturbances of interrelations of somatostatin and gastrin impairment of the stomach motility occurs. High level of insulin and cortisol is found in children with GERD. High level of insulin indicates of stimulation of protective and adaptative mechanisms. High level of cortisol intensifies catabolic processes, leads to disturbances of dynamic equilibration of aggressive-protective factors in the gastroduodenal zone. CONCLUSION: The results of our study revealed vital role of hormonal factors in the pathogenesis of GERD in children.

[Comparative evaluation of various methods of conservative therapy of early stage of cholelithiasis].

UNLABELLED: THE AIM OF INVESTIGATION: To explore the possibilities of use of conservative therapy in the early stage of cholelithiasis. MATERIALS AND METHODS: In the treatment of patients with early stage of gallstone disease in 103 patients was used mineral water Uvinskaya, in 96--Ursosan and in 118--Ursosan combined with mineral water Uvinskaya. RESULTS: The comparative evaluation of different variants of therapy showed that combined use of Ursosan and mineral water Uvinsky was the most effective to eliminate the clinical symptoms of the disease and reduce the lithogenic properties of bile.

[Ways to improve efficiency of patient clinical examinations during early stage of cholelithiasis].

PURPOSE: The aim of the work was to improve the organization and conduct of clinical examination of patients with gallstone disease (GSD). MATERIALS AND METHODS: An integrated study of 396 patients with different pathologies of the hepatobiliary system and the medical check-up for three years for 101 patients. RESULTS: Built logistic model to predict the likelihood of developing gallstone disease and developed a predictive scoring table it possible to distinguish patients at risk of developing gall stones. The result of follow-up of the proposed method was prevented economic losses due to the lack of need for a cholecystectomy, which is made up of one patient 6766.22 rubles., The entire group of 1,004,966.63 rubles. CONCLUSION: Obtained to diagnose cholelithiasis at an early stage dokamennoy. Developed a screening questionnaire, predictive scoring table, the scheme of follow-up also improves clinical examination of patients with cholelithiasis dokamennoy stage.

[The role of the small intestine in the development of metabolic syndrome].

AIM: To comprehensively investigate the function of the small intestine (SI) in metabolic syndrome (MS). SUBJECTS AND METHODS: Seventy-eight patients with MS were examined using, in addition to clinical studies, comprehensive ones of the function of SI: evaluation of its motor, digestive, and absorptive functions. The specific features of the hormonal and autonomic status were studied in the patients with MS. RESULTS: Clinical local and common signs of SI lesion were seen in 82.9% of the patients. Examination of SI function revealed its impairments at all stages of hydrolysis and resorption in the presence of hypomotor dyskinesia in the postprandial period and hypersympaticotonia in the patients with MS. New pathogenic patterns were found in relation to the role of hormones in intestinal digestive and absorptive dysfunctions in MS. CONCLUSION: The findings may suggest that SI functional changes found in MS are an important component of its complex pathogenetic circle.

[Wether cholescystectomy affects bile lithogenicity in cholelithiasis].

THE AIM: The studying of physical-chemical qualities of liver bile and lipid exchange before and after cholecystectomy. MATERIALS AND METHODS: We spent the complex investigation of physical-chemical qualities of bile and lipid levels in 210 patients with cholelithiasis stage I (pre-stone) and in 90 patients with cholelithiasis stage II and III (with gallstones) after cholecystectomy. THE RESULTS: In all examined patients we revealed disturbances of physical-chemical qualities of bile and lipid exchange. With correlation analysis it was found that bile lithogenity increases in high bile density, in progressing of inflammation process in bile ducts, in increasing of aterogene fractions of blood cholesterol. CONCLUSION: After cholecystectomy in liver-cells dyscholia the ability to stones formation preserves. It means that patients after cholecystectomy need in following-up with using of prophylactic measures to restoring of bile-formation.

[Medico-statistical characteristics of the cholelithiasis in the Udmurt Republic].

UNLABELLED: THE AIM OF OUR INVESTIGATION: siuay me level or moroiaity or cnolelimiasis and its dynamic in adult and children population of Udmurt Republic. MATERIALS AND METHODS: We used the materials of state statistic registration documentation. We took into account the average population of Udmurt Republic, data of cholrlithiasis morbidity and the quantity of registrated cases of disease. To reveal tendency of cholelithiasis morbidity we spent the regressive analysis with using of trend models. THE RESULTS: We found that during analyzing period (2005-2009) common morbidity of cholelithiasis in Udmurt Republic exceeds the same data in Russian Federation. Morbidity of adult urban population is significantly higher than in rural population. The cholelithiasis morbidity increases at the age of 41-60 years. In children population we marked significant raising of primary cholelithiasis morbidity. CONCLUSION. It was revealed that cholelithiasis morbidity in Udmurt Republic remains high. Due to this information we have possibility to determine medical and prophylactic measures.

[Possibilities of using of crystal-optic qualities of bile in early diagnostic stage of cholelithiasis].

The aim of our investigation was to study the changes of bile morphology and possibilities of its using in early diagnostic stage of cholelithiasis. We spent the complex investigation of biochemical and crystal-optic qualities of bile in 207 patients with cholelithiasis stage I with different disease duration. The revealed crystal-optic morphotypes have selective morphology due to the bile lithogene level that allows to determine the disease duration and the bile instability to make in-time adequate profilactic.

[Efficacy of balneotherapy in cholelithiasis].

AIM: To assess therapeutic efficacy of mineral water Uvinskaya at a prestone stage of cholelithiasis. MATERIAL AND METHODS: A total of 135 cholelithiasis patients entered the trial. Of them 57 patients had a prestone stage and 78--stone stage of the disease. The stages were verified by clinical data, findings of dynamic hepatobiliscintigraphy, biochemical bile tests, anatomoemission spectroscopy with induction-bound plasma. RESULTS: 57 patients at prestone stage of cholelithiasis received balneotherapy with mineral water Uvinskaya. The treatment relieved pain syndrome, dyspeptic symptoms, enhanced absorption-excretion function of the liver, prolonged the time of maximal gall-bladder filling, shortened radiopharmaceutical half-life in the gall-bladder, raised the level of trace elements (magnesium, iron, potassium) in the bile, improved gall-bladder contraction, lithogenic bile characteristics. CONCLUSION: Mineral water Uvinskaya has a positive effect in a physical-chemical stage of cholelithiasis.

[Mechanisms of formation and substantiation of pathogenetic treatment of the long-term non-cicatrizing gastroduodenal ulcers].

162 patients with a stomach ulcer were examined, 98 people were with torpid course of a stomach ulcer, and 64 sick people were usual periods of cicatrizing ulcers. 56 sick people (the first group) with torpid course of a stomach ulcer received immunal as a part of complex irradical therapy and comparising group 42 sick people (the second group) with torpid course used only irradical therapy. In estimation of efficiency of therapy, in addition to clinical and endoscopies data, indicators of genotypes Helicobacter pylori and immune system were used. The pathogenetic role of virulent genotypes Helicobacter pylori in the formation of the torpid course of a stomach disease is shown. The information about the dependence of the immune defense from cytotoxic characteristics Helicobacter pylori was received. Inclusion of immunal in complex therapy improves the elimination of Helicobacter pylori and has good clinical effect.

[Clinical and functional characteristics of small intestine in the metabolic syndrome].

THE AIM: Complex investigation of the small intestine functional condition in metabolic syndrome. MATERIALS AND METHODS: The 65 patients with metabolic syndrome were examined. We used clinical data and complex examination of the small intestine function by tests with mono-, di- and polycarboanhydrates. RESULTS: In mojoriti of patients (82.9%) the clinical local and common signs of small intestine lesion were reviled. In study intestine function the disturbances in all stages of hydrolysis and resorbtion were found. CONCLUSION: Exchangings of the small intestine functional condition in metabolic syndrome are not only secondary, but lead to its progressing.

[Differentiated approaches to the treatment of chronic pancreatitis patients with metabolic syndrome].

AIM: study and evaluation of clinical efficacy of combined use of Creon and Tricor in chronic pancreatitis (CP) accompanied by metabolic syndrome (MS). MATERIALS AND METHODS: We observed 60 patients with CP accompanied by MS, of whom 30 patients received standard therapy complex CPs (comparison group), 30--received Creon (microspheres of pancreatin) and Tricor (fenofibrate) in the combined treatment (observation group). In assessing the effectiveness of therapies used in clinical and advanced laboratory and instrumental studies. RESULTS: In the course of treatment in patients with the observation group occurred faster clinical improvement, improved lipid, carbohydrate and purine exchange and decreased insulin resistance. CONCLUSION: The combined use of Creon and Tricor is pathogenetically substantiated and clinically effective in the CP accompanied by MS.

[Effectiveness of combined application of ursosan and anxiolytic 2-mercaptobenzimidazole in early stage of cholelithiasis].

We spent the complex investigation of therapeutic efectiveness of ursosan and afobasol in 125 patients with gallstone disease on early stage (before stones). After the course of treatment we revealed positive changes of clinical symptoms and improvement of biochemical bile compound. Besides we found the positive changes in hormone levels correlated with decreasing of bile lithogenity.

[Clinical and functional changes in small intestine in the treatment of osteoarthritis with nonsteroidal antiinflammatory drugs].

Comparative evaluation of changing in functional conditions of the small intestine in using non-selective and selective non-steroidal anti-inflammatory drugs (NSAID) was estimated. The treatment of osteoarthrosis with NSAID lasted up to 3 years and longer then 3 years. As a result of integrated investigations of 92 patients it was revealed that NSAID damage the absorption primarily in proximal area of the small intestine, however the more prolonged period of using the drugs the more severe damage to intestinal digestion both of cavitary and membranous stages of hydrolysis occur. Enteropathy develops in a less extend of expression in comparison with non-selective NSAID in using selective NSAID. New pathogenic appropriateness concerning the role of hormones in functional disturbances of the small intestine in using NSAID was proved.

[Helicobacter pylori in the development of dental caries].

It is shown, that in patients with erosive and ulcer defects of gastroduodenal zone at settling Helicobacter pylori (Hp) in an oral cavity in 100% of cases caries develops at intensity 13.6 +/- 1.4 teeth. Produced Hp protease and ammonia cause disintegration connected to protein silica acids and reduce activity lysocim, worsening, thus, fluid and protective properties of a saliva. In the subsequent infringement of autopurification of a teeth results in accumulation of a dental strike where protease activity conditionally pathogenic microflora conducts to depolymerization and demineralization enamels of a teeth.

[Experience in using immunal in the complex treatment of patients with torpid peptic ulcer].

AIM: to provide a rationale for the use of immunal in intractable gastroduodenal peptic ulcers (PU), by studying Helicobacter pylori genotypes and immunological parameters. SUBJECTS AND METHODS: Sixty-eight patients (37 men and 31 women) with torpid PU were examined. A study group comprised 35 patients who took immunal as a component of complex eradication therapy; a control group included 33 patients who received complex eradication therapy only. In addition to clinical and endoscopic data, the values of H. pylori genotypes were used to evaluate therapeutic efficiency. RESULTS: The inclusion of immunal into the complex therapy in patients with torpid PU exerts a significant clinical effect in relieving the pain syndrome and dyspeptic symptoms and in accelerating ulcer cicatrization. The disappearance of virulent H. pylori strains was noted during treatment. Recovery of phagocytic, cellular, and humoral immunities is an important result of therapy. CONCLUSION: The use of immunal as a component of complex therapy for torpid PU is pathogenetically founded and clinically effective.

[Factors contributing to gallstone formation and their interaction].

AIM: to study factors contributing to gallstone formation and to elucidate their relationship. SUBJECTS AND METHODS: The examination of 230 patients with various hepatobiliary abnormalities used dynamic ultrasonic cholecystography, multifractional duodenal intubation, followed by a microscopic study and determination of the physicochemical properties of bile. Enzyme immunoassay was employed to measure the peripheral blood levels of gastrin, insulin, T3, T4, thyroid-stimulating hormone, cortisol, and growth hormone. RESULTS: All the patients were found to have signs of an early (gallstone pre-formation) stage of cholelithiasis. Decreased emptying of the gallbladder and its hypotonia and altered bile physicochemical properties were ascertained to be poor predictors of possible gallstone formation. CONCLUSION: Correlation analysis has shown the important role of hormonal factors in the formation of lithogenic bile.

[Treatment of postoperative pancreatitis, in patients undergoing cholecystectomy for cholelithiasis].

In the prevention of exacerbations of chronic pancreatitis 28 patients in the early period and one month after cholecystectomy were appointed by octreotide. In assessing the effectiveness of treatment, along with the general clinical data, used a number of modern laboratory instrumentation, ultrasound and biochemical studies. Comprehensive studies have shown that octreotide has a positive impact on the rehabilitation of patients after cholecystectomy, prevents the progression of inflammation and systemic complications.