[Use of itopride in the symptoms of functional dyspepsia in Russia: results of a phase IV prospective open-label multicenter clinical trial].

AIM: To evaluate the efficacy and safety of itopride used to treat the symptoms of functional dyspepsia (FD) of the upper gastrointestinal tract. SUBJECTS AND METHODS: A prospective, open-label, multicenter trial using as a control the placebo response obtained in the previous investigations enrolled 96 adult patients. The diagnosis of FD corresponded to its Rome II criteria. Patients received itopride (Ganaton) oral tablets (50 mg) 3 times daily for 8 weeks. When included into the trial, the patients were orally given itopride (ganaton) tablets (50 mg) thrice daily before meals for 8 weeks. The patients' status was evaluated during (at weeks 4 and 8) and after (at week 12) treatment. Treatment response was assessed using the Global Patient Assessment (GPA) and the Leeds Dyspepsia Questionnaire (LDQ). To evaluate the safety of itopride use, the investigators studied the frequency of adverse events and carried out laboratory tests (renal and liver function tests) and electrocardiography (ECG). RESULTS: The GPA showed that 53.76, 85.71, and 82.22% of the patients achieved a therapeutic effect of itopride at weeks 4, 8, and 12, respectively. The proportion of the patients who achieved the therapeutic effect (86%) at week 8 was higher than the historical placebo controls in the previous studies--45% (86% vs 45%; X2 = 68.868, df = 3; p < 0.001). The mean LDQ score at week 8 was significantly lower than that at baseline (2.09 and 9.36 scores; p < 0.001); 6 nonserious adverse events occurred in 3 (3.12%) of the 96 patients. During the follow-up period, there was a mild adverse event that was related to the test drug (atrial extrasystole as evidenced by ECG) and resolved a few days later. CONCLUSION: Itopride is an effective and well-tolerated drug in the treatment of functional dyspepsia in the Russian patients.

[Gastroesophageal reflux disease model].

The model of gastroesophageal reflux disease by administration of 0.2-0.25 ml of a 1% solution of methylene blue to fundal division of rat stomach was created. After 1-5 minutes electromotor activity of the lower third of the esophagus was observed. Mucosa staining was noted.

[Study of the esophagus and stomach acidification (according to the interpretation of 24-hour pH monitoring data)].

Is demonstrated current information about the nature and method of computing the 24-hour pH-metria of the esophagus and stomach, as well as the Interpretation acidification (acidification) of the gastrointestinal tract.

[Calculous pancreatitis].

Was shown current information on the diagnosis of pancreatic stones, their role in the development of calcificated (calculous) pancreatitis, as well as information on treatment of patients.

[Pharmacoeconomic analysis of treatment of certain diseases of the digestive system].

The article provides data of the pharmacoeconomic analysis (cost/effectiveness) of treatment of peptic ulcer, ulcerative colitis, Crohn's disease, gastroesophageal reflux disease, biliary sludge and cholelithiasis. It was shown that the most appropriate treatment scheme is one that characterized by lower costs per unit of effectiveness. Analysis of cost/effectiveness can give an economic assessment of clinical efficacy, compare alternative treatments and help to choose the method by which the efficiency increases faster than the level of costs.

[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.

[Biliary pancreatitis].

It is provided the basic information of the etiopathogenesis, diagnosis of biliary pancreatitis, drug treatment of patients with holetsistolitiaz, and the information of biliary pancreatitis's prevention.

[Idiopathic pancreatitis].

The basic current information on etiopathogenesis, diagnosis and treatment of patients with idiopathic pancreatitis.

[Decreasing prevalence and incidence of ulcerative disease--an amazing phenomenon of the end of XX and the beginning of the XXI century].

There demonstrated information on reducing the prevalence and incidence of peptic ulcer in the past 10 years in Moscow, as well as the authors' observations about the possible factors underlying the development trend in reducing the incidence and morbidity of peptic disease.

[Autoimmune pancreatitis: diagnostics and treatment].

The article presents current information about the different options for pathological changes detected in patients with autoimmune pancreatitis, the results of clinical, laboratory and instrumental examination of patients, as well as the possibility of drug treatment of patients.

[Chronic pancreatitis and enzyme drugs: questions and answers].

The article presents current information on a key aspects of chronic pancreatitis and enzyme drugs in the form of questions posed by physicians at the end of the lectures on topical issues of chronic pancreatitis, and responses to them.

[Standards of diagnostics and drug therapy of patients with chronic pancreatitis. Moscow agreement, 4 March 2009].

IX Congress of the Scientific Society gastroenterologists Russia and XXXV session of the Central Scientific Research Institute of Gastroenterology was held on 2-5 of March 2009 in Moscow. At the joint meeting were taken standards of "diagnostic and pharmaceutical therapy of chronic pancreatitis".

[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.

[Prevalence of gastroesophageal reflux disease in Moscow: results of a population study].

AIM: To study prevalence of the principal symptoms of gastroesophageal reflux disease (GERD) in Moscow. MATERIAL AND METHODS: A total of 1065 respondents aged 15-85 years (a random representative sample of population of one of the typical Moscow districts) participated in a questionnaire survey using the international questionnaire for detection of GERD incidence. RESULTS: Epigastric burning (EB) occurs in 39.6% examinees. GERD prevalence is 14.2%. Subjects with EB have the following symptoms of GERD: regurgitation (66.3%), epigastric pain (discomfort) (53.0%), nausea (43.6%), vomiting (23.2%), dysphagia (20.6%), chest pain (18.0%), odinophagia (5.5%), singultus (4.6%). There is a direct correlation between incidence rate of EB, height, body mass index, number of alcohol excesses and smoked cigarettes. CONCLUSION: EB occurs in both young and aged men and women with similar frequency. Significant differences were detected only in the age group 45-59 years in which EB is more frequent in women. All the symptoms excluding cough and singultus were seen in women significantly more frequently. With age, these differences disappeared but noncardial pain in the chest that was less frequent in the elderly. Muscovites with GERD symptoms are older (61.26 +/- 13.47 years) than those without such symptoms (58.44 +/- 16.28, p < 0.0001).

[Whether enzymatic and antisecretory drugs always correctly used in therapy of the chronic pancreatitis? An information for reflection].

Central scientific research institute of gastroenterology, Moscow It is presented debatable data of expediency of application of fermental medicines in therapies of chronic pancreatitis.

[Cholelithiasis and biliary pancreatitis: pathogenetic and clinical aspects].

The main pathogenetic and clinical aspects of the cholecystolithiasis and biliary pancreatitis beginning and progress are discussed, including the results of our investigations.