[NEWS IN ETIOLOGY AND PATHOGENESIS OF IRRITATED BOWEL SYNDROME].

The concept of irritated bowel syndrome as a complex of functional disorders that can not be explained by organic changes and are totally due to intestinal motility and visceral sensitivity needs revision. The development of this syndrome also depends on a number of pathogenetic and etiological factors, such as inflammation of intestinal mucosa, changes of its permeability, previous infection, altered microflora, gene polymorphism, and food hypersensitivity.

[Debatable aspects of diagnostics and differential diagnostics of irritated bowel syndrome].

Diagnostics and differential diagnostics of irritated bowel syndrome are currently governed by Rome III criteria that require that patients' complaints be correlated with these criteria and a minimal amount of laboratory and instrumental studies be conducted. However, such approach is fraught with errors bearing in mind the subjective character of complaints. It is therefore more reasonable to regard diagnosis of irritated bowel syndrome as exclusion diagnosis.

[Effectiveness of pharmacotherapy of irritated bowel syndrome from the standpoint of evidence based medicine].

Evaluation of the action of various medicines used to treat irritated bowel syndrome from the standpoint of evidence based medicine indicates that most of them (spasmolytics, probiotics, loperamide, aperients) show but low effectiveness. The use of more efficacious preparations (alosterone, cisapride, tegacerode) is associated with serious adverse reactions whereas prucalopride is applied for unregistered indications. It necessitates the development of new drugs with enhanced effectiveness and tolerability.

[On the possibility of using prokinetics in gastroenterology].

This review is concerned with the main classes of medicines stimulating the motor activity of the gastrointestinal tract widely used in clinical practice and studied in clinical trials (dopamine receptor blockers, 5-HT4- and 5-HT1-receptor antagonists, agonists of motilin receptors, antagonists of A type cholecystokinin and opioid receptors, etc.). The necessity of developing new generations of prokinetics is emphasized in order to improve efficiency and safety of therapy with these preparations.

[Quality of life in patients above 50 years with chronic hepatitis B].

The quality of life (QL) was assessed in patients with chronic hepatitis B (CHB). Both overall QL and its selected parameters were impaired in patients above 50 years. Also, QL deteriorated with duration of CHB. In patients with active CHB (frequent and prolonged exacerbation, development of complications, low efficiency of drug therapy) and duration of the disease over 5 years, QL impairment was due to serious limitations in almost all spheres and sub-spheres of life under consideration. QL parameters in patients above 50 years were shown to depend on activity of the infectious process. The higher the activity the worse QL was reported by the patients.

[Possibility of dynamic control over portal pressure in chronic hepatitis using Doppler ultrasonography].

Portal pressure (PP) was studied in 64 patients with chronic viral hepatitis (CVH) type B and C; Doppler ultrasonography and a special empiric formula of PP calculation, the reliability of which was confirmed by the results of invasive splenoportometry, were applied. The control group consisted of 40 practically healthy individuals. In the healthy PP was 11.3 +/- 0.44 mbar; in patients with minimal activity of CVH-- 12.005 +/- 0.739 mbar (p > 0.05), in patients with moderate CVH activity-- 16.704 +/- 1.416 mbar; in patients with high CVH activity-- 19.326 +/- 1.048 mbar (p < 0.05). The results show that CVH leads to portal hypertension, the degree of which depends on the activity of the inflammatory process in the liver. In 37 patients PP was measured after a course of complex therapy; despite positive clinical changes, the degree of PP only tended to lower. Prolonged (3 years) follow-up of 21 patients with CVH revealed that most of them had increased PP and dilatation of portal and splenic veins, which is a sign of a gradual progression of the disease.

Succinate-based preparation alleviates manifestations of the climacteric syndrome in women.

Clinical placebo-controlled study of Enerlit-Clima (bioactive succinate-based food additive) a showed positive effect of the preparation on general clinical and psychoemotional manifestations of the climacteric syndrome. A trend to an increase in estradiol level in early pathological climacteric and normalization of the endometrial status were observed.

[Use of the plant hepatoprotector Galstena tuberculostatics-induced hepatic lesions: experimental and clinical study]. / Ispol'zovanie gepatoprotektora rastitel'nogo proiskhozhdeniia galsteny pri porazheniiakh pecheni tuberkulostatikami (éksperimental'no-klinicheskoe issledovanie).

The efficiency of the use of the natural drug Galstena (Richard Bittner GmbH) was experimentally and clinically studied on a model of damage induced by toxic doses of tuberculostatics (rifampicin, isoniazid, pyrazinamide) in laboratory rats and in patients with different forms of pulmonary tuberculosis and with hepatitis caused by specific antituberculous drug therapy, who were treated at the Clinic of Phthiziology. Galstena was found to have marked hepatoprotective properties and to be able to prevent renal and pancreatic disorders. The drug also showed an antioxidative activity. The use of Galstena in patients with pulmonary tuberculosis substantially reduced the magnitude of clinical and laboratory signs of drug-induced hepatic damage.