[Irritable bowel syndrome in the light of Rome consensus III (2006): 10 years later].

Irritable bowel syndrome (IBS) is the most common diagnosis in gastroenterology. Over 10 years after Rome consensus III (2006), there has been much new information on the pathogenesis of IBS and its therapy options. The paper analyzes basic investigations that have contributed to the theory of this disease and to a better quality of life in patients.

[Safety of mesenchymal stromal cell therapy for inflammatory bowel diseases: results of a 5-year follow-up].

AIM: To compare the safety of therapy in patients with ulcerative colitis (UC) and Crohn's disease (CD) who have received combination anti-inflammatory therapy using bone marrow mesenchymal stromal cells (MSC) and standard therapy with 5-aminosalicylic acid, glucocorticosteroids, and immunosuppressive agents. SUBJECTS AND METHODS: Unfavorable consequences were analyzed in 103 patients (56 with UC and 47 with CD) with inflammatory bowel disease (IBD) after MSC administration. The findings were compared with data obtained in 208 patients with UC and CD on standard anti-inflammatory therapy. All the patients were similar in demographic parameters, the duration of disease, the extent of intestinal injury, the nature of a course, the type and degree of disease. The analyzed groups did not include patients who had received therapy with anti-TNF-α drugs. The safety of therapy was evaluated from the presence of complications occurring during the follow-up. RESULTS: By analyzing the unfavorable consequences in 103 patients with IBD and comparing them with treatment results in 208 patients with UC and CD on standard anti-inflammatory therapy, the authors revealed no differences in the development of acute posttransfusion reactions, infectious complications, exacerbations of chronic inflammatory diseases, severe infectious complications, malignant transformation, and fatal cases in patients with UC and CD, except for those with transient fever. CONCLUSION: The results of this study demonstrate that the innovative method of cell therapy is clinically safe.

[Cachexia and multiorgan insufficiency in a patient with small intestine carcinoid].

Carcinoid of the thin bowel is difficult to diagnose pathology. Complications diagnosticians with that doctors clash on ambulatory and hospital the stages, including at offtype clinical presentation of disease, result in late recognition of carcinoid and belated operative intervention. In taken apart case a diagnosis was set at pathomorphologic research. One of typical displays of carcinoid syndrome is a cachexy. Treatment of carcinoid is surgical, a conservative correction is sent mainly to the decline of hormones activity of this tumours type.

[Violation of bone mineral density tissue and its correction in patients with celiac disease].

There are shown results of studies of bone mineral density in patients with celiac disease. The problem of malabsorption syndrome with clinical and pathogenetic point of view, which can lead to bone loss due to on absorption violations of calcium and vitamin D at celiac disease. Also into account the effect of proinflammatory cytokines and hormones on calcium regulated processes of bone remodeling. The role of the commitment to a gluten-free diet in the formation of bone loss.

[Bone mineral density in patients with celiac disease and medical treatment of the disorder].

The article presents the results of a bone mineral density study in patients with glutensensitive celiac disease. Was discussed problem of malabsorption syndrome with clinical and pathogenetic point of view, which can lead to bone loss due to malabsorption of calcium and vitamin D for celiac disease. Also was take into account the effect of inflammatory cytokines and hormones on calcium regulating processes of bone remodeling. The role of adherence to a gluten-free diet in the formation of bone loss. The article is illustrated with three tables, one figure and two schedules.

[Disorder of bone mineral density in patients with the digestive system diseases].

This article studies the clinical features of the flow of the gastrointestinal tract and liver in the formation of osteopenia and osteoporosis. Were shown the incidence of disorders of bone mineral density in patients with chronic pancreatitis, liver cirrhosis, gallstone disease, inflammatory bowel diseases, and diseases accompanied by syndrome of malabsorption (gluten enteropathy, a syndrome of short small intestine). Were established population (age, sex, lower body mass index, menopause), clinical and laboratory factors indicating high risk of lower bone mineral density in these patients.

[Bone mineral density in patients with gluten-sensitivity celiac disease].

AIM: to determine the frequency of development of osteopenia/ostoporosis (OP) vitamin D deficiency, some population risk factors, and the effects of alpha-calcidol and calcitriol on bone mineral density (BMD) in patients with gluten-sensitivity celiac disease (GSCD). SUBJECTS AND METHODS: Densitometry of the lumbar vertebra and femoral neck (FN) was carried out in 47 patients with GSCD. Their sera were tested for 25OHD3, 1,25(OH)2D3, total alkaline phosphatase, calcium, phosphorus, parathyroid hormone (PTH), type 1 collagen type C-telopeptides (CrossLaps) and tumor necrosis factor-a (TNF-alpha), as well as urinary creatinine and calcium. RESULTS: The T score below -1 was found in 37 (78.7%) of the patients. BMD reduced to the level of osteopenia in 51.1% of the patients; OP was detected in 27.7%. Lower BMD was noted in 19 (95%) of the 20 menopausal women and in 15 (68.2%) of the 22 females with preserved menstrual function (p = 0.047). The mean value of 250 HD3 was 47.8 +/- 5.0 in patients with OP patients and 85.6 +/- 7.1 ng/l in those with normal BMD (p < 0.001). The latter had no decreased level of vitamin D, suggesting its deficiency, but 11 (30%) osteopenic patients were found to have vitamin D deficiency (25OHD3 < 30 ng/l). Impaired calcitriol synthesis (69.9 +/- 24.0 ng/l) was observed only in patients with OP; the level of calcitriol was 85.6 +/- 31.2 ng/ml in those with normal BMD. Decreased BMD was accompanied by elevated PTH levels in 25 (67%) patients with GSCD. There were increases in the bone resorption marker CrossLaps and in the level of TNF-alpha in 28 (76%) and 8 (22%) osteopenic patients, respectively. A more significant BMD reduction was seen in the presence of antibodies to gliadin and tissue transglutaminase. A significant correlation was found between the titer of immunoglobulin A antibodies to gliadin and TNF-alpha (rho = -0.57; p = 0.035), CrossLaps (rho = -0.58; p = 0.035), Tscores in the vertebral column and FN (rho = -0.62; p = 0.030) and (rho = -0 37; p = 0.06), respectively. CONCLUSION: The risk for OP in patients with GSCD is affected by menopause and the clinical features of the disease: secondary hyperparathyroidism due to impaired calcium and vitamin D absorption, by the activity of immunological inflammation and the compliance with a gluten-free diet. The immunological activity of inflammation is closely related to the activation of bone resorption and enhances a BMT reduction in patients with celiac disease. The use of vitamin D preparations (alpha-calcidol and calcitriol) in combination with calcium salts lowers BMD in patients with celiac disease just within the first 6 months.