[Pharmacoeconomic evaluation of treatment in patients with Helicobacter pylori-associated diseases].

AIM: To estimate the pharmacoeconomic parameters of treatment in patients with Helicobacter pylori-associated diseases when using 6 eradication therapy (ET) regimens. SUBJECTS AND METHODS: The investigation enrolled a total of 231 patients who received anti-Helicobacter pylori therapy according to the intention-to-treat (ITT) principle, including 229 patients who met the protocol requirements, i.e. who completed the prescribed per-protocol (PP) treatment: 106 patients with duodenal bulb ulcer disease, 2 with gastric ulcer, 90 with erosive gastritis, and 31 patients with non-atrophic gastritis. In an outpatient setting, the patients received one of the 6 ET regimens: OAC, RBMA, RBCA, EBCA, sequential OACM therapy, and modified sequential OACMB therapy (O--omeprazole; A--amoxicillin; C--clarithromycin; B--bismuth tripotassium dicitrate, R--rabeprazole; M--metronidazole; E--esomeprazole). Treatment costs were calculated only from direct drug expenditures. The effective cost coefficient (K(eff)) was determined from the cost/ treatment efficiency ratio: K(eff) = cos/eff, where the cost was the average total costs; the eff was efficiency (%). RESULTS: The modified sequential OACMB therapy has proven to be more cost-efficient than the other regimens as it has a lower K(eff), (14). The RBMA regimens can overcome an 80% ET barrier (82.4%); however, in this case the K(eff) is 21.5. the sequential OACM therapy can also overcome an 80% ET barrier (84.8%); the K(eff) being 10.8. Incorporation of the bismuth preparation can achieve a more noticeable therapeutic effect up to 95.4%. The EBCA regimen has turned out to be most expensive with the highest K(eff) of 36.9. The RBCA regimen is most effective with the least K(eff) of 29; the therapeutic effect is 96.7%. CONCLUSION: The clinical cost-efficiency of ET is enhanced by the incorporation of the bismuth preparation for the treatment of patients with H. pylori-associated diseases. The modified sequential OACMB therapy can overcome resistance to clarithromycin and metronidazole with a good cost-efficiency.

[Clinical significance of Helicobacter pylori infection].

This article deals with modern concepts of H. pylori infection and its role in the development of gastric and extragastic pathology. The currently available algorithms of diagnostics and treatment of this infection are presented Recommendations of recent Maastricht consensuses (7MC-3, 2005; MC-4, 2010) on diagnostics and treatment of H. pylori infection are considered. The data on resistance of H .pylori to antibiotics, mechanisms of its development and methods of control are summarized.

[Impact of tuberculosis in penal labor facilities on the epidemiological situation in the Sverdlovsk region]. / Vliianie tuberkuleza v ispravitel'no-trudovykh uchrezhdeniiakh na épidemiologicheskuiu situatsiiu v Sverdlovskoi oblasti.

The unfavourable tuberculosis situation in the corrective labour facilities affects the main rates of tuberculosis in the region. Presently, the total registered cases of tuberculosis among prisoners are 36.7 times as high as those in the age-matched general population of the Sverdlovsk Region. The rates of relapses, incidence, death due to tuberculosis show 72.0-, 36.1-, and 10.4-fold increases, respectively. Almost every 10 persons from the labour corrective facilities suffer from active tuberculosis. In the past decade, the growth rates of main tuberculosis parameters in the corrective labour facilities were much higher (total tuberculosis morbidity by 2.1 times, relapses by 2.1 times, general morbidity by 1.7 times, and total tuberculosis mortality by 2.8 times) than those in the region's general population. Extrapulmonary tuberculosis was not virtually detected in the labour corrective facilities) due to the lack of special diagnostic methods.