[Syndrome of overlap of autoimmune hepatitis and primary biliary cirrhosis with the outcome in cirrhosis of the liver, complicated by fatal bleeding in the small intestine].

The authors presents the clinical case of autoimmune overlap syndrome: autoimmune hepatitis and primary biliary cirrhosis with outcomes in the hepatic cirrhosis complicated fatal intestinal bleeding.

[The state of the vascular bed of the small intestine in patients with portal hypertension].

AIM: To evaluate the condition of vascular channel of small bowel in patients with portal hypertension. MATERIALS AND METHODS: We examined 60 patients from 17 to 70 years, 30 with cirrhosis of different etiologies and 30 with other gastrointestinal diseases, amounted control group. Patients were divided into 2 groups: the main and control: group 1--primary--patients with cirrhosis and portal hypertension. Group 2--control--patients without liver disease and portal hypertension who underwent videocapsule endoscopy. RESULTS: On the results of research, we can conclude that all patients with liver cirrhosis and portal hypertension have various vascular changes of small bowel. We examined patients in the course of the work revealed the following: 1. Varicose vein expansion and increased vascular pattern in 70% of patients. 2. Arteriovenous malformation in 12% of patients. 3. Angiodisplaziya 11%. 4. Delafua defect in 4%. 5. Bleeding in 3%. The combination of vascular disease in patients with liver disease and portal hypertension syndrome accounted for 70%. In the control group of patients vascular channel pathology dated only in 2% of cases in the form of strengthening of vascular pattern of small bowel. CONCLUSION: Videocapsule endoscopy is a highly informative diagnostic method for assessing the condition of vascular channel of the intestine in patients with portal hypertension. Carrying out videocapsule endoscopy is highly effective and comfortable for patients, which greatly improves their quality of life. Timely detection of vascular disease in patients with portal hypertension using videocapsule endoscopy can prevent such severe complications as gastrointestinal bleeding especially from the deep divisions of bowel which are not available to other research methods.

[The role of hormones and types of food behavior in the development of metabolic syndrome].

THE AIM: To investigate the role of hormones and the types of FB in the development of morbid obesity (MO), to develop a treatment policy for MO to examine the diagnostic predictive value of the FB hormones and FB modifications. MATERIALS AND METHODS: Were investigated 67 patients: 28 (42%) males and 39 (58%) female aged 18 to 60 years under the scheme: medical history, questionnaire on the questionnaire SF-36, score types of FB, the study of the anthropometric data (OT/OB, BMI), the definition of the FB hormones with subsequent control of BMI, OT/OB dynamics, types and FB hormones. RESULTS: In patients older than 50 years were dominated abdominal FB, in patients younger than 50 years - all three types of FB in approximately equal proportions. After the decline in MT was observed pattern between the FB modification and age of the patient. There was an increase of leptin and ghrelin and decrease in serotonin at all three types of FB. After weight correction was a decreased leptin, ghrelin, and increased serotonin, but the achievement of normal numbers are not marked. The paradoxical result is related to a violation of reciprocal relations of hormones. CONCLUSIONS: In patients with MO FB hormone levels (Leptin, Ghrelin) elevated to normal values, reduced levels of serotonin, there is an infringement of their reciprocal correlations. The approach to patients should be lengthy and complex, involving multidisciplinary team aimed at FB correcting the with the rejection of improper food stereotype. In the treatment of MO must used different methods: reducing diet, physiotherapy effects, drug therapy and their combination with the selection of individual programs, taking into contraindications account. For the above techniques inefficiency is necessary to use surgical treatment. Correction of FB in patients older than 50 years is the most difficult task (due to the presence of concomitant diseases). Necessary to draw attention and to start treatment at a young age.