All articles - Gastroenterology and Hepatology
Number of articles: 702
-
Achalasia of the esophagus is a chronic and progressive motility disorder characterized by lack of esophageal motility associated with impaired relaxation of the lower esophageal sphincter (LES) and usually with increased LES pressure, resulting in altered bolus passage through the cardio-esophageal junction. Currently established treatment options include pneumatic dilation, Heller's cardiomyotomy, botulinum toxin injection, oral endoscopic cardiomyotomy, and esophagectomy for refractory, terminal disease. Despite their effectiveness, a significant proportion of patients eventually relapse and require rc-trcatmcnt. In this context, several new therapies arc being explored that promise to enrich our therapeutic arsenal for patients with cardiac achalasia in the future. This review highlights the role of self-expanding metal stents in the treatment of patients with achalasia. Their possible position in the therapeutic algorithm of achalasia is also assessed along with established and new methods. -
BIOCHEMICAL CHANGES IN CHRONIC RECURRENT AFTHOUS STOMATITIS OF THE OROPHARYNGIAL REGION IN PATIENTS WITH CHRONIC CHOLECYSTITISThe majority of scientists, both in our country and abroad (1,7,8,9,15), are devoted to the diagnosis and treatment of chronic diseases of the oral mucosa. The pathogenetic commonality of erosive and ulcerative lesions on the oral mucosa with many general somatic processes is due to the development of a single mechanism for the whole organism of cellular damage and modification of tissue structures with the acquisition of autoantigcnic properties by them (3,5,11).
Medicine and innovations -
Optimization of tactical and technical aspects of complex surgical treatment of acute purulent cholangitis in cholelithiasisThe results of surgical treatment of 144 patients with acute purulent cholangitis as a consequence of cholelithiasis have been analyzed. In the main group of patients (83), staged surgical treatment taking into account the severity of acute purulent cholangitis with the use of minimally invasive decompressive interventions made it possible to arrest the phenomena of cholestasis and purulent intoxication, and significantly improve the results of radical operations. Excessive sanitation of the biliary tract with 0.06% activated sodium hypochlorite solution contributed to the early relief of cholangitis. Achieved a decrease in postoperative complications from 24.5% to 12.1% mortality from 8.2% to 2.4%.
Doctor's Herald -
Measures to prevent acute erosive wound changes in severe bums are not based on clear criteria. In particular, it is important to ensure normalization of the total blood volume, stabilize the functional state of the respiratory and circulatory systems, maintain acid-alkaline and electrolyte balance, and fight infection in a timely manner. Insufficient prevention of acute erosive ulcer gastroduodenal complications, despite the tendency to discover more and more effective and modern methods of treatment, often leads to sudden serious complications (acute bleeding, perforation) and even death, in spite of the improvement in the condition of patients. -
Introduction. Hydatidous echinococcosis belongs to the group of severe parasitic diseases, which remains a serious medical problem on a global scale due to the existence of a huge number of endemic foci and a steady increase in the number of patients. Echinococcosis is a zoonotic disease caused by infection with the tapeworm Echinococcus [1, 2, 3, 4, 6, 8, 7, 14]. Humans are random intermediate dead-end hosts infected by ingesting parasite eggs in contaminated food or by direct contact with animal hosts. Getting into the duodenal mucosa, the parasite larvae reach the bloodstream and then enter the liver (75%), lungs (15%) or other areas (heart, central nervous system, kidneys (extremely rare: 1-5%), bones, eyes, etc.), where they continue their development [5, 7, 18]. -
The laboratory characteristics of enteropathogenic (EPE) and enteroinvasive escherichiosis (EIE) in children have been studied and their comparative characteristics have been carried out. There were examined 82 sick children with early age Escherichiosis. caused in 28 by enteroinvasive, in 54 with enteropathogenic strains. In children with EPE, secretory diarrhea was observed, and EIE — colitis. There was no statistical reliability of the results between the compared groups of patients in relation to quantitative changes in the general blood test, but there was a more frequent decrease in the number of hemoglobin and blood erythrocytes compared with EPE. When coproscopic examination in the group of sick children with EIE. there was an increase in the frequency of detection of the presence of blood and erythrocytes, which amounted to 39.2% of the case in both indicators, respectively, while the concentration of iodo-philic microflora, soap and leukocytes were significantly more frequent in patients with EPE in comparison with EIE. It should be emphasized that in 20.3% of sick children with EPE and 46.4% of children with EIE. protein was found in the urine, which indicates that in this contingent of patients there was a violation of renal excretory function. The detection of leukocytes, mucus and bacteria in the urine may be a consequence of inflammatory processes in the renal parenchyma. -
This article analyzes the diagnostic and therapeutic tactics of treating 234 patients with gastroesophageal reflux disease and complicated with various erosive pathologies of the esophageal mucosa, which were investigated in the diagnostic departments of the Samarkand City Medical Association and the Republican specialized scientific and practice medical center of Surgery named of academician V. Vakhidov in the period 2019-2020. Patients, according to indications, were examined in different modes of endoscopic examination (in the usual and in the narrow-spectrum mode (NBI mode)). -
THE ROLE OF GENES-MEDIATORS OF IMMUNE INFLAMMATION IN DESTRUCTIVE- INFLAMMATORY DISEASES OF THE GASTRODUODENAL REGION IN CHILDRENA significant contribution to the development of gastroduodenal pathology is made by a violation of the functional activity of the immune system, implemented by T- and B-lymphocytes, in particular, cytokines. This is determined by the pleiotropy of cytokine effects and consists in the regulation of proliferation, differentiation and modulation of apoptotic cell death. The cytokine system includes about 200 individual polypeptide substances, among which are interleukins (IL) 1-37; interferons (INF) a, p and y; tumor necrosis factors (TNF) a and P; colony stimulating factors (CSF); growth factors; chemokines and some others. At the same time, two groups of cytokines are distinguished: anti-inflammatory (IL-l, IL-6, IL-8, IL-12, TNF-a, INF-y), and anti-inflammatory (IL-4, IL-10, IL-13, TGF-P) [5,11,48].
Doctor's Herald -
Mirizzi syndrome (MS) is one of the least understood concepts in bile duct surgery. This is due to the rarity of this pathology. This disease occurs according to the literature, from 0.5 to 5% among all patients operated on for gallstone disease [6, 12, 13, 17]. In connection with the progress of biliary tract surgery, an increase in the incidence of cholelithiasis, interest in this problem has increased in recent years. However, there is still no consensus on the diagnosis and tactics of surgical treatment [1, 2, 7, 15]. MS is often diagnosed only during surgery, which increases the percentage of access conversion and the risk of trauma to the common bile duct [9, 18]. -
INCIDENCE OF DIGESTIVE SYSTEM DISEASES IN WOMEN OF REPRODUCTIVE AGE LIVING IN THE KHOREZM REGIONThe purpose research was revealing of diseases of bodies of digestion at women at the fertile age, living in the Khoresm area. The analysis of the received results has shown women have a chronic gastritis which 1/3 patients with diseases of digestive system suffer. High percent of women (27,3%) suffer also a chronic cholecystitis. It is especially necessary to underline that fact, that chronic diseases of digestive system prevail over the others nosological units.
Journal of hepato-gastroenterological research -
CLINICAL AND LABORATORY INDICATORS OF FUNCTIONAL GASTROINTESTINAL DISORDERS IN CHILDRENFunctional digestive disorders in young children are common. Objective: to compare the features of clinical and laboratory parameters in children with functional gastrointestinal disorders. The study involved 30 children with functional gastrointestinal disorders. Patients were conditionally divided into 3 groups depending on the type of disorders: group I consisted of 10 patients with functional constipation, group II consisted of 10 children with functional diarrhea, group III included children with intestinal colic. Children of all groups underwent a general analysis of blood, urine, feces and objective studies. Thus, functional gastrointestinal disorder manifested in the form of intestinal colic is more acute compared with constipation and diarrhea, with a large number of complaints expressed by steatorrhea and the presence of mucus and leukocytes in the stool, which reflects the lipolytic ability of the pancreas, depends on the pH of the duodenum , intraduodenal pressure.
Journal of hepato-gastroenterological research -
SIGNIFICANCE OF THE DYNAMICS OF THE LEVEL OF A SERUM LIVER FIBROSIS MARKER WFA + - M2BP IN PATIENTS WITH CHRONIC HEPATITIS BObjective. To determine the role of the dynamics of the level of serum marker of liver fibrosis WFA+-M2BP in patients with chronic hepatitis В.. 56 patients with chronic hepatitis В who received antiviral therapy were examined. The degree of liver fibrosis was determined by indirect elastometry. Patients with the degree of liver fibrosis F0 were 8 people, F1 – 17 people, F2 - 6 people, F3 - 12 people and F4 - 13 people. The level of WFA+-M2BP was determined before the appointment of antiviral therapy, 6 month and 12 months. It was shown that both in patients with chronic hepatitis В and in patients with cirrhosis of the liver, a decrease in the levels of serum marker WFA+-M2BP in the dynamics of antiviral therapy is noted. The average value of WFA+-M2BP with liver fibrosis F3 (p<0,01) and F4 (p<0,01) was significantly higher than with the degree of fibrosis F0. In chronic hepatitis В with an increase in the degree of liver fibrosis, there is an increase in WFA+-M2BP levels and a decrease in the value of this biomarker in the dynamics of antiviral treatment. The determination of the dynamics of the level of this biomarker will allow timely detection of early degrees of liver fibrosis and monitoring of fibrosis in patients receiving antiviral therapy.
Journal of hepato-gastroenterological research -
RISK FACTORS OF DEVELOPMENT OF ULCER DISEASE IN CHILDREN, CLINICAL COURSE AND THERAPYA total of 25 children with peptic ulcer and duodenal ulcer were examined. It was revealed that repeated acute respiratory infections and acute intestinal infections and uncontrolled use of antibiotics with a short duration of breastfeeding were the highest risk for the development of peptic ulcer. The polymorphism of the clinical symptoms of peptic ulcer in children and adolescents with better efficacy in the treatment and prevention of recurrence of this pathology of rabeprazole was revealed.
Journal of hepato-gastroenterological research -
ALGORITHM FOR THE MANAGEMENT OF PATIENTS WITH BILE DUCT AFTER CHOLECYSTECTOMYRelevance. Cholecystectomy is the most frequent operation, and the number of cholecystectomies performed annually exceeds 500 thousand. Purpose of the study. To optimize diagnostic and surgical tactics in patients with bile duct after cholecystectomy in the early postoperative period by introducing modern diagnostic and minimally invasive treatment methods. Material and research methods. We analyzed the results of surgical treatment of 2268 patients who underwent cholecystectomy in the 1st clinic of the Samarkand State Medical Institute in the period 2010-2019. The results of the study. After the differentiated course of treatment among 52 patients with bile leakage, various complications in the early postoperative period were noted in 5.8% of patients. In the long-term postoperative period, strictures of the pancreas and arterial hypertension were observed in 7.6% of patients. Findings. Ultrasound is the initial method for diagnosing postoperative bile flow. With bile duct 1 degree, the absence of signs of peritoneal irritation and intoxication symptoms, it is necessary to adhere to the tactics of active dynamic observation. With bile ducts of the 2nd to 3rd degree, repeated intervention is indicated - laparoscopy, laparotomy.
Journal of hepato-gastroenterological research -
FEATURES OF THE ESTIMATION OF THE HEPATIC ENCEPHALOPATHY IN PATIENTS WITH LIVER CIRRHOSISPurpose. To determine the features of assessing the severity of hepatic encephalopathy in patients with liver cirrhosis. Material and methods. The study included 490 patients with liver cirrhosis. The criterion for assessing the severity of hepatic encephalopathy at the stages of portosystemic shunting was the results of determining the critical flicker frequency obtained using the HEPAtonormTM-Analyzer. All patients were operated on in a planned manner: selective shunting (distal splenorenal anastomosis) - 306 (62.4%); central - 184 (37.6%): proximal splenorenal anastomosis with splenectomy - 13 (2.7%); latero- lateral splenorenal anastomosis - 62 (12.7%); splenosuprarenal anastomosis - 84 (17.1%); H-splenorenal anastomosis - 25 (5.1%). Results. In 100.0% of cases, portosystemic shunting worsens the rate of critical flicker (from 39.5 ± 0.9 to 37.8 ± 1.2 Hz, P <0.001), and if before the operation, hepatic encephalopathy was absent or was in latent form in 76.3% of patients, already in the early stages after the intervention, this figure decreased to 46.7%, and the majority of patients had clinically significant signs of hepatic encephalopathy. Against the background of postoperative conservative therapy, the tendency to improve the level of the critical flicker rate was more pronounced after selective portosystemic shunting (39.5 ± 1.1 Hz), whereas in the group of patients with central decompression the rate of critical flicker improves with less intensity, reaching discharge moment is only 38.3 ± 1.2 Hz (P <0.001). Conclusions. The level of the critical flicker frequency when planning for system-bypass shunting is of fundamental importance, which leads to a high probability of the development of postoperative severe liver failure with initially low rates.
Journal of hepato-gastroenterological research -
CLINICAL AND IMMUNOLOGICAL PARALLELS OF ULCERATIVE COLITIS.The pathogenesis of ulcerative colitis was studied, which confirms the importance of changes in individual parts of the immune system: a decrease in the total number of T-lymphocytes, heterogeneity of their subpopulations, as well as violations from B-lymphocytes and natural killers.
Journal of hepato-gastroenterological research -
48 young children with food allergy were examined. Intestinal microflora was studied according to the generally accepted method. Identified dysbiotic disorders of the intestinal microflora are interrelated with the severity of clinical symptoms and laboratory data in food allergies in children, affecting to the functional ability of the gastrointestinal tract, contribute to the sensitization of the child’s body. -
LONG-TERM RESULTS OF SURGICAL AND ENDOSCOPIC TREATMENT OF PATIENTS WITH BLEEDING OF PORTAL GENESISThe research method was to determine the quality of life by calculating the calculated indicators of the SF-36 questionnaire in 338 patients aged 22 to 50 years who were urgently admitted for inpatient treatment for ongoing bleeding from varicose veins of the esophagus and stomach arising from portal hypertension cirrhotic origin. All study participants were divided into 2 groups depending on the methods used to stop bleeding: endoscopic ligation and / or sclerotherapy (group No. 1, n = 162) and surgical azigo-portal isolation according to M.D. Paсiora (group No. 2, n = 176). SF-36 values were determined before treatment, 3 months, 1, 2 and 3 years after treatment. Results. After 3 months, 1, 2 and 3 years after using endoscopic hemostasis methods, in all patients, without exception, the SF-36 indices were 11-74% higher than those who underwent surgery according to M.D. Paсiora. Conclusion. The use of endoscopic ligation and / or sclerotherapy in order to stop bleeding from varicose veins of the esophagus and stomach in patients of different sex and age provides for at least three years after the intervention a higher quality of life compared to that after the operation of azigo-portal dissociation according to the method of M.D. Paсiora
Journal of hepato-gastroenterological research -
INTESTINAL BARRIER FUNCTION IN GASTROINTESTINAL FORMS OF FOOD ALLERGY IN CHILDRENObjective: To evaluate the intestinal barrier function in gastrointestinal forms of food allergy in children. Materials and methods: We examined 109 children aged 3 months to 3 years old with a diagnosis of gastrointestinal form of food allergy. Permeability of the intestinal wall was assessed by the method of Petrov et al (Volgograd Medical Academy), and the level of secretory IgA in feces was determined. Results: 25 patients (35%) showed an increase in the permeability of the intestinal wall compared with the control group of healthy children. During spectrophotometry, the ratio of the optical densities of mannitol and lactulose in the samples obtained from patients was negative for FPIES - (-0.15 + 0.008), and for allergic enteropathy (- 0.1 + 0.005.). The sIgA values in the group of children with FPIES are 1.5 times, and with allergic enteropathy they exceeded the norm by 1.6 times. It was found that the higher the sIgA value, the harder the disease progressed. Conclusions: Thus, in FPIES and in allergic enteropathy, an increase in the permeability of the intestinal wall is noted. It is likely that increased intestinal permeability is a direct consequence of the disease or it may be an etiological factor in the development of gastrointestinal food allergy.
Journal of hepato-gastroenterological research -
THE ACTIVITY OF ANTIMICROBIAL PEPTIDES AND PRO-INFLAMMATORY CYTOKINES IN THE MIXED FORM OF CYSTIC FIBROSIS IN CHILDRENDetermine the activity of fecal β-defensin-2 and calprotectin and pro-inflammatory cytokines in young children with a mixed form of cystic fibrosis. The study involved 37 children with cystic fibrosis aged 2 months to 3 years, who were hospitalized in the Department of Gastroenterology RSSPMC of Pediatrics. It was found a four-fold increase in fecal calprotectin in children with cystic fibrosis compared with the control (p <0.001). Fecal β defensin-2 was increased 1.6 times in patients with cystic fibrosis (р<0.05). The results of measuring the activity of tumor necrosis factor alpha in children with cystic fibrosis showed an increase in its values in patients with cystic fibrosis - 6.9 + 2.3 ng / ml at a rate of 4.3 + 0.7 ng / ml (p <0.05). The highest results were observed in IL1 10.4 + 3.9 ng / ml (p <0.001), which reflects the increased activity of macrophages involved in maintaining the inflammatory process. Thus, there is clear evidence of intestinal inflammation in children with a mixed form of cystic fibrosis, which can negatively affect the patient’s nutritional status, which in turn adversely affects pulmonary function and survival. The data obtained are the basis for optimizing therapy aimed at improving bowel function.
Journal of hepato-gastroenterological research -
Severe combined trauma to the abdomen is a particular type of injury and one of the leading causes of deaths of the wounded and injured both in peacetime and war time. Damage to the abdomen is directly correlated with 30% of fatal out comes recorded annually due to car accidents and has a significant impact on the outcome in another 58% of accidents; abdominal trauma is usually accompanied by significant dysfunctions of the vital organs of the abdominal cavity and retroperitoneal space, which subsequently cause a metabolic disorder, the activities of other organs and systems. Most patients with severe combined abdominal trauma can be saved with a quick diagnosis (peritonitis and hemoperitonium), as well as modern active surgical tactics. -
DIETHERAPY IN FUNCTIONAL DISORDERS OF THE GASTROINTESTINAL BODIES IN CHILDREN OF EARLY AGEThe article discusses modern ideas about the causes of the most common functional disorders of the gastrointestinal tract in young children. The data on correction of nutrition with therapeutic mixtures and their effectiveness in functional disorders of the gastrointestinal tract in children aged 1.5 to 6 months who are on artificial feeding are presented.
Journal of hepato-gastroenterological research -
RESEARCH OF THE LONG-TERM OUTCOMES OF PORTOSYSTEMIC SHUNTING DEPENDING ON THE ETIOLOGY OF LIVER CIRRHOSISPurpose. Conduct a summary analysis of the results after the portosystemic shunting depending on the etiology of liver cirrhosis. Material and methods. The study selected 109 patients with cirrhosis of the liver, operated operated by the RSSPMCS named after acad. V.Vakhidov in 2014-2017. With hepatitis B, B + D and C - 72 patients. To compare the features of the course of the late postoperative period, the study included patients with alcoholic cirrhosis of the liver (n = 21) and idiopathic form (n = 16). Results. In hepatitis B liver cirrhosis within 5 years after portosystemic shunting, 10 out of 32 (31.3%) patients died, in HBV and HDV cirrhosis - 18 out of 26 (69.2%), HCV - 4 out of 14 (28, 6%), alcoholic– 7 out of 21 (33.3%) and idiopathic - 4 out of 16 (25%) patients. In the structure of mortality in HBV, hepatic failure accounted for 21.9% (7 of 32) cases, hemorrhagic syndrome - 9.4% (3), with HBV and HDV cirrhosis, these figures were 53.8% (14 of 26) and 15.4% (4) respectively, with HCV - 21.4% (3 out of 14) and 7.1% (1), with alcoholic - 23.8% (5 out of 21) and 9.5% (2) and for idiopathic, 12.5% (2 of 16) and 12.5% (2). A total of 66 (60.6%) patients were alive in all species in terms of 5 years of follow-up after surgery, the mortality rate was 39.4% (43 of 109 patients).
Journal of hepato-gastroenterological research -
EXTERNAL HEPATITIS MANIFESTATIONS OF CHRONIC VIRAL HEPATITIS CHepatitis C virus has not only hepatotropy, but can also affect various organs and systems. The main role in this pathology is played by cryoglobulins
Journal of hepato-gastroenterological research
1-25 of 702
