ІНФОРМАЦІЙНІ ТЕХНОЛОГІЇ І СИСТЕМИ ДЛЯ РАННЬОЇ ДІАГНОСТИКИ ОНКОЛОГІЧНИХ ЗАХВОРЮВАНЬ ЗА РІВНЕМ ЦИРКУЛЮЮЧИХ ПУХЛИННИХ КЛІТИН

Most modern systems and technologies of the automated analysis of medical microscopic images and early diagnostics of oncological diseases are analyzed in the article. The methods and algorithms used for image processing, segmentation, determination of parameters of the object, which are determined manually and require additional knowledge, make it significantly complicated for their practical application in clinical medicine due to insufficient knowledge of medical staff.В статье проанализировано большинство современных систем и технологий автоматизированного анализа медицинских микроскопических изображений и ранней диагностики онкологических заболеваний. Методы и алгоритмы, применяемые для обработки изображений, сегментации, определения параметров объекта, определяются в ручном режиме и требуют дополнительных знаний, это существенно затрудняет их практическое применение в клинической медицине вследствие недостаточного количества знаний у медицинского персонала.Проаналізовано більшість сучасних систем і технологій автоматизованого аналізу медичних мікроскопічних зображень та ранньої діагностики онкологічних захворювань. Методи та алгоритми, що застосовуються для оброблення зображень, сегментації, визначення параметрів об'єкта, визначаються в ручному режимі та потребують додаткових знань, це суттєво ускладнює їх практичне застосування в клінічній медицині внаслідок недостатньої кількості знань у медичного персонал

Digestive Disease Mortality Dynamics During New Coronavirus Infection Pandemic in Different Subjects of Russian Federation

Aim. An analysis of digestive disease mortality dynamics in different subjects of the Russian Federation in course of the new coronavirus infection pandemic.Key points. In most subjects of the Russian Federation, the first half of 2021 enduring the COVID-19 pandemic has witnessed a higher overall mortality from digestive diseases and from peptic ulcer, liver and pancreatic illnesses compared to the same period in 2020. This situation may have roots in both the adverse impact of coronavirus infection on pre-existing digestive diseases and shortages in providing specialty medical aid to gastroenterological patients during the pandemic. Improved outpatient care and remote counselling, as well as successful educational measures, may reduce gastroenterological disease-associated mortality.Conclusion. Most regions of Russia have registered a growing mortality from digestive diseases at the new coronavirus infection pandemic due to the SARS-CoV-2 adverse impact on illness progression, as well as imposed difficulties in providing specialty medical aid

Diagnosis and Treatment of Irritable Bowel Syndrome: Clinical Recommendations of the Russian Gastroenterological Association and Association of Coloproctologists of Russia

Aim. Current clinical recommendations accentuate current methods for the diagnosis and treatment of irritable bowel syndrome (IBS).Key points. IBS is a functional bowel disorder manifested with recurrent, at least weekly, abdominal pain with the following attributes (any two leastwise): link to defecation, its frequency or stool shape. The symptoms are expected to persist for at minimum three months in a total six-month follow-up. Similar to other functional gastrointestinal (GI) disorders, IBS can be diagnosed basing on the patient symptoms compliance with Rome IV criteria, provided the absence of potentially symptom-causative organic GI diseases. Due to challenging differential diagnosis, IBS can be appropriately established per exclusionem, with pre-examination as follows: general and biochemical blood tests; tissue transglutaminase IgA/IgG antibody tests; thyroid hormones test; faecal occult blood test; hydrogen glucose/ lactulose breath test for bacterial overgrowth; stool test for enteric bacterial pathogens and Clostridium difficile A/B toxins; stool calprotectin test; abdominal ultrasound; OGDS, with biopsy as appropriate; colonoscopy with biopsy. The IBS sequence is typically wavelike, with alternating remissions and exacerbations often triggered by psychoemotional stress. Treatment of IBS patients includes dietary and lifestyle adjustments, various-class drug agents prescription and psychotherapeutic measures.Conclusion. Adherence to clinical recommendations can facilitate timely diagnosis and improve medical aid quality in patients with different clinical IBS variants

Diagnosis and Treatment of Irritable Bowel Syndrome: Clinical Recommendations of the Russian Gastroenterological Association and Association of Coloproctologists of Russia

Aim. Current clinical recommendations accentuate current methods for the diagnosis and treatment of irritable bowel syndrome (IBS).Key points. IBS is a functional bowel disorder manifested with recurrent, at least weekly, abdominal pain with the following attributes (any two leastwise): link to defecation, its frequency or stool shape. The symptoms are expected to persist for at minimum three months in a total six-month follow-up. Similar to other functional gastrointestinal (GI) disorders, IBS can be diagnosed basing on the patient symptoms compliance with Rome IV criteria, provided the absence of potentially symptom-causative organic GI diseases. Due to challenging differential diagnosis, IBS can be appropriately established per exclusionem, with pre-examination as follows: general and biochemical blood tests; tissue transglutaminase IgA/IgG antibody tests; thyroid hormones test; faecal occult blood test; hydrogen glucose/ lactulose breath test for bacterial overgrowth; stool test for enteric bacterial pathogens and Clostridium difficile A/B toxins; stool calprotectin test; abdominal ultrasound; OGDS, with biopsy as appropriate; colonoscopy with biopsy. The IBS sequence is typically wavelike, with alternating remissions and exacerbations often triggered by psychoemotional stress. Treatment of IBS patients includes dietary and lifestyle adjustments, various-class drug agents prescription and psychotherapeutic measures.Conclusion. Adherence to clinical recommendations can facilitate timely diagnosis and improve medical aid quality in patients with different clinical IBS variants

Morbidity and Mortality Rates from Digestive Diseases in the RF Northwestern Federal District (NWFD) and Measures to Reduce Them

Aim: to analyze the dynamics of morbidity and mortality from digestive diseases, as well as their causes, in the RF Northwestern Federal District (NWFD).Materials and methods. A statistical analysis was carried out on the basis of the 2007–2017 annual reports of the Medical Information and Analytical Center (MIAC) in St. Petersburg and the reports of the chief gastroenterologists of the Northwestern Federal District subjects.Results. In the RF Northwestern Federal District, an increase in both morbidity and mortality from digestive diseases is observed. The main non-oncological reasons for the development of these disorders include alcoholic liver disease, chronic alcoholic pancreatitis, peptic ulcer complications and NSAID-associated gastropathies. Along with a decrease in the incidence of gastric cancer, an increase in the incidence of colorectal cancer, as well as pancreatic cancer, is observed. A decrease in mortality from all the aforementioned cancer localizations is revealed.Conclusions. The main reasons for the increase in morbidity and mortality due to gastroenterological diseases in the RF Northwestern Federal District include alcohol abuse among the population, inadequate prevention of gastric helicobacteriosis, insufficient expertise of physicians in terms of Helicobacter pylorieradication and cancer prevention

Morbidity and Mortality Rates from Digestive Diseases in the RF Northwestern Federal District (NWFD) and Measures to Reduce Them

Aim: to analyze the dynamics of morbidity and mortality from digestive diseases, as well as their causes, in the RF Northwestern Federal District (NWFD).Materials and methods. A statistical analysis was carried out on the basis of the 2007–2017 annual reports of the Medical Information and Analytical Center (MIAC) in St. Petersburg and the reports of the chief gastroenterologists of the Northwestern Federal District subjects.Results. In the RF Northwestern Federal District, an increase in both morbidity and mortality from digestive diseases is observed. The main non-oncological reasons for the development of these disorders include alcoholic liver disease, chronic alcoholic pancreatitis, peptic ulcer complications and NSAID-associated gastropathies. Along with a decrease in the incidence of gastric cancer, an increase in the incidence of colorectal cancer, as well as pancreatic cancer, is observed. A decrease in mortality from all the aforementioned cancer localizations is revealed.Conclusions. The main reasons for the increase in morbidity and mortality due to gastroenterological diseases in the RF Northwestern Federal District include alcohol abuse among the population, inadequate prevention of gastric helicobacteriosis, insufficient expertise of physicians in terms of Helicobacter pylorieradication and cancer prevention

ANTIBODIES TO THE CYTOPLASM OF NEUTROPHILS: A MARKER OF UNFAVORABLE CLINICAL COURSE IN NON-SPECIFIC ULCERATIVE COLITIS

Antibodies to the cytoplasm of neutrophils (p-ANCA) are detectable in 67% of patients with ulcerative colitis (UC). We have revealed typical clinical features of the patients with diagnostic p-ANCA titer, i.e., longer disease duration, prolonged fevers, and increased stool frequency. Moreover, thrombocytosis, leukocytosis and hypoalbuminemia are more common in this group. By endoscopic examination, mucosal ulcers of the colon are significantly more frequent in this group of patients. We have also noted higher rates of severe and relapsing cases among p-ANCA-positive patients. The data obtained allow us to suggest that the diagnostic titers of p-ANCA are predictive for unfavorable prognosis in UC

The effect of maintenance therapy on Crohn’s disease clinical outcomes

Aim of investigation. To study the effect of maintenance therapy on clinical outcomes of Crohn’s disease (CD) in patients with inflammatory and complicated forms. Material and methods. Five-year prospective study of 210 patients with CD receiving maintenance therapy was carried out. Treatment response was estimated in real-life conditions according to the guidelines of European Crohn's and Colitis Organisation (ECCO). Treatment response and failure at different types of pharmaceutical treatment were estimated. Results. At mesalazine maintenance therapy in patients with inflammatory forms of CD there was no statistically significant demand in treatment enhancement for medium-term perspective (р=0,0088, OR=0,46, 95% CI=0,26-0,80). «The steroid-sparing effect» of immunosuppressors was observed generally in all patients with inflammatory form of disease, which provided reduction of steroid dependency rate by 17%. Repeated prescription of systemic steroids led to development ofsteroid-dependency in complicated forms more frequently (p=0,0083, OR=10,1, 95% CI=1,9-52,5). The long-term outcomes related to biological maintenance therapy demonstrate more frequent mucosal healing at inflammatory (p=0,0423, OR=3,3, 95%CI=1,2-9,4), though not for complicated forms of disease. Conclusions. Mesalazine maintenance therapy is possible only at patients with the inflammatory form of CD without systemic activity under close follow-up by physician. In order to avoid disease progression it is necessary to avoid repeated application of systemic steroids at uncomplicated forms of disease. In complicated cases the combination of systemic steroids and immunosuppressants is ineffective. Biological therapy should be considered as disease-modifying treatment in patients with inflammatory forms of CD. The decision on pharmaceutical treatment of patients with complications should be made by gastroenterologists in consort with surgeons-coloproctologists

Chronic inflammatory bowel diseases: the course and treatment methods in Russian Federation

Aim of investigation. To evaluate the prevalence of clinical manifestations and variants of progression for ulcerative colitis (UC) and Crohn’s disease (CD) in population of the Russian Federation. Material and methods. The present investigation was designed as population-based one-stage observational study. The clinical data, treatment methods, laboratory tests results and the rate of adverse effects for patients with inflammatory bowel diseases (IBD) from 8 gastroenterological centers were obtained. Severity grade was estimated by a doctor. Encoding of concurrent therapy, complications and systemic manifestations was carried out according to MedDRA. Results. Original study included overall 1000 patients (667 UC patients, 333 CD patients). Most of the study patients were diagnosed to have chronic relapsing (53.1% for UC; 45.0% for CD) or chronic persistent (32.8% with UC; 39.65 with CD) course of disease, mild attack was revealed in 51.3% of UC patients and 52.3% of CD patients, moderate attack in 46.6 and 47.3% respectively. Systemic manifestations and complications of the disease were found in 33.5% of patients. At the moment of enrollments to the study patients received maintenance therapy, most frequently - by the drugs containing 5-aminosalicylic acid (72.0% for UC, 59.5% for CD) and immunosuppressors (28.0% for UC, 42.6% for CD); biological agents are prescribed rarely (11.75% for UC, 20.4% for CD). Previous surgical intervention was present in the past history of 43.8% CD patients and 5.7% - UC patients. The median (range) hospital admissions was 1 (1-10) in those with UC and 1 (1-24) in those with CD. Conclusions. High complication rate, previous surgical intervention and changes of therapeutic tactics demonstrates that treatment approaches to this cohort of IBD patients in the Russian Federation are not optimal enough