Clinical and laboratory features of iron deficiency in outpatients with Helicobacter Pylori infection

The purpose of the study is to identify the clinical features and risk of developing ID in outpatients with H. pylori infection.Цель исследования – выявить клинические особенности и риск развития ЖДС у амбулаторных пациентов с инфекцией H. pylori

Structural-functional state of the myocardium in patients with arterial hypertension associated with gastroesophageal reflux disease

Objective: to study the structural-functional state of the myocardium in patients with arterial hypertension (AH) in combination with gastroesophageal reflux disease (GERD). Materials and methods. When using questionnaires, clinical examination and echocardiography were examined 120 patients, among whom 30 people had been diagnosed with hypertension without comorbidities, in 30 - to isolate flows GERD, and 60 patients - occurred during the combined hypertension and GERD. Results. The parameters that characterize a state of central hemodynamics, and structural and functional parameters of myocardium in patients with isolated over AG, GERD, and in combination. Conclusion. A comparative analysis of selected features of myocardial remodeling, depending on the stage, the degree of hypertension and categories of cardiovascular risk.Цель исследования: изучить структурно-функционального состояния миокарда у больных артериальной гипертензией (АГ) в сочетании с гастроэзофагеальной рефлюксной болезнью (ГЭРБ). Материалы и методы. При использовании анкетирования, клинических методов обследования и зхокардиографии обследовано 120 пациентов, среди которых у 30 человек была диагностирована АГ без сопутствующей патологии, у 30 - изолировано протекающая ГЗРБ, а у 60 пациентов - наблюдалось сочетанное течение АГ и ГЗРБ. Результаты. Изучены показатели, характеризующие как состояние центральной гемодинамики, так и структурно-функциональные параметры миокарда у лиц с изолированным течением АГ, ГЗРБ и при их сочетании. Заключение. В результате сравнительного анализа выделены особенности ремоделирования миокарда в зависимости от стадии, степени АГ и категории сердечно-сосудистого риска

Non-alcoholic fatty liver disease and gastroesophageal reflux disease as a model of a patient with a high cardiovascular risk

A high level of cardiovascular diseases and the increase in the number of patients with excessive body weight indicate eating disorders among the population not only of Russia, but also in the whole world. Rhetorical remains the question of determining the primary pathogenetic link. However, the understanding and control of cardiovascular risk will entail improving the quality of life of patients with multiple organ pathology and positive changes in the dynamics of statistical indicators of health. The aim of our study was to study the features of cardiovascular system in 20 patients with nonalcoholic fatty liver disease (NAFLD) and gastroesophageal reflux disease (GERD) aged 18 to 60 years. As a result, we demonstrated a high prevalence of modifiable and non-modifiable factors of cardiovascular risk in patients with NAFLD and GERD, the leading of which was an inherited family history, arterial hypertension, inadequate physical activity, nicotine dependence, excessive alcohol consumption.Высокий уровень сердечно-сосудистых заболеваний и увеличение численности пациентов с избыточной массой тела свидетельствуют о нарушениях пищевого поведения среди населения не только россии, но и в мире в целом. риторическим остается вопрос определения первичного патогенетического звена. однако, понимание и возможность управления кардиоваскулярными рисками, повлечет за собой повышение качества жизни пациентов с полиорганной патологией и положительные сдвиги в динамике статистических показателей здравоохранения. Целью нашего исследования было изучение особенностей состояния сердечно-сосудистой системы у 20 больных с неалкогольной жировой болезнью печени (НаЖБП) и гастроэзофагеальной рефлюксной болезнью (ГЭрБ) в возрасте от 18 до 60 лет. В результате, нами была продемонстрирована высокая распространенность модифицируемых и немодифицируемых факторов кардиоваскулярных рисков у больных НаЖБП и ГЭрБ, ведущими из которых были наследственная отягощенность, артериальная гипертензия, недостаточная физическая активность, никотиновая зависимость, избыточное употребление алкоголя

Prevalence of Helicobacter pylori-associated diseases in the Ural Federal District

Introduction Helicobacter pylori has the most pronounced oncogenic potential among known biological carcinogens of humans. Helicobacter positivity leads to the development of chronic gastritis and with prolonged persistence of infection in the gastric mucosa it is associated with the development of atrophic gastritis and adenocarcinoma of the stomach. According to international data, the prevalence of infection in Russia corresponds to the level of countries with low socio-economic status. The domestic literature contains data for a limited number of regions, such as North-West Russia, Siberia and the Far East. The aim of the study was to determine the prevalence of Helicobacter pylori infection and chronic atrophic gastritis among patients residing in the Ural Federal District and to identify risk factors for these diseases using modern diagnostic methods used in clinical practice. Materials and methods Observational non-interventional anonymous cross-sectional study of 11,721 primary patients among those tested for H. pylori infection residing in the Ural Federal District. 13C-urease breath test was performed in 10,882 patients, FGDS with gastric mucosal biopsy according to OLGA and histological evaluation of biopsy specimens – in 839 patients. Results The prevalence of H. pylori infection among primary care patients by 13C-UT was 46.9 % and that of chronic atrophic gastritis by histological evaluation of a biopsy specimen was 24.9 %. The risk of chronic atrophic gastritis was higher in those infected with H. pylori (OR 1.71; 95 % CI: 1.24–2.37, p = 0.002) and in patients over 60 years old. Discussion The resulting prevalence of H. pylori infection in the Ural Federal District is below the levels reported in the current literary for Russia. The increasing prevalence of infection with age confirms the principle that the prevalence of infection depends on changing socio-economic conditions in a generation. The observed prevalence of chronic atrophic gastritis is comparable with the national data. The risk of gastric mucosal atrophy increases with age and in the presence of H. pylori infection, which prompts active screening of gastropathology in this category of individuals. Conclusion The prevalence of H. pylori infection and atrophic gastritis among primary patients, as determined by reference diagnostics, was 46.9 % and 24.9 %, respectively.Введение. Бактерия Helicobacter pylori обладает наиболее выраженным онкогенным потенциалом среди известных биологических канцерогенов человека. Положительный хеликобактерный статус приводит к развитию хронического гастрита и при длительной персистенции инфекции в слизистой оболочке желудка ассоциирован с развитием атрофического гастрита и аденокарциномы желудка. По международным данным, распространенность инфекции в России соответствует уровню стран с низким социально-экономическим статусом. В отечественной литературе присутствуют данные для ограниченного числа регионов: Северо-Западной части России, Сибири и Дальнего Востока. Цель работы – определить распространенность инфекции Helicobacter pylori и хронического атрофического гастрита среди пациентов, проживающих в Уральском федеральном округе, и выявить факторы риска данных заболеваний посредством современных методов диагностики, применяемых в клинической практике. Материалы и методы. Обсервационное неинтервенционное анонимное кросс-секционное исследование 11 721 первичного пациента. Все пациенты, проходившие обследование на инфекцию H. pylori, проживали на территории Уральского федерального округа. 13С-уреазный дыхательный тест выполнен 10 882 больным, ФГДС с биопсией слизистой оболочки желудка по OLGA (англ. Operative Link for Gastritis Assessment) и гистологической оценкой биоптатов – 839 пациентам. Результаты. Распространенность инфекции H. pylori среди пациентов, первично обратившихся за медицинской помощью, по результатам 13С-УДТ составила 46,9 %, а хронического атрофического гастрита по данным гистологической оценки биоптата – 24,9 %. Риск развития хронического атрофического гастрита выше у лиц, инфицированных H. pylori (ОШ 2,25; 95 % ДИ:1,62–3,11, р < 0,001), и пациентов старше 60 лет. Обсуждение. Полученная распространенность инфекции H. pylori в Уральском федеральном округе ниже представленных в современных литературных источниках уровней для России. Нарастание распространенности инфекции с возрастом подтверждает принцип зависимости распространенности инфекции от изменения социально-экономических условий жизни поколения. Выявленная распространенность хронического атрофического гастрита сопоставима с отечественными данными. Риск развития атрофии слизистой оболочки желудка повышается с возрастом и при наличии инфекции H. pylori, что побуждает к активному скринингу гастропатологии у данной категории лиц. Заключение. Распространенность инфекции H. pylori и атрофического гастрита среди первичных пациентов, определенная на основании референсных методов диагностики, составила 46,9 % и 24,9 % соответственно

Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period

STATUS OF VENOUS HEMODYNAMICS IN PATIENTS WITH ARTERIAL HYPERTENSION IN VARIOUS AGE GROUPS

Whereas evolution changes of central hemodynamics in healthy subjects and patients with arterial hypertension (AH) at various ages, literature lacks data on aging changes of hemodynamics in capacity vessels. The issue of possible influence of functional changes in the venous system on the development of postural hypotension in hypertensive subjects of various age groups is also studied insufficiently. 140 patients with moderate arterial hypertension aged 17 to 50 have been studied. Main values of central hemodynamics and peripheral venous blood Suppl.y at baseline and following an active postural test have been analyzed. The results of the study suggest progressing of venous hypertension patterns in AH patients with age and decrease of adequate vascular Suppl.y on the part of capacity vessels during a postural test

Specific Features of Vascular Endothelium in Patients with Severe Forms of Inflammatory Bowel Diseases

Aim. In this work, we set out to assess the specific features of vascular endothelium in patients suffering from severe (pan-ulcerative) and complicated forms of ulcerative colitis (UC) and Crohn’s disease (CD).Materials and methods. The research sample consisted in 65 patients with UC (n = 45) and CD (n = 20), who were either in the acute phase or had been diagnosed with such conditions for the first time. For assessing endothelial dysfunction (ED), we used such markers as levels of vascular endothelial growth factor (VEGF) in the blood serum and the number of plasma desquamated endotheliocytes (DEC).Results. The indicators of vascular endothelial dysfunction are shown to be significantly higher in patients with severe, pan-ulcerative forms of inflammatory bowel diseases (IBD). A statistically significant relationship has been established between ED indicators and the severity and localisation of the pathological process, the extra-intestinal manifestations and complications of the disease. A dependence of the endothelial dysfunction indicators on the UC endoscopic activity has been determined. A positive correlation between the levels of VEGF and DEC and the markers of systemic inflammation (ESR, CRP and fibrinogen) has been revealed.Conclusion. It is determined that, in IBD patients, endothelium dysfunction is manifested in an increase in the VEGF and DEC levels. The indicators of endothelial dysfunction are shown to be directly correlated with the serum markers of systemic inflammation. Therefore, VEGF and DEC values can be used not only as criteria for assessing the intensity of IBD, but also as predictors of a complicated disease course

Specific Features of Vascular Endothelium in Patients with Severe Forms of Inflammatory Bowel Diseases

Aim. In this work, we set out to assess the specific features of vascular endothelium in patients suffering from severe (pan-ulcerative) and complicated forms of ulcerative colitis (UC) and Crohn’s disease (CD).Materials and methods. The research sample consisted in 65 patients with UC (n = 45) and CD (n = 20), who were either in the acute phase or had been diagnosed with such conditions for the first time. For assessing endothelial dysfunction (ED), we used such markers as levels of vascular endothelial growth factor (VEGF) in the blood serum and the number of plasma desquamated endotheliocytes (DEC).Results. The indicators of vascular endothelial dysfunction are shown to be significantly higher in patients with severe, pan-ulcerative forms of inflammatory bowel diseases (IBD). A statistically significant relationship has been established between ED indicators and the severity and localisation of the pathological process, the extra-intestinal manifestations and complications of the disease. A dependence of the endothelial dysfunction indicators on the UC endoscopic activity has been determined. A positive correlation between the levels of VEGF and DEC and the markers of systemic inflammation (ESR, CRP and fibrinogen) has been revealed.Conclusion. It is determined that, in IBD patients, endothelium dysfunction is manifested in an increase in the VEGF and DEC levels. The indicators of endothelial dysfunction are shown to be directly correlated with the serum markers of systemic inflammation. Therefore, VEGF and DEC values can be used not only as criteria for assessing the intensity of IBD, but also as predictors of a complicated disease course