SMALL INTESTINAL MESENTERY INVERSION CAUSED BY THE ENTEROLITH FRAGMENTS IN THE PATIENT WITH SMALL INTESTINE DIVERTICULOSIS

This article represented the clinical case of small intestinal mesentery inversion, caused by the enterolith fragments formed in the jejunal diverticulum

RUPTURE OF THE SPLENIC ARTERY ANEURYSM IN PANCREATIC PSEUDOCYST FOLLOWED BY BREAKTHROUGH INTO THE STOMACH

The article presented the clinical case of massive bleeding due to a rupture of the splenic artery aneurysm in a pancreatic pseudocyst followed by breakthrough into the stomach.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information

Antioxidants in the Treatment of Chronic Diffuse Liver Diseases (the Results of the “MAXAR” Observational Program)

In the Russian Federation, liver diseases are most frequently represented by two their nosological forms, i.e., nonalcoholic and alcoholic fatty liver disease (NAFLD and ALD). A successful management of such patients, along with improving the functional state of the liver, requires a careful analysis of patients’ nonspecific complaints. In particular, it is important to investigate asthenic syndrome, which can indirectly result in the exacerbation of liver diseases, thus incurring additional economic costs to national healthcare systems. Therefore, the elucidation of the nature of asthenic syndrome and a search for methods for its resolution seem to be highly relevant research tasks.Aim. This study aims to investigate the effect of the antioxidant drug (the extract of the Amur maackia wood) on the organic and functional components of asthenic syndrome in patients with NAFLD and ALD, who do not show signs of the disease decompensation. Materials and methods. An observational program was carried out under the conditions of daily clinical practice in three Russian cities: Moscow, Chelyabinsk and Vladivostok. 80 patients (40 with NAFLD, 40 with ALD) were comprehensively examined according to a developed program. A number of laboratory indicators that reveal inflammatory processes in the liver were studied, including leukocytes, ESR, ALT, AST, GGTP and CRP. The patients’ psycho-emotional status was assessed using a Daily Fatigue Impact Scale (D-FIS) and a four-dimensional scale for assessing distress, depression, anxiety and somatisation (4DSQ). Results. According to the D-FIS questionnaire, all the patients showed fatigue. According to the 4DSQ questionnaire, a correlation of distress with the level of laboratory indicators was revealed among all the patients. No such a correlation was noted for depression and anxiety in the patients with NAFLD. On the contrary, in the case of ALD, all psycho-emotional disorders (except for somatisation) were positively correlated with the markers of inflammation. It is shown that asthenic syndrome in patients with both NAFLD and ALD has a complex origin, being associated both with inflammatory processes in the liver and psycho-emotional disorders. In all cases under study, the prescription of the preparation led to a decrease in the studied laboratory indicators (inflammation markers) and an increase in the patients’ psycho-emotional status. The latter improvement was manifested in the reduction of distress, depression, anxiety and somatisation, according to the 4DSQ questionnaire, as well as in the reduction of fatigue, according to the D-FIS questionnaire.Conclusion. The results of the observational program have shown that patients with NAFLD and ALD frequently experience such components of asthenic syndrome as distress, depression, anxiety, somatisation and fatigue. The prescription of the preparation is found to result in a decrease in laboratory inflammatory indicators. In addition, the preparation is determined to positively affect the components of asthenic syndrome in patients with NAFLD and ALD. In the course of the treatment, no clinically significant side effects were documented

Antioxidants in the Treatment of Chronic Diffuse Liver Diseases (the Results of the “MAXAR” Observational Program)

In the Russian Federation, liver diseases are most frequently represented by two their nosological forms, i.e., nonalcoholic and alcoholic fatty liver disease (NAFLD and ALD). A successful management of such patients, along with improving the functional state of the liver, requires a careful analysis of patients’ nonspecific complaints. In particular, it is important to investigate asthenic syndrome, which can indirectly result in the exacerbation of liver diseases, thus incurring additional economic costs to national healthcare systems. Therefore, the elucidation of the nature of asthenic syndrome and a search for methods for its resolution seem to be highly relevant research tasks.Aim. This study aims to investigate the effect of the antioxidant drug (the extract of the Amur maackia wood) on the organic and functional components of asthenic syndrome in patients with NAFLD and ALD, who do not show signs of the disease decompensation. Materials and methods. An observational program was carried out under the conditions of daily clinical practice in three Russian cities: Moscow, Chelyabinsk and Vladivostok. 80 patients (40 with NAFLD, 40 with ALD) were comprehensively examined according to a developed program. A number of laboratory indicators that reveal inflammatory processes in the liver were studied, including leukocytes, ESR, ALT, AST, GGTP and CRP. The patients’ psycho-emotional status was assessed using a Daily Fatigue Impact Scale (D-FIS) and a four-dimensional scale for assessing distress, depression, anxiety and somatisation (4DSQ). Results. According to the D-FIS questionnaire, all the patients showed fatigue. According to the 4DSQ questionnaire, a correlation of distress with the level of laboratory indicators was revealed among all the patients. No such a correlation was noted for depression and anxiety in the patients with NAFLD. On the contrary, in the case of ALD, all psycho-emotional disorders (except for somatisation) were positively correlated with the markers of inflammation. It is shown that asthenic syndrome in patients with both NAFLD and ALD has a complex origin, being associated both with inflammatory processes in the liver and psycho-emotional disorders. In all cases under study, the prescription of the preparation led to a decrease in the studied laboratory indicators (inflammation markers) and an increase in the patients’ psycho-emotional status. The latter improvement was manifested in the reduction of distress, depression, anxiety and somatisation, according to the 4DSQ questionnaire, as well as in the reduction of fatigue, according to the D-FIS questionnaire.Conclusion. The results of the observational program have shown that patients with NAFLD and ALD frequently experience such components of asthenic syndrome as distress, depression, anxiety, somatisation and fatigue. The prescription of the preparation is found to result in a decrease in laboratory inflammatory indicators. In addition, the preparation is determined to positively affect the components of asthenic syndrome in patients with NAFLD and ALD. In the course of the treatment, no clinically significant side effects were documented

Bicyclol in the treatment of patients with chronic diffuse liver diseases

Introduction. The increase in serum transaminases (ALT and AST) and the persistence of their high values is associated with morbidity and mortality from liver diseases. Bicyclol has anti-inflammatory and antioxidant effects, which formed the basis for this study.Materials and methods. The study enrolled 51 patients (MELD < 19); hepatitis stage – 84.4%, cirrhosis – 15.6%. Treatment: Bicyclol 75 mg/day for 12 weeks. Criteria of efficacy: dynamics of ALT, AST, CRP; general well-being (D-FIS scale).Results. After 4 weeks of treatment the share of patients with ALT normalization was 50,9% (p < 0,001); with AST normalization – 62.7% (p < 0.001); after 12 weeks - 79,5% and 89,7% respectively (p < 0,001). CRP decreased statistically significantly after 2 and 4 weeks from the beginning of treatment. The D-FIS questionnaire was filled in by 36 patients at the beginning of the study, in 4 weeks - by 35 patients, in 12 weeks – by 32 patients. Median D-FIS decreased from 12 (8.2; 32.2) to 8 (5; 29) points (p < 0,001) after 4 weeks of treatment, after 12 weeks – to 6.5 (3; 28.5) points (p < 0.001). The CRP was positively correlated with the D-FIS value. Fibrosis (“Fibromax”, “Fibroscan”) was studied in 10 additional patients, the dose of Bicyclol was 150/75 mg/day during 6 months, the result was statistically significant (p < 0.001).Conclusion. Application of Bicyclol leads to reduction of fatigue, local and systemic inflammation, fibrosis in chronic diffuse liver diseases regardless of etiology