37 research outputs found
Неселективные β-блокаторы в первичной профилактике кровотечений у больных с асцитом, включенных в лист ожидания трансплантации печени
Objective: to determine the efficacy of non-selective beta-blockers (NSBBs) in the primary prevention of bleeding esophageal varices and to assess their impact on the survival of patients with ascites enrolled in the liver transplant waiting list (LTWL).Materials and methods. We carried out a retrospective comparative study of cirrhotic patients with severe ascites and esophageal varices without bleeding before enrollment in the LTWL. Primary prophylaxis of variceal bleeding included the use of NSBBs (n = 97, group 1). These drugs were not used in the other patients (n = 91, group 2).Results. There were no significant differences between the groups in terms of clinical, laboratory and demographic parameters, MELD scores and Child-Turcotte-Pugh (CTP) classes for cirrhosis. Patient groups included in the study had no significant differences with respect to incidence of medium- and large-sized varices and incidence of severe ascites. Bleeding incidence was significantly lower in the NSBBs group than in the non-NSBBs group (52.6% and 95.6%, respectively, p = 0.0001).Conclusion. NSBBs constitute an efficacious therapy in primary prophylaxis of esophageal variceal bleeding, thereby saving life and preventing delisting of patients with ascites from the LTWL.Цель: определение эффективности неселективных β-блокаторов в первичной профилактике пищеводных кровотечений и оценка их влияния на выживаемость пациентов с асцитом, включенных в лист ожидания трансплантации печени.Материалы и методы. Проведено ретроспективное сравнительное исследование пациентов с циррозом печени, с выраженными формами асцита и развитием варикозных узлов пищевода, не имевших эпизодов кровотечений до включения в лист ожидания трансплантации печени. Первичная профилактика кровотечений из варикозных узлов пищевода включала использование неселективных Р-блокаторов (n = 97, первая группа), у других пациентов терапия этими препаратами не проводилась (n = 91, вторая группа).Результаты. Не было отмечено значимых различий между группами по клиническим, лабораторным и демографическим параметрам, показателям MELD и классам цирроза Child— Turcotte-Pugh. Группы пациентов, включенных в исследование, не имели значимых различий в частоте варикозных узлов среднего и большого размера и частоте выраженных форм асцита. Частота развития кровотечений была достоверно ниже в группе пациентов, получавших неселективные β-блокаторы, чем в группе больных без проведения этой терапии (52,6 и 95,6% соответственно, р = 0,0001). Выживаемость пациентов была достоверно выше в группе больных, получавших неселективные Р-блокаторы, чем в группе больных без данной терапии (40,2 и 4,4% соответственно, р = 0,0001).Заключение. Использование в терапии неселективных β-блокаторов является эффективным методом первичной профилактики кровотечений из варикозных узлов пищевода, обеспечивая сохранение жизни и предупреждение выбывания пациентов с асцитом из листа ожидания трансплантации печени
The parodont reaction by both supragingival and subgingival arranging an artificial crown edge
The quantity of gingival liquid and Са, P, Na, К containing in it from 220 almost healthy persons with partly adentia was studied before and after prosthetics with fixed dental bridges (stamped-soldered and whole piece metal-ceramic ones) at the different correlation between the edge of artificial crown and the gum (the crowns had been placed at the level of gum or they had been drowned in the gingival fissure by 0,5 mm). The investigations were conducted in 1 and 5 months respectively. Crowns (stamped, metal-ceramic) were not established to have damaging effect to be placed at the gum level. But on the contrary as stamped as metal-ceramic crowns being drowned in the gingival fissure by 0,5 mm have the damaging effect that has been confirmed by increasing both the quantity of gingival liquid and the content of studied macro- and microelements in it.У 220 пациентов (120 жен. и 100 муж.) в возрасте от 20 до 40 лет практически здоровых с частичной адентией было изучено количество десневой жидкости и содержание в ней Са, Р, Na,K, до и после протезирования несъемными мостовидными протезами (штамповано - паяные и цельнолитые металлокерамические) при различном соотношении края искусственной коронки и десны (коронки располагали на уровне десны и погружали в десневую щель на 0,5 мм). Исследования проводились через 1 месяц и 5 лет после протезирования. Установлено, что коронки (штампованые, металлокерамические) не наносят повреждающего эффекта при расположении на уровне десны, напротив, наносят повреждающий äффект, как штампованые, так и металлокерамические погруженные в десневую щель на 0,5 мм, о чем свидетельствуют увеличения количества десневой жидкости и содержание изучаемых макро - и микроэлементов в ней
The Russian consensus on the diagnosis and treatment of chronic pancreatitis: Enzyme replacement therapy
The Russian consensus on the diagnosis and treatment of chronic pancreatitis has been prepared on the initiative of the Russian Pancreatology Club to clarify and consolidate the opinions of Russian specialists (gastroenterologists, surgeons, and pediatricians) on the most significant problems of diagnosis and treatment of chronic pancreatitis. This article continues a series of publications explaining the most significant interdisciplinary consensus statements and deals with enzyme replacement therapy
Russian consensus on exoand endocrine pancreatic insufficiency after surgical treatment
The Russian consensus on exo - and endocrine pancreatic insufficiency after surgical treatment was prepared on the initiative of the Russian "Pancreatic Club" on the Delphi method. His goal was to clarify and consolidate the opinions of specialists on the most relevant issues of diagnosis and treatment of exo - and endocrine insufficiency after surgical interventions on the pancreas. An interdisciplinary approach is provided by the participation of leading gastroenterologists and surgeons
Российский консенсус по профилактике, диагностике и лечению рака желудка
The Russian consensus on prevention, diagnostic and treatment of gastric cancer was prepared on the initiative of the Moscow clinical scientific center named after A. S. Loginov according to the Delphi method. Its aim was to clarify and consolidate the opinions of specialists on the most relevant issues of prevention, diagnosis and treatment of gastric cancer. An interdisciplinary approach was provided by the participation of leading gastroenterologists, oncologists and surgeons.Российский консенсус по профилактике, диагностике и лечению рака желудка подготовлен по инициативе Московского клинического научного центра им А. С. Логинова ДЗМ по Дельфийской системе. Его целью явилась консолидация мнений отечественных специалистов по наиболее актуальным вопросам профилактики, скрининга, диагностики и лечения рака желудка. Междисциплинарный подход обеспечен участием ведущих гастроэнтерологов, онкологов и хирургов.Цель статьи: представить положения Российского консенсуса по профилактике, диагностике и лечению рака желудка
Investigation of gastric motility in patients with the overlap syndrome of the gastroesophageal reflux disease and functional dyspepsia
Rationale: The phenomenon of overlap of two disorders, non-erosive gastroesophageal reflux disease (NERD) and functional dyspepsia (FD) is an important clinical problem, while the symptoms in such patients are more severe and prevalent than in those with non-overlapping NERD or FD. This phenomenon may lead to treatment failure, if therapy does not take into account the specific pathophysiological mechanisms of the NERD and FD overlap.Aim: To study motility of the proximal and distal parts of the stomach in patients with the overlap syndrome of NERD with FD.Materials and methods: The study enrolled 56 patients (34 women and 22 men), aged from 18 to 45 years, who met the diagnostic criteria for NERD and FD (the Rome criteria III, esophageal endoscopy, 24-hour pH measurement or 24-hour impedance pH measurement), and had both NERD and FD symptoms simultaneously (overlap); 46 healthy volunteers. The accommodation of the proximal (fundal) part of the stomach and motility of the distal gastric part was assessed by ultrasonography (Aixplorer, SuperSonic Imagine, France, with convex probe 1–6 MHz) before and after the intake of the liquid test food. The patients filled in questionnaires to assess the symptoms and their severity (scored from 0 to 3). The difference between their mean ± standard deviation (SD) values was assessed by Students t-test and was considered significant at p < 0.05.Results: After intake of the liquid test food, the patients with the FD and NERD overlap syndrome demonstrated an advanced and statistically significant gastric motility abnormality both in its proximal and distal parts, compared to healthy control: accommodation disturbances and its reduction, decreased amplitude (61.4 ± 7.5 vs 90.2 ± 6.9%, p < 0.05), frequency of contractions of the antrum during 3-minute interval (4.3 ± 1.5 vs 9.7 ± 1.4, p < 0.05), antral motility index (4.3 ± 1.4 vs 8.8 ± 1.3%, p < 0.05), and gastric emptying (37.1 ± 14.5 vs 69.1 ± 19.5%, p < 0.05). Gastric accommodation abnormalities were associated with a statistically significant increase in the severity of the following symptoms: abdominal distention, postprandial feeling of fullness, early satiety, eructation, and heartburn (р< 0.05 for all symptoms).Conclusion: Detection of gastric accommodation and evacuation abnormalities that determine the overlap syndrome, indicate some common mechanisms of pathophysiology of FD and NERD, which should be taken into account for therapy optimization