Efficacy of cimetidin in the prevention of ulcer formation in the stomach during immobilization stress

The effect of stress on the formation of ulcers in the mucous membrane of the stomach, the increase in cyclic adenosine monophosphate level in the gastric tissues, and parietal cell structure alteration. Use of cimetidin prevents these effect

Laser Based ¹³C-urea Breath Test in Quantitative Assessment of Bacterial Colonization, Severity of Inflammation and Atrophy in Gastric Mucosa

Aim: to compare the results of 13C-UBT with the data of morphological analysis of the gastric and duodenal mucosa obtained during gastroduodenoscopy in gastritis and peptic ulcer. To analyze the dependence of the results of diode laser spectroscopy (DLS) based 13C-UBT on age, nosology, activity and severity of the inflammatory process, the degree of atrophy and metaplasia.Materials and methods. The 13C-UBT DLS was performed in 525 patients before the start of eradication therapy and in 196 patients 10–12 weeks after its completion. The breath test was carried out according to a standard protocol using the BSIA patent kit (Great Britain). During endoscopy, 134 patients underwent a biopsy from the upper third of the body of the stomach, the antrum (within 5 cm from the pylorus along the greater curvature) and the duodenal bulb with histological examination with hematoxylin-eosin staining, PAS-reaction and Giemsa. Histological assessment of the state of the gastric mucosa was carried out according to a modified Sydney system with an assessment of morphological changes according to a 4-point visual analog scale (0 to 3+).Results. A total of 525 patients (301 men and 224 women) aged 15–80 years (median 39.8 ± 15.1 years) were examined. 239 (45.5 %) patients were diagnosed with chronic gastritis, chronic duodenitis (including erosive forms). In 286 (54.5 %) patients, peptic ulcer was diagnosed with localization in the stomach — in 42 (8 %), in the duodenum – in 238 (45.3 %), combined lesions — in 9 (1.7 %) cases. Based on the results of 13C-UDT DLS, H. рylori infection was detected in 447 patients. H. рylori was not found in erosive gastritis in 15 %, erosive duodenitis in 21 % and chronic non-erosive gastritis in 23 %. In peptic ulcer of the stomach and duodenum, H. pylori was detected in 93 % and 97 %.A direct linear relationship between the results of the breath test and the quantitative content of H. рylori on the surface of the gastric mucosa was obtained. The parameters of laser 13C-UBT clearly correlate with the degree of severity of mononuclear infiltration of the mucosa (the strength of the connection is 0.78). When comparing the average values of laser 13C-UBT with the total assessment of the degree of mucosal neutrophilic infiltration, no significant relationship was found. With a slight severity of mucosal atrophy, the result of laser based 13C-UBT practically does not change; there is a tendency of a decrease in the breath test with an increase in atrophic changes.Conclusion. Indicators of 13C-UBT correlate with the quantitative content of H. pylori bacteria in the gastric mucosa, the severity of mononuclear infiltration of the gastroduodenal mucous, the severity of atrophic changes

Modern Approaches to Vaccination of Patients with Chronic Liver Diseases and Inflammatory Bowel Diseases against a Novel Coronavirus Infection

Aim. To analyze the literature data on the peculiarities of vaccination of patients with chronic liver diseases (CLD) and inflammatory bowel diseases (IBD) against COVID-19 infection.Key findings. It has been shown that many patients with CLD (cirrhosis of the liver, non-alcoholic fatty liver disease) have a higher risk of severe course of a novel coronavirus infection, which necessitates their vaccination. IBD patients are also subject to vaccination, although the immunomodulatory drugs which they take may reduce its effectiveness. In addition, the correct timing of the vaccine administration is of great importance. Vaccination of patients with CLD and IBD is safe, and the frequency of side effects during its implementation does not differ from that in the general population.Conclusion. Analysis of literature data shows that patients with CLD and IBD are subject to vaccination against COVID-19 infection, which is effective and safe

Gut Microbiota and its Metabolites in Pathogenesis of NAFLD

Aim: to provide information on the results of recent scientific research in the field of non-alcoholic fatty liver disease (NAFLD) metabolomic profiling.Key points. Metabolites of microbial origin are important biological molecules involved in many specific reactions of the human body. This literature review presents the results of recent studies in the field of metabolomics in patients with NAFLD. A more detailed understanding of the role of individual metabolites or their combinations in the NAFLD pathogenesis will allow us to determine the vector of further diagnostic and therapeutic approaches for this nosology. The research results of the probiotics effect on the levels of certain metabolites are currently being discussed.Conclusion. New research data in the field of studying the human metabolomic profile are presented. The results allow us to summarize the effects of microbial agents and their metabolites in the formation of changes in the liver parenchyma in the context of NAFLD. Changes in the level of endogenous ethanol, secondary bile acids, aromatic amino acids, branched chain amino acids, etc. have been described. Correlation between metabolites and certain bacterial strains has been established. A correlation between the ratio of bacteria types and clinical/laboratory parameters was noted in patients taking prebiotics

The Association of High COVID-19 Cases and Mortality with Anomalous High Surface Ozone Concentration in Moscow City in Summer 2021

Aim: to compare statistical data on the frequency of COVID-19 and deaths from it with the ozone content in the surface atmosphere of Moscow in the summer of 2021.Materials and methods. We used data on the frequency of daily COVID-19 cases and mortality from COVID-19 in Moscow in 2020–2021 published by Rospotrebnadzor. Data on the ozone content in the surface layer of the atmosphere were obtained by an automatic monitoring station using a chemiluminescent analyzer.Results. The waves of high frequency of COVID-19 cases and mortality from COVID-19 in Moscow in the summer of 2021 were compared with abnormally high concentrations of ozone in the surface atmosphere of the megalopolis. Variations of these parameters were found to be markedly correlated. The coefficients of correlation of the COVID-19 cases and mortality with the concentration of ground-level ozone were 0,59 (p < 0.01) and 0.60 (p < 0.01), respectively.Conclusion. The observed noticeable relationship may be due to the combined pathological effect of high concentrations of ozone and the SARS-CoV-2 on the respiratory and circulatory organs, which can lead to both easier transmission of infection and a more severe course of the disease with increased mortality

Structure and Functions of Human Serum Albumin in Normal Conditions and in Patients with Liver Cirrhosis

The aim: to highlight the main points of albumin synthesis, posttranslational modifications and functions in normal conditions and in patients with liver cirrhosis.Key points. Albumin is the most abundant protein in blood plasma. Along with oncotic properties, albumin performs transport, antioxidant, immunomodulatory and endothelioprotective functions. Serum albumin in patient with liver cirrhosis undergoes modifications, leading to functional impairment. Human serum albumin is a compaund of human mercaptalbumin with cysteine residues having a reducing ability, and oxidized human non-mercaptalbumin. The proportion of irreversibly oxidized non-mercaptalbumin-2 with impaired functional activity increases in liver cirrhosis.Conclusion. The conformational structure of the albumin molecule plays an important role in maintaining its non-oncotic functions. Non-oncotic functions depend on albumin conformation. Further investigation of albumin conformation and albumin functions in patients with hepatic insufficiency can serve as an additional criterion for assessing the severity of cirrhosis and predictor of complications may become an additional criterion to new clinical applications and treatment strategies of liver failure

The Role of Correcting Structural and Functional Albumin Properties in Ascites Control in Decompensated Cirrhotic Patients

Аim: to study the structural and functional characteristics of albumin in patients with decompensated cirrhosis, their relationship with ascites; to identify the relationship between improvement in albumin characteristics and regression of ascites.Materials and methods. Fifty patients with decompensated liver cirrhosis and ascites were divided into groups. The first group received standard treatment for cirrhosis, the second — standard treatment and replacement therapy with 20 % human albumin solution at a dose of 200 mL per week for 3 months.Results. The value of the native conformation of albumin and the functional parameters of albumin were significantly lower than in the group of healthy individuals (p < 0.001). With the severity of ascites, the native conformation index (DR), which characterizes the structural usefulness of the albumin molecule, decreased. Median DR for ascites stage I (IAC) was –1.69, II grade — –2.28, III grade — –2.42 (p < 0.05). Replacement therapy with albumin allowed to achieve regression of ascites in 48.4 % of patients, compared with 7.1 % in the standard treatment group. Along with clinical improvement, restoration of albumin structural and functional properties was observed in the albumin group. The mean serum albumin level at which ascites remained in remission for 3 months was 42.11 g/L (p < 0.001).Conclusions and discussion. The structural and functional characteristics of albumin were impaired in patients with decompensated cirrhosis and ascites. The severity of changes in the structural and functional properties of albumin depended on the severity of ascites. The regression of ascites was accompanied by the restoration of the functional and structural usefulness of albumin against the backdrop of albumin replacement therapy. The criterion for stopping transfusion therapy with albumin can be the achievement of a serum albumin level of 42.11 ± 7.04 g/L, DR — 1.05, BE — 73.51 %, RTQ — 75.10 %, DTE — 72.71 %

Changes in the Structural and Functional Albumin Properties in Patients with Decompensated Liver Cirrhosis

Аim: to conduct a comparative analysis of serum albumin's structural and functional properties in decompensated cirrhotic patients by means of spin prob EPR spectroscopy.Materials and methods. The main study group included 70 patients with decompensated liver cirrhosis and ascites. The control group consisted of 12 healthy volunteers, comparable in gender and age, without liver diseases. To assess the structural and functional ability, serum albumin was analyzed by EPR spectroscopy.Results. Albumin levels within reference intervals were found in 37 patients (59.8 %). The native albumin index decrease in cirrhotic patients as the disease progressed with the lowest values in the Child – Pugh C group (p < 0.001). The binding efficiency of albumin decreased in accordance with the severity of cirrhosis with minimal albumin binding capacity in the Child – Pugh C (Me = 25.43 %; n = 30; p < 0.001). The transport activity of RTQ albumin decreased in patients with decompensated cirrhosis, the lowest transport ability was observed in the Child – Pugh C group (Me = 26.09 %). In patients with decompensated disease the detoxification potential was significantly reduced: Child – Pugh B — Me = 44.03 %; Child – Pugh C — Me =17.16 %. Despite the normal values of serum albumin in 72.5% of patients with cirrhosis B and in 26.7% in the cirrhosis C group, only 12.3% in the cirrhosis B group had normal albumin function and in cirrhosis C nо patients had normal albumin function.Conclusion. There were not only serum concentration depletion in cirrhotic patients, but also albumin physiological non-oncotic properties were violated. The severity of these changes increased with the progression of cirrhosis. Our data allow us to raise the question of the need to use the EPR test to determine indications for albumin replacement therapy in patients with cirrhosis and the presence of ascites, even at normal values of its serum concentration

Patient with Jaundice, Dyspnea and Hyperferritinemia after COVID-19

The aim: to highlight the importance of considering hemophagocytic lymphohistiocytosis in patients with jaundice of unclear origin and systemic inflammatory manifestations after coronavirus infection.Key points. A 64-y.o. patient was admitted to the hospital with jaundice, pruritus, fatigue, weight loss. The complaints occurred 2 weeks after discharge from the hospital for treatment of patients with coronavirus infection. Laboratory tests revealed signs of hepatic insufficiency, markers of cholestasis and inflammation persisted in time. Upon instrumental examination no signs of hepatosplenomegaly, biliary tree changes, intra- and extrahepatic obstruction were found. S. aureus was identified in blood cultures, CT scan of the facial skull bones showcased the focus of infection in the area of the roots of teeth 2.4 and 2.5. Therefore, antibiotics were prescribed. Subsequently, the patient's condition was complicated by the development of two episodes of acute respiratory distress syndrome, which occurred during the withdrawal of glucocorticosteroid therapy. Liver biopsy was performed, morphological study revealed signs of “vanishing bile duct” syndrome, excessive activation of macrophages and hemosiderosis of sinusoidal cells. Identified lesions can be found in hemophagocytic lymphohistiocytosis (HLH), a life-threatening complication of coronavirus infection. Glucocorticosteroids therapy, transfusions of human immunoglobulin, albumin, and parenteral nutrition have led to patient's condition improvement.Conclusion. COVID-19 provokes the development of secondary HLH 10 times more often than other respiratory viral infections. The possibility of hemophagocytic syndrome development should be considered, including cases of overlap syndrome with sepsis, in patients with unresolved jaundice, hyperferritinemia after coronavirus infection. Routinely used scales and criteria for diagnosis of HLH (H-score, HLH 2004) in such cases lacks sensitivity, therefore, careful analysis of clinical picture and exclusion of other causes of jaundice are required