Advantages of alginate and PPI combination in relief of heartburn and regurgitation during the first days of treatment of gastroesophageal reflux disease

Aim of investigation. To estimate advantages of combined intake of proton pump inhibitor (PPI) and alginate in comparison to monotherapy by PPI in terms of symptom relief in the first days of gastroesophageal reflux disease (GERD) treatment.Material and methods. Overall 96 patients with GERD were investigated. All patients complained of heartburn, 41 patients had regurgitation. Symptoms were estimated by Likert scale prior to onset of therapy and daily during treatment course. General well-being was evaluated by visual-analog scale (VAS) prior to therapy, at the 7th and 14th days of treatment. The first group (46 patients, 19 males, mean age — 50,2±12,7 years) received combined therapy by pantoprazole 40 mg/day and alginate (Gaviscon DD) 20 ml qid at the 1st and 2nd days of treatment followed by «on demand» mode. The second group (50 patients, 22 males, mean age 51,3±14,4 year) received pantoprazole 40 mg per day. All patients underwent esophagogastroduodenoscopy.Results. At the 1st day of treatment heartburn has been completely relived in 61% of patients of the first group and in 14% — of the second (р<0,001), at the 2nd day — in 63% and 20% (р<0,001). At the 3rd day (alginate in «on demand» mode) the heartburn was absent in 48% of patients of the first group and in 44% — of the second (р=0,8). Regurgitation at the 1st day of treatment was relieved in 78% of patients of the first group and remained in all patients of the second group, who initially complained of it (р<0,001), at the 2nd day it stopped in 83% and 22% of patients respectively (р<0,001), at the 3rd day — in 67% and 22% (р=0,01). After the 4th day there were no intergroup differences. At the 7th day of treatment according to VAS wellbeing score in the first group increased from 57,3±9,7 to 78,1±11,2 mm (р <0,001), in the second — from 54,9±14,9 to 67,0±15,2 mm (р<0,001). The intergroup differences of the score at the 7th day was statistically significant (р<0,001). By the 14th day difference disappeared (78,8±9,7 mm vs 75,6±12,5 mm, р=0,1).Conclusions. This study has demonstrated advantages of the combined therapy in the first days of GERD treatment in decreased terms relief of symptoms and improvement of state of health

Предикторы неудачи в лечении по программе DOTS-PLUS у пациентов, страдающих множественно лекарственно-устойчивым туберкулезом

For the purpose of revealing predictors failure outcome of antitubercular therapy at patients suffering from multidrug resistant tuberculosis we have executed comparative analysis of clinical, laboratory, bacteriological and radiological data in the conditions of DOTS-PLUS program. The received results have shown that predictors were social, medical and biologic factors, according which we can forecast treatment’s outcomes at initial stage.С целью выявления предикторов неудачного исхода противотуберкулезной терапии у пациентов с множественной лекарственной устойчивостью M. tuberculosis проведен сравнительный анализ клинических, лабораторных, бактериологических и рентгенологических данных в условиях программы DOTS-PLUS. Полученные результаты показали, что предикторную роль играли как социальные, так и медико-биологические факторы, учитывая которые уже на начальном этапе возможно прогнозирование исходов лечения

Результаты игловой биопсии плевры в диагностике экссудативных плевритов

Summary. In this study, diagnostic value of pleural needle biopsy has been estimated. Biopsy specimens were obtained from 226 patients with pleural exudates of different etiologies. A high diagnostic sensitivity of this procedure was estimated under the lowest rate of complications. Резюме. Целью исследования являлось определение диагностической ценности игловой биопсии плевры (ИБП) при плевральной патологии. С марта 2006 по январь 2011 г. было выполнено 226 ИБП. Возраст пациентов, среди которых мужчин было 160 (70,8 %), женщин – 66 (29,2 %), варьировался от 18–84 лет. В 39,8 % случаев (у 90 больных) биопсия проводилась по поводу изолированного плеврита, в 60,2 % (у 136) – при плеврите, осложнившем основной процесс в легком или другом экстраторакальном органе. Проведенное исследование показало, что ИБП является высокоинформативным методом диагностики, а его чувствительность при выявлении туберкулезного плеврита составляет 70,2 %

Особенности преподавания фтизиатрии на примере разбора врачебных ошибок

In the educational program of the Chair of Tuberculosis and Pulmonology of Siberian State Medical University (Tomsk), there is a special consideration towards tuberculosis alarm, the ways of TB detection, diagnostics and differential diagnostics of pulmonary and extra-pulmonary TB. Moreover, there is an educational promotion of deontology and medical ethics questions to students and listeners of the Advance Training Faculty and the Post-graduate Professional Education Course. They also participate in review conferences related to causes and ways of prevention medical malpractice cases.На кафедре фтизиатрии и пульмонологии Сибирского государственного медицинского университета (г. Томск) в процессе обучения делается упор на фтизиатрическую настороженность, пути и способы выявления, диагностики и дифференциальной диагностики легочного и внелегочного туберкулеза. Такие вопросы, как деонтология, медицинская этика, раскрываются студентам и слушателям ФПК и ППС в процессе обучения, проводятся разборы причин и пути предотвращения врачебных ошибок

European registry on the management of helicobacter pylori infection (HP-EUREG protocol): The first results of Russian centers

Aim: To assess the clinical practice of diagnosis and treatment in patients with Helicobacter pylori infection and to compare this practice with the international guidelines in the European Registry on the management of Helicobacter pylori infection, Hp-EuReg protocol), a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group. Materials and methods: The data of 813 patients infected with H. pylori and entered in the Hp-EuReg register by the Russian centers in 2013-2015 were analyzed. Results: The most common methods for the primary diagnosis of H. pylori infection are histology (40.3%), rapid urease test (35.7%), and serology (17.2%). The duration of H. pylori eradication therapy was 7, 10, and 14 days in 18.0, 49.3, and 25.1%, respectively. To monitor the effectiveness of treatment, the investigators used a histological examination (34%), a urea breath test (27.3%), H. pylori stool antigen (22.8%), and a rapid urease test (16.3%). A serological test was carried out in 2.5% of the cases. No monitoring was done in 13.5% of the patients. The average eradication efficiency was 82.6%. If the therapy was ineffective, 80% of physicians did not intend to prescribe a new cycle of treatment. Conclusion: Significant differences were found between clinical practice and the current guidelines

Оценка проб выдыхаемого воздуха методом лазерной оптико-акустической спектроскопии у больных туберкулезом легких

Absorption spectra of breath air for 108 healthy persons, 28 patients with pulmonary tuberculosis and 56 patients with many a diseases were recorded using laser photoacoustic technique. It was ascertained that, as the breath air analysis result, pulmonary tuberculosis can be diagnosed.Методом лазерной оптико-акустической спектроскопии были получены спектры поглощения проб выдыхаемого воздуха 108 здоровых доноров, 28 пациентов с туберкулезом легких и 56 пациентов с другими заболеваниями. Проведенный анализ показал, что во многих случаях по результатам обработки спектров проб выдыхаемого воздуха можно установить наличие или отсутствие у пациента туберкулеза легких