Functional constipation

Aim of review. To discuss the recent updates in classification of constipation of functional origin (both as separate entity, and within the pattern of constipationpredominant irritable bowel syndrome), the concepts on pathogenesis and recommended treatment approaches. Key points. In 2016 multinational consensus statement on functional gastrointestinal disorders (so-called Rome IV criteria) was presented. In the section devoted to the bowel diseases the new entity - opioid-induced constipation was defined; besides that diagnostic (mostly - the time-based criteria) of irritable bowel syndrome and functional constipation were modified. In new Rome consensus different types of functional bowel diseases were considered as specific forms of certain continuum. The origin of functional bowel diseases is still presented in the context of biopsychosocial model; that develop due to impact of constitutive factors, in particular features of serotoninergic and adrenergic regulation, dietary habit, bile acid metabolism etc. In the recent years the role of intestinal microbiota changes was studied intensively. The treatment approach for functional constipation underwent no significant changes. First of all it is required to attempt to modify dietary habits and lifestyle, including consumption of fermented milk products; at the second stage food fibers are prescribed, at inefficiency of these measures - relatively safe laxatives, and if necessary - drugs to relieve pain. Administration of probiotics and prebiotics is the promising trend in the functional bowel disease treatment, being pathogenically justified and. Promising results are received at administration of specific strains of bifidobacteria and lactobacilli, in particular the combined probiotic «Florasan D» that includes Bifidobacterium bifidum, B.longum, B. infantis, Lactobacillus rhamnosus. Largescale studies proving efficacy of B. lactis DN-173 010 strain (the commercial name «ActiRegularis») at constipation and functional flatulence are received, the drug is included to the spectrum of functional nutritional products for daily intake

Оценка качества питьевой воды с помощью индекса качества воды и оценки риска для здоровья населения: на примере кантона Педро Висенте Мальдонадо, Республика Эквадор

The effluent water quality of a treatment plant in a canton of Ecuador according to water quality index (WQI) and health risk assessment was investigated in this study. The quality of the influent and effluent water of the treatment plant was monitored monthly from January 2017 to December 2019. Physicochemical and microbiological parameters, such as temperature, pH, turbidity, color, suspended solids, electrical conductivity, free chlorine, nitrates, nitrites, ammonia nitrogen, sulfates, fluorides, manganese, iron, fecal coliforms and total coliforms were determined. To evaluate the impacts of studied water on human health, health risk assessment for non-cancerogenic elements, including hazard index (HI) and risk of olfactory-reflex effects for organoleptic indicators were performed in accordance with Russian and foreign guidelines. Water quality parameter results were compared with WHO drinking water standards, revealing that the influent was contaminated microbiologically and other parameters such as color, turbidity, and iron were also above the limit values. The WQI results showed that water after purification is suitable for drinking (I class - excellent). Hazard Index (HI) results showed that the non-carcinogenic substances studied had a low risk for both adults and children (1). Additionally, the risk of olfactory-reflex effect was characterized as acceptable for all the collected purified water samples.Исследовано качество воды, выходящей со станции водоподготовки в кантоне Педро Висенте Мальдонадо (Республика Эквадор), в соответствии с методическими указаниями по расчету индекса качества воды (ИКВ) и оценке риска для здоровья населения. Ежемесячно с января 2017 г. по декабрь 2019 г. проводился мониторинг качества воды до и после очистки. Определены физико-химические и микробиологические показатели, такие как: температура, рН, мутность, цветность, взвешенные вещества, электропроводность, остаточный хлор, нитраты, нитриты, аммонийный азот, сульфаты, фториды, марганец, железо, колиформы фекальные и общие колиформные бактерии. Для оценки воздействия исследуемой воды на здоровье человека проведен анализ риска для здоровья по неканцерогенным веществам, включая индекс опасности, и риска ольфакторно-рефлекторных эффектов по органолептическим показателям согласно российским и зарубежным рекомендациям. При сопоставлении результатов параметров качества воды со стандартами ВОЗ выявлено, что вода, поступающая на станцию водоподготовки, загрязнена микробиологически, а также параметры, такие как цветность, мутность и содержание железа, превышали предельно допустимые концентрации. По рассчитанным значениям индекса качества воды установлено, что вода после очистки пригодна для питья (I класс - очень чистая). По значениям индексов опасности выявлено, что изученные неканцерогенные вещества имеют низкий риск как для взрослых, так и для детей (<1). Риск появления ольфакторно-рефлекторных эффектов охарактеризован как приемлемый для всех отобранных проб очищенной воды

Functional dyspepsia and its treatment methods

Functional dyspepsia (FD) is one of the dysregulatory lesions of the upper digestive tract. This syndrome has fairly well-defined clinical manifestations that include borderline psychopathological disorders. Its diagnosis becomes a method for ruling out organic gastrointestinal and mental illnesses. Treatment for FD is complex and includes a behavioral component, prokinetics, myotropic spasmolytics, antisecretory drugs, and tricyclic antidepressants. The efficiency of therapy directly depends on a physician's ability to choose an individualized regimen

EXPERIENCE WITH THE DRUG MEMANTINE IN PATIENTS WITH FOCAL EPILEPSY AND COGNITIVE IMPAIRMENT

Abstract: cognitive impairment of varying degrees of severity identified in patients with focal epilepsy in 40-50% of cases. The incidence and severity of cognitive impairment depends on the cause epileptic seizures, localization of the lesion, antiepileptic therapy, and other factors. It should be noted that the correction capability of cognitive disorders in patients with epilepsy are somewhat limited because number of drugs used for the treatment are in the instructions for use as contraindications and indications of use ostoozhnostyu in patients with epilepsy. This work reflects the results of a prospective uncontrolled focal observations efficiency NMDA-receptor antagonist: This drug memantine (Noodzheron). The study involved 50 patients with focal epilepsy and having symptoms of cognitive deficits of varying severity. Evaluating the effectiveness carried out in 2 months from the start of the reception, the dosage of 5.10 mg × 1 time per day. After the treatment, a statistically significant improvement in cognitive function based on the results of tests: Mini-mental state examination, clock drawing test, the test Luria test “symbols and numbers.” Noodzheron taking the drug had no effect on the frequency of epileptic seizures