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Baranovsky A.Yu., Raykhelson K.L., Marchenko N.V.
Application of S-adenosylmethionine (Heptral®) in treatment of patients with non-alcoholic steatohepatitis Aim of investigation. To estimate efficacy of Sadenosylmethionine (Heptral®) for treatment of nonalcoholic steatohepatitis (NASH).
Methods. Eighty four patients with NASHs were distributed for three groups, 30 person each. Patients of the 1st and the 2nd groups received Sadenosylmethionine orally in a dose of 1200 and 800 mg per day respectively for 4 months. Patients that were included into the 3rd group (control) did not receive the drug. Patients were instructed by dietary guidelines for weight loss. Clinical, anthropometric and laboratory data were estimated prior to beginning of treatment, in 10 days, 1 month and 4 months after beginning of treatment, and also in 2 months after termination of intake of the drug. Ultrasonography of abdominal organs was carried out before treatment, after 4 months of treatment, in 2 months after termination of intake of the drug.
Results. At comparison to the control group in the 1st and the 2nd groups dyspeptic symptoms (ð <0,001) disappeared more often, that is 45,8% of cases for the 1st group in 10 days of treatment. Asthenic syndrome disappeared in the 1st and 2nd groups in 4 months of treatment, being preserved after treatment. Levels of blood serum alanine transaminase (ALT) and aspartate aminotransferase (AST) normalized in the 1st group in 10 days of treatment in 86,2% of patients, in the 2nd group in 1 month of treatment — in 81, 5%. Biochemical effect was present during the whole course of treatment and after its cessation. In the 1st and 2nd groups the tendency to decrease of ultrasonographic stage of steatosis of the liver was revealed.
Conclusions. Obtained data testify efficacy of Sadenosylmethionine (Heptral®) in treatment of patients with NASH. Intake of increased dose of Heptral® (1200 mg per day) promotes faster regression of clinical manifestations and biochemical scores.
Kuznetsova A.V., Ostrovsky A.B.
On the issue of revealing autoimmune antibodies at chronic HCV-hepatitis Aim of investigation. To study frequency and spectrum of revealing of autoimmune antibodies at patients with chronic hepatitis C, to determine degree of genotype and viral load HCV effect on these parameters.
Methods. 241 patient with chronic HCVinfection has been included in original study. Frequency of genotypes HCV was following: 1 – 143 (59,3±3,2%), the other – 98 (40,6±3,2%). In 58,09±3,2% of cases viremia exceeded the level of 1 million copies/ml.
During the study detection of the markers specifically describing autoimmune reactions (ANA, ANCA, antiSMA, antiLKM1, antiSLA, antiLC1, cryoglobulins), with application of specific commercial testssystems of JointStock Company «BioKhimMak» by standard procedure prior to beginning of specific antiviral therapy of chronic hepatitis C was carried out.
Results. In patients with chronic HCVinfection autoantibodies (ÀNA, ANCA, antiSMA) were found in 24,47±2,8% of cases. Highly specific markers of autoimmune hepatitis/overlap syndrome (antiLKM1, antiSLA and antiLC1) in this study have not been found. The virus genotype exert no significant influence upon frequency, but affected (p<0,01) spectrum of revealing of autoantibodies in patients with chronic hepatitis C. On the contrary, the level of viral load significantly (p<0,01) affected relative frequency of detection of autoantibodies, but not their spectrum.
Conclusions. Revealing of autoantibodies in patients with chronic hepatitis C depends on biological properties of virus and morphological features of disease related to them, but in some cases can be secondary epiphenomenon as well.
Pirogova I.Yu., Nezdoymina N.N.
Application of elastometry in diagnostics of liver fibrosis at patients with chronic HBV- and HCV-infection at hemodialysis Aim of investigation. To estimate information value of elastometry by «Fibroscan» device (EchoSens, France) as screening procedure for assessment of fibrosis stage at persons with chronic renal failure of the III stage (CRF III) with combined chronic HBV and HCVinfection under programmable hemodialysis.
Methods. The pilot study was carried out, 30 patients with CRFs III under programmable hemodialysis with chronic HBV and HCVinfection were investigated. Besides standard procedures (TBC, biochemical, virologic investigations, US of organs of abdominal cavity) elastometry by «Fibroscan» device (EchoSens, France) was applied.
Study results. More than a half of patients (53%) had the F2 and higher stage of fibrosis (by Metavir), requiring the decision of a question on capability and expediency of antiviral therapy. At analysis of relation of HCV or ÍÂVinfection duration and stage of fibrosis, progression of fibrosis stage is revealed at greater history of HCV or ÍÂVinfection.
Conclusions. Elastometry allows noninvasive estimation of liver fibrosis stage, to testify antiviral therapy, it is especial in group of patients who are included into «waiting list» for kidney transplantation.
Radchenko V.G., Safronenkova I.G., Seliverstov P.V., Sitkin S.I., Teterina L.A.
Alimentary fibers in clinical practice The aim of review. To uncover a role of alimentary fibers and to demonstrate their therapeutic effect in clinical practice.
Original positions. An adequate nutrition is an integral part of complex treatment of diseases of internal organs. Alimentary fibers are used for prophylaxis and treatment of atherosclerosis, oncological diseases, diabetes mellitus, diseases of alimentary organs, positive influence on intestinal microflora. Deficiency of alimentary fibers in the ration is the cause of constipation, hemorrhoids, divertuculosis, tumors of the bowel and incompetence of biliary tract.
Nowadays the many prebiotic agents containing various alimentary fibers are developed. The agent mucofalk, on the basis of plant alimentary fibers from coating of plantain oval (Plantago ovata) seeds – psyllium, due to the unique composition (presence of three fractions) meets all characteristics of prebiotic drugs and is used for treatment of constipation, diarrhea, inflammatory bowel diseases (ulcerative colitis and Crohn’s disease), obesity at children and teenagers, hypolipidemic treatment, complex therapy of the 2nd type diabetes mellitus.
Conclusion. Alimentary fibers are claimed and are widely applied in a ration of person. Mucofalk is a drug of alimentary fibers with the proved efficacy.
Koprivitsa N.B., Okhlobystina O.Z.
Studying of quality of life at patients with the functional dyspepsia Functional dyspepsia is the frequent disease, having negative effect on quality of life and accompanying by significant economic expenses.
Aim of the study. To study of quality of life in patients with functional dyspepsia.
Methods. Overall 35 patients with functional dyspepsia diagnosed according to Rome III criteria were included in the study (15 men, 20 women, mean age 33,9±13,1 years). Before inclusion in the study and after 4 wks of treatment by omeprazole 40 mg per day and domperidone on 40 mg per day patients filled in following questionnaires: SF36 Health Status Survey, GSRS (Gastrointestinal Sómptom Rating Scale), Glasgow dyspepsia severity scale (GDSS). Severity of clinical manifestations of dyspepsia was estimated by visualanalog scale, mental status – by scales of state and trait anxiety, Beck’s scale, hospital anxiety and depression questionnaire, and by Hamilton’s scale.
Results. On a background of fourweek course of combined treatment by omeprazole and domperidone significant decrease of severity of pain and early satiety in the evening time, improvement of gastroenterological symptoms severity by GSRS scale was revealed. At assessment of dyspepsia severity by Glasgow scale no significant changes on background of treatment has been obtained. In this category of patients high level of trait and state anxiety – 51,6±10,5 and 46,1±8,2 points respectively was marked. At initial evaluation of anxiety and depressive disorders severity the scores, exceeding normal level of threshold values, have been revealed, which at the absence of specific treatment underwent no essential changes. Quality of life evaluation by SF36 questionnaire showed no significant changes in all 8 domains.
Conclusions. After 4 wks of antisecretory and prokinetic treatment at patients with the functional dyspepsia severity of clinical manifestations significantly decreased, that was not accompanied by significant decrease of severity of affective disorders and improvement of general parameter of quality of life related to health.
VAK
Thesis abstracts: information from the Higher attestation commission
Bueverov A.O.
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