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экспериментальная и клиническая гастроэнтерология | выпуск 117 | № 5 2015
информация | information
ABSTRACTS IN ENGLISH (A-Z)
110. Roles of neuronal or endothelial synthases of nitric oxide while control of gastric bicarbonate secretion induced by mild irritation of the mucosa
Andreeva J. V., Kropycheva R. P., Zolotarev V. A.
Pavlov Institute of Physiology of the Russian Academy of Sciences, St. Petersburg, Russian Federation, e-mail: basil@infran.ru
An increase of synthesis of endogenous nitric oxide (NO) in the gastric mucosa (GM) depending on activity of constitutive synthases of NO at the normal physiological condition is considered as the important factor of gastric protection. However, the role of endogenous NO in regulation of gastric bicarbonate secretion, the main process in gastric protection, is still poorly understood. In particular, effects of endothelial (eNOS) and neuronal (nNOS) synthases of nitric oxide, which are present almost in all types of GM cells, were not compared.
The aim of the study: to estimate involvement of nNOS or eNOS in control of bicarbonate production induced by transient irritation of GM at the normal condition under anesthesia, as well as after blocking of gastric acid secretion by omeprasol.
In anesthetized rats, concentration of HCO3- in stomach luminal perfusate was calculated basing on measurements of pH/PCO2. Mucosal irritation during 20 min with acidic hypertonic solution (1 M NaCl, pH=2,0)
caused marked and omeprazole-independent increase of HCO3- secretion. Selective blocker of nNOS in vivo, 7-nitroindazole (7-NI), or the nonselective blocker of nNOS and eNOS, NG-nitro-L-arginine (L-NNA), were applied into the splanchnic cyrculation via retrograde injection into the splenic artery (1 mg/kg). At the nor-mo-acid state, irritation-induced output of HCO3- was suppressed by 7-NI, but was not affected by L-NNA. After administration of omeprazole, both 7-NI and L-NNA equally inhibited HCO3-- output. Effect of 7-NI (but not L-NNA) was abolished by cyclooxygenase (COX), an inhibitor indomethacin, which by itself suppressed secretion of HCO3-. Additionally, bicarbonate output was substantially reduced by the blocker of soluble guanylate cyclase (GC), methylene blue. We conclude that irritation-induced secretion of HCO3- is largely mediated by intramural nNOS and depends on GC-COX interaction. As it was theoretically estimated, eNOS activity caused a reduction of HCO3- output in the normo-acid stomach which was abolished by omeprazole.
111. Non-farmacological treatment of NAFLD/NASH in Bardejov Spa
Belovicovâ M.U3, Svirkovâ H.1, Bachul'ak V.1
'Internal-hepatologic ambulance, 2Remedium s.r.o., 3VSZaSP sv. Alzbety, Bardejovské Kupele, Slovakia, e-mail: mriab9@gmail.com, mbelovicova@kupele-bj.sk
Background. Non-alcoholic fatty liver disease (NA-FLD) represents a wide range of clinical and pathological conditions which are gradually developed from simple hepatic steatosis through steatohepatitis (NASH) up to the stage of liver cirrhosis with its complications and failure. The epidemic of obesity and the associated NAFLD is the most common disease which we meet in our ambulances.
The aim of the study: to evaluate the non-farmaco-logical treatment of NAFLD in Bardejov Spa.
Material and methods. Bardejov Spa developed in 2012 a specialized 2-week spa stay focused on weight reduction. During this stay clients acquire new knowledge regarding diet, physical activity, are under medical supervision. Clients undergo testing to early detection of cardiovascular diseases and liver diseases. They have the opportunity to take the examination with transient elastography and abdominal ultrasonography.
Results. This spa-stay completed 151 clients (116 women, 35 men). The mean BMI in women was 36.5 kg/m2, in men 38.1 kg/m 2. The age of participants: in women 20-73 years, in male 20-70 years. Average for 2 weeks, we have achieved a weight loss of 2.6 kg in women, in men of 5.4 kg. Waist circumference in women on average decreased by 4.7 cm, in men by 5.4 cm. Thanks methodology transient elastography at 18 clients (11.9 % of the group) we diagnosed the presence of liver cirrhosis on the basis of NASH.
Conclusions. Treatment of obesity/NAFLD in spa versus outpatient treatment has its advantages. First there is at least 2-week presence of patienta at the spa — outside ofthe standard environment and the overall orientation of stay for lifestyle change. During the stay patients are always in a good psychological well-being. Spa treatment of obesity and NAFLD at the same time allows the group intervention and mutual motivation of patients.
112. Treatment of chronic constipation in stroke patients with diabetes
Bukreeva M. V., Koroleva L. U., Turchina M. S.
Orel State University, Russia, e-mail: Bukreyka@rambler.ru.
Objective: to evaluate the effectiveness of various schemes of treatment of chronic constipation in stroke patients with diabetes.
Materials and methods. In the study group included 67 stroke patients with type 2 diabetes. Patients by simple randomization were divided into 3 groups: the first group
received a dose of lactulose 30 ml/day in combination with a dose trimebutin 0.6 mg/day — 4 weeks. The 2nd group received trimebutin in a dose of 0.6 mg/day — 4 weeks. The third group received lactulose dose of 50 ml/ day 4 weeks. To assess the quality of life of patients by using SF-36 questionnaire at baseline and after therapy.
тезисы 15-го юбилейного съезда ногр... | abstracts 15th anniversary congress "gssr".
The results. Before treatment in all groups were observed persistent violations of the stool. In this case, 68 % of patients for the treatment oflong-term take drugs senna, 15 % used a diet therapy, 15 % used candles and enemas, the remaining 2 % were not treated. The therapy after 2 weeks in patients 1st and 2nd group 65 % showed normalization ofstool. Among patients treated with lactulose only by the end of the 2nd week of the number of cases normalization of stool reached 45 %. By the end of the 4th week
among patients ofthe 1st and 2nd groups, the incidence of normalization ofstool reached 76 %, while among patients treated with lactulose — 65 %. When analyzing the results of SF-36 in patients on therapy trimebutin observed a significant improvement in quality of life compared with patients receiving monotherapy lactulose.
Conclusions. Using trimebutin in the treatment of chronic constipation in stroke patients with diabetes, leads to a better quality oflife, faster recovery ofbowel function.
113. Analysis of proton pomp inhibitors efficacy in prevention of erosive damages of stomach after endoprosthesis replacement operation at H. pylori infected patients who take NSAIDs
Edemskaya M. A., Pakhomova I.G., Baryshnikova N. B., Belousova L. N.
NWSMU n.a. I.I. Mechnikov, FSPbSMY n.a. I. P. Pavlov, Saint-Petersburg, Russia
The aim: to study efficacy of proton pomp inhibitors (PPI) in prevention of erosive damages of a stomach in the postoperative period at H.pylori infected patients with damage of the large joints who take NSAIDs.
Materials and methods. 129 H.pylori infected patients with damage ofthe coxofemoral and knee joints needing endoprosthesis replacement and taking NSAIDs at least once a week, not less, than within 2 weeks before hospitalization were surveyed. Before operation and in 10-14 days after operation all patient completed the survey for the analysis ofabdominal pain and gastroscopy was made at the same dates. Before treatment according to gastroscopy results patients had no erosive changes in stomach. Patients were divided into 2 groups: the 1st — the patients
preventively taking omeprasol before and after operation 20 mg once a day (66 people); the 2nd — group of comparison without preventive therapy of PPI (63 persons).
Results. Abdominal pain before operation was in 29.5 % of patients in the 1st group and 30,5 % in the 2nd group; after treatment in 8,8 % in the 1st group and 31,4 % in the 2nd group. Erosions of a mucous of stomach after operation were at 3 % of patients in the 1st group and at 17,5 % — in the 2nd group.
Conclusions. Suppression of a gastric acidity in the postoperative period is an effective method of prevention of development of NSAIDs-associated damages of a stomach at H.pylori infected patients with diseases of the large joints needing endoprosthesis replacement.
114. The endotoxin aggression in children with erosive and ulcerative diseases of the duodenum, associated with H. pylori and small intestinal bacterial overgrowth syndrome
Guz N. P., Nalyotov A. V.
Donetsk National Medical University named after M. Gorky, Medical centre «Gastro-line», Donetsk, Ukraine, e-mail: nalyotov-a@mail. ru, gastrodoc@mail.ru
The aim. The purpose ofthis study was to determine the level of systemic endotoxemia in children with erosive and ulcerative processes of the duodenum, associated with H.pylori and small intestinal bacterial overgrowth syndrome (SIBO).
Material and methods. 60 children, aged 12 to 17 years, all with H.pylori-associated erosive and ulcerative duodenal diseases were included in the study: 20 patients with peptic duodenal ulcer (DU) and 40 patients with duodenal erosion (DE). The SIBO was determined in all patients. The concentration of lipo-polysaccharide (LPS) of Gram-negative bacteria was studied in all children. The diagnosis of H.pylori was carried out by two methods: the rapid urease test with biopsy and the urea breath test using the test system «Helic» with detector tubes («AMA», Russia). The SIBO was diagnosed by using the hydrogen breath test with lactulose load and using the digital analyzer of exhaled
hydrogen «LaktofaH2» («AMA», Russia). The control group consisted of 20 healthy children.
Results. The level of LPS in patients with H.pylo-ri-associated ulcerative and erosive gastroduodenal pathology significantly exceeded (p<0.05), this data in healthy children (0.52±0.04) EU/ml. The highest level of LPS is estimated in children with DU (2.1±0.1) EU/ ml. Among patients with DE it was (1.9±0.1) EU/ml. All children of the control group had endotoxinemia within the physiological range, which did not exceed 1.0 EU/ml. Physiological endotoxinemia were detected in only 2 — (10.0±6.7)% patients with DU and in 5 (12.5±5.2)% patients with DE.
Conclusion. Thus, H.pylori-associated erosive and ulcerative duodenal diseases in children occur on the background of SIBO. These microbial disturbances are accompanied by increased serum level of LPS of Gram-negative bacteria.
115. Risk of developing NSAID-gastropathy in elderly patients suffering from cardiovascular disease in combination with diabetes
Koroleva L. Yu., Bukreeva M. V., Turchina M. S.
Orel state University, Russia, e-mail: lilechka2004@bk.ru
Objective: to study the probability of developing therapy in elderly patients suffering from cardiovascu-NSAID-gastropathy on the background of antiplatelet lar disease in combination with diabetes.
