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    1. North-West Federal Medical Research Center named after V. A. Almazov (St. Petersburg, Russian Federation)
    2. The Leningrad Regional State Budgetary Healthcare Institution “Children’s Clinical Hospital” (St. Petersburg, Russian Federation)

    Abstract:The aim was to study the spectrum of gastroenterological diseases in adolescents with morbid obesity. Materials and methods: The study 34adolescents with a BMI> 35, and 20 adolescents with a BMI of 25 to 34. EGD, US, Fibromax test, lipidogram, the level of blood glucose and insulin was studied. Results. When morbid obesity more often were diagnosed esophagitis (26 % and 11,3 %, p <0,05), hiatal hernia (6 % and 0 %, p <0,05), NAFLD (71 % and 42,5 %, p <0,001), chronic gastritis (59 % and 35 %, p <0,05) and duodenal ulcer (6 % and 0 %, p <0,05). The positive correlations between gastrointestinal diseases and BMI, hyperinsulinemia and dyslipidemia were found. Thus Gastroenterological incidence of teenage obesity increases with increasing BMI and progression of metabolic disorders.

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      2. Метаболический синдром у детей и подростков: взгляд педиатра: учебное пособие / Захарова И. Н., Малявская С. И., Звенигородская Л. А., Боровик Т. Э., Творогова Т. М., Дмитриева Ю. А., Васильева С. В. Российская медицинская академия последипломного образования. Москва; Киров, 2016.
      3. Aaron S. Kelly, Sarah E. Barlow, Goutham Rao, Thomas H. Inge, Laura L. Hayman, Julia Steinberger, Elaine M. Urbina, Linda J. Ewing, Stephen R. Daniels. Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches. A Scientific Statement From the American Heart Association. Circulation. 2013; 128(15): 1689-1712
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      9. Wang YC, Gortmaker SL, Taveras EM. Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976-2006. Int J Pediatr Obes 2011; 6: 12-20.

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    Novikova V.P., Kalashnikova V.A., Burnysheva I.A., Usychenko E.A. STATE OF THE DIGESTIVE SYSTEM IN ADOLESCENTS WITH MORBID OBESITY. Experimental and Clinical Gastroenterology Journal. 2017;143(07):51-53
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    1. Federal State Government-financed Educational Institution of Higher Education “Stavropol State Medical University” (Stavropol, Russian Federation)

    Keywords:NERD and FD overlap syndrome,gastric motility disorders,myoelectric activity of the stomach,electrogastrography

    Abstract:The aim of this study was to investigate the motility of the stomach through the study of myoelectric activity in patients with the overlap syndrome of the gastroesophageal reflux disease and functional dyspepsia. Sixty-two patients with the overlap syndrome of the of gastroesophageal reflux disease and functional dyspepsia were examined. The control group consisted of 46 healthy volunteers. The diagnosis of the overlap syndrome of the of gastroesophageal reflux disease and functional dyspepsia was established on symptoms, data of esophagogastroduodenoscopy, 24-hour pH-meter or 24-hour impedance-pH-metry, Roman criteria III. Myoelectric activity of the stomach (MAS) was assessed by 24-hour electrogastrography (EGG) on an empty stomach and after taking a standard test breakfast (430 kcal, Nutri Drink). In preprandial and postprandial periods of detection of MAS, motility disorders were detected: a decrease in the dominant frequency of slow stomach waves, an increase in the coefficient of its instability. Chronotropic MAS dysfunction was characterized by a decrease in normogastric activity, an increase in bradygastric and tachigastric activities. Food intake led to a partial correction of MAS: an increase in normogastry and a decrease in bradygastria. The revealed disturbances are one of the mechanisms of the development of gastric motility disorders that cause the development of the overlap syndrome of the gastroesophageal reflux disease and functional dyspepsia.

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    1. Multidisciplinary medical center Bank of Russia (Moscow, Russian Federation)

    Keywords:Barrett’s esophagus,metabolic syndrome,and comorbid pathology

    Abstract:The purpose of the study is to examine the degree of influence of metabolic syndrome (MS) on the course of Barrett’s esophagus (SP) depending on gender characteristics and morphological patterns. Materials and methods. The study included 151 patients with Barrett’s esophagus (men 75 (49,6 %) and 76 women (50,3 %) aged 26 to 90 years). The patients were divided into two groups depending on the presence/ absence of metabolic syndrome. Flow analysis of PB was carried out taking into account gender characteristics and severity of morphological changes of the mucosa in segments of Barrett’s in two groups before and after treatment. Methods of research were endoscopy in various versions, data of morphological research of biopsy material, clinical and laboratory parameters. Results. The main peak of the presence of comorbid pathology, including PB and MS account for the age between 50-70 years, mainly in women in postmenopausal period. Before the start of the treatment the more pronounced morphological changes were revealed in the 2nd group of patients (PB+MS), but in the same group were obtained and better treatment results: epithelialization segment squamous epithelium occurred in 43,5 % and 48 % respectively. Conclusion. The presence of PB patients with comorbid pathology, particularly of the metabolic syndrome, contributes to more pronounced morphological changes in the mucosa of the esophagus. However, adequate therapy of concomitant pathology allows to achieve the best results. This fact confirms the claim that PB is a condition which can depend on many factors, including the presence of comorbid pathology. In this regard, the therapy “is not illness, but patient” can help to optimize the treatment of the most severe complications of gastroesophageal reflux disease, recognized as a disease of the XXI century.

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      13. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus, 2014

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    Belova G.V., Rudenko O.S. BARRETT’S ESOPHAGUS; THE IMPACT OF METABOLIC SYNDROME ON DISEASE. Experimental and Clinical Gastroenterology Journal. 2017;143(07):58-64
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    1. The Consultative and Diagnostic Centre with Polyclinic of the Administration of the President of the Russian Federation (Moscow, Russian Federation)
    2. First Saint Petersburg State Medical University n. a. I. P. Pavlov (St. Petersburg, Russian Federation)

    Keywords:habitual miscarriage,hepatopancreatobiliary system,metabolic syndrome

    Abstract:Introduction: To date, among the somatic and gynecological diseases in women of childbearing age, habitual miscarriage (PNP) is considered as a multifactorial problem. The aetiology of PNP remains completely unknown, and the role of general somatic pathology in the development of PND is poorly understood. Chronic liver diseases, leading to a disruption of its detoxification function and metabolic disorders, are one of the causes of PNP in the first trimester of pregnancy. Study Aims. To study the state of the hepatopancreatobiliary system in patients with PNP Methods. The study involved 74 women, aged 20-44 years (mean age = 32.5 ± 1.13). Group I (n = 53) included women with PNP (main group), group II (n = 21) - women with normal pregnancy in the history (control group). All women underwent a clinical examination, a biochemical blood test, ultrasound of the abdominal cavity, echo cholystography. Results. In the 1 group, a significant increase in cytolysis and cholestasis, fasting glucose, insulin and HOMA-IR index, atherogenic lipoprotein fractions, atherogenicity index. According to the data of ultrasound in the main group, the change in liver size, hepatic structure by the type of steatosis, enlargement of the gallbladder and thickening of its walls, sediment in the gall bladder was detected more often. Evaluation of the motor-evacuation function of the gallbladder indicated a predominance in the main group of hypomotor dysfunction of the gallbladder. Conclusions. In patients with PNP, changes in hepatic, lipid and carbohydrate metabolism, hepatomegaly with signs of steatosis of the liver, changes in the state and content of the gallbladder with a violation of its function predominate, which confirms the opinion of the influence of the pathology of the hepatobiliary system on the development of PNP, both in isolation and in metabolic syndrome.

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    Karpeev S.A., Karpeeva Yu.S., Balukova E.V. CHRONIC DISEASES OF THE HEPATOPANCREATOBILIARY SYSTEM IN THE GENESIS OF THE HABITABLE INJECTION PREGNANCY. Experimental and Clinical Gastroenterology Journal. 2017;143(07):65-70
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    1. Saint-Petersburg state pediatric medical University (St. Petersburg, Russian Federation)
    2. North-Western state medical University n. a. I. I. Mechnikov (St. Petersburg, Russian Federation)

    Abstract:Objectives: The aim of our study was to evaluate bone mineralization and metabolism in children with Crohn’s Disease (CD) and ulcerative colitis (UC). Material and methods: 113 patients with inflammatory bowel disease (IBD) (2-17 years) and 40 healthy children were included in the present study. We assessed markers of IBD activity. Bone mineral density (BMD) of lumbar spine (DEXA), serum osteocalcin (OC), C-terminal telopeptides (CTT), parathyroid hormone (PTH), serum calcium, alkaline phosphatase and 25 (OH) vitamin D were measured. Results: BMD in patients with CD and UC were lower than in control group (Zscore -1,4 SD, -1,3 SD and 0,31 SD, p=0,00001, respectively). Differences in level of PTH (39,4 pg/ml, 41,7 pg/ml и 24,8 pg/ml, p=0,04), and CTT (1,09 pg/ml, 1,08 pg/ml, 0,84 ng/ml, p=0,03) between CD, UC and healthy patients respectively have been found. There were no differences in serum OC between groups. Positive correlation between BMD and albumin, OC concentration and linear growth have been detected. IBD activity and duration, cumulative steroid dose were negatively associated with BMD. Vitamin D deficiency was observed in 98 % and 94,1 % of children with CD and UC respectively. Conclusions: patients IBD have low bone mineral density with increased bone resorption due to systemic inflammation, steroids side effect, vitamin D and calcium deficiency.

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    Gabrusskaya T.V., Revnova M.O., Kuzmina D.A., Kostik M.M. ASSESSMENT OF BONE MINERALIZATION AND BONE METABOLISM IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE. Experimental and Clinical Gastroenterology Journal. 2017;143(07):71-81
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