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    1. Almazov National Medical Research Centre (St. Petersburg, Russian Federation)

    Keywords:Non-alcoholic fatty liver disease, type 2 diabetes mellitus; obesity; adipocytokines; leptin; adiponectin; glucagon-like peptide-1; ghrelin; incretinomimetics; agonists of glucagon-like peptide-1 receptors

    Abstract:Incidence of non-alcoholic fatty liver disease (NAFLD) is growing rapidly throughout the world and has recently become the most common liver pathology. NAFLD's pathogenetic basis, which is insulin resistance, makes it similar to the metabolic syndrome diseases (visceral obesity, dyslipidemia, arterial hypertension and disorders of carbohydrate metabolism). High prevalence of NAFLD determines the importance of non-invasive predictors of its development and, particularly, of its progression to cirrhosis. Level of adipose tissue hormones (adipocytokines) is directly related to severity of insulin resistance and to high degree determines inflammation and fibrosis in liver. These hormones are good candidates both for predictors of NAFLD development and progression, and for markers of metabolic effects of therapy. Hormones involved in food behavior regulation (leptin, ghrelin, glucagon-like peptide type 1) have significant effects on adipose-tissue metabolism as well as adipose and liver tissue insulin sensitivity. Dynamics of these hormones in course of NAFLD treatment can also be an important marker of its effectiveness. This review explores the role of adipocytokines and other hormones in the insulin sensitivity, inflammation and fibrosis regulation in predicting development, progression and response to the therapy of NAFLD.

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    ROLE OF ADIPOCYTOKINES, GHRELIN AND INCRETINS IN PREDICATION OF NON-ALCOHOLIC FATTY LIVER DISEASE AND ITS TREATMENT IN PATIENTS WITH TYPE 2 DIABETES. Experimental and Clinical Gastroenterology Journal. 2018;150(02):121-136
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    1. I. M. Sechenov First Moscow State Medical University; Central Research Institute of epidemiology of the Federal Servise of Customers` Right Protection and Human Well-Being Surveillance (Moscow, Russian Federation)

    Keywords:irritable bowel syndrome, probiotics, microbiota, B. longum 35624

    Abstract:Irritable bowel syndrome (IBS) is a functional disorder of digestive organs, which manifests itself as abdominal pain and accompanied by disorders of defecation [2]. The prevalence of IBS ranges from 3% to 28% in different countries [2, 4]. The pathogenesis of IBS is still not completely clear, and now relation found with genetic, immune factors, impaired functioning axis the “brain-gut”, changes in the microbiota and psychosocial factors [3-12]. The ability of intestinal microbiota to produce neurotransmitters that change intestinal secretion and motility, as well as visceral sensitivity threshold [8, 9] was established in the studies. The data of observations in the world as a whole on the efficacy and safety of probiotic B. longum infantis (longum) 35624 in patients with IBS and some other gastrointestinal diseases.

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    ACTUAL CAPACITY OF TREATMENT IRRITABLE BOWEL SYNDROME, GLOBAL EXPERIENCE: REVIEW OF THE LITERATURE. Experimental and Clinical Gastroenterology Journal. 2018;150(02):137-141
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    1. Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuous Professional Education” Ministry of Healthcare of the Russian Federation (Moscow, Russian Federation)

    Keywords:liver cirrhosis, portal hypertension, CYP2D6, propranolol.

    Abstract:The review presents mechanisms, clinical manifestations, methods of diagnostics and pharmacotherapy of portal hypertension syndrome with β-blockers in patients with liver cirrhosis. In addition, the article describes pharmacogenetic major aspects of cytochrome P450 2D6 activities and the influence of CYP2D6 polymorphism on the hemodynamic response to non-selective β-blockerpropranolol.

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    Full text is published :
    PHARMACOTHERAPY PERSONALIZATION PERSPECTIVES OF PORTAL HYPERTENSION IN PATIENTS WITH LIVER CIRRHOSIS. Experimental and Clinical Gastroenterology Journal. 2018;150(02):142-148
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    1. FGBU DPO “Central State Medical Academy of the Presidential Administration of the Russian Federation (Moscow, Russian Federation)
    2. Federal State Autonomous Educational Institution of Higher Education The First Moscow State Medical University named after I. M. Sechenov (Sechenov University), Ministry of Health of the Russian Federation (Moscow, Russian Federation)
    3. Federal Clinical Hospital “Central Clinical Hospital with a Polyclinic” (Moscow, Russian Federation)
    4. FGBU “Polyclinic No. 2” of the Presidential Administration (Moscow, Russian Federation)
    5. FGBUZ “Treatment and Rehabilitation Center of the Ministry of Economic Development” of the Russian Federation (Moscow, Russian Federation)
    6. Moscow State University of Medicine and Dentistry. A. I. Evdokimova of the Ministry of Health of Russia (Moscow, Russian Federation)

    Abstract:Chronic constipation is one of the most important global medical and social problems. Symptoms of constipation, such as reducing the number of bowel movements per unit of time, changing the consistency of the feces to hard or lumpy, the need for additional straining, a feeling of incomplete emptying of the intestine, bloating occur in 20% of the adult population of the Russian Federation. increasing in parallel with increasing age of patients. The prevalence of Chronic constipation in the adult population of the city of Moscow is an average of 16.5%. The quality of life of patients suffering from chronic constipation is comparable to the quality of life of patients with diabetes, hypertension, and depression. Quite often, the term "constipation" doctors and patients imply different symptoms. The article describes the efficacy of Lactitol in the treatment of chronic constipation symptoms and improving the quality of life of patients.

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    CLINICAL-METABOLIC EFFICIENCY OF LACTITOL IN THE THERAPY OF CHRONIC CONSTIPATION (RESULTS OF THE NON-INTERVENTIONAL PROSPECTIVE OBSERVATION PROGRAM “OSMOAID”). Experimental and Clinical Gastroenterology Journal. 2018;150(02):149-160
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    1. I.M. Sechenov Moscow State Medical University (Moscow, Russian Federation)
    2. Russian University of Peoples’ Friendship (Moscow, Russian Federation)
    3. Orel State University named after I. S. Turgenev (Orel, Russian Federation)
    4. Joint-Stock Company Pharmaceutical Research and Production Enterprise «Retinoids» (Moscow, Russian Federation)

    Keywords:retinol palmitate, reflux esophagitis, hiatal hernia

    Abstract:The aim is to study the impact of Retinol Palmitate in combinative anti-ulcer therapy in the treatment of reflux esophagitis as a preoperative preparation for hiatal hernia surgery (HH). 40 patients were observed, including 27 men, women 13. All patients were divided into two groups. The first group of 20 patients received anti-ulcer therapy, the second group 20 - anti-ulcer therapy and retinol palmitate. Anti-ulcer therapy included assignments of proton pump inhibitors, antacids and preparations that improve the evacuation function of the stomach. Retinol palmitate patients took 16-18 drops of 50,000 IU once a day at night, dripping it on bread or breadcrumbs. All patients underwent esophagogastroduodenoscopy (EGDS) before and after the 14-day course of treatment. Our study reliably demonstrated the efficacy of prescribing retinol palmitate for 14 days in combination with anti-ulcer therapy in most patients with mild to moderate reflux esophagitis. This treatment restores the oxidation-reduction process in the mucosa of the esophagus and stomach, facilitating the rapid epithelialization of erosions with the formation of a little noticeable elastic scar. Clinical manifestations of the disease were not observed in patients of the 2nd group within 3 months after the termination of anti-ulcer therapy. Patients with severe reflux esophagitis require a longer-term intake of retinol palmitate (up to 6 months) without anti-ulcer therapy. The absence of retinol palmitate in the complex anti-ulcer treatment of reflux esophagitis showed a short-term improvement in the endoscopic and clinical picture of the disease only in patients with mild and moderate reflux esophagitis. The combined use of retinol palmitate together with proton pump inhibitors and antacid preparations significantly improves the results of treatment of patients with reflux esophagitis with mild, moderate and severe degree. Rapid rapid epithelialization of erosions in reflux esophagitis under the influence of retinol palmitate contributes to the adequate preparation of patients for surgical treatment.

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    EVALUATION OF THE EFFECTIVENESS OF RETINOL PALMITATE ON THE RECOVERY OF THE ESOPHAGEAL TUNICA MUCOSA AND STOMACH IN PATIENTS WITH REFLUX ESOPHAGITIS. Experimental and Clinical Gastroenterology Journal. 2018;150(02):161-166
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    1. FGBOU VPO MGMSU named after A. I. Evdokimov of the Ministry of Health of Russia (Moscow, Russian Federation)
    2. FGBOU VPO DVGMU of the Ministry of Health of Russia (Vladivostok, Russian Federation)
    3. FGBOU VPO “Omsk State Medical University Ministry of Health of Russia” (Omsk, Russian Federation)
    4. FGBNU Research Institute of Medical Problems of the North of the Siberian Branch of the Russian Academy of Sciences (Krasnoyarsk, Russian Federation)
    5. Pirogov Russian National Research Medical University (RNRMU) (Moscow, Russian Federation)
    6. Federal State Budgetary Educational Institution of Higher Education I. M. Sechenov First Moscow State Medical University of the Ministry of Health of Russian Federation (Moscow, Russian Federation)

    Abstract:Available data are suggestive that modified version of frequency scale for the symptoms of gastrointestinal reflux disease (mFSSG) consists specific questions reflecting symptoms of reflux and dyspepsia which can be measured in form of Reflux Score (RS) and Dyspepsia Score (DS). By calculating this individual score, it has high positive effect on the pre-investigational identification of Gastrointestinal Reflux Disease and Dyspepsia syndrome respectively. Beyond the significant sensitivity and specificity, mFSSG tool is very convenient for practical use. When DS score is ranged between 6 and 8, the greatest correlation is observed with the fact that clinical criteria for functional dyspepsia are met by patient: lower DS scores are not indicative for starting empirical treatment of dyspepsia. DS score of 8 and above should be regarded as sufficient for the initiation of empirical treatment of uninvestigated dyspepsia. This review recommends using mFSSG questionnaire in the complex diagnostic examinations of patients who have symptoms of gastroesophageal reflux and/or dyspepsia. Those patients with uninvestigated dyspepsia who have mFSSG dyspepsia score of 8 and above can be recommended empiric treatment with fixed dose combination of omeprazole 20mg and domperidone suspended release 30mg. Russian version of the questionnaire yet to be validated in Russian patients population. This review provides practical recommendations on using mFSSG questionnaires by GPs and primary care physicians for making preliminary diagnostic decisions, identify laboratory examinations to be required, and to decide empiric treatment administration for patients with upper gastrointestinal symptoms. mFSSG questionnaire is meant to assist with, not dictate, decision making in conjunction with patients.

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    DIAGNOSTIC EVALUATION OF PATIENT WITH DYSPEPSIA SYNDROME AND HEARTBURN BY GP AND PRIMARY CARE PHYSICIAN: NEED OF A NEW & SIMPLE QUESTIONNAIRE. Experimental and Clinical Gastroenterology Journal. 2018;150(02):167-173
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