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    1. St. Petersburg State Pediatric Medical University, St. Petersburg 194044, Russia
    2. Yu. E. Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University, Moscow 125412, Russia
    3. I. I. Mechnikov North-Western State Medical University, St. Petersburg 195067, Russia
    4. D. O. Ott Institute of Obstetrics, Gynecology and Reproduction, St. Petersburg 199034, Russia

    Keywords: ghrelin, serotonin, chromogranin A, celiac disease, giardiasis, Нelicobacter pylori.

    Abstract:Growth pathology duodenal among patients of diff erent age groups determines the relevance of the study. Causes duodenal disease suffi ciently heterogeneous and include celiac disease, gluten allergy and various proteins, autoimmune disease, atopy, and also bacterial, parasitic and viral infection (Helicobacter pylori infection, giardiasis). One of the characteristics of the mucosal morphofunctional state is its neuroendocrine duodenal activity, which is provided enteroendocrine cells, and chromogranin synthesizing neuropeptides, in particular, chromogranin A (CgA), ghrelin and serotonin. The aim of our study was to determine whether these markers in the duodenal mucosa with similar morphological manifestations duodenitis of various etiologies in children. The material of the study were 40 biopsies of the distal duodenum, obtained by fi brogastroduodenoscopy in children aged 6 to 17 years old with morphologically verifi ed chronic gastroduodenitis (CGD). The fi rst group consisted of children with celiac disease, the second group — with Helicobacter pylori infection (H.p), the third group consisted of children with giardiasis, in the fourth (the control group) — children with reliably excluded above listed diseases and preserved architectonic mucosal duodenum without morphological characters gastroduodenitis.When immunohistochemical study (IHC) expression levels were determined Chromogranin A (Abcam 1: 400); Serotonin (Abcam 1:50); Ghrelin (Abcam 1: 100). The intensity of the reaction was assessed by two indicators — the relative expression area (Ot. Pl) and the optical density (OP). In our study, for the fi rst time we studied markers in enteroendocrine duodenitis of various etiologies. We were looking for a morphological tool that will help diff erentiate duodenitis with similar clinical and histological features. Increased expression of ghrelin, serotonin and chromogranin A, playing an important role in the mechanisms of disorders duodenum structure in celiac disease. When H.p infections a decrease in all studied markers, while giardiasis is not observed signifi cant changes. All of this allows us to diff erentiate duodenitis etiology and, therefore, reasonable to appoint therapeutic measures.

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    Full text is published :
    Novikova V. P., Khavkin A. I., Kalinina E. Yu., Anichkov N. M., Krylova Yu. S. Diagnostic signifi cance of diff erones in chronic duodenites in children. Experimental and Clinical Gastroenterology. 2019;161(1): 124–128. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-124-128
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    1. FDO FGBOU IN “Russian Research Medical University. Pirogov” of Ministry of Health of Russia, Moscow, Russia
    2. Federal State Budgetary Educational Institution of Higher Education Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar 350001, Russia

    Abstract:The article presents a review of the literature on the etiopathogenesis, diagnosis and treatment of parasitic invasions in children. The etiological structure of parasites infecting the biliary system, their development cycles and places of the most frequent parasitism in the external environment are described. It is convincingly shown that Giardia has nothing to do with the gallbladder and the biliary tract. It is noted that the most frequent pathogens of parasitic invasions of the biliary tract in children are opisthorchiasis, clonorchosis and fascioliasis. The role of parasitic invasions in the formation of gallstones is shown. At the same time, the key pathogenetic mechanisms of stone formation in cholelithiasis on the background of parasitic invasion is the activation of cholesterol and pigment lithogenesis, the deconjugation of direct bilirubin in bile. It is shown that the main in the treatment of parasitic invasions is the use of etiotropic therapy (deworming). Based on a detailed analysis of modern literature, therapeutic tactics algorithms have been developed.

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    Full text is published :
    Kharitonova L. A., Kucherya T. V., Bostanjyan V. R., Veselova E. A., Matalaeva S. Yu. The role of parasitic invasions in the genesis of infl ammatory diseases of biliary tract in children. Experimental and Clinical Gastroenterology. 2019;161(1): 129–136. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-129-136
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    1. Federal State Budgetary Educational Institution of Higher professional Education of the Russian national research medical University n. a N. I. Pirogov, Moscow 117997, Russia
    2. N. E. Bauman City Clinical Hospital No 29, Moscow Department of Health, Moscow 111020, Russia

    Keywords: gestational diabetes mellitus, insulin resistance, obesity

    Abstract:Gestational diabetes mellitus (GDM) develops in 7–18% of women worldwide. The number of pregnant with GDM is steadily increasing. GDM is more likely to develop among obese patients. Women who are obese have features of chronic low-grade infl ammation, manifest by increased tumour necrosis factor alpha (TNF-α), interleukin-6 (IL-6), interleukin-12 (IL-12), and high sensitivity C-reactive protein (hsCRP). Obesity is characterised by insulin resistance, and down-regulation of adiponectin and up-regulation of leptin, resistin and retinol-binding protein-4 (RBP4) contribute to this. Obesity and excess gestational weight gain results in a three-fold increased risk of adverse pregnancy outcomes, including long term metabolic syndrome and endocrine diseases for baby. Off spring born from pregnancies complicated by GDM has higher body mass index (BMI) compared with non-GDM off spring and has high risk of obesity throughout all periods of childhood. GDM may have impact on genetic modifi cations in the off spring.

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    Papysheva O. V., Kharitonov L. A., Kotaysh G. A., Shurygina D. A. Lipid and carbohydrate exchanges in children born to mothers with gestational diabetes mellitus. Experimental and Clinical Gastroenterology. 2019;161(1): 137–144. (In Russ.) DOI: 10.31146/1682-8658-ecg-161-1-137-144
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