Vol 82, No 2 (2010)


On the occasion of the 50th anniversary of A. M. Ugolev's current theory of digestion

Parfenov A.I., Parfenov A.I.


In 1958, A. M. Ugolev (1926-1991) discovered parietal (membrane) digestion (MD) that differs fundamentally from cavity and intracellular digestion in the strictly directed arrangement of active centers of enzymes and in coupling to the membrane transport systems. The three-stage sequential triad: cavity digestion - MD - absorption has given an insight into the mechanism responsible for an extremely high food assimilation rate in the gastrointestinal tract and become as the basis of the current digestion theory stated by Academician A. M. Ugolev. Membrane maldigestion results from atrophic changes in the small bowel mucosa in gluten-sensitivity celiac disease, enteric infections, excessive small intestinal microflora growth, and intestinal damages induced by nonsteroidal anti-inflammatory drugs, some antibiotics, and antimetabolites. Clinically, it presents with poor tolerability of nutrients containing oligomers, whose digestion is impaired, and with malabsorption symptoms. Indirect (load) and direct (perfusion) tests, as well as biochemical and histological studies of the activity of membrane enzymes are proposed for the diagnosis of membrane maldigestion. The detection and elimination of agents that damage the intestinal mucosa (gluten, lactose, pathogenic microflora, and pharmacologicals) form the basis for the etiotropic treatment of patients with impaired MD. A. M. Ugolev's discovery has led not only to the major general biological generalization - the current theory of digestion, but also to the revision of the pathogenesis, clinical signs, and treatment of diseases accompanied by enteric food malassimilation.
Terapevticheskii arkhiv. 2010;82(2):5-10
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Clinical value of the time course of changes in postprandial intragastric acidity

Kolesnikova I.Y., Kolesnikova I.Y.


Aim. to study the level and duration of postprandial pH abnormalities in the body of the stomach in healthy individuals and in patients with duodenal peptic ulcer (DPU). Subjects and methods. 24-hour pH-metry was used to study the degree and duration of postprandial pH abnormalities in the body of the stomach in 50 healthy individuals and 188 patients with DPU. Results. Interdigestive gastric pH in healthy individuals was significantly higher than that in patients with DPU; food intake was followed by an 86 ± 3.4% increase in pH, the latter returned to the baseline pH values within 64.7-70.3 minutes. In the uncomplicated course of DPU, the mean postprandial pH increase was comparable in the level and duration with the similar indices in healthy individuals. Complicated DPU was characterized by a short-term and insignificant increase in postprandial pH. Conclusion. The mean postprandial pH increase and the time of its return to the baseline level in uncomplicated DPU were comparable with those in healthy individuals; there was a significant reduction in these indices in complicated DPU.
Terapevticheskii arkhiv. 2010;82(2):11-13
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Experience in using immunal in the complex treatment of patients with torpid peptic ulcer

Vakhrushev Y.M., Balagatdinov A.R., Vakhrushev Y.M., Balagatdinov A.R.


Aim. to provide a rationale for the use of immunal in intractable gastroduodenal peptic ulcers (PU), by studying Helicobacter pylori genotypes and immunological parameters. Subjects and methods. Sixty-eight patients (37 men and 31 women) with torpid PU were examined. A study group comprised 35 patients who took immunal as a component of complex eradication therapy; a control group included 33 patients who received complex eradication therapy only. In addition to clinical and endoscopic data, the values of H. pylori genotypes were used to evaluate therapeutic efficiency. Results. The inclusion of immunal into the complex therapy in patients with torpid PU exerts a significant clinical effect in relieving the pain syndrome and dyspeptic symptoms and in accelerating ulcer cicatrization. The disappearance of virulent H. pylori strains was noted during treatment. Recovery of phagocytic, cellular, and humoral immunities is an important result of therapy. Conclusion. The use of immunal as a component of complex therapy for torpid PU is pathogenetically founded and clinically effective.
Terapevticheskii arkhiv. 2010;82(2):13-17
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Results of evaluating the functional state of the gastric mucosa in duodenal peptic ulcer by means of a test GastroPanel in workers engaged in the manufacture of nitrogen compounds

Pomytkina T.E., Pomytkina T.E.


Aim. to study the specific features of working conditions in workers from the chemical plants manufacturing nitrogen compounds by the groups under study and by the time course of changes in the serum levels of gastrin-17 (G-17) and pepsinogen-1 (P-1) in relation to the chemical composition of noxious substances, the length of service, the stage of the disease, and the performed therapy. Subjects and methods. A test GastroPanel was used to study the serum levels of G-17 and P-1 in 54 patients with duodenal peptic ulcer (DPU) who worked at the chemical plants manufacturing nitrogen compounds (a study group) and in 15 healthy individuals (a control group). Results. The objective data on the time course of changes in the functional characteristics (G-17 and P-1) of the gastric mucosa (GM) in patients with DPU vary with the chemical composition of noxious substances and the length of service in chemical industry. The basic therapy for PDU contributes to a positive change in the functional parameters reflecting the state of GM. Conclusion. In patients with DPU, the working conditions at the chemical plants manufacturing nitrogen compounds result in changes in the functional parameters reflecting the state of GM.
Terapevticheskii arkhiv. 2010;82(2):17-20
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Time course of changes in the gastric juice levels of nitric oxide in patients with upper digestive tract diseases

Esedov E.M., Magomedeminova A.S., Esedov E.M., Magomedeminova A.S.


Aim. to study the time course of changes in the gastric juice levels of nitric oxide (NO) in patients with esophagogastroduonenal diseases (EGDD). Subjects and methods. One hundred and seventy-four patients with EGDD were examined. Results. In patients with chronic atrophic gastritis, the level of NO was significantly lower than the normal levels and correlated with the magnitude of mucosal atrophy. Elevated gastric juice NO levels were noted at exacerbations of gastroesophageal reflux disease (GERD), chronic nonatrophic gastritis (CNAG), and duodenal ulcer disease (DUD). At the end of a therapy course, the gastric juice levels of NO did not achieve the control values in patients with GERD, reduced to the normal values in those with CNAG, although became lower, but remained above the normal values in DUD in a remission phase. Conclusion. The patients with EGDD were observed to have heterodirectional changes in the content of NO in gastric juice. In the patients with DUD, the remaining gastric juice NO levels above the normal values after ulcerative defect cicatrization are indicative of incomplete reparative processes in the gastric mucosa, i.e. delayed morphological remission. In chronic atrophic gastritis, the gastric juice levels of NO did not achieve normal values after treatment despite the onset of clinical remission which may be caused by a continuous gastric mucosal atrophic process.
Terapevticheskii arkhiv. 2010;82(2):21-24
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Digestive system pathology in patients with chronic obstructive pulmonary disease concurrent with coronary heart disease

Shoykhet Y.N., Klester E.B., Shoikhet Y.N., Klester E.B.


Aim. to study clinical and functional impairments in the digestive system in patients with chronic obstructive pulmonary disease (COPD), including that in the presence of coronary heart disease (CHD). Subjects and methods. Clinical and functional impairments were analyzed in 1104 patients. Of them, 402 patients had COPD (Group 1); 459 had COPD concurrent with angina on exertion (Group 2); 243 had CHD (Group 3). All the patients suffered from cardiovascular diseases. Results. In patients with concomitant pathology, chronic gastritis is a most frequently detectable disease of the digestive system (62.3%), gastroenterological complaints being insignificant. The rate of Helicobacter pylori infection was 68.2% (in Group 2 patients) to 83.7% (in Group 1). A morphological study indicated that in concomitant pathology the number of patients with signs of atrophy increased; at the same time there were microcirculatory disorders in the gastric mucosa. Ulcerative disease was diagnosed in one third of the patients, a gastric ulcerative process being more commonly located in the stomach. Gastroesophageal reflux disease was detected in 206 (51.2%) patients in Group 1, in 267 (58.2%) in Group 2, and in 113 (46.5%) in Group 3. Conclusion. By resulting in the mutual burden of the disease, the high rate of concomitant digestive pathology necessitates additional examination and mandatory medical correction in patients with COPD.
Terapevticheskii arkhiv. 2010;82(2):25-28
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The parameters of collagen proteolytic and metabolic systems in chronic liver diseases of viral and toxic etiologies

Beloborodova E.V., Beloborodova E.I., Akbasheva O.E., Serebrov V.Y., Chernogoryuk G.E., Rachkovskiy M.I., Purlik I.L., Ostanko V.L., Chvyrina D.V., Beloborodova E.V., Beloborodova E.I., Akbasheva O.E., Serebrov V.Y., Chernogoryuk G.E., Rachkovsky M.I., Purlik I.L., Ostanko V.L., Chvyrina D.V.


Aim. to study a relationship of the plasma activity of elastase-like and collagenase-like proteinases and their inhibitors to hepatic collagen metabolism and to detect the serum markers of fibrosis severity. Subjects and methods. Three hundred and fifty-nine patients with chronic liver diseases (CLD), including 118 patients with chronic viral hepatitis (CVH), 113 with CVH concurrent with alcoholic liver disease (ALD), 109 with ALD, and 19 with CLD in the presence of opiomania were examined. The activities of α1-proteinase inhibitor and α2-macroglobulin (α2-MG) were determined by the unified spectrophometric assay from the inhibition of N-benzoyl-arginine ethyl ester hydrolysis. The activity of elastase-like proteinases was determined by enzymatic assay from the hydrolysis of the synthetic substrate N-butyloxycarbonyl-L-alanine-para-nitrophenyl ester. That of collagenase-like proteinases was determined, by using a collagen type I substrate and expressed in terms of micromoles of the resultant hydroxyproline. The content of hydroxyproline was determined by a color reaction with demethylbenzaldehyde, a free, peptide- and protein-bound hydroxyproline; their fraction was obtained under various conditions of plasma protein isolation and hydrolysis. Plasma fibronectin levels were measured by solid-phase immunoassay. Liver biopsy specimens were morphologically studied in the majority of patients to determine the histological hepatitis activity index and the stage of fibrosis. Results. Fibrosis formation in the liver in its chronic diseases was attended by a significant reduction in the activity of collagenase-like proteinases hydrolyzing collagen and by the lower activity of α2-MG, an inhibitor limiting collagen formation. Conclusion. The identified changes make themselves evident just in early fibrosis, which suggests the rapid onset of imbalance in the mechanisms responsible for regulation of connective tissue synthesis and promotes intensified fibrosis formation.
Terapevticheskii arkhiv. 2010;82(2):29-34
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Clinical and morphological characteristics of portal gastropathy in patients with liver cirrhosis

Tsukanov V.V., Krasnova M.V., Amel'chugova O.S., Tsukanov V.V., Krasnova M.V., Amelchugova O.S.


Aim. to study the clinical and morphological manifestations of portal gastropathy in patients with liver cirrhosis (LC). Subjects and methods. One hundred and sixty-nine patients with Child-Pugh Classes B and C CL and 150 patients with gastritis and peptic ulcer disease without LC were examined. All the patients underwent fibrogastroscopy and morphological study of the gastric mucosa (GM). Morphological and serological studies detected Helicobacter pylori in all the patients. Results. The endoscopic signs of portal gastropathy were found in 46.7-50.9% of the patients with LC; dilated capillaries and microbleedings in the GM were recorded in 73.9-83.7%. Ulcerative and erosive defects of the gastroduodenal area were identified in 31.9% of the patients with CL and these were accompanied by hemorrhages in 50% of cases. In patients with ulcers and erosions, the diameter of capillaries in different gastric portions was 23-56% larger than that in patients without these abnormalities. There was a significant direct correlation between the presence of H. pylori IgG and the morphological signs of portal gastropathy in the antrum. Conclusion. An association was found between the signs of portal gastropathy and the presence of ulcerative and erosive defects in the gastroduodenal area in patients with LC.
Terapevticheskii arkhiv. 2010;82(2):34-37
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USE of allogeneic mesenchymal stem cells in the treatment of intestinal inflammatory diseases

Lazebnik L.B., Konoplyannikov A.G., Knyazev O.V., Parfenov A.I., Tsaregorodtseva T.M., Ruchkina I.N., Khomeriki S.G., Rogozina V.A., Konoplyannikova O.A., Lazebnik L.B., Konoplyannikov A.G., Knyazev O.V., Parfenov A.I., Tsaregorodtseva T.M., Ruchkina I.N., Khomeriki S.G., Rogozina V.A., Konoplyannikova O.A.


Aim. to determine the whether mesenchymal stem cells (MSC) may be used in the treatment of patients with chronic intestinal inflammatory diseases (IID). Subjects and methods. Thirty-nine patients with ulcerative colitis (UC) (Group 1) and 11 with Crohn's disease (CD) (Group 2) were examined. Comparative groups included 30 patients with UC (Group 2) and 10 with CD (Group 4). Two-three days before MSC administration, immunodepressants were discontinued, the dosage of corticosteroids was reduced to 15-20 mg/day, and that of aminosalicylates remained to be 2 g/day. The results were quantified using the mean values of the Rachmilewich clinical activity index, the Crohn's disease activity index and the Mayo and Gebs scales. The patients were followed up for 4-8 months. Humoral immunological indices (cytokines, autologous antibodies) were determined. Bone marrow cells were obtained from the donor sternum or iliac crest. Cultivation at the end of weeks 5-6 provided a population of allogeneic donor MSC in a quantity of (1.5-2)108 cells required for transplantation to a patient. MSC cultures were once injected intravenously in a dropwise fashion. Results. A statistically significant decrease in the indices of the clinical and morphological activities of an inflammatory process was noted in 39 patients with UC and in 11 patients with CD as compared with the comparison groups after MSC transplantation. Clinicomorphological remission occurred in 40 patients. Inclusion of MSC into the treatment program was ineffective in 8 patients with UC and in 2 patients with CD. The use of MSC made it possible to discontinue corticosteroids in 34 of the 50 patients with the hormone-dependent and hormone-resistant forms of UC and CD and to reduce the dose of prednisolone to 5 mg/day in 7 patients, by administering 5-aminosalicylic acid only. Conclusion. The use of MSC may be appreciated as a new strategic direction of therapy for IID. The intravenously administered stem cells exert a potent immunomodulatory effect, reduce the activity of autoimmune inflammation, and stimulate a reparative process in the intestinal mucosa.
Terapevticheskii arkhiv. 2010;82(2):38-43
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Bone mineral density in patients with gluten-sensitivity celiac disease

Albulova E.A., Drozdov V.N., Parfenov A.I., Vyazhevich Y.V., Petrakov A.V., Varvanina G.G., Albulova E.A., Drozdov V.N., Parfenov A.I., Vyazhevich Y.V., Petrakov A.V., Varvanina G.G.


Aim. to determine the frequency of development of osteopenia/ostoporosis (OP), vitamin D deficiency, some population risk factors, and the effects of α-calcidol and calcitriol on bone mineral density (BMD) in patients with gluten-sensitivity celiac disease (GSCD). Subjects and methods. Densitometry of the lumbar vertebra and femoral neck (FN) was carried out in 47 patients with GSCD. Their sera were tested for 25OHD3, 1,25(OH)2D3, total alkaline phosphatase, calcium, phosphorus, parathyroid hormone (PTH), type 1 collagen type C-telopeptides (CrossLaps) and tumor necrosis factor-α (TNF-α), as well as urinary creatinine and calcium. Results. The T score below -1 was found in 37 (78.7%) of the patients. BMD reduced to the level of osteopenia in 51.1% of the patients; OP was detected in 27.7%. Lower BMD was noted in 19 (95%) of the 20 menopausal women and in 15 (68.2%) of the 22 females with preserved menstrual function (p = 0.047). The mean value of 25OHD3 was 47.8 ± 5.0 in patients with OP patients and 85.6 ± 7.1 ng/l in those with normal BMD (p < 0.001). The latter had no decreased level of vitamin D, suggesting its deficiency, but 11 (30%) osteopenic patients were found to have vitamin D deficiency (25OHD3 < 30 ng/l). Impaired calcitriol synthesis (69.9 ± 24.0 ng/l) was observed only in patients with OP; the level of calcitriol was 85.6 ± 31.2 ng/ml in those with normal BMD. Decreased BMD was accompanied by elevated PTH levels in 25 (67%) patients with GSCD. There were increases in the bone resorption marker CrossLaps and in the level of TNF-α in 28 (76%) and 8 (22%) osteopenic patients, respectively. A more significant BMD reduction was seen in the presence of antibodies to gliadin and tissue transglutaminase. A significant correlation was found between the titer of immunoglobulin A antibodies to gliadin and TNF-α (ρ = -0.57; p = 0.035), CrossLaps (ρ = -0.58; p = 0.035), T scores in the vertebral column and FN (ρ = -0.62; p = 0.030) and (ρ = -0.37; p = 0.06), respectively. Conclusion. The risk for OP in patients with GSCD is affected by menopause and the clinical features of the disease: secondary hyperparathyroidism due to impaired calcium and vitamin D absorption, by the activity of immunological inflammation and the compliance with a gluten-free diet. The immunological activity of inflammation is closely related to the activation of bone resorption and enhances a BMT reduction in patients with celiac disease. The use of vitamin D preparations (α-calcidol and calcitriol) in combination with calcium salts lowers BMD in patients with celiac disease just within the first 6 months.
Terapevticheskii arkhiv. 2010;82(2):43-48
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Fecal excretion of short-chain fatty acids as a marker of the severity of ulcerative colitis

Kosacheva T.A., Sil'vestrova S.Y., Drozdov V.N., Kosacheva T.A., Silvestrova S.Y., Drozdov V.N.


Aim. to determine the fecal excretion of short-chain fatty acids (SCFA) in patients with active ulcerative colitis (UC) depending on the duration, activity, and severity of the disease. Subjects and methods. The study enrolled 53 patients, including 9 patients with proctosigmoiditis, 18 with left-sided colitis, and 26 with total colonic lesion. The total levels of metabolites, the concentrations of acetic, propionic, and butyric acids in the feces were measured by gas liquid chromatography. Results. Comparison of the excretion of bacterial metabolites with the clinical activity index (CAI) and the endoscopic activity index (EAI) revealed that the level of bacterial metabolites increased with an EAI of 21-30 scores and a CAI of 9-12 scores and then drastically decreased with excess of these values (a group of patients with total colonic lesion). With an EAI of less than 20 scores, the total level of metabolites was 8.91 ± 1.027 mg/g. It rose steeply up to 17.12 ± 1.55 mg/g in the activity range of 21 to 30 scores, but dropped up 5.291 ± 0.916 mg/g when the EIA was more than 31 scores. The more severity of UC by the CAI resulted in a reduction in the total level of the metabolites from 12.84 ± 2.039 to 5.114 ± 1.186 mg/g. Conclusion. SCFA deficiency caused by impaired synthesis occurs only in severe total UC. In patients with UC, fecal SCFA excretion increases with the longer duration of an inflammatory process and with its higher activity.
Terapevticheskii arkhiv. 2010;82(2):48-51
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Lower extremity deep vein thrombosis associated with gluten-sensitivity celiac disease

Baryshnikov E.N., Krums L.M., Vorob'eva N.N., Parfenov A.I., Baryshnikov E.N., Krums L.M., Vorobyeva N.N., Parfenov A.I.


The paper describes a clinical case of gluten-sensitivity celiac disease (GSCD) and recurrent lower extremity vein thrombosis in a female patient. According to the data available in the literature, GSCD is associated with increased risk for thrombosis. Hyperhomocysteinemia and protein S, folates, and vitamin B12 deficiencies may be responsible for thrombophilia in GSCD. Moreover, GSCD may be associated with antiphospholipid syndrome.
Terapevticheskii arkhiv. 2010;82(2):52-54
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Case of disseminated intestinal and cutaneous thromboangiitis (Kohlmeier-Degos' syndrome)

Gasanenko L.N., Kapust'yan O.V., Ovsyannikov N.V., Mazhbich S.M., Kapralov E.A., Bagisheva N.V., Kononov A.V., Kochetov A.M., Borisenko M.V., Gasanenko L.N., Kapustyan O.V., Ovsyannikov N.V., Mazhbich S.M., Kapralov E.A., Bagisheva N.V., Kononov A.V., Kochetov A.M., Borisenko M.V.


Disseminated intestinal and cutaneous thromboangiitis (Kohlmeier-Degos' syndrome) is a rare syndrome of unknown etiology, which is characterized by cutaneous and visceral involvement. Two (cutaneous and visceral) stages are identified. A fatal outcome is inevitable although there may be a long (8-20-year) course of the disease during a benign process. The causes of death are peritonitis, central nervous system impairments, pleurisy, pericarditis. The paper describes a case of disseminated intestinal and cutaneous thromboangiitis (Kohlmeier-Degos' syndrome) in a 32-year-old female patient who has died from intoxication due to severely impaired permeability of the epithelial barrier mainly of the large bowel (diphtheritic inflammation of the mucosa, severe inflammatory edema of the submucous layer, and fibrinous impregnation of the serous membrane).
Terapevticheskii arkhiv. 2010;82(2):54-56
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A case of chronic Budd-Chiari syndrome

Zheltova O.I., Batorov E.V., Starostina N.M., Zheltova O.I., Batorov E.V., Starostina N.M.


The Budd-Chiari syndrome is a rare disease associated with occlusion of the hepatic vein by a tumor or a thrombus. It develops due to progressive narrowing or occlusion of the hepatic veins and may occasionally proceed through the chronic disease within months, rarely years as individual recurrences, with pains, enlarged liver, and mild jaundice. These patients generally have partial hepatic vein occlusion. The paper describes a long (more than 20 years) course of the Budd-Chiari syndrome in which only a special angiographic study could verify the presumptive diagnosis and reveal the cause of evolving liver cirrhosis.
Terapevticheskii arkhiv. 2010;82(2):56-59
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A rare complication of imatinib mesylate therapy: drug-induced pneumonitis

Stakhina O.V., Turkina A.G., Kostina I.E., Kochkareva Y.B., Stakhina O.V., Turkina A.G., Kostina I.E., Kochkareva Y.B.


The use of imatinib mesylate (Glivec®) (Novartis Pharma AG, Switzerland) that is the drug of choice in treating patients with chronic myeloid leukemia (CML) has increased 7-year survival and improved the prognosis of the disease. The drug is generally tolerated well; the proportion of patients in whom imatinib treatment results in the development of toxic complications is small. Drug-induced interstitial pneumonitis associated with imatinib therapy is a rare complication that requires timely differential diagnosis, discontinuation of an inductor (imatinib), and altered further treatment policy.
Terapevticheskii arkhiv. 2010;82(2):59-61
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Genetic aspects of digestive diseases. Part 1

Grigor'eva I.N., Nikitenko T.M., Tikhonov A.V., Romanova T.I., Maksimov V.N., Shakhtshneyder E.V., Malyutina S.K., Voevoda M.I., Grigoryeva I.N., Nikitenko T.M., Tikhonov A.V., Romanova T.I., Maksimov V.N., Shakhtshneider E.V., Malyutina S.K., Voyevoda M.I.


The paper presents the data available in the literature on mutations in known genes in pancreatitis, such as cationic trypsinogen (PRSS1), pancreatic secretory trypsin inhibitor (PSTI/SPINK1), cystic fibrosis (CFTR), and apolipoprotein E (APOE) genes, as well as the new candidate gene - chymotrypsinogen (CTRC). It also gives the results of the authors' studies estimating the spread of the mutations in the PRSS1 (2.5%), PSTI/SPINK1 (3.3%), and CFTR (0.8%) genes, as well as APOE polymorphism in patients with pancreatitis. It is shown that the E4 allele of the APOE gene was more frequently identified in patients with acute pancreatitis than in those with chronic pancreatitis (0.143 ± 0.05 and 0.026 ± 0.02, respectively; p < 0.05). An overview is given of 7 major classes of candidate genes implicated in the pathogenesis of cholesterol cholelithiasis (CL): hepatic enzymes regulating blood lipid composition; receptors of lipoproteins, hepatic and intestinal membrane and intracellular transport proteins; factors regulating the transcription of lipids and bile salts, cholecystokinin and its receptors, and mucin. In the authors' epidemiological study, the spread of APOE alleles and genotypes did not differ in women with and without CL; low molecular-weight apolipoprotein(a) isoforms (B, S2) were significantly found in patients with CL than in those without CL; the spread of the CG genotype in the TRPM8 gene was significantly lower in women with cholesterol CL than that in the Novosibirsk population. These polymorphisms have been proved to be associated with bile cholesterol concentrations in women with cholesterol CL. The opposite effect of the APOE4 allele on gallbladder stone formation processes is demonstrated, by using the APOE polymorphism as an example, which shows it necessary to examine each specific population to elicit a possible association between the polymorphism of different genes and gastrointestinal tract diseases.
Terapevticheskii arkhiv. 2010;82(2):62-66
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Crohn's disease: Genetic aspects

Loranskaya I.D., Stepanova E.V., Loranskaya I.D., Stepanova E.V.


The paper deals with the topical problem of modern gastroenterology and coloproctology - the influence of genetic factors on the development and course of Crohn's disease (CD). It presents the data of foreign authors and the results of Russia's first study evaluating the effect of the major polymorphic variants of the NOD2/CARD15 gene predisposing to CD on the risk, course, and other features of CD.
Terapevticheskii arkhiv. 2010;82(2):66-70
pages 66-70 views

Endothelial dysfunction in patients with systemic lupus erythematosus

Serikova S.Y., Kozlovskaya N.L., Shilov E.M., Serikova S.Y., Kozlovskaya N.L., Shilov E.M.


It is currently shown that endothelial function study is a rather informative way of assessing the cardiovascular risk. Many investigations have shown the high rate of endothelial dysfunction (ED) in systemic lupus erythematosus (SLE); however, clinical data on ED in patients with SLE are scarce; which seems to be generated by difficulties in the diagnosis of this condition and to necessitate the modification of the existing diagnostic methods. The signs of ED were detected in 40% of the patients. Its development was associated with the activity of SLE, the presence of Raynaud's syndrome, elevated systolic blood pressure, plasma fibrinogen levels, and the larger daily dose of prednisolone. The method proposed by the authors to study endothelial function from the diagnostic capacities on the basis of volumetric compression oscillometry is comparable with the standard ultrasound method, which allows its clinical use to evaluate the endothelial state.
Terapevticheskii arkhiv. 2010;82(2):70-74
pages 70-74 views

Retsenziya na knigu A.I. Parfenov. Enterologiya. Rukovodstvo dlya vrachey, M. 2009

Pal'tsev A.I.
Terapevticheskii arkhiv. 2010;82(2):75-76
pages 75-76 views

Retsenziya na knigu G.F. Korot'ko. Fiziologiya sistemy pishchevareniya, Krasnodar. 2009

Tsimmerman Y.S.
Terapevticheskii arkhiv. 2010;82(2):76-76
pages 76-76 views

IX s\"ezd nauchnogo obshchestva gastroenterologov Rossii

Shcherbakov P.L., Bordin D.S.
Terapevticheskii arkhiv. 2010;82(2):77-80
pages 77-80 views

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