Vol 94, No 2S (2022)

Cover Page

Full Issue

Материалы конференций

pages 295-342 views

Assessment of exo- and endocrine function of pancreas following distal pancreatectomy

Malykh M.V., Dubtsova E.A., Vinokurova L.V., Les’ko K.A., Dorofeev A.S., Kiryukova M.A., Savina I.V., Tsvirkun V.V., Bordin D.S.


Aim. The assessment of pancreatic resection volume influence on exo- and endocrine pancreatic functions.

Materials and methods. The resected pancreatic volume influence was assessed in 47 patients: 31 (66%) patients after resections of pancreatic body and tail, and 16 (34%) patients after distal resections. The exocrine pancreatic function was assessed by pancreatic fecal elastase 1 as well as endocrine pancreatic function was assessed by C-peptide level measurement. Computed tomography with intravenous contrast enhancement and postprocessing was used for pre- and postoperative pancreatic volume assessment. All tests were performed before and 1, 3, and 6 months after surgery.

Results. Type of surgery had no influence on C-peptide and pancreatic fecal elastase 1 levels (p>0.05). Exo- and endocrine pancreatic functions markers tended to decrease in 1st month after surgery with consequent functions restoration towards 6 months after surgery. There were 15 (35.7%) patients from 42 patients with normal exocrine pancreatic function with a fecal elastase 1 level decrease to 114.7±61.8 μg/g; exocrine insuficiency remained only in 2 (4.8%) patients after 6 months after surgery. C-peptide concentration decrease before surgery to less than 1.1 ng/ml was noticed only in 8 (17%) patients. C-peptide concentration decreased in 30 (63.8%) patients in 1st month after surgery, but after 6 months after surgery, C-peptide level decrease was only in 7 (14.9%) patients.

Conclusion. The exo- and endocrine function of the pancreas is restored in more than 80% of patients after DR. Probably it could be associated with the activation of the pancreatic compensatory abilities.

Terapevticheskii arkhiv. 2022;94(2S):343-348
pages 343-348 views

Clinical-anthropometric and laboratory-instrumental characteristics of iron deficiency states in children with celiac disease

Ivenskaya T.A., Klimov L.Y., Kuryaninova V.A., Yagupova A.V., Stoyan M.V.


Aim. To increase detection frequency and reduce the risk of celiac disease complications based on a comprehensive analysis of patterns of iron deficiency states in the active period of celiac disease in children.

Materials and methods. 228 children diagnosed with celiac disease, aged 8 months to 18 years, were enrolled. Forms of iron deficiency (ID) were determined according to the complete blood count.

Results. The median age of onset was 1.0 [0.6; 2.6] years in children without ID; 1.0 [0.5; 2.1] years in the latent iron deficiency (LID) group and 1.2 [0.5; 3.0] years in children with iron deficiency anemia (IDA). The median age at diagnosis of celiac disease in the analyzed groups was years, respectively. Gastrointestinal symptoms of celiac disease were more common in children with IDA, who were diagnosed with total villous atrophy of the small intestinal mucosa (SIM) in 82.1% of cases, which was 5 times higher than in children with LID (p=0.001) and 2.5 times higher than in children without IDS (p=0.001).

Conclusion. Iron deficiency states in the active period of celiac disease have been diagnosed in 73.3% of patients, with the highest incidence observed in infants and older children.

Terapevticheskii arkhiv. 2022;94(2S):349-355
pages 349-355 views

Visceral sensitivity in diagnostics and treatment of severe irritated bowel syndrome

Makarova A.A., Diukova G.M., Ruchkina I.N., Romashkina N.V., Indejkina L.K., Degterev D.A., Dbar S.R., Parfenov A.I.


Background. Irritable bowel syndrome (IBS) is a biopsychosocial model based on the malfunction of "brain-intestinal linking".

Aim. To improve diagnostics of the severe IBS accompanied with somatoform disorders by using balloon dilatation test (BDT) and optimize the therapy by using antidepressants from the serotonin and noradrenaline reuptake inhibitor type.

Materials and methods. 61 patients with severe IBS and diarrhea were examined, among them 29 female with a median age of 31 years old (24; 36), and 31 male with a median age of 31 (24; 36) years old. All patients were randomized into two groups, group 1 consisted of 30 patients (15 female, 15 male), group 2 consisted of 31 patients (15 female, 16 male).

The symptoms of all patients were assessed using the Visual Analogue Pain Scale (VAS Pain), visceral sensitivity index (VIS) was assessed according to the J. Labus questionnaire (2007) and visceral sensitivity threshold was assessed according to the BDT, the psycho-emotional state was assessed using the Beck scale of anxiety and depression and the Spielberger-Khanin scale. Both group patients underwent a comparative effectiveness evaluation between the therapy based on the use of Trimebutine at a dose of 600 mg per day and the SNRI-Duloxetine therapy at a dose of 60 mg per day for 8 weeks.

Results. Patients from group with severe IBS and diarrhea who had undergone the antidepressant therapy showed the decrease of pain syndrome from 7 (5; 7) to 2.5 (2; 3) points according to VAS Pain; normalization of stool frequency from 7 (6; 9) to 2 (1; 2) times a day; normalization of stool consistency from 6 (6; 7) to 3 (3; 4) type; and decrease of VIS: first urge from 56 (34; 74) to 95 (80; 98) ml.; as well as the decrease of the depression level (Beck scale) from 26 (23; 32) to 11.5 (10; 13) points and anxiety according to Beck scale from 38 (31; 45) to 11 (10; 12), the decrease of personal anxiety level (Spielberger-Khanin scale) from 42.5 (35; 53) to 22 (20; 24) points, and the decrease of situational anxiety from 40 (37; 49) to 22 (21; 36) points. During the trimebutine therapy in group 1, the clinical symptoms of IBS have persisted. According to the BDT, the visceral sensitivity (HF) threshold remained at a low level. And the indicators of anxiety and depression remained at a high level according to the psychometric scales.

Conclusion. The insufficient effect of the trimebutine therapy can be explained by the somatoform disorders persistence in patients from group 1. Meanwhile SNRI-duloxetine therapy in group 2 showed a clinical remission of IBS: such as a reliable relief from pain and diarrheal syndrome, as well as an increase in the HF threshold.

Thus, Duloxetine is a promising treatment for severe IBS with somatoform disorders. BDT can be used as an objective criterion to diagnose and evaluate the effectiveness of therapy in patients with IBS.

Terapevticheskii arkhiv. 2022;94(2S):356-361
pages 356-361 views

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