Vol 23, No 10 (2012)

Cholelithiasis and hiatal hernia rank first and third, respectively, in the structure of surgical diseases of the gastrointestinal tract. Despite the fact that laparoscopic cholecystectomy has long become the gold standard for treatment of chronic calculous cholecystitis, the results of surgical treatment for cholelithiasis cannot be unrecognized as satisfactory. This happens frequently because comorbidity, such as hiatal hernia, is not intraoperatively corrected.

The paper considers whether chondroprotective agents may have an effect on carbohydrate metabolism, which is particularly important in terms of the high comorbidity of osteoarthrosis with diabetes mellitus. It presents current clinical guidelines for the use of chondroprotective agents in the therapy of osteoarthrosis.

The paper describes the clinical manifestations and pathogenesis of gastroesophageal reflux disease and proposes its diagnostic algorithm based on the evaluation of its symptoms, endoscopic findings, and alginate test results. The place of alginates in the treatment of results is defined, by taking into account their clinical efficacy.

The paper considers the anatomic structure of the biliary tract, the pathogenesis, classification, clinical manifestations of its dysfunction. Particular emphasis is laid on diagnostic algorithms. Recommendations are given for the use of Festal to correct digestive disorders in biliary tract dysfunctions.

The statistical decision theory using the solution square test describes well the stages of a decision making process. By choosing the type of anastomosis during gastrectomy for cancer, a surgeon takes into account the stage of the disease, the location of the tumor, the possibility of its invasion into the pancreas and duodenum. Besides, the priority predictors include the sizes of the stump of the stomach after its resection. According to the results of a questionnaire survey, the impact of the nonspecific effects of the social medium and the immediate environment of the surgeon on decision making was ambiguously evaluated. This seems to be due not only to the place of employment (country, region of the world), but also to the status of a physician, his/her position in the team.

The paper provides new evidence for the successful use of leflunomide in rheumatology and other fields of medicine. It analyzes the comparative efficacy of leflunomide and methotrexate and their combination used in rheumatoid arthritis and the antiviral activity of leflunomide.

The arterial wall was compared in patients with systemic lupus erythematosus (SLE) or in those with hypertensive disease. In the SLE group, systemic inflammatory activity was rated using the SLEDAI and ECLAM scales. All the patients underwent 24-hour blood pressure monitoring, by calculating the values of vascular wall rigidity during daylight and nocturnal hours, by estimating desquamated endotheliocytes in the Goryaev chamber, by determining plasma endothelin-1, and by performing duplex Doppler ultrasound of the cervical vessels. There was a relationship between decreased arterial elasticity and increased endothelial dysfunction in patients with SLE. The findings suggest that chronic autoimmune inflammation affects the higher values of vascular wall rigidity.

The paper considers clinical and morphofunctional changes in the digestive organs in cystic fibrosis. It describes a case of this condition mainly affecting the digestive organs in a female patient over 18 years of age.

The incidence and prevalence of ulcerative complications and their association with the major types of urologic pathology and with surgical interventions were studied in the large-scale mono-profile urology clinic City Clinical Urology Hospital Forty-Seven. The results of 8346 surgical interventions into urogenital system organs and 1960 esophagogastroduodenoscopies, performed in City Clinical Urology Hospital Forty-Seven in 2004-2010, were retrospectively analyzed. The study indicated that the efficiency of antiulcerative prophylaxis during urologic interventions for preexisting gastroduodenal peptic ulcer disease was inversely related to the traumaticity of an operation. There was a high risk for ulcerative complications during radical organ-removing interventions (cystectomy, prostatectomy, and, to a lesser extent, nephrectomy) for cancer. Along with surgical traumaticity and blood loss, malignancy was shown to be an essential risk factor.

Asthma and gastrointestinal tract (GIT) diseases have common pathogenetic mechanisms. Changes in the composition of the enteric microflora cause not only GIT dysfunction, but also the body's sensitization and asthmatic attacks, increase bronchial obstruction, and negatively affect therapeutic effectiveness.

The paper considers different approaches to antiarrhythmic and antithrombotic therapy for atrial fibrillation in athletes and gives recommendations for their access to different kinds of sports depending on the type of arrhythmia and its impact on hemodynamics and on the drug therapy.

A scientific rationale for a homeopathic method was studied within the framework of experimental biology and pharmacology. The clinical efficiency of the method was confirmed by a scaling analysis. The homeopathic method was proposed for extensive use in anti-aging medicine.