Vol 28, No 7 (2017)

The paper analyzes the role of dietotherapy in the treatment of patients with nonalcoholic fatty liver disease (NAFLD). According to current clinical guidelines, dietotherapy and lifestyle changes are the basic treatment policy for patients with NAFLD regardless of its clinical form. A 7-10% weight loss is an obligatory condition for a clinically significant regression of necroinflammatory changes in the liver. The best effect of therapy for NAFLD is achieved through a low-calorie diet in combination with exercises.

The paper demonstrates the basic etiological and pathogenetic mechanisms of non-alcoholic fatty liver disease. Special attention is paid to management tactics for such patients on the basis of the guidelines of the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver (EASL), the European Association for the Study of Diabetes (EASD), the European Association for the Study of Obesity (EASO), the Russian Society for the Study of the Liver, and the Russian Gastroenterological Association.

The specific feature of a new liposuction technology for small adipose tissue volumes is its cytopreserving effect. No pronounced destructive action of low-frequency ultrasound on adipose tissue mesenchymal stem cells allows the use of this technology not only for liposculpture, but also for obtaining viable stem cells.

The paper gives the data of an investigation of the efficacy of the nail lacquer (amorolfine 5% - Exorolfinlac) in the treatment and prevention of onychomycosis. It presents an algorithm to choose a topical agent with regard to the etiology and clinical features of onychomycosis. The important advantage of Exorolfinlac is that the agent can be used for the primary and secondary prevention of onychomycosis.

Exenatide has been shown to have more positive effects on the efficiency of treatment for type 2 diabetes mellitus, on body mass index, frequency of acid refluxes, and levels of C-reactive protein than metformin.

The paper presents information on the features of the dermatoscopic pattern of the proximal nail fold during chronic graft versus host reaction (cGVHR) with cutaneous manifestations. It describes the nature of a vascular change in relation to the stage and form of cGVHR. An algorithm for dermatoscopic study of proximal nail fold vessels is given.

Acid production was comparatively analyzed in 150 patients with peptic disease with type III duodenal and gastric ulcers according to the classification developed by H. Johnson. Patients with duodenal ulcers were found to have a definite individual rhythm of daily intragastric acidity with its maximum during nocturnal hours. The features of gastric juice secretion were established depending on the location of ulcerative substrate. The paper shows a pathogenetic rationale for the use of antisecretory drugs in the treatment of duodenal ulcers and the need for the further improvement of a management algorithm for pyloric and prepyloric ulcers.

The paper shows the similar histological structure of the bezoar obtained during gastroscopy in one patient and the bezoars washed from the feces of other patients. An additional histochemical study with a positive lignin reaction has revealed that the fibrous structures of these masses (phytobezoars) are of plant origin. This suggests that digestion of plant food components is impaired because of the fibrous fixation of polymers that insulate the fibers from exposure to gastric juice enzymes. Gastroscopy with histological examination of mucosal specimens and fragments of undigested food particles is proposed for the early diagnosis and prevention of gastric obstruction.

The hemodynamics in the microcirculatory bed (MCB) as a response to blood loss was studied at the clinical bases of the Department of Surgery, I.M. Sechenov First Moscow State Medical University, together with the staff of the State Research Center of the Russian Federation the Institute of Biomedical Problems, Russian Academy of Sciences. The studies were conducted in 66 donors aged 21 to 42 years. MCB blood flow parameters measured by Doppler ultrasound were recorded and analyzed. The body's response to decreased circulating blood volume in the vascular bed was universal and identical in both healthy individuals and patients.

Clinical study of the application of the method of mesodiencephalic modulation in the treatment of glossalgia. Theoretical and practical substantiation of the methodology and evaluation of the results.

The paper describes a case, in which lymphoepithelioma (Schmincke’s tumor) has simulated a peritonsillar abscess.

The paper presents the basic problems of organization of municipal outpatient urological care and its perspectives, by introducing the principles of municipal-private partnerships. A program for restructuring the system in some conceptual areas is defined.