No 2 (2012)

The article is dedicated to the basic principles of the treatment of Helicobacter pylori infection and role of amoxicillin as a main antibacterial component. Current recommendations of international consensus Maastricht II-III devoted eradication therapy of H. pylori infection are discussed. The possible ways to solving problems of resistance of H. pylori to antibiotics included in eradication scheme with reference on amoxicillin are presented. Much attention is given to the prospects of use of new treatment regimens, in particular, sequential therapy and third-line eradication schemes. The algorithm of adjustment of optimal antihelicobacter therapy is presented.

There is a review of literature about results of experimental and clinical researches on silymarine presented in this article. Convincing evidences of existence in silymarine hepatoprotecting and anti-oxidative features, and also ability to stimulate regeneration of hepatocytes, to inhibit the liver fibrosis, and to act an antiviral effect are described. Reference drug of silymarine - Legalon has proved advantages in pharmacodynamics and clinical efficiency.

The article analyzes information on the prevalence and principles of treatment of Barretts esophagus. In Russia, the prevalence of Barretts esophagus is range from 1,5 to 2,9 %. In the US it varies from 1,5 to 5,0 %. Currently, the leading methods of treatment of Barretts esophagus are long-term administration of proton pump inhibitors or surgical interventions, including radiofrequency ablation.

Pantoprazole, proton pump inhibitor (PPI), blocks basal and stimulated secretion of hydrochloric acid in the stomach by inhibiting the H+/K+-ATPase. According to the literature data and own research results, antisecretory effect of pantoprazole is comparable with that of other PPIs. The main distinguishing features of pantoprazole are the lack of interaction with simultaneously taken drugs, the drug does not accumulate in the body, dose adjustment for elderly patients with the presence of renal and hepatic failure is not required, and its effect does not depend on the genetically determined metabolic rate in the liver. Modern medical regimens with pantoprazole for the treatment of gastroesophageal reflux disease, Helicobacter pylori infection, NSAID-associated gastropathy, and for the prevention and treatment of stress ulcers and gastroduodenal bleeding are presented.

The article analyzes modern information about the clinical features and therapeutic principles of treatment of peptic ulcer complications. Despite the declining prevalence of peptic ulcer disease in Western Europe and North America, the frequency of complications of the disease does not tend to decrease. In Russian Federation, the situation is especially unfavourable. Therapeutic treatment options for ulcer bleeding are parenteral administration of high doses of modern proton pump inhibitors, timely diagnosis, and eradication of Helicobacter pylori infection.

Minimal hepatic encephalopathy (latent, subclinical hepatic encephalopathy) is a frequent syndrome in patients with liver cirrhosis of different etiologies. Despite the absence of clinical symptoms, its presence significantly reduces the quality of life of patients with chronic diffuse liver diseases. Methods for detection of minimal hepatic encephalopathy are presented. The pathogenesis and pathogenetic substantiation of treatment with lactulose and other drugs are discussed.

On the one hand, diagnostic search in patients with iron deficiency anemia (IDA) is confined to the verification of this syndrome, and on the other hand, to the identification of the underlying disease (causes). In the setting of eliminable causes of IDA, therapy should be focused on the underlying disease and administration of iron preparations. In the presence of non-correctable causes, pathogenetic therapy with iron preparations is the primary method of treatment. The physicians must justify the choice of a particular iron preparation, route of administration; they must assess the efficacy and tolerability of the drug, and determine the duration of treatment and the need for maintenance therapy.

The article is dedicated to the main pathogenetic mechanisms of toxic metabolic chronic liver diseases (CLD). Characteristics of the major groups of hepatotropic drugs with more detailed discussion of the new combined medication Prohepar are demonstrated. The results of open controlled non-randomized clinical trial aimed to assessment of clinical efficacy and tolerability of Prohepar in patients with high AST/ALT levels against the background of proven metabolic CLD are presented.