Nº 2 (2013)

The article considers the main infectious diseases involving the liver in the pathological process. The clinical and laboratory manifestations and morphological changes typical of viral, bacterial, protozoan and fungal diseases with clinical picture of liver injury are described. The methods of laboratory diagnosis and treatment principles for each nosology are presented.

The article presents the key principles of the differentiated use of enzyme preparation (EP) in different types of dyspepsia syndrome, in the pathogenesis of which the lack of functional activity of the pancreas occupies an important place. Differentiated approach to the administration of multienzyme preparations is essential for the effectiveness of treatment of various forms of dyspepsia. Administration of replacement enzyme therapy needs clear criteria, reasoned choice of the drug, appropriate daily dose, and the optimal timing of a course of treatment. Indications for the use of integrated EP containing bile and hemicellulose, such as Festal, are discussed. Their use is pathogenetically justified for a number of diseases of the digestive system, and they occupy a strong position in the arsenal of enzyme preparations.

Distal forms of ulcerative colitis, including proctitis, are the major problem of treatment of exacerbations of ulcerative colitis with aminosalicylates. This is due to the fact that release of the active substance during application of traditional drug mesalazine occurs in the more proximal parts of the colon. The article considers the potentials for the use of new Multi-Matrix system formulation of mesalazine (Mezavant) with prolonged release of the active substance, which provides a more homogenous distribution of the active substance using a single daily dose. This increases the effectiveness of treatment of exacerbations of ulcerative colitis, especially its distal forms, and reduces the risk of relapses.

The article presents the results of a comparative study of two schemes of modified consecutive antihelicobacter therapy: the first scheme included the lengthening of the period of treatment up to 14 days - 7 days at each stage, and the second scheme included the drug bismuth (De-Nol) for the all period of therapy (14 days). Pantoprazole (Controloc) was used in these schemes as a proton pump inhibitor. The results showed that consecutive therapy with Controloc and including De-Nol provides the eradication rate of more than 90 %, and can be a good alternative to current eradication schemes of first-line treatment of patients with H. pylori infection.

Current potentials for the use of antacids, primarily Maalox, in schemes of therapy of acid-related diseases (ARD), such as gastroesophageal reflex disease, various gastropathies, especially non-steroidal anti-inflammatory drugs-induced gastropathy, are discussed in detail. It is shown that modern antacids occupy an important place in therapy of ARD. Absolute advantages of antacids include the speed of action and the ability to quickly relief the symptoms. Efficiently using the potentials of modern antacids in combination with PPIs in patients with ARD allows to achieve good clinical outcomes and improve the quality of life of patients in a short time.

The article presents the epidemiology, pathogenesis, classification, algorithm of diagnosis, and methods of treatment of drug-induced liver injuries (DILI). Particular attention is paid to the etiology and pathogenesis of these lesions. System of diagnostic search, and the stages of diagnosis and differential diagnosis are discussed; current approaches to the therapy of DILI and the best options of medical treatment are analyzed. It is emphasized that Heptral (ademetionine) is the most effective drug for the treatment of DILI.