No 15 (2015)

The article analyzes some aspects of the new international consensus on the management of patients with gastritis. A new classification of gastritis is presented; it indicates the possibility of development of inflammation in the stomach as a result of action not only Helicobacter pylori, but also other microorganisms. The article comments the provisions of guideline aimed to feasibility of serological screening of precancerous changes, the effectiveness of morphological methods in predicting the development of stomach cancer, the use of H. pylori eradication for the prevention of stomach cancer.

Torasemide is an alternative to conventional diuretics in the treatment of edematous-ascitic syndrome, the most common complication of hepatic cirrhosis. In recent years, a sustained-release torasemide (3B) appeared. Prolonged form (britomar), having all the properties of torasemide, provides a gradual release of the drug, which reduces fluctuations of the torasemide concentration in the blood plasma. The study was aimed to the evaluation of the efficacy and safety of torasemide 3B (britomar) in 42 patients with edematous-ascitic syndrome on the background of cirrhosis decompensation. All patients followed a diet with restriction of salt about 3 g/day, abstained from alcohol and received standard therapy for hepatic cirrhosis: transfusions of albumin and fresh frozen plasma, lactulose, ciprofloxacin, propranolol. The main group received torasemide 3B (n=20), the control group - furosemide (n=22). All patients received spironolactone. Drugs were taken orally in tablet form, for an average of 3 weeks. Initial doses of diuretic (torasemide 3B 10 mg, furosemide 40 mg, spironolactone 100 mg/day) were 2-fold increased every 3 days in the case of body weight loss less than 300 g/d. Against the background of diuretic therapy, both groups showed a decrease in edema syndrome: pastosity of legs and feet remained in 2 (10%) patients in torasemide 3B group; and in 6 (27%) patients in furosemide group. All patients had regression of ascites until I degree. More pronounced diuretic effect was observed in the torasemide 3B group. In the torasemide 3B group diuresis increased by an ave-rage of 865±660 ml, in the furosemide group - by 400±300 mL (p=0.018). Thus, comparison of furosemide and torasemide 3B in the study group indicates significantly greater diuretic and saluretic action. Statistically significant difference in weight loss and regression of edematous syndrome, however, have not been identified.

This retrospective study was aimed to the assessment of further course of the disease in patients with ulcerative colitis (UC), who initially had response to infliximab induction course and had relapses occurred against the background of maintenance therapy. There were 46 patients treated with infliximab during the year. Therapy was administered in the case of hormone dependence or hormone resistance. In the case of relapse, dose optimization before next administration was recommended. In the case of mild-to-moderate activity of relapse, therapeutic dose of 5-acetylsalicylic acid was prescribed to patients before the next administration. In severe attack and high activity, systemic corticosteroids were administered, and surgical treatment was considered. The study identified four types of course of UC on background of anticytokine therapy, depending on the frequency and timing of relapses. However, further observation of a large number of patients to clarify the frequency of occurrence of these types and their application in clinical practice is required.

In recent years, the data suggest that nutrition during infancy has significant influence on the risk of chronic non-communicable diseases in adults. The article presents the information about the role of individual food components in early childhood, which make an important contribution to understanding the formation of health of older children and adults, and allow to purposefully justify treatment and prevention programs.