No 3 (2017)

Approved by XVI Congress of the Scientific Society of Gastroenterologists of Russia and XI National Congress of Internal Medicine on November 25, 2016.

In recent years, in Russia epidemic situation on the VCH becomes apparent. Increase in morbidity of chronic hepatitis C (CHC) from 31.8 cases per 100 000 in 2005 to 39.9 per 100 000 in 2011 is observed; VHC often affects young persons, with a high Level of chronization and such possible outcomes as cirrhosis and primary liver cancer. The processes at key stages of hepatitis C virus life cycle are the main targets in the development of drugs for the treatment of chronic hepatitis C. The treatment is indicated for patients with hepatitis C with compensated and decompensated chronic liver disease, previously treated or not to receiving treatment, ready to receive therapy and with no contraindications. Through to 2011, the combination of pegylated interferon (PegIFN)-α and ribavirin for 24 or 48 weeks was officially recommended CHC treatment. After approval of three new DAAs for the treatment of CHC in Europe in 2014, wide interferon-free treatment regimens come into common use. These schemes have been used mainly for the treatment of patients with severe liver damage (stage 3-4 liver fibrosis according METAVIR scale (F3, F4)). Combination of drugs requires careful use and dose adjustment, alternation in drug intake time, and additional monitoring. Drug interactions should be especially considered when choosing a combination therapy in HCV and HIV co-infection.

A review of the literature on the topical issues of rehabilitation of patients with functional bowel disorders such as irritable bowel syndrome is presented. The review based on the results of randomized studies conducted in the recent 10 years. We consider terms such as irritable bowel syndrome, visceral hypersensitivity, probiotics, electroacupuncture. It has been shown that the combined application of rehabilitation techniques in the management of patients with irritable bowel syndrome is very promising.

Metabolic syndrome (MS) represents a set of metabolic abnormalities that increase the risk of diabetes, cardiovascular and cerebrovascular disease. The components of MS are abdominal obesity, hypertension, disturbances of lipid and carbohydrate metabolism. The pathogenesis of the MS involves complex disorders of carbohydrate and fat metabolism caused by physical inactivity, a load of bad habits as well as by macro- and micronutrient imbalances in diet. Magnesium is one of the main factors supporting the physiological metabolism of sugars and fats as magnesium ion is required for the active sites of a number of enzymes. The paper presents the results of a systematic analysis of the molecular mechanisms of effects on magnesium characteristic of MS disorders of carbohydrate and fat metabolism. The results of experimental and clinical research and the evidence-based data indicate feasibility of using organic salts of magnesium with pyridoxine in the prevention and treatment of MS.

Hypothyroidism is the most common form of thyroid dysfunction. High prevalence and nonspecific symptoms that involves almost any organs and systems, as well as the possibility of monosymptomatic manifestation, causes that patient goes to a specialist of any profile, depending on the leading complaint. The main tasks in this case remain timely diagnostics and adequate therapeutic tactics. The standard treatment of hypothyroidism remains monotherapy with levothyroxine sodium, which allows to restore the euthyroid status in most of patients.

The article outlines the impact of the social personality type on patient's adherence to treatment. The characteristics of various psychotypes and approaches to their medicamentous management are presented. It is stressed that the improvement of patient adherence to treatment is an urgent public health problem. The use of modern methodological approaches for improving adherence to treatment can ensure the high efficiency performance of tasks in providing medical care to the patient, which in turn will increase the quality and duration of life.