No 2 (2018)

Purpose of the review. Analysis of the Correa cascade. Overview of morphological types of atrophy, intestinal metplasia and dysplasia of the gastric mucosa (GM), as stages of gastro-carcinogenesis. Basic provisions. The Correa cascade is the sequential development of gastric adenocarcinoma by the progression of precancerous changes in the GM. Stages of the Correa cascade - atrophy, intestinal metaplasia and dysplasia - are considered as precancerous changes in the coolant, the triggering mechanism of which is the seeding of Helicobacter pylori GM. Thanks to the developed systems for assessing the mucosal condition in chronic gastritis, as well as the molecular and biological and genetic studies conducted, the Correa cascade received a clear morphological characterization of development at each stage, which makes it possible to develop a consistent plan for the management of patients for the purpose of cancer prevention. Сonclusion. The Correa cascade is the sequential development of gastric adenocarcinoma by the progression of precancerous changes in the GM. Eradication therapy in patients with premalignant changes in the gastric mucosa can reduce the risk of developing gastric cancer. Patients with H. pylori gastro-necrogenesis requires dynamic observation and treatment depending on the level of detected morphological changes.

Aim of the research. Studies of hyperlipidemic effect of psyllium in case of its long-term use (from 3 to 6 months) in patients with hyperlipidemia, metabolic syndrome and constipation as a monotherapy and as a part of combined therapy. Material and methods. Multicenter prospective randomized research work was performed. 721 patient from 19 to 91 y.o. with hyperlipidemia and different risk degree of cardiovascular diseases was involved. In dependence of risk degree of lipid metabolism disorders patients got monotherapy with psillium or psillium in combination with statines. Results. Efficacy of monotherapy with psillium as hypolipidemic remedy was fixed in 36,7% of patients with medium risk of cardiovascular diseases development: up to 12th week significant decrease of total cholesterol level to 6,8%, LDL cholesterol - at 10,62%. Up to the end of research work the decrease of that indexes consisted of 8,58 and 12,5%. On the phone of combined therapy (with statines), in spite of higher initial data, the decrease of total cholesterol level was 10,49%, and LDL cholesterol - 13,7%.In the groups of patients with high and very high risk of cardiovascular diseases development the hypolidemic effect of psillium is also proved. On the phone of prolongated treatment by this medicine the bowel evacuation returned to normal in the majority of cases. Conclusion. The possibility and practicability of psillium use in gastroenterologic patients with hyperlipidemia and bowel evacuation disorders as monotherapy and also in combination with statines was proved.

Epidemiology, semiotics, differential diagnostics of of irritable bowel syndrome on the basis of Rome IV criteria are considered. Trreatment of irritable bowel syndrome patients is described in details, particular attention is paid to new medicaments of basis and systemic therapy against visceral hypersensitivity and pain.

The immune response to standard scheme of seasonal vaccination against influenza was evaluated in HIV-infected patients without specific antibodies to influenza virus before vaccination. Titers of hemagglutinating antibodies to antigens of influenza virus A (H1N1), A (H3N2) and B were detected in standard agglutination inhibition test: before vaccination (day 0) and after it (on 21th and 150th days). Coefficient of seroconversion varied from 1.6to 2.3, seroconversion rate varied from 0to 25%); seroprotection rate - from 67% to A (H1N1) to 100% to A (H3N2) and B. Titer of antibodies detected on day 21 retained in all cases up to day 150 after vaccination. The minimal protective level of antibodies (1/40) was detected in the majority of vaccinated persons, including the at least fourfold increase of it in patients with CD4-cells level more than 350/pl.