[The characteristics of elderly citizen of perceiving communication effects of issues of formation of healthy life-style]

The article discusses results of communication effects of various information actors on elderly citizen stimulating healthy life-style. The purpose of the study was to establish characteristics of perception by elderly Russians communication effects targeting formation and maintenance of healthy life-style, to determine degree of significance of communication channels by which such measures can provide high degree of individual motivation. The contradiction was established. From one hand, life span increases due to achievements of science, medicine and technologies promoting decreasing diseases' mortality and improving health indicators.From the other hand, the need in larger volume of caring services at lesser number of professional personnel providing social care and medical personnel comes up. It is established that age principle is one of the basic ones in segmentation of health state. According it, population of elderly age consists of several main groups having different social characteristics concerning conditions of life, medical indications, consumer behavior and information perception. The elderly pre-retired, elderly relatives, early retired, socially active retired. It is concluded that communication impact on elderly citizens concerning formation of healthy lifestyle and promotion of health saving practices are to be implemented considering specifics of particular communication channels (both interpersonal and mass ones). It is recommended in planning and implementing socially-oriented marketing and educational campaign not only to segment target audiences of senior citizens, but to evaluate degree of significance of communication channels for each of them.

[The social role of intergenerational sports: the formation of norms, citizenship and the value of a healthy lifestyle]

The article discusses issues reflecting the importance of intergenerational sports as an institution influencing the formation of social values, civic identity, health-saving attitudes, etc. The paper defines the main and specific functions of sport as a social institution. Based on the author's sociological research, the results are presented reflecting the attitude of participants of intergenerational sports groups to certain types of social impact that sports activities and events held in mixed age groups have.

<i>Clostridioides difficile</i> infection: diagnosis, treatment, and prevention Clinical guidelines of the Russian Scientific Medical Society of Internal Medicine, the Gastroenterological Scientific Society of Russia, and the North- West Society of Gastroenterologists and Hepatologists

   Clostridioides difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea, and an important cause of nosocomial infection. Since the publication of the National Guidelines (2016, 2017), new data have been accumulated on the genetic structure and pathogenic properties of the most common causative agent of severe forms of antibiotic- associated diarrhea, which has led to the reclassifi cation of the pathogen, formerly known as Clostridium diffi cile, to Clostridioides difficile. Laboratory algorithms have been developed to diagnose CDI and determine the toxigenicity of strains reliably. New data on the effectiveness of antibacterials  have been published, monoclonal antibodies to toxin B (bezlotoxumab) have been introduced into clinical practice to prevent CDI recurrence, and fecal microbiota transplantation has been proposed. Over the past 5 years, many international guidelines on the management of adult patients with CDI have also been updated (USA, EU). In the last decade, including due to the COVID-19 pandemic, there has been an increase in CDI incidence. Considering therelevance of CDI, new data on the pathogen, and domestic features, the Russian Scientific Medical Society of Internal Medicine, the Gastroenterological Scientific Society of Russia, and the North-West Society of Gastroenterologists and Hepatologists developed these clinical guidelines.

Gastrointestinal disorders in post-COVID syndrome. Clinical guidelines

Summary Post- COVID syndrome refers to the long-term consequences of a new coronavirus infection COVID-19, which includes a set of symptoms that develop or persist after COVID-19. Symptoms of gastrointestinal disorders in post- COVID syndrome, due to chronic infl ammation, the consequences of organ damage, prolonged hospitalization, social isolation, and other causes, can be persistent and require a multidisciplinary approach. The presented clinical practice guidelines consider the main preventive and therapeutic and diagnostic approaches to the management of patients with gastroenterological manifestations of postCOVID syndrome. The Guidelines were approved by the 17th National Congress of Internal Medicine and the 25th Congress of Gastroenterological Scientifi c Society of Russia.

[Effectiveness of empirical Helicobacter pylori eradication therapy with furazolidone in Russia: results from the European Registry on Helicobacter pylori Management (Hp-EuReg)]

BACKGROUND

First-line therapy does not always provide a high level of Helicobacter pylori eradication due to the increase of H. pylori resistance to antibiotics; therefore, it remains necessary to identify the most effective rescue treatments. The purpose of this study was to evaluate the efficacy and safety of empirical H. pylori furazolidone-containing regimens.

MATERIALS AND METHODS

Adult H. pylori infected patients empirically treated with furazolidone-containing eradication regimens were registered in an international, prospective, multicenter non-intervention European registry on H. pylori management (Hp-EuReg). Data were collected at AEG-REDCap e-CRF from 2013 to 2021 and the quality was reviewed. Modified intention-to-treat (mITT) effectiveness analyses were performed.

RESULTS

Overall 106 patients received empirical furazolidone-containing therapy in Russia. Furazolidone was prescribed in a sequential scheme along with amoxicillin, clarithromycin and a proton pump inhibitor in 68 (64%) cases, triple regimens were prescribed in 28 (26%) patients and quadruple regimens in 10 (9.4%). Treatment duration of 7 days was assigned to 2 (1.9%) patients, 10-day eradication therapy in case of 80 (75%) and 14 days - in 24 (23%) patients. Furazolidone was mainly used in first- (79%) and second-line (21%) regimens. The methods used to diagnose H. pylori infection were: histology (81%), stool antigen test (64%), ¹³C-urea breath test (6.6%), and rapid urease test (1.9%). The mITT effectiveness of sequential therapy was 100%; 93% with the triple therapy and 75.5% with quadruple therapy. Compliance was reported in 98% of cases. Adverse events were revealed in 5.7% of patients, mostly nausea (3.8%). No serious adverse events were reported.

CONCLUSION

Furazolidone containing eradication regimens appear to be an effective and safe empirical therapy in Russia.

Ulcerative colitis (K51), adults

.

Russian Consensus “Hyperammonemia in Adults” (Version 2021)

Justification Given the large number of reports on the peculiarities of liver lesions during the Sars-Cov-2 infection [1], a team of experts who participated in the 23rd Congress of the Scientific Society of Gastroenterologists of Russia and 15 National Congress of Therapists of November 19, 2020 decided to make additions to the Russian Consensus of “Hyperammonemia in Adults” published early 2020 [2, 3].

Management of patients with digestive diseases during the COVID-19 pandemic. Clinical Practice Guidelines by the Russian scientific medical society of internal medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (2nd edition)

The presented clinical practice guidelines of the Gastroenterological Scientific Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The guidelines were approved by the XXIII Congress of the GSSR and the 22nd International Slavonic-Baltic Scientifi c Forum “St. Petersburg - Gastro-2020 ON-LINE” (St. Petersburg, June 11, 2020). The presented clinical practice guidelines of the Russian Scientific Medical Society of Internal Medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The recommendations were approved at the XV National Congress of Internal Medicine, XXIII Congress of NOGR on the basis of the 1st edition, adopted at the 22nd International Slavic- Baltic Scientific Forum “St. Petersburg - Gastro-2020 ON-LINE”.

Non-alcoholic fatty liver disease in adults: clinic, diagnostics, treatment. Guidelines for therapists, third version

.

European Registry on the management of Helicobacter pylori infection (Hp-EuReg): analysis of 2360 patients receiving first-line therapy in Russia

AIM

European Registry on the management of Helicobacter pylori infection («Hp-EuReg») - a multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group, conducted in 27 European countries in order to evaluate the real clinical practice of diagnosis and treatment of H. pylori and its comparison with international recommendations.

MATERIALS AND METHODS

The analysis of 2360 patients entered in the register by the Russian centres of «Hp-EuReg» in 2013-2017, who were underwent 1st line eradication therapy.

RESULTS

The most common methods of primary diagnosis of H. pylori are histological (37.7%), rapid urease test (29.2%) and serology (29.7%). The duration of eradication therapy in 9.4% of cases was 7 days, in 65.3% - 10 days, and in 25.3% - 14 days. To control the effec- tiveness of treatment, H. pylori antigen in feces (31.3%), urea breath test (23.4%) and histological method (23.3%) were used. In 3.6% cases was used serology by mistake. In 17.3% of patients control was not carried out. The effectiveness of triple therapy with a PPI, amoxicillin, clar- ithromycin (per protocol) was 67.6%, with 7-day course, 81.1% at 10-day and 86.7% at 14-day course. Eradication rate of triple therapy with addition of bismuth (per protocol) reached 90,6% in the group receiving 10-day scheme and 93.6% in the group receiving the 14-day treatment.

CONCLUSION

Significant deviations of clinical practice from expert recommendations, most pronounced at the stage of monitoring the effectiveness of therapy, were noted. The suboptimal efficacy of triple therapy is shown.

[European registry Helicobacter pylori (Hp-EuReg): how has clinical practice changed in Russia from 2013 to 2018 years]

The multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group (EHMSG) is conducted in 27 countries in Europe. The data from the Russian part of the European registry for the management of Helicobacter pylori infection (European Registry on the management of Helicobacter pylori infection, protocol: "Hp-EuReg") allows us to analyze the real clinical practice of diagnosis and treatment of H. pylori and compare it with international recommendations.

MATERIALS AND METHODS

A comparative analysis of the data entered in the register by the Russian research centers "Hp-EuReg", in the period from 2013 to 2018, was conducted.

RESULTS AND DISCUSSION

Invasive diagnostic methods prevail for the primary diagnosis of H. pylori [histology - 20.3% (in 2013 year) - 43.9% (in 2018 year), rapid urease test - 31.7% and 47.8% respectively]. The most popular mode of eradication therapy is a 10-day triple therapy (62.8-76.2%), the effectiveness of which does not exceed 79% (per protocol). Invasive tests (histology) are the leading method for control the effectiveness of therapy, however, there is a tendency towards a wider use of non-invasive methods (H. pylori stool antigen - from 17% in 2013 to 29.3% in 2018 and urea breath test from 6.9 to 18.3%, respectively). Serological test to control the effectiveness of eradication is still used from 8.2% (2013) to 6.1% (2018). Eradication therapy was not performed in 28% of patients throughout the entire observation period.

CONCLUSION

In Russia, despite approved domestic and international recommendations, deviations in clinical practice persist, both during eradication therapy and in monitoring the effectiveness of eradication therapy.

THE EFFECTIVENESS OF GOLIMUMAB IN SEVERE ULCERATIVE COLITIS WITH EXTRAINTESTINAL MANIFESTATIONS

A clinical case of severe ulcerative colitis vvith extraintestinal manifestations, development of steroid dependence and inefficiency of basic therapy is presented. A good effect of therapy with golimumabis demonstrated.

DIAGNOSTIC ALGORITHM FOR DIARRHEA

Diarrhea refers to one of the most common syndromes encountered in practice therapist, general practitioner, pediatrician, gastroenterologist and infectious disease. The article describes the main diseases and conditions in which there is a clinical syndrome of diarrhea.

[THE USE OF COMBINATION ANTIVIRAL THERAPY IN LIVER CIRRHOSIS HCV ETIOLOGY]

Is a clinical example of combination antiviral therapy drugs interferon and ribavirin in the treatment of liver cirrhosis in chronic HCV infection, class A on Child-Pugh which made the transition of liver cirrhosis in the F1 fibrosis (the Metavir) and achieved sustained antiviral response (SVR).

[Eyes' symptoms of the digestive diseases]

Substantial part of the eye disease manifestations constitute general or systemic diseases. Accordingly, the dosage systemic therapy of these diseases can affect the condition of the eye. Changes of the vision and the appropriate advice ophthalmologist can help the gastroenterologist in the diagnosis and adequate treatment of the patient. The article discusses the possible changes in the organ of vision in diseases of the digestive system and a number of infectious diseases, as well as changes occurring under the influence of drug therapy of these diseases.

[Bronchial spasm as extraesophageal manifestations of gastroesophageal reflux disease]

Gastroesophageal reflux disease is one of the common spread diseases. Its manifestations are diverse and include esophageal and extraesophageal manifestations. One of them is a so-called "respiratory mask". It is very difficult to cure it without realizing therapy of the main disease. A clinical case of a patient with bronchial asthma in combination with a hernia hiatal and GERD is described. Clinical effectiveness of surgical treatment is demonstrated clinically.

[Simulation of the interaction of gastroenterologists, endoscopists and surgeons, as the present and the future of high-tech gastroenterology of Chuvashia]

The analysis of the joint work of gastroenterologists, surgeons and endoscopists Republican gastroenterological center of the Chuvash Republic. The importance of creating a model of interaction of gastroenterologists, surgeons and endoscopists for the development of high-tech gastroenterology in the Chuvash Republic.

[Correction of indigestion in chronic biliary pancreatitis]

Chronic pancreatitis (CP) is one of the most urgent and investigated problems in gastroenterology. Despite the variety of the spectrum of etiologic, pathogenetic and provoking factors for CP, one of the leading causes of disease pathology is pathology of biliary tract. A key element in the treatment of CP is a correction of the digestive system, with biliary pancreatitis feature that distinguishes it from other forms of pancreatitis, is a combination of exocrine pancreatic insufficiency with chronic biliary insufficiency. The variety of biochemical and immunological effects of ursodeoxycholic acid (UDCA) can treat it with biliary pancreatitis as the drug of etiological, pathogenetic and substitution therapy. UDCA (Ursosan) in combination with modern mini-microspheroidal polyfermental drugs significantly improves the clinical efficacy of the correction of the digestive system in biliary pancreatitis.

[Drug safety in gastroenterology]

Drug safety is one of the priorities of modern medicine and pharmacy. In modern gastroenterology drug safety issues due to a number of reasons even more relevant than in other branches of medicine. The major areas of drug ensure patient safety in the practice of gastroenterologists, as well as other doctors, are: 1) direct involvement of practitioners in the system of pharmacovigilance, 2) used in the practice of clinical research and evidence-based medicine, 3) the use of the principles of rational pharmacotherapy.

[The relationship of clinical and morphological characteristics of chronic gastritis with microelements deficiency]

We aimed to analyze the interconnection of chronic gastritis clinicopathologic characteristics with the content of selenium, zinc and manganese in blood serum. It is stated that the concentration of the microelements being studied (mostly selenium) is the prognostic indication of prescription of inflammatory process in the mucous coat of stomach and its clinical activity (pain and dyspeptic syndrome intensity), and the degree of microelements deficiency increases proportionally with intensity augmentation of atrophic processes in stomach.

[Analysis of illness pathology causes of digestive organs in the Chuvash Republic and prospects of its reduction]

The main principles of organization of gastroenterological service of the Chuvash Republic are presented. The main significant causes of incidence rate of digestive apparatus pathology and the ways of their elimination are discussed. The peculiarities of population dietary habits are analyzed. The complex of measures carried out in Chuvashia for improving the quality of production and processing of alimentary products taking into account the peculiarities of every biogeochemical subregion and requirements of various population groups is presented. The forms and methods of healthy life-style formation, training of people responsible attitude to their health are described. Priority guidelines of gastroenterological assistance to the population of the Chuvash Republic are enumerated.

[Restoration of the quality of life by eliminating and prevention of heartburn by alginate: results of multicenter study "VIA APIA"]

Was conducted a muIticenter study VIA APIA, in which the impact of gaviscon forte (suspension) on symptoms, general state and quality of life of 148 patients (male 53, female 95, age 42.9 +/- 15.6) with gastroesophageal reflux disease (GERD) were investigated. The patients had undergone clinical evaluation of dynamics of GERD symptoms (Likert scale), general state (Visual Analogue Scale, questionnaire SAN) and quality of life (SF-36). It was shown that 14-days treatment with gaviscon forte provided symptoms relief in 84.5% patients and conducted improvement of general state and quality of life. Gaviscon forte recommended as drug of choice in initial treatment for the first time visited patient with heartburn before endoscopy and for pathogenetic treatment of typical reflux syndrome.

[Natural micronutrient deficiency as a cause of the digestive system diseases in Chuvashia]

Endemic, biogeochemical peculiarities of the Chuvash Republic territory were analyzed. The regional statistical analysis of the biogeochemical province influence on trace and major mineral elements content in food stuff was carried out. The conducted study let us reveal the following chief problems in the nutritional status of the population of the Republic which led to the inferior health rate and were associated with the biogeochemical peculiarities of the region: selenium, copper, manganese, ferrum deficiency in the food ration.

[Pathogenesis of chronic acalculous cholecystitis in inhabitants of the Republic of Chuvashia]

The study of Serum content of Selenium, Zinc, Manganese in inhabitants of the Republic of Chuvashia and also in chronic acalculous cholecystitis patients. Possibility of correction motor dysfunction of gallbladder with the use of natural mineral water "Syvlah-Zdorovie".

[Serological types of Yersinia enterocolitica isolated from humans and from environment]

A total of 1061 Y. enterocolitica strains isolated from patients with different clinical manifestations of yersiniosis (acute intestinal disease, hepatitis, generalized infection, meningitis, rheumatoid arthritis, chronic intestinal disease), from foodstuffs, from animals and from open water reservoirs have been studied. This study has revealed that the strains of serovars 09 and 03 are mainly isolated from humans (66% and 30.5% of cases, respectively). The strains of serovar 05B occur in 3%, and serovar 08 in 0.5% of cases. The clinical manifestations of infection have not been found to depend on the serovar of the strain causing this infection. All Yersinia serovars produced infections in children and adults with equal frequency. Y. enterocolitica strains belonging mainly to serovars 09, 03 and, less commonly, 05B and 08 circulate in different areas of our country. The same serovars of Yersinia have been isolated from foodstuffs (milk, meat, vegetables) and washings obtained from various objects of the environment, which indicates their role as the factors of infection transfer.

[Spread of Yersinia among patients with acute intestinal infections]

During 1979 a large-scale study of fecal samples obtained from patients with acute intestinal infections was carried out with the aim of establishing the presence of Yersinia. As a result, 9 Y. enterocolitica strains and 7 Y. pseudotuberculosis strains were isolated. Y. enterocolitica were classified with serovars O8, O3, and O5B and with biovars 2, 3, and 4; Y. pseudotuberculosis were classified with serovars 1 and 3. The isolation of Yersinia facilitated the identification of the etiological structure of acute intestinal infections.