The prevalence of Helicobacter pylori infection among urban population

AIM

Determination of the prevalence of Helicobacter pylori infection (H. pylori) among the urban population.

MATERIALS AND METHODS

655 people (638 adults and 17 children) were examined using the immunoassay method of quantitative detection of IgG class antibodies.

RESULTS

High infection of adult residents of Ryazan H. pylori - 64,4% is established. The greatest prevalence of H. pylori infection was observed in individuals 41 to 80 years of age (66,9%). Discovered gender differences in the prevalence of H. pylori infection in persons older than 40 years. H. pylori infection in males aged 41-80 was 76.3%, compared with 65.3% in females (p=0.02). In children 4-15 years, the proportion of persons with positive serological test anti-H. pylori IgG reached 23.5%. All H. pylori infected children were over 9 years of age. 90% of adults with H. pylori infection was detected, isolated or concomitant gastrointestinal symptoms of indigestion. More often, H. pylori infection was associated with abdominal pain - 48.3% (p=0.005) and heartburn - 27% (p=0.04).

CONCLUSION

The data obtained indicate a high proportion of H. pylori infection in the adult population in Ryazan - 64,4%. The incidence of detection of anti-H. pylori IgG in the population maximum from individuals 41 to 80 years of age (66,9%).

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.

[Normative values for peripheral electrical gastroenterocolonography]

AIM

To elaborate the normative values of peripheral electrical gastroenterocolonography (EGECG).

SUBJECTS AND METHODS

Fifty apparently healthy young people (14 women and 36 men; mean age 20.2 ± 4.7 years) were examined. Peripheral EGECG was used to study the motor-evacuating function of the gastrointestinal tract (GIT).

RESULTS

The values of the main indicators and coefficients of GIT electrical activity were defined; the concepts of normal physiological values for GIT electrical activity were identified and their values were determined.

CONCLUSION

Peripheral EGECG makes it possible to significantly estimate the bioelectrical activity of the gut. The informative markers of peripheral EGECG are relative electrical activity, ratio coefficient, rhythmicity coefficient, as well as the average amplitude and frequency of bioelectrical activity.

[Interrelation between trophological status and the course of stomach and duodenal ulcer diseases]

There was installed a significant positive relationship between body mass index (BMI) and the velocity of cicatrization of ulcer in patients with ulcer disease (PUD) with trophological violations. Change in the index ratio of lymphocytes and ESR in patients with PUD trophological violations can be used to predict the velocity of cicatrization of ulcer. The general maladjustment more often observed in patients (PUD) underweight.

[Essential phospholipids in the treatment of alcohol-related liver disease: clinical and experimental study]

Conducted clinical and experimental study showed the effectiveness of the use of essential phospholipids as hepatoprotector alcohol-related liver diseases. The application of essential phospholipids reduces the morphological severity of inflammatory and degenerative changes in the liver, improves the clinical picture and laboratory status of patients.

[Hepatoprotectors in treatment of alcoholic liver disease]

The best hepatoprotective effect has combined appointment Essentiale forte N, Heptral and Apilak at rats with chronic alcohol intoxication. Use of these drugs is characterized by minor morphological changes in structure of liver and constant biochemical parameters.

[Mebeverina drugs in the treatment of functional disorders of the digestive system]

Despite the identical content of mebeverine hydrochloride, Duspatalin and Niaspam, produced by different technological processes, can't be considered interchangeable as they are known to have different clinical effect in case of various functional diseases of alimentary organs. Duspatalin is effective in relieving biliary disfunction symptoms, Oddy's sphincter hypertonicity in particular, but has little effect on intestinal dyskinesia. Niaspam is known to have little effect on biliary dyskinesia, but has a prominent positive clinical effect on intestinal dyskinesia.

[Results of a multicenter trial "Epidemiology of Gastroesophageal Reflux Disease in Russia" (MEGRE)]

AIM

To assess prevalence of gastroesophageal reflux disease (GERD) in Russia in MEGRE trial in 6 cities of the Russian Federatiion (Kazan, Kemerovo, Krasnoyarsk, Ryazan, St-Petersburg, Saransk).

MATERIAL AND METHODS

Mayo Clinic questionnaire (USA) adapted for Russia was used to question 7812 people over 18 years of age from of random population sample. The symptoms (heartburn and regurgitation) were classified as frequent if they arose once a week and more often for the last 12 months, rare symptoms arose less often than once a week. The responders with frequent heartburn and/or regurgitation were regarded as persons with epidemiological quantitative criteria of GERD.

RESULTS

Heartburn occurred in 47.5% responders: frequent in 9%, rare in 38.5%. Regurgitation occurred in 42.9%: frequent in 7.6%, rare in 35.3%. GERD prevalence was 13.3% (city range 11.3-14.3%). Frequent GERD symptoms are associated with frequent gaseous eructation (24.3%), chronic cough (22.9%), chest pain (15.1%), dysphonia (11.4%.). To stop heartburn, 88% responders took antacids, 32%--blockers of histamine H2-receptors and only 23%--inhibitors of proton pump. Only 52.8% responders with frequent chest pain and 29.3% those with frequent heartburn visited a doctor.

CONCLUSION

The population-based trial MEGRE conducted by international methodology in 6 cities of Russia demonstrated that GERD prevalence is 13.3%. Most of the patients pay little attention to the symptoms, do not seek medical advice and, therefore, receive no adequate treatment.

[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.

[Multicentre study "Epidemiology of gastroesophageal reflux disease in Russia"(MEGRE): first results]

We aimed to determine the prevalence and clinical spectrum of GERD in the urban population of 6 cities in different parts of Russia (St. Petersburg, Ryazan, Kazan, Kemerovo, Krasnoyarsk and Saransk). A previously validated reflux questionnaire developed at the Mayo Clinic was translated into Russian, culturally adapted and administered. Data was collected from 7812 randomly selected subjects greater than 18 years old with the assistance of the yellow pages. 'Frequent symptoms' were defined as a major symptom (heartburn and/or regurgitation) occurring at least once a week or more. "Occasional symptoms" were defined as an episode of one of the major symptoms occurring less than once a week within the past 12 months. Patients were defined as having GERD if they reported frequent heartburn and/or regurgitation. The average prevalence of frequent and occasional GERD symptoms in Russia was 9% and 38.5% for heartburn and 7.6% and 35.3% for regurgitation respectively within the last 12 months. The average prevalence of GERD in Russia was 13.3% (11.3-14.3%). The prevalence of frequent heartburn decreased with age (r = -0.3); however, frequent regurgitation increased (r = 0.7) with age. As a result, we found that prevalence of GERD increased with age. The average prevalence of GERD was statistically the same in men (12.5%) and in women (13.9%). This prevalence didn't change with age in men but did increase with age in elderly women to 24%. Frequent heartburn and regurgitation (GERD) were significantly associated with frequent belching (24.3%), chronic cough (22.9%), dyspepsia (19.8%), non-cardiac chest pain (15.1%), nausea (14.9%), hoarseness (11.4%), dysphagia (8.1%), odynophagia (7.3%) and constipation (37.8%). Alcohol consumption (prevalence of 60.4% among respondents) and smoking (prevalence of 25.4% among respondents) didn't yield any significant difference in subjects with frequent symptoms. Importantly, we also found that only 52.8% of subjects with frequent chest pain and 29.3% of respondents with frequent heartburn had seen a physician for these symptoms.

[Non-invasive method of diagnostics of biliary tract motor function disorders]

Was developed screening test for early diagnosis of various biliary dysfunction. It is based on determining of elektrodermal resistance and temperature of skin in biologically active points. A new method of diagnosis hasn't contraindications, not require the use of expensive or complicated equipment.

[Autonomic disbalance in patients of different age with stomach ulcer and ways of its correction]

The study of peculiarity a tone of vegetative nervous system at patients of different age with ulcer defeats of a stomach, types of temperament, a level of neurotics, expressiveness introversion and extraversion. WE USED: Modified Eysenk Personality Questionnaire, EGG, standard vegetative test CITO (SVT CITO).

OUR RESULTS

Rise of neurotic level in patients with stomach ulcer, indications of vegetative distones with characteristic apportionment of activity of VNS. Reflexotherapy, carry on counting variation of tone VNS expedite scaring of ulcer defeat.

[Potentialities of alternative non-drug therapy of gastric ulcer]

The aim of the study was to evaluate the influence of non-invasive laser therapy on the efficacy of gastric ulcer therapy. The study revealed shortening of the time to ulcer cicatrization in patients who were treated with laser emission of the organospecific iridic zones and immunocompetent body parts in addition to standard drug therapy.

[Clinical and immunological aspects of low-intensity laser irradiation in patients with gastroduodenal ulcers]

Laser iridotherapy was carried out simultaneously with irradiation of immuno-competent zones on the integument of the human body in patients with stomach and duodenal ulcers. As a result of such treatment, it was discovered that laser therapy has immunomodulating action leading to the reduction of the ulcer cicatrisation period.

[The age aspect of treatment of patient with ulcer of gastroduodenal zone]

The existent methods of treatment patient with ulcer of gastroduodenal zone provide treatment of ills in correspondence with "Standards..." and don't take into account age features of patient. For increase efficiency of treatment patient with gastric ulcer taking into account infection Helicobacter pylori, age features a patient, we conduct the treatment 612 ills using eradication therapy, laser therapy, needlereflexotherapy. We made deduction that eradicates Helicobacter pylori increases time of remission of disease. The needlereflexotherapy conducting with using our methods measures spud of cicatrisation gastric ulcer, especially in cases with the elderly ills. The laser therapy conducting with using our methods especially increases speed of cicatrisation gastric ulcer in cases with the elderly ills, too.

[Microbiocenosis of the bowels in patients with gastroduodenal ulcers]

Gastroduodenal ulcer is accompanied by the bowels dysbacteriosis irrespective of the Helicobacter pylori infection. Any variant of ulcer treatment aggravates the bowels dysbacteriosis intensity. Eradication therapy destroys Bifidobacteria mostly.

[Characteristics of the different variants of the complex treatment of stomach ulcer]

The eradication therapy increases the speed of cicatrisation of ulcers in the gastroduodenal zones in infected patients. The best method to increase the efficiency of ulcer cicatrisation is reflex therapy for patients at the age of 22-50 years and laser therapy for older patients.