MECHANISMS OF THE FORMATION OF MOTOR-SECRETORY DISORDERS IN PATIENTS WITH GERD WITH CONCOMITANT AIT

OBJECTIVE

The aim: The aim of this work was to study the effect of thyroid hormones on motor-secretory dysfunction in patients with GERD with concomitant AIT.

PATIENTS AND METHODS

Materials and methods: The study involved three groups of patients: with isolated GERD, GERD with AIT at the stage of hypothyroidism and GERD with AIT at the stage of hyperthyroidism. The control group consisted of 15 practically healthy individuals. GERD and AIT were diagnosed on the basis of ICD-10. All patients underwent a comprehensive examination, including ultrasound examination of the motor-evacuation function of the esophagus and stomach. Quality of life of patients was assessed by using the GIQLI questionnaire.

RESULTS

Results: The most expressed complaints and low quality of life are observed among patients with combined pathology. The results of pH-metry indicate more severe course of GERD among patients with concomitant AIT. The most pronounced decrease in the tone of the lower esophageal sphincter and increased regurgitation were observed in the second group.

CONCLUSION

Conclusions: 1. It was found that more reliable motor-secretory disorders were observed among patients with GERD with concomitant AIT. 2. A close correlation was established between the severity of the clinical picture, the level of increased thyroid hormones and the degree of impairment of motor-secretory disorders among patients with GERD with concomitant AIT; 3. The results obtained indicate that changes in the metabolism of thyroid hormones are one of the factors involved in the mechanisms of GERD formation.

Alcohol addiction complicated with comorbid amnestic disorders: The search for innovative approaches to treatment

Introduction

Alcohol amnesia and palimpsests belong to understudied areas in addictology concerning the pathogenesis, risk factors, and development of effective integrated, targeted modalities of therapy, prevention, and after-treatment care.

Objectives

Development of a new integrated, pathogenetically grounded approach to the emergency and routine therapy for immediate and long-term consequences of amnestic alcohol intoxication.

Methods

Modern complex clinical-psychopathological, pathopsychological, laboratory, electrophysiological, biochemical examination; method of analogues and prototype analytical examination.

Results

Integrated anti-amnestic pharmacotherapeutic triad: Noobut IC (Phenibut) orally, before meals, for 6 days, twice a day: 250 mg in the morning, 500 mg at night, within days 7-14 250 mg twice: in the morning and at night; Vitaxon 2.0 ml daily, intramuscularly, No10 totally; ozone therapy for 10 days (ozone dissolved in olive oil, 6 mg/100 ml concentration), 5 ml orally 3 times a day. Complex therapy is concurrent with synergistic psychotherapeutic potentiation. Supportive anti-relapse prevention of alcohol-induced amnesia, palimpsests with Noobut IC: 1 tablet (250 mg) orally in the morning for 2 months. The pathogenetic support of the pharmacotherapeutic triad in treatment for alcohol addiction, comorbid with amnestic disorders, is pathogenetically focused on pharmacological properties of each component of the triad and their potentiating effects, involving most pathogenetic mechanisms of this disease.

Conclusions

Relieving and prophylactic efficacy of the proposed pharmacological triad (Noobut, Vitaxon, ozone and concurrent psychotherapeutic potentiation) is proven by the statistical reliability method and illustrated by clinical examples of patient-specific research.

Method of relieving alcohol dysphoria in the structure of hypertoxic alcohol abuse state with compulsive craving manifestations

Introduction

Alcohol dysphoria is a pathognomonic, severe, and therapeutically resistant syndrome considerable for alcohol and drug-addicted patients. The term “dysphoria” (from Greek δυσφορέω to suffer, torment, annoy) means an abnormally low type of mood, characterized by anger, gloom, irritability, feelings of hostility to others. In addictology, it is often identified in the withdrawal syndrome structure.

Objectives

To develop innovative improvement in treatment for alcohol dysphoria.

Methods

Valid clinical diagnostic, laboratory, biochemical, electrophysiological, psychological (scaling, testing), statistical methods identifying alcohol dependence complicated by dysphoria.

Results

The proposed method involves a complex of anti-affective, anti-abstinence, anti-craving pharmacological agents and drug-free methods, and differs from those conventional, along with psychotherapeutic potentiation, by additional targeted pharmacological triad (peroral Carbamazepine 200 mg twice a day: in the morning and in the evening; intramuscular Halopril (Haloperidol) 1 ml (5 mg) daily; oral Sonapax 1 tablet (25 mg) three times a day for 3-5 day treatment) used for a new purpose. 17 patients experienced this method. Efficacy: alcohol dysphoria acute manifestations were relieved by our method within 3-5 days that 37.8% exceeds conventional treatment. In 15 minutes, patients decreased irritability, motor restlessness, stress, cravings for alcohol. In 30 minutes, the patients fell asleep. Sleep lasted 3.5 hours on average. Subsequently, patients denied craving for alcohol, calmed down emotionally and psychomotorically, wished to be treated for alcoholism. No dysphoric relapses were observed.

Conclusions

The proposed multimodality method alleviates alcohol-induced dysphoria, involving pharmacotherapeutic triad along with psychotherapeutic potentiation.

Method of relieving hypertoxic alcohol abuse states in alcohol dependence

Introduction

Currently, alcohol dependence is characterized by immediate onset of dipsomania states (code F10.26, ICD-10) interpreted in clinical addictology as reliable diagnostic signs of morbid alcohol dependence. These are classified clinically by rate, severity, therapeutically resistant post alcohol comorbidities (alcohol-induced polyneuropathy, hepatic dysfunctions, etc.), and by the presence of “lucid spaces”, when patients, depleted physically and mentally by hypertoxic alcohol abuse states, periodically (after binge drinking) intake no alcohol.

Objectives

Effectiveness improvement and reducing time of treatment for hypertoxic alcohol abuse states by reasonable pathogenetic use of highly effective drugs, wide polymodality and synergistic pharmacological range, with few side effects, potential for inclusion to the conventional standard treatment patterns according to thiamine concepts.

Methods

Valid clinical-diagnostic, laboratory, biochemical, electrophysiological, psychological (scaling, testing), statistical methods for identification of alcohol dependence complicated by hypertoxic alcohol abuse states.

Results

A new method of alleviating the hypertoxic intoxication in alcohol dependence has been developed on representative clinical material, which involves conventional pharmacological and drug-free symptomatic remedies and methods. Along with psychotherapeutic potentiation, a therapeutically targeted pharmacological complex was prescribed: intramuscular Vitaxon № 10 per course; Sibazon 0.5% solution, 2 ml intramuscular, 3-5 injections per course; oral Phenazepam, one tablet (0.001g) twice a day for 10-14 days; Cocarnit one ampoule daily intramuscular injection, for a course of 3-10 injections.

Conclusions

The effectiveness of the proposed pharmacological complex has been proven by the statistical reliability method and illustrated by clinical examples of patient-specific research.

Method of treating alcohol dependence complicated by amnestic disorders

Introduction

Amnesia and palimpsests occurring and recurring in alcohol addicts due to alcohol intoxication (Ebrietas alcoholica) are accompanied by hazardous memory failures, gradual mental degradation and psychoorganic syndrome, which evidences urgent clinical, therapeutic and therapeutic issue in addictology, psychiatry, forensic medicine, sociology, medical psychology, etc. At EPA initiative (2019), research interest in non-invasive brain stimulation tools and methods for such populations was activated.

Objectives

Development of a patentable method of treatment in addictology using pyracetam and nicotinic acid transcerebral electrophoresis (TCE).

Methods

Valid clinical-diagnostic, laboratory, biochemical, electrophysiological, psychological (scaling, testing), statistical methods for identification of alcohol dependence complicated by amnestic disorders.

Results

The method of treatment of alcohol dependence complicated by amnestic disorders (Patent 141785 UA) provides complex pharmacological and drug-free therapy. Antiamnesic drugs are administered by TCE bilaterally; pyracetam 20% solution to the left orbit through active negative electrodes, and nicotinic acid 0.1% solution to the right orbit (positive electrode in the occipital fossa), current of 2-4 mA, 20-30 minutes exposure. The procedure was performed daily with a TCE device, for a 10-day course of treatment along with psychotherapeutic potentiation. TCE provides the ionic implementation of pharmacological agents in the brain and their physiological electrical stimulation.

Conclusions

In a representative clinical trial, using statistical methods and generated bank of patient-specific observations, significant potentiating effects of combined drug-free, non-invasive transcerebral electrical stimulation and electrophoretic implementation of pyracetam and nicotinic acid were demonstrated.