Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii最新文献

{"title":"Risk Factors of Portal Vein Thrombosis in Patients with Different Child-Pugh Classes Liver Cirrhosis","authors":"M. Nadinskaia, K. Kodzoeva, Kseniya A. Gulyaeva, Mariia-Doris E. Khen, Diana I. Koroleva, Maxim Privalov, Amina Kh. Tekaeva, Vladislav R. Fedorov, Sergey G. Prokofev, Nadinskaia M.Yu, Kodzoeva Kh.B, M. A. Tekaeva, A.Kh, S. Risk, М.Ю. Надинская, Х.Б. Кодзоева, К.А. Гуляева, М.-Д.Э. Хэн, Д.И. Королева, М.А. Привалов1, А.Х. Текаева, В.Р. Федоров, С.Г. Прокофьев","doi":"10.22416/1382-4376-2023-33-2-45-59","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-2-45-59","url":null,"abstract":"Aim: to evaluate the frequency of portal vein thrombosis (PVT) and build predictive models of the development of PVT for patients with liver cirrhosis (LC) of A and B/C classes by Child-Pugh.Materials and methods. Research design is a case-control. The Case group included 130 patients with newly diagnosed PVT not caused by invasive hepatocellular carcinoma (HCC); 29 patients were assigned to class A, 101 patients were assigned to class B/C. From the database of cirrhotic patients without PVT 60 Controls for class A and 205 for B/C were selected using sratified randomization by sex, age and etiology of cirrhosis. The Mann-Whitney U-test and Pearson's chi-squared test were used to compare the groups. Odds ratios (OR) and 95 % confidence intervals (95 % CI) were calculated. Logistic regression models are constructed with the separation of the sample into training and test (0.7; 0.3). The operational characteristics of the models were calculated on the test sample; ROC analysis was carried out, the area under the ROC curve (AUC) was calculated.Results. The overall frequency of PVT was 4.1 % (95 % CI 2.7-5.8 %) in class A and 10.4 % (95 % CI 8.5-12.5 %) class B/C. Patients with class A and B/C PVT differed from the corresponding controls by more severe portal hypertension: the frequency of bleeding / number of interventions on varices compared with the control were 41/45 % vs. 7/8 % (p < 0.001) for class A and 25.7/30.7 % vs. 16.1/16.1 % (p < 0.05) for class B/C, ascites frequency was 24 % vs. 8 % (p < 0.05) for class A and 89.1 % vs. 68.3 % (p < 0.001) for class B/C. The cutoff by the portal vein diameter was the same for both classes — 13.4 mm; the spleen length was similar and amounted 17.5 mm for class A, 17.1 mm for class B/C. Patients with PVT differed from the corresponding controls by neutrophil-to-lymphocyte ratio: class A 2.33 (1.82; 3.61) vs. 1.76 (1.37; 2.20), p < 0.01, class B/C 2.49 (1.93; 3.34) vs. 2.15 (1.49; 3.26), p < 0.05. Patients of class B/C had a higher incidence of newly diagnosed malignant tumors - 23.8% (primarily HCC that does not invade the portal vein), compared with control and cases of class A - 6.3 % and 3 % (p < 0.05), respectively. The best model for class A included variceal bleeding, ascites, portal vein diameter, absolute number of neutrophils, for class B — ascites, spleen length, portal vein diameter, malignant tumors / local factors; sensitivity, specificity, accuracy and AUC were 79.3 %, 90 %, 86.5 %, 0.897 and 73.3 %, 68.3 %, 69.9 %, 0.789, respectively.Conclusion. Independently of the Child-Pugh class of LC, the main risk factor for PVT is severe portal hypertension.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80193652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ilaser Submucous Destruction in the Treatment of Hemorrhoids","authors":"S. A. Frolov, D. V. Vyshegorodtsev, A. M. Kuzminov, Vyaheslav Yuliya L. Trubacheva, Yu. Korolik, I. S. Bogormistrov, Ivan A. Mukhin, Arseniy N. Ryndin, Akbermet A. Anarbaeva, С.А. Фролов, Д.В. Вышегородцев, А. М. Кузьминов, Ю.Л. Трубачева, В.Ю. Королик, И.С. Богормистров, И.А. Мухин, А.Н. Рындин, А.А. Анарбаева","doi":"10.22416/1382-4376-2023-33-2-70-78","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-2-70-78","url":null,"abstract":"Aim: to improve the results of treatment in patients with hemorrhoids of the 2nd and 3rd stages.Materials and methods. The prospective study included 60 patients with hemorrhoids of the 2nd and 3rd stages. All patients underwent destruction of internal hemorrhoids with a fiber laser with a diode pump with a wavelength of 1940 nm. The technique is based on the effect of laser energy on the cavernous tissue of the internal hemorrhoidal node and on the terminal branches of the upper rectal artery. The efficiency of the destruction of internal hemorrhoids and the frequency of relapses of the disease were evaluated. The effectiveness of the proposed method was evaluated using anoscopy, measurement of the size of internal hemorrhoidal nodes, transrectal ultrasound with dopplerography. The analysis of the intensity of the pain syndrome, the consumption of nonsteroidal anti-inflammatory drugs and the assessment of the quality of life on the SF-36 scale was carried out. Sphincterometry was performed in all patients to determine the possible effect of laser radiation on the rectal locking apparatus. To assess the possible causes of complications, a single-factor analysis of the amount of energy transferred to each hemorrhoidal node and the total amount of energy spent on the operation was conducted.Results. In all patients, by day 7 after surgery, the pain syndrome in 43 patients (75.4 %) corresponded to 0 points according to VAS. In 3 patients (5 %) intraoperative hemorrhage developed. In the early postoperative period, 5 patients (8.3 %) had 7 complications: 5 cases of thrombosis of the external hemorrhoidal node and 2 — of acute urinary retention. The conducted single-factor analysis showed the dependence of the development of complications on the energy transferred to each hemorrhoidal node and its total amount for the entire operation. In terms of up to 6 months, there were no signs of a return of the disease in any case (hemorrhoidal prolapse and blood discharge). The detected hemorrhoids before the operation, a month after the operation, were not visualized, which persisted after 6 months. The performed transrectal ultrasound examination with spectral-wave dopplerography for up to 6 months allowed to diagnose a persistent decrease in blood flow along the terminal branches of the upper rectal artery compared with preoperative values. When performed sphincterometry, there was no change in the parameters of the anal sphincter function compared to preoperative parameters.Conclusion. The proposed method applying a fiber laser with a diode pump with a wavelength of 1940 nm makes it possible to affect transdermally the internal hemorrhoidal node without damaging the mucosa of the anal canal. The absence of postoperative wounds in the anal canal leads to a decrease in pain syndrome, and by day 7 there are no clinical manifestations of hemorrhoids. The method of laser destruction of internal hemorrhoids can be used in outpatient conditions and can improve th","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77970536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrahepatic Cholestasis in Non-Alcoholic Fatty Liver Disease: Pathogenesis and Role of Ademetionine in Treatment","authors":"Ye.N. Shirokova","doi":"10.22416/1382-4376-2023-33-2-79-86","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-2-79-86","url":null,"abstract":"Aim: to evaluate features of intrahepatic cholestasis (IHC) pathogenesis in non-alcoholic fatty liver disease (NAFLD), as well as role of ademetionine in treatment of this condition.Key statements. NAFLD is the most frequent chronic diffuse liver disease. Increase in proportion of people with excess weight, obesity, and metabolic dysregulation leads to higher rates of NAFLD. Concomitant IHC is present in 30 % of NAFLD patients, while it is associated with more active disease course and possible worsening of prognosis. Impairment of adipocyte and hepatocyte metabolism, gut dysbiosis, and inherent factors are recognized as significant factors for NAFLD development. In NAFLD patients most of IHC cases are related to functional cholestasis. IHC in NAFLD is associated with increased risks of fibrosis and all-cause death. Ademetionine may restore transmethylation and improve rheologic properties of hepatocyte membranes in liver disease. In IHC patients treatment with ademetionine led to decreased serum bilirubin concentrations, as well as lowering of the liver transaminases' and alkaline phosphatase activities. At the same time improvement of symptoms severity, including itching, was noted. Taking into account the efficacy of ademetionine in IHC in NAFLD patients, its' use was included in the national clinical guidelines.Conclusion. Use of ademetionine in NAFLD with concomitant IHC is feasible from pathogenesis perspective and may be effective in clinical practice.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"237 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91314424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of N-Acetyl-Glucosaminil-N-Acetyl-Muramyl Dipeptide during Triple Component Anti-Helicobacter Pylori Therapy in the Period of Coronavirus Infection COVID-19","authors":"M. R. Konorev, E. N. Tyshevich, R. A. Pavlyukov, М.Р. Конорев, Е.Н. Тышевич, Р.А. Павлюков, Roman A. Pavlyukov — Senior Lecturer","doi":"10.22416/1382-4376-2023-33-2-60-69","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-2-60-69","url":null,"abstract":"Aim: evaluation of the incidence of COVID-19 infection after three-component H. pylori eradication therapy while taking N-acetyl-glucosaminyl-N-acetyl-muramyl dipeptide (GMDP).Materials and methods. A prospective randomized comparative clinical study was carried out. The study included 208 patients (147 men, 61 women; mean age — 48.1 ± 14.5 years) with duodenal ulcer associated with Helicobacter pylori (H. pylori) who underwent eradication therapy. H. pylori in the gastric mucosa was detected by a morphological method and a rapid urease test before treatment and 6-8 weeks after the end of treatment and the withdrawal of all drugs. Patients were divided into three groups according to treatment protocols: omeprazole 0.04 g/day, clarithromycin 1 g/day, amoxicillin 2 g/day (OСA; n = 103); omeprazole 0.04 g/day, clarithromycin 1 g/day, amoxicillin 2 g/day + GMDP 0.001 g/day (OCAL1; n = 61) or 0.01 g/day (OCAL10; n = 44) for 10 days. Detection of SARS-CoV-2 RNA by PCR was carried out from April 2020 to April 2022. Tracking completeness was 96.6 %.Results. The frequency of H. pylori eradication depending on “intention to treat” (ITT) and “per protocol” (PP): OCA — 79 % (95 % CI: 71-87) and 83 % (95 % CI: 75-91); OCAL1 — 95 % (95 % CI: 88-100) and 97 % (95 % CI: 92-100); OCAL10 — 96 % (95 % CI: 89-100) and 98 % (95 % CI: 93-100) respectively. The frequency of adverse reactions depending on ITT and PP: OCA — 24 % (95 % CI: 16-33) and 26 % (95 % CI: 17-35); OCAL1 — 2 % (95 % CI: 0.01-8) and 2 % (95 % CI: 0.01-8); OCAL10 — 2 % (95 % CI: 0.01-7) and 2 % (95 % CI: 0.01-7). The incidence of COVID-19 infection depending on ITT and PP: OCA — 9 % (95 % CI: 3-14) and 9 % (95 % CI: 3-15); OCAL1 + OCAL10 — 1 % (95 % CI: 0.003-1.9) and 1 % (95 % CI: 0.001-2.9), respectively.Conclusions. In H. pylori-infected patients, GMDP (an immunomodulator based on L. bulgaricus) at a dose of 1-10 mg/day, during a 10-day triple eradication therapy, allows a significant (p < 0.05) increase in the frequency of H. pylori eradication and reduce the incidence of adverse reactions compared with a 10-day protocol without adjuvant therapy with GMDP. There was a significant (p < 0.05) decrease in the incidence of COVID-19 infection after H. pylori eradication therapy with GMDP.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79700333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Rearrangements in Genes Responsible for Familial Adenomatous Polyposis, MUTYH-Associated Polyposis and Peutz–Jeghers Syndrome in Russian Patients","authors":"A. Loginova, Y. Shelygin, V. Shubin, A. M. Kuzminov, D. Y. Pikunov, T. A. Saveleva, A. S. Tsukanov","doi":"10.22416/1382-4376-2023-33-1-59-67","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-1-59-67","url":null,"abstract":"Аim: to reveal the rate of large rearrangements in the genes responsible for familial adenomatous polyposis, MUTYH-associated polyposis and Peutz–Jeghers syndrome.Materials and methods. The MLPA method was used for identification of large rearrangements. A total number of 135 patients was included in the study: 83 patients with a clinical diagnosis of “familial adenomatous polyposis”, 18 — with suspected MUTYH-associated polyposis, and 34 — with a clinical diagnosis of “Peutz–Jeghers syndrome”.Results. Seven large deletions and one large duplication in the APC gene were identified in 83 patients with classic familial adenomatous polyposis, with rate of large rearrangements 9.6 % (8/83). In 18 patients with suspected MUTYH-associated polyposis, no large rearrangements were found in the MUTYH gene. Four large deletions in the STK11 gene (12 %, 4/34) were detected in 34 patients with Peutz–Jeghers syndrome.Conclusion. For the first time, the expediency of including the method of detecting large rearrangements in routine DNA test list for Russian patients with various hereditary polyposis syndromes is demonstrated. Routine use of MLPA method makes it possible to increase the total frequency of detection of pathogenic variants in the APC and STK11 genes above 90 %. At the same time, the need for searching of large rearrangements in the MUTYH gene were not justified.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83746944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of the Parameters of 24-Hours pH-Impedance and High-Resolution Esophageal Manometry in Patients with Barrett's Esophagus on Proton Pump Inhibitors","authors":"I. Maev, D. S. Bordin, E. Barkalova, M. Ovsepyan, E. Valitova, N. G. Kalashnikova, D. Andreev","doi":"10.22416/1382-4376-2023-33-1-24-39","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-1-24-39","url":null,"abstract":"Аim: to identify predictors of insufficient effectiveness of proton pump inhibitors based on the evaluation of the results of 24-hour pH-impedance and high-resolution esophageal manometry in patients with Barrett's esophagus.Materials and methods. 52 patients with histologically confirmed Barrett's esophagus who are on therapy with proton pump inhibitors were examined. All patients underwent daily pH-impedance and high-resolution esophageal manometry.Results. According to daily pH-impedance, group 1 consisted of 37 patients who responded satisfactorily to antisecretory therapy, group 2 of 15 patients who demonstrated insufficient response to acid-suppressive therapy, 11 of whom had no clinical manifestations. The total number of reflux averaged 55 in group 1 and 106 in group 2. The average number of acid reflux in group 1 was 5.68, in group 2 — 48.5. The average number of non-acid reflux prevailed in patients of group 2 and averaged 58, in group 1 the indicator averaged 47. Evaluation of the results of high-resolution esophageal manometry showed that violations of the structure and function of the esophago-gastric junction were detected in 21 patients out of 52. Disorders of the motility of the thoracic esophagus were detected in 31 patients out of 52. When comparing the frequency of motor disorders from the thoracic esophagus in groups 1 and 2, no significant differences were obtained. However, significantly more frequent registration of violations of the structure and/or function of the esophago-gastric junction was found in the group with unsatisfactory effectiveness of proton pump inhibitors.Conclusion. In a number of patients with Barrett's esophagus, there is an insufficient effect of acid-suppressive therapy and at the same time an asymptomatic course of the disease, which may increase the risk of its progression. Predictors of insufficiently successful treatment of patients with Barrett's esophagus may be both insufficient pharmacological effect of proton pump inhibitors themselves, and motility disorders that cause the presence of non-acid reflux, decreased esophageal clearance, which in turn may cause the patient's symptoms to persist and adversely affect the condition of the esophageal mucosa.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80342115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Make the Right Choice of Proton Pump Inhibitor for Patients with Gastroesophageal Reflux Disease?","authors":"Yulia Evsyutina","doi":"10.22416/1382-4376-2023-33-1-68-76","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-1-68-76","url":null,"abstract":"Аim: to analyze the main pharmacokinetic properties of proton pump inhibitors (PPIs) and their significance in the treatment of gastroesophageal reflux disease (GERD).Key points. Pantoprazole has a high bioavailability, the absolute bioavailability of pantoprazole at a dose of 40 mg is 77 % from the first dose and does not change with repeated use. Pantoprazole shows a faster onset of action than omeprazole. Simultaneous food intake does not change the bioavailability of pantoprazole. Suppression of hydrochloric acid production while taking pantoprazole accompanies by the achievement of endoscopic remission of GERD by day 28 in 91 % of patients with reflux esophagitis and by day 56 in all patients in the PANSTAR studies. Pantoprazole has little effect on CYP2C19 compared to other PPIs, minimizing the risk of drug-drug interactions. Pantoprazole is the most pH-selective PPI, which determines the specificity of action only in the parietal cells of the stomach and the greatest safety of long-term use in patients with comorbid pathology.Conclusion. PPIs form the basis of the therapy of acid-dependent diseases, and, in particular, gastroesophageal reflux disease. Pantoprazole is distinguished from other PPIs by its persistent high bioavailability, long-term antisecretory effect, and very low affinity for cytochrome P450.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73987171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity and Gallstone Disease","authors":"I. Grigor’eva, T. Notova, T. I. Romanova","doi":"10.22416/1382-4376-2023-33-1-7-14","DOIUrl":"https://doi.org/10.22416/1382-4376-2023-33-1-7-14","url":null,"abstract":"Аim: to present data of Russian and foreign studies about association between physical activity (PA) and gallstone disease (GSD).Key point. A low PA level is one of the four major risk factors for chronic non-infectiuos diseases. The frequency of low PA in men and women of the Russian Federation (according to the medical examination in 2016) is 19 %. The global prevalence of GSD is up to 20 % among adults. Many systematic reviews and meta-analyses have confirmed an inverse association between GSD and PA in the world, regardless of potential risk factors for GSD, with a clear dose-dependent effect — the relative risk (RR) of GSD was 0.87 (95 % CI 0.83–0.92) per 20 metabolic equivalents (MET) of PA per week. According to our results of an epidemiological survey in the framework of the WHO MONICA program in Novosibirsk (n = 870) among women aged 25–64 with low total PA (less than 800 MET/min/week), as well as with the first class of PA in leisure-time, GSD occurred much more often (class 1 — 33 %, classes 2–4 — 8.7–11.0 %, p < 0.01). PA favorably affects almost all mechanisms of gallstone formation: improves cholesterol metabolism in bile, increases serum HDL cholesterol, bile acid synthesis, stimulates the release of cholecystokinin, reduces mucin hypersecretion, increases the diversity and richness of the intestinal microbiota. Daily PA serves as a preventive measure for GSD: the risk of GSD is reduced by 66 % (95 % CI 0.18–0.86).Conclusion. EASL has recognized PA as a protective agent against gallstone formation.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82746687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Centenary of the Birth of Professor Georgy I. Dorofeev","authors":"A. V. Gordienko","doi":"10.22416/1382-4376-2022-32-5-7-15","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-7-15","url":null,"abstract":"The article is devoted to one of the leaders of the Leningrad school of gastroenterologists of the second half of the last century. For almost two decades, he headed the oldest department of the Military Medical Academy — the Department of Hospital Therapy, turning it into one of the famous gastroenterological centers of the country of that period. The author offers the reader the complete biography of this famous scientist. One of the most important scientific merits of G.I. Dorofeev is the creation of an original scientific internist school. Many followers of it headed and continue to head the leading scientific centers of the country.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"144 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76808617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening and Early Diagnosis of Hepatocellular Cancer and Optimization of Diagnostic Imaging Techniques: A Review and Conclusion of the Expert Panel","authors":"V. Breder, R. Alikhanov, S. Bagnenko, E. Bessonova, V. Isakov, N. E. Kudashkin, B. Medvedeva, A. Mishchenko, M. Novruzbekov, V. Rudakov","doi":"10.22416/1382-4376-2022-32-5-16-23","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-5-16-23","url":null,"abstract":"Аim: to describe modern approaches for screening and early diagnosis of hepatocellular carcinoma (HCC).Key points. Screening for HCC in high-risk groups (cirrhosis of any etiology, patients with chronic viral hepatitis B and patients with F3 liver fibrosis) should be organized as regular (every 6 months) liver ultrasound in combination with determination of the serum alpha-fetoprotein (AFP) level. At an AFP level of ≥ 20 ng/ml, even in the absence of changes according to ultrasound data, it is advisable to perform MRI with a hepatospecific contrast agent (gadoxetic acid) which makes it possible to detect very small focal liver lesions. If focal liver lesions of 1–2 cm are detected on ultrasound, additional imaging of the liver using MRI with a hepatospecific contrast agent gadoxetic acid helps to identify HCC at an earlier stage or high degree dysplastic nodes. When planning surgical treatment and liver transplantation, it is preferable to use MRI with a hepatospecific contrast agent, since the presence of the hepatobiliary phase may allow the detection of additional smaller focal liver lesions and assess the nature of the focal liver lesion. When a patient is included in the waiting list for liver transplantation, the optimal frequency of liver MRI is 1 time in 3 months.Conclusion. MRI with hepatospecific contrast agent gadoxetic acid is effective in screening, early diagnosis and treatment planning for HCC.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73961007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}