Herald of Pancreatic Club最新文献

{"title":"Chronic pancreatitis: what should be considered in diagnosis, treatment, and prognosis","authors":"T. Khristich","doi":"10.33149/VKP.2020.04.07","DOIUrl":"https://doi.org/10.33149/VKP.2020.04.07","url":null,"abstract":"The aim of the literature review is to draw attention of doctors to the need of considering not only well-known etiological factors, but also pathogenetic ones that have an impact on the progression, chronicity of the process, treatment, prevention, and prognosis. \u0000The role of alcohol, mechanism of obstruction of the pancreatic ducts in the occurrence of abdominal pain in chronic pancreatitis, and the development and progression of exocrine pancreatic insufficiency are discussed in detail.The issues of the onset of chronic pancreatitis in elder age, comorbidity with other diseases of the internal organs, with a lack of certain vitamins are considered. It is necessary to remember that exocrine insufficiency can be associated with the progression of glandular fibrosis, metabolic disorders, food intolerance, allergic syndrome, which provoke acute attacks.The author draws attention to the fact that the syndrome of inflammatory, enzymatic intoxication and the syndrome of disseminated intravascular coagulation should not be missed out in the acute nature of the process. Above-listed recommendations will help to correctly evaluate the clinical picture and prescribe the proper treatment, as well as to prevent the development of complicationsin time.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"28 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116724877","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":"Duodenum-preserving pancreatic head resections for surgical treatment of paraduodenal pancreatitis","authors":"O. Usenko, V. Kopchak, I. Khomiak, A. Khomiak, A. Malik","doi":"10.33149/VKP.2020.04.04","DOIUrl":"https://doi.org/10.33149/VKP.2020.04.04","url":null,"abstract":"Introduction. Up to date, no consensus exists on the surgical treatment of paraduodenal pancreatitis (PDP). Most authors prefer to perform pancreaticoduodenectomy when surgical treatment is indicated. However, such an aggressive approach may not always be justified for the treatment of benign disease. The aim of our study was to investigate the results of duodenum-preserving pancreatic head resections (DPPHR) for the treatment of PDP. \u0000Materials and methods. We performed a retrospective analysis of a database consisting of 112 patients with PDP treated in Shalimov National Institute of Surgery and Transplantology from 2014 to 2019. A total of 45 patients after DPPHR were included to the study. Such modifications of DPPHR as Frey’s, Beger’s and Berne’s procedures were used. The primary study endpoint was pain control assessed according to the Izbicki pain score before surgery and at follow-up visits. Secondary endpoints were defined as complication rate (Clavien — Dindo >2), hospital length of stay and 90-day mortality. All patients were followed-up for the assessment of pain cessation with a median of 33 months (range 8–54 months). \u0000Results. There were 42 males (93.3%) and 3 females (6.7%) in the study group. Preoperative Izbicki pain score result was 52.6 points. Follow-up pain score results were significantly lower at 11.7 points. Postoperative complication rate (Clavien — Dindo >2) was measured at 8.9%. Median hospital length of stay was 17.4 days. No mortality was recorded in the study group. All results were statistically significant (p<0.05). \u0000Conclusion. Application of DPPHR for the surgical treatment of PDP allows to achieve excellent results in terms of pain control (52.6 and 11.7 points on the Izbicki pain score before surgical intervention and at follow-up), while maintaining low complication (8.9%) and mortality (0%) rates.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129414290","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":"Pancreatic steatosis: a giant step forward or recognition of ignorance","authors":"N. Gubergrits, N. Byelyayeva, T. L. Mozhyna, N. Monogarova, K. Borodiy, A. Yuryeva","doi":"10.33149/VKP.2020.04.02","DOIUrl":"https://doi.org/10.33149/VKP.2020.04.02","url":null,"abstract":"This review analyzes the terminology of pancreatic steatosis, the data about the prevalence of non-alcoholic fatty pancreas disease (NAFPD) were given. \u0000The etiological factors of NAFPD are usually subdivided into hereditary, metabolic, and toxic ones. The main etiopathogenetic factor of pancreatic fatty infiltration is obesity: it causes pancreatic infiltration by adipocytes, leading to the development of NAFPD. The pathogenesis of the disease is associated with adipocytic tissue dysfunction, which induces local and systemic inflammatory response with corresponding clinical consequences. Insulin resistance and oxidative stress play major role in the pathogenesis of NAFPD. From a histological point of view, NAFPD is a heterogeneous process, characterized by excessive intracellular accumulation of lipids and fatty infiltration followed by fatty replacement of the pancreas. \u0000NAFPD clinical picture is asymptomatic and nonspecific. Diagnosis of NAFPD is based primarily on the results of imaging methods (ultrasound, CT, MRI). A consequence of NAFPD is exocrine pancreatic insufficiency requiring enzyme replacement therapy. One of the NAFPD complications is the development of pancreatic adenocarcinoma. \u0000Currently, standards for the diagnosis, treatment and management of patients with NAFPD have not been developed yet, but on used the guidelines for the treatment of non-alcoholic fatty liver disease (rational diet, exercises, weight loss). The “gold standard” of enzyme replacement therapy, such as Creon®, is used for correction of exocrine pancreatic insufficiency. The detailed analysis of the clinical case of total pancreatic steatosis with severe exocrine pancreatic insufficiency was done in this article.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130656967","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":"Bile acids, non-alcoholic fatty liver and pancreatic disease: chained by ursodeoxycholic acid?","authors":"N. Gubergrits, N. Byelyayeva, T. L. Mozhyna","doi":"10.33149/VKP.2020.04.03","DOIUrl":"https://doi.org/10.33149/VKP.2020.04.03","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty pancreatic disease (NAFPD) develop against the background of metabolic syndrome, systemic insulin resistance, oxidative stress, changes in lipid and carbohydrate metabolism. There are a number of similarities between NAFLD and NAFPD: the natural course of diseases proceeds from steatosis through inflammation to fibrosis and cancer, one of the etiopathogenetic factors is the disbalance of bile acids synthesis and low expression of farnesoid receptor X (FXR). One of the possible methods of treatment NAFLD and NAFPD is a correction of the biosynthesis of bile acids and increase FXR expression with FXR agonists. Ursodeoxycholic acid (UDCA) is a selective FXR agonist. It has a multipled spectrum of actions: anticholestatic, anti-apoptic, antioxidant, cytoprotective, antifibrotic, hypocholesterolemic, immunomodulatory, hepatoprotective. The ability of UDCA correct lipid and carbohydrate metabolism in combination with anti-inflammatory and antiapoptic effects may be of great importance for the treatment of NAFLD and NAFPD. The article reviews the results of clinical and experimental studies describing the efficacy of UDCA in NAFLD and some pancreatic diseases. It has been suggested that the therapy of UDCA can reduce the severity of NAFLD and NAFPDand improve the functional activity of hepatocytes and β cells. The need for randomized clinical trials was emphasized in order to make an informed decision on the expediency of including UDCA in the treatment of NAFLD and NAFPD.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"164 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114444097","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":"Klotho protein as a mediator of antioxidant defense in young people with gastroesophageal reflux disease and autoimmune thyroiditis","authors":"T. Pasiieshvili","doi":"10.33149/VKP.2020.04.08","DOIUrl":"https://doi.org/10.33149/VKP.2020.04.08","url":null,"abstract":"Aim: to establish the content and role of Klotho protein in the pathogenesis of gastroesophageal reflux disease, which occurs against the background of autoimmune inflammation in young people. \u0000Materials and methods. Three groups of patients were involved in the study: with the gastroesophageal reflux disease (GERD ) and autoimmune thyroiditis (AIT ) (120 persons), isolated GERD (45) and AIT (42) aged 18 to 25 years, of the same sex and duration of the disease. The content of Klotho protein was determined in the serum by ELISA, Elabscience reagents (ELISA, USA). \u0000Results. Significant increase in Klotho protein was detected in patients with GERD and especially in its combination with AIT relative to the control. Content of Klotho protein did not correlate with the morphological form of the disease and its duration. In patients with isolated AIT , Klotho protein level did not have a significant difference with control group. \u0000Conclusion. The GERD and its combination with AIT in young people are accompanied by an increase in Klotho protein content, as a result of the presence of an active inflammatory process in the esophagus mucosa and its stimulating effect on antioxidant defense processes.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124972109","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":"Efficacy of antiinflammatory and metabolic bioregulation in complex therapy of chronic pancreatitis with the inflammatory changes of gastroduodenal zone organs","authors":"N. Shevchenko, L. Babinets","doi":"10.33149/VKP.2020.04.06","DOIUrl":"https://doi.org/10.33149/VKP.2020.04.06","url":null,"abstract":"Background. The clinical course of chronic pancreatitis (CP) is characterized by symptomatic polymorphism, which is often associated with comorbidity of CP with other lesions of the gastrointestinal tract. Destructive-inflammatory processes of the upper gastrointestinal tract are very common. Such comorbidity is especially typical for young patients with CP (up to 45 years). \u0000The aim is to study the effectiveness of bioregulatory anti-inflammatory and metabolic therapy based on the dynamics of clinical indices and parameters of exocrine pancreatic function and the condition of the mucous membrane of the gastroduodenal zone of patients with CP. \u0000Materials and methods. We examined 50 patients with CP with exocrine insufficiency in the phase of unstable remission in combination with inflammatory diseases of the mucous membranes of the gastroduodenal zone. Group 1 (28 patients, age 40.25±1.34 years) received conventional treatment (CT) — pure pancreatin enzymes, proton pump inhibitors, antispasmodics or prokinetics (if necessary), enhanced by a step-by-step course of bioregulatory therapy, including parenteral course of anti-inflammatory drug Traumel C 2.2 ml intramuscularly twice a week (e.g., Monday and Thursday) and metabolic Ubiquinone Compositum 2.2 ml intramuscularly twice a week (e.g., Tuesday and Friday) № 5 each drug with the transition for oral administration of Traumel C per 1 tablet 1 hour after meals three times a day for 30 days. 22 patients with CP and concomitant exacerbation in gastroduodenal zone group 2 (age 41.34±1.21 years) received only complex CT. \u0000Results and discussion. A comparative analysis of the dynamics of treatment outcomes in the two study groups showed that almost all clinical signs of the disease, endoscopy and exocrine pancreatic function after treatment in the group using anti-inflammatory and metabolic bioregulatory therapy results were significantly better than in CT group. The mean time to normalization of mucous membranes of gastroduodenal zone in the group with an additional course of bioregulation was 14.4±0.86 days, while in the group of CT — 18.1±0.46 days. \u0000Conclusion. It was proved that the additional inclusion of step-by-step bioregulatory antiinflammatory (Traumel C) and metabolic (Ubiquinone Compositum) therapy according to the proposed scheme to the CT significantly more effectively (p˂0.05–0.001) improved the clinical course of the disease, contributed to the normalization of exocrine pancreatic function, as well as more quickly normalized the condition of the mucous membrane of the gastroduodenal zone — during 14.4±0.86 days, while in the group of CT — during 18.1±0.46 days.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131920620","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":"Idiopathic recurrent pancreatitis in a young woman: unexpected clue","authors":"N. Gubergrits, N. Monogarova, N. Byelyayeva, A. Zeynalova, P. Fomenko, S. Shpak, E. Bakhchevan, A. Burka","doi":"10.33149/vkp.2020.03.08","DOIUrl":"https://doi.org/10.33149/vkp.2020.03.08","url":null,"abstract":"The article presents a complex clinical case of idiopathic recurrent pancreatitis in a young woman, 23 years old. The main clinical manifestation of the disease was acute, intense, recurrent abdominal pain. Despite ongoing symptomatic therapy, the patient’s condition had been worsened, and the intensity of abdominal pain increased. Adequate dosage of the enzyme replacement therapy allowed increasing the duration of remission. Differential diagnosis, additional laboratory and instrumental studies allowed determining the cause of recurrent pancreatitis and confirming the diagnosis of cystic fibrosis with a primary lesion of the pancreas. A distinctive feature of this clinical case is the diagnosis of a hereditary cystic fibrosis disease in adulthood, the absence of clinical symptoms of lungs’ involvement in the pathological process, as well as the absence of underdevelopment, malnutrition. The diagnosis of cystic fibrosis is confirmed by German specialists; currently, the patient continues treatment in a German clinic. \u0000The article presents current data on idiopathic pancreatitis, discusses a diagnostic algorithm for identification of the cause of the disease. The etiology, pathogenetic mechanisms of cystic fibrosis occurrence are considered, the known types of CFTR gene mutations, causing the development of the disease, as well as the principles of replacement enzyme therapy in patients with cystic fibrosis are described. Evidence-based medicine data are presented, revealing the efficacy and safety of taking enzyme preparations in the correction of the exocrine pancreatic insufficiency.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130887974","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":"Intestinal microbiota and pancreatic diseases","authors":"N. Gubergrits, N. Byelyayeva, A. Klochkov, G. Lukashevich, V. Rakhmetova, P. G. Fomenko P. G. Fomenko, L. Yaroshenko","doi":"10.33149/vkp.2019.04.02","DOIUrl":"https://doi.org/10.33149/vkp.2019.04.02","url":null,"abstract":"The article presents a detailed literature review on the role of intestinal dysbiosis, including bacterial overgrowth syndrome, as well as increasing intestinal permeability in the pathogenesis of the main pancreatic diseases: acute and chronic pancreatitis (AP and CP), autoimmune pancreatitis, pancreatic cancer. \u0000Thus, according to the results of meta-analysis, populations of Enterobacteriaceae and Enterococcus were larger in all patients with AP as compared with healthy. There was no difference between the groups with severe and mild AP. Number of Bifidobacterium was lower in all patients with AP as compared with healthy. In severe AP, level of endotoxin and cytokines in blood was higher than in mild AP and in healthy. \u0000Participation of Helicobacter pylori in pathogenesis of autoimmune pancreatitis via molecular mimicry is assumed. In addition, Helicobacter pylori may have significance in development of pancreatic adenocarcinoma. \u0000In CP, rate of syndrome of bacterial overgrowth has been studied in numerous studies, since dysbiosis halts the effect of enzyme preparations, causes worsening of clinical manifestations. According to the results of meta-analysis, patients with CP are characterized by quantitative and qualitative changes in the composition of intestinal microbiome: decrease of Bifidobacterium and Lactobacillus, and increase of Enterobacteriaceae. The authors also preseented their own data. \u0000Recent data suggest a connection between the oral microbiota, tongue plaque and pancreatic adenocarcinoma. Pancreatic cancer is characterized by decrease of Neisseria elongate, Streptococcus mitis, and increase of Porphyromonas gingivalis and Granulicatella adiacens. Recent reports have found that oral microbiota may be important in increasing the risk of pancreatic cancer. The conclusion is drawn on the prospects of studying the intestinal microbiota in pancreatic diseases and the need for its participation in the pathogenesis of this disease.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116850007","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":"Diagnosing pancreatic steatosis in obese patients","authors":"A. Starodubova, S. Kosyura, E. Livantsova, Y. Varaeva, A. Krasilova","doi":"10.33149/vkp.2019.04.03","DOIUrl":"https://doi.org/10.33149/vkp.2019.04.03","url":null,"abstract":"Frequency of pancreatic steatosis in adults of general population is up to 35%. Causes of triglyceride accumulation in the pancreas include aging, obesity, type 2 diabetes mellitus, metabolic syndrome, hypertriglyceridemia (genetically determined or secondary one). Nomenclature by M. M. Smits is used for diagnosing, which sets out pancreatic steatosis, lipomatous pseudohypertrophy of the pancreas, fatty replacement of the pancreas, fatty infiltration of the pancreas, non-alcoholic fatty pancreatic disease, non-alcoholic pancreatic steatosis, non-alcoholic steatopancreatitis. \u0000Pancreatic steatosis usually does not have any clinical manifestations, as it is characterized by an asymptomatic course. It is diagnosed on the basis of results of imaging methods (ultrasound, computed or magnetic resonance imaging). According to the ultrasound, there are 3 degrees of pancreatic steatosis: \u0000 \u0000Degree I — pancreatic echogenicity is equal to the echogenicity of adipose tissue in area of superior mesenteric artery. Pancreas is not enlarged, echogenicity is uniformly increased, contour is smooth, splenic vein, superior mesenteric artery and pancreatic duct are well-visualized; \u0000Degree II — increased echogenicity on the background of weak signal in the remote, dorsal part of the pancreas (reduced acoustic signal conductivity, attenuation of the ultrasonic signal behind the posterior surface of the pancreas), indistinct edges of splenic vein and pancreatic duct with almost non-visualized area of superior mesenteric artery; \u0000Degree III — reduction of ultrasound conductivity of the pancreas, undulating (convoluted), indistinct contours, splenic vein, area of superior mesenteric artery and pancreatic duct are not visualized. \u0000 \u0000Main feature of the pancreas lesion in obesity is the absence of changes in biochemical indices or their minor changes. Exocrine and endocrine pancreatic insufficiency, hyperlipidemia may develop.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122762866","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":"Diagnostic and prognostic value of immune indicators of inflammation in the course and progression of gastroesophageal reflux disease and autoimmune thyroiditis in young people","authors":"T. Pasiieshvili","doi":"10.33149/vkp.2019.04.07","DOIUrl":"https://doi.org/10.33149/vkp.2019.04.07","url":null,"abstract":"Cytokines are considered as “microendocrine system” due to the fact that they have a triple mechanism of action. First, they affect the cell-producer (autocrine effect); secondly, they influence neighboring (adjacent) cells (paracrine effect); thirdly, they affect the distant cells of organs and tissues (endocrine effect). Most cytokines have a wide range of biological activity, which is associated with their synthesis and secretion of various types of cells. \u0000Aim of study was to determine the role and prognostic values of tumor necrosis factor (TNF) α, interleukin (IL) 1β and IL-18 in young patients with autoimmune thyroiditis (AIT) and gastroesophageal reflux disease (GERD). \u0000Materials and methods. Study involved 83 patients (students) with GERD and AIT. The average age for the group was 22.1±2.11 years. The comparison group was represented by 30 patients of similar age with isolated GERD. The enzyme immunoassay was used to study the content of TNF-α, IL-1β and IL-18. \u0000Results. Upon evaluating the complaints of patients, it was found that the main manifestation of GERD was heartburn of varying severity, duration and frequency of occurrence. It has been shown that the course of GERD occurs against the background of the development of a systemic inflammatory reaction (increased synthesis of proinflammatory cytokines IL-1β and TNF-α), and also depends on the form of esophagitis: more pronounced in the erosive variant of the mucous membrane of the esophagus. At the same time, there was an increase in the synthesis of IL-18, which, with isolated GERD, is associated with a general inflammatory reaction, and with the addition of AIT, the inclusion of immune mechanisms. Relationship between the level of TNF-α in peripheral blood and the content of thyroid-stimulating hormone was studied. However, unlike the results of other scientists, the authors have not identified such a relationship.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131213115","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}