Herald of Pancreatic Club最新文献

{"title":"Chronic pancreatitis: some modern provisions indicated classifications of the last years","authors":"T. Hristich, O. Fediv, D. Hontsariuk","doi":"10.33149/vkp.2019.03.04","DOIUrl":"https://doi.org/10.33149/vkp.2019.03.04","url":null,"abstract":"The article provides information about classifications of pancreatitis (both chronic and acute) close to clinical practice. The issue directly related to medical practice is highlighted, such as classification of diseases and causes of death (ICD-11), with appropriate headings for pancreatic diseases.The analysis of the general provisions indicated in the M-ANNHEIM classification (2007) and in the Marseilles-Rome classification with amendmentsbyYa. S. Tsimmerman and N. B. Gubergrits (2002), used by the Ukrainian physicians, is analyzed. The authors drew attention of gastroenterologists, therapists, family doctors to the need for predictionof the development of complications that threaten patients’ life.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131292950","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":"Exocrine pancreatic insufficiency in diabetes mellitus: frequency, pathogenesis, diagnosis, treatment","authors":"N. Gubergrits, N. V. Belyayeva, O. Klochkov, P. Fomenko","doi":"10.33149/VKP.2019.03.01","DOIUrl":"https://doi.org/10.33149/VKP.2019.03.01","url":null,"abstract":"The article represents a detailed literature review, which analyses normal physiological interrelations of exocrine and endocrine pancreatic parenchyma. Literature data regarding pathogenesis, clinical peculiarities, treatment of pancreatogenic diabetes mellitus (DM) and exocrine pancreatic insufficiency secondary to the DM are highlighted. Fecal elastase‑1 (FE‑1) is found to be a perfect biomarker to reflect the exocrine pancreatic insufficiency in patients with DM type 2. We demonstrate study results which highlighted a strong association of diabetes with low FE‑1 levels and positive correlation FE‑1 with C-peptide levels, lipase, C-reactive protein, body mass index, total 25-(OH)-vitamin D. Results of the studies which reveal the existence of two intra-pancreatic axes of communication are presented: one involved in the regulation of enzyme production by insulin via the insular-acinar axis; another involved in the regulation of insulin release by pancreatic enzymes via the acini-insular axis. The concept of acini-islet-acinar axis is introduced. Exocrine pancreatic insufficiency might be explained as a DM complication. A pathogenetic substantiation of reasonability of Creon indication in DM type 3 and for treatment of exocrine pancreatic insufficiency in patients with DM is presented. Pancreatin therapy can be used safely in patients with DM and exocrine pancreatic dysfunction.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121169644","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":"Problematic issues of chronic gastritis studies","authors":"Y. Tsimmerman, Y. Zakharova","doi":"10.33149/VKP.2019.03.06","DOIUrl":"https://doi.org/10.33149/VKP.2019.03.06","url":null,"abstract":"The article defines chronic gastritis as a polyetiological and polypathogenetic stomach disease with a chronic, slowly progressing course, which is based on a specific inflammatory process with lymphoplasmocytic infiltration of its mucosa and neutrophilic component indicating its activity, and with development of disregenerative, dystrophic changes, leading to its secretory insufficiency, manifested hypo- and achlorhydria and gastric achilia. \u0000The history of studying chronic gastritis from the beginning of the 19th century till present days is briefly described. \u0000It is proposed to distinguish between causal (Helicobacter pylori, etc.) and predisposing (alcohol, smoking, coarse food, etc.) factors in the development of chronic gastritis. The analysis of various classifications of gastritis is carried out: based on etiology, pathogenesis, functional features, clinic, endoscopic and histological characteristics. The Sydney, Houston classifications, the OLGA system are described. Particular attention is paid to diagnosis, biopsy technique of the gastric mucosa, ratio of diagnoses of chronic gastritis and functional dyspepsia, as well as the role of gastric microflora in development of gastritis. It is revealed that gastric microflora in chronic gastritis is represented by numerous types of bacteria (more often in the form of bacterial associations), moreover, Helicobacter pylori is not the dominant microorganism colonizing the stomach, and the mucosal microflora found in the stomach has adhesiveness, invasiveness and pathogenic properties, including its urease activity.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125419435","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":"Classification of acute cholecystitis:etiopathogenetic principles of construction","authors":"V. Mamchich, M. Chaika","doi":"10.33149/VKP.2019.03.08","DOIUrl":"https://doi.org/10.33149/VKP.2019.03.08","url":null,"abstract":"Aim of study is to suggest a scientifically based pathogenetic classification of acute cholecystitis, corresponding to the classical R. Virchow triad “etiology, pathogenesis, outcome”. \u0000Materials and methods.Comparative assessment of the classical classifications by H. Kehr (1907), L. Aschoff (1909), S. P. Fedorov (1934) and modern disease schemes, combining the signs of the three ones, is conducted. \u0000Results and discussion.The proposed improved classification of acute cholecystitis (AC) corresponds to research principles, taking into account the etiology, pathogenesis and predicted outcome of the disease. There are 4 groups of AC variants: \u0000I — Acute calculous cholecystitis with all options and combinations (cholangitis, choledocholithiasis, Opie syndrome — papillary ileus, Mirizzi syndrome, Bouveres — acute gallstone ileus, hemobilia (80–85%)). \u0000II — Acute non-calculous cholecystitis without stones (8–15%) — no obstruction of the cystic duct of the gallbladder. \u0000III —Special AC forms. The dominant factors are enzymatic, vascular, non-productive anaerobic microflora, stress factors (severe injury, burns or surgery, childbirth). These forms require urgent surgeries and occur in 2–15% of all cases of AC destructive forms. \u0000IV — Специфические формы ОХ.Specific AC forms. Caused by specific microflora: typhoid, salmonella, dysentery, and parasitic (opisthorchosis, alveococcosis, amebiasis, ascariasis, less often — giardiasis). Rare forms are characteristic of endemic zones and in violation of generally accepted sanitary standards. \u0000Conclusion.Use of ultrasound, CT, SCT, MRI, endoscopic and endovascular interventions allows to diagnose almost all the AC various forms in the pre-operative period and individualize therapeutic and surgical tactics by taking into account the possible outcome. The proposed pathogenetic classification of AC can serve as a scheme for general practitioners, physicians, surgeons, anesthesiologists, and intensive care workers.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125690660","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":"Effectiveness of the vitamin drug Doctovit for correction of clinical symptomatology and restoration of life quality in complex therapy of chronic erosive H. pylori-associated gastritis","authors":"N. Gubergrits, L. Babinets, I. Halabitska","doi":"10.33149/VKP.2019.03.07","DOIUrl":"https://doi.org/10.33149/VKP.2019.03.07","url":null,"abstract":"Inclusion of the vitamin drug Doctovitin the complex treatment of patients with chronic erosive gastritis contributed to a statistically significant regression of clinical symptoms (p<0.05). This led to significant improvement of physical and psychological parameters of life quality: according to the SF-36 questionnaire scale — at the average of 4.9%, GSRS questionnairescale — by 17.2% (p<0.05), which proved the effectiveness and reasonability of using the vitamin drug in complex treatment and rehabilitation of patients with chronic erosive gastritis. It is expedient to prescribe 2 tablets of the vitamin complex Doctovit per day after eating during 2 months for the correction of polynutrient disorders in complex treatment of chronic erosive gastritis.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125992285","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":"Сlinical case of pancreatic cancer","authors":"M. Kankia, I. Jikia, G. Mtskherashvili, G. Cucxubaia","doi":"10.33149/VKP.2019.03.05","DOIUrl":"https://doi.org/10.33149/VKP.2019.03.05","url":null,"abstract":"Description of a rare case of pancreas body tumor, which was grown into celiac trunk, is presented. The patient was saved due toanftomy of right hepatic artery, which was a branch of superior mesenteric artery. \u0000Patient Z.V, 60 years old, came to the clinic with such complaints as pain, heaviness in abdomen and waist area,weakness.4–5 cm tumor of pancreas body was detectedduring surgery. The tumor had grown into celiac trunk and into left adrenal gland. \u0000The friable tissue of hepato-duodenal ligament was dissected duringthe surgery.Thesurgeons mobilized duodenum usingKoxertechnique. As a result of this manipulation, the followingblood vesselswere visualized:inferior vena cava and abdominal aorta, celiac trunk, superior mesentericartery. Surgical team opened ligament of Treitz and excisedpancreas body2.5 cm away from thetumor proximally. The stump was sewed with “mattress stich”, celiac trunk was sectioned and entangled, surgeons also dissected common hepatic artery. After section they checked blood supply of liver. The pressure of blood flowing from gastro-duodenal and pancreato-duodenal artery was enough for providing normal blood flow in the left hepatic artery. \u0000Morphological result of the excisedtissue — Ductal adenocarcinoma (No 672). \u0000The patient’sstate was satisfactory when he left the clinic. He underwent medical check-up three times next year. He feels well, his state of health is normal. Patient is capable of working. \u0000This case is interesting due to the anatomy of right hepatic artery (which was a branch of superior mesenteric artery) that saved patient’s life.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126233955","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":"Comorbidity of chronic pancreatitis and metabolic syndrome: mechanisms of development","authors":"T. Hristich, D. Hontsariuk","doi":"10.33149/VKP.2019.02.02","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.02","url":null,"abstract":"In this article, the authors analyze a number of known and probable mechanisms involved in the formation of metabolic disorders upon chronic pancreatitis in comorbidity with metabolic syndrome. The issue of involvement of pancreatic endocrine apparatus in development of insulin resistance upon chronic pancreatitis, namely, the role of such a hormone as insulin, is highlighted. The role of this hormone in development of disorders of fat metabolism, obesity and arterial hypertension is presented. The authors emphasize the role of adrenal hormones, estrogen in the pathogenesis of both diseases. The issue of effect of endocrine function disorders on the state of external pancreatic secretion with subsequent development of disorders in the microbiota composition is considered (which also contributes to the progression of both diseases). \u0000The data on presence of a possible relationship between the composition, functional activity of the intestinal microbiota and development of metabolic syndrome, chronic pancreatitis are given. The significance of intestinal microbiota in the maintenance of various vital processes of a healthy person, food digestion, as well as synthesis, metabolism, recycling, utilization of various biologically active substances (vitamins, hormones, steroids, immunoglobulins) and elimination of toxins is revealed. The role of microorganisms in the formation of feeding behavior via axis “intestinal microbiome — intestine — brain” is analyzed. Modern ideas on the ability of microorganisms to provoke formation of metabolic disorders upon chronic pancreatitis are presented. The data confirming connection of certain dysbiotic changes (increased ratio of Firmicutes/Bacteroidetes, reduced number of Bacteroidetes and increased number of Firmicutes) with development of obesity, overweight, type 2 diabetes mellitus (known risk factors of metabolic syndrome) is given. It is suggested to prevent formation of metabolic syndrome in chronic pancreatitis by increasing the number of specimens of Bifidobacterium genus and Faecalibacteriumprausnitzii strains in the intestine.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116853899","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":"Functional state of pancreas in patients with chronic pancreatitis","authors":"О. Krylova","doi":"10.33149/VKP.2019.02.05","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.05","url":null,"abstract":"Аim of research is to study the functional state of the pancreas in patients with various forms of chronic pancreatitis. \u0000Materials and methods. Complex examination of 210 patients with various forms of chronic pancreatitis (І, n=26 — obstructive, ІІ, n=56 — calcifying, ІІІ, n=78 — fibrous-parenchymal, ІV, n=50 — chronic pancreatitis complicated by pseudocyst) was carried out. Activity of enzymes (amylase, lipase, trypsin, phospholipase A) in serum, duodenal and ductal pancreatic contents was determined by common clinical techniques. In addition, content of bicarbonates was determined in duodenal and ductal contents. Exocrine pancreatic function was assessed by fecal elastase-1 level, endocrine function — by glycosylated hemoglobin level. \u0000Results of study. Increased activity of enzymes was determined (amylase, lipase, trypsin, phospholipase A) in the serum of patients of all groups: amylase activity (61.6%), trypsin (85.9%) by 3.5 times and phospholipase A (84, 6%) — by 2.3 times in comparison with the control group (p <0,001). Most often, α-amylase activity increased in patients of I and IV groups (with the same frequency of 70.0%) due to the process exacerbation or obstacle for the pancreatic juice outflow; increased trypsin activity was more frequent in III group of patients (91,0%). According to the fecal elastase test, the highest degree of pancreatic parenchymal involvement was detected in II and III groups of patients. \u0000Fecal elastase test showed increased level of enzymes in the duodenal and ductal pancreatic contents, increased level of bicarbonates, and decrease in the exocrine pancreatic function. Inhibition of basal pancreatic secretion and increase of debit-hour of pancreatic enzymes in duodenal contents after stimulation of the pancreas was states, which corresponds to the intraoperatively obtained data. \u0000Conclusions. It was found out that functional activity of the pancreas was preserved in 83.3% of patients, which coincides with literature data on changes in the indices of pancreatic functional activity upon 90.0% lesion of its parenchyma.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"255 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114362825","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":"Adherence of patients to medical recommendations (compliance) as an important factor in increasing the effectiveness of treatment (by example of acid-dependent diseases)","authors":"Y. Tsimmerman, L. G. Vologzhanina","doi":"10.33149/VKP.2019.02.09","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.09","url":null,"abstract":"List of medical terms has been recently supplemented with relatively new notions of compliance (adherence), which means “consent, compliance with your wishes” in English. They are used to denote the patient’s strict adherence to medical recommendations, especially with regard to pharmacotherapy (use of the drug at the recommended dose with the necessary frequency and duration), correction of lifestyle, rationalization of dietary habits, getting rid of bad habits. High compliance is very important in the treatment of acid-related diseases: organizing a lifestyle, following advice on dietary restrictions and habits, avoiding stressful situations and physical exertion significantly affect the effectiveness of therapeutic measures in gastroesophageal reflux disease, gastric ulcer and duodenal ulcer, non-atrophic gastritis, Zollinger-Ellison syndrome, chronic gastritis induced by nonsteroidal anti-inflammatory drugs. Optimization of compliance (adherence), control over the implementation of prescriptions, elimination of factors that impede the realization of medical recommendations will improve the effectiveness of treatment of acid-related diseases. The key to successful treatment of any pathology is an active involvement of a patient in the treatment process.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"185 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124697943","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":"Statistical characteristics of number and structure of hospitalizations and treatment of patients with acute and chronic pancreatitis in the surgical departments in Kemerovo region","authors":"V. I. Podoluzhniy, V. Pelts, I. Radionov","doi":"10.33149/VKP.2019.02.07","DOIUrl":"https://doi.org/10.33149/VKP.2019.02.07","url":null,"abstract":"Aim. Determine the number of hospitalizations and treatment of patients with acute (AP) and primary chronic pancreatitis (PCP) in surgical departments No 1 and No 2 of the Regional Clinical Hospital of Emergency Medical Care n. a. M. A. Podgorbunsky (Kemerovo) and surgical departments in Kemerovo region from 1993 to 2017. \u0000Methods. A comparative analysis of the number and structure of treatment of patients with AP over two decades was carried out. Number of PCP surgeries in the Regional Hepatology Center after 1995 was comparatively analyzed. \u0000Results. There was an increase in number of average annual hospitalization of patients with acute (primary and secondary) pancreatitis over the past decade by 79.7% (incidence 64.3/100000 and 125.3/100000), as well as increased number of surgeries for PCP. In urgent patients, mild pancreatitis occurred in 76.8%, pancreatic necrosis — in 23.2%. Those who had destructive pancreatitis underwent surgery in 15.1% of cases. Mortality with pancreatic necrosis reaches 7.9%. Over the last decade, compared with the past one, 26.4% more patients were operated on for PCP. Pancreatic resections were performed in 22.5% of cases, draining anastomoses were installed in 65.4% of surgical cases. \u0000Conclusion. Over 23 years, the number of hospitalized patients with AP has increased statistically significantly. 3.5% of hospitalized patients were operated on (15.1% with pancreatic necrosis). Mortality upon pancreatic necrosis reached 7.9%. AP is viewed as a predictor of chronic pancreatitis, there is a clear upward trend in the number of surgeries for PCP.","PeriodicalId":378182,"journal":{"name":"Herald of Pancreatic Club","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124136180","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}