EVALUATION OF EFFECTIVENESS OF APPLICATION OF ALGINATES IN NONEROSIVE GERD

R.A. ABDULKHAKOV, S.R. ABDULKHAKOV

Kazan State Medical University, Clinical Hospital of MSU of the MIA for the RT

Kazan, RUSSIA

Objective: To study effectiveness of alginates in relieving clinical anifestations of the disease in patients with GERD.

Materials and methods: We have studied the effectiveness of Gaviscon forte in 25 patients with nonerosive form GERD (m-9, w-16); average age 45±5.1 years. Before treatment there was carried out fibrogastroduodenoscopy for the assessment of changes in the esophagus; before and after treatment was assessed frequency and intensity of main esophageal and extraesophageal symptoms of GERD (heartburns, regurgitations, dysphagias, odynophagias, pain along the esophagus, cough). The degree of severity of clinical symptoms was defined in points. Patients took the drug at a dose of 10 ml 4 times a day within 14 days; the results of treatment were assessed on the 7^th and 14^th days.

Results: Before the treatment, frequent heartburn was observed in 24 patients (96%), in 19 of them (76%) heartburn was intensive. Average point of expressiveness of heartburn according to five-point scale before the treatment constituted 4.1. Eructation of swallowed air was observed in 22 patients (88%), regurgitation - in 19 (76%), dysphagia - in 10 (40%), sternal pain - in 7 (28%) patients.

Heartburn and regurgitation were completely arrested on the 7^th and 6^th days at average; by the end of treatment (on the 14^th day) dysphagia and sternal pain, which existed in some patients prior to treatment, disappeared.

Conclusions: Thus, the use of alginatea (Gaviscon) is effective in relieving of GERD symptoms.

FREQUENCY OF GERD SYMPTOMS AMONG URBAN POPULATION OF KAZAN

S.R. ABDULKHAKOV, R.A. ABDULKHAKOV

Kazan State Medical University, Kazan, RUSSIA

The aim of the study was to assess the prevalence of main symptoms of GERD in the population of Kazan, as well as to identify drugs used by patients for relief of heartburn.

Materials and methods. The study included randomly polled 908 persons (m-347, w- 561, aged between 18 -87 years). Respondents were asked questions about frequency of heartburn and regurgitation, influence of heartburn / regurgitation on the quality of life, frequency of intake of medications for heartburn.

Results. Results of survey showed that heartburn is suffered by 516 (56.83% of respondents) persons. The prevalence of heartburn in men and women did not significantly differ (m-59.65%, w - 55.1%). Occasionally (less than once a week), heartburn was in 244 (26.87% of respondents), heartburn with a frequency of once a week or more (GERD) occurred in 272 (29.95%) of respondents. In all the age groups except for respondents in the 18-20 and 21-30 age groups, GERD in men occurred more common than in women.

Eructation was encountered in 59.03% of respondents, and in 28.74% of the respondents there was observed acid eructation. Among persons with GERD, eructation was observed significantly more - in 79.3% of cases, including acid regurgitation - in 53.62%.

Manifestations of GERD significantly reduced quality of life of respondents: heartburn caused general discomfort in 48.79% of patients with GERD, in 43.96% of patients had to refuse from food intake, 32.67% of patients limited their physical activity, and in 28.71% of cases resulted in failure to work. In more than 46% of persons with GERD, heartburn caused of sleep disturpance.

Drugs were taken by 40.98% of persons with episodic heartburn and 76.84% of patients with GERD. However, rational therapy (antisecretory agents) were taken by only 14% of patients with GERD: 9.19% of persons with GERD took proton pump inhibitors, 4.8% - blockers of H2-receptors of histamine, 33.1% of persons achieved relief of heartburn by taking antacids.

Conclusions: 1. The frequency of heartburn according to the results of survey constituted 56.83%, regurgitation - 28.74%, frequency of GERD - 29.95%.

2. Heartburn significantly reduces the quality of life in patients with GERD.

3. 76.84% of persons with GERD independently take drugs on heartburn, however, the rational treatment of GERD by antisecretory drugs is carried out only in 14% of persons with GERD.

METHOD OF VERTICAL INVAGINATED GASTROPLASTY IN MORBID OBESITY

J.S. ABDULLAYEV

National Surgical Center. Kyrgyz State Academy, Bishkek, KYRGYZSTAN

Introduction: Nowadays obesity became a problem of the century, and morbid obesity represents a subject of bariatric surgery. Restrictive gastric surgery, leading to a decrease of gastric volume and early satiety, is of a definite interest.

Material and methods: We possess the experience of appliance of the new restrictive method of vertical invaginated gastroplication (VIG) in 13 patients with morbid obesity that allows to reduce the volume of stomach and to lose weight. After mobilizing the greater curvature of stomach with ligation of short gastric arteries, was performed a gradual immersion of the greater curvature of a stomach body into the lumen of the stomach with imposing of serous-muscular sutures in 2-3 rows with non-absorbable thread, until the formation of a stomach tube with clearance of 2-3 cm on a gastric probe with a diameter of 20 mm, pre-held into the stomach lumen. As a result, was formed a gastric tube with two reservoirs of 40-50 ml in the proximal and distal piloroantral parts. To reduce the volume of the proximal gastric reservoir and to prevent reflux esophagitis Nissen or Dor fundoplication was carried out. At the end of the operation nasointestinal intubation for enteral tube feeding (ETF) was performed.

Results: Of the total 13 patients there were 9 females and 4 males. In 5 patients with ventral hernia herniotomy, geteroplasty with prolene mesh and abdominoplasty with removal of skin- fat "apron" were performed simultaneously. We practiced early getting up, prevention of thromboembolic complications, ETF in the poseoperative period. The postoperative period was uneventful, the wound healed by first intention. Patients were under observation for 3,6,12,18,24 months after the operation, they complianced the diet. Was noted a gradual decrease in body weight (BW) for 15 - 20%. Special complaints were absent.

Conclusion: Thus, the results of operation of VIG suggest that this method can be used in patients with II and III degree of obesity, it is simple in technical performance, easily tolerated by patients, leads to a gradual steady decline of BW, does not require large material costs and can also be used as a preparation for surgery of bilio-pancreatic shunting.

PREVALENCE OF GENETIC POLYMORPHISM IL28B IN AZERBAIJAN COHORT

N. ABDULLAYEVA, E. MAMMADBAYOV, Y. ALKHAZOV , M. WEIZENEGGER,

J. BARTEL, M. SH. BABAYEV

Baku State University, “EuroMed” Private medical centre, Head of Molecular Genetics and Microbiology Department, Baku, AZERBAIJAN; Labor Dr. Limbach and colleagues, Heidelberg, GERMANY

Background: Chronic hepatitis C virus (HCV) infection affects 170 million people worldwide and is the leading cause of liver cirrhosis. As known genotype 1 of hepatitis C virus (HCV) is found in 75 % of HCV-infected in Azerbaijan. This correlates with data obtained in Europe. Treatment outcome in this group remains unsatisfactory: only 50-55% achieves sustained virological response (SVR).

In recent genome-wide association study a single nucleotide dimorphism (rs12979860) 3 kilobases upstream of the interleukin 28B (IL28B) gene on chromosome 19, which encodes the type III interferon IFN-λ3, was shown to predict response to HCV drug treatment. In patients of European ancestry, the CC genotype is associated with a twofold greater rate of SVR than the TT genotype (80 and 35 % accordingly). Hereby host genetics may help to predict individuals that are likely to respond to treatment of HCV infection.

No data are available for the prevalence of IL28B genetic dimorphism in Azerbaijan.

Aim: Evaluation of the genetic dimorphism IL28B in a group of Azerbaijan origin patietns.

Methods: 108 Caucasian HCV- infected patients aged from 18 to 60 years (60 male and 48 female) were genotyped for IL-28B on a LightCycler 1.5 Assay(Roche, Germany). DNA was isolated with a GenoXtract device and the appropriate cardridge (Hain Lifescience, Germany).The ILB28 dimorphism (rsC12979860T) was identified with a FAM labeled HyBeacon probe, which creates specific melting peaks.

Results: Following different genotypes of the IL28B gene in the investigated Azerbaijan cohort were found: CC genotype - 35%, CT-44%, TT-21%. No statistically relevant difference was revealed between males and females (in male: CC-35,8% , CT-45,3% , TT-18,9% ; in famele: CC-36,1% , CT-44,6% , TT-19,3%)

Conclusions: The distribution of the dimorphism IL28B in Azerbaijan correlates with data obtained in Europe. Our data allow predict efficiency of antiviral therapies in patients with HCV-infection in the investigated Azerbaijan cohort. Evaluation of treatment outcomes in HCV-patients with different HCV genotypes depending on IL28B genotype require additional clinical trials which are now in progress.

Date: 2014-12-28; view: 855