Aim of review: To analyze current publications devoted to controversial issues of pathogenesis, diagnosis and differential diagnosis of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in remission with IBS-like symptoms. Key points: There are three main hypotheses discussed in the literature: 1) IBS as a prodrome, pre-stage of the IBD; 2) IBS and IBD are different variants of inflammatory disorder which is common to both diseases; 3) The onset of IBS-like symptoms in IBD patients in remission. Conclusion: It is shown that modern literature data on this issue is contradictory and ambiguous.
Objective. To conduct a comparative analysis of the emotional and personality characteristics ofpatients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in remission with IBS-like symptoms. Patients and methods. This study carried out based at a specialized gastroenterology clinic in the period from 2010 to 2015 included 125 patients with IBS (IBS-D - 46, IBS-C - 20, IBS-M - 59) and 37 patients with IBD in remission: Crohn's disease (CD) - 11 and ulcerative colitis (UC) -26 patients. The levels of depression (Beck questionnaire), urgent and personal anxiety (Spielberger questionnaire), the degree of alexithymia (Toronto scale) as well as the severity of psychopathology and behavioral symptoms (PBS) were estimated. Results. Patients with IBS were not significantly different from those with IBD in remission with IBS-like symptoms in terms of depression, actual anxiety, alexithymia and PBS. Only the index of personal anxiety was significantly higher in the group of patients with IBS compared with IBD in remission with IBS-like symptoms (p = 0.0376). Men with IBS exhibited significantly higher actual anxiety than men with IBD (p = 0.04). Maximum severity of depression, anxiety and alexithymia was documented in the locking version of IBS (IBS-C) in comparison with other variants of IBS (p <0.05). Patients with CD in remission are characterized by higher rates of depression and alexithymia compared to UC (p <0.05). Behavioural disorders are most pronounced in the diarrheal variant of IBS and CD. Conclusion. A higher personal anxiety was observed in patients with IBS compared to those in remission of IBD with IBS-like symptoms although other parameters were not significantly different. Patients with IBS-C were characterized by more pronounced manifestations of emotional and personality disorders. More severe emotional and behavioral disorders distinguish CD from UC.
Clinical practice shows that right-hemisphere cerebral strokes are often accompanied by one speech disorder or another. The aim of the present work was to analyze published data addressing speech disorders in right-sided strokes. Questions of the lateralization of speech functions are discussed, with particular reference to the role of the right hemisphere in speech activity and the structure of speech pathology in right-hemisphere foci. Clinical variants of speech disorders, such as aphasia, dysprosody, dysarthria, mutism, and stutter are discussed in detail. Types of speech disorders are also discussed, along with the possible mechanisms of their formation depending on the locations of lesions in the axis of the brain (cortex, subcortical structures, stem, cerebellum) and focus size.
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