Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.
Aim: To study intestinal microbiota and the parameters of oxidative stress in patients with metabolic syndrome (MS). Methods: The sample consisted of 50 patients with MS aged 55-65 years and residing in Saint Petersburg. The reference group consisted of 129 individuals of similar age without MS. The quantitative and qualitative composition of parietal intestinal microbiota was studied by gas chromatography with mass spectrometry using microbial markers in plasma. Oxidative stress the final oxidation products of protein molecules and lipids including 8-hydroxy-2-deoxyguanosine and malonic aldehyde were estimated. Nutritional antioxidants including vitamin E, unsaturated fatty acids etc. were assessed by chromatography mass spectrometry and mass spectrometry. Results: In the parietal layer of the intestine in individuals with MS, the total number of microbial markers is positively associated with the markers of the opportunistic microflora and lower levels of normal microflora. In MS patients, the ratio of normal microflora to conditionally pathogenic microflora is twice as low as in the reference group. Level of malonic dialdehyde and 8-hydroxy-2-deoxyguanosin were 48 % and 39 % higher in the MS group. Moreover, plasma concentrations of vitamin E and zinc were lower by 42 % and 80 % in patients with MS compared to the reference group. Сonclusions: The observed differences in the quantitative and qualitative composition of the parietal microbiota of the intestine in individuals with MS compared to the reference group suggest development of intestinal dysbiosis in MS patients. The intestinal dysbiosis is accompanied by oxidative stress manifested by an increase in the level of malonic dialdehyde in the blood plasma and 8-hydroxy-2-deoxyguanosine in the urine, as well as a decrease in the level of vitamin E and zinc in the blood plasma.
Relevance. The high incidence of diseases of the liver and other organs of digestion in employees of State Fire Service of EMERCOM of Russia results from exposure to harmful chemical factors when performing professional tasks. Currently, the growing interest of the medical scientific community and practitioners is the nutritional support for the treatment of diseases of the digestive system. Therefore, the study aimed at substantiating the effectiveness of nutritional support in the treatment of liver diseases is certainly relevant.Intention. To scientifically substantiate effectiveness of enteral nutrition in the treatment of patients with liver diseases. Method. From 2015 to 2018, 237 patients, middle-aged men (56.4 ± 9.4) years, with liver diseases and trophic insufficiency of moderate severity were examined. All subjects were divided into 2 groups, the first group consisted of 121 people receiving enteral nutrition with Nutricomp HEPA liquid, the second group consisted of 116 people treated without enteral support. To assess the effectiveness of enteral nutrition in the treatment of liver diseases, the following were analyzed: trophological status, biochemical parameters of the protein fraction of peripheral blood, proteins of the blood coagulation system and the activity of transaminases. The indicators of self-assessment of quality of life before and after treatment were also analyzed.Results and Discussion. Nutraceuticals, compared to no enteral nutrition, significantly reduced the concentrations of ammonia, increased concentrations of albumin, product of protein metabolism, indicators of blood coagulation and the activity of transaminases. They have significantly increased body mass index, and body mass deficit decreased. After treatment with enteral nutrition in patients, self-assessment of quality of life was significantly higher than in the group not receiving enteral nutrition.Conclusion. Thus, the use of nutraceuticals for enteral support of patients with reduced trophological status can significantly improve the effectiveness of therapy, promotes faster recovery and reduces time spent in hospital.
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