Aim of publication. To present indications for antihelicobacter therapy, methods and sequence of diagnostics and eradication treatment of Helicobacter pylori (H. pylori) infection to general practitioners. Key points. Chronic gastritis caused by H. pylori infection, including that in «asymptomatic» patients can be considered to be an indication for H. pylori eradication therapy both as etiological treatment and opportunistic screening diagnostics for gastric cancer prevention. Indications for obligatory antihelicobacter therapy include stomach and a duodenum peptic ulcer (PU), stomach MALT-lymphoma, early gastric cancer with endoscopic resection. Breath test with 13 С-labeled urea, laboratory test for assessment of anti-H. pylori antibodies in feces, rapid urease test and serological method can be recommended for primary diagnostics of infection. Serological test is not applicable after antihelicobacter therapy. According to the bulk of regional studies clarithromycin resistance level of H. pylori strains in Russia does not exceed 15%. Obtained data indicate the absence of high metronidazole-resistance of H. pylori as well as double resistance to clarithromycin and metronidazole. Standard triple therapy including proton pump inhibitor (PPI), clarithromycin and amoxicillin is recommended Цель публикации. Ознакомить практикующих врачей с показаниями к проведению антигеликобактерной терапии, методами и порядком проведения диагностики и эрадикационной терапии инфекции Helicobacter pylori (H. pylori). Основные положения. Хронический гастрит, вызванный инфекцией Н. pylori, в том числе у «бессимптомных» лиц, можно рассматривать как показание к проведению эрадикационной терапии инфекции Н. pylori в качестве этиотропного лечения и оппортунистического скрининга для профилактики рака желудка. Показаниями к обязательному проведению антигеликобактерной терапии служат язвенная болезнь желудка и двенадцатиперстной кишки, MALT-лимфома желудка, ранний рак желудка с эндоскопической резекцией. В качестве методов первичной диагностики инфекции H. pylori используют дыхательный тест с мочевиной, меченной 13 С, определение антигена H. pylori в кале лабораторным способом, быстрый уреазный тест и серологический метод. После проведения антигеликобактерной терапии серологический метод не применяют. Согласно результатам большинства региональных исследований, показатели устойчивости штаммов H. pylori к кларитромицину в России не выше

Helicobacter pylori infection is widespread among the Siberian populations with some trend in its prevalence to decrease northward. In Siberia age-specific prevalence rates of H. pylori infection are similar to those usual for developing countries.

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The dynamics of morbidity and mortality due to primary liver cancer in the population of Novosibirsk according to population cancer register and the total mortality over 25 years (1988-2012) as well as the levels of its risk factors were analyzed. There was a 2-2.5-fold reduction in morbidity and mortality from liver cancer. Among the risk factors, a significant reduction in the incidence of hepatitis B and increase in the incidence of hepatitis C were noted. Prevalence of metabolic syndrome, opisthorchiasis and alcohol consumption remain stable. The epidemiological prognosis for liver cancer in the coming years in the region is discussed.

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Possible early diagnostic application of optical methods (dielectrophoresis, spectral and imaging ellipsometry, Fourier-transform infrared spectroscopy, Raman spectroscopy) in studies of red blood cells and serum of patients with diffuse liver disease with varying degrees of fibrosis has been evaluated. Application of combined optical methods was confirmed to significantly improve the performance of sensitivity, specificity, and accuracy index as well as to achieve the reliable results in diagnosis of both severe fibrosis and slight ulterior liver fibrosis. Identified diagnostic potential of optical methods can be effectively utilized in noninvasive screening evaluation of stages of diffuse liver disease of various geneses.

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