Hepatobiliary System Diseases Research Articles

Hepatobiliary System Diseases as the Predictors of Psoriasis Progression

To assess the state of the hepatobiliary system in psoriasis andpsoriatic arthritis in order to establish a causal relationship and to identify clinical and functional predictors of psoriatic disease progression. The study includedpatients with extensive psoriasis vulgaris (n = 175) aged 18 to 66 years old and healthy donors (n = 30), matched by sex and age: Group 1--patients with psoriasis (PS, n = 77), group 2--patients with psoriatic arthritis (PsA, n = 98), group 3--control. The evaluation of functional state of the hepatobiliary system was performed by the analysis of the clinical and anamnestic data and by the laboratory-instrumental methods. We identified predictors of psoriasis: triggers (stress and nutritionalfactor), increased total bilirubin, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, eosinophilia, giardiasis, carriers of hepatitis C virus, ductal changes andfocal leisons in the liver, thickening of the walls of the gallbladder detected by ultrasound. Predictors ofpsoriatic arthritis: age over 50 years, dyspeptic complaints, the presence of hepatobiliary system diseases, the positive right hypochondrium syndrome, the clinical symptoms of chronic cholecystitis, excess body weight, high levels of bilirubin, cholesterol and low density lipoprotein, hepatomegaly, non-alcoholic fatty liver disease. High activity of hepatocytes cytolysis, cholestasis, inflammation, metabolic disorders let us considerpsoriatic arthritis as a severe clinical stage psoriatic disease when the hepatobiliary system, in turn, is one of the main target organs in systemic psoriatic process. Non-alcoholic fatty liver disease and chronic cholecystitis are predictors of psoriatic disease progression.

ДОСЛІДЖЕННЯ СТРУКТУРИ УКРАЇНСЬКОГО РИНКУ ЛІКАРСЬКИХ ЗАСОБІВ ДЛЯ ЛІКУВАННЯ ЗАХВОРЮВАНЬ ГЕПАТОБІЛІАРНОЇ СИСТЕМИ

<p><strong>THE RESEARCH OF UKRAINIAN MEDICINES MARKET STRUCTURE FOR THE TREATMENT OF HEPATOBILIARY SYSTEM DISEASES </strong><strong></strong></p><p><strong>A</strong><strong>.</strong><strong> V. Volkova</strong><strong>,</strong><strong> A</strong><strong>.</strong><strong> I. Fedosov, V.</strong><strong> </strong><strong>S. Kyslychenko</strong><strong></strong></p><p>The NationalUniversityofPharmacy,Kharkov</p><p> </p><p><strong>Keywords:</strong> diseases of the liver and biliary tract, market of medicines, marketing analysis.</p><p><strong> </strong></p><p>In modern gastroenterology much attention is paid to treatment of liver and bile passages diseases as on prevalence and chronic character they concede only to pathology of cardiovascular system. The pathogenesis of hepatobiliary system leads to development of destructive processes and disease course. Under such circumstances the question of effective, timely, non-toxic and available treatment for the patient is topical.</p><p>Market research of drugs for treatment of liver and bile passages diseases, determination of features of its structure became the purpose of our research. In the research data of the State register of drugs, the research companies and manufacturing enterprises, which are generalized by means of methods of the marketing, structural, statistical and graphic analysis are used.</p><p>By results of the market sales analysis of drugs the capacity of segment A05 group "Bile and Liver Therapy" makes 6,39% of the general market capacity of drugs group A "Alimentary tract and metabolism".</p><p>It is established that preferential quantity of national production drugs are presented in A05A group and foreign in A05B group on the market by A05A "Bile therapy" and A05B "Liver therapy, lipotropics" groups.</p><p>It is significant that among 7 subgroups of the analyzed segment A05A X10 ** and A05B A50** groups are the largest, the quantity of drugs in which on trade names makes 37 and 34 respectively.</p><p>It is established that on the Ukrainian market of medicine for treatment of hepatobiliary pathology are delivered by 34 producers from 18 countries. The segment of the Ukrainian production is provided by 26 producers with a total number of 55 drugs.</p><p>By results of the structural analysis this market segments it is established that drugs are made for treatment of peptic pathology in 14 dosage forms. The greatest number of drugs is provided in the form of capsules (53 names) and tablets (46 names), the smallest is granules, concentrates for preparation of solutions for infusions and liquid dosage forms (suspension oral, solution peroral) which are presented by three names of drugs.</p><p>Thus, the Ukrainian market of drugs for treatment of liver and bile passages diseases is characterized by the wide range and is presented by 7 groups II of level of ATC-classification which drugs are delivered from 60 producers from 19 countries and are almost evenly provided by the Ukrainian and foreign enterprises. The structural analysis of subgroups testifies to dominance of dosage forms and number of drugs names in the combined drugs segments.</p>

Dental Health in Children and Adolescents with Somatic Pathology

A complex clinical and instrumental evaluation is performed among 1347 children and adolescents with somatic pathology; physical development retardation is established in 61% and sexual development retardation – in 26%. Among various somatic diseases, ENT-diseases (96%), gastrointestinal (83%), central nervous system (72%), urogenital tract (72%), hepatobiliary system (71%) and other diseases were found. In children and adolescents with somatic pathology, dental diseases are occured in 40,6±0,42% cases. The most common were dental caries (90,1%), periodontal diseases (68,3%), and dentofacial abnormalities (41,6%). The low hygienic status of the oral cavity was established (HI=2,4± 0,28). Dental health in children and adolescents with somatic pathology was 59,4±0,60%, which is lower than in almost normal children by 12,7% and age-related normal values by 22%. DOI: 10.5901/mjss.2014.v5n20p2671

Prophylactic antibiotics used in patientsof hepatobiliary surgery

To clarify the use of antibiotics in our hospital and to guide the prophylactic use in future hepatobiliary surgical procedures. A retrospective review of patients who underwent hepatobiliary surgery from January 2011 to June 2011 was included. Data were collected, and surgical site infection (SSI) was defined by the criteria of Center for Disease Control and Prevention. Patients were prescribed antibiotics for the clinical diagnosis of hepatobiliary system diseases. 1564 patients were identified, in which 784 patients (50.13%) did not receive preoperative antibiotic prophylaxis. Of these 355 patients with 784 surgical sites received either preoperative or both preoperative and postoperative antibiotic prophylaxis. The SSI rate of the patients who received prophylaxis alone (2.56%, 20 of 780 sites) was not statistically higher than that of the patients who have not received prophylaxis (2.68%, 21 of 784 sites), and the two groups were not statistically correlated (P=0.77). The number of the patients who developed SSI was relatively low, and no reduction in the SSI rate was observed among the patients who have received antibiotic prophylaxis.

Concentration of serum bile acids as an index of hepatic damage in systemic lupus erythematosus.

The aim of this work is to evaluate the concentration of serum bile acids (SBA) as an index of impaired liver function in systemic lupus erythematosus (SLE) patients versus usual laboratory tests of hepato-biliary system diseases. In patients with SLE the mean fasting SBA concentration was 9.6 +/- 1.4 mumol/L; in normal subjects the concentration was 2.9 +/- 0.6 mumol/L (P less than 0.01). In patients with SLE, mean gamma-glutamyl transpeptidase (GGTP) concentration was 31.5 +/- 5.9 mU/ml versus 10.05 +/- 1.1 mU/ml in controls (P less than 0.01). The bromsulphalein (BSP) excretion test, 45 minutes after injection, was 6.8 +/- 1% in SLE patients versus 2.8 +/- 0.4% in controls (P less than 0.02). No significant difference was found between these two groups of subjects with respect to leucine aminopeptidase (LAP), alkaline phosphatase (AlPh), glutamic-oxalacetic transaminase (SGOT), glutamic-pyruvic transaminase (SGPT), bilirubin serum rates. SBA rate was abnormal in 50% of the SLE patients; GGTP rate and the BSP excretion test were abnormal in 38% and 27% respectively. Our findings show the presence of an actual liver impairment in SLE patients, significantly demonstrated by fasting SBA concentration, GGTP rate and BSP excretion test. Other liver function tests are less useful in evaluating hepatic damage in SLE.