Pathology Of Gastrointestinal Tract Research Articles

Kinetics of severe dengue virus infection and development of gut pathology in mice.

Dengue virus, an arbovirus, causes an estimated 100 million symptomatic infections annually and is an increasing threat as the mosquito range expands with climate change. Dengue epidemics are a substantial strain on local economies and health infrastructure, and an understanding of what drives severe disease may enable treatments to help reduce hospitalizations. Factors exacerbating dengue disease are debated, but gut-related symptoms are much more frequent in severe than mild cases. Using mouse models of dengue infection, we have shown that inflammation and damage are earlier and more severe in the gut than in other tissues. Additionally, we observed impairment of the gut mucus layer and propose that breakdown of the barrier function exacerbates inflammation and promotes severe dengue disease. This idea is supported by recent data from human patients showing elevated bacteria-derived molecules in dengue patient serum. Therapies aiming to maintain gut integrity may help to abrogate severe dengue disease.

Gastrointestinal tract pathology of the owl monkey (Aotus spp.).

Owl monkeys are small nocturnal new world primates in the genus Aotus that are most used in biomedical research for malaria. Cardiomyopathy and nephropathy are well-described common diseases contributing to their morbidity and mortality; less is known about lesions affecting the gastrointestinal tract. Records from a 14-year period (2008-2022) at the Keeling Center for Comparative Medicine and Research were queried to identify instances of spontaneous gastrointestinal disease that directly contributed to the cause of death from the 235 adult owl monkeys submitted for necropsy. Of the 235, 10.6% (25/235) had gastrointestinal disease listed as a significant factor that contributed to morbidity and mortality. Diagnoses included candidiasis (3/25), gastric bloat (4/25), and intestinal incarceration and ischemia secondary (11/25), which included intussusception (4/25), mesenteric rent (3/25), strangulating lipoma (2/25), intestinal torsion (1/25), and an inguinal hernia (1/25). Intestinal adenocarcinomas affecting the jejunum (4/25) were the most common neoplasia diagnosis. Oral squamous cell carcinoma (1/25) and intestinal lymphoma (2/25) were also diagnosed. This report provides evidence of spontaneous lesions in the species that contribute to morbidity and mortality.

Gynaecological Causes of Acute Pelvic Pain: Common and Not-So-Common Imaging Findings.

In female patients, acute pelvic pain can be caused by gynaecological, gastrointestinal, and urinary tract pathologies. Due to the variety of diagnostic possibilities, the correct assessment of these patients may be challenging. The most frequent gynaecological causes of acute pelvic pain in non-pregnant women are pelvic inflammatory disease, ruptured ovarian cysts, ovarian torsion, and degeneration or torsion of uterine leiomyomas. On the other hand, spontaneous abortion, ectopic pregnancy, and placental disorders are the most frequent gynaecological entities to cause acute pelvic pain in pregnant patients. Ultrasound (US) is usually the first-line diagnostic technique because of its sensitivity across most common aetiologies and its lack of radiation exposure. Computed tomography (CT) may be performed if ultrasound findings are equivocal or if a gynaecologic disease is not initially suspected. Magnetic resonance imaging (MRI) is an extremely useful second-line technique for further characterisation after US or CT. This pictorial review aims to review the spectrum of gynaecological entities that may manifest as acute pelvic pain in the emergency department and to describe the imaging findings of these gynaecological conditions obtained with different imaging techniques.

Bowel preparation in children and adolescents undergoing ileo-colonoscopy: what is new?

Ileo-colonoscopy is a vital diagnostic and therapeutic tool undertaken for evaluating and treating gastrointestinal tract pathologies in children and adolescents as well as adults. Proper visualization of the lower intestinal mucosa, completion of the procedure including terminal ileum/cecal intubation, detection of pathological lesions and therapeutic maneuvers are hinged on how adequate the bowel preparation is. About 25% percent of pediatric patients have inadequate bowel preparations, which can lead to prolonged colonoscopy procedure time, missed pathology, difficult ileal intubation/incomplete examination, and requiring cancellation or repeat procedure with attendant anesthetic risks. An ideal bowel preparation regimen should clear the colon of fecal material with no alteration of the colonic mucosa that could affect the histological findings. There is no acceptable universal regimen for bowel preparation in children; however wide variability of practices exists globally. Hence, the current review is aimed at analyzing recent published literature and personal practical experiences as well as developing a standard bowel preparation guideline that will improve outcome of the ileo- colonoscopy procedure in children particularly in resource limited settings.

Üçüncü Basamak Hastanede Endoskopik Ultrasonografi: Tek Merkez Deneyimi

Introduction : Endoscopic ultrasonography (EUS) is widely used to determine the character of lesions in the hepatobiliary system, pancreas, mediastinum, and rectum, in addition to subepithelial lesions of the upper gastrointestinal tract and for staging in addition to sampling from the lesion.Aim: The aim of this study is to present the endoscopic ultrasonography experience of our clinic over the last year. Material and Methods: EUS indication were performed by two gastroenterologists using a Pentax EPK-i5000 video processor and linear and radial echoendoscopes, under the guidance of an anesthesiologist under sedoanalgesia. Data were analyzed using descriptive statistics. The study results were analyzed using SPSS vn. 22.0 software.Results: Evaluation was made of 155 patients who underwent endoscopic ultrasonography, comprising 88 (56.8%) females and 67 (43.2%) males with a mean age of 56.3±14.2 years (range: 19-91 years). The 41 patients who underwent the EUS procedure for pancreatic lesion comprised 24 (59%) males and 17 (41%) females with a mean age of 54.3±17.1 years.EUS was performed in 74 patients due to subepithelial lesions of the upper gastrointestinal tract. These patients comprised 39 (52.7%) females and 35 (47.3%) males with a mean age of 55.2±13.5 years. Discussion The results of this study show that EUS is a reliable and very useful tool in appropriate indications, especially for the evaluation of subepithelial and malignant lesions of the gastrointestinal tract, pancreas, and ampulla pathologies. Conclusion and suggestions: Endoscopic ultrasonography; It is an effective and guiding method used in the diagnosis of submucosal lesions of the gastrointestinal tract, staging of malignant lesions, and the diagnosis of cystic and solid lesions of the pancreas.

Peculiarities of the course and treatment of the upper gastrointestinal tract pathology in patients with diabetes mellitus

Peculiarities of the course and treatment of the upper gastrointestinal tract pathology in patients with diabetes mellitus

Metabolism of free fatty acids in patients with gastrointestinal diseases depending on the body mass index

Background. The purpose of the study is to analyze the content of free fatty acids (FFA) in the blood serum of overweight and underweight patients with gastrointestinal diseases. Mate­rials and methods. Thirty-one patients with gastrointestinal diseases were examined, 19 (61.3 %) men and 12 (38.7 %) women with a median age of 39 (27; 48) years. Depending on the results of the body composition study with the multifunctional monitor TANITA MC-780MA (Japan), they were divided into the following groups: overweight patients (body mass index (BMI) more than 25.0 kg/m2) and underweight persons (BMI below 18.5 kg/m2). Determination of the FFA spectrum in the blood serum was carried out using a gas chromatograph with a flame ionization detector Chromatek-Crystal 5000. The control group consisted of 16 practically healthy people. Statistical processing of the results was carried out using the Statistica 6.1 application program package. Results. Patients with a change in body weight reported a statistically significant decrease in the median total content of short-chain saturated FFA (C4:0) mainly due to a decrease in the butyric acid content by 67 times (p = 0.001) with increased BMI and by 114 times (p = 0.002) with decreased BMI compared to controls. At the same time, the analysis of the serum spectrum of saturated FFA with an average carbon chain length showed a probable increase in the content of capric acid by 14 times (p < 0.01), undecyl acid by 19 times (p < 0.01), and lauric acid by 25 times (p < 0.001) in patients with changes in body weight. The content of caproic acid increased in the group with excessive body weight by 3.9 times (p = 0.046) compared to controls and by 2.6 times (p > 0.05) compared to underweight patients. The total content of monounsaturated FFA in the blood serum of patients with increased and decreased BMI increased significantly by 32 times (p < 0.001) and 19 times (p = 0.001), respectively, compared to controls. The total content of polyunsaturated FFA in the blood serum of patients of both groups was found in a trace amount. Overweight patients had a 38-fold (p < 0.01) increase in the trans-FFA elaidic acid (C18:1(trans-9)) compared to controls, while underweight patients had a decrease in linoelaidic acid (C18:2(trans-9,12)) by 11.7 times (p < 0.05). Correlation analysis revealed a positive relationship between BMI and increased serum content of saturated caproic acid (r = 0.39; p = 0.019); monounsaturated acids — palmitoleic (r = 0.33; р = 0.045) and heptadecenoic (r = 0.35; р = 0.034); trans-configuration fatty acids — elaidic (r = 0.43; p = 0.009) and linoelaidic (r = 0.43; p = 0.007). Conclusions. Patients with gastrointestinal diseases had an imbalance in the fatty acid spectrum of the blood serum. Against the background of the tendency to decrease the total content of short-chain saturated FFA, a significant increase in the content of monounsaturated FFA and trans-FFA was noted, especially with increased BMI. In all patients, the trace amount of polyunsaturated FFA fractions was found. The obtained results can be used to improve the differential treatment of metabolic disorders in patients with gastrointestinal tract pathology.

PREVALENCE OF GASTROINTESTINAL TRACT PATHOLOGY AND HELICOBACTERIOSIS IN HORSES

This article presents information on the prevalence of helicobacteriosis in horses of different age groups. It has been found that gastrointestinal tract (GIT) pathology is widely prevalent in horses, ranging from 50% to 80%. The main conditions among GIT pathologies in horses are gastrophylosis, erosions, ulcers, and helicobacteriosis. Helico-bacteriosis is registered in 66.7% to 100% of the investigated adult population and in 20% to 66.7% of the young horses. Stomach examinations using endoscopy and video gastroscopy provide a clear picture of the mucous membrane's condition in different parts of the stomach and allow for the collection of biomaterials for additional research. The percentage of animals affected by helicobacteriosis increases with age. Animals suf-fering from helicobacteriosis experience significantly reduced productivity, delayed growth and development in young horses, leading to premature culling. It is incorrect to only test suspicious animals with indications for helicobacteriosis, as not all carriers of Helicobacter pylori show symptoms of the disease. The use of the drug Domosedan at a dose of 0.5 μg per kilogram of body weight, or Combistress at a rate of 0.5 cm3 per 100 kg of body weight, effectively calmed the an-imals, fully relaxed the GIT, and facilitated successful endoscopy and video gastroscopy examinations.

Genomic biomarker for the top risk factor of gallbladder cancer, cholelithiasis, in a Latinx population.

e16326 Background: Cholelithiasis or Gallstone disease (GSD), is one of the most common and costly digestive disorders in adults worldwide, presenting 10-20% of the general population but in greater than 30% of Latina and Hispanic American women aged 40 years or older. Moreover, GSD individuals contribute significantly to the incidence and mortality of gallbladder and other digestive system cancers; specifically, the excessive risk of gallbladder cancer is 3-10-fold. Parallel to gallbladder cancer, an appalling female preponderance of GSD has been documented for decades; thus, precisely defining high-risk populations and properly managing patients with GSD would lead to reduced disease burden from GSD and multiple cancers. Several genome-wide association studies (GWAS) in the past have identified genes associated with GSD but few were focused on Latinx population. Methods: To identify genetic risk factors for GSD in Latinx population, we used the Sangre Por Salud cohort (SPS) where participants are Latinx adult individuals aged 18-85 years who were current patients in the Mountain Park Health Center in Arizona. This sample represents historically underrepresented population with low socioeconomic status that are primarily Spanish-speaking, majority being born outside of the US, with low rates of health insurance coverage. A total of 172 GSD cases were identified, each matched with 6 controls (n = 1032) who were people from the same community but without history of GSD diagnosis; matching variables are age at enrollment to SPS, sex, height and weight, dyslipidemia, and HbA1C level indicative of type 2 diabetes. We characterized genome-wide interrogation for biomarkers predicting GSD and contributing to the observed gender disparity by performing a GWAS using a matched case-control design. Results: We identified several novel loci associated with GSD and validated few loci that were reported in previous GWAS. The top 3 loci (MATN2, GPRIN3, GPC6) were strongly associated with GSD in our overall analysis; follow-up pathway enrichment analysis suggests enrichment of GO terms that are associated with immunological pathways, enzymatic processes in gallbladder, liver and gastrointestinal tract and GSD pathology. In a sex-specific analysis, CDHR3 and RPL31P35-SEC61G were identified for females, which have been associated respectively with rhinovirus C infection and HbA1c level in previous studies. Conclusions: Our findings suggest directions towards better and deeper understanding of sex differences in GSD pathology, biological mechanisms, and disease progression among Latinx people. Knowing approximately 80% of gallbladder cancer patients harbored gallstones, our optimal goal is to provide evidence for an innovative strategy to early detect and effectively intervene the modifiable risk factors to reduce gallbladder cancer burden in high risk populations.

Selenium plasma levels in children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract

Despite the success of the treatment of infected individuals, Helicobacter pylori infection remains the most common human bacterial pathogen, infecting half of the world’s population. In a large part of people, H. pylori causes gastroduodenal diseases, in particular, chronic antral gastritis and ulcer disease. The possible role of selenium in the course of chronic inflammatory H. pylori-associated pathology of the upper gastrointestinal tract in children has not yet been fully investigated and understood. The aim is to determine selenium plasma levels in children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract. Materials and methods. The study included 135 school-age children with Helicobacter pylori-associated diseases of the upper gastrointestinal tract, who made up the main study group (55 children with chronic gastritis (CG), 57 children with chronic gastroduodenitis (CGD), 23 children with duodenal ulcer (DU), and 20 practically healthy age-matched children were the comparison group. Quantitative measurements of plasma selenium were performed using inductively coupled plasma mass spectrometry (MS-ICP) on an Optima 2000 DV spectrometer (Perkin Elmer, USA). Results. The lowest level of plasma selenium was registered in children with H. pylori-negative DU (67.81 ± 2.67 μg/l), while in children with H. pylori-associated DU, its level was higher – 73.56 ± 2.34 μg/l (p < 0.05), however, it did not reach the level in children of the comparison group. A similar direction of changes in the selenium plasma concentration was observed in children with CGD: higher levels of selenium were detected in children with H. pylori-positive CGD compared to H. pylori-negative CGD (75.61 ± 2.48 μg/l and 70.99 ± 2.31 μg/l, respectively, p < 0.05). Conclusions. Significantly lower levels of plasma selenium in children with chronic destructive-inflammatory diseases of the upper gastrointestinal tract were found, which could be explained by the acute phase of inflammation in the mucous membrane of the stomach and duodenum resulting in a decrease in selenium absorption. In H. pylori-positive children, the level of selenium was significantly higher compared to H. pylori-negative children indicating a possible role of selenium in the pathogenesis and further progression of H. pylori-associated diseases.

Dental diseases in patients with pathology of the gastrointestinal tract: a literature review

Annotation. The study aimed to analyze references in the scientific literature on hard dental tissue damage and periodontal and oral mucosal diseases in patients with concomitant gastrointestinal tract pathology. We used the bibliosemantic method to identify the status of the outlined issues and analysis of the scientific research data. Based on data from national and international published literature on the topic, the prevalence, severity and structurality of changes in the organs and tissues of the oral cavity associated with gastrointestinal tract diseases were evaluated. The review was carried out using data from scientific articles for the period of 2011-2022 with search words “Digestive System Diseases”, and “Diseases of the Oral Cavity” using the MESH subject headings: dental caries susceptibility, mouth diseases, gastrointestinal diseases, malabsorption syndromes, dental caries, tooth demineralization and others. The final analysis included 75 scientific articles corresponding to the purpose of the study. Data obtained from analysis of literary sources of recent years suggests that both local and general factors are involved in the process of occurrence and course of dental pathology with concomitant involvement of the gastrointestinal tract. The nature of their interaction will determine the peculiarities of the course of dental diseases. However, the lack of convincing data on the age-related features of the occurrence and development of dental diseases, as well as the inconsistency of the results regarding the significance of risk factors for the progress of comorbid conditions complicates the methods development of their treatment and prevention. The listed features of the course of dental diseases with a combined involvement of gastrointestinal disorders indicate the mandatory complexity of treatment, taking into account concomitant pathology.

When is it possible to get false positive screening results for celiac disease?

Goals. Determine the causes of overdiagnosis of gluten dependent conditions, based on the level of antibodies (AT) to transglutaminase (tTG) IgA and total IgA, which have high sensitivity and specificity.Materials and methods. We enrolled patients with an increased level of TG2 antibodies (average level — 45.64 ± 11.3 IU/ml), examined at the Clinical Center for the period 2020–2021. The total number of patients with positive re4sults was 61, up to 4 years old — 49 patients, 12 children — over 10 years old.Results. Complaints typical for gastrointestinal tract pathology were present in less than 1/3 of cases (most often, abdominal distension — 18/29.6%). Among the extra- gastrointestinal manifestations, complaint that is more common was poor appetite — 46/75.4% (with normal level of physical development) and the presence of allergic manifestations in the form of atopic dermatitis — 35/57.4%. We re-monitoring the level of TG2 antibodies after 3 months (children were on a regular diet). It was shown that in 56 patients the level of TG2 were within the normal range. 5 patients with the exacerbation of the allergic process had the level of TG2 1.5 times higher than normal, followed by normalization as the skin manifestations fade away.Conclusions. As a result of screening for celiac disease with testing of TG2 antibodies, false- positive results were detected in 1.6% of cases with negative tests for antibodies to endomysium. According to our data, the most common reasons for false positive results were the presence of an allergic pathology in the acute stage, an acute intestinal infection and parasitic infections.

The upper digestive tract pathology effect on the course of chronic lung diseases

Aim was to study the prevalence of gastrointestinal tract pathology and the state of intestinal biocenosis among bronchial asthma patients.Materials and methods: 93 patients with asthma in the exacerbation stage who had diseases of the gastrointestinal tract were examined. Instrumental, immunological, bacterial studies of the respiratory and digestive organs were carried out.The results of our study indicate a relationship between the development of bronchial asthma and gastrointestinal pathology due to negative environmental effects, stress, glucocorticosteroid therapy, changes in general and local protective reactions against a background of a chronic disease involving organ barriers with an autoimmune pathogenesis mechanism in the pathological process.

Anemic Syndrome and Molecular Mechanisms and Regulation of Iron Absorption in Gastroenterological Diseases

In this review, we tried to combine and systematize the accumulated information on the problem of anemic syndrome in the pathologies of the gastrointestinal tract. Anemic syndrome is the most frequent extraintestinal complication in patients with gastrointestinal tract pathology, which can significantly impair the quality of life. Depending on the combination of pathogenitic mechanisms, the iron deficiency, anemia of chronic diseases, B12-deficiency, and folate deficiency anemia are distinguished. Other types of anemia are less common. It is necessary to conduct a comprehensive laboratory examination to reveal the leading factor in the development of anemia and select adequate therapy. Anemia is one of the most common complications in patients with inflammatory bowel disease. In clinical practice, the intravenous iron is frequently administered. However, this therapy can lead to excess iron and cause exacerbation of the disease. Understanding the pathogenesis of anemia is important for the selection of therapy and minimizing the risk of complications. Parenteral forms of iron and vitamin preparations are more preferable for this category of patients due to their higher bioavailability, low safety profile, and minimal negative effect on the gastrointestinal tract. Erythropoietin preparations and inhibitors of proinflammatory cytokines are used mainly for the correction of anemia of chronic diseases. The latter showed themselves well in the treatment of patients with anemic syndrome on the background of severe inflammatory bowel diseases. Various clinical trials are being conducted to introduce new drugs to correct anemia. However, today, there is practically no experience of their application. Further study of patients with gastroenterological pathology complicated by anemia is required to form a final conclusion on the effectiveness and appropriateness of the intravenous iron administration in these categories of patients.

Оцінка стану тканин пародонта у хворих із соматичною патологією

The purpose of the study was to investigate the influence of concomitant somatic pathology on periodontal tissues. Materials and methods. 104 patients, aged 28–46 years, with diseases of periodontal tissues, who had somatic pathology, were involved in the study. The examined persons were divided into groups: 35 persons (group 1) with pathology of the hepatobiliary system, 37 persons (group 2) with pathology of the gastrointestinal tract, and 32 persons (group 3) with pathology of the cardiovascular system. The comparison group included 30 people with periodontal tissue diseases without somatic pathology. To determine the depth and prevalence of the inflammatory process of the gums the Svrakov’s number indicator was used. Oral hygiene was assessed according to the Silness-Loe and Stallard indices. The papillary-marginal-alveolar index (C. Parma, 1960) was determined to assess the severity of gum inflammation. Bleeding gums were assessed by the gum's papilla bleeding index according to Muhllemann. Statistical processing of the research results was carried out with a computer program for variational and statistical analysis of medical and biological research data “GraphPad Prism 5”. Results and discussion. Patients with diseases of periodontal tissues against the background of somatic pathology had the highest percentage of chronic generalized periodontitis of the II degree, in contrast patients of the comparison group had the highest percentage of chronic generalized periodontitis of the initial – I degree. Svrakov's number in patients with periodontal disease against the background of somatic pathology significantly (р ˂0.05) exceeded the indicators of patients of the comparison group. At the same time, there is no significant difference between the results of groups 1, 2 and 3. The highest values of the indexes of Silness-Loe and Stallard were recorded in patients with the cardiovascular system pathology, which significantly (p<0.05) exceeded the data in the comparison group, but did not significantly differ from the results of patients with pathology of hepatobiliary system and gastrointestinal tract. The papillary-marginal-alveolar index data were the highest in patients with hepatobiliary system pathology (64.25 ± 8.19%), which significantly (p<0.05) exceeded the results of the comparison group and in individuals of groups 2 and 3. The highest indicator of the bleeding index is 1.98 ± 0.22 points in patients of the 1st group, which significantly exceeds the indicators in the group of people without somatic pathology and in the group of patients with pathology of gastrointestinal tract and cardiovascular system. Conclusion. The conducted studies show that the presence of somatic pathology contributes to the development of periodontal tissue diseases, and certainly aggravates their course, which is proven by the results of the index assessment

Impact of Carpal Tunnel Syndrome Surgery on Early Diagnosis and Treatment of Transthyretin Cardiac Amyloidosis

Background and Objectives: Cardiac amyloidosis is an infiltrative, progressive, and restrictive cardiomyopathy that leads to heart failure, reduces life quality, and causes death. This is a multisystem disorder caused by mutations of the transthyretin protein and is associated not only with cardiac diseases or carpal tunnel syndrome but also with nerve, liver, lung, gastrointestinal tract, kidney, or eye pathologies. Carpal tunnel syndrome is an early red-flag symptom of transthyretin (TTR) cardiac amyloidosis; therefore, screening for unsuspected cardiac amyloidosis can be performed through histological testing of flexor retinaculum specimens gathered during carpal tunnel release surgery. Our case highlights that early detection and accurate diagnosis of a disease are important factors for improving clinical outcomes in patients with TTR amyloidosis. Case Summary: We report the case of a 71-year-old man who presented with bilateral carpal tunnel syndrome. Amyloid deposits were detected after carpal tunnel release surgery through histological testing of the synovial tissue. The patient was sent for a cardiological evaluation. Physical examination, laboratory tests, and the ECG revealed no significant changes. The diagnosis of amyloidosis was confirmed with multimodality imaging in the early stage, which helped to start specific medicamental treatment with the transthyretin stabilizer tafamidis. Conclusions: Our objective is to highlight the early recognition and specific medicamental treatment of cardiac amyloidosis for better patient prognosis and outcomes.

Pathology of the Gastrointestinal Tract in Patients with Primary Hyperparathyroidism

Aim. To present data of Russian and foreign studies on the prevalence, pathogenesis and clinical picture of gastrointestinal tract (GIT) pathology in patients with primary hyperparathyroidism (PHPT).Key point. At the beginning of the 20th century PHPT was considered a severe endocrine disease with specific bone and kidney complications, however in 1957 W.T. St Goar proposed a mnemonic triad to recognize this pathology as “diseases of stones, bones and abdominal groans”. A high frequency of gastrointestinal complaints, peptic ulcer, pancreatitis, cholelithiasis in patients with PHPT has been reported. Hyperparathyroidism has been shown to cause smooth muscle atony with specific upper and lower GI symptoms such as nausea, heartburn and constipation. The prevalence of peptic ulcer in patients with PHPT, according to studies of the 50s–60s of the last century, ranged from 10 to 25 %. However, studies linking PHPT to peptic ulcer development were performed before the advent of proton 1). On the other hand, the development of pancreatitis in PHPT is one of the most studied pathologies. In developing countries its frequency can reach 10–20 % due to the absence of routine screening for blood calcium. Some authors report the impact of elevated parathyroid hormone levels on the formation of gallbladder stones by inhibiting of gallbladder emptying, hepatic bile secretion and mobility of the sphincter Oddi, and changing of the bile composition. A number of studies have found an increased risk of developing malignant neoplasms of the intestine, especially the colon, in patients with PHPT.Conclusion. The digestive manifestations of parathyroid dysfunction in patients can often be overlooked, and serum calcium levels should be included in the routine examination in the presence of abdominal symptoms.

Клиническое наблюдение пациентки с синдромом циклической рвоты

Aim. To demonstrate a clinical case of cyclic vomiting syndrome in a patient with central nervous system damage and pathology of the upper gastrointestinal tract. Main points. Cyclic vomiting syndrome is a chronic periodic disorder of childhood that can persist into adulthood. The causes of its occurrence include central nervous system disorders such as abdominal migraines, epilepsy, structural brain damage, mitochondrial diseases, autonomic disorders, and others. Gastrointestinal tract pathology can manifest as episodes of recurrent intense vomiting and nausea lasting from several hours to several days, with varying symptom-free intervals. Conclusion. Detailed study of cyclic vomiting syndrome can help reduce diagnostic search in patients with combined pathology requiring an interdisciplinary approach. Key words: cyclic vomiting syndrome.

Modern view on the age-associated gastrointestinal diseases. Review

The substantial improvement of diagnostic methods, treatment and preventive measures in recent years resulted in the significant increase in life expectancy, which in turn contributed to an increase in the frequency of chronic noncommunicable diseases among elderly patients. Pathological conditions that are related to the gastrointestinal (GI) tract are an extremely common reason for consultations among patients of all ages, but the elderly people are most prone to the development of GI diseases. Available information regarding which GI changes are normal in older age and which ones are pathologic is limited, and the available data is usually contradictory. The diagnostic algorithm in elderly patients with GI symptoms is even more complicated by the frequent presence of concomitant diseases. In addition, the elderlies usually have atypical manifestations of the GI disease with subtle symptoms; therefore, doctors who are not familiar with It may not diagnose the disease timely. Drug side effects manifested in the GI tract are also a common phenomenon in elderly patients and they can also change the clinical picture and complicate the diagnosis of GI pathologies. Thus, elderly patients represent a population group among whom effective detection and correct diagnosis of GI diseases become extremely difficult for physicians who are not familiar with the features of age‑related changes in the GI tract and peculiarities of GI diseases. Therefore, the expansion of knowledge about the course of GI disorders in this category of patients is absolutely necessary for further improvement of the quality and duration of life of such patients. Our review presents modern data on the prevalence of gastrointestinal tract pathologies, their role in the general morbidity of the population, the most typical disorders of the gastrointestinal tract in elderly patients, the mechanism of drug interactions and side effects of drugs that can cause the development of complications from the GI tract.

The influence of the gastrointestinal tract deseases on the process of chronic lung pathology

Aim was to study the prevalence of gastrointestinal tract pathology and the state of intestinal biocenosis among bronchial asthma patients. Materials and methods: 93 patients with asthma in the exacerbation stage who had diseases of the gastrointestinal tract were examined. Instrumental, immunological, bacterial studies of the respiratory and digestive organs were carried out. The results of our study indicate a relationship between the development of bronchial asthma and gastrointestinal pathology due to negative environmental effects, stress, glucocorticosteroid therapy, changes in general and local protective reactions against a background of a chronic disease involving organ barriers with an autoimmune pathogenesis mechanism in the pathological process.