scholarly journals The effectiveness of ursodeoxycholic acid and «Uvinskaya» mineral water in the treatment of cholelithiasis and concomitant motor-tonic disturbances of the gallbladder

2012 ◽  
Vol 93 (2) ◽  
pp. 193-196
Author(s):  
A Yu Gorbunov ◽  
Ya M Vakhrushev ◽  
D S Rybin ◽  
D R Sharafutdinova ◽  
E V Suchkova
Keyword(s):  
Gall Bladder ◽  
Ursodeoxycholic Acid ◽  
Bile Acids ◽  
Mineral Water ◽  
Stone Formation ◽  
Gallstone Disease ◽  
Control Group ◽  
Observation Group ◽  
Biliary Sludge ◽  
Medicinal Treatment

Aim. To optimize the conservative treatment of patients with cholelithiasis. Methods. Conducted was a comprehensive in-depth examination and treatment of 87 patients with gallstone disease (cholelithiasis) at the stage of biliary sludge (in the initial physicochemical stage - before stone formation) with associated hypokinesia of the gallbladder. The diagnosis was verified by the means of ultrasound investigation, multifractional duodenal probing and the intensity of biliary sludge was determined by the content of cholesterol, bile acids (spectrophotometrically) and cholate-cholesterol coefficient in the bile. The content of microelements in the bile was estimated by the method of atomic emission spectroscopy with inductively coupled plasma. The spectrum of bile acids in the bile was determined by the method of matrix laser desorption ionization. The acid-producing function of the stomach was evaluated by the means of intragastric pH-metry. During endoscopy investigation a targeted biopsy of the mucous membrane of the anterior and posterior walls of the stomach was performed, followed by morphological examination of biopsy specimens. The patients were divided into two groups. Sulfate sodium-calcium mineral water «Uvinskaya» (Udmurtia) and ursodeoxycholic acid (Ursosan) was used in the treatment of patients of the observation group. In the comparison group monotherapy with ursodeoxycholic acid at a dose of 15 mg/kg body weight was conducted. Hydrotherapy in the observation group was conducted for 24 days, while medicinal treatment in both groups was continued for another 2 months. The control group consisted of 15 practically healthy individuals. Results. In the course of treatment a marked decrease in the pain in the right hypochondrium, the disappearance or reduction of dyspeptic complaints, loss of echo-positive particulates in the gall bladder and an increase in its contractility was noted in all patients of the observation group, at the same time the signs of inflammation also disappeared and the cholate-cholesterol coefficient increased. Registered was a favourable dynamics of the content of microelements in the bile. Conclusion. The combined use of the «Uvinskaya» mineral water and ursodeoxycholic acid for the treatment of cholelithiasis with biliary sludge promotes the most rapid elimination of clinical symptoms of the disease, improves the functional state of the gall bladder, reduces the lithogenic properties and normalizes the content of microelements in the bile.

scholarly journals The combined application of Ursodeoxycholic acid (UDCA) and probiotic complex ProbioLog may affect lithogenesis processes in the early stages of gallstone disease in elderly people

2020 ◽  
pp. 29-34
Author(s):  
N. N. Glazyrina ◽  
N. A. Khokhlacheva ◽  
O. D. Mikhailova ◽  
E. V. Belova
Keyword(s):  
Ursodeoxycholic Acid ◽  
Bile Acids ◽  
Intestinal Microflora ◽  
Comparison Group ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Gallstone Disease ◽  
Observation Group ◽  
Hydrogen Breath Test ◽  
Early Stages

The aim of the study was to evaluate the effectiveness of ursodeoxycholic acid (UDCA) in combination with ProbioLog at the early stage of gallstone disease in the elderly.Material and methods: 92 patients with early stage of cholelithiasis (CL) were examined, the average age was 66,69 ± 5,52 years, there were 29 men and 63 women. In addition to anamnestic and general clinical data, the results of ultrasound examination (US) of the gallbladder were used to verify the diagnosis. The biochemical properties of bile (cholesterol, bile acids, phospholipids levels, bile lithogenicity indices) were studied. The composition of the intestinal microflora was determined using a hydrogen breath test with lactulose and culture of feces for dysbiosis. Two groups were formed due to the course of treatment, which amounted to 30 days. 45 patients of the observation group received UDCA 15 mg / kg per day once for a night in combination with the probiotic ProbioLog (Mayoly Spindler, France), 1 сapsule twice per day. UDCA monotherapy of 15 mg / kg daily was administered to 47 patients of the comparison group once for the night.Results. After the course of treatment, a favorable dynamics of clinical symptoms of the disease was noted. According to US, elimination of biliary sludge was observed in 62.2% of patients of the observation group and in 14.8% of patients of the comparison group. An improvement in the biochemical composition of bile was manifested by decreasing of its lithogenic properties. The important results of therapy were positive changes in the composition of the intestinal microflora, contributing to the normalization of the exchange of bile acids, cholesterol and phospholipids.Conclusion. The combined using of UDCA and ProbioLog in elderly patients is clinically effective in the treatment of early stages of cholelithiasis and pathogenetically justified in the prevention of gallstone formation.

scholarly journals Hymecromone in the treatment of biliary diseases: options and prospects

2020 ◽  
Vol 18 (5) ◽  
pp. 66-74
Author(s):  
A.V. Okhlobystin ◽  
◽  
A.K. Ufimtseva ◽  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Gallstone Disease ◽  
Experimental Studies ◽  
Oral Intake ◽  
Sphincter Of Oddi ◽  
Gallbladder Motility ◽  
Sphincter Of Oddi Dysfunction ◽  
Biliary Sludge ◽  
Treatment Safety ◽  
Oddi Dysfunction

Pharmacological treatment of biliary dyskinesia is to a great extend aimed at reducing smooth muscle spasms and recovering gallbladder motility. Prolonged courses of myotropic antispasmodics are used as the basic therapy. Hymecromone is notable to its predominantly spasmolytic action on the bile ducts and the sphincter of Oddi without any significant effect on the gallbladder contractility, and therefore it is safe in patients with cholecystolythiasis. Hymecromone decreases the severity of cholestasis, prevents the formation of cholesterol crystals and therefore, the development of cholelithiasis. It is effective both as a monotherapy and in combination with ursodeoxycholic acid for treatment of biliary sludge and prevention of the progression of gallstone disease. Its local action on the biliary tract and low systemic bioavailability after oral intake increases the treatment safety. Experimental studies demonstrated the antifibrotic and antihyperglycaemic effect of the drug. Key words: biliary dysfunction, cholelithiasis, sphincter of Oddi dysfunction, biliary sludge, hymecromone, ursodeoxycholic acid

Therapeutic physical factors in restorative treatment of patients with nonalcoholic steatohepatitis combined with biliary sludge

2021 ◽  
pp. 7-13
Author(s):  
Agnessa Sardoevna Kaysinova ◽  
Andrey Alekseevich Fedorov ◽  
Zarema Adamovna Vakhaeva ◽  
Nataliya Viktorovna Efimenko ◽  
Leila Khyzyrovna Bolatchieva ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Nonalcoholic Steatohepatitis ◽  
Mineral Water ◽  
Comparison Group ◽  
Main Group ◽  
Control Group ◽  
Restorative Treatment ◽  
Biliary Sludge ◽  
Therapeutic Measures ◽  
Peloid Therapy

Purpose of the study. To study the effectiveness of restorative treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge at the inpatient stage when low-mineralized mineral water and preformed peloid therapy are included in the basic scheme. Material and methods. A total of 119 patients with nonalcoholic steatohepatitis in combination with biliary sludge were observed and distributed into 3 randomized groups: in the main group, 39 patients received basic drug therapy in accordance with the Federal Clinical Recommendations, «Sernovodskaya» mineral water for ingestion and in the form of gallbladder cleanse, and preformed application peloid therapy; in the comparison group, 40people received only pharmacotherapy and balneotherapy, in the control group — pharmacotherapy. The control of the effectiveness of the treatment was carried out according to the dynamics of clinical, biochemical and functional studies. Results. The inclusion of medium-mineralized mineral water «Sernovodskaya» in the form of drinking treatment and cleanse and preformed peloid therapy in the complex of therapeutic measures for patients provides a significant decrease in the intensity of clinical manifestations by 54.4% versus 40% with the use of pharmaco- and balneotherapy and 28,8% — with only drug therapy; cytolysis and cholestasis syndromes — by 46,2; 39,8 and 28.9%, respectively. Restoration of the contractile function of the gallbladder is observed in 78,8% of cases versus 65.6% when using only pharmacotherapy. The duration of hospitalization in the main group was reduced by 3 days, and in the comparison group — by 1,5 days, compared with the indicators in the control group. Conclusion. The developed new medical technology for the treatment of patients with nonalcoholic steatohepatitis in combination with biliary sludge with the combined use of mineral waters and preformed peloid preparations against the background of basic pharmacotherapy at the inpatient stage provides a significant increase in the efficiency of therapeutic measures.

scholarly journals Gallbladder Kinetics: Correlation between Gall Bladder Emptying in Patients With and Without Cholelithiasis by Ultrasonography

2012 ◽  
Vol 2 (1) ◽  
pp. 13-17
Author(s):  
P Jaiswal ◽  
P Sharma ◽  
DM Shrestha ◽  
S Pradhan
Keyword(s):  
Gall Bladder ◽  
Gallstone Disease ◽  
Gall Stone ◽  
Mean Difference ◽  
Bladder Volume ◽  
Control Group ◽  
Gallbladder Emptying ◽  
Case Group ◽  
Bladder Emptying ◽  
The Mean

Background: Gallstone disease or cholelithiasis, is one of the most common surgical problems worldwide. The assessment of gallbladder kinetics in patients with cholelithiasis as well as in patients with high risk for cholelithiasis could play a significant role in better management and is recommended as a routine workup of biliary system in these patients.Objectives: This study was carried out to establish the relationship between impaired gall bladder emptying and gall bladder stones. It also aimed at finding out correlation between chosen risk factors. Materials and Methods: Eighty six subjects with cholelithiasis and 35 controls (without cholelithiasis) were studied. Pre-prandial gall bladder volume was measured after 6 hours of fasting, gallbladder emptying was stimulated by fatty meals of 610 and 740Kcal and post-prandial gallbladder volume was measured after a period of two hours with ultrasound. The difference of pre-prandial and postprandial gall bladder volume was calculated. Results: Gallbladder emptying was significantly more (p < 0.001) in the control group than in the group of subjects with cholelithiasis. In the case group the mean difference of volume was 9.2±7.1 cc. While in control group the mean difference of volume was 17.6±14.3. The prevalence of cholelithiasis was significantly high in females between 26- 35 years of age group and in patients with nonalcoholic fatty liver disease and in patients who had first degree relative with gall stone. Incidence of silent gall stone was also statistically significant. Conclusion: Impaired gallbladder emptying was found to be strongly associated with gall stones. NJR I VOL 2 I ISSUE 1 13-17 Jan-June, 2012 DOI: http://dx.doi.org/10.3126/njr.v2i1.6973

scholarly journals Value of Serum Glycocholic Acid and Total Bile Acids in Predicting Maternal and Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Chong Fu ◽  
Yali Xu
Keyword(s):  
Bile Acids ◽  
Intrahepatic Cholestasis ◽  
Perinatal Death ◽  
Perinatal Outcomes ◽  
Diagnostic Value ◽  
Control Group ◽  
Observation Group ◽  
Glycocholic Acid ◽  
Total Bile Acids ◽  
Cholestasis Of Pregnancy

Objective. To see whether serum glycocholic acid (CG) and total bile acids (TBA) can predict maternal and perinatal outcomes in pregnant women with intrahepatic cholestasis (ICP). Method. The observation group consisted of 80 women with ICP who were treated in our hospital, whereas the control group consisted of 50 ordinary women who were also treated at our hospital at the same time. The levels of CG and TBA in the two groups were determined independently, and the differences in poor perinatal outcomes were compared. Finally, the predictive diagnostic value of CG and TBA for poor perinatal outcomes in ICP mothers was displayed using the Spearman correlation between CG and TBA and Apgar. The maternal CG and TBA levels in the observation group were substantially higher than in the control group (P0.05). The observation group had more significant maternal-fetal discomfort, neonatal asphyxia, preterm birth, and perinatal death than the control group (P0.05). The risk of poor perinatal outcomes in ICP mothers rose when TBA and CG levels increased (P0.05). Apgar ratings were inversely associated with CG and TBA (r = −0.8251 and r = −0.5969, respectively, P0.05). The CG and TBA diagnostic AUCs for unfavorable perinatal outcomes in ICP mothers were (P0.05). Conclusion. CG and TBA have a high diagnostic value for ICP and may better predict and identify poor prenatal outcomes. It is suitable for clinical use.

scholarly journals New Approaches to Studying Prevalence Gallstone Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 281-287
Author(s):  
N. A. Khokhlacheva ◽  
T. S. Kosareva ◽  
A. P. Lukashevich
Keyword(s):  
Russian Federation ◽  
Liver Diseases ◽  
Stone Formation ◽  
Gallstone Disease ◽  
Microsoft Excel ◽  
The Past ◽  
Biliary Sludge ◽  
Udmurt Republic ◽  
The Russian Federation ◽  
Statistical Indicators

The aim — predicting the growth of gallstone disease based on the study of the dynamics of the incidence of the liver. Materials and methods. In clinical conditions, 98 patients (62 women and 36 men, average age 43.4 ± 3.3 years (21-60)) with various chronic liver diseases were examined. Anamnesis, clinical and laboratory data were used to verify the diagnosis. In portions “B” and “C” of bile obtained by multifractional duodenal sounding, the total concentration of bile acids, cholesterol and phospholipids was determined, and lithogenicity indices of bile were calculated: cholate-cholesterol and phospholipid-cholesterol coefficients. The results were analyzed using Microsoft Excel 2010 and PSPP statistical processing programs. The next stage of the work was the analysis of statistical indicators of the general and primary liver morbidity in the Udmurt Republic over the past 10 years (2008-2018). The study applied statistical forecasting methods. Models were built in the Microsoft Excel 2010 program in a polynomial trend.Results. In 52 (53,1%) examined patients, ultrasound examination of the gallbladder were signs of biliary sludge. Microscopic examination of bile 71 (72,6%) patients had crystals of cholesterol and calcium bilirubinate, which is evidence of stage I gallstone disease. In all patients with biliary sludge, a violation of the biochemical composition of bile was noted — a decrease in the concentration of bile acids and phospholipids, an increase in the concentration of cholesterol, a decrease in cholesterol and phospholipid-cholesterol coefficients. When studying statistical indicators over the past 10 years, a higher general and primary incidence of liver diseases in the Udmurt Republic was noted than in the Russian Federation as a whole. Based on the results of trend modeling, a significant increase in the total and primary liver morbidity is predicted both in the Udmurt Republic and in the Russian Federation.Conclusion. Summarizing the data obtained, it can be noted that over the past 10 years (from 2008 to 2018) among the adult population of Udmurt Republic, a clear tendency has been revealed for an increase in the general and primary incidence of the liver. As the results of trend forecasting showed, an increase in the incidence of the liver will continue in the coming years. With liver pathology, bile secretory function suffers, as a result of metabolic processes, bile produces supersaturated cholesterol, which is the basis for stone formation in the gall bladder. A study of the dynamics of liver disease allows predicting an increase in cholelithiasis in the coming years. Despite the fact that the asymptomatic course of cholelithiasis is often quite observed, if this disease is not diagnosed and the preventive treatment of stone formation is not carried out in a timely manner, this leads to the development of serious complications. 

scholarly journals Construction of exchange integrated information chain management model leading by information nurse for large instrument and equipment in operating room

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Dai ◽  
Xiaoqiang Ren ◽  
Peng Wu ◽  
Xiangdong Wang ◽  
Jiang Li ◽  
...  
Keyword(s):  
Life Cycle ◽  
Life Cycle Management ◽  
Management Model ◽  
Control Group ◽  
Equipment Management ◽  
Observation Group ◽  
Chain Management ◽  
Information Chain ◽  
Whole Life Cycle ◽  
Running Mode

Abstract Background This study aims to explore the information chain management model of large instrument and equipment inter-working in the operating room (OR) led by information nurses. Methods Through the chain management process of large instruments and equipment in the OR, which was based on information nurses, the management model of inter-working and integrating information chain was established, the key links were controlled, and the whole life cycle management of instruments and equipment from expected procurement to scrapping treatment was realized. Using the cluster sampling method, 1562 surgical patients were selected. Among these patients, 749 patients were assigned to the control group before the running mode, and 813 patients were assigned to the observation group after the running mode. The related indexes for large instrument and equipment management in the department before and after the running mode were compared. Results In the observation group, the average time of equipment registration was (22.05 ± 2.36), the cost was reduced by 2220 yuan/year, and the satisfaction rate of the nursing staff was 97.62%. These were significantly better, when compared to the control group (P < 0.05). Furthermore, the awareness rate of the whole staff for equipment repair application was 95.12%, and the arrival time of maintenance personnel and the examination and approval time of equipment management were greatly shortened (P < 0.05). Conclusion The integrated management model of large instrument and equipment interworking in the OR based on chain flow realizes the whole life cycle management of instruments and equipment, which is essential to improve management efficiency.

scholarly journals A non-bioartificial liver support system combined with transplantation in HBV-related acute-on-chronic liver failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peng Li ◽  
Xi Liang ◽  
Shan Xu ◽  
Ye Xiong ◽  
Jianrong Huang
Keyword(s):  
Survival Rate ◽  
Blood Loss ◽  
Liver Failure ◽  
Control Group ◽  
Observation Group ◽  
Intraoperative Blood Loss ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Liver Support ◽  
Liver Support System

AbstractWe aim to determine the impact of an artificial liver support system (ALSS) treatment before liver transplantation (LT), and identify the prognostic factors and evaluate the predictive values of the current commonly used ACLF prognostic models for short-term prognosis after LT. Data from 166 patients who underwent LT with acute-on-chronic liver failure (ACLF) were retrospectively collected from January 2011 to December 2018 from the First Affiliated Hospital of Zhejiang University School of Medicine. Patients were divided into two groups depending on whether they received ALSS treatment pre-LT. In the observation group, liver function tests and prognostic scores were significantly lower after ALSS treatment, and the waiting time for a donor liver was significantly longer than that of the control group. Both intraoperative blood loss and period of postoperative ICU care were significantly lower; however, there were no significant differences between groups in terms of total postoperative hospital stays. Postoperative 4-week and 12-week survival rates in the observation group were significantly higher than those of the control group. Similar trends were also observed at 48 and 96 weeks, however, without significant difference. Multivariate Cox regression analysis of the risk factors related to prognosis showed that preoperative ALSS treatment, neutrophil–lymphocyte ratio, and intraoperative blood loss were independent predicting factors for 4-week survival rate after transplantation. ALSS treatment combined with LT in patients with HBV-related ACLF improved short-term survival. ALSS treatment pre-LT is an independent protective factor affecting the 4-week survival rate after LT.

scholarly journals Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hong Lv ◽  
Ning Yang
Keyword(s):  
Tract Infection ◽  
Perioperative Period ◽  
Postoperative Recovery ◽  
Control Group ◽  
Observation Group ◽  
Activity Time ◽  
Joint Function ◽  
Vein Thrombosis ◽  
Accelerated Rehabilitation

Abstract Objective To analyze the application of concept nursing of accelerated rehabilitation surgery in orthopedic postoperative recovery. Methods A total of 120 patients who received orthopedic surgery were divided into the control group undergoing routine orthopedic nursing and the observation group undergoing the concept of accelerated rehabilitation surgery nursing. Results Patients in the observation group had shorter in-bed activity time and out-of-bed activity time, average time of hospital stay, and lower total treatment costs. The incidence of incision infection, respiratory system infection, digestive tract infection, urinary tract infection, deep vein thrombosis, and other complications in the observation group was much lower. The recovery scores of joint function in the observation group at 1, 3, 6, and 12 months after the operation were all better, and the recovery rate of joint function within 1 year after the operation was higher. Conclusion Following the concept of accelerated rehabilitation surgery nursing during the perioperative period can improve the quality of postoperative orthopedic recovery.

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