scholarly journals Some Approaches to the Therapy of Changes in Intestinal Microbiocenosis in Non-Alcoholic Steatohepatitis

2021 ◽  
Vol 17 (28) ◽  
pp. 30-35
Author(s):  
I.V. Kozlova ◽  
◽  
E.A. Lapteva ◽  
A.P. Bykova ◽  
A.L. Pakhomova ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Structural Changes ◽  
Saccharomyces Boulardii ◽  
Colon Mucosa ◽  
Neutrophilic Infiltration ◽  
Alcoholic Steatohepatitis ◽  
Intestinal Dysbiosis ◽  
Complex Therapy ◽  
Prospective Comparative Study ◽  
Intestinal Microbiocenosis

The aim is to evaluate the effectiveness of complex therapy with the inclusion of the drug Saccharomyces boulardii in patients with non-alcoholic steatohepatitis (NASH) and intestinal dysfunction. Material and methods. An open prospective comparative study of the effectiveness of complex therapy of intestinal dysfunction in patients with non-alcoholic steatohepatitis was carried out. The study included two groups of 36 patients with NASH with symptoms of intestinal dysfunction, established intestinal dysbiosis, structural changes in the mucous membrane of the colon. Results and discussion. It was found that the complex therapy of intestinal dysfunction with the inclusion of the drug Saccharomyces boulardii against the background of NASH reduces the frequency of abdominal pain associated with the intestines, normalizes stool, reduces the degree of dysbiosis, promotes epithelialization of microerosions, and reduces the frequency of neutrophilic infiltration of the colon mucosa. Conclusion. The results of the study indicate the effectiveness of complex therapy with the addition of Saccharomyces boulardii in patients with NASH and intestinal dysfunction

scholarly journals The Results of Giardiasis Treatment Using Giardicidal Drugs and their Combination with Probiotics in Children: A Retrospective Cohort Study

2018 ◽  
Vol 17 (4) ◽  
pp. 301-306
Author(s):  
Olga G. Kimirilova ◽  
Gennady A. Kharchenko
Keyword(s):  
Abdominal Pain ◽  
Combination Therapy ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Saccharomyces Boulardii ◽  
Lactase Deficiency ◽  
Intestinal Dysbiosis ◽  
Number Of Patients ◽  
Freeze Dried ◽  
Inpatient Settings

Background. Giardiasis in children remains an urgent problem, the significance of which is determined by the endemicity for many countries and regions, outbreaks of sporadic epidemics, polymorphism of clinical symptoms, and insufficient treatment efficacy. Objective. Our aim was to study the results of giardiasis treatment using giardicidal drugs or their combination with probiotics in children. Methods. We analyzed the frequency of Giardia lamblia elimination (the main outcome) as a result of giardiasis treatment (laboratory confirmed) in children aged from 3 months to 18 years who received giardicidal drugs (nifuratel, albendazole) or their combination with probiotics based on Saccharomyces boulardii (probiotic 1) and live freeze-dried lactic acid bacteria Lactobacillus acidophilus (L. gasseri), Bifidobacterium infantis, and Enterococcus faecium (probiotic 2) in outpatient or inpatient settings. Additionally, we registered the duration of the main symptoms of giardiasis (abdominal pain, diarrhea), the prevalence of intestinal dysbiosis and lactase deficiency. The considering period is from January 2015 to September 2017. Results. The results of giardiasis treatment were studied in 4 groups: monotherapy with nifuratel (n = 65) or albendazole (n = 64), a combination of nifuratel + probiotic 1 (n = 67) or albendazole + probiotic 2 (n = 64). The groups were comparable by sex, age, and clinical manifestations of the disease. The elimination of lamblia on the 14–16th day of monotherapy with giardicidal drugs was achieved in 56–60%, when combined with probiotics — in 84% of patients for each combination (df = 3, p < 0.001). Against the background of combination therapy, the disease symptoms (abdominal pain, diarrhea, vomiting) were reversed 1.5 times faster; the number of patients with lactase deficiency and intestinal dysbiosis decreased two and more times, under monotherapy with giardicidal drugs — 1.2 times (df = 3, p < 0.001). Conclusion. Giardiasis treatment in children using combination therapy, including giardicidal drugs and probiotics, is more effective than monotherapy with giardicidal drugs.

Prevention of structural changes in liver in patients with chronic acalculous cholecystitis

2021 ◽  
pp. 21-24
Author(s):  
M. V. Pecherskikh Pecherskikh ◽  
L. I. Efremova
Keyword(s):  
Functional State ◽  
Bile Ducts ◽  
Structural Changes ◽  
Acalculous Cholecystitis ◽  
Hepatoprotective Effect ◽  
Intrahepatic Bile Ducts ◽  
Complex Therapy ◽  
Chronic Acalculous Cholecystitis ◽  
Hepatobiliary Tract

Chronic acalculous cholecystitis is the cause of violations of the functional state of the liver in the form of stagnation in the intrahepatic bile ducts and a decrease in the activity of hepatocytes and is considered within the framework of a single pathology of the hepatobiliary tract. Complex therapy with the inclusion of the drug ademetionine, which in addition to the hepatoprotective effect affects the outflow of intrahepatic bile, contributes to the restoration of the detected violations.

scholarly journals Positive Effect of Electroacupuncture Treatment on Gut Motility in Constipated Mice Is Related to Rebalancing the Gut Microbiota

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Mingmin Xu ◽  
Lu Wang ◽  
Yu Guo ◽  
Wei Zhang ◽  
Ying Chen ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Structural Changes ◽  
Functional Constipation ◽  
Therapeutic Modality ◽  
Functional Bowel Disorder ◽  
Intestinal Dysbiosis ◽  
The Individual ◽  
Positive Effect ◽  
Electroacupuncture Treatment

Functional constipation (FC) is a common and often recurrent functional bowel disorder that seriously affects the quality of life of affected individuals and incurs a significant economic burden on both the individual and society. There is accumulating evidence that intestinal dysbiosis contributes to constipation and that rebalancing the gut microbiota may be a novel therapeutic modality for FC. Electroacupuncture (EA) has been shown to restore the gut microbiota to normal levels in a variety of diseases. Additionally, several high-quality clinical studies have confirmed that EA is an effective, sustained, and safe treatment for FC. However, whether the effects of EA are secondary to changes in the gut microbiota and how EA modulates intestinal dysbiosis induced by constipation are unknown. Therefore, here, we focused on the potential regulatory mechanisms of EA on diphenoxylate-induced constipation in mice by analyzing structural changes in the gut microbiota. Our results showed that EA treatment effectively rebalanced the gut microbiota of constipated mice, mainly by decreasing the Firmicutes/Bacteroidetes ratio, which may represent one way in which EA promotes gastrointestinal motility and alleviates constipation. Our findings lay the foundation for further mechanistic and clinical research into the application of EA in patients with FC.

Structural Changes in the Nervous Fibers of the Colon Mucosa in Experimental Acute Colitis

2020 ◽  
Vol 169 (1) ◽  
pp. 104-109
Author(s):  
D. N. Khochanskiy ◽  
V. A. Mkhitarov ◽  
A. S. Sladkopevtsev ◽  
V. P. Chernikov ◽  
L. P. Mikhailova ◽  
...  
Keyword(s):  
Structural Changes ◽  
Colon Mucosa ◽  
Acute Colitis

scholarly journals PATHOGENETIC EFFECTS OF COMBINATION THERAPY IN THE TREATMENT OF COMORBID PATHOLOGY

2019 ◽  
pp. 29-35
Author(s):  
P. Herych ◽  
I. Popadynets ◽  
R. Yatsyshyn ◽  
V. Mygovych ◽  
V. Kaminskyi
Keyword(s):  
Nitric Oxide ◽  
Structural Changes ◽  
Patient Treatment ◽  
Control Group ◽  
Chronic Obstructive ◽  
Peripheral Arteries ◽  
Mean Values ◽  
Stable Coronary Heart Disease ◽  
Complex Therapy ◽  
Experimental Group

The objective of the work was to determine the possibility of drug correction of endothelial dysfunction, structural changes in peripheral arteries and the synthesis of end products of nitric oxide metabolism by the use of a combination of roflumilast and quercetin in the baseline therapy. In contrast to the baseline, the use of integrated therapy was followed in 6 months by a probable increase in the initial rate by 18.76 % (0.61 ± 0.04) m/s to (0.75 ± 0.04) m/s (t = 2.47; P < 0.05) and a probable decrease in the initial diameter of the brachial artery to (3.69 ± 0.29) mm (t = 2.49; P < 0.05). Patients of the experimental group have shown a significant increase in mean values of EDVD at the end of in-patient treatment and after 6 months of intensive supportive therapy (t = 2.17; Р < 0.05). The appointment of complex therapy after 6 months showed an increase in concentration in the blood of metabolites of NO in 1,3 times to (10.35 ± 1.89) μmol/l (t = 1.00; P > 0.1) at normal (12.05 ± 2.11) μmol/l. In patients of the index group after six months of the background therapy, IMT index has appeared in 1.07 times lower than the input data and has not reached the level of the control group. The IMT index for patients in the experimental group was considerably lower than the index before treatment (t = 0.31; P > 0.1).  Application of complex therapy in patients with severe chronic obstructive pulmonary disease in the exacerbation phase in combination with stable coronary heart disease, stable angina pectoris I–II FK contributes to the restoration of endothelial function, improves structural changes in the peripheral arteries and has a stimulating effect on the synthesis of nitric oxide.

scholarly journals Non-alcoholic steatohepatitis in patients with endocrine pathology. Review

2021 ◽  
pp. 82-93
Author(s):  
S. M. Tkach ◽  
Т. L. Cheverda
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary ◽  
Hormone Deficiency ◽  
Endocrine Disorders ◽  
Male Hypogonadism ◽  
Pathophysiological Mechanism ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Steatohepatitis ◽  
Intestinal Dysbiosis ◽  
Obstructive Sleep

Non-alcoholic steatohepatitis (NASH) is a subtype of non-alcoholic fatty liver disease (NAFLD), which in the absence of treatment can progress to the development of cirrhosis and hepatocellular carcinoma, as well as to increased mortality associated with these diseases. The main risk factors for the development of NAFLD and NASH are the presence of insulin resistance and obesity. Quite often NAFLD and NASH are associated with so-called extrahepatic manifestations, such as obstructive sleep apnea, hypertension, dyslipidemia, intestinal dysbiosis, genetic predisposition, sedentary lifestyle and consumption of certain foods. However, NAFLD and NASH are also associated with some endocrine diseases and conditions, including type 2 diabetes, polycystic ovary syndrome, hypothyroidism, male hypogonadism, growth hormone deficiency or excess, hypercortisolism, vitamin D or prolactin deficiency. In many of these diseases, the key pathophysiological mechanism is insulin resistance. This review considers the putative pathophysiological mechanisms that play an important pathogenetic role in the development of NASH in these endocrine disorders.Unfortunately, our understanding of the pathophysiology of NAFLD in various endocrinopathies is far from complete. In addition, the natural course of NAFLD due to endocrine disorders compared to the course and consequences of “primary” NAFLD is still poorly understood. Therefore, in the coming years, further research into the pathophysiology and clinical features of NASH will be important to better understand the relationship between different endocrinopathies and NAFLD, which will help improve the treatment of this pathology.

Gastrointestinal symptoms in SARS-CoV‑2 infected: emphasis on increased mucosal permeability

2021 ◽  
pp. 13-20
Author(s):  
E. Yu. Eremina
Keyword(s):  
Intestinal Permeability ◽  
Gastrointestinal Symptoms ◽  
The Other ◽  
Virus Spread ◽  
Mucosal Permeability ◽  
Potential Source ◽  
Complex Therapy ◽  
The One ◽  
The Impact ◽  
Intestinal Microbiocenosis

The article presents data on the prevalence of gastrointestinal symptoms in patients with COVID‑19, the mechanisms of its development, the impact on the course of the disease and the tactics of drug therapy. It is noted that the persistence of the SARS-CoV‑2 virus in the intestine may be responsible for an increase in the duration of the disease and the development of multi-organ lesions, since the intestine, on the one hand, is the site of penetration and replication of the SARS-CoV‑2 virus, and on the other, is a potential source of virus spread due to increased intestinal permeability against the background of infection and disturbed microbiocenosis. Based on this, it seems pathogenetically justified to use drugs in the complex therapy of patients that contribute to the normalization of intestinal microbiocenosis and intestinal permeability.

Cytokine profile in women with threatened miscarriage and intestinal dysbiosis

2021 ◽  
Vol 70 (1) ◽  
pp. 51-58
Author(s):  
Alexander A. Bezmenko ◽  
Natalia D. Sadovaya ◽  
Marina E. Meshkova ◽  
Elena A. Malakhova
Keyword(s):  
Pregnant Women ◽  
Intestinal Microflora ◽  
Main Group ◽  
Control Group ◽  
Endotoxin Level ◽  
Threatened Miscarriage ◽  
Intestinal Dysbiosis ◽  
Grade Ii ◽  
Pro Inflammatory Cytokines ◽  
Intestinal Microbiocenosis

Hypothesis/Aims of study: Systemic endotoxinemia resulting from intestinal dysbiosis activates the Th1 immune response and excessive production of proinflammatory cytokines, which can cause abortion. This study was aimed at assessing interleukin levels in women with the threat of miscarriage and exploring their dependence on intestinal microbiocenosis and the level of endotoxinemia. Study design, materials and methods: The study involved 87 women aged 18 to 43 years in pregnancy from six to 22 weeks. The main group consisted of 50 women with a threatened miscarriage. The control group included 37 women with normal pregnancy. A qualitative and quantitative analysis of intestinal microbiocenosis was performed by real-time PCR, with endotoxin and interleukin levels evaluated using conventional methods. Results: In patients of the main group, intestinal dysbiosis of grade I was detected in 30 % (n = 15), of grade II in 46 % (n = 23), and of grade III in 24 % (n = 12) of cases. In the control group, intestinal microflora disorders corresponded to grade I dysbiosis in 67.6 % (n = 25) and grade II dysbiosis in 32.4 % (n = 12) of cases, there being no cases of severe dysbiosis revealed. The level of endotoxin in pregnant women of the main group was 0.57 0.02 nmol / ml and was classified as increased. The endotoxin level in the blood serum of pregnant women of the control group was 0.34 0.02 nmol / ml and was characterized as low (p 0.001). A strong correlation was found (r = 0.8, p 0.001) between the grade of intestinal dysbiosis and the level of endotoxinemia. The cytokine profile in patients of the main group was characterized by increased concentrations of pro-inflammatory cytokines (IL-1 4.9 1.6 pg / ml, IL-6 4.8 1.5 pg / ml) and a decreased concentration of anti-inflammatory cytokine (IL-10 18.0 4.5 pg / ml), when compared to the control group (IL-1 1.8 0.2 pg / ml, IL-6 2.1 0.2 pg / ml, IL-10 30.3 4.4 pg/ml). There were a statistically significant moderate positive correlation between the level of endotoxinemia and the concentration of pro-inflammatory cytokines and a weak negative correlation between the endotoxin level and the concentration of anti-inflammatory IL-10. Conclusion: Endotoxinemia, which occurs as a result of intestinal microflora dysbiosis and activates pro-inflammatory pathways, can really be as a triggering factor in the pathogenesis of miscarriage in pregnant women.

Clinical efficacy of hepatoprotector in the complex therapy of non-alcoholic steatohepatitis against the background of obesity for comorbidity with chronic obstructive pulmonary disease

2021 ◽  
Author(s):  
O. S. Khukhlina ◽  
O. Ye. Hryniuk
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Liver Steatosis ◽  
Subjective Assessment ◽  
Main Group ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Alcoholic Steatohepatitis ◽  
Complex Therapy

Objective — to establish the Antral efficacy in terms its effects on the intensity of clinical and biochemical syndromes of non‑alcoholic steatohepatitis (NASH) against the background of obesity at comorbidity with chronic obstructive pulmonary disease (COPD). Materials and methods. The examinations involved 65 NASH patients with I degree obesity and COPD 2 — 3 D. The patients were divided into two groups: 32 patients control groups received NASH therapy (Essentiale forte N (Sanofi Avensis/Nutterman and Cie GmbH) 300 mg, 2 caps., 3 times per day) for 30 days and basic COPD therapy. The second, main group consisted of 33 NASH patients with I degree obesity and COPD 2 — 3 D, who along with the basic therapy for COPD received hepatoprotector Antral (Farmak, Ukraine) 200 mg, 3 times daily for 30 days. The mean age of the patients was 56.3 ± 3.21 years. The comparison group consisted of 30 apparently healthy people (AHP). The values of 30 practically healthy individuals were used as reference. Results. According to the scale of subjective assessment of the intensity of asthenia after treatment in patients of the main group, the effectiveness of its elimination was 3.9 times higher than that of patients in the control group (relative risk 3.87; 95 % CI [1.16 — 12.91], p < 0.05). The manifestations of dyspepsia disappeared faster in the patients of the main group. The use of antral 3.7 times more influenced the manifestations of cholestasis (p < 0.05). Body mass index (BMI) > 32 kg/m2 after treatment, which included a hypocaloric diet and Antral, remained in 13 patients in the main group (39.4 %) versus 29 patients in control group (90.6 %) (p < 0.05). During one month after the treatment, markers of cytolysis remained in 9 patients in control group (28.1 %), and in 1 patient of the main group (3.0 %) (OR 9.28; 95 % CI [1.11 — 77, 52], p < 0.05). The increased activity of cholestasis markers after treatment remained only in 5 patients in the main group (15.2 %) in comparison with 22 (68.8 %) controls. In the dynamics of treatment of patients in the main group, significant increase in the protein‑synthesizing function of the liver was revealed (albumin levels increased by 30.56 % (p < 0.05) relative to the indicator in the control group). Conclusions. The use of Antral in the complex therapy of NASH of patients with the concomitant obesity and COPD was more effective than standard therapy in terms of removal of clinical NASH syndromes: asthenic‑vegetative, dyspepsia, abdominal discomfort, cholestasis, hepatomegaly, degree of liver steatosis; biochemical syndromes: cytolysis, cholestasis, mesenchymal inflammation, hepatocellular failure.  

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