Terapevt Arkh
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Case Reports Classical Article
[Sarcoidosis and primary biliary cholangitis in a patient with cholestasis].
Primary biliary cholangitis and sarcoidosis are both cholestatic liver diseases. Currently, there are no established specific criteria for distinguishing the diseases from each other; diagnosis is based on the anamnesis, as well as the results of physical, laboratory and instrumental examination. The case report presents a female patient with a rare combination of histologically verified liver sarcoidosis and primary biliary cholangitis. Despite the similar clinical manifestations, the approaches to the treatment of these diseases are completely different, that underlines the importance of the differential diagnosis to exclude combined liver damage.
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To develop a questionnaire to assess the individual risk of food interactions in a patient taking warfarin. ⋯ A specialized questionnaire was developed, implemented as a computer program, to assess the significance of food preferences in ensuring the safety and effectiveness of warfarin therapy. Further research is required to determine the risk limit of alimentary interactions of warfarin, but now this questionnaire can be used to monitor the uniformity of consumption of products that affect its activity. The authors suggested using a questionnaire for assessing the risk of food interactions as one of the factors influencing the decision to prescribe warfarin to patients with insufficient adherence to lifestyle modification.
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Classical Article
[Lung disease/pneumonitis in a patient with ulcerative colitis due to mesalazine].
Mesalazine is a main medicine for treatment of ulcerative colitis. Most patience of left-sides and total colitis receive oral mesalazine for many years. Currently, there is a little information about the tolerability and safety of long-term use of mesalazine. ⋯ The article presents case of the development interstitial lung disease induced by mesalazine under long-term maintenance treatment for three years in the young patient with ulcerative colitis. It shows the difficulties in diagnosing this disease due to the work-long low-grade fever in manifestation of pneumonitis, the similarity of clinical and radiological manifestations (diffuse bilateral pattern in chest imaging). The article demonstrates the limitations of modern laboratory and instrumental diagnostic methods for the differentiation of disseminated lesions of the lung tissue, and shows the importance of elimination treatment of mesalazine-induced pneumonitis.
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Classical Article
[The role of fibroblast growth factor 19 in pathogenesis of bile acid diarrhea of the patients who underwent cholecystectomy].
The occurrence of chronic diarrhea after cholecystectomy (CCY) has been described by many researchers. However, the main mechanisms of the development of this diarrhea are not fully understood. Supposed that dysregulation of the bile acids (ВA) absorption in the ileum is played a significant role in the development of diarrhea syndrome. ⋯ Low level of FGF19 in the blood serum and a high excretion of BA in the feces may be one of the causes of BAD in patients undergoing cholecystectomy. Our results indicate the important role of FGF19 in the development of chronic diarrhea, which can be considered as one of the variants of postcholecystectomy syndrome.
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Classical Article
[Features of intestinal microbiota disorders in the development of metabolic disorders in non-alcoholic fatty liver disease].
We discussed about the term intestinal permeability like as the mucosal barrier a single structural and functional conception that includes the layer of mucus, the indigenous microbiota and the epithelium of the mucosa in this publication. Information was presented about the role of the microbiota, the composition of intestinal mucus, epithelial cells and proteins of tight junctions which lead to various metabolic diseases. The complex pathogenetic interactions are formed between the intestinal mucosal barrier, metabolic disorders such as non-alcoholic fatty liver disease and cardiovascular diseases. The complex researches and modification of this interactions will allow to create personalized approaches and to prevent of these diseases.