Functional dyspepsia is a widespread disease with many symptoms that reduce the patient's quality of life. The effectiveness of prokinetics, including in combination with proton pump inhibitors, has a high level of scientific evidence in the treatment of functional dyspepsia. The effectiveness of itopride hydrochloride is determined by a dual mechanism of action: antagonism to D 2-dopamine receptors and inhibition of acetylcholinesterase. The drug exceeds of metoclopramide and domperidone in safety in relation to cardiac and neurological disorders. Itopride hydrochloride is not expected to have pharmacokinetic interactions with other drugs metabolized by the CYP3A4 system. In addition to functional dyspepsia, itopride hydrochloride is indicated in the treatment of chronic gastritis, gastrointestinal symptoms associated with gastric dysmotility or delayed gastric emptying, such as bloating, rapid satiety, a feeling of fullness in the stomach after eating, pain or discomfort in the epigastric region, loss of appetite, heartburn, nausea and vomiting. The pharmacoeconomic analysis shows an advantage of Itopride-SZ in comparing of the direct cost of it with the original and several generic drugs. In this way, it allows recommend Itopride-SZ as an affordable drug for various cohorts of patients.

The aim of the study was to assess the tolerability and impact on the quality of life of pharmacotherapy for gastric ulcer, erosive gastritis using regimens including rebamipide. The quality of life of patients was assessed using the SF-36 questionnaire. Pharmacotherapy of gastric ulcer with the inclusion of rebamipide as part of the conventional treatment regimen provides data comparable to the healthy group on the scales of physical functioning, role functioning due to physical condition, pain intensity, general health, and vital activity. The results of our own research and data from literary sources indicate that rebamipide is a drug with a confident evidence base, good tolerance and safety of use.

Цель исследования: изучить частоту различных хронических неинфекционных заболеваний у реципиентов печени

In this paper we present a review of literary data about the modem views on glucocorticoid arterial hypertension arrangement in donor organs recipients. Arterial hypertension is one of the main risk, pacing for cardiovascular complications development. In cases with glucocorticoids uptake arterial blood pressure develops approximately in 15–20%. We generalized the main schemes participating in genesis of the arterial hypertension induced by glucocorticoids: a time delay of sodium and increase in circulating liquid volume, GC-dependent vasoconstriction, increased synthesis of catecholamines and beta-1 adrenergic receptor expression, change of noradrenaline sensitivity as a result of the increased endothelin synthesis. In a practical manipulation it is necessary to use non-steroid protocols or minimize doses in internal organs recipients, weighing risks of transplant rejection and possible undesirable side responses in cases with glucocorticoids administration.

The aim of the study – to evaluate the quality of life of patients after liver transplantation.Patients and methods. The quality of life of patients after liver transplantation was studied with the help of «SF-36 Health Status Survey» questionnaire and correlation analysis of all scales of the questionnaire with the MELD indices, Child-Pugh before transplantation, SCORE before and after transplantation, body mass index, immunosuppressants, presence of tumor, encephalopathy, hepatitis transplant was performed.The results. In the surveyed group, the average indicators on the scales «physical functioning» were reduced by 31.3%, «role functioning due to physical condition» - by 60.8%, «pain intensity» - by 13.2%, «general health condition» - by 33.4%, «Life activity» by 19.9%, «social functioning» by 19.8%, «emotional role functioning» by 52.9%, «mental health» by 11.7%, «physical component of health» by 24.5% and «psychological component of health» by 15.6%. Between hepatitis grafts and psychological health, as well as between the presence of tumors and pain intensity, the correlation coefficient is greater than 0.25, and the significance levels of both chi-square criteria are less than 0.05.Conclusions. Liver recipients have the lowest quality of life on the role-playing scale due to their physical condition compared to healthy liver recipients. A moderate statistically significant relationship between hepatitis grafts and psychological health, as well as the presence of tumors and pain intensity, has been revealed. There are no gender differences in all components of QL in the group of liver recipients.

Background. In patients after liver transplantation cardiovascular complications is the third main reason of death afer allograf failure and infections. The most important factors in the development of cardiovascular diseases are dyslipidemia and impaired renal function.The aimof the study was to investigate the lipid spectrum and renal function in liver recipients in real clinical practice and the correspondence of their correction to current clinical recommendations for the diagnosis and treatment of dyslipidemia and chronic kidney disease (CKD).Methods.A retrospective analysis of lipid spectrum and renal function in patients who underwent OLT in Research Institute – Regional Clinical Hospital №1, Krasnodar was performed. The level of creatinine, GFR and lipid spectrum was studied before and 36 months after liver transplantation. The GFR was calculated using the formula CKD‑EPI (Chronic Kidney Disease Epidemiology Collaboration). Statistical analysis of the study results was made using the program Statistica 10.Results.Liver recipients have a significantly higher total cholesterol by 31.0% (p<0.01) in comparison with the baseline before surgery. Total cholesterol was increased in 13.7% (p<0.01), triglycerides in 12.3% (p<0.01) before transplantation. Tree years after transplantation, the increasion in cholesterol was registered in 42.6% (p<0.01) and triglycerides in 37.9% (p <0.01), respectively. 3 years after transplantation reduction of GFR was observed in comparison with the baseline by 22.6% (p=0.00006). Verification of chronic kidney disease and statin administration in patients were carried out in some cases. The levels of total cholesterol and triglycerides had a reliable inverse correlation with GFR (r = ‑0.42; p<0.01 and r = ‑0.36; p<0.05).Conclusions. In the long‑term postoperative period there was an impaired lipid metabolism and decreased level of GFR. Dyslipidemia was closely related to the progression of renal dysfunction in liver recipients, an inverse correlation was established between the glomerular filtration rate and the increasion in cholesterol and triglyceride levels. It is necessary to increase the attention of physicians with regard to timely correction of lipid metabolism disorders and detection of initial manifestations of renal dysfunction.

Background. Glomerular filtration rate is the main parameter characterizing the kidney functional condition. The evaluation of glomerular filtration rate is of significant importance, since in addition to an objective indicator of the kidney functional capacity, it is also a predictor of various pathological conditions, including cardiovascular complications.The aim of the study was to assess creatinine levels and glomerular filtration rates before and after orthotopic liver transplantation in clinical practice.Material and methods. A retrospective analysis of data obtained at different stages of the postoperative period in patients (n = 89) who underwent orthotopic liver transplantation in Research Institute – Regional Clinical Hospital № 1, Krasnodar, was performed. The creatinine level and glomerular filtration rate were studied before and at 6, 12, 24, and 36 months after liver transplantation, taking into account gender and age differences. Statistical analysis of the study results was made using Statistica 10 software.Results. The creatinine level was 82.9 ± 19.8 mmol/L before liver transplantation; creatinine increased by 20.4% (p = 0.004) at 6 months, by 24.8% (p = 0.00001), 24.4% (p = 0.0004), and 26.0% (p = 0.0005) at 12, 24 and 36 months after transplantation, respectively statistical significant in all cases. Compared to the baseline, the glomerular filtration rate decreased by 14.2% (p = 0.0005), 18.8% (p = 0.00001), 20.2% (p = 0.00003), and 22.6% (p = 0.00006) at 6, 12, 24, and 36 months, respectively statistical significant in all cases. Significant differences in kidney functional condition between men and women, as well as between the recipients younger and older 50 years were observed only at one year after transplantation.Conclusions. In the long-term postoperative period, there was an increase in creatinine level and a decrease in the level of glomerular filtration rate compared to the period before liver transplantation. At 6 months, two, and three years after liver transplantation, there were no significant differences in the studied liver functional parameters between the age groups or genders. Monitoring the glomerular filtration rate and preventing the progression of renal dysfunction in liver recipients

Arterial hypertension is an established risk factor for cardiovascular complications. Since the introduction of calcineurin inhibitors (CNI), аrterial hypertension is observed in 50-80% of transplanted patients. Arterial hypertension and transplantation are closely linked, and its association may promote impaired graft and overall survival. We summarize the main mechanisms involved in the genesis of CNI-induced hypertension as follows: impaired renal function with the sodium retaining, endothelial dysfunction, renin-angiotensin-aldosterone system and sympathetic activation, production of vasoconstrictor substances, activation the renal Na+/Cl--cotransporter. Attention is focused on the dose-dependent increase in arterial pressure and the need for further study of the intensity of the pro-hypertensive effect of various calcineurin inhibitors.

In this paper we present a review of literary data about the modem views on glucocorticoid arterial hypertension arrangement in donor organs recipients. Arterial hypertension is one of the main risk, pacing for cardiovascular complications development. In cases with glucocorticoids uptake arterial blood pressure develops approximately in 15 – 20%. We generalized the main schemes participating in genesis of the arterial hypertension induced by glucocorticoids: a time delay of sodium and increase in circulating liquid volume, GC-dependent vasoconstriction, increased synthesis of catecholamines and beta-1 adrenergic receptor expression, change of noradrenaline sensitivity as a result of the increased endothelin synthesis. In a practical manipulation it is necessary to use non-steroid protocols or minimize doses in internal organs recipients, weighing risks of transplant rejection and possible undesirable side responses in cases with glucocorticoids administration.

The article analyzes information of the prevalence, causes and mechanisms of development of hypertension in patients after liver transplantation. The authors integrate data from domestic and foreign literature about priorities of choice of antihypertensive drugs and possible changes in patterns of immunosuppressive drug therapy to reduce the risk of onset and progression of cardiovascular disease in patients who were underwent orthotopic liver transplantation.

The aim of the study is pharmacoepidemiologicalanalysis of the structureandreasonability of diuretic therapy in patients with hypertensive disease (HD)in ‘real-life’ clinical practicesettings.Materialandmethods:we underwentthe retrospectivepharmacoepidemiologicalcomparative analysisof the structureofdiuretic therapyreviewingoutpatient cardsfrom 2011 to 2014.We extracted data from outpatientcardsin outpatient department of Krasnodar Territoryusingcontinuous sampling method(421 patients)with the subsequent assessmentin accordance withmodern guidance materials. Results. In comparison with the regional study historic resultsthe administrationoftorsemidehad significantly increasedin patients withHD andnoncomplicatedchronic cardiac failure(12%).The priority drugs for the administrationamong diuretics werehydrochlorothiazide (24%)and indapamide (20%),spironolactone (20%).The ACE inhibitoror sartanusing in fixed combination with diuretic was recommended in 20% of out- patient cards.Structure ofdiuretic distribution in group of patients with HD, associated withCHF(II-IVfunctional class)had showedthe efficiencyof spironolactonein26%,of hydrochlorothiazide - 15%,torsemide - 13%,indapamide - 7%;the combination of spironolactoneandtorsemidewas receivedby 14% of patients,the combination of spironolactoneandhydrochlorothiazide - 6%,spironolactoneand furosemide - 1%,in 4% of outpatient cardswe noticed the triple combination of monocomponentdiuretic.Conclusion. We did not find unreasonable administration of diuretic therapy combination out ofindication and in the presence of contradictions.The prescription of modern long-termdiuretics associated with lower risk of side-effects developing will improve efficiencyand safetyof pharmacotherapy.It is very important to use fixed drugs combinationin case of administration the diuretic and agentsofrenin angiotensin system inhibitors.The volume and prescription reasonability analysis ofdiuretic therapy in patients withHDin ‘real-life’ clinical practicesettingshas shown compliance with modernnational guidance materials for the HD and CHF treatment.