The purpose of the study is to establish the relationship between the accentuation of temperament properties, clinical picture of disease, and adherence to therapy in patients with gastroesophageal reflux disease with different phenotype of oxidative metabolism. Materials and methods. To achieve this goal, a case-control study was conducted in 156 patients aged 21 to 55 years (101 men and 55 women, mean age 38 years (IQR 29-46)) with verified gastroesophageal reflux disease with assessment of the clinical picture, assessment of the severity of symptoms using a visual analogue scale, concomitant pathology, adherence to therapy, phenotype of oxidative metabolism with the eufillin marker drug, determination of personal psychophysiological features using a temperament accentuation test. Statistical analyses were performed according to study objectives and data set features. Results. In patients with gastroesophageal reflux disease, 3 main personality types were identified: hyperthymic (n = 29; 19 %), mixed (n = 61; 39 %) and emotionally unstable type (n = 66; 42 %). By oxidative metabolism phenotype, 156 patients were divided into rapid (n = 51; 33 %), intermediate (n = 82; 52 %) and slow metabolizers (n = 23; 15 %). Analysis of multinomial logistic regression showed that in patients with rapid metabolism, in contrast to intermediate and slow metabolizers, low pain syndrome intensity should be expected (p = 0.014). There was no effect on the clinical presentation of temperament properties (p = 0.063). When studying the dependence of adherence to therapy on the properties of temperament and the patient`s metabolic level by multinomial logistic regression in patients with a hyperthymic type of accentuation of temperament properties, the probability of high adherence to therapy was more than 65 % in fast and intermediate metabolizers and 100 % in slow metabolizers (p = 0.006), in patients with mixed types the probability of high adherence to therapy is observed only in slow metabolizers (p = 0.006), patients with emotionally unstable type have a high probability of low adherence to therapy regardless of metabolic level (p = 0.006). Conclusion. To predict adherence of patients with gastroesophageal reflux disease to therapy, it is advisable to determine the level of oxidative metabolism and the type of accentuation of temperament properties.

Aim: To develop evidence-based recommendations for primary care physicians and general practitioners (GP) on choosing the proper management tactics and making valuable & quick diagnostic decisions at outpatient phase for patients with symptoms of dyspepsia, and also reveal possible oncology on time. Summary of recommendations: Approximately 40% of the patients in Russia presenting to primary care with symptoms of dyspepsia. A doctor has to focus on the warning signs, which may require an urgent additional examination & the consultation with a surgeon/onco-surgeon or other specialists if required. With regard to a risk of cancer, a doctor should be more cautious in patients over 45 years of age. Early diagnosis of oncology depends mainly on cautiousness of GP, primary care physicians and their knowledge, future tactics with regard to the patients. From the mandatory diagnostic tests during the first visit, esophagogastroduodenoscopy and H. pylori diagnostics helps to exclude any organic esophagus and stomach pathology, possible oncology. While waiting for endoscopy results, a physician should use the preliminary diagnoses “Uninvestigated Dyspepsia” (ICD-10 К 31.9) (disease of stomach and duodenum, unspecified). After exclusion of all warning signs, therapy of dyspepsia should be in accordance to the order of the Ministry of Health No 248 which gives an option to use proton pump inhibitors (omeprazole or rabeprazole 20 mg daily) in combination with prokinetic (domperidone 30 mg daily). Fixed drug combination of omeprazole 20 mg and modified-release domperidone 30 mg/daily (Omez® DSR) is medically reasonable. Conclusion: The introduction of this recommendation into clinical practice will help clinicians to prevent diagnostic mistakes, unreasonable use of expensive diagnostic examinations and inappropriate treatment leads to improvement in the overall prognosis and quality of life for the patients.

Aim. To study the impact of risk factors on development of pancreatitis in comparison with other diseases of the hepatopancreatoduodenal area and to evaluate the effectiveness of physical training as a preventive approach. Material and methods. The study involved 488 people who were treated for diseases of hepatopancreatoduodenal area. Results. The following factors significantly (p < 0.001) determining the direction of pathogenesis along the path of pancreatitis or other diseases should be considered most important: patient's dietary intervention and alcohol consumption by patient's family members ( r(Q) = 0.39-0.42 and 0.28-0.67, respectively), as well as gender ( r(Q) = 0.40-0.51, p < 0.001) and employment ( r(Q) = 0.24-0.26, p < 0.05). The strongest correlations between quantitative risk factors and the formation of pancreatitis in contrast to cholecystitis were observed for age (vertical bar r(bs)vertical bar = 0.23, p < 0.001), alcohol abuse (vertical bar r(bs)vertical bar = 0.17, p < 0.001), age at starting smoking (vertical bar r(bs)vertical bar = 0.29, p < 0.001), and diet costs (vertical bar r(bs)vertical bar = 0.21, p < 0.001). Regression analysis revealed a special preventive effect of 'sports expenses' factor rate on the development of bad habits. The optimal level of such costs is 7-10 %. Conclusion. The obtained results can be used to develop the personalized strategy for prevention of pancreatitis and allow recommending to patients to maintain the level of expenses on physical training at the level of 7-10 % of their income.

Aim . To study the antidiarrheal activity of enterosorbent on the basis of montmorillonite on the model of serotonin-induced diarrhea. Materials and Methods . The study was conducted on laboratory mice of both sexes, acute diarrhea was induced by intraperitoneal injection of serotonin hydrochloride at the dose of 0.32 mg/kg, enterosorbent was introduced orally in the form of aqueous suspension in a wide range of doses 30 minutes before introduction of serotonin. Within 4 hours, the time of onset of diarrhea, the number of defecations, the fluid content in fecal masses were taken into account. Morphological examination of the small intestine was carried out. Results . introduction of serotonin led to diarrhea in 100% of animals within 12.8±1.2 minutes, the number of defecations increased 2.5 times as compared to the intact animals and was 19.5±0.5 times in 4 hours, the fecal masses were predominantly semi-liquid and liquid. Use of enterosorbent coded Crim_04 at the maximum dose led to a delay in diarrhea up to 73.6±4.1 minutes, the number of defecations decreased to 9.4±0.1 with a significant solidification of feces. The antidiarrheal effect of enterosorbent was confirmed morphologically. Conclusions . Enterosorbent on the basis of montmorillonite with laboratory code Crim_04 possesses a dose-dependent antidiarrheal effect in modeling of serotonin-induced diarrhea.

The endotelio- and cardioprotective effects of vitamin B6 (2 mg/kg) and folic acid (0.2 mg/kg) upon modeling of methionine-induced hyperhomocysteinemia via methionine intragastric administration at a dose of 3 g/kg were studied. It was shown that the combined use of vitamin B6 and folic acid allows on the background of a significant reduction in homocysteine concentrations normalizing the endothelial dysfunction coefficient and the parameters of maximum left ventricular pressure in response to intravenous administration of adrenaline. The research was partially supported by the grant of the President of the Russian Federation №MD-4711.2015.7.

The experiment was carried out in female white Wistar rats to investigate the effect of L-norvaline, rosuvastatin and their combination on parameters of blood supply to the bone tissue on models of experimental osteoporosis and osteoporotic fractures. It was found that the studied drugs prevent reduction of microcirculation in osteoporotic bone tissue as well as in callus tissue of experimental osteoporotic fractures and it positively influences the course of reparative regeneration of bone tissue.

The article is devoted to the investigation of polymorphism of Helicobacter pylori genes associated with resistance to Clarithromycin (Т2182С, A2142G/С, and A2143G mutation) using the polymerase chain reaction (restriction fragment length polymorphism). The following was investigated: the biopsy material from altered areas of gastric mucosa obtained from outpatients of Kursk city polyclinics and referred to fibroesophagogastroduodenoscopy in order to conduct the differential diagnostics between the gastroesophageal reflux disease and the dyspeptic syndrome. During the research, no cases of А214G/C mutation were detected in the investigated biopsy material. It was found out that Т2182С mutation was detected in 10.3% of cases, while mutation A2143G - in 13.79% of cases. Thus, the incidence of НР mutations related to the resistance to Clarithromycin is 24.13%, which is the rationale for the use of reserved 1 st - and 2 nd -line eradication schemes to treat НР-associated diseases in city of Kursk.

Ischemic injury was formed in laboratory rats by applying mechanical pressure (110 mm Hg) to the anterior eye chamber for 30 minutes.The experiment revealed that the recombinant erythropoietin (50 IU/kg) prevents the development of degenerative changes in retinal layers caused by ischemic injury.Intensity of the protective effect of erythropoietin on the retina of rats was assessed after 1 hour and 72 hours of reperfusion after pathology simulation.The observed protective effect of erythropoietin with the development of ischemia was confirmed by laser Doppler flowmetry, electroretinography and histomorphometry.Identification and use of pharmacological agents with the preconditioning effect may be a new approach in the correction and prevention of retinal ischemia, which is the leading element in the pathogenesis of a number of ophtalmic pathologies.The possibility of pharmacological preconditioning of ischemic lesions of the retina with erythropoietin is essential for the development of anti-ischemic agents for the .

Determination of oxidative metabolic phenotype in patients with gastroesophageal reflux disease allowed analyzing peculiarities of clinical signs of gastroesophageal reflux disease as well as efficiency of Helicobacter pylori eradication in the patients in question. While investigating symptoms of reflux (heartburn) and noncardiac chest pain it was revealed that patients with fast oxidative metabolic phenotype experiencing painful sensations were found rarer compared to the group with very slow metabolizers. Patients with gastroesophageal reflux disease proved to reduce the frequency of Helicobacter pylori eradication in the subgroup of fast and slow metabolizers in comparison with very slow metabolizers.

Using the combined use of recombinant erythropoietin «Darbopoetin alpha» (500 mcg / kg) with simvastatin, atorvastatin, rosuvastatin and rosuvastatin nanopartikulirovanny on background modeling sepsis-induced disease, the introduction of strain 603 Staphylococcusaureus shows endotelio- and cardioprotective effects, manifested in preventing the proliferation of QED, adrenoreactivity, maintaining myocardial reserve and the normalization of the values of biochemical markers (Total NO, expression of eNOS, C-reactive protein, IL-6, TNF). Thus, combination therapy found an additive effect of drugs.

The article presents current data about the features of the drug production considering substance quality. It was investigated the advantages and disadvantages of various original and generic drugs, include hepatoprotectors. It was discussed and gave recommendations on the tactics of the choice of drug for treatment.

Helicobacter pylori (HP) eradication therapy is a compulsory component of the etiological treatment of HP-associated diseases, but modern standardized schemes of eradication therapy do not lead to complete destruction of HP. Determination of the phenotype of the oxidizing metabolism allows to personalize the dosage of the drugs in the treatment of the patients with peptic ulcer. This approach allows to reach maximum efficiency and eradicate HP, thus, making essential impact on the forecast of the disease and quality of life of the patients.

В статье представлен анализ эффективности персонализированной в зависимости от фенотипа окислительного метаболизма терапии больных язвенной болезнью в сравнении со схемой, включающей эзомепразол. Исследования показали, что индивидуализированная, дозозависимая от фенотипа окислительного метаболизма терапия язвенной болезни характеризовалась большей результативностью влияния на клинические проявления заболевания, эрадикацию Helicobacter pylori, показатели качества жизни больных язвенной болезнью по сравнению с группой эзомепразола. Показано, что применение индивидуальных схем лечения больных язвенной болезнью с учетом фенотипа окислительного метаболизма (определенного по показателям фармакокинетики препарата-маркера эуфиллина) является экономически рентабельным.

Determination of the phenotype of oxidizing metabolism allows to personalize the dosage of the drugs in treatment of the patients with peptic ulcer. This approach allows to reach maximum efficiency and economic profitability of the treatment that leads to stop pain and dyspepsia, to change рН, to eradicate Helicobacter pylori, thus, making essential impact on the forecast of the disease and quality of life of patients.