The purpose of the review--to analyze the basic data on modifiable and genetic risk factors of pancreatic cancer (PC). PC is the most fatal disease that kills about 95% of patients. Among the known risk factors for PC only for smoking, obesity, and family history a positive association with the PC risk in meta-analyzes confirmed. The PC etiology remains unclear, more than 90% of patients acquire it sporadically. Currently, the most significant genes for PC include KRAS2, p16/CDKN2, TP53, SMAD4/DPC4. Mutations in the KRAS noted in 90% of cases of pancreatic ducts adenocarcinoma. p16/CDKN2A mutation is accompanied by a 38-fold increased risk of PC compared with the general population. TP53 mutations are associated not only with carcinogenesis but also PC metastasis, as well as SMAD4/DPC4 mutations. Study of the role of genetic aspects in the PC development is necessary both to identify individuals with high PC risk, as well as for the development of gene-specific treatments, such as inhibitors of proteins, histone deacetylase, and histone acetyltransferase (vorinostat, belinostat, entinostat, panobinostat, curcumin) are in clinical trials.

THE PURPOSE OF THE REVIEW: Analyze the basic data on the role of obesity in the pathogenesis of pancreatic cancer (PC) and the modern mechanisms of this association.RECENT LITERATURE DATA:In the European Union and in Russia incidence of pancreatic diseases increases, such pancreatic cancer (PC) ranks 10th among cancer diseases. Obesity is a risk factor for not only of severe acute pancreatitis, but also PC at that independently of diabetes. In a meta-analysis the PC risk in obese increased by 47%, while the person with a central obesity have a higher PC risk compared to those with a peripheral type of obesity (odds ratio = 1,45, 95% CI: 1,02-2,07), but association between BMI and PC risk in this Japanese population may be different from that in Western populations, sometimes inversely. The link between obesity and PC is explained by insulin resistance and hyperinsulinemia: was proved a direct correlation between the level of circulating C-peptide and PC, low levels of serum adiponektin and leptin increase the PC risk. There are also genetic risk factors for PC: a statistically significant interaction between IVS1-27777C> and IVS1-23525A>T genotypes of the FTO gene with obesity and the PC risk: AA genotype in patients with BMI < 25 kg/m2 reduced PC risk by 22%-28% (p < 0,0001), and with BMI ≥ 25 kg/m2 was associated with 54%-60% increased PC risk (p < 0,0015). Lifestyle factors (smoking, consumption of saturated fats, etc.) increase the PC risk.

Review of the literature devoted to one of the most important problems of modern medicine--nosocomial infections (NI). In the article there are examined relevant, epidemiology, pathogenesis, and criteria for NO determining. Special attention is paid to the mutual influence of gastrointestinal tract pathology and nosocomial infections.

THE PURPOSE OF THE REVIEW: Present new data on the causative agent, pathogenesis, diagnosis and treatment of opisthorchiasis.RECENT LITERATURE DATA:When samples of parasites were genotyped by novel nuclear marker Pm-int9, it was shown various properties of Opisthorchis viverrini, O. felineus and C. sinensis. It has been proven the oxidant damage to DNA of biliary epithelium cells infected with opisthorchiasis, and overexpressed of cellular protooncogene c-Ski, as well as platelet-derived growth factor alpha (Pdgfa) gene, which in some cases leads to the development of cholangiocarcinoma. Describes the innovations in the diagnosis of opisthorchiasis: primers OP1 and OP2 are used to amplify the ITS2 region rDNK eggs and metacercariae of Opisthorchis in feces. Opisthorchiasis treatment remains traditional - praziquantel, at least - with albendazole. Treatment of opisthorchiasis patients with praziquantel was shown to reduce inflammation-mediated tissue damage and carcinogenesis.

THE PURPOSE:Analyze national characteristics of prevalence and association between gallstone disease (GSD) and diabetes mellitus (DM), both in the world and in Western Siberia, and some possible mechanisms of this association.RECENT LITERATURE DATA:Changes in human behaviour and lifestyle over the last century have resulted in a dramatic increase in the incidence of DM and GSD worldwide, many risk factors are common to these diseases (overweight, age, arterial hypertension, dyslipidemia, etc.). In some studies it was shown a higher prevalence of gallstones among patients with DM compared with persons without DM, in others - there were no association between GSD and DM. In epidemiological study in frame of the WHO "MONICA" in the unorganized population of Novosibirsk in Western Siberia (1994-1995 years) it was shown, that in the male population aged 35-54 years found no relationship between GSD and DM, in the female population aged 25-64 the prevalence of GSD was 10,5% and among women with DM the frequency of GSD showed 37.5% (univariate analysis: OR = 5.0 (CI 2.04-12.2, p = 0.001). The association between GSD and DM in women remained in multivariate logistic regression analysis, which includes age, BMI, arterial hypertension: OR = 3.9 (95% CI 1.47-10.5, p = 0.006). In the female population aged 25-64 years the prevalence of diabetes was 6.7%, among women with gallstone disease--20.0%, p < 0.05. Possible mechanisms for the relationship between GSD and DM--gallbladder hypomotility, decrease of cholecystokinin-A receptor (CCK-A) gene expression and decreased sensitivity to CCK, insulin resistance, decreased activity of PPAR-receptors (peroxisome proliferator-activated receptor) in patients with DM.

THE AIM:to investigate possible associations between quality of a life (QoL) and basic risk factors of the Gallstone disease--GSD--sex, age, adiposity, diabetes mellitus, an arterial hypertension.MATERIALS AND METHODS:QoL at 142 GSD patients by means of questionnaire MOS SF-36 and a specific questionnaire to GSD patients "Gallstone Impact Checklist" (GIC) has been estimated.RESULTS AND CONCLUSIONS:among GSD patients a male (on a pain scale of GIS), age (on scales PF, RP, RE of SF-36), obesity (on all scales of questionnaire GIC, except a dyspepsia scale, and on scale PF of SF-36) and a diabetes mellitus (on scales of emotions, a food and eating an overall account of GIC) associated with considerable decrease in the QoL indices, but the presence of arterial hypertension does not influence.

UNLABELLED:The aim of the study was to evaluate the quality of life in patients with gallstone disease (GSD) in the remote period after cholecystectomy for various forms of surgical intervention and the disease (latent or symptomatic). Also we compared them with the indicators of quality of life of patients with cholecystolithiasis.MATERIALS AND METHODS:In an open clinical study were surveyed 170 patients with gallstone disease, of which 60 people were operated for gallstone disease, 110 patients had cholecystolithiasis. At 1/3 of patients with gallstone disease was asymptomatic, in 2/3--with clinical manifestations. To assess the quality of life using were validated specific questionnaire for patients with gallstone disease--Gallstone Impact Checklist.RESULTS:Among all patients with cholelithiasis who underwent cholecystectomy that asked for gastroenterologists help patients the quality of life was significantly worse on the scale of power (26.0 +/- 2.8 points) and the joint account (89.0 +/- 9.6 points) than in patients with stones in the gallbladder (16.5 +/- 2.2 and 61.0 the mini-access (total score 83.6 +/- 13.7 points), did not differed from those after laparoscopic cholecystectomy (85.0 +/- 10.9 points, p > 0.05). For those patients with cholelithiasis in which the disease before surgery were no symptoms quality of life (general account) decreased more significantly (to 29.8%) compared to patients with cholelithiasis who have this disease before the operation proceeded with clinical manifestations (4.1%), when compared with the total score of all examined patients with CL.CONCLUSIONS:Quality of life in patients with gallstone disease in the postoperative period after cholecystectomy was significantly worse than the individual scales of the questionnaire GIC compared to patients with stones in the gallbladder, regardless of the type of operation (from the mini-access or laparoscopic). In this patient with a latent course of gallstone disease before the operation quality of life significantly worse on all scales than patients with clinical symptoms before surgery.

Blood serum Lp (a) level's increasing accompanied significant rising of gallbladder bile lithogenicity in the women with gallstone disease (GSD) with verified cholesterol gallstones. Apolipoprotein (a) (Apo (a)) isoforms B, S1 (most atherogenic) frequency in the women with GSD was significantly higher, and isoforms Apo (a) 0, S4 - significantly lower than in the women in control group without GSD. Gallbladder bile was significantly more lithogenic in the women with GSD who had Apo (a) B and S1 isoforms than in women with GSD with isoforms Apo (a) 0 and S4.