Search

The aim of the study was the study of ten-year trends (1999-2009) of GERD symptoms and risk factors in schoolchildren in Novosibirsk from 14 to 17 years.The comparison of the results of the screenings performed at 1999 and 2009 was analyzed. Anthropometry, the survey to identify the symptoms of GERD and eating habits, smoking and alcohol consumption, determination of lgG and CagA antibodies to Helicobacterpylori were included at the program of screenings.No significant dynamics of GER symptoms in adolescents, except weekly heartburn among boys. Among the factors associated with dyspepsia and GER, there have been some mixed changes: the frequency of smoking significantly reduced, but the proportion adolescents with excess body weight have increased. Violations of the regime and diet, and Helicobocrerpylori-infection has not changed significantly.The frequency of GERD in adolescents remains high but does not reach the prevalence of GERD in adults.

The paper presents the long-term experience of Siberian epidemiological studies in the field of gastroenterology (cross-sectional and prospective). High prevalence of Helicobacterpylori infection (75-85%) in the adult population of Siberia, and the association with dyspeptic symptoms in different age groups are shown. The dynamics of infection in children and adolescents, the high detection rates of CagA-positive strains, the prevalence of the different phenotypes of gastritis and the predictive value of gastric atrophy biomarkers in relation to gastric cancer were studied. The importance of epidemiological studies for the formation of groups at risk for a number of diseases and the development of prevention programs is demonstrated.

This review deals with pepsinogen metabolism, physiological role, and clinical implications. Effects of various factors, e.g H. pylori, on pepsinogen levels are considered. It is concluded that non-invasive screening of gastric precancer conditions provides a cost-effective and efficacious approach to the prevention of this pathology.

Gastroesophageal reflux (GER) is frequent among the general population affecting 10-20% of adults. However, there is a notable lack of epidemiological data describing prevalence of GER in children. The aims of the present study were to assess the prevalence of GER symptoms (GERS) in adolescents and to evaluate factors associated with GERS including markers of H. pylori infection.All school students in grades 9-11 in four randomly selected secondary schools in Novosibirsk participated (449 adolescents, 189 boys, 260 girls aged 14-17). They completed the Bowel Disease Questionnaire, life-style questionnaire, and sera were tested for antibodies against Helicobacter pylori infection.Overall, 60% of adolescents experienced GERS (heartburn and/or acid regurgitation) over the previous year. GER symptoms on a monthly basis were reported by 22% of students, weekly GERS were reported by 9% of adolescents with the same frequency in both genders. GERS were related to family history of dyspepsia or GER, mother's lower educational attainment, overweight, unhealthy eating patterns, alcohol consumption, smoking, and H. pylori infection, as well as concomitant dyspepsia and irritable bowel syndrome. The majority of associations were more prominent in girls. Visiting a physician, endoscopic study, and school absenteeism were reported in the last year more frequently by adolescents with GERS vs those without GERS.Gastroesophageal reflux symptoms are frequent among the adolescent population and result in frequent use of health care resources. Some precipitated factors found in this study are modifiable and may be corrected in adolescent population.

In a prospective study the risk of subsequent gastric cancer (GC) was assessed in persons aged 45-69 over 5 years after the initial testing with a set of serological tests (pepsinogen I, pepsinogen II, gastrin-17, antibodies to Helicobacter pylori). The presence of gastric atrophy markers was a significant predictor of GC in the forthcoming years. Non-invasive techniques may be used in the formation of high-risk groups, followed by GC active surveillance.

Serum contents of 7 cytokines (IL-1, IL-1beta, IL-6, IL-8, TNF-alpha, INF-gamma, INF-alpha) were examined in 87 children aged 14-17 years according to presence of antibodies against Helicobacter pylori and cytotoxic CagA protein. There was a lack of difference in cytokine levels between infected and non-infected children. Thus H. pylori infection in children in contrast to adults does not cause changes in systemic cytokine secretion.

The authors describe a current approach to the laboratory diagnosis of chronic gastritis, by using the plates of serological tests: pepsinogen I (PG-I), gastrin 17, and antibodies to Helicobacter pylori (HP). These tests and a questionnaire were used to examine 168 persons aged 45-70 years, who were a random population sample. Almost a fourth of the adult population was observed to have pronounced gastric mucosal atrophic changes, which might be associated with the high prevalence of HP infection. The concentration of PG-I is high in the persons infected with HP, its cytotoxic strains in particular, its elevated level servers as a valid marker of peptic ulcer disease and gastroesophageal reflux.

The objective of this study was to assess the prevalence of gastroesophageal reflux symptoms (GERS) in 403 adolescents at the age of 14-17 according to the Helicobacter pylori status in a two-year prospective school-based survey. Initially the H. pylori infection was revealed in 55.3%. GERS were reported by 16.1% of H. pylori negative subjects, 17.3% of H. pylori positive but CagA negative adolescents, and by 30.3% of those being CagA positive. Over 2 years, among 275 subjects without initial GERS, symptoms appeared in 43 (15.6%), being 10.8%, 18.8%, and 21.0% in three groups under the study, respectively. The H. pylori infection (especially with CagA positive strains) in older children results in GERS, which can be explained by antral gastritis with a subsequent increase of acid secretion.

To study the prevalence of CagA-positive strains of Helicobacter pylori in Novosibirsk residents and to assess their relation to some clinical parameters.Random sample of the population (218 males and 220 females aged 25-64 years) was examined. Antibodies against Helicobacter pylori and CagA protein were tested in the sera using enzyme immunoassay. Gastrointestinal symptoms were evaluated with questionnaire.The prevalence of H. pylori infection was 88%, among H. pylori-positive persons CagA-positivity was revealed in 58%. Presence of antibodies to CagA protein was associated with dyspepsia (OR = 2.5, 95% CI 1.2-2.5) and history of peptic ulcer (OR = 3.6, 95% CI 1.0-14.5). CagA-positive subjects more frequently reported bowel disturbances, diarrhea, in particular (OR = 2.9, 95% CI 1.2-7.4).The data showed similar distribution of H. pylori and CagA-positivity among adult population in Russia and Eastern European countries. CagA-positivity is associated with peptic ulcer and dyspepsia.

During prophylactic examination of blood sera taken from the members of 59 families by the enzyme immunoassay, antibodies to H. pylori and CagA protein were determined. As shown in this study, the children of non-infected mothers proved to be infected in 6.3% of cases and the children of infected mothers, in 72.1% of cases (p0.001). The children of non-infected fathers were H. pylori-positive in 71.4% and those of infected fathers, in 58.4% of cases. The CagA status was found to coincide in mothers and their children (p = 0.01), but not in fathers and their children. These data indicate that children acquire H. pylori infection from the members of their family, mainly from their mothers.

The concentration of pepsinogen I as well as antibodies to Helicobacter pylori and CagA protein were determined in the blood serum in 84 schoolchildren at the age of 14-17 using the immune-enzyme analysis. The level of pepsinogen I did not depend on the sex, age, gastroenterological symptoms and ulcer occurrence in parents. However, the concentration of pepsinogen was higher in teenagers infected with H. pylori (89.6 ug/l) than in non-infected ones (69.4 ug/l, p = 0.012), this increase taking place mostly due to strains containing CagA.

The purpose of the present study was to evaluate the prevalence of H. pylori infection in various regions of Siberia and the Far East. A representative sample of adult Novosibirsk population participated in the study and four groups of native population of various regions of Siberia were examined, and patients' sera were tested using ELISA. H. pylori is widespread among Siberian populations with prevalence rates ranging between 71% and 92%. Almost maximum prevalence rates of H. pylori infection occurred by the age of 30 years, with only minor increase at older ages.

687 adults in 5 regions of Siberia and 79 children and young persons in Novosibirsk were examined. IgG antibodies to H. pylori in their blood sera were determined with the use the enzyme immunoassay. The detection rate of antibodies among the adult population varied within 70-87%, depending on the region, being somewhat lower among the population north of latitude 60 degrees (75%) in comparison with the population residing south of this latitude (86%, p0.001). In Novosibirsk the number of seropositive persons was found to be unrelated to sex, age and clinical manifestations of digestive tract diseases. A high detection rate of antibodies to H. pylori was registered in persons aged 25-34 years with a minor increase in older age groups. In children the detection rate increased with age: 29% in children of 5-10 years old and 56% in children 11-14 years old. By the age of 15 more than a half of the children had antibodies.

Helicobacter pylori (HP) is a widespread human pathogen closely associated with gastroduodenal diseases. Thirty-four males from one of the settlements of coastal Chukotka (72% of total adult male population, mean age 31.6 years) underwent upper endoscopy, and HP was examined histologically in antral biopsies (Giemsa stain). Histology revealed normal mucosa in 16%, antral superficial gastritis in 29%, and atrophic gastritis in 55%. HP was found in 40% of histological specimens of normal mucosa, in 100% of superficial gastritis, and in 77% of atrophic gastritis. Correlation was found between the degree of bacterial contamination and both the activity of gastritis and grade of mononuclear infiltration. Data indicate a high prevalence of HP among Chukotka Natives (77%) which may partly explain the significant frequency of antral gastritis in this population.

The study of a complex of anamnestic, clinicoendoscopic and functional-morphological characteristics in type I and II (according to Johnson) gastric ulcer.Esophagogastroduodenoscopy, gastric secretion tests, determination of blood group and Rh factor were performed in 91 patients (52 patients with ulcer type I and 39 with ulcer type II).Ulcers type I have arisen in the presence of long-term chronic gastritis. They were associated with marked changes in the mucosa of gastric body, its atrophy and intestinal metaplasia, persistent recurrences in the same gastric zone. Ulcers type II are characterized by hereditary loading, 0(I) blood group, combination with gastroduodenal erosions, season occurrence, trend to migration and recurrence in different gastric or duodenal zones, HCl hypersecretion, high occurrence of Helicobacter pylori infection.It is thought valid to include types of gastric ulcer in current classification of ulcer.

Patients with gastroduodenal ulcer, chronic gastritis (CG) and healthy controls (124, 57 and 24 subjects, respectively) were examined for intensity and duration of duodenogastric reflux (DGR). These indices were assessed by concentrations of gastric juice bilirubin. It is found that DGR occurred in 29% of the examinees free of gastroduodenal diseases, does not correlate with morphological CG-induced changes and Helicobacter pylori contamination degree. The reflux in CG seems to be secondary in pathogenesis of this disease. In patients with aggravated duodenal and gastric ulcer the reflux in the basal stage is 2-2.5 and 5-6 times higher than in the controls, respectively. DGR parameters correlated with the height of the ulcer defect. Retrograde entrance of the duodenal content into the stomach in duodenal ulcer enhances acid production in the stomach through gastrin mechanisms.

Corpus atrophic gastritis (CAG) maybe the outcome of Helicobocterpylori (U pylon) - infection or autoimmune damage of the parietal system, affecting the risk of gastric cancer and requiring different approaches in the treatment and observation.To study the prevalence and peculiarity of CAG in population with, high prevalence of H.pylori infection.Prevalence of CAG was studied in the representative group of Novosibirsk citizens (246 subjects aged 45-69,117 males and 129 females) using serology for noninvasive testing of gastritis phenotype Gastro-Panel. Pepsinogen I (Pgl) level30 pg/I and/or Pgl/Pgil ratio c 3.0 were interpreted as sever atrophy. In addition, a clinical group with serologically proven corpus atrophy was studied: 39 females and 8 males aged 38-79. Upper endoscopy and morpholojical examination was performed in 38 patients. As a pilot project, in 19 patients with suspicion on autoimmune gastritis (AIG) (low Pgl + high Gastrin-17) parietal cells antibodies (PCA) and vitamin B12 level were determined.In Novosibirsk population prevalence of both H.pylori infection and CAG (10.2%) is high. AIG is often associated with H.pylori infection (in 47.4% of cases); however, its role demands a further evaluation. Autoimmune phenotype of gastritis which was found using noninvasive diagnostic was confIrmed with the presence of PCA. In all cases ofAIG atrophy was confirmed morphologically with the presence of intestinal metaplasia in 52.6% and ~ysplasia in 10.5% of cases.