The growth of cognitive impairment (CI) in clinical practice makes us search for their new pathogenetic mechanisms, among which the effect of intestinal microbiota on the brain is currently being actively studied. The mechanisms of interaction of the axis “brain - microbiota” have not been completely studied. The aim of this study was to confirm the possible effect on the brain of the neurotoxin ammonia, which rises in the blood due to the syndrome of excessive bacterial growth (SIBO). Materials and methods: The article presents data from a clinical observation, which included an examination of 70 patients of the gastrocenter in Perm with dyspepsia syndrome, who studied changes in the intestinal microbiota, the level of ammonia of capillary blood, and cognitive impairment, and conducted a correlation analysis. Results: According to the results of a statistical analysis of the obtained data, we did not find any significant changes or significant correlations between the studied parameters. However, the identified tendency in the connection “SIBO - hyperammonemia - cognitive impairment” suggests that the presence of SIBO can aggravate the severity of not only existing gastroenterological manifestations, but also be a risk factor for hyperammonemia, as well as contribute to the formation of impaired human cognitive functions.

These recommendations are intended for primary care professionals: internists, general practitioners, paramedics and include a statement of the basic requirements for the follow-up of patients with a number of diseases of the digestive system. The main material of the methodological recommendations is presented by adapted sections from modern clinical recommendations of specialized societies on certain nosological forms of diseases and current regulatory federal documents on dispensary supervision of the adult population. The guidelines were approved by the Perm Regional United Organization “Professional Medical Community of the Perm Region” and the Ministry of Health of the Perm Region. Also, the main provisions of the recommendations were presented and approved at the National Congress of the Society of Therapists (November 19, 2021).

Исследование не имело спонсорской поддержки. Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. Аннотация Целью исследования было изучение особенностей венозного кровообращения нижних конечностей при хронических заболеваниях вен (ХЗВ) у мужчин с артериальной гипертензией (АГ). Выполнен сравнительный анализ параметров венозного кровотока нижних конечностей между двумя группами мужчин с АГ в возрасте 30-50 лет: тестовая группа с АГ и ХЗВ (63 человека) и контрольная группа с АГ без ХЗВ (30 человек). Тип исследования-одномоментный. АГ диагностировали согласно рекомендациям ESC/ESH (2018). Наличие ХЗВ оценивали по классификации СЕАР и результатов ультразвуковой диагностики патологических рефлюксов в поверхностных, глубоких и перфорантных венах обеих конечностей. С помощью допплерометрического исследования регистрировали в покое (лежа) в поверхностных, глубоких и перфорантных венах слева следующие параметры: диаметр и площадь просвета сосуда, скорость венозного кровотока и венозное давление. Выявлено, что в тестовой группе были больше такие параметры как: диаметр и площадь просвета поверхностных вен, скорость кровотока в поверхностных, глубоких и перфорантных венах. Тестовая группа характеризовалась более высоким венозным давлением, чем группа контроля. Выводы. Расширение вен, ускорение кровотока и увеличение венозного давления необходимо рассматривать как характерную особенность коморбидности АГ и ХЗВ. АГ и ХЗВ имеют общий патогенетический механизм-флебогипертензию, наличие которой необходимо учитывать при назначении гипотензивной терапии пациентам с АГ и ХЗВ.

AIM: to assess the effectiveness and safety of sodium picosulfate for screening colonoscopy.PATIENTS AND METHODS: the retrospective study included 299 patients at mean age of 54±14 years who had screening colonoscopy, . All patients received sodium pikosulfate for bowel cleansing. The quality of bowel cleansing was evaluated by the Boston international scale. Organoleptic and subjective sensations were also evaluated.RESULTS: the quality of bowel cleansing was 8.5±1.0 point by Boston scale. As a result of screening colonoscopy in 96 (32.1%) patients, polyps of the rectum, sigmoid, colon and ileum were detected in 11%, 8%, 11% and 2% of cases respectively. Pathology showed that 78 (26%) patients had adenomatous polyps, 13 (4%) – adenocarcinoma. All patients reported comfortable use of the agent.CONCLUSION: sodium picosulfate fully meets the requirements for the drug used for bowel cleansing for colonoscopy.