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The multicenter prospective observational study initiated by the European Helicobacter and Microbiota Study Group (EHMSG) is conducted in 27 countries in Europe. The data from the Russian part of the European registry for the management of Helicobacter pylori infection (European Registry on the management of Helicobacter pylori infection, protocol: “Hp-EuReg”) allows us to analyze the real clinical practice of diagnosis and treatment of H. pylori and compare it with international recommendations. Materials and methods. A comparative analysis of the data entered in the register by the Russian research centers “Hp-EuReg”, in the period from 2013 to 2018, was conducted. Results and discussion. Invasive diagnostic methods prevail for the primary diagnosis of H. pylori [histology - 20.3% (in 2013 year) - 43.9% (in 2018 year), rapid urease test - 31.7% and 47.8% respectively]. The most popular mode of eradication therapy is a 10-day triple therapy (62.8-76.2%), the effectiveness of which does not exceed 79% (per protocol). Invasive tests (histology) are the leading method for control the effectiveness of therapy, however, there is a tendency towards a wider use of non-invasive methods (H. pylori stool antigen - from 17% in 2013 to 29.3% in 2018 and urea breath test from 6.9 to 18.3%, respectively). Serological test to control the effectiveness of eradication is still used from 8.2% (2013) to 6.1% (2018). Eradication therapy was not performed in 28% of patients throughout the entire observation period. Conclusion. In Russia, despite approved domestic and international recommendations, deviations in clinical practice persist, both during eradication therapy and in monitoring the effectiveness of eradication therapy.

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The human body, like any other, is an intermediate component of the nitrogen cycle in nature. Consuming nitrogen from the external environment in the form of various compounds, the body processes it into ammonia - one of the final products of exchange of nitrogen-containing substances [1], which is removed from the body in the form of urea. The most active ammonia producers are organs with high exchange of amino acids and biogenic amines - nerve tissue, liver, intestine, and muscles. In a state of nitrogen equilibrium, the adult body consumes and releases about 15 g of nitrogen per day, temporary or permanent disruption of nitrogen balance results in a great number of physiological conditions and diseases, and the need to stabilize it is well known. However, despite a huge number of studies on the role of nitrogen metabolism and its compounds in the clinic, to date we have not been able to find any conciliation document in the world literature on the classification of ammonia-ammonium levels in human blood and approaches to the correction of hyperammonemia, which was the basis for the emergence of this consensus.