No abstract

The treatment of upper gastrointestinal bleeding (UGIB) remains one of the complex problems of clinical practice. In the structure of UGIB, 30%-60% of cases are occupied by bleeding of ulcerative etiology. Success in treating patients with ulcerative gastroduodenal bleeding is possible only with the use of an integrated approach that includes endoscopic, medicinal, endovascular, and surgical hemostasis technologies. In contrast, endoscopic hemostasis (EH) is crucial in the treatment of such patients. The use of modern advances in endoscopy can significantly improve the treatment results of patients with UGIB, reducing the number of operations and mortality in this severely affected group of patients. Modern therapeutic endoscopy has a wide arsenal of tools that can reliably stop bleeding. They differ from each other in the nature of impact, effectiveness, availability, safety, and cost. This article presents an overview of the technological and clinical features of hemostasis, modern views on the choice and application of methods of EH for ulcerative gastroduodenal bleeding.

Introduction: The article deals with to the new approaches to the immunotherapy of chronic cystitis. Cystitis appears to be a disease linked to the decreased immunity of the population. Materials and Methods: The study included 200 patients with chronic cystitis, and was performed in three stages. At the first stage, all 200 patients were questioned to determine whether they do or do not have the basic immunopathological syndromes. At the second stage, the patients of 6 clinical groups underwent a routine immunologic examination using tests to evaluate basic populations, lymphocyte subpopulations, immune globulins, circulating immune complexes, average weight molecules, absorbing and metabolic phagocytic ability, pro- and anti-inflammatory cytokines by using flow cytofluorometry methods. The third stage included distribution of the major group of patients with chronic cystitis in the relapse stage into subgroups of 25 patients each who received conventional therapy. Results and Discussion: The study has the following findings: the formation of risk groups depends on immunopathological syndromes and clinical-laboratory markers of disease peculiarities; signal tests of immunologic disorders and their correlative links with metabolic stress parameters were specified and formalized as diagnostic formulas; high clinical-bacteriological and low hemato-immunological efficacy of the conventional therapy patients with chronic cystitis and the capacity of the local and systemic modulators, such as kipferon, superlimf and imunofan, galavit, and their combinations, to normalize the parameters under study during 7-10 days were demonstrated. When combining the correctors, it was possible to achieve new quality independent of the properties of individual agents included in the composition; the reveal targets of various immune therapies were conditioned by the treatment provided, the characteristics of the correctors, the identification period – 7-10 days – 3-4 months. The analysis of the formulas of modulator targets made it possible to identify laboratory findings for their selection. Conclusion: The data obtained during the study support the fact that there was no clinical efficacy of the conventional therapy for patients; this efficacy was maintained through to the administration of the combination of modulators in the acute period. Substantiated differentiated immunotherapy resulted in implementing the proper algorithm of observations, which prevented recurring of chronic cystitis in 3-4 months.