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A I Parfenov

Publications and source records attributed to A I Parfenov.

At least 19 recordsLinked to original sources
PubMed1992

[Crohn's disease. The problem of early diagnosis].

A retrospective analysis was made of the diagnostic period of Crohn's disease as well as of x-ray and endoscopic signs in 28 patients. Three forms of the disease were distinguished: acute (pseudoappendicular), stenosing with chronic intestinal obstruction syndrome and primary chronic characterized by the triad (pains in the stomach, diarrhea, fever) or by the syndrome of malabsorption with extraintestinal manifestations. In the stenosing and primary chronic forms of Crohn's disease, a correct diagnosis was established in the majority of the patients 3-5 years after appearance of the symptoms. To improve early diagnosis of Crohn's disease, it is recommended that indications for x-ray and endoscopic examinations be extended. These examinations are indicated in all the patients with recurrent pains in the right iliac area, fever of obscure genesis and chronic diarrhea.

Colonoscopy↗
PubMed1992

[Gluten enteropathy].

The authors relate the results of 10 years of observations of 113 patients suffering from gluten enteropathy (GE) of the adults. In all the patients, the diagnosis was supported by the presence of hyper-regenerative atrophy of the small intestinal mucosa (total in 70% and subtotal in 30%). Metabolic disorders and cellular immunity were investigated. At the onset of the observations 70.7% of the patients demonstrated malabsorption, stage III gravity, and 29.3% stage II. It has been proved that permanent and strict adherence to the agluten diet and administration of corticosteroids in the most severe cases in combination with pathogenetic therapy of diarrhea and metabolic disorders permit attaining a steady clinical remission, improvement of normalization of the biochemical and immunological characteristics, a tendency toward normalization of the small intestinal mucosa, and even the recovery of its normal structure in part of the cases.

Adolescent↗
PubMed1991

[Treatment of chronic diseases of the small intestine].

Multimodality and differentiated treatment of small-intestinal diseases is to combine methods of etiological action with pathogenetic treatment of the main clinical syndromes: chronic diarrhea, malabsorption syndrome, hypercatabolic exudative enteropathy. Each nosological form should be treated specifically. Pathogenetic treatment involves diet therapy, chemotherapeutic correction of metabolic processes (vitamin administration, recovery of normal protein and lipid metabolism, water and electrolyte balance, anemia), management of chronic diarrhea. Treatment regimens are specified for gluten enteropathies, total variable immunodeficiency, Whipple disease, small-intestinal diverticulosis, Crohn's disease, amyloidoses, intestinal lymphoma and retroperitoneal lymph nodes. Clinical experience justifies the above methods as highly effective.

Chronic Disease↗
PubMed1991

[Mechanisms of the development of the chronic phase of diseases of the small intestine].

The results of studying mechanisms underlying chronicity of functional (chronic enteritis ) and severe organic (celiac disease) lesions of the small intestine have been analyzed. Mechanisms causing the diseases take a chronic course appeared very similar. They involve bacterial proliferation in the intestine with consequent impairment of the digestion, absorption and motility resultant in derangement of metabolism. Defects in protein and lipid metabolism proved most essential. Chronic enteritis is associated with a favorable outcome provided there are no grave malabsorption symptoms. Combined treatment as a rule produces good therapeutic response in chronic enteritis and celiac disease. Relevant schemes are presented.

Amino Acids↗
PubMed1991

[Current problems in the diagnosis and treatment of small intestinal diseases].

Based on the data obtained during clinical examination of 1,026 patients with small intestinal diseases the authors provide the portion of laboratory and instrumental methods employed in the diagnosis of different disease entities. The clinical picture of small intestinal diseases is mainly determined by the gravity of malabsorption. Histological examination of the small intestinal mucosa is a method of choice in the diagnosis of gluten enteropathy, Whipple's disease, primary lymphangiectasis and amyloidosis. Immunoassays play the key role in recognition of variable immunodeficiencies and disease of heavy alpha-chains. Meanwhile in differential diagnosis of Crohn's disease, small intestinal tumors, congenital abnormalities of rotation and in some others, the leading part is played by x-ray methods. The authors describe the treatment schedule based on the pathogenetic approach, that makes it possible to reach a stable clinical remission and recovery of the working capacity even in part of patients with stage III malabsorption.

Diagnosis, Differential↗
PubMed1990

[Disorders of lipid metabolism in patients with chronic diseases of the small intestine].

Lipid metabolism was evaluated in patients with chronic enteritis, celiac disease, general variable immunodeficiency (GVI), short-bowel syndrome. In chronic enteritis with malabsorption syndrome degree I and II changes in metabolism were characterized by hyperlipidemia due to high lipid fractions, mainly triglycerides; in malabsorption syndrome degree III (celiac disease, general variable immunodeficiency, short-bowel syndrome) by a drop of serum total lipids, phospholipids, cholesterol, beta-lipoproteins, free fatty acids, elevated concentrations of triglycerides. Changes in fatty acid composition of blood serum in patients with malabsorption syndrome degree III manifested by derangement of polyunsaturated fatty acids ratio. Arachidonic acid concentration was reduced in 100% of cases, linolenic acid in 45%. In all the patients with celiac disease and malabsorption syndrome degree III there was hypoactivity of lipolytic blood enzymes lipase and tributyrinase.

Celiac Disease↗
PubMed1990

[Hydrogen test: its diagnostic possibilities in intestinal diseases].

The determination of hydrogen in exhaled air by gas chromatography was used for investigation of patients with relapsing diarrhea of various genesis. An increased H level on an empty stomach, regarded as a sign of bacterial growth in the intestine, was detected in 45% of examines, mainly in celiac disease immunodeficiency, intestinal tuberculosis, diverticulosis, diabetic enteropathy, and erosive duodenitis. An increase in the H level in exhaled air after a lactose tolerance test (50 g of lactose) made it possible to diagnose lactose deficiency in 38% of patients with chronic relapsing diarrhea. In the irritable colon syndrome lactose deficiency was detected in 40% of patients.

Breath Tests↗
PubMed1990

[Diagnosis and treatment of psychogenic intestinal dyskinesia].

Intestinal dysfunction resulting from psychological factors associated with vegetative disorders were found in 79% of relevant patients. It is stated that comprehensive program of screening persons suffering from psychosomatic intestinal diseases should involve diagnosis of psychopathologic syndromes, analysis of personal traits, factors of psychic trauma, internal pattern of the disease. The treatment technique affecting all the levels of the disease (central, vegetative and somatic) provides good therapeutic effect and normal psychological profile in the majority of patients.

Adult↗
PubMed1990

[General variable immunologic deficiency with malabsorption syndrome].

Twenty-two patients with general variable immunodeficiency (GVI) and malabsorption syndrome (MS) were followed up for 2-12 years. III degree MS was found in 17 cases. Serum immunoglobulins concentration and T-lymphocyte count were reduced, the latter at the expense of theophylline-resistant and active E-RFC. With casein and milk albumin as the antigens, lymphokine-producing capacity of the mononuclear cells appeared elevated. MS treatment with adjuvant gamma-globulin produced a positive trend in clinical manifestations of the disease, content of T lymphocytes and relevant subpopulations. Long-term results were less favourable: partial compensation with recurrences persisted in 15 patients only. Seven patients died: two of pneumonia, five of cardiac failure and visceral dystrophy. All MS patients are recommended to undergo serum immunoglobulins diagnosis of GVI and in case of its verification to receive life-time gamma-globulin replacement therapy.

Adolescent↗
PubMed1989

[The role of disorders of secretion of pancreatic enzymes and bile and bacterial contamination of the small intestine in the pathogenesis of diarrhea in patients with celiac disease].

The study of 53 patients with celiac disease provided evidence for the impotent role of the inhibited hyposecretion of pancreatic enzymes, atony of the gallbladder responsible for abnormal bile acids introduction into the intestinal lumen in digestion, elevated concentrations of free bile acids at the expense of lowjugated ones in duodenal and jejunal contents as well as bacterial dissemination of the proximal portion of the small intestine in pathogenesis of diarrhea observed in celiac disease. It is concluded that inclusion of continuous courses of enzyme preparations and light cholagogues in the treatment schemes of celiac disease and administration in its exacerbation of adsorbents, astringents, antibacterial preparations should be necessary therapeutic measures.

Amylases↗
PubMed1988

[Chronic colitis].

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Chronic Disease↗