The high prevalence of H. pylori and diseases caused by this infection determine the relevance of discussing the problems of its diagnosis and treatment on the eve of the emergence of new international and domestic agreements. Studies published in recent years, including articles on the materials of the European Registry on the management of Helicobacter pylori infection (Hp-EuReg), provide a rich background for the analysis of errors in diagnosis and treatment of this infection, and the development of approaches to optimize clinical practice.

Since its discovery, H. pylori infection is known as one of the risk factor for the development of gastritis, peptic ulcer, GIT tumors and numerous other diseases such as psoriasis. Infection caused by H. pylori is posed as the top oncogene in the risk of the development of gastrocarcinoma (First class oncogene by Classification of International Agency for Research of Cancer). That is why the elaboration of fast and accurate methods of diagnosis (non-invasive methods especially) and proper treatment of Helicobacter infection is still very important. Throughout the time, knowledge about pathogenesis of Helicobacter infection have been expanded with the detection of adhesins, chemotaxins and multiple virulence factors related to invasion, adhesion and cytotoxicity of H. pylori. Invasive and non-invasive methods of diagnostics are currently being improved in effectiveness and accuracy. But still, due to different factors (e. g., dramatically increasing drug resistance), eradication of H. pylori remains big problem world-wide. Our review represents modern data on pathogenesis, diagnostics and treatment of Helicobacter infection.

The aim of the pilot study of a group of adolescents with H. pylori infection was to study the preliminary data obtained on the rs602662 locus of the FUT2 gene and to establish its role in the realization of clinical manifestations of chronic gastritis, gastric ulcer and duodenal ulcer associated with H. pylori.

Methods: The study included 91 patients. The study for the presence of the polymorphic locus rs602662 of the FUT2 gene was carried out by the standard TaqMan PCR method on a Real-Time CFX96 Touch amplifier. The duration of the study was 6 months.

Results: The main group included 25 adolescents aged 16 to 17 years 11 months, the control group included 20 patients. Patients infected with H. pylori more often noticed symptoms of dyspepsia - in 36%, compared with the control group - 9.7%. The presence of a family history in the main group for associated diseases had a significant difference, χ2 = 4.97, p <0.05.

To assess the contribution of the genotype of the rs602662 locus of the FUT2 gene to the risk of clinical manifestations in H. pylori infection, the main group was divided into subgroups. In the distribution of alleles in these groups, statistically significant differences were revealed.

Allele “A” has a protective effect against the onset of clinical symptoms of dyspepsia. The odds ratio (OR) with the carriage of allele “A” (genotypes A / A and G / A versus G / G) to have clinical symptoms with a positive H. pylori status was 0.175 (CI = [0.049-0.625] chi2 = 7.79 p = 0.0053).

Conclusion. As a result of the study, we were unable to identify a significant association of alleles and genotypes of the rs602662 locus of the FUT2 gene with clinical manifestations of H. pylori infection. At the same time, carriers of the A allele have a pronounced association with the absence of clinical symptoms in patients with a positive H. pylori infection status of 0.175 (C.I. = [0.049-0.625] chi2 = 7.79 p = 0.0053).

The aim of the article is to update the pathophysiological mechanisms that cause the appearance and activation of pathological peristalsis of the esophagus and stomach and associated esophageal-gastrointestinal-diaphragmatic noise, described earlier, designed to expand the diagnostic capabilities of physical methods for diagnosing hiatal hernia and to facilitate the differential diagnosis of this disease with other diseases of the chest. The result of the study is to describe 5 the pathophysiological mechanisms of developing hernia hiatal and lead to the emergence of pathological motility of the esophagus and stomach in the form of the strengthening or emergence of antiperistaltic waves. The resulting acoustic phenomenon is the essence of a new physical symptom in this disease - esophageal-gastrointestinal-diaphragmatic noise. The first mechanism that determines the pathological motor activity of the smooth muscle cells of the esophageal wall is the so-called esophageal “cleansing” peristalsis, which prevents the regurgitation of the acidic contents of the stomach into the esophagus, where the environment is normally neutral. The second mechanism that causes the appearance and strengthening of pathological peristalsis of the stomach is the deformation during the passage of its part through the esophageal opening of the diaphragm into the chest cavity. The third mechanism that determines the occurrence of pathological peristalsis of the esophagus and stomach is a violation of the secretion and metabolism of nitric oxide in diaphragmatic hernias. The fourth mechanism that leads to the appearance of esophageal-diaphragmatic noise is the pathological peristalsis of the esophagus and stomach in patients with hiatal hernia, which causes the appearance of antiperistaltic waves accompanied by gastro-esophageal reflux and manifests itself in clinically pathological belching. The fifth mechanism that causes pathological peristalsis of the esophagus is the phenomenon of hydrodynamic cavitation, which occurs as a result of regurgitation of the contents of the stomach into the esophagus. Understanding the pathophysiological mechanisms that cause the appearance of pathological peristalsis and antiperistalsis of the esophagus and stomach in patients with diaphragmatic hernia allows us to understand the causes of the sound phenomenon and the associated physical symptom in this disease.

Helicobacter pylori (H. pylori) infection is known to lead to various diseases such as gastric and duodenal ulcers, chronic gastritis and malignant diseases, including MALT lymphoma and stomach cancer. To date, various factors of pathogenicity and virulence of the H. pylori bacterium have been studied. The interaction of infection with host cells leads to the induction of inflammatory responses through the release of cytokines, activation of apoptosis or proliferation, which leads to inflammation and dysfunction of the epithelial barrier. This process can facilitate the movement of H. pylori virulence factors and inflammatory mediators into the bloodstream and promote or enhance the development of a systemic inflammatory response and the possible clinical effects of H. pylori infections outside the stomach. The purpose of this review is to clarify the available data on H. pylori-associated comorbidity with diseases of the cardiovascular, nervous, endocrine systems, autoimmune diseases and some other pathologies outside the digestive system.

The aim of the study was to evaluate the effect of eradication therapy on the quality of life of patients with chronic erosive gastritis induced with Helicobacter pylori. The quality of life was assessed according to the GIQLI questionnaire before treatment during incomplete remission, remission, and during the year. It was found that the exacerbation of the disease significantly changes the level of quality of life of patients, and the complex treatment, eradication of Helicobacter pylori, which stopped the exacerbation of the disease, gradually increases and brings this indicator closer to the control group. The gastrointestinal quality of life index can be used as an additional criterion for diagnosing the stages of chronic erosive gastritis, for evaluating the effectiveness of therapy, determining the timing of treatment, rehabilitation and prevention in the dispensary management of patients at the therapeutic site.

Currently, there is an urgent question of optimizing the treatment of stomach diseases associated with Helicobacter pylori, due to the increasing resistance of the pathogen to antibiotics and the presence of side effects of standard therapy. To optimize it, it is proposed to use probiotics as an additional or monotherapy. The review presents the results of studies of anti-helicobacter activity by in vitro and in vivo systems, as well as an assessment of the clinical effectiveness of various probiotic strains of microorganisms in eradication therapy. Several mechanisms of action of probiotics in the treatment of HP-related diseases are discussed. The problems and prospects of using personalized therapy of helicobacteriosis with probiotics and autoprobiotics, based on strains obtained from the gastrointestinal tract, are indicated.

Using an original computer program, a quantitative characteristic of the structural features of the cultures of two reference strains of Helicobacter pylori, identified by transmission electron microscopy, was performed. The results obtained made it possible to establish morphological, ultrastructural and brightness differences between individual bacterial cells of the studied strains. The proposed program, compiled in accordance with the requirements of computer vision technology, makes it possible to detect differences in the structure of bacterial cells that are not detected by visual assessment, and also opens up the possibility of studying the phenotypic heterogeneity of isogenic populations of Helicobacter pylori and its pathogenic significance.

The study features of premorbid background and the most significant predictors of the development of chronic gastroduodenal pathology in children and adolescents of school age. Materials and methods. The results of screening questioning of schoolchildren with chronic gastroduodenal pathology (CGDP) - n=286, and practically healthy schoolchildren - n=1023, from 6 to 15 years agо. The survey conducted according to the questionnaire developed by us, which includes 24 questions. The relative risk (RR) calculated using traditional statistical formulas with a confidence interval limit 95% CI (confidence interval). Results. In this study, it was found that the main nutritional reason for the development of СGDP in schoolchildren is a malnutrition - 69.2%, RR=2.25 (CI=1.81-2.79), and food for fast food - 65.0%, RR=4.19 (CI=3.45-5.09). The least observed was the abuse of spicy food - 4.9%, RR=1.24 (CI=0.80-1.91). The 42.7% of patients were constantly in a state of heightened psychoemotional stress - RR=1.6 (CI=1.32-1.93). Helicobacter pylori (HP) - infection was diagnosed in 57.7% of patients - RR=4.84 (CI=4.04-5.79), 29.0% of patients underwent acute intestinal infections - RR=2.74 (CI=2.29-3.27), and 62.3% had a history of hereditary burden of chronic diseases of the gastrointestinal tract - RR=1.65 (CI=1.34-2.02) Conclusion. The most significant predictors and premorbid backgrounds for the development of СGDP in schoolchildren are HP-infection (RR=4.84; CI=4.04-5.79; RRR=3.84), food for fast food (RR=4.19; CI=3.45-5,09; RRR=3.20) with the development of overweight and obesity (RR=3.64; CI=2.97-4.47; RRR=2.64), the presence of chronic foci of infection (RR=2.58; CI=2.05-3.23; RRR=1.58).

Helicobacter pylori (H. pylori) infection is one of the most common in the world. More than 50% of the world’s population is infected and infection rates are especially high in countries with poor socio-economic conditions. H. pylori causes gastroduodenal and extra-gastroduodenal diseases including such metabolic disorders as obesity, diabetes mellitus and non-alcoholic fatty liver disease. Recent epidemiological and clinical studies showed that the long-term persistence of H. pylori infection is associated with the development and progression of atherosclerosis and consequently cardiovascular diseases. However, the correlation between these conditions is ambiguous and there is not enough evidence to confirm it. The lack of consensus might be related to differences in diagnostic methods used for H. pylori and the variety of its genotypes. Considering high prevalence of H. pylori infection as well as high incidence of metabolic and cardiovascular diseases, a verified correlation between these can be of great epidemiological, prophylactic and clinical significance.

The aim is to study the effect of Helicobacter pylori infection on risk of developing gastroesophageal reflux disease. Materials and methods - cross-sectional observational study of 1007 patients with dyspepsia syndrome who underwent videoesophagogastroduodenoscopy with biopsy and histological examination of biopsy specimens of the gastric mucosa by OLGA-system. The age, gender, overweight, cigarette smoking, presence of Helicobacter pylori infection and gastritis stage were assessed. Results - the study showed a significant decrease in the incidence of gastroesophageal reflux disease in patients with positive H. Pylori status by 4% (RR 0,68; 95% CI, 0.49-0.94, p=0,041). The risk of developing gastroesophageal reflux disease significantly higher in overweight (RR 2,62; 95% CI 2,0-3,56; р<0,001) men (RR 1,76; 95% CI 1,33-2,32; р=0,0046) who smoked cigarettes (RR 3,23; 95% CI 2,45-4,24; р<0,001) and was not associated with the patient’s age and the stage of gastritis (р>0,05). Conclusion - a significant reduction in the frequency and risk of developing gastroesophageal reflux disease in patients with Helicobacter pylori infection is demonstrated.

Несмотря на крайне высокую степень инфицированности Helicobacter pylori в популяции Homo sapiens, подавляющее большинство инфицированных являются бессимптомными носителями. Широкое распространение инфекции H. pylori среди лиц без признаков патологии и низкая заболеваемость при хронической колонизации слизистой оболочки желудка указывают на то, что H. pylori с большей вероятностью является условно-патогенным микроорганизмом или патобионтом. Популяционная ликвидация инфекции H. pylori существенно снизила заболеваемость инфекцией H. pylori, однако появление устойчивости к противомикробным препаратам привело к их неэффективности.

1. pylori infection is widespread throughout the world. It causes chronic progressive stomach disease and is associated with conditions such as chronic gastritis, peptic ulcer disease, atrophic gastritis, intestinal metaplasia, and gastric cancer. H. pylori-associated gastritis is an infectious disease. The main route of transmission is intra-familial. The new strategy of “screening and treating all family members” in regions with a high prevalence of H. pylori, including Russia, is cost-effective and aimed at reducing the risk of infection spreading in the population, progression of changes in the gastric mucosa and the occurrence of gastric cancer.

Eradication therapy is the mainstay of treatment for H. pylori-associated diseases. A case of the development of tendinitis of the left patellar ligament proper during eradication therapy using a triple regimen with levofoloxacin for 14 days for exacerbation of duodenal ulcer is presented.