Гастроэзофагеальная рефлюксная болезнь и функциональные расстройства пищевода в практике врача первичного звена с позиций v московских соглашений
Bibliographic record
Abstract
Summary Th e article discusses the pathogenesis, clinical features, diagnosis and treatment of gastroesophageal refl ux disease (GERD) from the point V Moscow agreement. Particular attention is paid to the diff erential diagnosis of GERD with functional esophageal disorders (FED) and atypical manifestations of GERD. Relevance of GERD is caused by increasing the number of complications, such as ulcer s and strictures of the esophagus, Barrett’s esophagus. Th e prevalence of GERD in Western Europe is 40-50 %. Typical symptoms of GERD — heartburn (81 %), belching and regurgitation symptoms, lump in the throat. Th e basic mechanisms of GERD pathogenesis include dysfunction of the lower esophageal sphincter (LES) and degradation of the antirefl ux barrier’s components, dysmotility of the esophagus and stomach, increased esophageal acid and / or bile exposure. Extraesophageal and atypical manifestations of GERD include pulmonary, cardiac, otolaryngologic and dental symptoms, which requires as endoscopy and 24-hour pH-study and further diagnosting testing to exclude diseases of pulmonary and cardiovascular systems, otolaryngology diseases, oral lesi ons mouth. Patients with FED have typical symptoms of GERD, but endoscopic mucosal changes of the esophagus and pathological gastro-oesophageal refl ux in the survey are not revealed. Th ere are four FED defi ned by the ROME III consensus, namely functional heartburn, functional dysphagia, globus and functional chest pain. Psychological factors such as anxiety, depression, stressful l life, environmental stress in childhood play an important role in development FED. Treatment of patients with PRP includes as standar d therapy antisecretory drugs, antacids and the prescription of psychotropic drugs such as tricyclic antidepressants and selectiv e serotonin reuptake inhibitors. According to its own data, psychovegetative disorders, which were evaluated by means of Beck dep res-sion test, Spielberg State-Trait Anxiety inventory (STAI), and Toronto alexithymia test (TAS), MIL, scale autonomic disorders, sleep disorders questionnaire, signifi cantly more prevalent in patients with FED. Treatment with citalopram resulted in a decrease in the frequency of esophageal and gastrointestinal complaints, reduce the severity of depression, anxiety and improve sleep quality.Keywords: gastroesophageal refl ux disease, functional esophageal disorders, functional heartburn, functional dysphagia, globus, atypicalEksperimental’naya i Klinicheskaya Gastroenterologiya 2014; 106 (6):78-84
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.020 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".