German O. Clinico-instrumental and morphological description in upper gastro-intestinal tract in juvenile rheumatoid arthritis and correction of disorders detected

The thesis is dedicated to the research of the upper gastrointestinal tract state within children with juvenile rheumatoid arthritis, depending on the composition of the treatment, prevention of the development and progression of gastroduodenal pathology within these children and the improvement of safety pharmacotherapy of disease by amelioration of the complex of therapeutic interventions using methotrexate (MTT) with parenteral way of injection. Morphological changes of the gastroduodenal were registered in 79.3% of patients and significantly depend on the degree of activity of JRA, its clinical form and kind of therapy, whereas endoscopic picture of the esophagus, stomach and duodenum proving only 61.9% of cases, what justify the need of fibroezofagogastroduodenoscopy within children suffering from juvenile rheumatoid arthritis with a compulsory target biopsy. Particular attention is drawn to the comparison of tablets and parenteral forms of the main basic medicine - methotrexate. The role of other factors in the development of pathology of the upper gastrointestinal tract was disclosed it appears to be infection with Helicobacter pylori. The expediency of MTT usage by parenteral way of injection in conventional doses to reduce the risk of surface and erosive changes of the mucosa of the stomach, duodenum in children with JRA was scientifically proved, especially in cases with concomitant application of methotrexate and non steroid anti-inflammatory medicines. Obtained findings suggest optimal efficacy and safety profile of parenteral methotrexate in long-term use within children with JRA.