With liver diseases, jaundice syndrome is one of the most common. It is extremely important for the doctor to suspect and identify this syndrome in the early stages of the disease, as well as decide which hospital to hospitalize the patient: infectious, surgical or therapeutic. The detection of jaundice syndrome during the initial examination, as a rule, does not require therapeutic additional research methods, but a common pathology accompanied by jaundice syndrome is an alcoholic liver disease.

Objective. To assess the correlation between the presence of excess body weight and the development of constipation and heartburn in patients with a gastroenterological profile. Materials and methods. A questionnaire was completed for 51 patients of the gastroenterological department using the author's questionnaire, which takes into account the following indicators: age, height, body weight, body mass index (BMI), stool frequency, once a week, type of stool according to the Bristol scale (1–7), frequency of heartburn (once a week), severity of heartburn (on a scale from 0 to 10 points). Statistical processing was performed using the SPSS 8.0 program, the clinical base was the Elizabethan Hospital (Saint Petersburg). Results. The following correlation relationships were identified: 1) BMI – age. BMI increases with age: r = 0.329 (p = 0.014); 2) stool frequency – age. With age, a decrease in stool frequency occurs: r = –0.651 (p < 0.001); 3) the type of chair on the Bristol scale is age. With age, the type of stool shifts toward constipation: r = –0.515 (p < 0.001); 4) gender – frequency of heartburn. The female sex is more likely to suffer from heartburn: r = –0.269 (p = 0.047); 5) the type of chair on the Bristol scale – BMI. With an increase in BMI, the stool shifts toward constipation: r = –0.307 (p = 0.023); 6) frequency of heartburn – body weight. With an increase in body weight, the frequency and severity of heartburn increase: 0.439 (p = 0.001); 7) the frequency of heartburn BMI. With an increase in the frequency and severity of heartburn, BMI increases: 0.403 (p = 0.002). Conclusions. The correlation relationships revealed that overweight people require an active survey regarding the presence of complaints of constipation and heartburn, as well as monitoring the status of patients in dynamics for the early detection of concomitant gastroenterological pathology and prevention of esophageal cancer in patients with heartburn and colorectal cancer in patients with constipation.

Introduction. Nutritional support (NS) is one of the areas of accompanying therapy in the treatment of tumors. The tactics of detoxification nutrition are still debated. Material and methods. 108 patients with colorectal cancer who received standard NS (58 people) and NS with a detoxification food component (50 people). Evaluation of the effectiveness of NS was carried out according to the criteria alimentazione-volume diagnosis and parameters of metabolic syndromes, characteristic for the cancer patients. The results obtained allowed us to identify the stages of nutritional extinction (NE). The detoxificating NS is indicated in the second phase of treatment, in the first phase of NS is appropriate depending on the needs of the body. Conclusion. The alimentory program should be assigned depending on the degree of nutritional extinction.

The article demonstrates the diagnostic effectiveness of clinical, laboratory and instrumental methods for the differentiation of clinical and morphological forms of acute destructive pancreatitis. The importance of such promising methods as minimally invasive multi-frequency bioimpedancemetry of the pathological focus, the crystallographic study of aspirate performed during fine-needle diagnostic puncture and differential diagnosis of exudative complications of acute destructive pancreatitis is shown. The results obtained determine the necessity of a comprehensive approach with the expansion of the diagnostic algorithm by using fine-needle diagnostic puncture. A comprehensive assessment of diagnostic methods significance can increase the effectiveness of differential diagnosis of clinical and morphological forms of destructive pancreatitis, thereby allowing to timely determinate the tactical position in the treatment of this category of patients.

Currently, a large number of studies have been published supplementing our knowledge of sarcopenia and its effect on the development of metabolic disorders, including the formation of non-alcoholic fatty liver disease (NAFLD). This data allows a new look at the pharmacological and non-pharmacological ap proaches to the treatment of NAFLD, based on basic physiological processes, including the biological axis the ′muscle – the liver′. This provides a compelling rationale for studying skeletal muscle as the main therapeutic target for NAFLD and metabolic syndrome.

The work was performed on experimental material. An experimental model of thyrotoxicosis in laboratory animals, white male rats, was obtained by daily administration оf l-thyroxine at a dose of 1.6 mg per 1 kg of body weight. The duration of the experiment was 45 days. 67 mature rats weighing 250–300 g were selected for the experiment. Rats were removed from the experiment after 7, 14, 21, 28, 35 and 45 days. As a control, we used 22 rats that were not injected with L-thyroxine. The level of thyroid hormones in the blood of rats was determined by enzyme immunoassay. A macroscopic study was performed and the size and mass of the rat liver were determined. For histological examination, pieces of liver tissue were taken, and they were fixed in 10 % buffered formalin for 10 days. Histological preparations were prepared by the standard method, using histological, histochemical and immunohistochemical studies. The results of the study showed that in experimental thyrotoxicosis, the level of thyroid hormones increases: T3 (triiodothyronine) equals 21.37 ± 0.03 mmol/l, 4.75 ± 0.02 mmol/l in the control; T4 (thyroxine) equals 2.55 ± 0.03 mmol/l, 1.80 ± 0.03 mmol/l in the control. Macroscopic examination revealed a 2-fold increase in the size and weight of the liver. Histological examination revealed widespread interstitial edema of the liver stroma, dystrophic and destructive changes, necrosis of hepatocytes, formation of cavities, thinning and atrophy of the liver beams, lymphocytic infiltration. The immunohistochemical study shows a decrease in Ki-67 expression level to 1.8 % compared to the control (5.0 %), which indicates a decrease in reparative processes in the liver.

The article presents the results of the diagnostic effectiveness of non-invasive methods for assessing the state of the liver parenchyma, such as liver elastography (transient, strain and 2D shear waves) and the current trend in medical imaging contrast-enhanced ultrasound (CEUS). 25 people aged 31 to 72 years with chronic viral hepatitis B and C were examined. All patients underwent multiparametric ultrasound examination of the liver: ultrasound in B-mode, color Doppler’s mapping of liver vessels, elastography (transient, strain and 2D shear waves), CEUS with 1,0 ml of the contrast agent and subsequent analysis of contrast parameters in the arterial, portal and late venous phases. The liver biopsy was used as a reference method, which was performed after receiving voluntary informed consent in 100 % of cases.

Introduction. Despite the rather long path of development of nutritionology and its significance, a number of doctors and managers of medical institutions do not take into account the level of nutritional safety of the patient. Even after evaluating the operational and anaesthetic risks, there is still a risk of developing metabolic complications that lead to a prolonged postoperative period and surgical problems. The goal. To show the need for metabolic counseling (consultation of a nutritionist) already in the preoperative period, which may limit the choice of the nature of surgery. Material and methods. Two groups of patients with pancreatic head adenocarcinomas (who have passed neoadjuvant consultation only by a surgeon and anesthesiologist and who have passed consultation by a surgeon, anesthesiologist and nutritionist). All patients were assessed for operational, anaesthetic and nutritional risks using standard methods. Results. Neoadjuvant nutritional correction is a mandatory component of treatment of patients with pancreatic cancer. In determining the treatment strategy, consultation with a nutritionist before surgery on the pancreas is mandatory, as consultation with an anesthesiologist and a surgeon.

Background. According to existing data, the decisive role in the development of gallbladder cholesterosis is played by the lipid metabolism violation of the body. In this regard, the most important stage in the complex treatment of this disease is correction of the detected lipid disorders in the patient, which contributes to regression and stopping the pathological process progression in the gallbladder wall. Materials and methods. In this work the safety and efficacy of using the drug Vazosponin (Vifitech, Russia) in the treatment of dyslipidemia in 50 patients with a verified diagnosis of non-alcoholic fatty liver disease and gallbladder cholesterosis was evaluated. The main group (n = 25) of patients received Vazosponin at a dosage of 400 mg per day in addition to dietary recommendations as a hypolipidemic therapy. The control group consisted of 25 patients, which received rosuvastatin at a dose of 10 mg per day in addition to the dietary recommendations. The total duration of observation for each patient was 84 days with three control points: before treatment, on the 28th and the 84th days of therapy. Results. The drug Vazosponin on the 84th day of therapy made it possible to achieve a significant (p < 0.05) and general decrease in total cholesterol by 38 %, LDL – by 17 %, VLDL – by 66 %, TG – by 47 %, CA – by 28 %. To the 84th day of the therapy with Vazosponin positive changes were revealed in the biochemical markers of liver function indicator as a significant (p < 0.05) decrease in levels of ALT – by 42 %, AsAT – by 46 %, GGTP – by 61 %, ALP – by 23 %, total bilirubin – by 41 %. In the main group of patients, adverse effects of therapy have not been established. Conclusion. The inclusion of Vazosponin in the treatment regimens for patients with non-alcoholic fatty liver pathology and gallbladder cholesterosis makes it possible to achieve significant and persistent lipid-lowering and mediated hepatoprotective effects.

(HP) infection was performed using invasive and non-invasive methods. The study group consisted of 95 patients with dyspepsia. HP infection was detected in 47 patients (49.4 %). The expediency of using a set of diagnostic methods for detecting HP (PCR, immunochromatographic, bacteriological and method for determining urease activity) is proved. Most often (100 %) in patients HP infection was detected in biopsies using the PCR method. Somewhat less frequently it was detected when examining biopsies with an invasive biochemical method (AMA RUT Reader) (82 %) and fecal immunochromatographic method (83 %). Despite the fact that helicobacteriosis was detected bacteriologically in a small number of patients (24 %), this method is of particular value, since it allows you to assess the sensitivity to antimicrobial drugs and probiotics, and does not give false positive results.