A retrospective analysis of 73 case histories of COVID‑19 patients were made to study the potential relationship between obesity, liver damage and COVID‑19. The average BMI of the study participants was 30.8 ± 5.8 kg/m2, waist circumference 103.5 ± 13.5 cm, 77 % of patients had abdominal obesity, 71 % of patients had cytolytic syndrome. There was not link between the presence of obesity and the level of transaminases. The degree of transaminases increase depended on the severity of COVID‑19 (level of ferritin, CRP, and oxygen saturation of the blood) and wasn't connected with BMI, waist circumference, and the presence of type 2 diabetes.

183 patients with non-alcoholic fatty liver disease (NAFLD) were included into the case control study. Objective. Development a medical decision support system to improve the prediction of metabolic risks in persons with comorbid NAFLD and gallstone disease (GD) after cholecystectomy. Materials and methods. The main group was represented by patients with NAFLD and GD (n = 88), of which 53 patients underwent cholecystectomy. The comparison group was represented by patients with NAFLD without GD (n = 95). A standard laboratory and instrumental examinations were performed, including elastometry to assess of the stage of liver fibrosis and assessment of the level of hormones leptin, its soluble receptor, adiponectin and insulin. Results. Patients suffering from GD and NAFLD had a symptom of dyspepsia and general weakness. High prevalence of type 2 diabetes (rs = 0.164; р ≤ 0.01) and сoronary heart disease (25.00 % versus 9.47 % in the comparison group; р ≤ 0.01), high level of LDL and GGT (rs = 0.228, р ≤ 0.01 and rs = 0.298, р ≤ 0.01) were found in patients with GD after cholecystectomy. The phenomenon of insulin and leptin resistance, high levels of adiponectin were detected in patients suffering from NAFLD and GD. Hyperleptinemia was observed in NAFLD patients with GD after cholecystectomy (H = 5.812, p ≤ 0.05, rs = 0.313, p ≤ 0.05). Cholecystectomy in patients suffering from GD and NAFLD was associated with the formation of progressive stages of liver fibrosis (rs = 0.366; р ≤ 0.01). Conclusion. We have developed a decision support system to assess of the possibility of cholecystectomy in patients with NAFLD and GD according to the level metabolic risk of cardiovascular diseases and NAFLD progression.

The article is devoted to the description of a rarely diagnosed secondary opportunistic infection in an HIV-infected patient – atypical mycobacteriosis. A feature was the predominant lesion of the digestive system. Clinical, laboratory and instrumental research methods and prognosis are analyzed. The diagnosis was verified only by sectional and histological examinations.

An original study evaluating the effectiveness and safety of mebeverin in treatment of abdominal pain in patients with irritable bowel syndrome (IBS) are presented. Materials and methods: 40 patients diagnosed with IBS, according to the Rome Criteria IV, were monitored. Patients depending on the type of therapy were divided into two groups: 20 patients of the first group had recommendations for lifestyle modification, a hypocaloric diet and took mebeverin per os at a dose of 135 mg three times a day 20 minutes before meals for a month; 20 patients of the second group received only recommendations for lifestyle modification and a hypocaloric diet. All patients were evaluated before and after treatment using the Gastrointestinal Symptom Rating Scale (GSRS), Visual-Analog Pain Intensity Rating Scale (0–10 points), SF‑36 Quality of Life Assessment Question, adverse events assessment. Colonoscopy was performed before treatment to exclude organic pathology of the colon. Results. After treatment patients in the first group had a faster and more significant relief of complaints compared to the second group, a significant improvement in the quality of life on the scales of physical and mental functioning, as well as almost complete disappearance of pain on a visual-analog scale (7.1 out of 10 points before treatment and 0.4 points after). Conclusions. Mebeverin in a dosage of 135 mg three times a day during a month contributes to a significant improvement in well-being, optimizes the quality of life of this category of patients, is effective and safe, which allows us to recommend its use as a first-line spasmolytic drug in the complex therapy of IBS, as well as in various variants of visceral abdominal pain.

The article presents the results of a study of the effectiveness of the use of an inhibitor of pancreatic enzyme secretion of octreotide (Octrade) for the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). It was shown that the administration of Octrade at a dose of 0.3 mg in 500 ml of 0.9 % NaCl by continuous intravenous infusion for 7 hours and then 0.1 mg of Octrade subcutaneously at 6 and 12 hours after the end of intravenous infusion significantly reduced the frequency of pancreatitis (4.0 % and 22.2 %; p < 0.05) and hyperamylasemia (8.0 % and 25.9 %; p < 0.05) after ERCP. It is concluded that Octrade is effective in preventing the development of pancreatitis and hyperamilasemia after ERCP.

Objective. To evaluate the diagnostic efficiency of the contrast-enhanced third-generation agent in the detection of angionephrosclerosis in patients with type 2 diabetes and non-alcoholic fatty liver disease background.

Materials and methods. 26 patients (9 men and 17 women; mean age 61.5 ± 4.3 years) with a confirmed diagnosis of type 2 diabetes mellitus and NAFLD were examined. All patients underwent complex diagnostics, including: quantitative ultrasound steatometry of the liver in the framework of combined elastography with visual and quantitative assessment of the attenuation coefficient of the ultrasonic wave; ultrasound examination of the kidneys in B-mode with vascular diagnostics in the Doppler mapping mode. Also, all patients underwent contrast-enhanced ultrasound examination of the kidneys with the contrast agent for the diagnosis of angionephrosclerosis.

Results. The method of CEUS of the kidneys with patients with type 2 diabetes and NAFLD has sensitivity of 92.7 %, and accuracy of 90.4 %. Color Doppler mode has sensitivity of 66.5–81.4 %, and accuracy of 58.4–73.6 %.

Conclusion. The ultrasound contrast agent may be used in the early diagnosis of angionephrosclerosis in patients with type 2 diabetes and NAFLD as a non-alternative imaging method with no radiation exposure and no nephrotoxicity.

The article is devoted to the description of a rare pathology of the digestive system – to an acquired anomaly of the stomach – the gastric volvulus. The clinical symptoms of the disease are analyzed. Gastric fluoroscopy is the leading research method that allows verifying this pathology. Conservative treatment methods are not effective. With volvulus of the stomach, surgical treatment is indicated.

Currently, patients quite often and often uncontrollably take antibacterial drugs, which leads to the development of various complications from many organs and systems. One of the most common adverse reactions to taking antibiotics is antibiotic-associated diarrhea. Moreover, such a pathological condition is due to both the direct effect of the drug, and a change in the composition of the intestinal microflora. Despite the frequent occurrence of antibiotic-associated diarrhea, this problem raises many questions among practitioners, since the risk factors for its development and methods of prevention have not been fully studied. This is especially important in patients who have undergone surgical interventions, since the combination in this contingent of the appointment of broad-spectrum antibacterial drugs and altered body reactivity in most cases leads to the development of adverse effects.

The original article presents the results of a study in which 12 patients with DM type 2 received 14-day therapy with an industrial probiotic (E. faecium L3 strains) or autoprobiotic (patient's own E. faecium). Therapy with the industrial probiotic and autoprobiotic had approximately the same effect on the severity of gastroenterological complaints and the quantitative/qualitative characteristics of the intestinal microbiota. In the group of E. faecium autostrain, there was a significant decrease of C-reactive protein.