The aim of the study was to assess the tolerability and impact on the quality of life of pharmacotherapy for gastric ulcer, erosive gastritis using regimens including rebamipide. The quality of life of patients was assessed using the SF-36 questionnaire. Pharmacotherapy of gastric ulcer with the inclusion of rebamipide as part of the conventional treatment regimen provides data comparable to the healthy group on the scales of physical functioning, role functioning due to physical condition, pain intensity, general health, and vital activity. The results of our own research and data from literary sources indicate that rebamipide is a drug with a confident evidence base, good tolerance and safety of use.

The purpose is the tactics of nutritional rehabilitation after extensive intestinal resection. The metabolic characteristics of the short intestine syndrome and the consequences of combined fine-binding resections, as well as the adaptive and regenerative capabilities of the bowel, are presented. The optimal scheme of nutritional correction for the consequences of combined bowel resections is presented.

Conclusion. To stimulate adaptive-regenerative processes in the intestine, it is advisable to use teduglutide (analogue of GLP-2); if ineffective, surgical rehabilitation can be recommended.

The aim of the study was to assess the pathogenetic, diagnostic and clinical role of tissue molecular pathogens – fragments of cytokeratin-18 in the development of acute chronic liver failure (ACLF) in decompensated alcoholic liver cirrhosis (ALC).

Materials and methods. 80 patients with ALC were examined: 30 without signs of ACLF and 50 with signs of ACLF and 36 healthy individuals. Hepatic functional tests were determined, a marker of hepatocyte apoptosis – fragments of cytokeratin-18 (FCK-18) (Biotech, Sweden) by the enzyme immunoassay, ACLF scores were calculated using an on-line calculator at www.efclif.com/scientific-activity/score-calculators/ clif-c-aclf.

Results. With ACLF, a high level of FCK-18 was detected – 1505.4 ± 446.9 U/L, more than 20 times higher than that in healthy individuals – 71.5 ± 19.6 U/L (p < 0.05) and three times higher than the level of FCK-18 in patients with ALC without ACLF – 489.4 ± 490.2 U/L. The levels of aminotransferases, bilirubin, creatinine, INR were significantly higher in patients with ACLF compared with patients without ACLF, and the level of albumin was lower. FCK-18 level directly correlated with ALT – r = 0.61 (p < 0.05), AST – r = 0.68 (p < 0.05), with bilirubin level – r = 0.41 (p < 0, 05) and the ACLF score – r = 0.48 (p < 0.05) and inversely correlated with the albumin level r = –0.51 (p < 0.05).

Conclusion. Apoptosis of hepatocytes and tissue molecular pathogens released during it – fragments of cytokeratin-18 – play a role in the development of acute chronic liver failure in decompensated alcoholic liver cirrhosis.

Postinfectious irritable bowel syndrome (PI–IBS) is a distinct phenotype of the disease. The occurrence of gastrointestinal symptoms in PI–IBS is in direct chronological connection with an episode of acute intestinal infection. Previously the problem was considered as the outcome of parasitic, protozoal or bacterial infection. The global spread of a novel coronavirus infection (COVID-19) and increase in the number of new cases of IBS in the population suggests a renaissance of PI–IBS and makes us look at this problem again. This article summarizes and presents modern information on the possible mechanisms of development of PI–IBS, including in persons who have undergone COVID-19.

Purpose of the study. To study the level of blood calcium, reflecting the functional state of the calcium-regulating system (CRS), in the comorbid course of gastroduodenal ulcers (GDU) with chronic erosive gastritis / chronic erosive duodenitis (CEG/CED), arterial hypertension (AH), their symptomatic nature when taking non-steroidal drugs (NSAIDs) and find out its effect on the activity of the ulcerous process, the state of regional microcirculation and the secretory function of the stomach.

Materials and methods. 132 patients with GDU were examined. All patients were divided into groups: the first (39 people) – patients with recurrent peptic ulcer (PU) and CEG/CED, the second – 23 people with recurrent peptic ulcer and hypertension, the third – 20 patients with symptomatic gastroduodenal ulcers (SGDU) when taking NSAIDs. The fourth (control) group included 56 patients with PU without associated pathology.

Results and discussion. Recurrence of PUr, comorbid to its course with CEG/CED, AH, SGDU, when taking NSAIDs, occurs with an increase in the level of calcium in the blood, which contributes to the activation of the acid-peptic factor, impaired microcirculation and repair processes in the mucous of the gastroduodenal zone, the development and maintaining the ulcerous process.

Conclusion. Gastroduodenal ulcers are accompanied by dysfunction of the calcium regulatory system, which is characterized by an increase in blood calcium, which supports the formation of the main ulcerous mechanisms. In the treatment of comorbid and symptomatic gastroduodenal ulcers, it is necessary to include drugs for correcting the calcium-regulating system, which will increase the activity of sanogenic mechanisms.

Disorders of interstitial barrier permeability as one of the promising mechanisms of psoriasis formation and development is a trend of the last decades. In the analysis of modern works devoted to the evaluation of the role of intestinal barrier damage in the development of psoriasis, several ways of assessing intestinal permeability have been noted (including measurement of transepithelial electrical responses using a Ussing chamber, measurement of excretion of orally injected molecules, determination of dynamics and kinetics of LPS intestinal bacteria, immunohistochemical confocal analysis of uniform Z-sections perpendicular to the epithelial cell surface, etc.). However, most authors emphasize the diagnostic significance and availability of biomarker detection. Among the described biomarkers, claudin-3, fecal zonulin, α1-antitrypsin, calprotectin and intestinal fatty acid binding protein (I-FABP) are the most valuable. Through these methods of assessing intestinal permeability and the results of their studies, a number of authors practically prove the correlation between the violation of the intestinal microbiota, intestinal barrier permeability and the development of psoriasis, as well as its severity. This aspect is promising to the therapy of patients with psoriasis, which includes correction of intestinal microbiota and intestinal wall permeability.

The article is devoted to the description of the case of echinococcosis of internal organs. An algorithm for the diagnosis, treatment and control of this disease is presented. Echinococcosis of internal organs is not a rare pathology; however, it is often verified at a late stage. The disease after radical treatment is prone to relapse.

A polymorbid patient is a patient with several diseases occurring simultaneously at different stages and phases of their development. Patients with polymorbid pathology have a statistically significant almost 2.5 times higher risk (odds ratio [OR] = 2.41; p = 0.01) of pain syndrome and other diseases (for example, depression, arterial hypertension, etc.), which will contribute to the progression of polymorbidity. Individuals with chronic pain have a significantly increased risk of all causes’ death (hazard ratio [HR] = 1.95; 95 % confidence interval [CI]: 1.26–3.03) and cardiovascular causes (RR = 2.72; 95 % CI: 1.41–5.26) compared to patients without chronic pain. Therefore, in order to improve the prognosis and quality of life of the patient, both acute and chronic pain must be treated with non-pharmacological (exercise therapy, taping, virtual reality, etc.) and pharmacological methods. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for mild to moderate pain. The rational choice of NSAIDs in polymorbid patients can be difficult due to the presence of pathologies that limit their use or conditions that are risk factors of complications of drug therapy. In this article, the author present approaches to choosing the optimal NSAID in polymorbid patients, and justify efficacy and safety of administration of original meloxicam in these individuals (Movalis®, Boehringer Ingelheim International).

The increasing proportion of the population suffering from overweight or obesity is now taking on the character of a pandemic. In the literature, there have begun to appear reports of associations in individuals with impaired colonic motility and a body mass index above 25 kg/m2. The present publication was prepared to systematize data on possible mechanisms of colonic motility disorders in overweight and obese individuals, including through changes in adipokine secretion and function. The literature search was performed in Embase, PubMed, and Google Scholar, using the key words ‘colon motility regulation’, ‘adipokines’, ‘gastrointestinal hormones’, ‘intestinal microbiota’, ‘overweight’, ‘obesity’, ‘visceral fat’.

Among patients with autoimmune hepatitis concomitant autoimmune diseases occur in 40 % of cases. The most commonly associated autoimmune hepatitis is primary biliary cholangitis, primary sclerosing cholangitis and thyroid disease. With regard to the association of autoimmune liver diseases with each other there is experience in management and this is reflected in the clinical guidelines. Information on the features of comorbidity in autoimmune hepatitis and autoimmune thyroid diseases is very limited. This article presents our own clinical observation of the manifestation of thyrotoxicosis against the background of autoimmune hepatitis.

The aim. To study the quality of life and psychoemotional state of patients with non-alcoholic fatty liver disease against the background of primary hypothyroidism during the use of ethylmethylhydroxypyridine succinate.

Materials and methods. 111 patients with non-alcoholic fatty liver were examined, among them 35 were without thyroid dysfunction, 55 with compensated primary hypothyroidism, 21 with decompensated hypothyroidism. The patients underwent general clinical, biochemical, enzyme-linked immunosorbent assays of blood, instrumental studies, testing according to psychological questionnaires.

Results. With decompensation of hypothyroidism, a statistically significant increase in indicators of depression, situational and personal anxiety was revealed in comparison with patients without hypothyroidism. The examined patients showed an increase in the level of situational and personal anxiety. The presence of hypothyroidism in the examined patients significantly worsens these indicators, leading to an increase in the degree of anxiety, aggravated by decompensation of hypothyroidism. A positive dynamic was revealed in the correction of the psychoemotional status of patients in the observation group during the complex treatment with ethylmethylhydroxypyridine succinate: the severity of depression, situational and personal anxiety, manifestations of dyspeptic and reflux syndromes decreased.

Conclusion. Hypothyroidism affects the quality of life and psycho-emotional state of patients with non-alcoholic fatty liver disease: it worsens the degree of depression, situational and personal anxiety. The addition of ethylmethylhydroxypyridine succinate to standard therapy with sodium levothyroxine in patients with non-alcoholic fatty liver disease in the setting of hypothyroidism improves the quality of life and psycho-emotional state.