Colon cancer is currently a serious public health problem. The most important action in reducing morbidity and mortality associated with colorectal cancer is the introduction of screening programs including colonoscopy. The use of modern acquired endoscopy brings the accuracy of optical diagnosis closer to that of histopathologic diagnosis. The review provides an overview of existing classifcations and approaches which are used in Russia and abroad to describe and assess colonic epithelial lesions and to choose the best treatment. The use of common terminology simplifes the process of interaction between specialists in related felds throughout the medical stages which contributes to improving quality of treatment. This article may be helpful for endoscopists, gastroenterologists, surgeons, coloproctologists, oncologists and physicians of other specialties, both beginners and experienced

The mode and structure of nutrition clearly have an impact on health. Collected and summarized scientifc data on the positive and negative impact on the health of specifc diets. Self-preservation behavior encourages healthy people and people with chronic illnesses to make intuitive dietary changes to improve health or to prevent ill health. Due to the wide availability of professional information and the lack of basic knowledge among the masses, misconceptions arise that can potentially worsen the state of health. One of the trends of self-preservation behavior in recent years is adherence to the Paleolithic diet. Research shows positive health outcomes in people with overweight and certain chronic diseases, and controversial results in healthy people. Data from scientifc studies on the influence of the Paleolithic diet on metabolic processes, hormonal levels, the cardiovascular system, and the gastrointestinal tract have been accumulated. Results have been obtained confrming the effectiveness of the Paleo diet in metabolic disorders and overweight. There are controversial and conflicting results on the use of the Paleo diet for liver disease and disorders of the intestinal microflora. Data on thyroid disease and inflammatory bowel disease come from small samples and cannot be considered reliable. Based on the available research to date, it can be concluded that the inclusion of a Paleolithic diet in prevention and treatment regimens is possible. In any case, a change in diet should be regarded as a risk factor for the development of chronic diseases. It is necessary to systematically manage the self-preserving behavior of the population, at least in relation to nutrition, due to scattered, contradictory, often unreliable information about the safe composition of the diet. An independent choice of a nutrition system without appropriate qualifcation and assessment of the state can lead to the formation of false expectations from self-preserving behavior in general and the loss of confdence in nutrition as a factor in managing health.

Introduction. Non-drug therapy for obesity cannot always guarantee a positive result, which forces doctors and scientists from all over the world to look for new methods for analyzing the effectiveness of treatment, including using artifcial intelligence. Its active implementation can significantly improve the quality of diagnosis and prognosis of the disease. Purpose of the study. To evaluate the possibilities of using the artifcial intelligence system in predicting the effectiveness of non-drug therapy for obesity in children.

Materials and methods. An artifcial neural network was built using the Statistica Neural Networks software package based on data from patients who were hospitalized at the Voronezh Children's Clinical Hospital of the VSMU n.a. N.N. Burdenko.

Results. The study group included 60 children (30 boys and 30 girls), aged 8 to 16 years. We selected the parameters that, in our opinion, have the most signifcant impact on the effect of non-drug treatment of obesity: the presence and frequency of inpatient treatment; obesity complications; compliance with the regime of physical activity and dietary recommendations; dynamics of body weight during non-drug treatment. After training, the neural network MLP 5-5-1 was selected with determination coeffcients of 0.925231; 0.981940; 0.936712 for training, test and control samples. The learning error is 0.105782, the learning algorithm is BFGS. The activation function of hidden neurons is hyperbolic, and the output function is identical.

Conclusion. The results of the study show that an artifcial neural network can be used to evaluate the effectiveness of non-drug treatment with a minimum error.

СOVID-19 is a systemic disease with dysfunction of the immune system and damage to internal organs, including the liver. The purpose of the study is to fnd out the impact of the SARS-CoV-2 virus on the liver, the possibility of its recovery after a coronavirus infection. We examined 112 patients with a positive test for COVID-19. А clinical examination, clinical and biochemical blood tests, computed tomography of the chest, pulse oximetry, ultrasound examination of the abdomen were performed. All patients were divided into two groups based on the presence or the absence of cytolytic syndrome. It was found that liver pathology was detected in 48.2% of patients. These changes were accompanied by statistically signifcant lower levels of oxygen in the blood and a greater amount of damage to the lung tissue, disorders of the platelet germ of hematopoiesis. Three months after a coronavirus infection with liver damage, a third of patients had cytolysis syndrome. The use of ademetionine at a dose of 800–1600 mg per day led to the elimination of clinical symptoms, normalization of the liver.

Conclusion. Liver damage during coronavirus infection was common and had a hepatocellular nature, accompanied by hypoxia, increased lung tissue damage and changes in platelet count. Patients need to be examined to identify the presence of liver pathology, treatment of disorders using ademetionine.

The initial stage of infection is the penetration of SARS-CoV-2 into target cells that have receptors for angiotensin-converting enzyme type II (ACE2). Levels of ACE2 receptors in exocrine and islet cells of the pancreas are higher than in the lungs, suggesting the potential for SARS-CoV-2 infection to cause pancreatic injury, and most notably the development of acute pancreatitis. It has been established that SARS-CoV-2 can infect exocrine and endocrine cells of the pancreas ex vivo and in vivo. In the electronic search engines PubMed and Scopus, we searched for literature on the association of a new coronavirus infection COVID-19 with pancreatic pathology, with an emphasis on ‘SARS-CoV-2’ or ‘COVID-19’ and ‘pancreas’ and ‘pancreatitis’. The sources found indicate that direct, indirect and systemic mechanisms of damage to the pancreas in COVID-19 are possible. The review considers the prevalence of acute pancreatitis in COVID-19, features of diagnosis, clinic and prognosis. Special attention is paid to hyperenzymemia observed in COVID-19. The conclusion notes that there is fairly strong evidence for an association between acute pancreatitis and COVID-19, but the diagnosis of acute pancreatitis associated with COVID-19 is challenging as other potential etiological factors must be ruled out

Relevance. Currently, metabolic syndrome (MS) occurs in 20–30% of the population. The main age of patients is 20–65 years. The study of this syndrome is genetically determined, which indicates that insulin resistance is genetically determined. The obtained facts allowed us to consider MS as the principle of primary prevention of type 2 diabetes and its complications. MTS affects such vital organs as kidneys, pancreas, etc. Since the topic of the development of CKD in patients with metabolic syndrome is acute, a qualitative diagnosis of this complication is necessary. To date, such a method is non-ionizing contrast-enhanced ultrasound, which is not nephrotoxic and hepatotoxic and can be used in patients with reduced renal function.

Objective. Evaluation of the effectiveness of the multimodal approach in the algorithm of instrumental diagnostics of examination of patients with metabolic syndrome on the background of type 2 diabetes mellitus.

Materials and methods. A study of patients with metabolic syndrome (n = 240) was conducted in 2020–2022. When collecting and analyzing clinical and laboratory data, (n = 67) had metabolically associated fatty liver disease: 22 of them were women (32.8%), 45 men (67.2%), average age 51.0 ± 4.2. All patients were examined according to a single diagnostic algorithm, which included four stages. Stage 1. Examination of patients by specialists, including clinical and laboratory data, with the resolution of the conclusion (n = 67). Stage 2. Ultrasound of the liver with quantitative ultrasound steatometry with determination of the level of the attenuation coeffcient of the ultrasonic wave (n = 67). Stage 3. Conducting dualenergy X-ray absorptiometry (DXA) in the ‘Whole body’ mode (with an assessment of the percentage of adipose tissue, abdominal obesity index) (n = 67). Stage 4. Conducting multiparametric ultrasound of the kidneys in B-mode and colour Doppler mapping (CDC) mode in patients with CKD, followed by contrast-enhanced ultrasound (n = 14). The criteria for inclusion in the study are age over 18 years, metabolic syndrome.

Conclusions. 1. The algorithm of examination of patients with metabolically associated fatty liver disease may include extended ultrasound examination of the kidneys, including contrast-enhanced ultrasound examination of the kidneys as a safe and effective method of assessing chronic kidney disease. 2. Two-energy X-ray absorptiometry in the ‘Whole body’ mode is a highly sensitive method in determining and monitoring the components of the metabolic syndrome. 3. A multimodal instrumental study of patients with metabolic syndrome and type 2 diabetes mellitus makes it possible to identify possible complications at an early stage.

The article analyzes the problem of post-COVID syndrome, which is formed in a number of patients after an infection caused by the SARS-CoV-2 virus. The manifestations of the post-COVID syndrome are highly variable. Almost all organs and systems can be involved in the pathological process. In the presented report, two clinical cases of manifestation of post-COVID syndrome caused by dysfunction of the gastrointestinal tract are purposefully analyzed and discussed. In one case, the post-COVID syndrome manifested itself as a manifestation of dyspeptic disorders. The examination did not confrm the functional nature of the pathology. In the second case, a diarrheal syndrome was observed that arose 2 months after the infection with SARS-CoV-2. The peculiarity of the observation is that in a patient suffering from diverticular disease of the colon, a rapid growth of the polyp of the sigmoid colon was observed. The issue of the influence of infection on the progression of the tumor process is discussed.

One of the key problems of modern medicine is the bradienteria syndrome, which is manifested by a slowdown in the circadian rhythm of the enteral evacuation function at a frequency of defecation less than 7 times a week. From the standpoint of chronobiology and chronomedicine, the regularity of the circadian rhythm of defecation is the same circadian rhythm of the body as the regularity of the sleep-wake cycle. However, the chronophysiological mechanism of the regularity of the intestinal rhythm and the frequency of its occurrence among people of different ages remains poorly understood. The chronophysiological mechanism of violation of the regularity of the circadian rhythm of defecation shown in our work indicates the need to observe not only the frequency, but also the morning acrophase of this rhythm for the prevention of many complications arising from bradienteria in patients with chronic constipation.