Vladimir Ivashkin

• Academician of the Russian Academy of Sciences
• Head of Department at I.M. Sechenov First Moscow State Medical University

Aim. The clinical guidelines are intended to provide information support for making decisions by gastroenterologists, general practitioners and internists that will improve the quality of medical care for patients with non-alcoholic fatty liver disease, taking into account the latest clinical data and principles of evidence-based medicine. Key poin...

The Russian medical community has positively received “A multisociety Delphi consensus statement on new fatty liver disease nomenclature” and the EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). We consider it a big step forward, improving the doctors’ understanding o...

Aim: to demonstrate difficulties of differential diagnostics in the case of combined autoimmune pancreatitis, sclerosing cholangitis and ulcerative colitis. Colonic lesions that initially had low grade of inflammation were resistant to immunosuppressive therapy. Key points. A 28-year-old female patient was admitted to the clinic for jaundice associ...

Aim: to familiarize gastroenterologists, therapists, functional diagnostics and general practitioners (family doctors), radiologists, and endoscopists with modern methods of diagnosis and treatment of achalasia of the cardia. Key points. Achalasia is an idiopathic neuromuscular disease manifested by a functional disorder of the patency of the cardi...

Aim: to review the pathogenesis of thrombocytopenia and possible ways of its correction in patients with liver cirrhosis before elective surgical interventions or invasive procedures to optimize clinical practice. Key points. Thrombocytopenia is a common hematological complication of liver cirrhosis, affecting up to 75–86 % of patients with decompe...

Aim. These recommendations are developed for practitioners in order to familiarize them with modern diagnostic methods, management features and pharmacotherapy of patients with gastroesophageal reflux disease (GERD). General provisions . GERD is the most common reason for patients to visit clinics. There are esophageal and extraesophageal manifesta...

Aim: to highlight the challenges of diagnosing and treating a patient with severe intrahepatic cholangiolithiasis. Key points . Primary sclerosing cholangitis is a chronic progressive liver disease characterized by destructive inflammation and fibrosis in the bile ducts, leading to biliary strictures, secondary biliary cirrhosis, portal hypertensio...

Aim: to evaluate the effects of the probiotic Symbiosys Alflorex (Bifidobacterium longum longum 35624®) on the symptoms and quality of life in patients with irritable bowel syndrome (IBS). Materials and methods . A multicenter, observational program (SAGA) was conducted to evaluate the effects of Symbiosys Alflorex on symptoms and quality of life i...

Aim: to demonstrate an artificial intelligence model that optimises the differential diagnosis of achalasia. Material and methods . The study included 75 patients: 52 % men (mean age 44.5 ± 17.8 years) and 48 % women (mean age 45.6 ± 16.6 years,) with a preliminary diagnosis of achalasia. Patients were divided into four groups: type I, II, III acha...

The guidelines describe the management of outpatient follow-up by a general practitioner of patients with esophageal diseases (esophagitis, gastroesophageal reflux disease, Barrett’s esophagus and achalasia cardia). The following is presented: an approximate scope and frequency of paraclinical investigations, information on the diagnosis, treatment...

The aim of this study was to investigate the levels of various tryptophan metabolites in patients with alcoholic liver disease (ALD) and metabolic-associated fatty liver disease (MAFLD) at different stages of the disease. The present study included 44 patients diagnosed with MAFLD, 40 patients diagnosed with ALD, and 14 healthy individuals in the c...

Background Sarcopenia and gut dysbiosis are common in cirrhosis. The aim is to study the correlations between the gut microbiota taxa and muscle mass level in cirrhosis. Methods The study included 40 cirrhosis patients including 18 patients with sarcopenia. The gut microbiota composition was assessed using amplicon sequencing of the hypervariable...

Introduction . The use of hypoammonemic agents to treat sarcopenia in liver cirrhosis has the potential to positively affect muscle mass, strength and function, given the pathogenetic basis of sarcopenia in liver cirrhosis. Aim. To compare muscle mass, strength and function, as well as capillary blood ammonia levels in patients with decompensated l...

Introduction. The muscle mass in sarcopenia is assessed in patients with liver cirrhosis (LC) using skeletal muscle indices (SMI) measured by dual-energy X-ray absorptiometry (DXA), the results of which are distorted due to lower limb edema. This requires the development of upper limb SMI (UL SMI) to ensure more accurate assessment of muscle mass i...

Aim: to present the results of the Expert Panel with a discussion of modern concepts of the pathogenesis of functional gastrointestinal diseases and the possibilities of multitarget therapy with trimebutine. Key points. Low-grade inflammation can be considered as a morphological substrate of functional diseases with an increase in activated mastocy...

Aim: to optimize outcomes of the treatment and prevention of gastrointestinal diseases in adults and children. Key points. The Methodological Guidelines contain sections on the terminology, classification, mechanisms of action, requirements for sale in the Russian Federation, requirements for proving the efficacy and safety of probiotics, prebiotic...

Introduction. As a result of portal hypertension (sequestration of platelets in an enlarged spleen) and liver failure (decreased production of thrombopoietin in the liver) in liver cirrhosis, thrombocytopenia develops, which is associated with the risk of periprocedural/perioperative bleeding complications. There are still unresolved questions rega...

Aim: to provide the basic points of the Expert Panel of the Russian Gastroenterological Association with discussion of measures to improve diagnostics, treatment and management of chronic gastritis patients. Key points. In the Russian Federation in 2021 more than 30 million patients diagnosed with “Gastritis and duodenitis” were recorded (K29 in ac...

Aim: to study the metabolic activity of the intestinal microbiota depending on the stage of metabolic dysfunction-associated fatty liver disease (MAFLD). Materials and methods. The study included 85 patients with MAFLD (27 patients with steatosis without steatohepatitis and fibrosis, 42 patients with steatohepatitis, 16 patients with cirrhosis as a...

We aimed to systematize the results of published studies on the use of Saccharomyces boulardii (SB) for the treatment of various liver disorders (CRD42022378050). Searches were conducted using PubMed and Scopus on 1 August 2022. The PubMed search was updated on 15 June 2024. The review included sixteen studies: ten experimental animal studies (EASs...

Introduction. Genetic predisposition in combination with environmental factors and the patient’s psychological and emotional state play a key role in the development of irritable bowel syndrome (IBS). Studies of association between genetic polymorphisms and IBS can help in understanding the key pathophysiological mechanisms. To date, 11 meta-analys...

Aim: to demonstrate the need for a detailed differential diagnosis and selection of therapy in a patient with decompensated liver cirrhosis of combined etiology (HCV infection and primary sclerosing cholangitis). Key points. The patient came to the clinic with complaints of shortness of breath with minimal physical activity, abdominal enlargement,...

Abstract. Objective: to evaluate basic metabolism and its relationship with changes in body composition in patients with liver cirrhosis. Material and methods. A retrospective study was conducted, which included an analysis of data from 110 patients with a confirmed diagnosis of liver cirrhosis from 02.2020 to 12.2022. Assessment of body compositio...

Introduction Increasing the effectiveness of eradication therapy is an important task in gastroenterology. The aim was to evaluate the efficacy and safety of postbiotic containing inactivated (non-viable) Limosilactobacillus reuteri DSM17648 (Pylopass) as adjuvant treatment for Helicobacter pylori eradication in patients with functional dyspepsia (...

Background and Aims Gut dysbiosis and abnormal cytokine profiles are common in cirrhosis. This study aimed to evaluate the correlations between them. Methods In the blood plasma of cirrhosis patients and controls, 27 cytokines were examined using a multiplex assay. The plasma levels of nitrites (stable metabolites of the endothelial dysfunction bi...

BACKGROUND The gut–liver axis and bacterial translocation are important in cirrhosis, but there is no available universal biomarker of cellular bacterial translocation, for which presepsin may be a candidate. AIM To evaluate the relationship of the blood presepsin levels with the state of the gut microbiota in cirrhosis in the absence of obvious in...

2023 г. международным консенсусом принято решение о введении новой номенклатуры жировой болезни печени. В статье обсуждаются причины изменения номенклатуры и принятые новые термины: жировая болезнь печени, метаболически-ассоциированная жировая болезнь печени, метаболически-ассоциированная жировая болезнь печени в сочетании с употреблением избыточно...

Aim. In 2023, international consensus decided to introduce a new nomenclature for steatotic liver disease. The article discusses the reasons for the change in nomenclature and the new terms adopted: steatotic liver disease, metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction and alcohol associated steatotic liver disease...

Aim: to evaluate the relationship of body composition components with the development of ascites in patients with liver cirrhosis. Materials and methods. One hundred and ten patients (44 men and 66 women) with the established diagnosis of liver cirrhosis were treated at the University Clinical Hospital No 2 of the Sechenov University. The assessmen...

Aim: to analyse the principles of diagnosis and treatment of intrahepatic cholestasis in chronic liver diseases, to present data on the effectiveness of ademetionine in the treatment of chronic liver diseases with intrahepatic cholestasis and the materials of the Expert Meeting held in 2023. Key points. During the Expert Meeting, the problems of di...

Aim . The guidelines set out the modern methods of diagnostics and treatment of peptic ulcer and are created for gastroenterologists, primary care physicians, general practitioners, surgeons, endoscopists. Key points . The clinical guidelines contain modern views on the etiology and pathogenesis of peptic ulcer, its clinical features, methods of la...

The guidelines describe the organization of follow-up of patients with alcohol-associated liver cirrhosis by a general practitioner.This document presents modern approaches to diagnostics, including clinical and paraclinical methods necessary for follow-up monitoring of patients with alcohol-associated liver cirrhosis. It also includes treatment st...

Abstract. Changes in body composition, in particular sarcopenia and sarcopenic obesity, are complications of liver cirrhosis affected by unfavorable parent substances. The selection of diet and exercise for at least 8 weeks allows you to get the best results when taken by patients with cirrhosis of the liver. The correlate of motor activity in the...

Введение. У пациентов с циррозом печени в результате нарушения процессов обезвреживания аммиака и портосистемного шунтирования крови может развиваться гипераммониемия, которая наиболее часто ассоциирована с печеночной энцефалопатией и саркопенией. На сегодняшний день остаются вопросы по диагностике гипераммониемии и влиянию гипоаммониемической тера...

Aim : in the retrospective study to assess the frequency of various gastritis variants based on the results of morphological examination of gastric biopsies over a 5-year observation period. Methods . The study included 3162 individuals who underwent esophagogastroduodenoscopy with biopsy collection between 2017 and 2022. Pathological examination o...

Introduction. In cirrhotic patients, hyperammonemia develops due to impaired ammonia detoxification and porto-systemic blood shunting and is most commonly associated with hepatic encephalopathy and sarcopenia. Currently, there are questions regarding the diagnosis of hyperammonemia and the effect of ammonia-lowering therapy on disease outcomes. Mat...

Introduction. In cirrhotic patients, hyperammonemia develops due to impaired ammonia detoxification and portosystemic blood shunting and is most commonly associated with hepatic encephalopathy and sarcopenia. Currently, there are questions regarding the diagnosis of hyperammonemia and the effect of ammonia-lowering therapy on disease outcomes. Mate...

Gut dysbiosis and subclinical intestinal damage are common in cirrhosis. The aim of this study was to examine the association of intestinal damage biomarkers (diamine oxidase [DAO], claudin 3, and intestinal fatty acid binding protein [I-FABP; FABP2]) with the state of the gut microbiota in cirrhosis. The blood levels of DAO were inversely correlat...

Aim: to discuss current views on the clinical significance, diagnostic opportunities, and therapeutic approaches in the treatment of small intestinal bacterial overgrowth (SIBO) as an important component in the gut microbiota function assessment, to assess the awareness of physicians and the opportunities in the diagnosis and treatment of this dise...

Our aim was to study the association of endothelial dysfunction biomarkers with cirrhosis manifestations, bacterial translocation, and gut microbiota taxa. The fecal microbiome was assessed using 16S rRNA gene sequencing. Plasma levels of nitrite, big endothelin-1, asymmetric dimethylarginine (ADMA), presepsin, and claudin were measured as biomarke...

(1) Background: The aim was to evaluate the effectiveness of the probiotic containing Saccharomyces boulardii in the treatment of small intestinal bacterial overgrowth (SIBO) in patients with decompensated cirrhosis. (2) Methods: This was a blinded, randomized, placebo-controlled study. (3) Results: After 3 months of treatment, SIBO was absent in 8...

Aim: to provide data on the pathogenesis of functional biliary pain and provide rationale for the use of trimebutine for this indication. Key points. Biliary pain is one of the most frequent reasons for patients to see a doctor. The diagnosis of functional disorder of the gallbladder and Oddi's sphincter is legitimate only after the exclusion of or...

А im : to investigate the impact of COVID-19 on the course and prognosis of cirrhosis. Materials and methods . This was a cohort study in patients with cirrhosis. We included patients with cirrhosis who underwent a medical examination at our center between September 2019 and March 2020. We determined which of these patients were infected with COVID...

The prevalence of gastroesophageal reflux disease is steadily rising. The number of patients with non-erosive reflux disease is increasing worldwide, including the form of the disease refractory to standard therapy. This article presents current data on the pathogenesis, diagnosis, and therapeutic approaches for patients with refractory non-erosive...

Increasing the effectiveness of eradication therapy is an important task of gastroenterology. The aim was to evaluate the efficacy and safety of postbiotic (metabiotic) contained inactivated Limosilactobacillus reuteri DSM 17648 (Pylopass™; Helinorm™) as adjuvant treatment for Helicobacter pylori eradication in patients with functional dyspepsia (F...

Objective. Cytokine release syndrome (CRS) is a dangerous complication of the new coronavirus infection (COVID-19). The study aimed to compare sarilumab (SAR group) with tocilizumab (TOC group) and patients without anticytokine treatment (CON group) in treatment of CRS in COVID-19. Methods. The retrospective real life study included COVID-19 patien...

Aim : to present a clinical case of post-COVID bronchiolitis in an adult. Key points . A 54-year-old female patient with a long history of smoking was hospitalized in the pulmonology department of the Clinic with a leading complaint of progressive shortness of breath after a COVID-19 infection. The diagnosis was established: bilateral bronchiolitis...

Aim : to study the effectiveness and safety of using the drug Kolofort® in outpatients with irritable bowel syndrome (IBS) after a new coronavirus infection. Materials and methods . An observational non-interventional program was conducted in patients with exacerbation of IBS symptoms after a new coronavirus infection. One hundred forty-one patient...

Cirrhosis is the end result of liver fibrosis in chronic liver diseases. Studying the mechanisms of its development and developing measures to slow down and regress it based on this knowledge seem to be important tasks for medicine. Currently, disorders of the gut–liver axis have great importance in the pathogenesis of cirrhosis. However, gut dysbi...

The aim of this study was to investigate the short-chain fatty acid (SCFA) activity of the gut microbiota of patients with metabolic-associated fatty liver disease (MAFLD). The level and spectrum of short-chain fatty acids (SCFAs) were determined via gas–liquid chromatography. Liver fibrosis was assessed using the FIB-4 index and elastography. Amon...

Background Disturbances in the intestinal barrier and gut dysbiosis have been observed in patients with functional bowel diseases. Aims To investigate the correlation between biomarkers of intestinal barrier disorders at different layers and the severity of symptoms in patients with overlapping diarrhea-predominant irritable bowel syndrome and fun...

Treatment of functional digestive disorders is not always effective. Therefore, a search for new application points for potential drugs is perspective. Our aim is to evaluate the effect of rebamipide on symptom severity, intestinal barrier status, and intestinal microbiota composition and function in patients with diarrheal variant of irritable bow...

Background: Complications of liver cirrhosis (LC), such as thrombocytopenia and portal vein thrombosis (PVT), have similar pathophysiology. However, the association between PVT and platelet count in LC patients is contradictory. Aim: To assess factors affecting the platelet count in patients with LC and PVT. Materials and methods: This was a retros...

А im: to analyze a series of cases of dysplasia and early gastric cancer developed in patients with autoimmune gastritis (AIG), and to identify their clinical and morphological features. Materials and methods. The study included six cases of detection of early gastric cancer on the background of AIG. Four out of six patients underwent endoscopic tr...

The aim was to evaluate the relationship between gut dysbiosis and hemodynamic changes (hyperdynamic circulation) in cirrhosis, and between hemodynamic changes and complications of this disease. This study included 47 patients with cirrhosis. Stool microbiome was assessed using 16S rRNA gene sequencing. Echocardiography with a simultaneous assessme...

А im: to study the structural and functional characteristics of albumin in patients with decompensated cirrhosis, their relationship with ascites; to identify the relationship between improvement in albumin characteristics and regression of ascites. Materials and methods. Fifty patients with decompensated liver cirrhosis and ascites were divided in...

Lysosomal acid lipase deficiency is s a rare hereditary enzymopathy. The article presents epidemiological data and features of etiopathogenesis of two phenotypic forms of lysosomal acid lipase deficiency — Wolman disease and cholesterol ester storage disease. Special attention has been given to the key issues of differential diagnostic search, clin...

А im: the clinical practice guidelines intended for gastroenterologists, internal medicine specialists, infectious disease specialists, general practitioners (family doctors), coloproctologists, surgeons and endoscopists present modern methods of diagnosis, prevention and treatment of C. difficile -associated disease. Key points. C. difficile -asso...

А im: to highlight the importance of broad differential diagnosis and possibility of conversion of benign recurrent intrahepatic cholestasis type 2 into more aggressive clinical phenotype. Key points. A 19-year-old female patient was admitted to the Clinic with skin pruritus, jaundice, dark urine, clay-colored stool, and general fatigue. Past medic...

Gut dysbiosis presents in many digestive diseases. The aim of this study is to investigate the composition of the gut microbiota and its metabolic activity in patients with diarrhea-predominant irritable bowel syndrome combined with functional dyspepsia (I + D). This study included 60 patients with I + D and 20 healthy controls. Gut microbiota comp...

We present a 27-year-old man with a 2-year history of extrahepatic portal vein obstruction and selective immunoglobulin A deficiency, referred for acute cholangitis from portal cavernoma cholangiopathy (PCC). Because recurrent cholangitis rapidly led to liver failure, orthotopic liver transplantation (OLT) was successfully performed. To date, this...

Background: Portal hypertension in patients with chronic liver diseases causes a number of complications that lead to significant mortality of patients. In this regard, the most urgent issue is the study of prognostic factors of the development of PG, one of which is the constitutional features of the organism (somatotypes). Aim: To assess the impo...

The objective of this study was to investigate the metabolic activity of the gut microbiota in cirrhosis due to different variants of fatty liver disease (alcoholic vs. non-alcoholic [metabolic-associated] one [AFLD and MAFLD]). The present study included 24 patients with alcoholic liver cirrhosis, 16 patients with MAFLD-related cirrhosis, and 20 h...

Decreased muscle mass and function, also known as sarcopenia, is common in patients with cirrhosis and is associated with a poor prognosis. Although the pathogenesis of this disorder has not been fully elucidated, a disordered gut-muscle axis probably plays an important role. Decreased barrier function of the gut and liver, gut dysbiosis, and small...

Small intestinal bacterial overgrowth (SIBO) is defined as an increase in the bacterial content of the small intestine above normal values. The presence of SIBO is detected in 33.8% of patients with gastroenterological complaints who underwent a breath test, and is significantly associated with smoking, bloating, abdominal pain, and anemia. Proton...

Objective. To evaluate the nature of changes in body fat composition in cirrhotic patients of various somatotypes. Materials and methods. The data of 46 cirrhotic patients and 20 volunteers were analyzed. Anthropometric examination was carried out according to methodological requirements with assessing the body composition of patients by means of...

The composition of the respiratory tract microbiota has been actively studied around the world. In this article, we have analyzed and summarized the data published over the last 20 years (PubMed/Medline, RSCI/e-library databases) and presented the results of our research of the intestinal and respiratory tract microbiota in patients with bronchial...

Аim: diagnosis and treatment algorithms in the clinical recommendations intended for general practitioners, gastroenterologists, infectious disease specialists, hepatologists on the of chronic hepatitis C are presented. Summary. Chronic viral hepatitis C is a socially significant infection, the incidence of which in the Russian Federation remains s...

Introduction . The gradual progression of liver cirrhosis with the development of complications has a negative impact on the life quality of patients with this disease. Modern therapeutic strategies are aimed not only at disease compensating, but much attention is paid to improving the quality of life. No data exists on the effect of serum albumin...

А im: to conduct a comparative analysis of serum albumin's structural and functional properties in decompensated cirrhotic patients by means of spin prob EPR spectroscopy. Materials and methods. The main study group included 70 patients with decompensated liver cirrhosis and ascites. The control group consisted of 12 healthy volunteers, comparable...

Introduction. It is often observed that decompensated liver cirrhosis is accompanied by hepatic encephalopathy. The role of violation of the structural and functional properties of albumin in the development of this pathology is currently not defined. Aim. Was to evaluate the effect of albumin replacement therapy on the clinical manifestations of h...

A change in the gut microbiota composition is a risk factor for the development and progression of a number of socially significant diseases. Thus, the prevalence of small bacterial overgrowth syndrome (SBOS) in patients with chronic heart failure CHF) is 38.2–42.0%, as shown by different data, which greatly exceeds that among the persons without C...

Aim : to present data on the prevalence of various phenotypes of non-alcoholic fatty liver disease (NAFLD), the features of its diagnosis and treatment in various regions of the Russian Federation following a meeting of chief gastroenterologists. Key points . Non-alcoholic fatty liver disease (NAFLD) holds the leading position among non-infectious...

Aim : to review the modern approaches to the diagnosis and treatment of C. difficile -associated disease in adults and present the resolution of the Expert Council held on March 25, 2023 in Moscow. General provisions . C. difficile is the most important nosocomial pathogen which spores are also commonly found in the environment. Microbiota impairme...

Background: Small intestinal bacterial overgrowth (SIBO) is associated with numerous manifestations of cirrhosis. To determine whether the presence of SIBO affects the prognosis in cirrhosis was the aim of the study. Methods: This prospective cohort study included 50 patients. All participants underwent a lactulose hydrogen breath test for SIBO. Th...

Objectives: The aim is to study impact of vaccination against the novel coronavirus disease (COVID-19) with Sputnik V on mortality during the period of predominance of the delta variant of SARS-CoV-2. Methods: This was a retrospective cohort study of individuals with state health insurance at the Moscow Ambulatory Center. The cohorts included 41...

Background Rifaximin effectively treats symptomatic uncomplicated diverticular disease (SUDD) and has shown eubiotic potential (i.e., an increase in resident microbial elements with potential beneficial effects) in other diseases. This study investigated changes in the fecal microbiome of patients with SUDD after repeated monthly treatment with rif...

Aim: to provide information on the results of recent scientific research in the field of non-alcoholic fatty liver disease (NAFLD) metabolomic profiling. Key points. Metabolites of microbial origin are important biological molecules involved in many specific reactions of the human body. This literature review presents the results of recent studies...

Aim: to compare the results of ¹³ C-UBT with the data of morphological analysis of the gastric and duodenal mucosa obtained during gastroduodenoscopy in gastritis and peptic ulcer. To analyze the dependence of the results of diode laser spectroscopy (DLS) based ¹³ C-UBT on age, nosology, activity and severity of the inflammatory process, the degree...

The hepatobiliary system can be affected by a new coronavirus infection (COVID-19), in addition to the respiratory organs. Vanishing bile duct syndrome (VBDS) is a rare cause of jaundice that usually develops as a result of drug-induced liver injury or possibly due to the combined effect of several etiological factors. Clinical case . A 77-year-old...

Eosinophilic esophagitis (EoE) is an immune-mediated disease characterized by complaints of dysphagia and eosinophilic infiltration of the esophageal epithelium with at least 15 cells per high power field (×400). Currently, there has been an increase in the incidence of EoE worldwide. Patients with EoE include both adults and children. The diagnosi...

On October 21, 22, 23, 2022, within the framework of the 122nd International Session of the National School of Gastroenterology, Hepatology (NSGH) of the Russian Gastroenterological Association (RGA), the First Russian Gastroenterology Olympiad was held.

Aim : to analyze current approaches to H. pylori eradication therapy in adults and present the materials of Experts Council held on December 9, 2022 in Moscow. General statements . H. pylori infection is the main etiological factor of gastritis, peptic ulcer, and gastric cancer. Eradication of H. pylori is recognized as a necessary measure to reduc...

Aim : bring to the attention of practitioners indications for anti-Helicobacter therapy, methods and procedure for diagnostics and eradication therapy of Н . pylori infection. Key points . Chronic gastritis caused by Н . pylori infection, including asymptomatic persons, may be considered as an indication for eradication therapy of Н. pylori as etio...

Hemostasis disorders in cirrhosis / severe liver disease are complex, as they affect both pro- and anticoagulant factors, as well as pro- and antifibrinolytic components. Most of the tests that are used in clinical practice to assess coagulation do not take into account the compensatory capabilities of this system as a whole. This document provides...

Background: Eosinophilic esophagitis (EoE) is the second most common cause of esophagitis. Topical steroids represent a promising group of drugs for inducing and maintaining clinical and histological remission in these patients. Objective. To evaluate the effectiveness of topical steroids in inducing and maintaining clinical and histological remiss...

Aim: present clinical guidelines, aimed at general practitioners, gastroenterologists, cardiologists, endocrinologists, comprise up-to-date methods of diagnosis and treatment of non-alcoholic fatty liver disease. Key points. Nonalcoholic fatty liver disease, the most wide-spread chronic liver disease, is characterized by accumulation of fat by more...

Background: It was established that the high biological diversity of intestinal microorganisms promotes the needed SCFAs production, which induces immune regulatory pathways and contributes to the anti-inflammatory response. Study. A group of 30 patients with allergic bronchial asthma (BA) were investigated in our study. All of the patients were t...