The intestine is one of the most important target organs of stress caused by hemorrhagic shock, traumatic shock, burns, and severe injuries to bones and soft tissues. This review examines the microbial endoecology of the gastrointestinal tract in wounded patients with polytrauma. Severe intestinal injury plays a major role in the development of infectious complications and multiple organ failure in wounded patients with polytrauma. Such complications result from interactions between impaired gastrointestinal motility, damage to the intestinal epithelium, the immune system, and the gastrointestinal microbiota. The formation of gastrointestinal endoecology depends on the influx of microorganisms into the system, the reproduction rate of individual representatives, and their elimination into the environment. The gut microbiome can be disrupted under the influence of the intestinal environment in critically injured patients. Three hypotheses are highlighted—bacterial translocation, lymphocyte-derived bacteremia, and in situ virulence—that explain the role of the gastrointestinal biota-tissue complex in the pathogenesis of sepsis and multiple organ failure in critically injured patients. Early diagnosis and stratification of patients with biotissue complex disruption of the intestine in systemic response to injury may improve outcomes through the timely initiation of appropriate specific treatment.

Functional disorders of the biliary tract are included in the group of functional diseases of the digestive system, widespread everywhere, and represent a complex of clinical symptoms developing as a result of motor-tonic dysfunction of the gallbladder, bile ducts and sphincters. Their clinical manifestations are often quite diverse and non-specific. Therefore, the problem of verification, treatment and prevention of this pathology continues to be relevant. In our study, among 37 practically healthy volunteers, in 55% of cases, a functional disorder of the gallbladder of the hypomotor type was detected, correlations of indicators of the motor function of the gallbladder with markers of systemic inflammation were established.

The study of inflammatory bowel disease is characterized by dynamism and new discoveries. Subtle and new mechanisms of participation of genetic and environmental factors in the pathogenesis of inflammatory bowel diseases have been deciphered, as well as new classes of drugs have appeared that allow influencing many parts of the inflammatory process. However, the paradox of the situation lies in the fact that the more recent advances and discoveries in the field of biology and medicine, the more “gray spots” become in our understanding of the pathogenesis and approaches to the treatment of this category of patients. At the same time, the fundamental problems of IBD, related to reducing the risk of surgical interventions and restoring the quality of life of patients to the population level, are far from being resolved. The article discusses new methodological approaches to the treatment of patients with inflammatory bowel diseases using new classes of cytostatics and granulocyte-macrophage colony-stimulating factors.

Eurasian clinical practice guidelines for dietary management of cardiovascular diseases include actual healthy diet recommendations and modern dietary approaches for prevention and treatment of cardiovascular diseases. Nutritional assessment and interventions based on pathogenesis of atherosclerosis and cardiovascular diseases are presented.Modern nutritional and dietary recommendations for patients with arterial hypertension, coronary heart disease, chronic heart failure, heart rhythm disorders, dyslipidemia and gout are summarized in present recommendations. Particular attention is paid to the dietary management of cardiovascular patients with obesity and/or diabetes mellitus. This guide would be interesting and intended to a wide range of readers, primarily cardiologists, dietitians and nutritionists, general practitioners, endocrinologists, and medical students.

Ulcerative colitis is an autoimmune disease characterized by ulcerative destructive processes in the mucous membrane of the colon. Despite advances in the pharmaceutical industry, its prevalence in the world is increasing every year. The etiology of UC is currently unknown to the end. According to modern concepts, ulcerative colitis is considered as a multifactorial disease, in the pathogenesis of which genetic determinism, disorders of the intestinal microbiota with a decrease in populations of anaerobic bacteria in combination with the trigger action of environmental factors are discussed. With high probability, the leading pathogenetic mechanisms of the disease are associated with the polarization of the Th2-type immune response, which is characterized by the synthesis of IL-4, IL-5, IL-9 and IL-13, which is regulated by STAT-5 and Gata-3. During the development of the disease, Th17, a type of immune response, is also involved in the immunopathological process, but with the participation of transcription factors STAT-3 and ROR-yt and the synthesis of IL-17, IL-2, IL-6, IL-26 and IL-22, as well as chemokine CCL20. Diet and lifestyle are part of the global guidelines for the treatment of patients with ulcerative colitis. Derivatives of 5-aminosalicylic acid are used as basic therapy preparations: combined preparations and preparations of pure 5-aminosalicylic acid. Nevertheless, the administration of systemic glucocorticosteroids is indicated to control the activity of the disease. However, as our practice shows, they are effective, but only at the first attack and subsequent 2-3 relapses of the disease, followed by a high incidence of hormone resistance. To date, there are modern medicines with a different mechanism of action, allowing achieving stable remission and improving the quality of life of patients. Among them, JAK -tofacitinib inhibitors are of particular interest in the treatment of ulcerative colitis. This is the first oral drug capable of inducing and maintaining steroidal remission. The choice of a particular drug is determined by the experience of use, cost and national recommendations.

Summary Post- COVID syndrome refers to the long-term consequences of a new coronavirus infection COVID-19, which includes a set of symptoms that develop or persist after COVID-19. Symptoms of gastrointestinal disorders in post- COVID syndrome, due to chronic infl ammation, the consequences of organ damage, prolonged hospitalization, social isolation, and other causes, can be persistent and require a multidisciplinary approach. The presented clinical practice guidelines consider the main preventive and therapeutic and diagnostic approaches to the management of patients with gastroenterological manifestations of postCOVID syndrome. The Guidelines were approved by the 17th National Congress of Internal Medicine and the 25th Congress of Gastroenterological Scientifi c Society of Russia.

Chronic non-communicable diseases (CNID) are an important problem for health care worldwide. In this connection, there was a need to develop preventive measures aimed at their early detection and timely correction. Taking into account the available evidence base on the effectiveness of preventive measures to reduce risk factors of CNID, special attention should be paid to people with high risks of their development and patients with an already established diagnosis. To improve the quality of preventive medicine, it is necessary to consistently develop and implement modern technologies aimed at early detection of risk factors at all stages of human life using available tests. To date, remote screening is considered as one of the promising areas of telemedicine technologies, which can be successfully used during medical examinations, medical examinations, etc. We have developed a methodology for telemedicine multidisciplinary remote questionnaire screening of the adult population using a system of analysis of unstructured data for population monitoring of CNID. Our telemedicine program was tested based on the city polyclinic for the first stage of medical examination. Depending on the identified risk factors, it was found that patients with the greatest frequency are concerned about complaints from the endocrine, digestive, respiratory, cardiovascular systems and oncological alertness. The interim results of the study once again show that the transition to new social conditions causes an active destabilization of the physical and psycho-emotional capabilities of the human body, which, under excessive loads, are able to increase the degree of activity of the CNID risk factors.

Background. Ferritin is an important integral and diagnostic marker of liver diseases. In 1/3 of patients with nonalcoholic fatty liver disease (NAFLD), manifestations of hyperferritinemia are revealed. Increased ferritin level indicates the severity of the disease course and affects the prognosis. Objective: to determine the prevalence and character of hyperferritinemia manifestations in NAFLD patients and to evaluate the effectiveness of its correction with human placenta hydrolysate. Material and methods . We examined 158 patients aged from 20 to 63 years (92 men and 66 women). There were no significant differences in age between men and women. The control group consisted of 20 practically healthy individuals. Molecular mechanisms of peptide components of human placenta hydrolysate (Laennec®) impact on pathophysiological processes of serum ferritin disorders, iron metabolism indicators, and inflammation manifestations were analyzed. Results. Nineteen peptides potentially important for regulation of iron homeostasis were identified in Laennec® composition. These peptides contribute to the elimination of iron metabolism disorders by regulating the levels of hepcidin (the main hormone of iron homeostasis), reducing ferritin synthesis, as well as exhibiting anti-inflammatory, and immunomodulatory effects. The efficacy of the drug monotherapy in patients with hyperferritinemia was shown. Conclusion. Laennec® was found to be one of the medicines contributing to the reduction of hyperferritinemia manifestations, iron metabolism disorders, and systemic inflammatory process in NAFLD.

Atrial fibrillation and ischemic heart disease are the key problems in cardiology. Despite of numerous clinical trials and researches underlying molecular biology remains uncertain. Atrial fibrillation and ischemic heart disease are often combined. During ischemic heart disease progression myocardial tissue structure are changing which lead to structural and electrophysiological remodeling and promote atrial fibrillation. It has been shown a crucial role of oxidative stress and chronic systemic inflammation in ischemic heart disease and atrial fibrillation. Myeloperoxidase (MPO) is one of marker of oxidative stress and inflammation that located in azurophilic granules of neutrophils and monocytes. There are a numerous articles showed a relation between MPO level and cardiovascular disease. MPO is a peroxidase enzyme that is important part of immune system. During disease MPO could facilitate chronic inflammation and local tissue damage through active oxygen forms. MPO releases after lysosome conjunction with phagosome. Oxygen reductase activity of MPO lead synthesis of hypochlorous acid that play role not only in organism protection from infection agents but in matrix transformation and fibrosis. It has been shown MPO can destabilize atherosclerotic plaque and modifies low- and high-density lipoproteins that promote atherosclerosis and ischemic heart diseaseу progression. This review summarizes current data about role of MPO in atrial fibrillation and ischemic heart disease pathogenesis.

Nutrition occupies one of the important places in the programs of prevention and non-drug therapy of CHF and associated diseases. At the same time, the validity of dietary recommendations to patients regarding salt intake, dietary habits and the use of individual nutraceuticals is questionable. The purpose of this review is to present up-to-date data of clinical and experimental studies concerning sodium restriction, the use of various diets, nutraceuticals, and means for correcting intestinal dysbiosis in CHF. Materials and methods: the articles are searched in the databases eLibraryRU and Medline by key terms and their combinations: “heart failure”, “diet”, “sodium restriction”, “nutraceuticals”, “nutrition”, “cardiac cachexia”, “nutritional support”, “salt”, “dietary supplement”, “probiotic”, “prebiotic”, “enteral nutrition” in Russian and English. We select articles containing the results of clinical and experimental studies published from 1997 to 2021. The research data indicate that the pathogenesis of anorexia, malnutrition and “metabolic remodeling” of the myocardium in CHF is based on complex mechanisms determined by stagnant phenomena in the liver, impaired permeability of the edematous intestinal wall, dysbiosis and chronic systemic infl ammation. The recommendations on the consumption of sodium from 2 to 2.5 g/day and table salt from 5 to 6 g/day in patients with CHF are justified. Limitation of fluid intake is relevant only for decompensation of CHF. The use of the Mediterranean and antihypertensive (DASH) diets is recognized by most authors as a promising direction for the prevention and treatment of CHF. The enrichment of the diet of patients with CHF with ω-3 polyunsaturated fatty acids, coenzyme Q10, dietary fibers, polyphenols and saponins is justified. The benefits of enteral nutrition and the complex use of nutraceuticals in order to slow the progression of weight loss, reduce the severity of neurohormonal and pro-inflammatory shifts are shown. Promising trends of research are the creation of personalized diets taking into account the peculiarities of the course of CHF, the nutritional status, the composition of the intestinal microbiota and its metabolites.

Introduction. Coronavirus infection is an acute viral disease with a primary lesion of the upper respiratory tract, caused by an RNA-virus of the Betacoronavirus genus of the Coronaviridae family. The course of a viral infection varies from asymptomatic to a wide range of clinical manifestations, including fever, chills, gastrointestinal manifestations, pneumonia, respiratory distress, and death. Ulcerative colitis (UC) and Crohn's disease (CD) are chronic immune-mediated diseases with intestinal and systemic symptoms, which are based on an impairment of the intestinal microbiota and dysregulation of the immune system in genetically predisposed individuals. In the Kazakh population, risk factors also include irregular food intake (p=0.043; OR=3.61 [95% CI: 1.04–12.51]), consumption of fish and seafood (p=0.000; OR= 15.77 [95% CI: 4.56-54.59]), consumption of frozen processed foods (p = 0.018; OR = 4.62 [95% CI: 1.3-16.4]), diet based on meat dishes (p=0.029; OR=3.2 [95% CI: 1.13-9.2]), use of NSAIDs other than aspirin (p=0.031; OR=3.79 [1.13-12.69 ]) and smoking (p=0.008; OR=4.93 [95% CI: 1.52-15.98]). The suppression of the immune response is associated with the risk of infection with viral or bacterial pathogens, including potentially the SARS-CoV-2 virus. On the other hand, SARS-CoV-2 infection as a potential trigger factor for de novo occurrence of inflammatory bowel disease is currently being discussed. The aim of this study was to assess the characteristics of the course of COVID-19 during the treatment of inflammatory bowel diseases (IBD), risk factors and outcomes of COVID-19, as well as the activity of IBD before and after a coronavirus infection. Materials and methods. A longitudinal descriptive study included 158 patients with IBD who applied on an outpatient basis (including via remote consultation) or inpatient with SARS-Cov2 or COVID-19 infection in the academic centers of Almaty (Kazakhstan) n=54 and St. Petersburg (Russia), n= 104. The observation period was from May 2020 to May 2022. The median and interquartile range were used to describe quantitative data (age), and absolute frequencies and percentages were used for qualitative data. The Mann-Whitney U-test was used for intergroup comparison of quantitative data (age), for the remaining indicators, the likelihood ratio test (Likehood ratio test), and in the case of 2X2 tables, Fisher's exact test. Results. There was no association between IBD type/activity or drugs taken and the severity of COVID-19. However, the severity of COVID-19 affected the activity of IBD. We`ve identified the same risk factors for the development of a more severe course of COVID-19 were as in the world literature: cardiovascular pathology, arterial hypertension and chronic liver pathology. Conclusion. Thus, inflammatory bowel disease and current therapy do not affect the risk of SARS-Cov-2 infection and/or the severity of COVID-19, while infection associated with severe COVID-19 affects the activity or outcomes of IBD. Актуальность.Коронавирусная инфекция – острое вирусное заболевание с преимущественным поражением верхних дыхательных путей, вызываемое РНК-геномным вирусом рода Betacoronavirus семейства Coronaviridae. Заражение вирусом варьируется от бессимптомного до широкого спектра клинических проявлений, включая лихорадку, озноб, желудочно-кишечные проявления, пневмонию, респираторный дистресс и смерть. Язвенный колит (ЯК) и болезнь Крона (БК) – хронические иммуноопосредованные заболевания с кишечной и системной симптоматикой, в основе которых лежат нарушение микробиоты кишечника и дисрегуляция иммунной системы у генетически-предрасположенных лиц. У лиц казахской популяции к факторам риска также можно отнести нерегулярный прием пищи (р=0,043; ОШ=3,61 [95% ДИ: 1,04-12,51]), потребление рыбы и морских продуктов (р=0,000; ОШ=15,77 [95% ДИ: 4,56-54,59]), потребление замороженных полуфабрикатов (р=0,018; ОШ=4,62 [95% ДИ: 1,3-16,4]), питание, основанное на мясных блюдах (р=0,029; ОШ=3,2 [95%ДИ: 1,13-9,2]), применение НПВС, кроме аспирина (р=0,031; ОШ=3,79 [1,13-12,69]) и курение (р=0,008; ОШ=4,93 [95% ДИ: 1,52-15,98]) [25] Подавление иммунного ответа ассоциировано с риском инфицирования вирусными или бактериальными патогенами, в том числе, потенциально вирусом SARS-CoV-2. С другой стороны, в настоящее время обсуждается SARS-Cov2 в качестве триггера de-novo ВЗК случаев [22]. Цель проведенного исследования: оценить особенности течения COVID-19 на фоне терапии воспалительных заболеваний кишечника, факторы риска и исходы COVID-19, а также активность ВЗК до и после перенесенной КВИ. Материалы и методы.Продольное описательное исследование включало 158 пациентов с ВЗК, обратившихся амбулаторно (в том числе посредством дистанционной консультации) или стационарно с инфекцией SARS-Cov2 или COVID-19 в академических центрах Алматы (Казахстан), n=54 и Санкт-Петербурга (Россия), n=104. Период наблюдения был с мая 2020 по май 2022. Для описания количественных данных (возраст) были использованы медиана и межквартильный размах, для качественных данных - абсолютные частоты и проценты. Для межгруппового сравнения количественных данных (возраст) применялся U-критерий Манна-Уитни, для остальных показателей тест отношения правдоподобия (Likehood ratio test), а в случае таблиц 2Х2 Точный тест Фишера. Результаты. Не было выявлено связи между типом/активностью ВЗК или принимаемыми препаратами и тяжестью течения COVID-19. Однако, тяжесть течения COVID-19 влияла на активность ВЗК. Выявлены те же факторы риска развития более тяжелого течения COVID-19, что и в мировой литературе: сердечно-сосудистая патология, артериальная гипертензия и хроническая патология печени. Заключение. Таким образом, воспалительное заболевание кишечника и текущая терапия не влияют на риск заражения SARS-Cov-2 и/или тяжесть течения COVID-19, в то же время, инфекция, ассоциированная с тяжелым течением COVID-19 влияет на активность или исходы ВЗК. Сәйкестік. Коронавирустық инфекция – Coronaviridae тұқымдастығы Betacoronaviridae тектес РНҚ геномдық вируспен шақырылған жоғарғы тыныс жолдарының зақындануымен жүретінжедел вирустық ауру. Вирусты жұқтыру симптомсыз түрінен кең спектрлі, қызба, қалтырау, асқазан ішек жолдарының кқріністерімен, пневмония, респираторлық дистресс және өлім сияқты клиникалық көрініспен жүруі мүмкін. Жаралы колит (ЖК) және Крон ауруы (КА) – ішек микробиотының бұзылуымен және генетикалық бейімділігі бар адамдардың иммундық жүйесінің дисрегуляциясына негізделген ішектік және жүйелік симптомдары бар созылмалы иммуносуперессорлық ауру. Қазақстандық популяцияда қауіп факторларына тамақты тұрақты емес тұтыну (p=0,043; OR=3,61 [95% CI: 1,04–12,51]), балық пен теңіз өнімдерін тұтыну (p=0,000; OR= 15,77 [95% CI: 4,56) жатады. -54,59]), мұздатылған өңделген тағамдарды тұтыну (p = 0,018; OR = 4,62 [95% CI: 1,3-16,4]), ет тағамдарына негізделген диета (p=0,029; OR=3,2 [95% CI: 1,13-9,2] ]), аспириннен басқа NSAID қолдану (p=0,031; OR=3,79 [1,13-12,69 ]) және темекі шегу (p=0,008; OR=4,93 [95% CI: 1,52-15,98]) [24] Иммундық жауаптың басылуы вирустық немесе бактериялық қоздырғыштармен, соның ішінде SARS-CoV-2 ықтимал вирусымен жұқтыру қаупімен байланысты. Екінші жағынан, SARS-Cov2 қазіргі уақытта де-ново IҚА жағдайлары үшін триггер ретінде талқылануда. Зерттеудің мақсаты: IҚА емдеу кезіндегі COVID-19 ағымының сипаттамаларын, COVID-19 қауіп факторлары мен нәтижелерін, сондай-ақ коронавирустық инфекцияға дейін және одан кейінгі IҚА белсенділігін бағалау. Материалдар мен тәсілдер. Бойлық сипаттамалық зерттеуге Алматы (Қазақстан), n=54 және Санкт-Петербург (Ресей) қалаларындағы академиялық орталықтарда амбулаториялық (соның ішінде қашықтан консультация арқылы) немесе SARS-Cov2 немесе COVID-19 инфекциясы бар стационарлық пациенттер ретінде келген IҚА бар 158 пациент қамтылды, n = 104. Бақылау кезеңі 2020 жылдың мамырынан 2022 жылдың мамырына дейін болды. Сандық деректерді (жас) сипаттау үшін медиана және квартильаралық диапазон, ал сапалы деректер үшін абсолютті жиіліктер мен пайыздар пайдаланылды. Сандық деректерді (жасы) топ аралық салыстыру үшін Манн-Уитни U-тесті, қалған көрсеткіштер үшін ықтималдық коэффициенті тесті (Likehood ratio test), ал 2X2 кестелер жағдайында Фишердің нақты сынағы қолданылды. Нәтижелер. IҚА түрі/белсенділігі немесе қабылданған препараттар мен COVID-19 ауырлығы арасында ешқандай байланыс болмады. Дегенмен, COVID-19 ауырлығы IҚА белсенділігіне әсер етті. Әлемдік әдебиеттердегідей COVID-19-дың неғұрлым ауыр ағым дамуының қауіп факторлары анықталды: жүрек-қан тамыр ауруы, артериалды гипертензия және бауырдың созылмалы ауруы. Қорытынды. Осылайша, ішектің қабыну ауруы және ағымдағы терапия SARS-Cov-2 инфекциясының қаупіне және/немесе COVID-19 ауырлығына әсер етпейді, ал ауыр COVID-19 инфекциясымен байланысты инфекция IҚА белсенділігіне немесе нәтижелеріне әсер етеді.

The aim of the study was to evaluate the efficacy and safety of Kolofort® (a complex medicine containing technologically processed forms of antibodies to S-100 protein, tumor necrosis factor-α and histamine) in the management of functional dyspepsia (FD) in outpatient clinical practice. Methods : Outpatients (N = 309) at the age of 18–45 in whom FD was diagnosed according to the Rome IV criteria were enrolled in a multicenter, double-blind, placebo-controlled, randomized clinical trial. Patients were randomized in two groups receiving Kolofort ® or placebo 2 tablets tid for 8 weeks. The primary endpoint of the study was a change in the FD symptoms severity score according to the Gastrointestinal symptom score (GIS) at week 8. ITT and [PP] analysis were performed. Results : at week 8 the reduction in GIS sum score was observed in Kolofort® group and placebo group (by 7.2 ± 3.3 [7.2 ± 3.4] and 6.3 ± 4.6 [6.2 ± 4.5], respectively, p = 0.041 [0.039]). The proportion of cases with GIS score reduction by ≥4 was 88,1 % [88.6 %] and 79.1 % [79.6 %] in Kolofort® group and placebo group, respectively (p = 0.046 [p = 0.051]). None of the patients in Kolofort ® group had progression of FD symptoms or required additional therapy. There were 29 adverse events (AEs) recorded in 25 patients including 16 cases in 13 (8.6 %) patients in Kolofort® group and 13 AEs in 12 (7.6 %) patients in placebo group. Conclusion : the clinical trial demonstrates the positive effect of Kolofort ® in FD with a favorable safety profile.

This document was produced with the support of the National Medical Association for the Study of Comorbidities (NASС). In 2021 the first multidisciplinary National Consensus on the pathophysiological and clinical aspects of Increased Epithelial Permeability Syndrome was published. The proposed guidelines are developed on the basis of this Consensus, by the same team of experts. Twenty-eight Practical Guidelines for Physicians statements were adopted by the Expert Council using the "delphic" method. Such main groups of epithelial protective drugs as proton pump inhibitors, bismuth drugs and probiotics are discussed in these Guidelines from the positions of evidence-based medicine. The clinical and pharmacological characteristics of such a universal epithelial protector as rebamipide, acting at the preepithelial, epithelial and subepithelial levels, throughout gastrointestinal tract, are presented in detail.

Introduction. A new coronavirus infection (COVID-19) is a pathogenetically complex disease characterized by the involvement of the main human organs and systems in the pathological process, including the organs of the gastrointestinal tract (gastrointestinal tract).Purpose: to study the gastroenterological manifestations of COVID-19 in patients of mild and moderate severity based on the analysis of complex data, including computed tomography examination.Material and methods. The study included 80 patients hospitalized with a confirmed diagnosis of COVID-19 (19 patients with mild and 61 with moderate severity) who underwent a comprehensive original examination upon admission to the hospital and outpatient at week 8 of dynamic follow-up. In the complex therapy of 41 patients, the drug rebamipid was used. The scope of the examination included questionnaires, traditional clinical, clinical and laboratory, biochemical, instrumental and radiation studies, unique methods for studying microbiota and intestinal permeability. All patients also underwent computed tomography (CT) of the chest organs, followed by analysis and postprocessing of images of the upper abdominal cavity. The study also included a group of 43 inpatient patients with moderate severity of the disease, a group of 17 practically healthy patients was used as a control.Results and conclusions. A method of qualitative and quantitative assessment of the state of parenchymal and hollow organs of the upper abdominal cavity according to CT data is proposed. It was found that with moderate severity of COVID-19, quantitative criteria (attenuation coefficient of the liver, pancreas, bile) were subject to more pronounced deviations, as was the diameter of the colon. Additional diagnostic capabilities of the standard chest CT protocol in patients with COVID-19 are associated with postprocessor analysis of images of abdominal organs.

The authors consider the nutriciology aspects of therapeutical problems from the perspectives of the General theory of medicine developed by them — the theory of noosphere–anthropogenic harmony. The authors consider the evolution aspects new scientifi c data on the molecular biology, microbiology and biotechnology as a part of biological culture, which determines the relationship of a person with the internal and external world and is one of the main factors in the evolution of the biosphere. The article analyzes the problems of qualitative and quantitative changes in nutrition parameters during the formation of diseases, their prevention and treatment.

An important area of effective control of the COVID-19 pandemic is the study of the pathogenetic features of SARSCoV-2 infection, including those based on the assessment of the state of the microbiota and intestinal permeability.Purpose: To study the clinical features of the new coronavirus infection (COVID-19) in patients of mild and moderate severity at the stage of hospitalization, to determine the role of intestinal permeability disorders, changes in the qualitative and quantitative composition of the microbiota in the formation of systemic inflammation in COVID-19 patients.Material and methods: The study was performed in 80 patients with COVID-19, whose average age was 45 years, 19 of them had mild and 61 had moderate severity of the disease. The scope of the examination included traditional clinical, clinical and laboratory, biochemical, instrumental and radiation studies, as well as original methods for studying microbiota and intestinal permeability.Results and conclusions: Clinical features of the course of COVID-19 were studied, clinical and biochemical features, manifestations of systemic inflammation, changes in the intestinal microbiome of patients with mild and moderate severity were identified, concentration levels of proinflammatory cytokines, insulin, fecal calprotectin and zonulin were determined, reflecting the features of intestinal permeability against the background of COVID-19. The role of intestinal permeability and microbiota as the main drivers of the development of gastroenterological manifestations of COVID-19, accompanied by a more severe course of the disease, is emphasized.

The purpose of the first multidisciplinary Consensus: to comprehensively analyze the pathophysiological, clinical, and pharmacotherapeutic aspects of the syndrome of increased epithelial permeability (SPEP) as one of the basic mechanisms of the development of human pathology. The Consensus presents the structure of the three main levels of cytoprotection: preepithelial, epithelial and subepithelial, and the structure of intercellular tight contacts in epithelial tissues and endothelium is considered in detail. The clinical sections of the Consensus are devoted to the role of SPEP in diseases of the digestive system, cardio-cardio-vascular and other visceral systems. A separate section summarizes the materials illustrating the significant role of SPEP in mental disorders and diseases of the nervous system. A separate chapter of the Consensus is devoted to cytoprotective therapy in SPEP. Cytoprotective effects of such proton pump inhibitor as rabeprazole, bismuth preparations and probiotics have been shown. Special attention is paid to the clinical and pharmacological specialties of the cytoprotector of rebamipide. Clinical the effectiveness of re-bamipide shown as in functional, so in organic lesions of the digestive system. Its anti-cancer preventive effects are of practical importance.