Lesions of the digestive system in diabetes mellitus (DM) are of secondary nature and arise due to autonomic neuropathy. As a result of hyperglycemia, lesions of the esophagus, stomach, small and large intestine develop. The most common disorder of the digestive system in diabetes is gastroparesis. The diagnosis of gastroparesis is currently insufficient. It is connected with low awareness and, as a consequence, rare visit of patients to specialists, and also with similarity of clinical symptoms with other functional disorders of gastrointestinal tract (GIT). The main risk factors for gastroparesis are hyperglycemia, smoking, alcohol, and certain medications. Most patients with gastroparesis suffer from depression and increased anxiety. Taking medications to treat depression negatively affects the function of the digestive system. This problem interferes with patients’ quality of life. During the pandemic of coronavirus infection, the number of patients seeking medical care due to exacerbation of gastrointestinal disorders increased. The question of etiology is subject to further study. This review also considers the effect of cholecystectomy on the development of gastroparesis in these patients. These patients need special monitoring of glucose levels to prescribe timely antidiabetic therapy and prevent future gastroparesis. For the treatment of lesions of the digestive system in diabetes mellitus, a special diet, in particular the exclusion of hard-to-digest fiber, fatty foods, inclusion of vitamin complexes and normalization of the microbiota plays a paramount role. The main therapeutic value is the timely diagnosis and normalization of glucose levels.

Autonomic neuropathy in patients with diabetes mellitus (DM) is the leading cause of damage to the digestive tract. As a result of chronic hyperglycemia and high glucose variability, the esophagus, stomach, small intestine, and large intestine are most often affected. The most common disorder of the digestive system in diabetes is gastroparesis. Clinical symptoms of gastroparesis have similarities with other functional disorders of digestive tract, which complicates differential diagnosis with other diseases. Quality of life of these patients is worsened because of significant difficulties in managing postprandial glycemia. Since patients with diabetes are quite often affected by cholelithiasis, this review also considers the need for surgical intervention and the subsequent effect of cholecystectomy on the development of gastroparesis in these patients. It is important to remember that after gallbladder removal patients need more careful monitoring of glucose levels. This will allow timely prescription of antidiabetic therapy and reduce the risk of developing gastroparesis in the future. In addition, the effect of coronavirus infection on functional damage of the digestive tract in patients with diabetes is discussed. A special diet is important in the therapy of gastroparesis. Exclusion of hard-to-digest fiber, fatty foods, inclusion of vitamin complexes and normalization of microbiota contribute to slower glucose absorption after meals and better compensation of disease. The main therapeutic value is the timely diagnosis of gastroparesis and normalization of glucose levels.

Gastric cancer is the leading cause of death among all cancer deaths. Identification of risk groups and special carcinogens will prevent the development of the tumor or detect it in the early stages, which will significantly increase the quality of life of patients with high risks of developing gastric cancer. For the timely detection of tumor development, it is optimal to use systematic screening. Undoubtedly, the approaches to the diagnosis of cancer have significant differences in the countries of the West and the East.

Background. The influenza vaccination coverage has steadily increased in the Russian Federation. The introduction of new domestic influenza vaccines into practice and the study of their effectiveness are of great importance for public health. However, a systematic analysis of the effectiveness of vaccines manufactured and used in Russia in recent years has not been performed. The aim ofthe study was to assess the epidemiological effectiveness of three domestic influenza vaccines in St. Petersburg during the 2018–2019 epidemic season.Material and methods. The organized community of 1892 young students aged 18 to 23 years has been under supervision during the period of time from October 2018 to March 2019. Influenza vaccines Grippol Plus, Sovigripp, and Ultrix were used for vaccination.Results and discussion. Prophylactic vaccination with influenza vaccines Sovigripp, Grippol Plus and Ultrix in the fall of 2018 led to a decrease in the incidence of influenza and other acute respiratory infections (ARI) by a total of 1.6–3.8 times; a decrease in the incidence of influenza by 2.7–7.1 times; the total protective efficacy of vaccines against influenza and ARI was 52.4%, and against influenza, taking into account laboratory correction, 73.3%.Conclusions. Under the conditions of the viruses circulating in Russia and in St. Petersburg in the 2018–2019 epidemic season the strains introduced into the composition of influenza vaccines, domestic influenza vaccines were characterized by good tolerance, were safe, areactogenic and had a pronounced protective effect. If the viruses circulating in Russia and in St. Petersburg in the 2018–2019 epidemic season corresponded to the strains introduced into the composition of influenza vaccines, domestic influenza vaccines, showing good tolerance, safety and low reactogenicity, had a pronounced protective effect.

Purpose of the study. To study the epidemiological pathology of the upper gastrointestinal tract among the population of St. Petersburg for the period 2015 to 2018.Materials and methods.We calculated and analyzed the incidence, prevalence, dynamics and structure of the pathology of the upper gastrointestinal tract in various age groups. The reporting forms of Federal Statistical Observation № 1 for 2015–2018 were the source of the information.Results.The gastritis and duodenitis has a high incidence among chronic diseases of the upper gastrointestinal tract. The high incidence is can be seen among adolescents aged 15–17–20.3 per 1000. Peptic ulcer can be seen among people aged 18–55–1.2 per. Nowadays there is a problem of registration and accounting of gastroenterological hernias and gastroesophageal refl ux disease. This issue has to be solved and requires search for resolutions in the face of its prevalence and social signifi cance.

The results of numerous studies indicate an increase in the incidence and prevalence of obesity and diabetes in various age groups. To create a system of effective prevention of complications of these diseases, it is necessary to use an interdisciplinary approach. In order to comprehensively apply preventive measures, the epidemiological features of obesity and diabetes are studied. In the study, groups with high morbidity, frequency of complications and the main causes of death were identified. In St. Petersburg, the highest incidence of obesity is observed among adolescentso - 13.3 per 1000 surveyed. Diabetes mellitus is most common among the working population - 5.0 per 1000 patients. Deach rate due to diabetes complications was 20.5 per 100,000 population.

High incidence of endocrine and uroandrologic disorders among children and adolescents results in negative reproductive potential in the future. These disorders include obesity, diabetes, thyroid disease (autoimmune thyroiditis, hypothyroidism), delayed puberty, cryptorchidism and varicocele. Despite a wide variety of studies on the problem of infertility, information about risk factors of reproductively significant pathology is currently of limited. Purpose. The aim of the present study was to evaluate the risk factors for reproductively significant endocrine and uroandrologic diseases in children and adolescents in St. Petersburg. Materials and methods. A questionnaire survey of 1 456 parents of children and adolescents was conducted during the period from 2015 to 2017. Results and discussion. It was found that a history of rubella was associated with diabetes mellitus in girls (OR 2.7, CI 1.3–5.5). Risk factors related to the parents’ health were thyroid pathology (2.7; 1.3-5.5), obesity (8.4; 2.5–27.7), varicose veins of mother (5.0; 1.8–14.0), cardiovascular diseases of father (28.7; 3.4–237.6). Insulin-independent diabetes mellitus of close relatives (grandparents) was associated with obesity (3.5; 1.8–6.8) and type 1 diabetes mellitus (6.8; 3.8–12.7) in boys. Toxicosis (2.5; 1.4–4.6), risk of pregnancy termination (2.8; 1.4–5.8), bleeding (5.1; 3.2–1.9), miscarriages (3.3; 1.2–8.9), birth of children less than 2 years apart (2.7; 1.1–6.9), birth weight less than 2 kg (5.7; 1.2–26.5) or more than 4 kg (5.1; 2.1–12.4) were found to be risk factors for reproductive significant diseases. There was a relationship between artificial nutrition and obesity in the group of boys (6.5; 2.2–19.0). The study also revealed that smoking (3.4; 1.6–7.3) and alcohol (2.1; 1.2-3.8) were risk factors. The use of diapers older than 1 year was a risk factor for cryptorchidism and varicocele (2.8; 1.4–5.6).