Colorectal cancer is an urgent health problem in Russia and other countries. The aim is to present up-to-date data on CRC screening programs. A review of current recommendations has shown the effectiveness of screening programs using occult blood tests and fibrocolonoscopy in reducing morbidity and mortality from colorectal cancer. The implementation of screening programs in Russia is presented as part of the development of preventive medicine in general.
The purpose of the review is to present an analysis of the current literature data on the pathogenesis and therapy of liver damage in Covid-19. Liver damage in COVID-19 patients can be caused by the direct cytopathogenic effect of SARS-CoV-2, an uncontrolled immune response, sepsis, severe hypoxia, or drug damage. In addition, COVID-19 can exacerbate and decompensate previously formed chronic liver diseases with the development of acute liver failure. Physicians should carefully assess the initial state of the liver, and after prescribing therapy, intensify monitoring of its functional state, especially in patients with severe COVID-19. In each clinical case, the doctor needs to establish the possible mechanisms of organ damage in order to select the most optimal patient management tactics, which would take into account all aspects of the COVID-19 course and liver damage. Currently, additional scientific information is required to uncover the features of liver damage during SARS-CoV-2 infection and in the postcovid period. Patients who have undergone COVID-19 need further monitoring to assess the long-term effects of the disease.
Цель обзора представить анализ литературных данных об этиопатогенезе и терапии заболеваний печени при COVID-19. У пациентов с COVID-19 часто встречается повреждение печени, которое может быть вызвано прямым цитопатическим эффектом вируса, неконтролируемой иммунной реакцией, сепсисом или лекарственным поражением органа. Учитывая наличие рецепторов ACE2 в печени, она является потенциальной мишенью для SARS-CoV-2. Более того, COVID-19 может вызвать обострение основного хронического заболевания печени, что приведет к ее декомпенсации, острой печеночной недостаточности, ассоциирующихся с более высокой смертностью. Врачам следует тщательно оценивать исходное состояние печени, обращать внимание на изменения в течении фонового заболевания печени, во время лечения следует усилить мониторинг и оценку функции печени у пациентов с тяжелым течением заболевания. Врач должен установить причины поражения печени в сочетании с патофизиологическими изменениями, вызванными COVID-19 и на основе активного лечения основного заболевания, назначить лечение для защиты печени, чтобы уменьшить степень ее повреждения. В настоящее время требуются дополнительные данные, чтобы выяснить характер и степень поражения печени, определить походы к терапии у пациентов с COVID-19.
The purpose of the review is to present an analysis of the literature data on the etiopathogenesis and therapy of liver diseases while Covid-19. Liver damage is common in patients with COVID-19, which can be caused by the direct cytopathic effect of the virus, an uncontrolled immune response, sepsis, or drug damage to the liver. Given the presence of ACE2 receptors in the liver, the liver is a potential target for SARS-CoV-2. Moreover, COVID-19 may exacerbate underlying chronic liver disease, leading to hepatic decompensation, acute liver failure, associated with higher mortality. Doctors should carefully assess the initial state of the liver, pay attention to changes in the course of underlying liver disease, and during treatment should intensify monitoring and evaluation of liver function in patients with severe disease. The physician should establish the causes of liver damage in combination with the pathophysiological changes caused by COVID-19 and based on active treatment of the underlying disease, prescribe treatment to protect the liver to reduce the degree of liver damage. Additional data are currently required to clarify the nature and extent of liver damage, and to determine approaches to therapy in patients with COVID-19.
In 2019, a retrospective analysis of medical records for 10 previous years (2019-2009) was conducted for 426 patients with confirmed malignant neoplasm (MN) of the stomach registered in 125 outpatient and polyclinic medical and preventive treatment facilities in 12 cities of the Russian Federation. The average age of patients at the time of diagnosis was 61.9 years, the life expectancy after diagnosis being 2.2 years. In 67.4% of patients the diagnosis was made at stages III and IV of the disease. All patients had a history of any upper digestive tract pathology. The record of H. pylori c examination was detected in 16.9% of patients, all of them with positive results. In 64,3% of esophagogastroduodenoscopy (EGDS) protocols there were visible changes in the gastric mucosa. Dynamic EGDS control was performed irregularly. During the whole period of observation, an average of 2.5 biopsies per patient were taken during EGDS. In the clinical diagnosis of “chronic gastritis” morphological examination was performed in 70.0% of patients. Classical “warning signs” were registered on the average 2.4 years before the diagnosis of gastric cancer. Dyspepsia syndrome was registered 4.6 years before cancer verification. The correlation between dyspepsia and the timing of cancer diagnosis was confirmed. Thus, the dyspepsia syndrome can be categorized as “early warning signs”. For the diagnosis of gastric adenocarcinoma, 3D correlation analysis showed a correlation between the number of biopsy samples taken, the number of “warning signs” and the number of years lived after the diagnosis of malignant neoplasms.
Metabolically associated fatty liver disease is a widespread disease (MAFLD).The main treatment strategy for MAFLD is the correction of metabolic factors, changes in lifestyle, normalization of body weight, which is achieved by the use of diet therapy and physical activity.The purpose of this review is to present the characteristics of diets that have been studied in the treatment of patients with MAFLD.Results. The greatest evidence base on the effectiveness of treatment of MAFLD and the safety profile is the use of the Mediterranean diet and the diet with a low glycemic index. Patients should be advised to reduce their sugar intake, reduce their intake of saturated fatty acids and trans fats, and increase their intake of dietary fiber. Eating a balanced, calorie-restricted diet can help to provide healthy lifestyle and healthy eating habits, which are essential for the prevention and treatment of MAFLD. Hereditary factors, the composition of the intestinal microbiota, comorbid pathology can affect the results of diet therapy, which emphasizes the urgent need for an individualized approach in the treatment of this disease.
The purpose of the review was to study the data of the modern literature on the effect of diet on the skin condition and the course of some dermatological diseases. Recent studies have shown a strong link between diet and a number of dermatological conditions. Food allergies and Western eating patterns can dramatically alter microbiome composition and intestinal permeability. In conditions of disturbed microbial balance and changes in the barrier function of the intestine, the penetration of immunogenic molecules into the systemic circulation, including food antigens, bacterial toxins and pathogens, which can accumulate in the skin, disrupt the epidermal barrier and contribute to chronic inflammation, increase. However, in children with atopic dermatitis, elimination diets did not show a significant advantage in reducing the severity of the disease; on the contrary, adverse events associated with malnutrition, lack of vitamins and minerals were more often recorded. Despite the fact that dietary intervention is an important aspect of the treatment and prevention of a wide range of dermatological diseases, many questions remain open today.