Aim: to present the results of an interdisciplinary international expert council on addressing the challenges of managing patients with non-alcoholic (metabolic dysfunction-associated) fatty liver disease in connection with the creation of a new nomenclature, the definition of diagnostic criteria, and the development of approaches to the diagnosis and treatment of fatty liver disease.

Key points. The key role of metabolic dysfunction in non-alcoholic (metabolic dysfunction-associated) fatty liver disease has been proven. Therefore, in the nomenclature, non-alcoholic fatty liver disease (NAFLD) has been replaced by metabolic dysfunction-associated fatty liver disease, and non-alcoholic steatohepatitis has been replaced by metabolic dysfunction-associated steatohepatitis. It is noted that, according to research, the prevalence of fatty liver disease in Russia is high: one-third of patients seeking primary care have this diagnosis. The results of a study of two incretin mimetics, semaglutide and tirzepatide, are presented, along with an opinion on their rational combination with ursodeoxycholic acid. The comorbidity of fatty liver disease with cardiovascular, endocrine, and oncological diseases, chronic kidney disease, and other conditions is discussed.

Conclusion. The expert council included leading specialists: gastroenterologists-hepatologists, cardiologists, internists, and endocrinologists. There were confirmed that treatment for fatty liver disease should be comprehensive and integrated into the overall concept of metabolic health. Algorithms for diagnosis and personalized treatment of fatty liver disease have to be developed for the Russian medical community.

Aim: to analyze the results of studies that examined volatile organic compounds of various analytes (exhaled air, feces, urine) for the diagnosis of inflammatory bowel diseases.

Materials and methods. A systematic electronic literature search was conducted (without restrictions on the language or type of publication) using the Medline/PubMed, Embase, Scopus and Web of Science databases using keywords.

In the process of analyzing the published articles, the quality of the created diagnostic models was evaluated.

Results. To study volatile organic compounds, metabolomic methods involving the quantification of compounds and so-called “electronic noses” are used — various types of sensors to create a “pattern” of metabolites. It has been shown that the determination of volatile organic compounds in exhaled air, feces, urine is inexpensive, affordable, acceptable to patients and doctors, has high diagnostic accuracy, allowing to distinguish patients with inflammatory bowel diseases from healthy individuals, differentiate nosological forms — ulcerative colitis and Crohn’s disease, the activity of the disease, monitor the nature of its course. Sensitivity and specificity indicators for solving different diagnostic tasks vary depending on the method used (the combined sensitivity and specificity of volatile orga- nic compounds as biomarkers for distinguishing patients with inflammatory bowel diseases from healthy individuals were 87 % (95 % confidence interval (CI): 0.79–0.92) and 83 % (95 % CI: 0.73–0.90), respectively, with an AUC of 0.92), the analyte under study, the number of volatile organic compounds analyzed, the number of patients examined, and consideration of influencing factors.

Conclusion. Volatile organic compounds demonstrate great potential as noninvasive biomarkers of inflammatory bowel diseases. In the future, more extensive multicenter prospective studies are needed to develop optimal approaches to sampling, standardizing the analysis and interpretation of volatile organic compounds data in solving various diagnostic tasks in patients with inflammatory bowel diseases.

Aim: to evaluate the efficacy and safety of Kolofort^® in patients with irritable bowel syndrome accompanied by an anxiety-depressive disorder.

Materials and methods. A total of 70 patients with irritable bowel syndrome confirmed by Rome IV criteria and a HADS (Hospital Anxiety and Depression Scale) score of ≥ 8 points were included in an open, prospective, observational, non-interventional program. Patients received Kolofort^® at a dose of 2 tablets twice daily for 8 weeks. The efficacy of the therapy was assessed according to the HADS, the Visual Analogue Scale for pain (VAS), and the Epworth Sleepiness Scale.

Results. After 8 weeks of therapy, the severity of anxiety and depression was significantly reduced (p < 0.0001): the mean score on the anxiety subscale decreased from 11.1 ± 2.4 to 5.3 ± 3.0, and from 7.6 ± 3.3 to 3.5 ± 2.8 on the depression subscale. The intensity of abdominal pain according to the VAS decreased from 4.8 ± 1.8 to 1.0 ± 1.0  (p < 0.0001). Clinically significant pain reduction (≥30 % from baseline) was recorded in 92.9 % of patients. The level of daytime sleepiness according to the Epworth scale decreased from 6.7 ± 4.2 to 4.0 ± 2.2 (p < 0.0001). Analysis of variance showed an association between reduced anxiety and decreased abdominal pain (p = 0.0058).

Conclusion. The results of the observational program demonstrate the efficacy and safety of Kolofort^® in the treatment of irritable bowel syndrome accompanied by elevated anxiety and/or depression. The synergistic effect of the drug components provides improvement in both somatic and psycho-emotional symptoms of irritable bowel syndrome.

Aim: to determine the frequency of detection of nonsteroidal anti-inflammatory drug-induced (NSAID-induced) gastropathy in patients with rheumatoid arthritis depending on risk factors.

Materials and methods. A total of 97 patients with rheumatoid arthritis were examined. The control group consisted of 35 virtually healthy individuals who did not take NSAIDs and were matched for age and sex with the main group. A questionnaire survey was conducted to evaluate seven risk factors (one point for a positive response). All patients underwent esophagogastroduodenoscopy with the assessment of gastropathy severity using the F.L. Lanza scale for quantitative evaluation of erosive and ulcerative lesion severity.

Results. The analysis showed that the number of patients with rheumatoid arthritis who had no risk factors was small and amounted to 7 individuals (7.2 % of the total number of patients in the group). At the same time, gastropathy was detected in 5 (71.4 %) cases even among these individuals. Gastropathy was detected in 73 (81.1 %) out of 90 patients with ≥ 1 risk factor, but the difference with the group without risk factors was statistically insignificant (χ² = 0.39; p > 0.05; odds ratio (OR) = 1.718; 95% confidence interval (95% CI): 0.307–9.618). In the group of patients with ≥ 2 risk factors, gastropathy was detected in 70 (84.3 %) out of 83 patients; the difference with the group with ≤ 1 risk factor was statistically significant (χ² = 5.62; p < 0.05; OR = 4.038; 95% CI: 1.201–13.581). In patients with ≥ 3 risk factors, gastropathy was detected in 58 (89.2 %) out of 65 cases; the difference with the group with ≤ 2 risk factors was statistically significant (χ² = 9.73; p < 0.05; OR = 4.971; 95% CI: 1.719–14.374).

Conclusions. The calculation of the odds ratio with a 95% confidence interval shows that the absence of risk factors does not exclude the presence of gastropathy in a patient; however, the risk of its development increases statistically significantly with the accumulation of two or more factors.

Aim: to assess the prevalence and characteristics of erosive-ulcerative lesions of the gastrointestinal tract in patients with chronic coronary artery disease and acute myocardial infarction, determining the role of Helicobacter pylori (H. pylori) and other independent risk factors in their pathogenesis.

Materials and methods. A single-center prospective cohort study analyzed data from 110 patients divided into two groups based on the clinical form of coronary artery disease (CAD). Group 1 (n = 56) included patients with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (mean age — 62.0 years) and consisted predominantly of men (n = 41; 73.21 %). Group 2 (n = 54) included patients with stable CAD who had undergone percutaneous coronary intervention within the preceding year (mean age — 67.5 years), and there was also a predominance of men (n = 37; 72.55 %). All patients underwent a comprehensive examination, including the collection of clinical and anamnestic data and laboratory diagnostics. Esophagogastroduodenoscopy (EGD) was performed at different time points depending on clinical status: patients with stable CAD underwent EGD at the time of hospitalization, while for patients with AMI, the examination was conducted in a delayed manner to minimize risks. H. pylori infection was diagnosed using the ¹³C-urea breath test in AMI patients and via biopsy during EGD in stable CAD patients. The one-month follow-up examination included: esophagogastroduodenoscopy to assess the condition of the upper gastrointestinal mucosa, and the ¹³C-urea breath test for patients with baseline H. pylori infection to evaluate the efficacy of eradication therapy.

Results. The prevalence of H. pylori was 46.4 % in the AMI group and 31.5 % in the stable CAD group. Planned EGD in patients with stable CAD before treatment revealed erosive-ulcerative lesions of the upper gastrointestinal tract in 51.9 % of cases, with 46.4 % of these lesions being associated with active H. pylori infection (p = 0.012). The application of active screening and preventive H. pylori eradication strategy in AMI patients resulted in successful eradication in 92.3 % of cases. At the 1-month follow-up EGD, mucosal changes persisted in 30.9 % of AMI patients; however, the majority of these findings were minimal and clinically insignificant (superficial gastritis, catarrhal bulbitis). True erosive-ulcerative lesions were detected in only 18.2 % of patients, indicating the role of the ulcerogenic effect of antiplatelet therapy in their pathogenesis. In patients with stable CAD, targeted therapy (eradication of H. pylori and prescription of proton pump inhibitors) led to a significant reduction in the frequency of erosive-ulcerative lesions from 51.9 to 7.4 % (p < 0.001). Multivariate analysis confirmed that in stable CAD, active H. pylori infection is an independent risk factor for gastrointestinal lesions (adjusted odds ratio [OR] — 4.32; 95 % CI: 1.22–18.20; p = 0.023). In contrast, in the AMI group after preventive eradication, this association completely lost statistical significance (OR = 0.84; 95 % CI: 0.22–3.20; p = 0.79).

Conclusions. Erosive-ulcerative gastrointestinal lesions in patients with CAD are closely associated with H. pylori infection and can be effectively prevented through its early diagnosis and eradication. In patients with AMI, preventive H. pylori eradication is a mandatory but insufficient element of prophylaxis and must be complemented by measures to mitigate the risks associated with dual antiplatelet therapy. Thus, an individualized approach to gastroprotection, tailored to the clinical form of coronary artery disease, enhances the safety and efficacy of pharmacotherapy in these patient groups.

Introduction. Assessing the quality of life of patients with various chronic diseases, including celiac disease, is an important component of scientific research, determining the rationale and effectiveness of treatment and rehabilitation strategies. Few studies have examined the quality of life of children with celiac disease on a gluten-free diet. Furthermore, all of these studies utilized a variety of questionnaires.

Aim: to study the quality of life of children and adolescents with celiac disease on a gluten-free diet using a validated Russian-language version of the CD-QOL questionnaire.

Materials and methods. A cross-sectional study surveyed 599 children and adolescents with celiac disease (aged 2–22 years) using a validated Russian-language version of the CD-QOL questionnaire; the impact of diet on social functioning was also assessed. Comparisons were made using Student’s t-test (Welch’s test was used if homogeneity of variances was not met). For age groups, one-way analysis of variance (ANOVA) was used, with a preliminary check for homogeneity of variances using Levene’s test; in case of homogeneity, Tukey’s post-hoc test was performed. In cases of deviations from normality, the nonparametric Mann — Whitney test was used to compare independent groups. Multiple linear regression was used to assess the influence of factors on indicator levels; associations between variables were additionally assessed using the Pearson or Spearman correlation. The significance level was p < 0.05.

Results. The mean subscale scores for 599 respondents were: “social-emotional limitations” — 3.39 (SD = 0.96),“anxiety/fear for health” — 3.16 (SD = 1.07). A moderately strong positive correlation was found between the subscales  (r = 0.649; p < 0.001). No gender differences were found (p = 0.956 and p = 0.970 for both subscales). In the analysis by age groups, a statistical trend was observed for the “limitations” component (ANOVA: F(3,590) = 2.63; p = 0.053). For the  anxiety component, with confirmed homogeneity of variances using Levene’s test, significant between-group differences were revealed (ANOVA: F(3,590) = 8.84; p < 0.001). Tukey’s post-hoc comparisons revealed higher values in younger groups compared to adolescents and adults. Linear regression showed that anxiety was most strongly associated  with the severity of socioemotional limitations (β = 0.636; p < 0.001) with an independent negative effect of age (β ≈ –0.24;  p < 0.01). The model explained 44.4 % of the variance (R² = 0.444); VIF < 1.1. Psychometric analysis confirmed the two-factor structure with high internal consistency of the subscales (α = 0.904 and α = 0.874).

Conclusions. The quality of life of children and adolescents with celiac disease on a gluten-free diet is characterized by moderate "restriction burden" and associated anxiety. Anxiety is higher in younger age groups; no gender differences were found. The priority of medical and social support is to reduce daily limitations through organizational and environmental measures (in educational and leisure contexts, when eating out), supplemented by psychoeducational support for families, especially in younger age groups. According to the study, such measures are associated with reduced anxiety and improved daily functioning.

Aim: to perform a systematic review and meta-analysis of the efficacy of Saccharomyces boulardii CNCM I-745 in the prevention of antibiotic-associated diarrhea (AAD) in adults and children.

Materials and methods. The protocol for this systematic review and meta-analysis was prospectively registered in the international PROSPERO database (CRD420261296647). In accordance with the PRISMA 2020 guidelines, a systematic literature search was conducted in MEDLINE/PubMed, Embase, the Cochrane Library, Scopus, and RSCI (Russian Science Citation Index) from the time first publications appeared to February 6, 2026. Studies evaluating the efficacy of S. boulardii CNCM I-745 (Enterol^®) in the primary prevention of AAD and Clostridioides difficile infection (CDI) in adults and children were included.

Results. A total of 29 studies met the inclusion criteria and were included in the meta-analysis. The use of S. boulardii CNCM I-745 was associated with a statistically significant reduction in the incidence of AAD compared with control in the overall pooled analysis (OR 0.38; 95 % CI 0.32–0.45). Subgroup analysis confirmed the efficacy of the probiotic in both adults (20 studies, n = 3937; OR 0.45; 95 % CI 0.33–0.61) and children, in whom the effect was even more pronounced (7 studies, n = 1608; OR 0.31; 95 % CI 0.23–0.41). In the analysis of studies in which S. boulardii CNCM I-745 was used as part of Helicobacter pylori eradication regimens, a statistically significant reduction in AAD risk was also observed (13 studies, n = 2333; OR 0.36; 95 % CI 0.25–0.52). Additional analysis demonstrated a significant reduction in CDI risk with S. boulardii CNCM I-745 use (8 studies, n = 18,426; OR 0.67; 95 % CI 0.49–0.92).

Conclusions. The results of this meta-analysis demonstrate the high efficacy of S. boulardii CNCM I-745 in the prevention of AAD in adults and children, as well as in reducing the risk of CDI during antibiotic therapy from the very first

day of treatment.

Background. Ulcerative colitis (UC) is a chronic inflammatory disease characterized by relapsing episodes that require accurate evaluation of disease activity to guide therapeutic decisions. Although endoscopy remains the gold standard for assessing mucosal inflammation, its invasive nature limits frequent use. The serum immune-inflammation index (SII), derived from routine blood counts, has emerged as a potential non-invasive biomarker of systemic inflammation.

Aim: to evaluate the role of SII in assessing disease activity and severity in UC patients.

Materials and methods. This cross-sectional study included 80 adult UC patients attending Ain Shams University Hospitals. Clinical evaluation, laboratory testing (C-reactive protein, fecal calprotectin, and complete blood count), and colonoscopic assessment using the Mayo Endoscopic Subscore were performed on the same day. SII was calculated as (platelet count × neutrophil count) / lymphocyte count.

Results. Of the 80 patients, 25 (31.25 %) were in remission and 55 (68.75 %) had active disease. SII values were significantly higher in patients with active UC compared to those in remission (1357.97 ± 831.17 vs. 582.86 ± 188.88; p < 0.001). SII positively correlated with C-reactive protein and fecal calprotectin, and negatively with lymphocyte count. At a cutoff of > 838.76, SII discriminated active disease from remission with 70.91 % sensitivity, 96.00 % specificity, and 86.1 % accuracy. A cutoff of > 1148.67 distinguished moderate-to-severe from mild disease with 78.00 % accuracy.

Conclusion. The SII is a simple, cost-effective, and reliable non-invasive marker for assessing disease activity and severity in UC. Its incorporation into routine monitoring may reduce dependence on frequent endoscopic evaluation. 

Aim: to compare the effectiveness and oncological safety of colon preparation for surgical treatment in patients with colorectal cancer complicated with obstructive colonic ileus using endoscopic stenting and protective ostomy.

Materials and methods. A prospective, single-center, randomized study was carried out. All patients with colorectal cancer complicated with obstructive colonic ileus consecutively admitted to the Proctology Clinic of the University Clinical Hospital No. 2 of the Sechenov University were included in the study. Patients were randomized into two groups: Group 1 (study group) included patients who underwent endoscopic placement of a self-expanding metal stent to resolve obstructive colonic ileus; Group 2 (control group) included patients who underwent protective ostomy.

Results. Endoscopic stenting requires less general anesthesia and can be performed outside the operating room. The duration of decompression surgery is statistically significantly shorter with stenting compared to ostomy: 23 [20–30] and 50 [40–60] min, respectively (p < 0.001). The rehabilitation period, which is also the period of preparation for the main surgical intervention, with stenting was 4 [3–5] days, which was statistically significantly shorter compared to the control group (p < 0.001). Satisfactory quality of colon preparation after decompression in the study group was noted in 92.9 % of cases, in the control group — in 50 % of cases (p < 0.001). The result of nutritional correction in both groups was assessed as positive, however, in intergroup comparison, the level of serum albumin was statistically significantly higher in the group of stented patients (p = 0.015). The duration of the main surgery was statistically significantly longer in the ostomy group than in the study group: 300 [270–320] vs. 180 [160–220] min, respectively (p < 0.001). The results of the data indicating the oncological safety of both decompression methods were similar.

Conclusion. Endoscopic stenting of tumor stenosis in obstructive colonic ileus may be considered a preferable option for preoperative colon decompression compared to unloading stoma in the treatment of complicated forms of colorectal cancer within a single hospitalization.

Aim: to determine the safest and most effective parameters for the laser coagulation method of uncomplicated pilonidal sinus.

Materials and methods. Three single-center randomized pilot studies were conducted, involving 21 patients with chronic inflammation of the pilonidal sinus. During the operation, depending on the randomization group, fiber laser devices with wavelengths of 970, 1560, and 1940 nm were used, with end or radial light guides and varying amounts of energy. To determine the effectiveness, safety, and characteristics of laser exposure, the sinus tract was excised, and the removed specimen was subjected to morphological examination. This study demonstrated the depth of thermal laser exposure on the structures of the pilonidal sinus at different wavelengths, amounts of energy transferred, and types of fiber instruments.

Results. Lasers with wavelengths of 970, 1560, and 1940 nm can be used for laser coagulation of the pilonidal sinus. The use of end-face and radial light guides is acceptable, but from the point of view of technical characteristics and safety, the use of an end-face type is most justified. The study demonstrated a direct relationship between the level of energy delivered and an increase in the depth of thermal damage, but it is not possible to definitively determine the optimal amount of energy per 1 cm of pilonidal sinus length due to the small sample of patients.

Conclusions. Laser coagulation is a minimally invasive, highly effective method of treating the pilonidal sinus, with an efficiency rate of 90–97 %. The results of the studies showed that lasers of different wavelengths can be used for this surgical method. But considering the penetration depth of laser radiation with a wavelength of 1940 nm, its use is preferable. The use of an end-face light guide is the most appropriate in terms of its technical characteristics, safety, and ease of use. The results of the study also demonstrated a direct relationship between the level of energy delivered and the depth of thermal impact on tissue.

Aim: to present two clinical cases of low-grade appendiceal mucinous neoplasms (LAMN) and evaluate the oncological adequacy of ileocecectomy with ileoascending anastomosis in patients with cecal involvement.

Key points. Appendiceal mucinous neoplasms are rare tumors detected either during radiological examinations conducted for other reasons, intraoperatively in patients operated on with a diagnosis of appendicitis, or during histopathological examination of the appendectomy specimen. In 2025, two male patients, aged 36 and 70 years, with the aforementioned diagnosis were operated on at the Oncology Clinic of Azerbaijan Medical University. The neoplasm in the 36-year-old patient was discovered during intraoperative revision for suspected appendicitis at a district hospital. In the other patient, the tumor was detected preoperatively during a CT scan performed to stage an endoscopically and histopathologically confirmed sigmoid colon carcinoma. Both patients underwent an ileocecectomy with an ileoascending anastomosis for the appendiceal mucinous neoplasms. The postoperative period was uneventful, and histopathological examination of the resected specimens confirmed a low-grade appendiceal mucinous neoplasm (LAMN) in both cases.

Conclusion. In patients with LAMN adherent to or infiltrating the cecum, an ileocecectomy with ileoascending anastomosis can be performed as an adequate surgical procedure. Although this volume of surgery is less extensive than a right hemicolectomy, it can theoretically be compared with it in terms of providing oncological radicality.

Aim: to present a clinical case of simultaneous thrombosis of the hepatic veins and total thrombosis of the vessels of the portal system in a myeloproliferative neoplasm.

Key points. The patient was admitted to the gastroenterology department with complaints of abdominal distension, abdominal pain syndrome, and hyperthermia. An examination revealed widespread thrombosis of the hepatic veins and the portal system. Conservative therapy with diuretics, low-molecular-weight heparins, and albumin preparations proved ineffective. The patient was referred to a federal clinic for verification of the diagnosis of myeloproliferative neoplasm. As a result of the examination, a diagnosis of essential thrombocythemia was established. Against the background of comprehensive conservative therapy, a regression of refractory ascites was achieved. The patient is under dynamic observation of a hematologist, a hepatologist, hepatobiliary surgeon, and a transplantologist.