Vol 11, No 9 (2025)

Chronic hepatitis C (CHC) remains a pressing healthcare problem, including due to the high risk of developing liver cirrhosis (LC), which is associated with high mortality from complications and leads to the need for liver transplantation.

The aim: to present the current clinical and laboratory characteristics of LC as a result of CHC and to analyze them depending on the degree of compensation of the pathological process.

Material and methods. Data from 65 patients with LC in the outcome of CHC, divided into classes according to the Child – Pugh scale, were analyzed. All participants underwent a comprehensive examination. Obtained data were compared between the groups and with a group of apparently healthy individuals.

Results. Almost half of the patients (44.6%) had decompensated LC (class C). Males predominated among all examined persons (61.5%), and genotype 1 of the hepatitis C virus (HCV) was the most common (55.6%). A high frequency of comorbidities (87.7%) was fixed in the observed patients, as well as a statistically significant increase in the proportion of gastrointestinal and cardiovascular diseases in case of decompensated liver cirrhosis. With the progression of cirrhosis from class A to class C, the frequency of the absence of specific complaints and clinical symptoms significantly decreased, while the prevalence of abdominal pain, jaundice, urine discoloration, peripheral edema, and ascites significantly increased. According to laboratory data, the highest levels of alanine aminotransferase and aspartate aminotransferase were characteristic of class A cirrhosis, while bilirubin concentrations, its fractions, and the international normalized ratio increased significantly with disease progression, while albumin levels and the prothrombin index decreased with the transition to class C.

Conclusion. Clinical picture and laboratory indexes are directly depending on the class of liver cirrhosis. Compensated cirrhosis is often asymptomatic, so laboratory tests play a key role in its diagnosis. In decompensated cirrhosis, symptoms associated with hepatocellular insufficiency and portal hypertension are predominating. Regular monitoring of clinical and laboratory changes allows for an objective assessment of the severity of patients’ condition, promptly identifying the development of liver cirrhosis decompensation, and timely initiating treatment.

Since the end of 2019, coronavirus infection caused by SARS-CoV-2 has resulted in over 777 million clinical cases worldwide and over 6.8 million deaths. This virus had the greatest danger to people over 65 and patients with chronic diseases. For today, data on laboratory indexes’ dynamics in COVID-19 patients has been accumulated, but age-specific patterns of these changes have not been studied.

The aim: to study the differences in laboratory parameters in patients with severe coronavirus infection across age groups.

Material and methods. A retrospective, comparative study of laboratory parameters in patients with severe coronavirus infection was performed from 2021 to 2025 at COVID-19 Clinical Center of A.I. Yevdokimov Moscow State Medical University (now Russian University of Medicine) of the Ministry of Healthcare of Russia. The sample consisted of 795 patients (53.6% female and 46.4% male individuals) aged 20 to 90 years (median 70 [61; 80] years), divided into age groups according to WHO criteria. Then a pairwise intergroup analysis of laboratory parameters was performed.

Results. In patients aged 18–44 years, an increase in the median alanine aminotransferase level to 80.75 [41.55; 198.45] U/L was recorded on days 5–7 of hospitalization. Patients aged 60–74 years at the same hospitalization stage were prone to hypoproteinemia, with a median total protein level of 58 [53.2; 62.075] g/L. Patients over 75 years of age were characterized by significant changes in renal function parameters at all stages of hospitalization. The identified changes in these groups can be explained by both the influence of SARS-CoV-2 at organ systems and also the presence of comorbid pathology with its decompensation, which is confirmed by laboratory test results in patients over 75 years of age.

Conclusion. Increasing of the patients’ age is associated with deterioration in protein metabolism, renal function, coagulation disorders, and the development of a “cytokine storm”. Patients over 75 years of age are more likely to have significant laboratory abnormalities indicating a poor prognosis. These obtained data should be considered during outpatient monitoring of individuals who have had severe COVID-19 infection.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in patients with osteoarthritis (OA), but nephrotoxicity is a common side effect of their use. Safety estimation of NSAIDs is based on an analysis of drug-related complications in real clinical practice and monitoring of renal function.

The aim: to determine the effect of NSAIDs nimesulide, celecoxib, and etoricoxib on renal magnesium transportation in patients with OA without signs of chronic kidney disease (CKD).

Material and methods. The study included 126 patients with Kellgren – Lawrence stages 2–3 knee OA without signs of CKD who required NSAIDs prescription. Participants were randomized into three groups: Group 1 (n = 48) received nimesulide (6000 mg/monthly dose); Group 2 (n = 40) received celecoxib (6000 mg/monthly dose); Group 3 (n = 38) received etoricoxib (2700 mg/monthly dose). Renal magnesium transportation was assessed by measuring serum and 24-hour urine Mg²⁺ concentrations, calculating magnesium clearance, and comparing it with the estimated glomerular filtration rate before and after NSAIDs administration.

Results. The study showed that, during a course of treatment for OA exacerbations by selective cyclooxygenase-2 inhibitors (nimesulide, celecoxib, and etoricoxib), patients without signs of CKD significantly reduced the estimated glomerular filtration rate by 10–12%, increased urinary magnesium excretion by 9–11%, and increased renal clearance by 20–25%, without a statistically significant change in serum Mg²⁺ concentrations, regardless of the type of drug used (p >0.05).

Conclusion. In our opinion, for the purpose to ensure rational and safe NSAIDs therapy, monitoring for the potential development of magnesium deficiency is essential when increasing the duration of treatment with these drugs.

Current article, basing on a literature review, presents data on the biological activity and clinical and pathogenetic significance of kidney injury molecule-1 (KIM-1) in case of acute kidney injury (AKI) and viral infections development. KIM-1 is a surface protein of immunoglobulin family. During renal tubular injury, it is massively expressed by epithelial cells and, to a lesser extent, produced by other cell types. Significant expression of KIM-1, including its urinary form, has been fixed in the early stages of AKI of various etiologies. By stimulating the immune response to the inflammatory process in case of AKI, it enhances the phagocytosis of apoptotic cells by epithelial cells and suppresses inflammatory modulation. In COVID-19, KIM-1 serves for SARS-CoV-2 as an alternative to the ACE2 receptors, through which the pathogen enters cells. Therefore, KIM-1 expression in lung and kidney epithelial cells enhances their damage by the virus. Moreover, this protein is involved in the development of viral infections such as Ebola, dengue, Marburg fevers, Japanese encephalitis, hepatitis A and C, and HIV: by interacting with phosphatidylserine receptors, it enhances viral penetration into cells. KIM-1 may become a biomarker for the early diagnosis and prognosis of AKI outcomes of various etiologies, as well as for assessing the severity of viral infections.

Article examines current aspects of using drinking mineral waters in the treatment and rehabilitation of patients having various internal diseases. Recent results of the studies reflect the high interest of researchers and practitioners to that aspect. Of particular interest is the potential for mineral waters to correct magnesium deficiency, which is accompanied by multiple functional disorders, development and progression of metabolic syndrome, gout, cardiovascular diseases, gastrointestinal tract diseases, and nervous system diseases in human organism. Prescribing magnesium-containing mineral water “Donat” promotes rapid saturation of the body with magnesium and can be successfully used by general practitioners as a part of complex therapy to both achieve and maintain remission in patients with many therapeutic disorders.

Article presents a clinical case of Still’s disease arising in adults, diagnosed using the modified Yamaguchi criteria. Differential diagnostic search in a female patient admitted to an infectious diseases hospital with a diagnosis of fever of unknown etiology is described in details.

The article presents a clinical observation of a patient with combined clinical course of Crohn’s disease and ankylosing spondylitis – chronic inflammatory diseases from the group of immune-inflammatory pathologies. Despite their different clinical focuses – gastrointestinal in case of Crohn’s disease and musculoskeletal in spondylitis – these diseases share common pathogenetic mechanisms. However, their coexistence in the same patient is rare and is of particular interest both from a diagnostic and therapeutic perspective. Such cases require a multidisciplinary approach to the patient and individualized therapy selection.

Listeriosis is an infectious disease caused by bacteria of Listeria genus, which are widespread in environment due to the large number of natural reservoirs. In the structure of infectious diseases, this nosological form is quite rare due to the low susceptibility of healthy individuals to it. However, listeriosis has a serious danger to patients receiving immunosuppressive therapy, having immunodeficiency conditions of various etiologies, as well as to pregnant women. This article presents clinical observations of patients developing listeria infection in the form of listeria meningoencephalitis and septicemia. These observations illustrate clinical course of the disease, complexities of its diagnosis, and importance of promptly administering etiotropic therapy. Laboratory and instrumental data are presented, and pathogenetic mechanisms of infection development in immunocompromised patients are discussed.

Treatment-refractory gastric and duodenal ulcers are predisposed to exacerbations and complications, making their timely diagnosis and treatment particularly relevant. The aim of the review is to present a differential diagnosis algorithm and therapeutic strategies for peptic ulcer disease refractory to proton pump inhibitors (PPIs). Elimination of possible causes of ulcer refractoriness to antisecretory drugs should begin with a search for more common causes for them and end with a search for rare ones. Although there is currently no unified approach to the treatment of difficult-to-heal gastric and duodenal ulcers, PPIs are considered to be the most effective remedies for their therapy. If the ulcer does not heal with a standard PPI dose, the dose should be doubled, and treatment should be continued for another 6–8 weeks. In the treatment of difficult-to-heal gastric and duodenal ulcers, classical PPIs can be replaced with potassium-competitive PPIs and the use of cytoprotectors. In case of ineffective treatment, arising of complications, or malignancy detection, surgical intervention may be required.

Nowadays dyspepsia syndrome is a common problem in the practice of gastroenterologists and general practitioners. To diagnose functional dyspepsia, Helicobacter pylori-associated gastritis must be excluded. However, the efficacy of H. pylori eradication in relieving dyspeptic symptoms requires to be studied more.

The aim of current review is to systematize the available literature data on the nature of dyspepsia syndrome clinical course in post-eradication period.

Acute respiratory viral infections (ARVI) are still remaining to be an actual public health problem: approximately 1 billion cases of ARVI and influenza are registered annually worldwide, with associated mortality reaching 3.9 million. Due to diverse etiologies of ARVI, development of mixed infections, and the lack of specific prophylaxis for most diseases in this group, the use of pathogenetic therapy is becoming to be of great importance. A promising drug for the combination therapy of acute respiratory viral infections, influenza, and COVID-19 is sodium aminodihydrophthalazinedione. It is an immunomodulator with anti-inflammatory and antioxidant effects, which mechanism of action involves regulating the functional and metabolic activity of innate and adaptive immune cells. The article presents a clinical observation of a patient with novel coronavirus infection, in whose treatment this drug was included in the combination therapy.