The aim: Is to determine the peculiarities of changes in the gastric acid secretion against the background of diabetic autonomic neuropathy and autonomic dysfunction in patients with chronic pancreatitis (CP) and type 2 diabetes (T2DM). Materials and methods: We investigated 64 patients with CP and T2DM, who were included in the first group of the patients examined; Group II consisted of 40 patients with T2DM; and Group III of the patients examined consisted of 34 patients with CP. Results: Differences were found in assessing the degree of autonomic nervous system (ANS) dysfunction in the examined patients, namely – the most pronounced ANS dysfunction according to the Wayne questionnaire was diagnosed in patients Group I, while patients of Group III. Analysis of gastric acid secretion indicates that no patients of Group III had normal acidity. Normal acidity is more often found in the second group of subjects. Both in patients with CP and T2DM, and in isolation with CP, moderate hyperacidity was more often determined. Conclusions: The predominance of the parasympathetic division of the ANS, as well as manifestations of severe ANS dysfunction, are observed in patients with CP and T2DM. The prevalence of gastric hyperacidity on the background of DAN was established in patients with CP and T2DM. In this case, the absence of clinical symptoms or their minimal severity is determined, which indicates the lesion of the digestive tract in these patients.

The aim: To explore the features of the congnitive (CD) and neurovegetative dysfunctions (NVD) of patients with different forms of non-alcoholic fatty liver disease NAFLD (nonalcoholic fatty hepatosis (NAFH) and non-alcoholic steatohepatitis (NASH)) and type 2 diabetes mellitus (T2DM), as well as their dynamics against the background of complex therapy using armadin (2-ethyl-6-methyl-3-hydroxypyridine succinate). Materials and methods: 50 patients with NAFLD (24 patients with NAFH and 26 patients with NASH) and T2DM were examined. Dysfunction of central and vegetative nervous system was carried out with the help of neuro-psychometric testing. Results: The analysis of the conducted research before treatments indicates the NVD in the surveyed patients. Cognitive dysfunctions (mostly mild and moderate) was revealed in all of our patients in both groups. The most pronounced disturbances before treatments were determined in the areas of attention and concentration, memory, less pronounced – visually constructive area, especially among patients with NASH and T2DM. Stressful situations have a pronounced impact on the lives of these patients, but they are not critical enough to any issues. Patients of Group 2 before treatments had the lowest level of resistance to stress. They found a slight vulnerability even from minor impacts. Conclusions: In patients with NAFLD and T2DM, congnitive and neurovegetative dysfunctions were found, according to neuro-psychometric testing. Complex therapy using 2-ethyl-6-methyl-3-hydroxypyridine succinate is an effective and safe method for the correction of congnitive and neurovegetative dysfunctions in patients with NAFLD and T2DM.

The aim: To study the features of changes in the level of prostaglandins (I2 and F2α) in blood serum of patients GERD on the background of OH of the cervical and thoracic spine and obesity. Materials and methods: The examined patients included 56 patients with GERD and OH of the cervical and thoracic spine. All patients had their blood serum prostaglandin (Pg) F2α and 6-keto prostaglandin F1α (blood prostacyclin – Pg I2) levels examined using the method of immunoassay analysis. Results: In all patients with GERD and OH an excessive body weight or obesity of varying degrees was found while analyzing anthropometric study results. The determination of prostaglandin F2α and prostacyclin (Pg I2) levels in blood serum in patients with GERD and OH and healthy individuals was performed. A more pronounced increase of Pg I2 and Pg F2α in blood serum in patients with GERD and OH with III degree obese was found and the smallest concentration of prostaglandines in blood serum was diagnosed in patients with excessive weight (p<0.05). Conclusions: 1. In patients with GERD and OH, an increase in levels of prostaglandins F2α and I2 in blood serum has been established. 2. The relationship between the duration of excess body weigh, obesity and the dynamics of the level of prostaglandin Pg I2 and F2α in blood serum in patients with GERD on the background of OH has been established.

The aim: To investigate the effectiveness of determining the activity of faecal calprotectin for detecting colonic lesions in patients with nonalcoholic fatty liver disease who have had a COVID-19 acute respiratory infection. Materials and methods: The study included 46 patients with non-alcoholic fatty liver disease NAFLD at the stage of outpatient observation after suffering a COVID-19 acute respiratory infection. Results: One of the main clinical signs indicating intestinal lesions among the COVID-19-infected patients with NAFLD at the time of admission to hospital was diarrhea (identified in 43.5% of cases during the patients’ examination), as well as bloating and pain in the colon (identified in 26.1% and 32.6% of cases during the patients’ examination, respectively). The analysis of the data obtained indicates a slight increase in the level of faecal calprotectin among NAFLD patients infected with COVID-19 during hospital treatment, and in this regard the indicators did not exceed the reference values. A more pronounced deviation from the norm was observed 2 months after hospital treatment, namely, its increase to 101.6 ± 2.5 μg / L. Conclusions: A frequent clinical manifestation of intestinal lesions among NAFLD patients infected with COVID-19 is defaecation disorder, which at the beginning of the disease is more often manifested through alternating diarrhea (up to 43.5%) and constipation (32.6% of the examined patients). NAFLD patients infected with the COVID-19 virus are diagnosed with an intensified activity of faecal calprotectin and α1-antitrypsin in the blood serum and faeces, as well as the clearance, and this indicates the presence of inflammatory changes in the colon, which requires conducting further research of these patients’ cases.

The aim: To determine the peculiarities of changes in the homocysteine levels in the patients with chronic pancreatitis and type 2 diabetes blood serum depending on the vitamin status. Materials and methods: We investigated 36 patients with chronic pancreatitis and type 2 diabetes, who were included in the first group of the patients examined; Group 2 consisted of 34 patients with chronic pancreatitis; and Group 3 of the patients examined consisted of 40 patients with type 2 diabetes. Results: All patients examined were diagnosed with type 2 diabetes mellitus of moderate severity. Also, the diagnosis of chronic pancreatitis was confirmed in all patients with type 2 diabetes, which was manifested by exocrine pancreatic insufficiency according to the results of clinical, laboratory and instrumental methods of examination. There was a significant decrease in the level of all B vitamins and 25-(OH)D in patients with chronic pancreatitis and type 2 diabetes (Group I). An increase in the concentration of homocysteine in the serum in all examined groups of patients was established, with the maximum deviation from the norm in patients with chronic pancreatitis and type 2 diabetes (up to 32.7 ± 0.8 μmol / L <0.01). The correlation analysis revealed a strong direct relationship between the level of homocysteine and vitamins B12, B6, 25-(OH)D and an inverse correlation between vitamin B9 in the group of patients with chronic pancreatitis and type 2 diabetes. Conclusions: Patients with chronic pancreatitis and type 2 diabetes have a decreased levels of B vitamins (B1, B6, B9, B12) and 25-(OH)D, which is accompanied by an increase in serum homocysteine. In patients with chronic pancreatitis and type 2 diabetes, the level of homocysteine in the blood serum directly depends on the decrease in the levels of vitamins B6, B12 and 25-(OH)D in blood serum, as well as inverse depends on vitamin B9 levels in these patients.