No 90 (2022)

Pharmacology, clinical efficacy, side effects, drug interactions and the place of bitter melon in therapy are described. Bitter melon (Momordica charantia) is an alternative therapy that has mainly been used to lower blood glucose levels in patients with diabetes mellitus. The components of bitter melon extract seem to have a structural similarity to animal insulin. Antiviral and antitumor activity has also been reported in vitro. Four clinical trials have shown that bitter melon juice, fruit and dry powder have a moderate hypoglycemic effect. However, these studies were small and were not randomized or double-blind. Side effects of bitter melon have been reported, including hypoglycemic coma and seizures in children, decreased fertility in mice, favism-like syndrome, increased levels of gamma-glutamyltransferase and alkaline phosphatase in animals, and headaches. Bitter melon can have an additive effect when taken with other hypoglycemic agents. To properly assess safety and efficacy, randomized placebo-controlled trials with adequate nutrition are needed before bitter melon can be regularly recommended. Bitter melon can have a hypoglycemic effect, but there is not enough data to recommend its use in the absence of careful observation

Despite the long existence of diabetes mellitus and its high prevalence among the population, which has acquired the character of a pandemic, there are still many unexplored questions regarding both the pathophysiology of the development of the disease and methods of prevention and treatment [5,8,15,17,18]. Meanwhile, diabetes mellitus leads to numerous negative consequences, reducing the quality of life, in some cases leading to disability of the population, economic losses in health care [4,5,6,19,20]. All this necessitates an in-depth study of the pathogenesis of diabetes mellitus, means of its prevention and complex treatment, and leads to the creation of experimental models [6,15,18]. Currently, there are a large number of experimental models that allow the study of type 1 and type 2 diabetes mellitus, the means of their therapy: surgical, genetic, chemical, endocrine, immune models. However, all of them have their own advantages and disadvantages, which must be taken into account in an in vivo experiment [8,13,14,15].

Cardiovascular disease is a major health problem worldwide due to its high prevalence and mortality. In their structure, the largest percentage is coronary heart disease (CHD), the main cause of which is atherosclerosis. One of the manifestations of this condition is myocardial infarction. Another no less formidable pathology is diabetes mellitus. This disease is polyetiological and is characterized by either insulin resistance or a reduced amount of insulin, or both. For this reason, it is necessary to develop new approaches to assessing the functional state of comorbid patients with myocardial infarction and diabetes mellitus. Thus, the aim of the study was to identify a direct relationship between such blood parameters as ADPGn, KDPGn, ADPGo, and the likelihood of developing oxidative stress in patients with diabetes mellitus and myocardial infarction.

Most of the publications on the problem of viral diarrhea are devoted to morbidity in children. However, acute intestinal infections of viral etiology in adults are becoming increasingly important. In the Voronezh region, there is an increase in the proportion of viruses as the etiological cause of acute infectious gastroenteritis. This is due to the introduction of centralized research using molecular biological methods for the detection of pathogens. PCR made it possible to simultaneously determine the presence of bacteria and viruses in the test material - the causative agents of acute intestinal infections (multiplex format). In the etiological structure of viral diarrhea in children and adults, rotaviruses dominate. With the expansion of the range of laboratory tests and clinical observations performed, the number of cases of norovirus infection is growing. The stability of pathogens in the environment, the presence of asymptomatic carriers, the frequent family and group nature of the disease, the ease of infection in various ways, the low coverage of specific prevention, create prerequisites for an increase in the incidence. This article studied the clinical and epidemiological features of the most relevant infectious diarrhea of rotavirus and norovirus etiology. This information is of undoubted interest for practitioners, it aims to help in the early detection of patients, the implementation of adequate anti-epidemic measures and rational pathogenetic treatment.

The prevalence of neuroendocrine tumors (NETs) has been increasing in recent years. The most common localization of NET is the gastric-intestinal tract, in particular the pancreas (PV). Among hormonally active NETs, the most common are insulinoma, gastrinoma, glucagonoma and VIPoma. The treatment of the latter three is rarely addressed in the scientific literature due to their low prevalence. The purpose of this review is to summarize the latest information on the treatment of hormone-active RV tumors such as gastrinoma, VIPom and glucagonoma (excluding insulin). For treatment with gastrin, symptomatic therapy is used, including antisecretory drugs (mainly proton pump inhibitors), surgical treatment is currently used more often than in the past. Symptomatic therapy also plays a major role in the treatment of VIP, since the tumor is often malignant, and by the time of diagnosis, most patients have metastases. Symptomatic treatment includes replenishment of fluid and electrolytes, including with the help of infusion therapy, administration of somatostatin analogues, antidiarrheal agents. Somatostatin analogues, resection of the primary pancreatic tumor are used for glucagon treatment. In metastatic-advanced NETs, surgical treatment, tumor embolization, ablation, targeted therapy, and in some cases liver transplantation are used.

Currently, inflammatory bowel diseases (IBD) occupy a leading position in the structure of diseases of the gastrointestinal tract (GIT). Nonspecific ulcerative colitis, Crohn's disease are progressive chronic diseases with an autoimmune type of inflammation. The presence of severe forms of IBD is observed in patients with comorbid pathology, a large proportion of which are metabolic disorders (obesity, type 2 diabetes mellitus).