Background. Non-alcoholic fatty liver disease is one of the main multidisciplinary problems in pediatrics. Approximately one in 3-4 people in the population has non-alcoholic fatty liver disease. The overall incidence of the disease in children is 9%, and in overweight and obese children it reaches 40%. The growth of this pathology is associated with an increase in the number of patients suffering from overweight, obesity, type 1 and type 2 diabetes mellitus and a condition such as insulin resistance. An important pathogenetic factor is a violation of intestinal permeability with bacterial translocation and a change in the composition of the intestinal microbiota. Disruption of the gut-liver axis in the pathogenesis of non-alcoholic fatty liver disease requires mandatory inclusion of strain-specific probiotics in the treatment program.

Objective. To conduct a literary review of modern domestic and foreign literature on the early diagnosis of non-alcoholic fatty liver disease, to substantiate patient management tactics using the example of a clinical case.

Materials and methods. Modern literature on the problem of non-alcoholic fatty liver disease has been studied, general scientific methods have been applied: analytical, scientific and organizational.

Results. Modern research denies the benign course of this disease. It has been proven that non-alcoholic fatty liver disease can lead to fibrous changes in the liver parenchyma and in the future, in the absence of early treatment, to its cirrhosis. Therefore, early diagnosis and comprehensive treatment of non-alcoholic fatty liver disease in children is an interdisciplinary task. The diagnosis of non-alcoholic fatty liver disease in children consists in the use of non-invasive methods: biochemical tests, ultrasound diagnostics (ultrasound), elastography, magnetic resonance imaging and computed tomography.

Conclusion. Early diagnosis and initiation of treatment are especially important in childhood, since the disease during this period of life is characterized by reversible structural and functional changes. The most promising drugs are those that affect the main targets of the disease: inflammation, liver fibrogenesis, correction of insulin resistance, correction of the intestinal microbiota, as well as the organization of a rational diet, daily routine and physical activity.

Background. We present a previously undescribed clinical case of a combination of nephroblastoma and bilateral vesicoureteral reflux in a 7-year-old girl. Vesicoureteral reflux is one of the most common congenital uropathies in children. High degrees of vesicoureteral reflux and frequently recurring urinary tract infections lead to progressive kidney damage with the development of reflux nephropathy (RN). Nephroblastoma or Wilms' tumor is a highly malignant embryonic tumor of the kidney in children. Despite the low incidence, it is the most common among all malignant neoplasms of the kidney. The clinical picture is diverse and can consist of nonspecific general and local symptoms, the severity of which depends on the localization, size, and metastasis of nephroblastoma. Due to ethnic characteristics, the girl first underwent a medical examination at the age of 7.

Results. The results of the examination of the urinary system revealed combined bilateral damage to the kidneys and upper urinary tract, Wilms tumor of the right kidney, bilateral grade IV vesicoureteral reflux on the right, grade V on the left in a secondary shrunken kidney, secondary hypochromic anemia of mild degree. Pediatricians together with urologists, nephrologists, oncologists, and transplantologists developed a treatment strategy for the patient.

Background. Alagille syndrome is a hereditary multisystem pathology that is transmitted in an autosomal dominant manner. The disease is characterized by significant clinical heterogeneity, from life-threatening severe cardiac abnormalities and severe liver dysfunction to mild forms with minor abnormalities in liver enzyme levels. This variability complicates differential diagnosis. It is noteworthy that the degree of manifestation of the syndrome can vary greatly even among relatives with the same genetic mutations. The disease occurs with a frequency of 1:30,000-1:50,000 newborns.

Results. The article presents three clinical cases of Alagille syndrome: patient R., 1 month old, patient C., 3 months old, and patient B., 5 months old. All children had symptoms of cholestasis from the first days of life, including jaundice of the skin and sclera, acolic stools, elevated total bilirubin with a predominance of the direct fraction, and a negative reaction to stercobilin in the stool. Two patients with cholestasis developed cholestatic hepatitis with a high degree of activity, manifested by increased transaminases and echographic signs of diffuse liver changes. In children aged 1 and 5 months, manifestations of hemorrhagic syndrome were revealed, which was clinically manifested by the presence of ecchymoses. All the examined patients developed secondary anemia due to liver damage. A patient of 3 months and 5 months of the presented clinical cases had a specific syndrome in the form of "butterfly-shaped" vertebrae. These patients also had a hemodynamically significant congenital heart defect. According to the results of mass parallel panel sequestration, pathogenic variants in the JAG1 gene were found in all patients.

Conclusion. Alagille syndrome is characterized as a multifactorial pathological condition characterized by significant clinical heterogeneity, which significantly complicates the diagnostic process in the first three months after the patient's birth. The identification of specific clinical and instrumental markers associated with this syndrome is a key element in the early diagnosis system. This allows not only to prevent the progression of severe disabling complications, but also to form sound strategies for clinical management and therapeutic intervention in patients with this syndrome.

Background. Kawasaki syndrome is an acute systemic vasculopathy of unknown etiology, primarily affecting infants and preschool-aged children. Persistent fever, conjunctivitis, polymorphic rash, mucosal lesions, and lymphadenopathy are not pathognomonic symptoms, leading to a high risk of misdiagnosis and delayed diagnosis. As a result, patients are often initially hospitalized in infectious disease wards, where time is wasted on the laborious process of differential diagnosis with a wide range of bacterial and viral infections. Effective therapy is aimed at preventing lifethreatening complications, which directly depends on its timely initiation. The "gold standard" of treatment is the combined administration of intravenous immunoglobulin and acetylsalicylic acid within the first 7-10 days of illness. Delayed initiation of adequate therapy increases the risk of developing specific complications (coronary artery disease with the formation of aneurysms, stenosis, thrombosis, or vessel rupture), which become the leading cause of acquired coronary artery disease, myocardial infarction, and sudden death in children in the future.

Purpose: medical education to physicians on the issue of Kawasaki syndrome.

Materials and methods. Analysis of the hospital chart, clinical and anamnestic data, and laboratory and instrumental examination results of a 3-year-old patient with complete Kawasaki syndrome was conducted.

Results. A description of the symptoms and course of Kawasaki syndrome in a young child is presented through an analysis of the clinical situation and diagnostic errors made at the onset of the disease. The basis for the diagnosis of Kawasaki syndrome in our observation were: fever during antibacterial therapy for more than 5 days, the presence of a rash, changes in the oral mucosa, lymphadenitis, scleritis, erythema, and swelling of the extremities. This article may be of interest to primary care physicians for medical education on the topic of Kawasaki syndrome.

Background. Measles is an acute highly contagious viral disease transmitted by airborne droplets and characterized by fever, symptoms of intoxication, damage to the respiratory tract and conjunctivae, and the presence of maculopapular exanthem with subsequent pigmentation. The article describes current knowledge about the sources, carriers, and various mechanisms of infection transmission. According to EMISS, in 2024, 22,455 cases of measles were reported in Russia, an increase of 72% (1.7 times) compared to the previous year. Most of the cases (14,166) were children aged 0 to 17. In 2024, 8 cases of measles were reported in the Arkhangelsk Region, 6 of which were children aged 0 to 17. The article presents a clinical case of a family outbreak of measles detected in Arkhangelsk in January 2024.

Objective. The purpose of this article is to provide a comprehensive assessment of the epidemiological significance of the imported case of measles that occurred in Arkhangelsk, given the high level of collective immunity among the local population. The article focuses on a detailed analysis of the effectiveness of the sanitary and epidemiological measures that were promptly implemented in response to the detection of the disease, aimed at preventing the possible further spread of the infection among the residents of the city. As part of the epidemiological investigation, two clinical cases of measles were examined in detail, both of which were reported within the same family in January 2024 in the city of Arkhangelsk. This allowed us to assess the key role of timely diagnosis and isolation of patients in successfully containing an infectious disease outbreak.

Conclusion. The data presented in the article highlight the importance of maintaining a high level of vigilance among healthcare professionals, even with widespread vaccination coverage, and confirm the significance of prompt response in the event of an infectious disease outbreak in organized groups.

Background. In December 2025, a hybrid (in-person and online) Scientific-Practical Conference "Moscow Gastroenterological Council. Year's Results" was held in Moscow. At the event, leading gastroenterology specialists gathered to discuss current issues in the treatment of hepatobiliary system diseases and to share experiences.

Results. The conference was an important event for practicing physicians, allowing them to stay abreast of the latest trends in medicine. The most pressing issues in modern gastroenterology were discussed – inflammatory bowel diseases, comorbid pathology, and interdisciplinary aspects. The symposium "Interdisciplinary Tasks in Hepatology. Practical Solutions," held as part of the conference, focused on effective approaches to therapy for patients with combined pathology (non-alcoholic fatty liver disease + cardiovascular diseases), as well as new clinical guidelines for drug-induced liver injury. The symposium's presidium included M. V. Maevskaya, Cand. of Sci. (Med.), Professor, Consultant of Medical and Diagnostic Department No. 3 of the University Clinical Hospital No. 2, I. M. Sechenov First Moscow State Medical University (Sechenov University) Ministry of Health of the Russian Federation, Vice-President of the Russian Society for Liver Research, Moscow, Russia, and E. V. Vinnitskaya, Dr. of Sci. (Med.), Chief Researcher of the Hepatology Department at the A. S. Loginov Moscow Clinical Research Center.

Background. Chlamydia-induced urogenic reactive arthritis (x/iUREA) is a complex interdisciplinary problem, as its clinical manifestations are characterized by a combined lesion of the urogenital tract, joints, skin, mucous membranes and other organs. Despite belonging to the group of spondylarthritides, the leading role in the primary diagnosis and management of patients belongs to the dermatovenereologist. Polymorphism and non-simultaneous manifestation of symptoms, along with the frequent subclinical course of urogenital inflammation, cause significant difficulties in timely diagnosis and often lead to the chronicization of the process.

Objective. To study and systematize the clinical features of x/uUREA in male patients living in the Moscow region, as well as to assess the diagnostic significance of immunomorphological examination of intact skin using direct immunofluorescence (DIF) in this disease.

Materials and methods. A prospective study was conducted on 65 men with a verified diagnosis of x/uUREA who were hospitalized in the Department of Dermatovenereology at the Moscow Regional Research Institute of Dermatology and Venereology. All patients underwent a comprehensive clinical and laboratory examination, which included detection of chlamydia infection, assessment of joint syndrome, urethroscopy, examination of prostate secretion, dermatological examination, and immunomorphological examination of intact skin biopsies.

Results. The average age of the patients was 30 [24; 39] years. The average duration of the disease before hospitalization was 12 [6; 24] months, and only 6.2% of patients were hospitalized in the first 3 months of the disease. All patients (100%) were diagnosed with a combination of arthritis and chronic urethroprostatitis of chlamydial etiology, and in 30.8% of cases, the urogenital inflammation was asymptomatic. Eye lesions were detected in 44 (67.7%) patients, and dermatological lesions (skin and/or mucous membranes) were detected in 60% of patients, with circinous/xerotic balanitis (46.2%) and psoriiform rashes (27.7%) being the most common. The classic triad of symptoms (urethritis-arthritis-eye damage) was diagnosed in 30.8% of patients, the tetrad (with inclusion of dermatological pathology) – in 36.9%. Axial lesions (mainly sacroiliitis) were found in 69.2% of patients. In an immunofluorescence study, diffuse deposits of IgG were detected in the reticular layer of the dermis of apparently healthy skin in 95.3% of cases.

Conclusion. Chronic urogenital reactive arthritis is characterized by pronounced clinical polymorphism. Its obligate, although often asymptomatic, manifestations include damage to the urogenital tract, as well as joint syndrome, which necessitates mandatory testing for chlamydia infection in all men with asymmetric arthritis. Although not pathognomonic, dermatological symptoms are observed in more than half of patients and have several distinctive features. The inclusion of an immunomorphological study (direct immunofluorescence method) in the diagnostic algorithm, aimed at detecting IgG deposits in the reticular layer of the dermis, can serve as an additional laboratory marker of the disease, reflecting the systemic immune-mediated nature of inflammation in this pathology.

Background. The current focus of scientific research is to find treatment methods and auxiliary support for patients with OA with an improved safety and tolerability profile, including parafarmaceuticals with chondroprotective effects.

Objective. The purpose of the study was to evaluate the efficacy and safety of the parafarmaceutical Chondroguard Quadro in patients with stage II-III (K-L) OA of the knee and grade 1-2 joint functional insufficiency (FI).

Materials and methods. The non–interventional follow-up program included 47 patients (14 men and 33 women aged 59-74 years) with stage II-III (K-L) and grade 1-2 FI. The control group (CG) included 15, and the main group (MG) included 32 patients who received standard therapy for OA (NSAIDs) for courses of up to 10 days. The MG patients parafarmaceutical with chondroprotective effects Chondroguard Quadro take 2 tablets 2 times per day with meals in the morning and afternoon for 1 month after taking NSAIDs. The dynamics of pain were assessed using the VAS, the severity of OA using the Leken index, the quality of life (QL) using the SF-36 questionnaire before and after treatment, the global assessment of therapy effectiveness by the doctor and the patient using the 5-point Likert scale. A radiological examination of the knee was performed. The dynamics of CRP, TNF-α, interleukin-6, PIIANP, N-osteocalcin, COMP, 25(OH)D₃, vitamin K₂, as well as uCTX-1, deoxypyridinoline, uCTX-II in urine by ELISA, CLIA and HPLC/MS. The safety of parafarmaceutical with chondroprotective effects was evaluated using the WHO and Naranjo scales.

Results. In MG after taking parafarmaceutical with chondroprotective effects, the difference from the initial indicators of pain severity was more significant compared to CG: the dynamics of pain intensity according to VAS during movement (-85.1% vs. -73.8% in CG) and at rest (-86% vs. -58.1% in CG), according to the Leken index (-83.5% vs. -61.8% in CG). In MG the most pronounced improvement of the QL of patients was noted using the SF-36. On the 40th day of the program, a significant increase in the patient's and doctor's assessment of the overall effectiveness and tolerability of the therapy was observed using the Likert scale compared to the CG. In patients with OA, there was a significant decrease in all biomarkers in the blood, an increase in the levels of 25(OH)D₃ and vitamin K₂ in the blood, and there were intergroup differences in all laboratory tests by the 40th day of the program. No adverse events were reported during the use of parafarmaceutical with chondroprotective effects.

Conclusion. Parafarmaceutical with chondroprotective effects Chondroguard Quadro can be recommended as an adjuvant support for patients with OA of the knee with moderate to mild pain syndrome when markers of cartilage degradation and calcification are detected.

Background. Povidone-iodine is a water – soluble iodine formulation with antimicrobial effect against a wide range of microorganisms (bacteria, fungi, protozoa, viruses). No acquired microbial resistance has been reported for povidone-iodine over the decades of its use due to its multiple-targeted action. Povidone-iodine has been used for a long time in surgical, gynecological and dermatological practice; it is highly effective in different forms and concentrations and retains its antimicrobial activity even when diluted 1:100 or more. Due to the high safety profile of lower concentration povidone-iodine solutions (while maintaining their effectiveness), they can also be used on the skin and mucous membranes of the genitourinary system, so these solutions may be considered as a promising addition to the main therapy (or in some cases as a variant of the main therapy) of bacterial vaginosis or sexually transmitted infections.

Conclusion. The range of povidone-iodine formulations is registered in the Russian Federation in the form of a 10.0% ointment and a 7.5% solution; it has a declared antimicrobial effect and is indicated for use in dermatovenereology. Ural Scientific Research Institute of Dermatovenerology and Immunopathology has scheduled a study of using povidone-iodine solution in patients with urogenital infectious and inflammatory diseases in addition to the systemic treatment indicated for these diagnoses in accordance with current guidelines.

Background. A comprehensive analysis of modern digital technologies, including wearable sensors, computer vision, and artificial intelligence algorithms, was conducted.

Objective. To evaluate the use of these technologies for the diagnosis, monitoring, and rehabilitation of patients with Parkinson’s disease, focusing on their potential to objectively assess motor symptoms, identify key advantages, and highlight systemic limitations that hinder their widespread clinical integration.

Materials and methods. A systematic review of the scientific literature from 2020 to 2025 was conducted using the PubMed, Scopus, Web of Science, and eLibrary.ru databases. The search employed key terms such as digital biomarkers, computer vision, machine learning, Parkinson’s disease, and telemedicine platforms. The methodology included critical analysis and systematization of data, emphasizing architectural solutions, algorithmic approaches, and results of clinical testing of digital systems.

Results. Digital technologies, particularly multi-level platforms such as the Parkinson Expert System, demonstrate high efficiency in forming objective digital biomarkers for assessing tremor, bradykinesia, and gait disturbances, showing strong correlation with traditional clinical scales. The key limitation lies in the lack of standardized protocols, validation procedures, and unified methodological approaches, which complicates the comparability of results and their translation into routine clinical practice.

Conclusion. Digital technologies possess significant transformative potential for the personalization of Parkinson’s disease diagnosis and monitoring by enabling continuous and objective data collection. However, successful clinical integration requires the development of unified standards, large-scale multicenter studies, and solutions addressing algorithm validation, data protection, and system interoperability. Further development of this field will improve the accuracy and efficiency of medical care for patients with neurodegenerative diseases.

Background. For patients with localized prostate cancer, a personalized approach to treatment selection is advisable. This approach, in addition to surgery or hormonal therapy combined with radiation therapy, may include cytokinogenetic therapy.

Objective. To evaluate the feasibility of using cytokinogenetic therapy in a patient with localized prostate cancer in combination with hormonal therapy.

Material and methods. Patient N., 65, presented to the clinic with a diagnosis of cT2bN0M0 prostate cancer. He underwent prostate biopsy on June 23, 2023, and had been receiving hormonal therapy since July 2023. The diagnosis was confirmed histologically after examination of the prostate biopsy specimen. His Gleason score was 6, G2, and his initial PSA was 7.189 ng/mL. Since July 2023, the patient has been receiving Eligard 45 mg subcutaneously every 6 months for antitumor treatment. Wishing to avoid complications from radiation therapy, the patient declined radiation and presented to the clinic in October 2024 for cytokine gene therapy. The patient's condition was monitored during treatment using Karnofsky performance status assessment, PSA and tumor necrosis factor-alpha levels, and contrastenhanced magnetic resonance imaging (MRI).

Results. After 7 courses of cytokinogenetic therapy (CGT) combined with hormonal therapy, MRI showed complete regression of the prostate tumor. The PSA level was 0.12 ng/ml. The use of CGT was not associated with additional toxicity. The patient's overall survival since diagnosis is 29+ months, and since the start of CGT, 13+ months.

Conclusions. Cytokinogenetic therapy drugs likely have a synergistic effect with hormonal therapy for prostate cancer. Further research is needed to explore the mechanisms of action and potential use of cytokinogenetic drugs in this patient population.

Background. About 71 million people worldwide are infected with hepatitis C virus, and chronic hepatitis C often forms after the acute period, with clinical manifestations ranging from subclinical and asymptomatic cases, as well as nonspecific manifestations of liver dysfunction to manifestation of hepatitis with extrahepatic manifestations.

Objective. To present a modern clinical and laboratory characterization of the course of chronic hepatitis C in the persons observed in outpatient and inpatient conditions.

Materials and methods. Clinical and laboratory data of 77 patients who were under observation from 2021 to 2024 are presented. Complaints and anamnesis were collected, examination was performed, and medical histories were studied. The patients underwent a comprehensive laboratory and instrumental examination, as well as fibroelastometry. Also 100 conditionally healthy individuals were included.

Results. 44 individuals were observed in outpatient conditions (57.1%) and 33 patients (42.9%) underwent inpatient treatment. Among outpatients, males and females occurred with equal frequency; among inpatients, males predominated with 72.7% (p = 0.044). The median age was 44 [37; 54] years. Outpatients and inpatients did not differ statistically significantly by age. A moderate viral load was determined in 72.0% of individuals. Hepatitis C virus genotype 1 was determined in 48.6% of individuals. Viral load and genotype distribution in the patient groups were not statistically significant. Associated diseases were identified in 27.3% (n = 12) of outpatients and 93.9% (n = 31) of inpatients (p < 0.001). Among outpatients, patients were statistically significantly more likely to have no complaints (p < 0.001). Asthenic, dyspeptic, and abdominal pain syndromes were reported with statistically significantly higher frequency in patients seen as inpatients. Among inpatients, more than half of the individuals had normal ALT values, and among outpatients - moderate elevation of ALT activity (p = 0.055). In outpatients, moderate elevation of GGT was determined more often, while inpatients had normal values (p = 0.461). Both among outpatients and inpatients the persons with normal values of total bilirubin prevailed (p = 0,004). Coagulogram parameters in outpatients and inpatients did not statistically differ from reference values. Indicators of clinical blood analysis were within normal values in all groups. According to the results of fibroelastometry, fibrosis of F0-F1 stage was registered in 71.0% of all patients.

The distribution of outpatients and inpatients by fibrosis stages was not statistically significant.

Conclusion. Outpatients have no complaints in half of cases. Inpatients more often have various concomitant pathologies that can mask the clinical picture of hepatitis and affect laboratory parameters. In outpatients, a moderate increase in liver enzymes is more often detected, and in inpatients these indicators are within normal values. Indices of coagulogram and clinical blood analysis practically do not change both in outpatients and inpatients. However, in the latter, abnormalities in the clinical blood count may reflect comorbidities. At the present stage, most patients are either fibrosis-free or have mild fibrosis.