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The article examines the discourse of post-conflict projects of a human that appeared or were transformed as a result of the Second World War. The author distinguishes between the terms “post-war” and “post-conflict”. If the first one means only a period of time after any war, then the second one implies the final stage in the life cycle of a conflict. The “hot” phase of a conflict proceeded in the form of war, whereas the final stage is marked by the restructuring of projects of a human and their adaptation to new realities. From the point of view of creating the desirable future, it is children and youth that are the most important material for the actors and institutions of designing a human. The article analyzes changes in the activities of pioneer organizations of the USSR, the GDR, and Yugoslavia. It is noted that the reforms carried out in the Soviet Union also affected other countries of the socialist camp. The main goal is the realization of a new project of a human. A diligent student and adult assistant replaced the young revolutionary fighter and partisan hero. Pioneer self-government was increasingly subordinated to the school as an educational institution. The Ernst Thälmann Pioneer Organization, founded in East Germany in 1948, sought to form a peaceful, collectivist personality. Much attention was paid to overcoming the experience of the war and participation in Nazi children’s organizations. In the post-war period, the Union of Pioneers of Yugoslavia (“Tito’s pioneers”), created in 1942, was focused on the common to the socialist camp direction of work with children. However, it wasthis country where the tendency towards the demilitarization ofthe pioneer movement was most clearly manifested, and started being regarded as an institution for organizing leisure and education in a peaceful manner.

Non-alcoholic fatty liver disease, or NAFLD – is a pathology that usually has a metabolic cause and is not caused by excessive alcohol consumption. NAFLD is the most frequent chronic liver disease worldwide and is accompanied by a high financial burden for the patient and the healthcare system. NAFLD is generally considered a “benign disease” with low progression to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Nevertheless, due to the large number of affected patients, the prevalence of cirrhosis of the liver has gradually increased, and in fact it represents the third cause of liver transplantation in the world. Moreover, even if the frequency of HCC in patients with NAFLD is lower than in patients with HCV/HBV cirrhosis, the absolute number of HCC associated with NASH is higher due to the higher number of patients with NAFLD. It is likely that the importance of this disease will continue to grow in the future, when new treatments and prevention programs for hepatitis C and B reduce the size of viral liver infections. Many aspects of the disease have yet to be solved. It is very important to understand the mechanisms underlying the occurrence and development of NAFLD, the features of the clinic and diagnosis, as well as the tactics of management and treatment of patients with non-alcoholic fatty liver disease. It is important for patients to get a complete understanding of NAFLD so that they can play an active role in the treatment of their disease.

The paper demonstrates the phenomenology of shock-driven air bubble and triple-layer microbubble collapse near tissue-like gelatin by direct numerical simulation. We validate the numerical method by comparison with experimental data for water jet generated by shock-driven bubble collapse near a gelatin interface. Coupled dynamics of bubble collapse and gelatin deformation is revealed during the early stages of the process. As the shock wave overpressure decreases, the coupling effect becomes more pronounced. The phenomenology of agent delivery initiated by shock-driven triple-layer microbubble collapse is presented. The results show that increasing the shock overpressure or reducing the agent layer thickness significantly enhances delivery efficiency, with the attached triple-layer microbubble exhibiting the highest efficiency. The results show how process parameters settings in shock-driven multi-material microcapsule collapse can control agent delivery processes in biomedical therapies. [ABSTRACT FROM AUTHOR]

Introduction. The increase in serum transaminases (ALT and AST) and the persistence of their high values is associated with morbidity and mortality from liver diseases. Bicyclol has anti-inflammatory and antioxidant effects, which formed the basis for this study.Materials and methods. The study enrolled 51 patients (MELD < 19); hepatitis stage – 84.4%, cirrhosis – 15.6%. Treatment: Bicyclol 75 mg/day for 12 weeks. Criteria of efficacy: dynamics of ALT, AST, CRP; general well-being (D-FIS scale).Results. After 4 weeks of treatment the share of patients with ALT normalization was 50,9% (p < 0,001); with AST normalization – 62.7% (p < 0.001); after 12 weeks - 79,5% and 89,7% respectively (p < 0,001). CRP decreased statistically significantly after 2 and 4 weeks from the beginning of treatment. The D-FIS questionnaire was filled in by 36 patients at the beginning of the study, in 4 weeks - by 35 patients, in 12 weeks – by 32 patients. Median D-FIS decreased from 12 (8.2; 32.2) to 8 (5; 29) points (p < 0,001) after 4 weeks of treatment, after 12 weeks – to 6.5 (3; 28.5) points (p < 0.001). The CRP was positively correlated with the D-FIS value. Fibrosis (“Fibromax”, “Fibroscan”) was studied in 10 additional patients, the dose of Bicyclol was 150/75 mg/day during 6 months, the result was statistically significant (p < 0.001).Conclusion. Application of Bicyclol leads to reduction of fatigue, local and systemic inflammation, fibrosis in chronic diffuse liver diseases regardless of etiology.

Alcohol abuse with resultant alcoholic liver disease (ALD) are a leading cause of morbidity and mortality worldwide. Due to absence of clinical symptoms of the disease in the early stages, it is diagnosed in the later stages with higher complications and mortality rates. Diagnosis of ALD requires a better determination of life history and prognostic factors, as well as the search for reliable non-invasive techniques. Early detection of alcoholic steatohepatitis in primary care settings and subsequent interventions will facilitate the satisfaction of this requirement. Despite some important advances in understanding the pathogenesis and clinical features of ALD, the past 40 years have not seen significant advances in the therapy. The long-term alcohol abstinence is the main therapy for ALB patients, regardless of the disease stage. It is associated with improved clinical outcomes across the ALD spectrum: from asymptomatic early cases to complicated severe cases. Clinical ultimate outcomes depend on the ALD stage. The ultimate outcomes are associated with normalisation of abnormal laboratory test results and reduction in liver fibrosis in compensated patients. These ultimate outcomes can be monitored using non-invasive tools, but current medical interventions are largely limited and ineffective. Supportive therapy forms the basis of the treatment, it is worth paying special attention to combined herbal medicines as less toxic ones with single contraindications and consistent with the desire of many patients to use natural preparations.

Aim. To identify trends in the structure of patients with liver diseases, in particular hepatocellular cancer (HCC), by analysing the experience of two specialised medical centres.Materials and methods. A retrospective analysis of the medical records of hepatological patients who sought medical treatment at to the V.Kh. Vasilenko Clinic of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology of the Sechenov University in 2013, 2014 and 2017 (total 2459 patients) was carried out. The number of patients with chronic viral hepatitis (CVH) was 651, with non-alcoholic fatty liver disease (NAFLD) — 590, with alcoholic liver disease (ALD) — 66, with autoimmune liver diseases — 416, with liver cirrhosis (LC) of any etiology 407, other liver diseases — 329. A retrospective analysis of the medical records of patients with HCC who were examined and treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine in the period from 2008 to 2017 (n = 86) was carried out.Results. The ratio of patients with chronic hepatitis C and B in 2013–2017 significantly changed. An almost twofold decrease in the number of patients with chronic hepatitis C (210 patients in 2013 and 141 patients in 2017) and an increase in the number of patients with chronic hepatitis B (20 patients in 2013 and 45 patients in 2017) was observed. An almost twofold increase in the total number of NAFLD patients was detected (163 patients in 2013 and 276 patients in 2017). The number of ALD patients increased from 12 patients in 2013 to 31 patients in 2017. The proportion of patients with autoimmune liver diseases in the overall structure of patients who applied to the department was 20 % in 2013, 13.6 % in 2014 and 10.8 % in 2017. An almost twofold decrease in the number of patients with alcoholic LC and LC associated with HBV was observed (73 patients and 17 patients in 2013 and 38 patients and 6 patients in 2017, respectively) as well as a noticeable increase in the number of patients with alcoholic LC and LC associated with HCV (6 patients and 51 patients in 2013 and 26 patients and 75 patients in 2017, respectively). In the analysis of HCC patients, the ratio of men to women was 3:1 (64 men and 22 women), the median age was 54.5 years (IQR 48–59). The median time from the establishment of chronic liver disease to the detection of HCC was 7.5 years (IQR 3–14.5). In 86 % of cases, the HCC development was preceded by cirrhosis (Child-Pugh A: n = 24; Child-Pugh B: n = 30; Child-Pugh C: n = 20), in 14 % — by chronic hepatitis. Viral liver lesions were the leading cause of HCC in 79 % (n = 68), ALD in 4 % (n = 3), NAFLD in 1 % (n = 1), AIH in 1 % (n = 1). In 10 % (n = 9), a combined liver lesion was observed, in 5 % (n = 4), no previous liver disease was known. The highest five-year survival rate (100 %) was found in the group of patients who received antiviral therapy (AVT) before and after liver transplantation.Conclusions. NAFLD, ALD, and chronic hepatitis B patients began to seek medical help more frequently. An increase in the number of patients with autoimmune LC and LC associated with chronic hepatitis C virus (HCV) infection was observed. The conducted analysis of trends in the structure of HCC patients showed that chronic HCV and HBV infection is the main prerequisite for the development of cancer. Liver transplantation is the most effective treatment for HCC. AVT before and after liver transplantation allows a statistically significant increase in the five-year posttransplant survival of HCC patients with chronic hepatitis C to be achieved.

Objective of the study. prove the effectiveness of brief psychological intervention (BPI) conducted by an internist in achieving and maintaining abstinence in patients with alcoholic liver disease (ALD).Materials and methods. A total of 65 patients were included in the study: 29 patients in the BPI group and 36 in the historical control group. A comparative analysis of the frequency of achievement and maintenance of abstinence and analysis of factors associated with these parameters were conducted.Results of the study. The frequency of achieving abstinence was significantly higher in the BPI group compared with the control group after 6, 9, 12 and 24 months from the date of inclusion in the study (p

Aim: to prove the effectiveness of combined physical and psychological assessment in improving the long-term outcome of patients with alcoholic liver disease (ALD).Materials and methods: the active outpatient follow-up (AOF) group included 29 patients with ALD consisted of active liver function and motivation assessment, motivational interviewing, liver panel lab tests with the rate once at 3 months. The AOF program consisted of dynamic monitoring of liver function at least 1 time in 3 months and psychological support provided by the hepatologist using brief interventional approach. The control of abstinence was provided by using self-reports and indirect biomarkers of alcohol consumption. The control group included 36 patients with ALD and history of two-years follow-up after first alcoholinduced liver injury who received comprehensive therapy and a simple advice to avoid alcohol.Results: the adherence to abstinence were significantly higher in AOF group compared with control group. The proportion of patients with decompensated cirrhosis was significantly lower in AOF group compared with control group at 12 and 24 months after enrollment. The long-term survival in AOF-group was significantly higher than in control group. The only parameter independently associated with long-term survival was the presence of AOF program.Conclusion: the combined physical and psychological assessment of patients with ALD, provided by internists improves adherence to abstinence, reduces the risk of decompensation of liver function, severity of ALD and improves patients survival in the long term period.

Aim. To evaluate effects of ursodeoxycholic acid (UDCA) on inflammation, steatosis and liver fibrosis and atherogenesis factors in patients with non-alcoholic fatty liver disease (NAFLD).Materials and methods. The study included 139 patients with NAFLD who received 15 mg/kg of UDCA (Ursosan®) per day for 24 weeks. Before and after the study, liver function and lipid metabolism, liver steatosis index FLI, intimamedia thickness (IMT) of the carotid arteries were determined. The cardiovascular risk was calculated according to the ASCVD 2013.Results. The use of UDCA in patients with NAFLD led to a decrease in ALT (p < 0.001), AST (p < 0.001) and GGT (p < 0.001) activity; total cholesterol concentration (p < 0.001); triglycerides (p < 0.001); and LDL (p < 0.001) in the blood and the FLI liver steatosis index (p < 0.001). In addition, the rate of cardiovascular risk (p = 0.022) and IMT (р = 0.048) in women also decreased.Conclusions. The use of UDCA in NAFLD reduces the activity of inflammatory processes in the liver, its steatosis, and also improves lipid metabolism and exerts potential anti-atherogenic effects. Against the background of UDCA administration, there was no progression of liver fibrosis. None of the participants in the observational programme reached a normal body mass by the end of the program; therefore, the attained positive changes should be attributed directly to the effects of UDCA.

Over the period after an exacerbation of chronic liver diseases, patients often retain common symptoms (weakness or fatigue, bad mood, sleep disorder, vegetative disorders — asthenic syndrome). In the context of prevention and treatment of these symptoms, such nutraceutical products as enriched foods in the form of tablets, sachets, etc, have been increasingly attracting research attention.Aim. To study the efficacy of the “Hepato Smart” nutraceutical product for the treatment of asthenic syndrome in outpatients suffering from chronic diffuse liver diseases with compensated function and functional disorders of the gallbladder over the period after exacerbation.Materials and methods. The study included 50 patients, with 41 of them having completed the program. The nutraceutical product (curcumin, piperine, tanshinone IIA, choline; standardized for curcumin and choline) was assigned 1 pill 3 times a day with meals for 4 weeks. To objectify common symptoms, we used a D-FIS questionnaire (Daily Fatigue Impact Scale), a 4DSQ Four-Dimensional Symptom Questionnaire for assessing distress, depression, anxiety and somatization, and a SF-36 questionnaire for assessing the quality of life.Results. Following 4 weeks of the “Hepato Smart” course, a statistically significant decrease in fatigue was noted by D-FIS scores (p = 0.003), as well as a decrease in the level of distress, depression, anxiety and somatization by 4DSQ scores (p = 0.005; p = 0.006; p = 0.003; p = 0.003, respectively). The quality of patients’ life according to the SF36 questionnaire also improved due to both physical and psychological components (p = 0.003). 16 patients continued taking the preparation for another 8 weeks to maintain the achieved result. As an additional effect, the disappearance of pain in the right hypochondrium was noted in those cases when patients presented this complaint at the time of inclusion in the observation program. The safety profile was good, 1/3 of the patients noted the appearance of heartburn, which was eliminated when taking the product with food.Conclusion. The “Hepato Smart” nutraceutical product improves the general condition of patients with chronic diffuse liver diseases and functional disorders of the gallbladder due to a significant reduction in fatigue and anxiety. It also improves the quality of patients’ life due to the physical and mental components of health.