Consilium Medicum

Peer-review medical journal




Professional medical multidisciplinary journal , based on the principles of evidence-based medicine. Consilium Medicum magazine has been issued since 1999.

The journal publishes national and international recommendations, reviews, lectures, original works, and clinical cases dealing with the most actual problems of the modern medicine, as well as interviews with experts within the different fields of medicine and conferences, congresses and forums reviews.

The journal is practically-oriented and publishes articles by leading clinicians who are professional in the special field of medicine in Russia, Ukraine, Belarus, and includes the high level of scientific information.

Consilium Medicum journal is the most popular journal among medical practitioners. There are 12 thematic issues per year. The journal is designed for therapeutists, pediatricians, cardiologists, endocrinologists, gastroenterologists, pulmonologists, dermatologists, obstetrician-gynecologists, urologists, nephrologists, neurologists, rheumatologists and physicians in other specialties, as well as for resident physicians, post-graduate students and senior students at medical universities.

Types of accepted articles

  • reviews, systematic reviews and meta-analysis
  • original research
  • clinical case reports and series of clinical cases
  • letters to the editor
  • hystorical articles in medicine

Research fields

  • Internal medicine
  • Endocrinology
  • Otorhinolaryngology
  • Cardiology
  • Neurology
  • Phthisiology
  • Surgery
  • Rheumatology
  • Urology
  • Pulmonology
  • Gastroenterology
  • Gerontology and geriatrics

Publication, distribution and indexation

  • Russian and English full-text articles;
  • issues publish monthly, 12 times per year;
  • no APC, Platinum Open Access
  • articles distributr under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0).


  • Russian Science Citation Index (
  • DOAJ
  • CrossRef
  • Google Scholar
  • WorldCat
  • Ulrich's Periodicals Directory
  • CyberLeninka


No announcements have been published.
More Announcements...

Current Issue

Vol 25, No 5 (2023)


Nausea and vomiting in the practice of a therapist and gastroenterologist: A review
Livzan M.A., Korpacheva O.V., Bikbavova G.R., Romanyuk A.E.

Nausea and vomiting are among the most common complaints in outpatient clinics and hospitals, while they are associated with poor quality of life. Their causes are diverse, and pathogenetic mechanisms are multifactorial. In the presented article, the pathophysiology of nausea and vomiting is examined in detail, an algorithm of sequential actions is proposed, which is based on the following stages: finding out what the patient means by nausea and vomiting; determining whether these symptoms are acute or chronic; thorough detailing of complaints; detailed collection of anamnesis; careful physical examination. The indicated sequence of actions of the doctor during the initial treatment of the patient forms the basis for a differential diagnosis and determines further examination. Special attention is paid to the treatment of nausea and vomiting, the place of dopamine receptor blockers in the relief of these painful symptoms is discussed. The search for literature containing information on relevant studies was conducted in PubMed and Google Scholar systems according to the words: nausea, vomiting, postoperative vomiting, gastroparesis, dopamine receptor blockers, domperidone.

Consilium Medicum. 2023;25(5):301-307
pages 301-307 views
Chronic pancreatitis: prospects for early detection: A review
Ledeneva E.M., Vertkin A.L., Sediakina I.V., Kurdjieva S.S., Shamuilova M.M.

Over the last 10 years, the incidence of chronic pancreatitis (CP) has increased 4 times and nowadays is about 27.4–50 cases per 100 000 adults. In the outpatient gastroenterologist practice, patients with CP account for about 35–45%, in the hospital gastroenterology department – up to 20–45%. CP criteria according to imaging methods – fibrosis, duct dilatation and deformation, calcifications in the pancreatic parenchyma or its atrophy – are formed at a late stage of the disease. Simultaneously, diagnosis at the early stage with potentially reversible changes remains difficult, due to the lack of clear instrumental and laboratory findings confirming minimal changes in the pancreas. However, some methods in combination with a detailed history taking, risk factors identification in comparison with the clinical features are of interest for the early diagnosis of chronic pancreatitis.

Consilium Medicum. 2023;25(5):308-312
pages 308-312 views
Prevalence of non-alcoholic fat disease liver in Russian Federation: meta-analysis
Maev I.V., Andreev D.N., Kucheryavyy Y.A.

Aim. To systematize data on the prevalence of non-alcoholic fatty liver disease (NAFLD) in the adult population of Russia.

Materials and methods. The studies were searched in the MEDLINE/PubMed and RSCI electronic databases from January 2000 to December 2022 (inclusive). The search included relevant publications in peer-reviewed periodicals in English or Russian; publications with data from cross-sectional/epidemiological studies assessing the prevalence of NAFLD in the Russian population; studies on adult patients with NAFLD; publications with detailed descriptive statistics that allow using the data in the meta-analysis.

Results. The final analysis included 5 studies involving 96.680 subjects. The overall prevalence of NAFLD in the five adult studies analyzed was 27.562% (95% confidence interval – CI 19.056–36.979). The analysis used a random effect model, as there was significant heterogeneity between the results in both groups (I2=99.87%; p<0.0001). In the studies enrolling patients before 2015, the overall prevalence of NAFLD was 22.409% (95% CI 11.550–35.615), whereas, in studies that enrolled patients after 2015, it was 35.874% (95% CI 28.094–44.046). When analyzing multicenter studies only, the overall prevalence of NAFLD was 31.975% (95% CI 24.670–39.755).

Conclusion. This meta-analysis demonstrated that NAFLD is a widespread chronic liver disease in the adult population of Russia, affecting approximately one in four country residents. For a more accurate objectification of the epidemiological structure of NAFLD in Russia, further multicenter studies of unified design are required.

Consilium Medicum. 2023;25(5):313-319
pages 313-319 views
Peculiarities of antibiotic therapy after pancreaticoduodenectomy
Gasieva O.Y., Khatkov I.E., Vertkin A.L.

Aim. To reveal and evaluate predictors of infectious complications in the postoperative period after pancreatoduodenectomy.

Materials and methods. An analysis was made of 790 articles that dealt with the subject of complications after pancreatoduodenectomy.

Results. Seventy five articles met the inclusion criteria. Studies with small samples (less than 20 patients) were not considered. Based on the multifactorial nature of the problem of preventing infectious complications in the postoperative period, the results of the review are divided into several sections. PBD is highly effective in obstructive jaundice syndrome at the preoperative stage, but is associated with the risk of bile infection and complications in the postoperative period. These circumstances should be taken into account when determining the indications for PBD, choosing the method of decompression, in cases where stenting is used, attention should also be paid to the choice of material. Bacteriobilia is an independent predictor of surgical site infections (SSI) after PDR.

Conclusion. Changing the approach to antibiotic prophylaxis based on the antibiotic sensitivity of the microflora can lead to a decrease in the incidence of SSI, a reduction in the duration of hospitalization, the number of complications associated with long-term antibiotic therapy, a decrease in the rate of spread of antibiotic resistance and a decrease in the financial costs of the institution for a completed case of medical care.

Consilium Medicum. 2023;25(5):320-324
pages 320-324 views
Non-alcoholic fatty liver disease: from understanding risk factors to finding optimal treatment regimens: A review
Teplyuk D.A., Kaisina A.A., Ibragimova S.I., Bestavashvili A.A., Tinkova I.O., Pashkova E.I., Kaibullayeva J.A., Nersesov A.V., Pavlov C.S.

Non-alcoholic fatty liver disease (NAFLD) is now a major risk factor for death among patients with liver disease. Currently, drugs that primarily affect surrogate markers of NAFLD are available. However, none of these drugs showed a significant effect on the course of steatohepatitis and fibrogenesis. The search for the most relevant lifestyle modification programs is still a priority in comprehensive treatment. A clinical case of follow-up of a comorbid patient is presented. Despite comprehensive treatment, disease regression was not achieved. NAFLD therapy remains a relevant issue. Finding new ways to affect the NAFLD course and individualize treatment approaches is necessary.

Consilium Medicum. 2023;25(5):325-332
pages 325-332 views
Features of the motor function of the gastrointestinal tract at the cross-functional pathology
Lychkova A.E., Samsonov A.A., Andreev D.N., Kuznetsova E.I.

Aim. To identify the role of impaired motor function of the gastrointestinal tract (GIT) in the overlap of functional disorders (FD).

Materials and methods. Thirty-two abdominal FD patients were followed up, with a predominance of women aged 33.7±6.1 years (75%). Men aged 31.8±5.6 years were 25%. All patients had symptoms of GIT FD established according to the Rome IV criteria, endoscopy, and abdominal ultrasound. In addition, patients underwent 2-hour pH-metry and electromyography of the abdominal organs using bipolar silver electrodes with a surface area of 0.5–0.6 cm2. The amplitude-frequency characteristics of slow waves and spikes and the power of phase and tonic contractions were analyzed using the Canon M hardware and software complex with a transmission frequency of 0.1 to 10 Hz and a noise level of 1–5 W.

Results. Overlapping clinical symptoms of motor disorders in gastrointestinal tract functional disorders are observed at a young age, mainly in women. The abnormal ratio of the gallbladder and common bile duct motility in overlapping GIT FD was 1:1.08, with a pronounced increase in contractions of the common bile duct, which could lead to an increase in pressure in the biliary system, pain, and insufficient flow of bile to the duodenum, disrupting the digestion and worsening the dyspepsia.

Conclusion. The study showed a tendency for higher incidence of functional disorders in young women. Patients with overlapping disorders also have more severe pain than those with isolated disorders.

Consilium Medicum. 2023;25(5):333-335
pages 333-335 views
The role of probiotics in current algorithms for the treatment of irritable bowel syndrome: A review
Andreev D.N., Maev I.V.

Irritable bowel syndrome (IBS) is a widespread disease that affects working-age people and significantly reduces their quality of life. Many experts have suggested that the colon microflora in patients with IBS is characterized by dysbiosis, which leads to increased fermentation, excessive gas formation, and symptoms typical of the disease. Currently, alterations of the intestinal microbiota are considered one of the main mechanisms of IBS development, which warrants the use of probiotics with proven effectiveness as a part of the complex therapy. Certain probiotic strains (including Bifidobacterium longum 35624 and Saccharomyces boulardii CNCM I-745) have been shown to be effective in normalizing stool frequency and consistency in IBS patients, regressing abdominal pain, and normalizing quality of life.

Consilium Medicum. 2023;25(5):336-342
pages 336-342 views
Opinions of gastroenterologists about intestinal microbiota modulating agents: results of the survey in focus groups
Golovenko O.V., Golovenko A.O.

Aim. To study the opinions of gastroenterologists about drugs affecting the intestinal microflora.

Materials and methods. A qualitative survey was conducted in focus groups to study the patterns of prescribing drugs that regulate intestinal microflora in chronic gastrointestinal diseases. The survey included only outpatient gastroenterologists who managed patients with irritable bowel syndrome, an uncomplicated diverticular disease with clinical manifestations and excessive bacterial growth in the small intestine for at least 3 years.

Results. Physicians perceive the non-absorbable antibiotic rifaximin alpha as the drug of choice for treating these diseases; they are aware of its low bioavailability and suitability for repeated use. However, with severe clinical symptoms, some doctors tend to use systemic antibiotics before infectious or inflammatory complications are confirmed. It is due to the erroneous perception of systemic antibiotics as obviously more effective drugs than non-absorbable antibiotics. When choosing a drug, it is essential to consider the risk of antibiotic-associated diarrhea, adverse changes in the microflora, and the patient's comorbidities.

Conclusion. Surveyed gastroenterologists consider rifaximin alfa (Alfa Normix) the most suitable drug that helps in routine practice achieve the desired result with a minimum risk of adverse events. Many study participants are skeptical about the effect of probiotics due to the lack of evidence but emphasize their safety and the request for probiotics from patients. Not all doctors are aware of metabiotics. Prebiotics and dietary fibers are perceived as agents that affect both the intestinal microflora and the stool frequency. Some healthcare professionals are concerned about prebiotics and probiotics registered as dietary supplements, which can cause patient misunderstandings. Identified opinions about such agents can be used in training gastroenterologists and developing clinical guidelines.

Consilium Medicum. 2023;25(5):344-350
pages 344-350 views
Decreased liver density as a potential predictor of severe COVID-19: a retrospective cohort study
Shumskaya Y.F., Akhmedzyanova D.A., Mnatsakanyan M.G.

Background. To stratify the risk in patients with COVID-19, it is important to understand the parameters that predispose to a severe course. Following risk factors were described: age over 60 years, overweight, male gender, chronic diseases: hypertension, diabetes mellitus. Low liver density on computed tomography (CT) is also considered as a potential risk factor.

Aim. To evaluation whether low liver density can be used as a predictor of severe COVID-19.

Materials and methods. Retrospective single-center cohort study. Patients with COVID-19 treated in a hospital setting, who underwent two CT scans of the thoracic organs in dynamics, were included. The patients were divided into groups according to the severity of the course (groups of moderate course, severe course and lethal outcome). Relation of the investigated factors was estimated using regression analysis.

Results. 99 patients were enrolled; 3 comparison groups were formed (moderate-severe course n=37, severe course n=52, lethal outcome n=8). All groups significantly differed in C-reactive protein levels. According to multivariate regression analysis, COVID-19 severity was influenced by the liver to spleen density ratio as measured by CT scan on admission [odds ratio 12.18 (95% confidence interval 1.67–89.07); p=0.008].

Conclusion. Reduced liver density on CT scan in a patient with COVID-19 may be a predictor of severe course of novel coronavirus infection.

Consilium Medicum. 2023;25(5):351-356
pages 351-356 views
Perforative duodenal ulcer in a patient in the acute period of ischemic stroke. Case report
Abramov D.V., Zubarev A.P., Afanasiev V.M., Smolkina A.V., Karimova E.A.

Perforated duodenal ulcer is a common pathology with fairly high postoperative mortality, especially in late diagnosis. In some cases, timely diagnosis of a perforative ulcer may be difficult and the results of the survey may be contradictory. The classical triad of clinical signs of perforative ulcers is not always observed in patients, sometimes the clinical picture is so unclear that the final diagnosis can only be made intraoperative. The article presents an analysis of the clinical case of difficult diagnosis and treatment of perforative duodenal ulcer in a patient in an acute period of ischemic stroke. In addition, the patient had severe concomitant somatic pathology with a high risk of systemic thromboembolism and at the same time a high risk of bleeding.

Consilium Medicum. 2023;25(5):357-360
pages 357-360 views
Features of GERD therapy in obese patients: A review
Bakulina N.V., Tikhonov S.V., Efremova A.Y., Mirtskhulava V.V.

Epidemiological, endoscopic and pathophysiological studies confirm the relationship between obesity and gastroesophageal reflux disease (GERD) and is characterized by a more severe course, has clinical and pathophysiological features. In the treatment of GERD, it is necessary to use an individualized integrated approach, which consists in the combined use of diet therapy, lifestyle changes and drug therapy. The basis of pharmacotherapy for GERD are proton-pump inhibitors that positively affect the quality of life and long-term prognosis. At the same time, pharmacodynamic and pharmacokinetic features determine the advantage of the rabeprazole molecule in obese patients, including the minimal risk of drug-drug interactions.

Consilium Medicum. 2023;25(5):361-367
pages 361-367 views
Gastroprotective therapy in patients with atrial fibrillation receiving anticoagulant therapy: A review
Ostroumova O.D., Kochetkov A.I., Batyukina S.V., Cheremushkin S.V.

Prevention of thromboembolic complications is the main goal in patients with atrial fibrillation. Anticoagulant therapy is used as prophylaxis, and direct oral anticoagulants are preferred. However, this therapy is associated with a risk of bleeding, among which gastrointestinal bleeding takes a leading place. Proton pump inhibitors are now widely used as prophylaxis for upper gastrointestinal bleedings, but when used long-term, may be associated with a number of adverse drug reactions, including an increased risk of adverse cardiovascular events. Long-term use of these drugs may suppress the action of antiplatelet drugs, disrupt the function of the vascular endothelium, and at the same time cause hypomagnesemia, iron deficiency, vitamin D and K deficiency. At the same time, monotherapy with proton pump inhibitors does not protect against the risk of bleeding from the lower gastrointestinal tract. Thus, as an effective gastro- and enteroprotection, it is necessary to prescribe drugs that protect the gastrointestinal tract throughout its entire length. Such a drug is rebamipide, which has a complex protective effect on the gastrointestinal tract, protecting the mucous membrane at all its levels (pre-, post-epithelial and directly epithelial level), and ensures the restoration of tight contacts in the epithelium of the intestinal tube throughout its entire length. It should be noted that the current consensus documents of the leading experts on the problem of decreasing the risk of gastrointestinal bleedings during direct oral anticoagulant treatment recommend the use of rebamipide for the entire duration of therapy.

Consilium Medicum. 2023;25(5):368-374
pages 368-374 views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies