[THE RESULTS OF THE ANALYSIS OF RISK FACTORS, CARDIOVASCULAR RISK, CHRONIC NON-COMMUNICABLE DISEASES IN YOUNG AND MIDDLE-AGED PATIENTS, DEPENDING ON THE EDUCATION].

AIM: To assess the frequency of risk factors (RF), total cardiovascular risk (CHR) and their association with the level of education in young and middle-aged people. METHODS: Persons aged 25-59 (40.4 ± 9.2) years old took part in a one-stage comparative study; an anamnesis was taken, a physical examination was carried out, risk factors for cardiovascular diseases, cardiovascular risk were assessed according to the Systematic Coronary Risk Estimation scale in persons aged 40 years and older, according to the relative risk scale - under the age of 40, laboratory parameters. RESULTS: Hypercholesterolemia was present in 6.1%, hyperglycemia - in 4%, obesity - in 2.5%, one risk factor - in 25.5%, 3 or more risk factors - in 30.7% of patients, the maximum number of risk factors - in men. Moderate CVR was present in 58.4%, very high - in 3.7%, low - in 31.8% of cases. Low CV risk: prevalence in women with higher education (p = 0.034), compared with women with secondary education, which was not observed in the group of men (p = 0.109). Men smoked more. Persons with higher education quit smoking 4 times more often than persons with secondary education (p = 0.001; OR = 3.98), persons with secondary education smoked 2.74 times more often (p = 0.001, OR = 2.74), than higher education. Overweight was detected in 47%: in females (p < 0.001) and males (p = 0.003), its occurrence was less common in the group with higher education. AH was present in 8.3% of patients, and the level of its control was better in those with higher education than those with secondary education (p < 0.001). CONCLUSION: The gender conditionality of low CVR and unidirectional trends in attitudes towards smoking in connection with the level of education were established. Purposeful consideration of the level of education, age, gender, increases the identification of risk groups for the formation of multimorbidity and high cardiovascular risk in the future.

[Problems of insufficient control of target blood pressure levels in the outpatient practice].

AIM: Assessment of the frequency of reaching the target level of blood pressure (BP) and the factors affecting it in outpatients with arterial hypertension (AH). MATERIALS AND METHODS: An open, one-stage, comparative study involving 64 patients with hypertension and 47 without hypertension at the age of 40 to 59 years. All patients underwent physical examination, assessment of cardiovascular risk (CVR), 24-hour blood pressure monitoring (ABPM), echocardiography (ECHOCG), color duplex scanning of brachiocephalic arteries. RESULTS: Patients with hypertension and comparison groups were comparable in age, sex, smoking, history of myocardial infarction. 1st degree of hypertension was present in 26.6%, 2nd in 40.6%, 3rd in 12.5% of patients. Obesity was detected in 24.3% of patients and all patients with obesity had AH. The SCORE score in individuals with hypertension was 4.94.5; in the comparison group, 2.32.6 (p0.001). Non-stenosing atherosclerosis was present in 54.8% and 88%, p=0.020, and atherosclerotic plaque in the vascular lumen was present in 45.3% and 12% of patients with and without hypertension, respectively (p0.001). 68.8% were constantly treated, and the target BP was reached in 31.3% of patients with hypertension. Male gender (OR 1.68; 95% CI 1.6828.49; p=0.007), obesity (OR 4.78; 95% CI 1.1420.29; p=0.033), concomitant pathology (OR 3.09; 95% CI 1.029.37; p=0.046) were negative, and dyslipidemia (OR 0.10; 95% CI 0.010.84; p=0.033) was positive, affecting the achievement of the target level of blood pressure. CONCLUSION: The target level of blood pressure was achieved in 31.3% of outpatients with hypertension, mainly in women. Among patients who did not reach the target level of blood pressure, men, individuals with high SSR and obesity predominated. Concomitant pathology and obesity are negative, and dyslipidemia was positively associated with the achievement of the target level of blood pressure, which must be taken into account when developing measures for prevention and treatment.

[The asymptomatic microhematuria in the physician's practice].

The review article presents data on: a) definition of microhematuria and diagnosis; b) prevalence estimation and causes of the asymptomatic microscopic hematuria; c) diagnostic approaches for the first time identified of microhematuria; d) follow-up monitoring of patients with asymptomatic hematuria; e) feasibility of medical screening for microhematuria. The analysis includes recommendations of Russian and foreign urological associations, the results of cohort and observational studies, previous study reviews. The identification of 3 or more red blood cells during microscopic examination should be considered microhematuria. There is no uniform examination algorithm for all patients. The basic principle is an individual diagnostic tactic, taking into account the anamnesis, age, concomitant diseases and risk factors. The purpose of a comprehensive examination is to exclude life-threatening conditions (malignant neoplasms and/or glomerular kidney damage). In some cases, after research, the cause of microhematuria remains unclear and monitoring is required. Routine screening of the population in order to detect microhematuria is currently not justified.

[Primary prevention of chronic non-communicable diseases and acetylsalicylic acid: ambiguity of opinions].

Chronic noninfectious diseases (cardiovascular, bronchopulmonary, oncological diseases and diabetes mellitus) are presently the most common cause of death worldwide, with cardiovascular diseases (CVD) being predominant. For this reason, the key goal of a physician is not only to treat but also to prevent diseases. Acetylsalicylic acid (ASA) is considered one of the most effective drugs for secondary prevention of CVD. However, the use of ASA for primary prevention is still debated. Results of many studies of ASA are inconsistent. Some studies have suggested that using ASA in patients aged 40-70 with a high 10-year risk of CVD and a low risk of bleeding may reduce the incidence of CVD. Administration of ASA to patients with a high or medium risk of CVD is also considered.

Current Trends and Possibilities of Providing Medical Palliative Care in Chronic Heart Failure.

Chronic heart failure (CHF) is an important healthcare problem because of high prevalence, morbidity and mortality rates. Treatment resistant symptoms, need for communication and support, unite patients with CHF and oncological diseases but despite that CHF patients rarely receive specialized palliative care (SPC). This review is devoted to the need and possible ways of providing SPC to patients with CHF and their families. We discuss here variants of CHF course in terminal phase, the term end of life appropriate care, various specialists' concepts of SPC delivering to CHF patients in accordance with their preferences.

[Hemodynamics in the organs of small pelvis during complex treatment using electromagnetic fields in patients with tubal infertility of inflammatory etiology]. / Gemodinamika organov malogo taza pri primenenii magnitnogo polia v kompleksnom lechenii bol'nykh s trubnym besplodiem vospalitel'noi étiologii.

Hydrotubation treatment of uterine tube impotency of an inflammatory origin results in many cases in stubborn hemodynamic disorders in the small pelvis organs, that may be normalized after exposure to a permanent magnetic field (magnetophores). Multiple-modality treatment results in recovery of the uterine tube patency in 50% of cases and in pregnancy coming within a year in 22.6% of cases.