[The mobile applications developed for self-control arterial pressure: systematic review and content-analysis].

The high prevalence of arterial hypertension and necessity for permanent monitoring of blood pressure requires implementation of new methods of interaction between patient and physician in order to optimize medical care. The purpose of the study was to describe and to evaluate functional possibilities of Russian-speaking mobile applications utilized in collecting blood pressure readings to monitor efficiency of arterial hypertension treatment. The study was carried out in June 2023 in three mobile application stores: Apple Store, Google Play and RuStore. The Russian-speaking applications applied to hypertension self-controlling were considered. For final analysis 45 mobile applications were selected out of 380 applications tested. The most common functions, besides fixing blood pressure levels, were ability of fixing pulse rate (n=41), weight (n=21), sugar level (n=10), blood oxygen saturation (n=8), cholesterol (n=6), rhythm disturbances (n=6) and body temperature (n=5). Additionally, applications made it possible to add tags (n=33), to view statistics (n=41) (including average blood pressure (n=8), pulse pressure (n=9), average daily blood pressure (n=6) and to compare data for different periods of time (n=6), to filter data by tags (n=17), to export statistics (n=32). The 6 applications also supported technology of wireless reception of blood pressure and emergency data. The educational information about blood pressure was enclosed in 17 applications and dietary advice in 12 applications. The content included basic information about blood pressure, treatment, diet, and physical activity. No clinical studies that proved efficiency or inefficiency of analyzed applications were found. None of descriptions comprised both involvement of physicians in development of application and use of clinical recommendations. The results demonstrated large choice of applications used in recording blood pressure with purpose of hypertension self-control. Besides, mobile applications contain various functions and their combinations that can help patient to control blood pressure more effectively. The physicians are to be aware of capabilities of mobile applications developed with purpose of monitoring health of patients.

[Comorbid status of patients with hypertension].

AIM: To establish age and gender characteristics, nosological structure of comorbidity among persons 20-99 years with hypertension. MATERIALS AND METHODS: The study is based on data from 21 514 electronic health records of the population (20-99 years old) with hypertension, mean age 63.0 years, 68.2% women. Diseases associated with hypertension with a frequency above 10% were analyzed. RESULTS: In the sample of people with hypertension, concomitant diseases were detected in 82.7% of cases, 1 disease accompanies 21.0% of the sample with hypertension, 2 diseases 17.9%, 3 diseases 14.0%, 4+ diseases 29.8%. The frequency of association of hypertension with ≥1 concomitant disease at the 20-29 years is 60.8% of cases, at 30-39 years - 65.1%, at 40-49 years - 73.9%, at 50-59 years - 81.1%, 60-69 years - 85.8%, 70-79 years - 87.3%, 80+ years - 86.2% of cases. Among women with hypertension, the average number of concomitant diseases is higher compared to men (3.47 vs 2.4 cases; p<0.001). Among young and middle-aged people, hypertension in most cases is associated with osteochondrosis, osteoarthritis, chronic pancreatitis, gastritis and duodenitis, retinal diseases, thyroid diseases, the female with hypertension accompanied by benign breast disease and menopausal disorders. Hypertension in the elderly is most often associated with cerebrovascular disease, coronary heart disease, diabetes mellitus, senile cataract, but osteochondrosis and osteoarthritis also do not lose their relevance. CONCLUSION: The existing system of organization of medical care cannot meet the needs of patients with comorbidity, which indicates the need to reorient medical care towards patient-centered care.

[GENDER AND AGE FEATURES OF THE PREVALENCE OF HYPERTENSION IN THE POPULATION OF A MEDIUM-URBANIZED CITY OF CENTRAL RUSSIA].

THE PURPOSE OF THE STUDY: to establish gender and age characteristics of the prevalence and risk of developing hypertension (AH) among outpatients living in the city of Tambov, according to electronic medical records (EMR). The information from the EMC of 47,113 people aged 20-99 living in Tambov was used. The prevalence rate (per 100 people) and the relative risk of developing (RR) hypertension in different sex and age groups were calculated. The prevalence of hypertension among people aged 20-99 was 45.7 cases, in women it is higher than in men by 23% (50.1 vs 38.4 cases). With age, there is an increase in the prevalence of hypertension from 1.7% in 20-24 to 86.8% in 70-74 years old people. In the transition from a smaller age group to a larger one, the increase in the prevalence of hypertension among the female cohort averaged 22.5%, among the male cohort - an average of 17.2%. The RR for the development of hypertension among the female cohort aged 20-99 years is 1.2 times higher compared to the male cohort of the same age. At the age of 25-34, the OR for the development of hypertension prevails among the male cohort, at 45-89 years old - among the female cohort. The high level and established differences in the prevalence and risk of developing hypertension determine the need to develop recommendations for hypertension screening among the population, stratification into risk groups, prevention and treatment, focused on different age and gender groups.

[Prevalence and detection rate of senile cataract in individuals with cardiovascular diseases]. / Rasprostranennost' i vyyavlyaemost' vozrastnoi katarakty pri zabolevaniyakh serdechno-sosudistoi sistemy.

OBJECTIVE: To determine the prevalence of senile cataracts and its detection rate among the population at the age of 40 and older with diseases of the cardiovascular system. MATERIAL AND METHODS: This observational cross-sectional study was based on the information extracted from electronic health records (EHR) of patients aged 40-99 years assigned for medical services to a city polyclinic. RESULTS: Among the population with essential hypertension (EH) senile cataract occurs with the frequency of 10.4±0.3% (95% CI 9.8-10.9%) of cases, in patients with cerebrovascular diseases (CVD) - 17.1±0.2% (95% CI 16.6-17.5%) of cases, with varicose veins of the lower extremities - 19.9±0.2% (95% CI 19.4-20.3%) of cases, with ischemic heart disease (IHD) - 15.8±0.2% (95% CI 15.4-16.2%) of cases. At the same time, senile cataract is associated with an increase in the likelihood of its detection in patients with hypertension by 6.8 times (OR 6.57; 95% CI 5.89-7.74), with CVD by 5 times (OR 5.02; 95% CI 4.64-5.44), with varicose veins by 3.7 times (OR 3.70; 95% CI 3.34-4.10), with IHD by 3.5 times (OR 3.53; 95% CI 3.20-3.90). Female gender is associated with an increased likelihood of developing senile cataracts in the presence of EH by 1.4 times (OR 1.420; 95% CI 1.299-1.553), in the presence of CVD by 1.2 times (OR 1.199; 95% CI 1.066-1.348), in the presence of varicose veins by 1.4 times (OR 1.355; 95% CI 1.064-1.725), in the presence of IHD by 1.5 times (OR 1.476; 95% CI 1.298-1.679). The detection rate of senile cataract is highest at the ages of 70-79 years, amounting to 18.1% of cases with hypertension, 24.0% of cases with CVD, 29.2% of cases with varicose veins, and 33.7% of cases with ischemic heart disease. CONCLUSION: Target population groups have been identified for more effective screening studies in order to detect senile cataracts among them.

[Integrated indicator of the current assessment of the COVID-19 pandemic process in the subjects of the Russian Federation].

Information on the main indicators of the Pandemic COVID-19 is published daily for each subject of the Russian Federation. Of interest is the comparative ranking of regions in terms of new cases, active cases that have recovered from COVID-19, the allocation of homogeneous groups of regions in terms of the distribution of COVID-19. Since several indicators, respectively, the ranking of regions can be several options: the same regions with a high level of morbidity can be characterized by lower mortality from COVID-19 and vice versa, which will shift their position in the overall rating assessment. Such a state complicates the perception of the situation with the COVID-19 pandemic in the spatial-territorial context. In this regard, it makes sense to develop a certain latent integral indicator for assessing the COVID-19 pandemic process, which will allow comparing the subjects of the Russian Federation with each other in order to develop practical recommendations.

[Gender and age features frequencies of COVID-19].

The incidence of COVID-19, both complicated and uncomplicated pneumonia, among men is 40% higher than in women and increases at the age of 35-49 years, with a subsequent decrease in the rate. Pneumonia complicates the course of COVID-19 in older persons, due to the greater burden of comorbidity. Among men, the probability of contracting COVID-19 complicated by pneumonia is 1.4 times higher than among women. At the same time, the average duration of outpatient treatment among women is significantly higher both in the group of patients with COVID-19 with complicated and uncomplicated pneumonia. The data obtained indicate the need to develop additional measures to prevent the spread of COVID-19 infection among the male population and the middle-aged population, the incidence of the disease among which is the highest.

[The medical demographic and social characteristics of women that discontinued observation and infertility treatment].

The recovering of reproductive health of women is one of prospective means to stabilize fertility. The purpose of the study is to investigate medical, demographic and social risk factors of discontinuing screening and treatment of infertility in women of the Tambov Oblast. The materials and methods. The comparative data analysis of women who discontinued infertility screening and treatment prior to referral to auxiliary reproductive technologies (n = 239) and women who were factually referred to these technologies (n = 206). The results of the study. The risk factors for women of discontinuing screening and treatment of infertility included age (OR = 1.070; 95% CI 1,035-1,105; p<0.001), residence in rural areas (OR = 2.059; 95% CI 1.592-2.663; p<0.001), secondary education (OR = 2.593; 95% CI 1.767-3.805; p<0.01), low level of financial security (OR = 2.524; 95% CI 1,720-3,703; p<0.01), secondary nature of infertility (OR = 1.587; 95% CI 1.065-2.364; p=0.023), occurrence of sexually transmitted diseases in anamnesis (OR = 2.736; 95% CI 1,722-4,346; p<0.01). Discussion. The study results demonstrate that the most effective measures improving compliance of women to screening and treatment of infertility are the reorientation of medical care to the second-level regional centers from the regional center that will bring medical care, including active detection of infertility at younger age, more comprehensive regular preventive examinations and health education to preserve reproductive health, closer to remote areas. The conclusions. The medical, demographic and social risk factors of discontinuing testing and treatment of infertility in women are established to be applied in improving the organization of medical care for this category of patients.

[The analysis of concomitant pathology in ophthalmologic practice based on electronic medical records data].

The study substantiates possibility of using data retrieved from electronic medical records (EMR) for analyzing comorbidity under diseases of the eye and its adnexa. The purpose of the study is to analyze prevalence and evaluate risk of development of comorbidity in patients with ophthalmologic pathology, based on the data presented in EMR. The total number of patients included into comprised 12 120 individuals. The 653 diagnoses were established and 122 703 requests for medical care were registered. The calculation was applied concerning prevalence, comorbidity index, relative risk of comorbidity. The study established prevalence and level of relative risk of development of opportunistic diseases characteristic for senile cataract and glaucoma. The obtained data on comorbidity may testify in-depth mechanisms of interaction of diseases at cellular, protein or genetic levels. The understanding of mechanisms of interaction of main and concomitant diseases can result in development of new methods of diagnostic, treatment and prevention of diseases. Thus, establishment of glaucoma diagnosis can induce physician to look for possible presence or high probability of development of prostate neoplasm that implies periodic control of prostate-specific antigen. The presented results demonstrate how EMR data can be used to identify, estimate prevalence and risk of comorbidity and also reveals pathogenic mechanisms of interaction between primary and recurrent diseases that can be applied in clinical practice.