The paper presents algorithms for adult outpatient care of coronavirus disease 2019 (COVID-19) and its assumption.

Цель. Проанализировать клинические особенности Российской популяции пациентов с неклапанной фибрилляцией предсердий, включенных во II фазу международного регистра пациентов Gloria Af. Материал и методы. Представлены данные по клиническим характеристи-кам Российской популяции пациентов с фибрилляцией предсердий, получен-ные в результате анализа данных второй фазы программы Gloria Af. Gloria Af является международной проспективной наблюдательной программой, пред-ставляющей собой регистр пациентов с впервые диагностированной фибрил-ляцией предсердий. Результаты. Большинство пациентов, включенных в российскую популяцию регистра Gloria Af, имели одно или несколько сопутствующих заболеваний: 93,6% пациентов имели артериальную гипертонию, 37,4% -ишемическую болезнь сердца, 14,4% имели инфаркт миокарда в анамнезе. 19,3% пациентов имели диагноз сахарного диабета, 56,4% -диагноз хронической сердечной недостаточности, 8,7% пациентов имели в анамнезе инсульт. Оценка риска инсульта показала, что среднее количество баллов по шкале CHA 2 Ds 2 -VAsc составило 3,2 балла, при этом 14,4% пациентов имели риск 1 балл, 85,6% пациентов -два и более балла, данный профиль риска сопоставим с данными полученными в общей популяции регистра Gloria Af, а также близки к данным регистра Garfield. Анализ профиля антитромботической терапии, получаемой пациентам, свидетельствует об интенсивном внедрении Новых Пероральных Антикоагулянтов в реальную клиническую практику исследовательских цент-ров, принимающих участие в Gloria Af. Заключение. Результаты свидетельствуют о сопоставимом с международ-ными данными профилем риска Российской популяции пациентов с фП, вклю-ченных во вторую фазу регистра Gloria Af, а также об интенсивном внедрении класса Новых Пероральных Антикоагулянтов в рутинную клиническую практику исследовательских центров, принимающих участие в регистре.Российский кардиологический журнал 2017, 9 (149): 21-27 http://dx

Prevention strategies aim to change environmental and lifestyle risk factors that contribute to the development of cancer. Screening detects abnormalities before they become clinically apparent, allowing intervention either before cancer develops or at an early stage when treatment is most likely to be effective. Despite reliable data on factors that reduce the risk of neoplasms, in routine clinical practice, the effectiveness of cancer prevention is still not high enough. This determines the high importance of the topic of this review, which summarizes the current scientific data on risk factors for the development of oncopathology and ways to influence them. Such risk factors as lifestyle, alcohol and tobacco use, physical activity, nutrition and other environmental factors are considered. A large role is given to infections, which is also considered in this review. The article highlights the intake of vitamins and microelements for the purpose of cancer prevention, as well as the influence of certain drugs taken to treat non-oncological diseases on the development of oncopathology. The purpose of the review is to present an analysis of current literature data on the methods of cancer prevention.

Follow-up is the basis for the effectiveness of secondary cardiovascular prevention. Preferential drug provision is a necessary condition for the mass implementation of cardiac rehabilitation programs, as it ensures maximum adherence of patients to expensive drug therapy and the need for regular doctor’s appointment. The Omsk Region has organized and operates a patient routing system aimed at timely initiation and continuous drug provision within the framework of the Federal Project “Fight against Cardiovascular Diseases”. Aim. To evaluate the effectiveness of the first year of cardiac rehabilitation in patients with very high cardiovascular risk who received preferential drugs from the list approved by the Order of the Ministry of Health of the Russian Federation dated January 9, 2020 No. 1n. Material and methods. The study was conducted at the Omsk Region Clinical Cardiology Dispensary, a state-financed health care institution, from January 1 to December 31, 2020. A retrospective cohort study was conducted of outpatient records of patients subjected to preferential provision of medicines, namely, those who were in the dispensary for acute stroke, myocardial infarction, or for coronary artery bypass grafting, coronary artery stenting or catheter ablation. A clinical-expert analysis of 1502 final clinical reports of patients who completed follow-up after one year was carried out. The patients’ adherence to dispensary observation, achievement of the target values of the main risk factors, total one-year mortality, frequency of recurrent cardiovascular events and occurrence of adverse events, primary disability were determined. Results and discussion. Outcomes of follow-up monitoring against the background of subsidized drug coverage: total one-year mortality – 1.5% (28 patients, 65.9±6.3 years, men 72.7%). Recurrent cardiovascular events in 12 months – 249 (13.8%) patients (68.4±7.4 years, men 182 (73.1%)). 10 patients had significant atrial fibrillation paroxysms requiring hospitalization (0.6%, 59.4±5.8 years, 40.0% men). Recurrent cardiovascular events were significantly more common in men (χ2 7.45; p=0.045). Target LDL-C level of less than 1.4 mmol/L were achieved in 270 (15.0%) patients with very high cardiovascular risk. Adverse events were identified: non-fatal bleeding – 14 patients (0.8%, 73.4±7.6 years, men 57.1%), transaminitis – 14 patients (0.8%, 70.4±2.3 years, men 71.4%), myalgia on statin therapy – 21 patients (1.2%, 71.2±2.5 years, men 52.4%), dyspnea on ticagrelor – 21 patients (1.2%, 58.4±4.3 years, men 47.6%) 1432 patients (95.3%) had no specified adverse events. There was a significant increase in new cases of type 2 DM from 331 (18.3%) to 339 (22.6%; χ2 McNemar A/D 4.07; p=0.044; B/C 93.09; p=0.002). High-normal blood glucose levels were observed at baseline in 384 patients (21.3%); by the end of follow-up, the number of patients with high-normal glucose was 540 (30.0%; χ2 86.08; p=0.002). There was a significant decrease in the number of patients with CHF (from 72 (4.0%) to 45 (3.0%); χ2 McNemar A/D 48.52; p=0.000; B/C 45.14; p=0.034). Conclusion. The results obtained testify to the effectiveness of the ongoing comprehensive program of medical rehabilitation (medication, physical rehabilitation and psychological counseling).

Aim. To evaluate the antihypertensive efficacy and tolerability of a fixed combination of amlodipine and ramipril in hypertensive patients with very high cardiovascular risk. Material and methods. A retrospective cohort study of real clinical practice of prescribing antihypertensive drugs according to 255 medical records of outpatient hypertensive patients with a history of acute coronary syndrome (ACS) and coronary artery stenting was performed in the first part. An open observational study was performed in the second part. 69 people older than 18 years with a history of ACS and coronary artery stenting, without reaching the target blood pressure (BP) level while using free combinations of antihypertensive drugs and with indications for a fixed combination of ramipril and amlodipine were included into the study. Analysis of self-monitoring of BP, office BP, daily BP monitoring (ABPM) and patients’ adherence to treatment (Morisky-Green test) initially, after 4 and after 12 weeks of taking the fixed combination of ramipril and amlodipine was performed to assess the clinical efficacy of the studied drug. Results. It was found that 42.0% of patients did not follow the recommendations for regular intake of antihypertensive drugs. So, hypertension of all patients regarded as false-refractory, which was the basis for the prescription of the fixed combination of ramipril and amlodipine in accordance with clinical guidelines for the diagnosis and treatment of hypertension. After 4 weeks of therapy, there was significant decrease in office BP with the achievement and preservation of the target level by the 12th week, normalization to the 12th week of day and night BP variability in 54.9% of patients. 78.0% of patients followed medical recommendations for regular administration of antihypertensive drugs, none of the patients had adverse events. Conclusion. The use of fixed combinations of drugs, in particular, amlodipine and ramipril as a part of multicomponent therapy in hypertensive patients with very high cardiovascular risk, led to the achievement of target BP by the 4th week of therapy and stable preservation of antihypertensive effect in 12 weeks of treatment as well as gradual normalization of day and night BP variability in more than half of patients. Fixed combination of ramipril and amlodipine allowed to improve adherence of patients to cardiovascular diseases.