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.

Introduction. As a result of the COVID-19 pandemic that swept the whole world in 2020, the level and structure of morbidity changed, the “center of gravity” of adult mortality shifted towards infectious diseases. The anti-epidemic reorientation of healthcare systems in the world has had a negative impact on the health of patients with non-communicable diseases (NCDs). As a result, the morbidity of the adult population, in particular respiratory diseases related to the most important NCDs, becomes particularly relevant in the conditions of epidemiological restrictions in Moscow with the spread of the COVID-19 and the increased burden on the Healthcare system of Moscow. Purpose. The purpose of this study is to analysis of indicators of incidence and prevalence of the respiratory system diseases of the adult population of Moscow and the Russian Federation for the periods 2015–2019 and 2019–2020. Methods and materials. The study used data of the official statistics of the Ministry of Health of the Russian Federation of the “Morbidity of the Russian population” (incidence and prevalence by the care seeking data) for 2015–2020, by the ICD-10 chapter X “Diseases of the respiratory system” (J00-J99), blocks “Chronic lower respiratory diseases” (J40-J47): Asthma, Status asthmaticus (J45, J46); Other chronic obstructive pulmonary disease (J44); chronic bronchitis, Emphysema (J40-J43). Results. The respiratory system diseases continue to occupy leading positions in the structure of morbidity of the adult population of Moscow and the Russian Federation. In the structure of the prevalence of the adult population of Moscow in 2020, respiratory system diseases accounted for 16.8 % (in 2015 – 15.1 %), which is lower than in the whole of the Russian Federation – 17.7 % (2015 – 13.8 %). In the structure of the incidence of the adult population of Moscow was 33.8% (in 2015 – 33.5 %), which is lower than in the whole of the Russian Federation, amounting to 36.9 % (2015 – 28.2 %). The prevalence the respiratory system diseases of the adult population of respiratory system diseases in 2020 in Moscow was 20 830.8 per 100 000 population, which is 19.6 % lower than in the whole of the Russian Federation (25 910.0). Over the period 2015–2019, the indicator of prevalence tended to increase in Moscow by 10.2 %, in the Russian Federation – by 6.2 %. For the period 2019–2020 in Moscow, the increase was only 5.4 %, in the Russian Federation there were higher growth rates (+21.9 %). The incidence the respiratory system diseases in 2020 in Moscow was 15,832.1 per 100 000 population, which is 1.3 times lower than the national average (21,376.0). Over the period 2015–2019, the incidence rate decreased in Moscow by 7.9 %, in the Russian Federation – by 6.6 %. In 2019–2020, the growth rate in Moscow was 4.8 %, in general, a higher increase of 29.7 % was recorded in the Russian Federation. For the period from 2015 to 2019 and during the period of “COVID-19 lockdowns” in 2020, mainly in Moscow, there are high rates of increase in the incidence of chronic obstructive pulmonary disease and asthma. At the same time, a decrease in the level of prevalence and incidence of chronic bronchitis and emphysema was registered both in Moscow and in the Russia. Conclusion. Thus, the morbidity of the adult population the diseases of respiratory system in Moscow tends to decrease, while in the Russian Federation to increase, which requires additional research to find cause-and-effect relationships.

BACKGROUND: The problem of metabolic syndrome is considered a demographic catastrophe. According to WHO experts,«by 2025, the prevalence of metabolic syndrome (MS) in the world will amount to more than 300 million people, and in the next 25 years it is expected to increase by 50%.» The pathophysiological mechanisms of MS formation and the role of unhealthy diet on the development of intestinal dysbiosis, mitochondrial insufficiency remain unclear.AIM: To study the effect of unhealthy diet on the state of the intestinal microbiota and the development of metabolicmitochondrial insufficiency in the formation of a multi-organ metabolic syndrome, evaluation of ways of correction.MATERIALS AND METHODS: Clinical picture assessment, anthropometric data (body mass index), laboratory results (glucose, cholesterol and fractions) were carried out in patients with MS, triglycerides, aspartate aminotransferase, alanine aminotransferase, C-reactive protein, lipid peroxidation indicators: malondialdehyde, diene conjugates, schiff bases, hydroperoxides, catalase, superoxide dismutase, succinate dehydrogenase (ASDH), α-glycerophosphate dehydrogenase (α-AGFDH). Hemorheological parameters were evaluated by the apparent viscosity of blood, the yield strength, the aggregation coefficient of erythrocytes and platelets. The microbiota and microbiome of the intestine were evaluated by species, strain composition and the level of metabolites-propionic, butyric, acetic acid, lipopolysaccharides, peptidoglycans. A questionnaire was conducted to study the nature of nutrition.RESULTS: The study included 128 patients with MS and 25 healthy individuals. According to medical outpatient records from anamnesis, questioning of each patient, complaints and clinical picture, 26.2% of patients had type 2 diabetes, 3.74% of men had erectile dysfunction, 7.5% of women had polycystic ovaries, 15.1% had night apnea syndrome, 8.7% hyperuricemic syndrome, 96.5% of patients had metabolic fatty liver steatosis. According to the results of the survey, it was revealed that 99.8% of patients adhered to an unhealthy and unbalanced, high-calorie diet, 46.4% of patients had a low level of physical activity, 48.7% had an average. The revealed disorders of lipid, carbohydrate metabolism, microbiota and intestinal microbiome were associated with increased lipid peroxidation, decreased levels of antioxidant defense enzymes, indicators reflecting mitochondrial function against the background of hemorheological disorders.CONCLUSION: In multi-organ MS, unhealthy diet can be considered as a targeted risk factor triggering pathophysiological mechanisms at the level of the intestinal microbiota, followed by a cascade of metabolic disorders in the form of activation of lipid peroxidation with inhibition of antioxidant defense enzymes, the development of multi-organ mitochondrial insufficiency and the development of latent hemorheological syndrome. The revealed metabolic complex obviously constitutes a multiorgan morphological cluster underlying the development of multi-organ metabolic syndrome. Based on the identified disorders, pathogenetically justified correction of MS should include a balanced diet with mitochondrial protective therapy.

Successful immunization programmes are the result of high vaccine effectiveness and timely use. Numerous studies have shown that immunization will be effective with government support, taking into account the local culture of the population, and approaches to vaccination to optimize results. Purpose. Summarize the world’s data on existing immunization programs and their accompanying problems. Literature search methods included search queries, in the form of a set of keywords «vaccination/vaccine», «immunization», «anti-vaxxers», «pandemic», «public health» followed by full-text sources, Web of Science, Scopus, MedLine, The Cochrane Library. In the information retrieval systems, the analysis of the results was carried out, taking into account full compliance with the specified criteria of search among documents and sites. Unlike most medicines, which have limited benefits, vaccines prevent serious diseases and their public health consequences. Immunization outcome is determined by assessing the impact directly on the vaccinated person, indirectly on the unvaccinated community. The success of immunization depends on a level of universal coverage sufficient to interrupt pathogen transmission. Declines in immunization coverage will lead to a resurgence of diseases and new outbreaks with significant gain in the morbidity and mortality rate. In many cases, refusal to vaccinate is the result of people listening to beliefs and copying the behavior of others. An important consequence of this misperception is the potential involvement in the spread of an infectious pathogen due to the false belief that “vaccination is harmful”. Thus, ensuring the success of the continuity of immunization programs is the responsibility of citizens, health professionals and government, among others.

Introduction. The incidence of diseases of the circulatory system among the working-age population continues to be a nationwide problem that has worsened during the COVID-19 pandemic. In Moscow, the restrictions imposed during the COVID-19 pandemic, both for the population and for medical organizations of the Moscow Healthcare Department, have become one of the reasons for the deterioration of health and an increase in the incidence of the working-age population.Aim. Analysis of the dynamics of indicators of general and primary morbidity by diseases of the circulatory system and individual nosologies of working-age population of the city of Moscow for the period 2014-2021.Materials and methods. As materials, we used Moscow Healthcare Department data (morbidity according to the data of negotiability, reporting form of the Federal Tax Service N 12) for 2014-2021, analytical and statistical methods of research, indicators of time series were used.Results. In Moscow in 2014-2021 general and primary morbidity of the working-age population in the diseases of the circulatory system decreased by 3,6% and 23,8%, diseases characterized by high blood pressure by 5.7% and 3,4%, cardiac ischemia by 13,9% and 33,4%, cerebrovascular diseases by 4,9% and 19,5%. In 2020-2021 the increase in the level of general morbidity in the class was 10,6%, diseases characterized by high blood pressure - 9,2%, cardiac ischemia - 8.1%, cerebrovascular diseases - 22%, against the background of a decrease in primary morbidity in the class by 9,3%, diseases characterized by high blood pressure by 6,3%, cardiac ischemia by 22,1%, cerebrovascular diseases by 10,2%. The number of people of working age under dispensary observation by class increased by 24,6%, diseases characterized by high blood pressure by 12,9%, cardiac ischemia by 24,6%, cerebrovascular diseases by 2 times.Conclusion. The current trends in the incidence of diseases of the circulatory system in the working-age population reflect the effectiveness of the implemented state programs and preventive measures in the metropolis, including in the context of the COVID-19 pandemic, the state of public health and adherence to prevention and treatment.