Methodical guidelines are devoted to the functional status control and medical support of young female athletes in team sports and are intended for sports doctors and the coaching staff of teams.

Настоящие методические рекомендации разработаны на основании сравнительного анализа литературных данных, проведения научно-экспериментальных диагностических исследований для категории лиц, занимающихся различными видами спорта, а также изучения отечественного и международного опыта в области спортивной медицины. Цель работы заключалась в предоставлении информации специалистам, участвующим в системе подготовки спорт сменов, о новом подходе в выборе критериев оценки адаптационных возможностей организма на различных этапах тренировочного процесса. Проведенное экспериментальное исследование включало решение следующих задач. 1. Выявить диагностическую значимость применения иммунологических показателей для оценки функционального состояния спортсмена в покое и при нагрузке. 2. Обосновать научно-практическое использование метода на основе установления взаимосвязи биохимических и иммунологических показателей. 3. Провести апробацию иммунолоИммунологический метод оценки адаптационных резервов организма

The review summarizes the current data on the methods of assessment of adaptation and disadaptation (fatigue, overreaching, overtraining, OT) of athlete during training; special attention is paid to the diagnostic value of biochemical and immunological markers of adaptation potential (AP). Their diagnostic significance was analyzed. Hypotheses and possible mechanisms of OT development were considered. Based on the results of recent studies published by domestic and foreign authors, both the diversity and the number of proposed adaptation markers have been established, and a lack of unity of approaches in the assessment of AP and OT has been revealed. Large amount of biochemical, immunological and other tests proposed for the evaluation of AP was summed up. The most significant AP and OT markers are protein metabolism factors, enzymes, lactate, urea. The role of immune factors, besides leukocytes and lymphocytes, is intensively studied: these are leukocyte toxicity index, level of neutrophils, cytokines, natural antibodies to AP bioregulators. The prospects of using an integrated test system for determining the e-At panel to AP bioregulators is shown for monitoring the athlete's condition, and especially for early diagnosis of OT.

Currently, there are two parallel permit-to-work systems in health care in Russia — certification and accreditation of specialists. A system of specialist certification has been used for more than twenty years. Accreditation as a new permit-to-work system has been applied since January 1, 2016. A full transition to accreditation will occur in 2026, and the certification system will go defunct.

Accreditation of specialists in the medical education system began to be applied on January 1, 2016. Two types of accreditation (primary and primary specialized) have already been introduced into the educational practice of medical educational institutions and are successfully functioning. The third type of accreditation — periodic accreditation will start functioning from January 1, 2021.

Moscow Aim – to study the prevalence of arterial hypertension (AH) and left ventricular hypertrophy among male liquidators (ML) of Chernobyl accident consequences and a group of unorganized males (UM) from one of the Moscow regions. Materials and methods. The results of examining a random representative sample of three hundred and ninety-five 35–64-year-old Mos-cow Registry MLs of Chernobyl accident consequences (n = 395; 79 % response rate) were analyzed. A random sample of males from one of the Moscow regions (n = 382; 70 % response rate) was used to make up an age-matched comparison group.Results. The age-adjusted prevalence rate (AAPR) of AH according to the expanded WHO criteria (> 140/90 Hg mm) was substantially higher among MLs than among UMs (64.9 and 54.7 %, respectively; p < 0.01). The prevalence of AH was associated with the men’s age in both populations. Thus, this among MLs and UMs in the 35–44 year age group was 54.6 and 47.2 %, respectively and in the 55–64 year age group 80 and 62.2 % (i.e. the incidence of AH increased by 1.3 (р < 0.01) and 1.2 (р < 0.05) times, respectively). Conclusion. AAPR of AH among the liquidators was significantly higher than that in the control group (64.9 % versus 54.7 %, respectively). In the compared groups, that of left ventricular hypertrophy did not differ and was 25 and 25.6 %, respectively; significant differences were found in the degree of left ventricular hypertrophy: certain (concentric) left ventricular hypertrophy was more common in the liquidators than in the comparison group (12.9 % versus 7.4 %, respectively). In the ML group compared to the control group, there was much higher awareness of having AH (59.1 % versus 46 %, respectively), drug treatment was performed in 38.7 % versus 7.9 %; effective BP control in the patients was 13.1 % versus 4.7 %, respectively.

Moscow Aim – to study the prevalence of arterial hypertension (AH) and left ventricular hypertrophy among male liquidators (ML) of Chernobyl accident consequences and a group of unorganized males (UM) from one of the Moscow regions. Materials and methods. The results of examining a random representative sample of three hundred and ninety-five 35–64-year-old Mos-cow Registry MLs of Chernobyl accident consequences (n = 395; 79 % response rate) were analyzed. A random sample of males from one of the Moscow regions (n = 382; 70 % response rate) was used to make up an age-matched comparison group.Results. The age-adjusted prevalence rate (AAPR) of AH according to the expanded WHO criteria (> 140/90 Hg mm) was substantially higher among MLs than among UMs (64.9 and 54.7 %, respectively; p < 0.01). The prevalence of AH was associated with the men’s age in both populations. Thus, this among MLs and UMs in the 35–44 year age group was 54.6 and 47.2 %, respectively and in the 55–64 year age group 80 and 62.2 % (i.e. the incidence of AH increased by 1.3 (р < 0.01) and 1.2 (р < 0.05) times, respectively). Conclusion. AAPR of AH among the liquidators was significantly higher than that in the control group (64.9 % versus 54.7 %, respectively). In the compared groups, that of left ventricular hypertrophy did not differ and was 25 and 25.6 %, respectively; significant differences were found in the degree of left ventricular hypertrophy: certain (concentric) left ventricular hypertrophy was more common in the liquidators than in the comparison group (12.9 % versus 7.4 %, respectively). In the ML group compared to the control group, there was much higher awareness of having AH (59.1 % versus 46 %, respectively), drug treatment was performed in 38.7 % versus 7.9 %; effective BP control in the patients was 13.1 % versus 4.7 %, respectively.

Государственные структуры должны играть одну из ведущих ролей в укреплении здоровья населения и профилактике неинфекционных заболеваний (НИЗ). Для того чтобы государственные структуры эффективно работали, управленцы должны знать и использовать научно обоснованные подходы для развития программ и политики в области профилактики НИЗ и формирования здорового образа жизни. Однако зачастую экспертные оценки программ показывают нехватку опыта и отсутствие четкой схемы этапов создания и организации программ профилактики НИЗ у специалистов, которых привлекли к их разработке. С целью обучения управленцев в области здравоохранения методологии научно обоснованной профилактики НИЗ в 2000 г. в Государственном научно-исследовательском центре профилактической медицины был разработан обучающий семинар «Научно обоснованная профилактика НИЗ». За последние 14 лет курс проходил в семи регионах России (Москва, Тверь, Санкт-Петербург, Якутск, Томск, Челябинск, Тюмень). Материалы обучающего семинара постоянно обновлялись и модернизировались с учетом потребностей его основных слушателей — лиц, принимающих решения. Для этого слушателям предлагалось оценить семинар в целом, отдельные его темы, работу преподавателей, организационные моменты, а также оставить свои комментарии и внести предложения по его модернизации. Исследование, проведенное в период 2010—2011 гг. по оценке потребностей лиц, принимающих решения в области обучения научно обоснованному подходу при разработке программ профилактики НИЗ, также показало, что потребность у организаторов здравоохранения в знаниях, связанных с различными аспектами работы с профилактическими программами, среди лиц, принимающих решения, остается достаточно высокой. За последние 2 года было проведено три обучающих семинара для лиц, принимающих решения. В семинарах приняли участие 121 слушатель, представители 62 регионов. Основной контингент составили главные внештатные специалисты по профилактической медицине, представители департаментов и министерств здравоохранения регионов РФ. Опыт проведения семинара показал необходимость его дальнейшего развития и потребность в нем тех лиц, для которых он изначально разрабатывался, а именно — управленцев в сфере укрепления здоровья населения и профилактики заболеваний. Ключевые слова: программы профилактики, обучение лиц, принимающих решения, научно обоснованная профилактика НИЗ. State structures must play one of the leading roles in promoting the population’s health and in preventing non-communicable diseases (NCD). To ensure that the state structures work effectively, their members should know and use scientifically sound approaches to working out NCD prevention programs and policy and to molding a healthy lifestyle. However, expert judgments for the programs frequently show that experience and a well-defined scheme of the elaboration and implementation of NCD prevention programs are absent in the specialists involved in their elaboration. To teach scientifically sound NCD prevention methods to public health administrators, in 2000 the National Research Center for Preventive Medicine worked out an educational seminar «Scientifically Sound NCD Prevention». In the past 14 years, the course has taken place in seven regions of Russia (Moscow, Tver, Saint Petersburg, Yakutsk, Tomsk, Chelyabinsk, and Tyumen). The materials of the educational seminar have been constantly updated having regard to the needs of its chief audience — decision makers. To do this, the audience has been proposed to assess the seminar as a whole, its individual topics, teachers’ work, and organizational moments, to leave own comments, and to offer suggestions on its modernization. The 2010—2011 investigation estimating the decision-makers’ needs for teaching a scientifically sound approach to elaborating NCS prevention programs has also demonstrated that the public health administrators’ need for knowledge about different aspects of working with prevention programs among the decision-makers remains rather high. In the past two years, three educational seminars have been conducted for decision-makers. The seminars have been attended by 121 listeners, the representatives of 62 regions. The chief audience has been composed of chief freelance preventive medicine specialists and representatives of the departments and ministries of the Russian Federation’s regions. The experience with seminar has shown the need for its further development and its demand among those who it was initially worked out for; namely, health promotion and disease prevention administrators.

These recommendations contain the procedure for choosing patients with stable angina pectoris and effective combination therapy of antianginal drugs from the three main groups (nitrates, calcium channel blockers and b-blockers) by repeated tests with physical exercise on a bicycle ergometer. We show how to determine the optimal combination of these drugs to the patient considering clinical data, tolerability and acceptability of the proposed treatment.The guidelines are intended for cardiologists, therapist, specialists in functional diagnosis, and scientific workers specialized in cardiac units. The guidelinesare recommended by Educational and Methodological Association of medical and pharmaceutical education in Russian universities as a textbook for doctors’ postgraduate education system.

Background. The elevation of blood pressure (BP) affects the development of vascular inflammation. At the same time, it has been suggested that inflammation itself could be an independent risk factor (RF) of arterial hypertension (AH) development. Aim. To investigate whether the association between increased levels of C-reactive protein (CRP) and AH is independent from classical RFs. Material and methods. The data were obtained during a crosssectional survey of 1876 Muscovites (47,9% men) aged ≥55 years, who participated in the prospective study “Stress, Ageing, and Health in Russia”. In all participants, socio-demographic characteristics, health behaviours, parameters of anthropometry and rest electrocardiography (ECG) were assessed. The levels of BP and blood lipids were also measured. The outcome variable was an increase in CRP levels (>3 mg/l). Statistical methods included logistic regression; the risk estimates were presented as odds ratios (OR) and 95% confidence intervals (CI). Results. There was a positive link between AH and CRP levels of >3 mg/l. After adjustment for age and sex, OR of increased CRP levels in hypertensive participants vs. their AH-free peers was 1,688 (95% CI 1,323-2,154; p=0,0001). In the final model (adjustment for age, sex, educational level, smoking, alcohol consumption, abdominal obesity, high atherogenicity index, and coronary heart disease, CHD), this effect remained statistically significant (OR 1,450; 95% CI 1,127-1,864; p=0,004). Conclusion. In elderly Muscovites, a positive association between increased CRP levels and the elevation of BP was independent from RFs and CHD.

Aim.High-sensitive C-reactive protein (hsCRP) is currently regarded as an important marker of cardiovascular disease (CVD). The aim of the study was to assess the population characteristics of hsCRP in the sample of Moscow residents aged 55 years and older.Material and methods.The analysis included 1851 people (response rate 65 %), who participated in the SAHR (Stress, Aging, and Health in Russia) study.Results.The hsCRP levels were similar in men and women, with the right-skewed distribution. The hsCRP values ranged from 0,5 to 69,5 mg/dl in men (median 1,5 mg/l), and from 0,5 to 75 mg/l in women (median 1,5 mg/l). The mean hsCRP levels were slightly higher in men than in women (3,4±0,19 vs. 3,1±0,15, respectively;р=0,36). Overall, there was no marked age-related dynamics of hsCRP levels in men or women. The prevalence of high hsCRP levels (>3 mg/l) non-significantly increased from 31,2 % in the youngest age group to 36,2 % in those aged 75 years and older. Acute inflammation (hsCRP levels >10 mg/l) was registered in 85 participants (4,5 %), including 42 men and 43 women. After adjustment for age and gender, the lower education level remained a significant predictor of hsCRP elevation.Conclusion.No clear associations between hsCRP and age or gender were observed. However, participants with university and secondary education had significantly lower hsCRP concentrations, compared to their peers with education level lower than secondary.

The paper discusses fixed-dose combined therapy of arterial hypertension (AH), as an effective method for increasing AH treatment compliance.

The paper discusses fixed-dose combined therapy of arterial hypertension (AH), as an effective method for increasing AH treatment compliance.