The functional responsibilities of general practitioners (family doctors) (GPs) have changed significantly over the past decade. The number of GP functions has expanded. Despite the increasingly complex professional activities of GPs, there is no scientific evidence for the qualification characteristics of GPs expressed in knowledge, skills, abilities, and competencies in the theory and practice in training. In this regard, a study was conducted to determine the priority of GP competencies that make up the qualification characteristics of a specialist. Aim. To analyze, generalize and rationale the research results, as well as to develop preliminary guidelines for GP training. Material and methods. The information base for the study was the results of ranking competencies according to their importance in the professional activities of GPs in Russia. It was obtained during the ascertaining experiment, implemented using the Delphi method as a method of expert assessment and strategic planning of training specialists. Conclusion. The analysis of competencies developed and agreed upon by experts showed its compliance with the job functions of GPs, the requirements of the Federal State Educational Standard for the General Medical Practice (Family Medicine) and the WONCA guidelines. A summary of the study results to determine the priority of competence in GP activities showed the following: — all competencies (25) were defined as necessary and constitutive of GP qualification; — 21 competencies were considered significant and highly significant for GPs; — 4 competencies were considered as of moderate significance and below moderate significance. The analysis of the priority of competences revealed insufficient methodological support for GP training in accordance with the social order. The results obtained showed the need to continue the study within the project "Quality Management of Training of General Practitioners (Family Doctors)".

It is known that iron deficiency is a negative factor for the onset of pregnancy. It aggravates its course, increasing the risk of preeclampsia, placental insufficiency, uterine inertia, premature birth, bleeding and hypogalactia. This condition increases the risk of unfavorable outcomes, iron deficiency anemia and cognitive delay in a child. Raising the awareness of women of reproductive age and the clinical suspicion of physicians regarding the iron deficiency anemia and latent iron deficiency can facilitate timely visit a doctor. At the expert council “Relevant issues of iron deficiency in the Russian Federation” held in June 2020, aspects of the epidemiology, diagnosis and treatment of this condition were discussed, and promising directions for improving the situation were proposed.

Structural alterations of heart and vessels were studied in 275 patients with arterial hypertension and in 138 healthy persons by echocardiography and applanation tonometry with TensioClinic device of TL1 type. Cardiac morphometric parameters and vascular rigidity alterations differed in elderly hypertensive patients and in normotensive persons of the same age. Applanation tonometry and echocardiography allowed to reveal the degree of target organs’ affection (heart and vessels remodeling) and to administer proper treatment.

Aim: to study cerebral blood flow and cholesterol metabolism in menopausal women with arterial hypertension (AH); to evaluate dynamics of cerebral blood flow parameters and plasma lipid concentrations in these patients during 6-month antihypertensive and hypolipidemic therapy.Material and methods: 24 women with AH of I and II grade were examined. They were in postmenopausal period of life during 7,1±0,5 years. At the beginning of the study all women were prescribed moexipril as monotherapy, daily dose 7,5 – 15 mg. Patients with initial dislipidemia were prescribed lipid reducing drug atorvastatin in 10mg daily dose additionally to the antihypertensive therapy. Therefore all the patients were divided into two groups: I – monoteraphy with moexipril (13 people), II – combined therapy with moexipril and atorvastatin (11 people). At the beginning of the study and after 6 months all the patients passed through ultrasonic Dopplerography of vessels of head and neck, rheoencephalography, their lipoproteidogrammes were studied.Results: During 6-month therapy all the patients showed proved decrease in systolic and diastolic blood pressure, also positive dynamics of neuropsychological status, improvement in cerebral blood flow according to the results of Dopplerography of vessels and rheoencephalography. Normalization of plasma lipid spectrum was noted. More significant positive changes in cerebral hemodynamic parameters and plasma lipid spectrum were observed in patients, who received combined therapy with antihypertensive and lipid reducing drugs.Conclusion: Deterioration of cerebral hemodynamics is typical for women with long-lasting AH. The most positive influence on cerebral perfusion was received due to combined therapy with moexipril and atorvastatin.

Aim: to study cerebral blood flow and cholesterol metabolism in menopausal women with arterial hypertension (AH); to evaluate dynamics of cerebral blood flow parameters and plasma lipid concentrations in these patients during 6-month antihypertensive and hypolipidemic therapy. Material and methods: 24 women with AH of I and II grade were examined. They were in postmenopausal period of life during 7,1±0,5 years. At the beginning of the study all women were prescribed moexipril as monotherapy, daily dose 7,5 – 15 mg. Patients with initial dislipidemia were prescribed lipid reducing drug atorvastatin in 10mg daily dose additionally to the antihypertensive therapy. Therefore all the patients were divided into two groups: I – monoteraphy with moexipril (13 people), II – combined therapy with moexipril and atorvastatin (11 people). At the beginning of the study and after 6 months all the patients passed through ultrasonic Dopplerography of vessels of head and neck, rheoencephalography, their lipoproteidogrammes were studied. Results: During 6-month therapy all the patients showed proved decrease in systolic and diastolic blood pressure, also positive dynamics of neuropsychological status, improvement in cerebral blood flow according to the results of Dopplerography of vessels and rheoencephalography. Normalization of plasma lipid spectrum was noted. More significant positive changes in cerebral hemodynamic parameters and plasma lipid spectrum were observed in patients, who received combined therapy with antihypertensive and lipid reducing drugs. Conclusion: Deterioration of cerebral hemodynamics is typical for women with long-lasting AH. The most positive influence on cerebral perfusion was received due to combined therapy with moexipril and atorvastatin.

The diurnal profile peculiarities in normotensive elderly persons have been shown. The variability ranges of systolic arterial blood pressure are discussed.

AIM:To examine effectiveness and safety of quadropril.MATERIAL AND METHODS:Changes in blood pressure (BP), heart rate (HR), levels of glucose, potassium and creatinine, creatinine clearance were studied in 120 patients (48 males and 72 females, mean age 60.6 +/- 0.7 years) with mild to moderate arterial hypertension (AH) with average duration 13.8 +/- 0.7 years. The patients were divided into 3 groups: with AH (n = 40), AH + noninsulindependent diabetes mellitus (DM) (n = 43), AH and nephropathy (n = 37). 8-week treatment was performed with a standard dose of 6 mg/day (1 tablet of quadropril). Control examinations were made 2, 4 and 8 weeks after the treatment.RESULTS:After 8 weeks of treatment a decrease in systolic blood pressure in AH group was 24.0 +/- 3.0 mm Hg and in diastolic blood pressure 16.3 +/- 1.3 mm Hg (P < 0.001). In the group with DM this decrease was 22.4 +/- 2.8 mm Hg and 15.7 +/- 1.4 mm Hg (p < 0.001), respectively. In the group with nephropathy this decrease was 26.4 +/- 2.4 and 16.5 +/- 1.3 mm Hg (p < 0.001), respectively. Heart rate changed significantly only in diabetics: from 75.1 +/- 1.7 to 72.9 +/- 1.3 beats/min. Biochemical parameters in the hypertensive and diabetic patients did not change significantly. In the nephropathy group there was a significant decrease in creatinine and increase in creatinine clearance. Their level of glucose and potassium changed insignificantly.CONCLUSION:The treatment with quadropril results in a significant decrease in blood pressure, does not influence parameters of carbohydrate metabolism, improves nitrogen eliminating function of the kidneys.