Background: to achieve control of asthma and reduce mortality, as well as improve the patients' quality of life, it requires not only the new drugs development and improvement of stepwise therapy regimens but also new approaches to comprehensive individual rehabilitation programs for patient management. Aim: to assess the impact of comprehensive rehabilitation programs on asthma control, pulmonary function, motor activity, and quality of life (QOL) in multimorbid patients with asthma and obesity. Patients and Methods: 70 patients with asthma and obesity were divided into 2 groups of 35 subjects: group 1, in which patients underwent a rehabilitation program, and group 2, patients who were only under the outpatient supervision of a pulmonologist.The following tests were conducted twice: Asthma Control Questionnaire (ACQ-5), Cumulative Illness Rating Scale (CIRS) for assessing the multimorbid profile, 6-minute walk test for identifying the functional capacity, ODA23+ for motor activity assessment, QOL according to Asthma Quality of Life Questionnaire (AQLQ), pulmonary function test. Results: the patients were comparable in all assessed parameters. Functional capacity in both groups corresponded to the class I. The motor activity level according to ODA23+ was low to moderate. In group 1, the CIRS index was 10.0±1.1, in group 2 – 9.2±1.1 (p>0.005). After rehabilitation actions in group 1, the BMI decreased by 0.7 kg/m2 and waist circumference by 3.3 cm (p<0.05), motor activity increased from 63.8±4.9 to 70.4±4.5 (p<0.0001). In group 2, motor activity increased unreliably: the number of patients with low motor activity increased by 11.4%. The level of asthma control according to ACQ-5 in group 1 was 1.2±0.1, in group 2 — 1.58±0.1 (p<0.05). QOL in group 1 increased from 3.8±0.4 to 4.5±0.3 (p<0.0001) in all major domains except the emotional function, which increased unreliably (p>0.05). In group 2, QOL did not change significantly (p>0.05). Conclusion: to increase the level of asthma control, multimorbid patients with preserved rehabilitation potential should be offered multicomponent rehabilitation programs that affect both asthma and concomitant diseases. The use of rehabilitation programs improves the asthma control, increases the QOL of obese patients, promotes weight loss, increases motor activity level and functional capacity.

Aim. To study in real clinical practice extrapulmonary personalized factors in patients with asthma depending on the presence or absence of obesity and to build a model of asthma control based on them. Materials and methods. Cross-sectional study was performed in 7 outpatient centers and included 237 adult patients with bronchial asthma (mean age 52.6 ± 1.3 years). The patients were divided in groups according to body mass index (BMI): without obesity (BMI < 30 kg/m 2 ) – 128 patients, with obesity (BMI ≥ 30 kg/m 2 ) – 109 patients. Asthma control was assessed by Asthma Control Questionnaire-5, physical activity – by the motor activity questionnaire (ODA23+), physical activity motivation – by data from the questionnaire. A linear regression model was built with the inclusion of sex, smoking, BMI, physical activity to predict the level of asthma control. Elasticity coefficient Ej, β- and Δ-coefficients and their ranks were calculated. Results. The distribution of patients according to the degree of asthma control differed statistically significantly in the groups: controlled, partially controlled and uncontrolled were 25.8 %, 60.2 %, 14 % and 0 %, 33.9 %, 66.1 %, respectively, in groups without obesity and obese (p < 0.001). High or moderate physical activity was present in 88 % of non-obese and 47% of obese patients (p < 0.05). No differences were found in the motivation for physical activity: 41% with obesity and 42 % without obesity belonged to the category of “thinking about or trying to exercise”. In the regression model, the ranks were distributed as follows (the sum of the ranks of the coefficients Ej, β, and Δ is calculated) rank 1 – BMI (0.8857, 0.4163, 0.5429), rank 2 – level of physical activity (0.6489, 0.3497, 0.4467), rank 3 – smoking status (0.0339, 0.1333, 0.0047). The coefficient of the model was not significant for sex. Conclusion. Obesity and low physical activity are the main personalized extrapulmonary factors that affect control of asthma. A significant part of the patients are motivated to modify their level of physical activity.

The materials of statistical reports on morbidity and mortality due to chronic obstructive pulmonary disease (COPD), primary detection of patients both in the framework of clinical examinations, and in the daily work of a primary care doctor-a General practitioner and a therapist were studied. It is shown that screening spirometric examination during medical examination can serve as an effective tool for early diagnosis of COPD, and the use of new organizational forms of work of the region brings pulmonological care to the population of the districts of the Voronezh region (VO), where there is no pulmonologist. An important role in the management of COPD patients is played by educational pro-grams for primary care physicians, which are a mandatory element of pulmonary health Days.

An anonymous survey of physicians in the Tambov region was conducted using a questionnaire based on guidelines, which evaluated knowledge of managing patients with pneumonia as part of the multicenter study “KNOCAP” (“The assessment of physicians' knowledge of community- acquired pneumonia basics”) . To study the issues of prevention, diagnosis and treatment of pneumonia, the distance course “Review of guidelines “Pneumonia” was developed and posted on the Moodle. The results of the survey were analyzed before and after distance training.

The aim of this study was to assess effects of non-thermal microwave electromagnetic radiation (NMER) on asthma control and quality of life of patients with bronchial asthma (BA). Methods. Sixty outpatients with moderate BA aged 18 to 60 years were treated with NMER using the "Aster" device, 4 courses for 10 days of each Results. Clinical and spirometry parameters, asthma control and quality of life were significantly improved in comparison with BA patients receiving the standard therapy only. Conclusion. Thus, NMER in BA outpatients allowed increasing efficacy of therapy and prevention.