Aim: To update the definitions of selected questions of the "QAA-25" (quantitative adherence assessment) scale and evaluate it according to the criteria of validity and measure of agreement.Materials and Methods. In a descriptive cross-sectional study including 200 patients with coronary heart disease, adherence was determined using traditional and alternative versions of selected questions of the QAA-25 scale, followed by assessment of construct validity, factor validity, and measure of agreement.Results. Alternative question versions did not significantly affect test results, with 81% of respondents in the outpatient sample and 69% in the inpatient sample rating them as "more acceptable." The QAA-25 scale has good construct and internal validity (α – 0.818, α_st – 0.832), with moderate agreement (κ – 0.562) and demonstrates high reliability of internal validity – when scale items are consistently excluded, α values remain in the 0.801-0.839 range.Conclusion. The QAA-25 scale with modified question definitions should be used instead of the previous version of the scale. Good construct validity and factor validity, sufficient measure of agreement and specificity, high sensitivity and reliability of the QAA-25 scale allow to recommend it as a tool for assessing adherence to drug therapy, medical support, lifestyle modification and integral adherence to treatment in scientific and clinical practice.

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

The term "microbiota" refers to the microbial community occupying a specific habitat with defined physical and chemical properties and forming specific ecological niches. The adult intestinal microbiota is diverse. It mainly consists of bacteria of Bacteroidetes and Firmicutes types. The link between the gut microbiota and cardiovascular disease (CVD) is being actively discussed. Rapid progress in this field is explained by the development of new generation sequencing methods and the use of sterile gut mice in experiments. More and more data are being published about the influence of microbiota on the development and course of hypertension, coronary heart disease (IHD), myocardial hypertrophy, chronic heart failure (CHF) and atrial fibrillation (AF). Diet therapy, antibacterial drugs, pro- and prebiotics are successfully used as tools to correct the structure of the gut microbiota of the macroorganism. Correction of gut microbiota in an experiment on rats with coronary occlusion demonstrates a significant reduction in necrotic area. A study involving patients suffering from CHF reveals a significant reduction in the level of uric acid, highly sensitive C-reactive protein, and creatinine. In addition to structural and laboratory changes in patients with CVD when modifying the microbiota of the gut, also revealed the effect on the course of arterial hypertension. Correction of gut microbiota has a beneficial effect on the course of AF. We assume that further active study of issues of influence and interaction of gut microbiota and macroorganism may in the foreseeable future make significant adjustments in approaches to treatment of such patients.

Фибрилляция предсердий (ФП) является наиболее распространенной аритмией и встречается у 0,1—18% взрослых. Несмотря на большое количество исследований до сих пор остаются нерешенными вопросы относительно механизмов развития ФП. В обзоре представлены данные о наличии связи между нарушениями кишечной микробиоты и различными формами ФП. Триллионы микроорганизмов, населяющих желудочно-кишечный тракт, превращают питательные вещества в активные метаболиты (триметиламин-N-оксид, короткоцепочечные жирные кислоты и др.), которые обеспечивают взаимодействие с макроорганизмом. В работе рассмотрены новейшие данные об эффективности диеты (воспалительный индекс (dietary inflammatory index, DII), значение функциональных связей между диетой, кишечной микробиотой, ее метаболитами и макроорганизмом. Несмотря на существенный прогресс в изучении ФП, необходимы дальнейшие исследования для уточнения связи микробиоты кишечника и механизмов ФП, создания прогностических биологических и вычислительных моделей, определения надежных биомаркеров риска развития данной патологии.

Inflammatory bowel disease (IBD) is a common pathology that reduces the quality and duration of a patient’s life. The cornerstone of treatment of IBD patients is polypharmacotherapy based on the use of salicylates, antibiotics, immunomodulatory and biological drugs, and topical dosage forms. Multicomponent treatment has shown to reduce the quality of life and negatively affect adherence to drug therapy in IBD patients.One of the leading causes of treatment failure is low treatment adherence, which leads to disease progression, disability, and increased financial costs. Currently, there are many factors that affect adherence to therapy, some of them are modifiable, which creates opportunities to improve the effectiveness of existing medical interventions. However, the available data on the level of adherence in IBD patients are not numerous and homogeneous, so a low level of adherence to drug therapy in IBD patients is registered in 7–72% of cases.An important issue in understanding adherence in IBD patients is a lack of research on the level of adherence to counselling and lifestyle modification. However, the course of IBD, treatment features related to the duration of therapy and necessary lifestyle modifications (nutrition), as well as regular monitoring of laboratory and instrumental parameters determine the need to assess adherence to lifestyle modification and counselling along with adherence to drug therapy.