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.

To optimize non-drug methods of treatment of patients with irritable bowel syndrome (IBS) against the background of obesity to identify the peculiarities of food preferences and permeability of the intestinal wall.Materials and methods: An anonymous questionnaire survey of 52 IBS patients was carried out using the author’s set of dietary assessment questions “Nutrition Information and Food Behavior” developed at the Department of Hygiene, Human Nutrition of Omsk State Medical University. The study of the level of zonulin in the feces was carried out at the Central Research Laboratory of the Federal State Budgetary Educational Institution of Higher Professional Education Omsk State Medical University of the Ministry of Health of Russia by enzyme immunoassay using the IDK Zonulin ELISA test system (Immundiagnostik, Germany).Results: The eating habits of IBS patients with BMI ≥25 kg/m2 diff er from those of normal weight patients and can be considered a component of the phenotype of this patient cohort. IBS patients with BMI ≥25 kg/m2 have a higher level of intestinal permeability as assessed by zonulin content in feces.

High medical adherence is a prerequisite for achieving goals in the treatment of hypertension (HTN). The majority of patients with HTN showed low adherence to treatment, which requires finding ways to solve this problem. This review describes the factors influencing adherence, ways of its assessment, and analyzes methods of increasing medical adherence in hypertensive patients. Noteworthy is the lack of publications describing the effectiveness of methods for increasing long-term (>2 years) adherence in hypertensive patients. The review also describes a not fully clear individualized approach, which consists in choosing a therapy regimen based on levels of medical adherence, medical follow-up and lifestyle modification.

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.