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

Intense physical activity increases the risk of sudden death by 10–17 fold. Some of the most important tasks of modern pathophysiology in sports medicine include searching for factors that allow an athlete’s body to adapt to loads, understanding the line between adaptation and pathology and identifying risk groups of adaptation failure. It is necessary to distinguish between hypertrophic cardiomyopathy and true myocardial hypertrophy in athletes that results from the adaptation of the cardiovascular system to intense physical exertion. In Seattle, the American Medical Society of Sports Medicine together with the European Society of Cardiology proposed standards for the interpretation of electrocardiogram in athletes and considered criteria for the detection of pathological changes. The best functional state of an athlete and the effectiveness of his/her training are noted with high autonomy and high variability of heart rate. This is reflected in rhythmocardiogram data by increases in high frequency and root mean square of successive differences in heartbeats and a decrease in the low-frequency to high-frequency ratio.A promising direction in the study of markers of an athletic heart is the analysis of echocardiographic (EchoCG) images of young and professional athletes. According to EchoСG analysis, nonadaptive remodelling is the loss of the ellipsoid shape of the left ventricle in favour of a spherical one. In athletes, when assessing transmitral flow by EchoCG, a low A peak can be considered a reserve of adaptive capabilities of the heart and not a pathology. For athletes-dischargers, a concentric variant of changing the geometry of the myocardium is characteristic. Upon reaching the qualification of a candidate, master of sportsan eccentric change in the left ventricle cavity prevails.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributionsConception and design: Y.P. Skirdenko Drafting the article: A.V. Gorbenko, O.V. Zamahina, S.A. SherstyukCritical revision of the article: N.A. NikolaevFinal approval of the version to be published: A.V. Gorbenko, Y.P. Skirdenko, N.A. Nikolaev, O.V. Zamahina, S.A. Sherstyuk, A.V. Ershov

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.

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.

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.