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Aim. To develop a visual aid “Comorbid patient Scale” and evaluate its effectiveness through dynamic follow-up of patients with chronic non-communicable diseases (NCDs) in outpatient practice.Materials and methods. The prevalence of risk factors and NCDs were analyzed in the course of a retrospective study of 1444 patients in rural areas. A visual aid “Comorbid Patient Scale” developed on obtained data has been evaluated in a 3-month prospective comparative study of 93 patients with NCDs, randomized to group 1, in which the Scale was used (n = 47), and a control group (group 2, n = 46).Results. Group 1 showed a statistically significant increase in adherence to treatment after using the Scale for 3 months: 81% vs 57% at baseline (p < 0.05); in group 2 similar indicators were: 61% vs 54% (the difference is not significant). In group 1, the proportion of smoking patients (39% vs 15% (p < 0.05)) and the number of patients with hypercholesterolemia (23% vs 0% (p < 0.05)) significantly decreased; the number of patients with well-controlled arterial hypertension increased from 47% to 87% (p < 0.05). A similar dynamics was observed in group 2, however, the difference was not statistically significant. At baseline and 3 months later, the share of patients without exacerbation of diseases of the musculoskeletal system and respiratory tract diseases was the same across the groups.Conclusion. The use of “Comorbid patient Scale” compared to standard patient management increases patient adherence to treatment by 17%, reduces the share of smoking patients by 21%, with hypercholesterolemia by 14%, with the achievement of target blood pressure indicators by 26%.

Pregnancy is a physiological condition that takes a defined period of time in a woman’s life. For nine months, the mother’s heart works under conditions of daily additional load, which is necessary to ensure placental blood flow. In this regard, structural and functional adaptation of the heart develops in a healthy woman with a normal pregnancy. A pregnant woman with some heart diseases is less likely to adapt. That leads to greater susceptibility to stress resulting in pathological changes of pregnancy. In addition, each pregnancy may develop new heart diseases, which in some cases may be relatively innocent, but in others — fatal. In this regard echocardiography (EchoCG) is a necessary procedure for assessing a woman’s health status that needs before bearing a fetus, during and after pregnancy.

In recent decades, in the southern macro-slope (catchment) of Te Russian Plain, mainly within the basins of the Volga and the Don rivers, the spring flood flow decreased due to both anthropogenic and climatic factors. Of anthropogenic factors, the creation of reservoirs played a signifcant role in changing the water regime of the Volga and the Don. Another important factor, affecting the river runoff, is agricultural activities on flat interfluves and slopes. Compared with the conventional-natural period (for the Volga from 1879, and for the Don from 1876 to 1929) to the date (for the period 1930–2014), the flood flow of the Volga has been decreased by more than 4300 km3, and the Don – by almost 900 km3. Te contribution of anthropogenic factors to this decrease in the Volga basin exceeded 70%, and for the Don it was equal to 45%, while the climatic ones contributed 30 and 55%, respectively. During the period of instrumental observations on the rivers of the region, long-lasting phases of high/low water content with duration from 15–20 to 90 years or longer, caused by the climatic changes, were determined. Tese are a characteristic feature of long-term changes in flood flow (and in a runoff of other seasons) on both medium and large rivers of the southern macro-slope of the Russian Plain. Te period since early 2000s was a start of the decreased flood flow everywhere, i.e. on medium and large rivers. It is most clearly (by tens of percent) manifested in the decrease of the spring surface flow due to the following factors: more frequent thaws, reduction of the depth of soil freezing, increase of infltration, especially in the forest-steppe and steppe zones. Increase in flow of the infltration origin does only partially compensate the decrease of the flow in rivers.