To compile a personalized program for correcting the metabolism of a professional athlete, it is necessary to take into account many factors, including age, gender, sports specialization, individual characteristics, the pathologies in the anamnesis, the stage of the athlete’s training cycle, etc. When drawing up such programs for athletes of sports national teams of the Russian Federation, a scheme for assessing the characteristics of the athlete’s body is used, the basis for which is information obtained during in-depth medical examinations of athletes conducted on the basis of clinics of the FMBA Russia. To improve the quality of personalized programs of metabolic correction in the future, it is possible to use professionally oriented reference intervals of laboratory blood parameters, as well as the results of genetic screening based on the strategy of complete exomic sequencing of the athlete’s genome. One of the ways to increase the efficiency of metabolic correction of professional athletes is the introduction of modern information technologies and the development of a modern information system based on them. The introduction of such an information system will increase the speed of primary processing of initial information about the health status of the athlete and the peculiarities of his metabolic processes, as well as partially automate the formation of individualized recommendations regarding the diet and hydratation, and the choice of metabolic correction at various stages of the sports season.

In recent years, interest in the search for new potential molecular biomarkers to assess the effectiveness of the training process in elite sports, various pathologies caused by overload, and abuse of prohibited substances has reached an unprecedented level. MicroRNAs that regulate the processes of metabolism, differentiation, proliferation, and apoptosis of cells at the post-transcriptional level are the most valuable candidates for use in this regard. They are found in all biological fluids of the human body, are stable during long-term storage and resistant to changes in environmental conditions. It is known that changes in the miRNA expression profile are closely associated with physical activity, as well as with the administration of recombinant hormones, erythropoiesis-stimulating agents, and other substances and methods that improve sports performance, which are prohibited by the World Anti-Doping Agency (WADA).

Objective: In this study, plasma samples from athletes involved in endurance sports (race walking) and non-athletic volunteers were analyzed using a hypoxia signaling pathway panel to identify hypoxia candidate markers.

Materials and methods: Expression profiles of plasma circulating miRNAs were assessed by reverse transcription followed by real-time quantitative polymerase chain reaction (RT Q-PCR). The obtained data were subjected to statistical processing using the CFX Manager Software v3.1 program.

Results: Three potential microRNA markers were identified: hsa-miR-210-3p, hsa-miR-320a and hsa-miR-935 (increased in athletes by 61.6 times, 51.8 and 41.0 times, respectively) — of physiological response to the training, load, which may be associated with the emergence of hypoxia during endurance training.

Conclusion: We have obtained preliminary data on differences in the expression profiles of circulating miRNAs in healthy non-athletic volunteers and professional athletes in the out-of-competition period. In the future, it is planned to expand the sample of studied blood plasma samples and compare the expression profiles of circulating microRNAs in athletes in competition and out-of-competition periods, as well as to compare the expression profiles of circulating microRNAs during aerobic and anaerobic loads. In addition, it is of interest to analyze changes in the expression levels of circulating miRNAs when using hypoxia mimetics applied to improve sports performance.

Objective: The aim of the study was to analyze the structure and dynamics of morbidity of athletes, members of sports teams of the city of Moscow based on the results of an in-depth medical examination in the period 2017–2021.

Materials and methods: The data of the medical examination of athletes, which took place at the Moscow scientific and Practical Center for Medical Rehabilitation, restorative and sports medicine, including instrumental, functional and laboratory studies from 2017 to 2021, were analyzed. In 2017, 15176 athletes were examined, in 2018 and 2019, 11200, in 2020, 10080 people and in 2021–11922 athletes.

Results: The results of the study showed an increase in the proportion of amenorrhea within the triad of athletes, an increase in general therapeutic morbidity, diseases of the gastrointestinal tract, among which the proportion of secondary hyperbilirubinemia in 2021 increased 3 times compared to 2020, which, in our opinion, is also due to the impact of the pandemic and quarantine restrictions.

The high prevalence of ophthalmological morbidity of athletes and changes in the cardiovascular system is shown. During 2017–2021, a change in the structure of cardiac morbidity was revealed in the form of an increase in the proportion of cardiac arrhythmias and hypertensive response to stress.

An increase in the endocrine morbidity of athletes in 2021 was revealed due to an increase in the proportion of hypothyroidism and more frequent detection of hyperthyroidism, possibly related to the COVID-19 pandemic, which requires further research.

There was also an increase in diseases of the skin and genitourinary system in athletes. Psychological problems of athletes increased during the observation period from 2017 to 2021. There was no significant dynamics of surgical and traumatological diseases, otolaryngological pathologу.

Conclusion: The results of the study indicate the importance of regular full-fledged examination of athletes, identification of various functional disorders and diseases for their timely prevention and treatment in order to preserve the health of athletes and improve athletic performance.

COVID‑19 continues demonstrating possible complications after recovery. One of these complications is avascular osteonecrosis, which can lead to bone destruction and patient disability. Cases of the development of osteonecrosis associated with coronavirus infection were widely reported during and after the SARS epidemic in 2003. They also appear to be common in COVID‑19 infection. All patients who have recovered from COVID‑19 infection, especially who received glucocorticoids, are threaten of osteonecrosis development.

We describe a case of bone necrosis in a healthy young woman without additional risk factors with a mild course of COVID, who received a short course of glucocorticoids.

This is the first described case of COVID‑induced osteonecrosis in our country, although due to the large‑scale use of glucocorticoids, there are probably more such cases. Early diagnosis is important to prevent disease progression. Therefore, clinical alertness is necessary in all patients with COVID‑19.

The study reflects the results of comprehensive rehabilitation of professional athletes with fibular tendinopathy. The effectiveness was evaluated based on the indicators of goniometry of the ankle joint at different stages of the rehabilitation process.

Objective. To evaluate the effectiveness of the developed comprehensive program of physical rehabilitation with tendinopathy of the fibular tendons.

Materials and methods. The study involved 60 professional male athletes with the diagnosis of “fibular tendinopathy” established by ultrasound examination. All patients were randomly divided into two equal groups of 30 people. Group I patients, in addition to the main ones, were assigned specially designed exercises for balance, balance and proprioceptive sensitivity on the Biodex Balance System (BBS) biofeedback system (Biodex Medical Systems, Inc. New York, USA), as well as balancing disks

Results. The percentage of reduction in the total amplitude of movement in the ankle joint, that is, its deficiency, statistically significantly differed between the groups. Thus, at the time of examination before the start of treatment, the total amplitude deficit in group I patients was 13.2°, and in group II – 14.0°. At week 6 after the start of treatment, this indicator improved in group I patients and amounted to 3.8°, and in group II – 12.2°.

Achilles tendon disorders are represented by a big group of heterogenous in etiology and pathogenesis conditions, that are quite frequent in patients of various age groups. The diversity of this group of orthopedic disorders and the insufficient information provided on this topic in specialized literature leads to confusion in terminology, which, in turn, leads to misunderstanding the essence of patient’s problem and to mistakes in treatment of such patients.

We carried out a content-analysis of contemporary Russian and foreign literature to summarize the existing knowledge and to create the universal nomenclature of the studied pathological conditions for further correct understanding of the problem and creation of classification of disorders and injuries of Achilles tendon.

The eyes, like other human organs, are deficient in nutrients during over-training, which can affect visual acuity and, accordingly, the quality of training.

This article defines the importance of the organ of vision for sports results. It also provides an overview of the latest scientific research on the impact of biologically significant micronutrients on the functions of the visual analyzer with examples of products that help improve visual functions.

Objective: to study the variability of the heart rate of athletes during hypoventilation training, which provides an increase in the result of speed-strength load.

Materials and methods: Athletes performed speed-strength load with their hands on a training apparatus against the background of maximum voluntary breath holding before and after hypoventilation training. The duration of breath holding, the number of power movements, parameters of heart rate variability and electromyography were measured.

Results: After hypoventilation training of athletes at rest, parasympathetic influences on the heart rate increased, which led to an increase in the total power of the heart rate spectrum from 3201 ± 520 to 4047 ± 585 ms², the power of the low frequency of the heart rate spectrum from 1458 ± 216 to 2055 ± 392 ms² and the standard deviation of the duration of adjacent cardiac cycles from 45 ± 5 to 52 ± 4 ms. Sympathetic influences increased during exercise against the background of maximum voluntary breath holding. The longer maximum voluntary breath holding was, the more power movements the athletes performed.

Conclusion: Hypoventilation training changed the vagosympathetic balance of the athletes’ body, increasing their performance and hypoxic resistance.

Objective: consideration of the importance of vaccination as a preventive measure of support the athlets immunne system in conditions of extreme physical exertion and increased epidemic risks.

Materials and methods: analysis of local and foreign dates of immunocorrection and vaccination problems.

Results: the presented review provides an integral assessment of the transitory immunosuppression, developing by the intensive training and competitive activities — exercise-induced immunosuppression. These dates described as an “open window” syndrome and characterized by an increased risk of viral and/or bacterial infection with predominant damage of the upper respiratory tract and gastrointestinal tract. Widespread immunoprophylaxis provides an effective and relatively safe method of infectious control at risk groups including athletes.

Conclusion: Vaccines of National Immunization Schedule and Epidemiological Immunization Schedule provide complex impact to the athletes immune status in wide variety of physical and psychological stresses. Vaccination increases the ability of specific and nonspecific resistance to infections that provide significant prevention of the “open window” syndrome.

There are many classifications of sports disciplines, which base on various approaches, which separately take into account the patterns of training activity, physiology, the risk of collision and injury, etc. In our opinion, it most fully reflects the specifics of sports changes that occur in the body of athletes under the influence of intense physical activity, at the level of biochemical processes. The classification of sports disciplines proposed by us takes into account the influence of the nature of the training process, the specifics of sports loads, the leading type of energy supply of sports work on the biochemical profile of an athlete, which makes it possible to identify the key features that occur in the body of an athlete under the influence of a specific load.

Accurate resting metabolic rate readings are essential for dietary planning and body composition monitoring not only for healthy individuals but also for athletes. A number of factors can alter resting metabolic rate during its measurement by indirect calorimetry. The methodology used may affect the results of the study. A clear standardisation of this procedure is needed to obtain the most accurate results.

Purpose: To review the literature to determine the optimal subject condition and methodology for the resting metabolism measurement procedure using indirect calorimetry.

Materials and methods: A literature search was conducted in PubMed, MEDLINE and Cochrane Library databases. The query included key words and logical phrases: “calorimetry”, “indirect calorimetry”, “resting metabolic rate”, “energy metabolism”, “basal metabolism”, “standards”. Only English-language studies and human studies were considered. Additional information was identified because of the review and included in the review.

Results: the parameters of standardization during the resting metabolism measurement procedure are described: consumption of food, ethanol, caffeine, nicotine; daily activities and physical activity; body position in space and environmental conditions during the measurement; actions of the specialist performing the procedure, etc. The article outlines effective methods for measuring resting metabolism to obtain the most accurate results in both healthy individuals and athletes.

Conclusion: an attempt has been made to formulate precise methodological rules for standardisation and recommendations for measuring resting metabolism by indirect calorimetry.