PHYSIOLOGICAL MONITORING OPERATORS ACS IN AUDIO-VISUAL SIMULATION OF AN EMERGENCY

In terms of ship simulator automated control systems we have investigated the information content of physiological monitoring cardiac rhythm to assess the reliability and noise immunity of operators of various specializations with audio-visual simulation of an emergency. In parallel, studied the effectiveness of protection against the adverse effects of electromagnetic fields. Monitoring of cardiac rhythm in a virtual crash it is possible to differentiate the degree of voltage regulation systems of body functions of operators on specialization and note the positive effect of the use of means of protection from exposure of electromagnetic fields

ФИЗИОЛОГИЧЕСКИЙ МОНИТОРИНГ ОПЕРАТОРОВ АСУ ПРИ АУДИО-ВИЗУАЛЬНОЙ ИМИТАЦИИ АВАРИЙНОЙ СИТУАЦИИ

In terms of ship simulator automated control systems we have investigated the information content of physiological monitoring cardiac rhythm to assess the reliability and noise immunity of operators of various specializations with audio-visual simulation of an emergency. In parallel, studied the effectiveness of protection against the adverse effects of electromagnetic fields. Monitoring of cardiac rhythm in a virtual crash it is possible to differentiate the degree of voltage regulation systems of body functions of operators on specialization and note the positive effect of the use of means of protection from exposure of electromagnetic fields.В условиях тренажера судовых автоматизированных систем управления выполнены исследования информативности физиологического мониторинга кардиоритма для оценки надежности и помехоустойчивости операторов различных специализаций при аудио-визуальной имитации аварийной ситуации. Параллельно изучалась эффективность средств защиты от негативного воздействия электромагнитного поля. Мониторинг кардиоритма в условиях виртуальной аварии позволил дифференцировать степень напряжения систем регуляции функций организма операторов по специализации и констатировать положительный эффект от применения средств защиты от воздействия электромагнитного поля

ASSESSMENT OF EFFICACY OF SURGICAL CEREBRAL REVASCULARIZATION IN PATIENTS WITH LARGE POST-STROKE CYSTS

Background: At present, efficacy of carotid endarterectomy for prevention of cerebrovascular accidents has been convincingly proven. Its results in patients with a history of an ischemic stroke depend on multiple factors.Aim: To study results of reconstructive interventions on internal carotid arteries in patients with post-stroke cerebral cysts.Materials and methods: We analyzed data from 210 patients who had undergone an intervention (159 men and 51 women, aged 61 ± 2.7 years) with occluding lesions of the internal carotid artery and a history of an ischemic stroke. Depending on the size of a post-stroke lesion, patients were divided into 5 groups: patients from group 1 had a lesion of more than 5 cm in diameter, from group 2, from 2 to 5 cm, from group 3, ≤ 2 cm, patients from group 4 had a lacunar cysts and patients from group 5 had no focal lesions.Results: A clear positive correlation between the size of a post-stroke cyst and the degree of hemodynamic abnormalities in internal carotid arteries was found. The most prominent asymmetry of blood flow in the middle cerebral artery (on average, 34.1%) was seen in patients from the group 1. Patients from the group 1 more often had low and critical brain tolerance to ischemia (42.9%). In patients with large post-stroke cysts (group 1) mean Barthell index was 69 ± 8.1, and NIHSS score 8.2 ± 1.6. In patients from other groups neurological deficiency was less pronounced: 80 ± 6.8 and 7.6 ± 1.9 in the group 2, 82 ± 5.7 and 4.1 ± 1.3 in the group 3, 94 ± 4.6 and 3.2 ± 1 in the groups 4 and 5. The differences between groups in the rates of postoperative complications were not statistically significant (p > 0.5). However, signs of hyperperfusion without any clinical manifestations were more often observed in patients from the group 1 (19%). Assessment of changes in neurological status at 1 year after the intervention, depending on the size of post-stroke lesions, showed that in patients with large cysts the regression of neurological deficiency was less obvious, than in other groups (NIHSS 7.5 ± 1.7, Barthell index 76 ± 7.7). The best restoration of impaired neurological functions was seen in patients with small cysts (NIHSS 2.2 ± 0.7, Barthell index 91 ± 3.4).Conclusion: In patients with large and intermediate post-stroke cerebral cysts surgery is associated with a higher complication rate, and, first of all, of hyperperfusion syndrome. However, the risk of these complications is significantly smaller than the probability of repeated acute cerebrovascular accidents

Multidisciplinary approach to the treatment of patients with periprosthetic joint infection of the hip complicated by injury to the great vessels

Introduction Total counts of total hip arthroplasty (THA) have been increasing for several decades, and the procedures are associated with considerable risk of intra- and postoperative complications. Vascular complications are defined as multiple pathological conditions. They are subdivided into acute adverse events such as intraoperative bleeding, acute ischemia and hematoma and chronic complications such as pseudoaneurysms and arteriovenous fistulas which can cause late ischemic events. A specialized and well-trained multidisciplinary team is required to perform surgical interventions due to the small number of intravascular lesions. The objective was to demonstrate findings of clinical, instrumentation methods and staged treatment of patients with periprosthetic joint infection (PJI) of the hip and complications associated with injury to the great vessels. Material and methods We report two cases of vascular complications in patients with PJI and migration of femoral components into the lesser pelvis. Results An integrated approach to the diagnosis and treatment of patients with PJI and complications associated with injury to the great vessels helped to avoid lethal outcomes of the Girdlestone operation. Discussion Revision THA requires careful planning and an interdisciplinary approach with the help of a clinical pharmacologist, microbiologist, plastic or angiosurgeon. PJI is associated with a high risk of recurrence that would require two-stage, three-stage surgical interventions. With the bone deficiency of the acetabulum and the proximal femur the Girdlestone operation is performed as the final procedure with resultant significant decrease in the functional adaptation of patients. Conclusion Careful preoperative preparation of patients with unstable hip replacement components including migration of the acetabular component into the pelvic cavity and associated PJI would help to avoid such a devastating complication as great vessel injury