Current status of nuclear cardiology in the Russian Federation

The article is devoted to the analysis of the current status of nuclear cardiology in the Russian Federation. The data on the number of facilities performing radionuclide investigations for the diagnosis and monitoring of the treatment of cardiovascular diseases, their staffing and equipment are given. The statistics of the conducted nuclear cardiology tests for 2018-2020 are given, as well as their methods, features and diagnostic significance are described

ВОЗМОЖНОСТИ ХИРУРГИЧЕСКОЙ КОРРЕКЦИИ ТРОМБОЗА ВНУТРЕННЕЙ СОННОЙ АРТЕРИИ У ПАЦИЕНТОВ С ОСТРЫМ ИШЕМИЧЕСКИМ ИНСУЛЬТОМ

Objective. To estimate the efficacy of surgical treatment of internal carotid artery (ICA) thrombosis in patients suffered from acute ischemic stroke (AIS).Material and methods. Author operated 25 patients suffered from AIS and ICA thrombosis from 01 Feb, 2014 till 31 Aug, 2016 in Neurosurgical Department of N.V. Sklifosovsky Research Institute for Emergency Medicine. Among them, 15 patients had total thrombosis of ICA and were operated on, 10 patients had partial mural thrombosis or floating thrombus (6 patients were operated on). There were 7 thrombectomies with the removal of intima, 13 superficial temporal artery (STA)-middle cerebral artery (MCA) bypasses, 1 ICA stent installation.Results. The excellent outcomes were seen in 7 (33.4%) patients, good outcomes — in 11 (52.3%) and satisfactory outcomes were observed in 3 (14.3%) patients. The improvement of functional deficit in the early post-operative period was 4.85 scores according to NIHSS, 1.2 scores according to Rankin scale and 2.3 scores according to Rivermead mobility index. The regress of neurological deficit was more significant among patients with severe focal disturbances; better outcomes were among patients operated on within first 3 days from an onset of the disease. There was no significant improvement among non-operated patients at the moment of discharge from hospital. Thrombectomy with the removal of intima performed in 2 (40%) patients with partial mural thrombosis was complicated by repeated thrombosis of ICA. The improvement of cerebral blood supply was verified in 16 (76.2%) operated patients according to the data of cerebral perfusion examination.Conclusions. The early surgical treatment is indicated for patients with acute total thrombosis of ICA. It is possible to perform STA-MCA bypass in case of inability to perform endovascular thrombextraction or open thrombectomy with the removal of intima. The conservative treatment is indicated for patients with partial mural thrombosis while urgent operation is necessary among patient with floating thrombus to decrease the risk of cerebral embolism. Цель. Оценить эффективность хирургического лечения тромбоза внутренней сонной артерии (ВСА) у пациентов с острым ишемическим инсультом (ОИИ).Материал и методы. В период с 1.02.2014 по 31.08.2016 гг. в нейрохирургическом отделении НИИ СП им. Н.В. Склифосовского пролечены 25 пациентов с ОИИ и тромбозом ВСА. У 15 больных выявлен полный тромбоз (все 15 оперированы), у 10 — неполный пристеночный или флотирующий тромб (6 оперированы). Выполнено 7 тромбинтимэктомий (ТИЭ), 13 экстра-интракраниальных микроанастомозов (ЭИКМА), одно стентирование ВСА. Результаты. Отличные исходы получены у 7 (33,4%), хорошие — у 11 (52,3%), удовлетворительные — у 3 (14,3%) больных. Снижение функционального дефицита в раннем послеоперационном периоде состави- ло 4,85 балла по шкале NIHSS, 1,2 балла по шкале Рэнкина и 2,3 балла по индексу мобильности Ривермид. Регресс неврологического дефицита был более выражен у пациентов со значительными очаговыми нарушениями; лучшие исходы имели пациенты, оперированные в первые 3 сут заболевания. У неоперированных пациентов достоверного улучшения к моменту выписки не было. ТИЭ по поводу пристеночных тромбозов в 2 наблюдениях (40%) сопровождалась ретромбозом ВСА. У 16 оперированных пациентов (76,2%) отмечено улучшение кровоснабжения головного мозга по данным исследований его перфузии.Заключение. Пациентам с острым полным тромбозом ВСА показано проведение раннего хирургического лечения. При невозможности проведения эндовазальной тромбэкстракции или открытой ТИЭ предлагается выполнить обходное шунтирование (ЭИКМА). Пациентам с неполным пристеночным тромбозом показано проведение консервативного лечения. Больным с неполным флотирующим тромбозом и высоким риском эмболии в головной мозг показано проведение экстренной операции.

ROLE OF MAGNETIC RESONANCE IMAGING IN THE STUDY OF PATIENTS WITH DIABETIC FOOT SYNDROME

Objective: to give the results of magnetic resonance imaging (MRI) in patients with complicated diabetic foot syndrome (DFS) to rule out or identify osteomyelitis.Material and methods. Twenty-seven (14 women and 13 men; mean age 60±12.2 years) with type 1 and 2 diabetes mellitus and suspected osteomyelitis that had developed in the presence of DFS were examined. Ankle joint and foot MRI was carried out in T1-weighted MR image, T2-weighed MRI image, and FSat sequences. The soft tissue, tendoligamentous apparatus, and bones were evaluated. The results of MRI were compared with the data of a clinical follow-up study and surgery, followed by morphological examination. The diagnosis of osteomyelitis was validly established in 7 cases; this disease was absent in 20 patients.Results. MRI showed the highest sensitivity for bone marrow edema (100%), soft tissue swelling (85.7%), and their concurrence (85.7%) and the highest specificity for an extensive wound defect or fistula attached to the bone (100%) and bone marrow edema concurrent with tenosynovitis (90%). With a sensitivity of 14.3% and a specificity of 10%, MRI was of less informative value in assessing bone destruction. It was characterized by moderate sensitivity and moderate specificity for soft tissue destruction (57.1 and 42.9%, respectively) and tenosynovitis (55 and 50%, respectively).Conclusion. Osteomyelitis MRI demonstrated a polymorphic pattern with different diagnostic efficiency for individual symptoms

POSSIBILITIES OF SURGICAL CORRECTION OF INTERNAL CAROTID ARTERY THROMBOSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE

Objective. To estimate the efficacy of surgical treatment of internal carotid artery (ICA) thrombosis in patients suffered from acute ischemic stroke (AIS).Material and methods. Author operated 25 patients suffered from AIS and ICA thrombosis from 01 Feb, 2014 till 31 Aug, 2016 in Neurosurgical Department of N.V. Sklifosovsky Research Institute for Emergency Medicine. Among them, 15 patients had total thrombosis of ICA and were operated on, 10 patients had partial mural thrombosis or floating thrombus (6 patients were operated on). There were 7 thrombectomies with the removal of intima, 13 superficial temporal artery (STA)-middle cerebral artery (MCA) bypasses, 1 ICA stent installation.Results. The excellent outcomes were seen in 7 (33.4%) patients, good outcomes — in 11 (52.3%) and satisfactory outcomes were observed in 3 (14.3%) patients. The improvement of functional deficit in the early post-operative period was 4.85 scores according to NIHSS, 1.2 scores according to Rankin scale and 2.3 scores according to Rivermead mobility index. The regress of neurological deficit was more significant among patients with severe focal disturbances; better outcomes were among patients operated on within first 3 days from an onset of the disease. There was no significant improvement among non-operated patients at the moment of discharge from hospital. Thrombectomy with the removal of intima performed in 2 (40%) patients with partial mural thrombosis was complicated by repeated thrombosis of ICA. The improvement of cerebral blood supply was verified in 16 (76.2%) operated patients according to the data of cerebral perfusion examination.Conclusions. The early surgical treatment is indicated for patients with acute total thrombosis of ICA. It is possible to perform STA-MCA bypass in case of inability to perform endovascular thrombextraction or open thrombectomy with the removal of intima. The conservative treatment is indicated for patients with partial mural thrombosis while urgent operation is necessary among patient with floating thrombus to decrease the risk of cerebral embolism

New satellite project Aerosol-UA: Remote sensing of aerosols in the terrestrial atmosphere

International audienceWe discuss the development of the Ukrainian space project Aerosol-UA which has the following three main objectives: (1) to monitor the spatial distribution of key characteristics of terrestrial tropospheric and stratospheric aerosols; (2) to provide a comprehensive observational database enabling accurate quantitative estimates of the aerosol contribution to the energy budget of the climate system; and (3) quantify the contribution of anthropogenic aerosols to climate and ecological processes. The remote sensing concept of the project is based on precise orbital measurements of the intensity and polarization of sunlight scattered by the atmosphere and the surface with a scanning polarimeter accompanied by a wide-angle multispectral imager-polarimeter. Preparations have already been made for the development of the instrument suite for the Aerosol-UA project, in particular, of the multi-channel scanning polarimeter (ScanPol) designed for remote sensing studies of the global distribution of aerosol and cloud properties (such as particle size, morphology, and composition) in the terrestrial atmosphere by polarimetric and spectrophotometric measurements of the scattered sunlight in a wide range of wavelengths and viewing directions from which a scene location is observed. ScanPol is accompanied by multispectral wide-angle imager-polarimeter (MSIP) that serves to collect information on cloud conditions and Earth's surface image. Various components of the polarimeter ScanPol have been prototyped, including the opto-mechanical and electronic assemblies and the scanning mirror controller. Preliminary synthetic data simulations for the retrieval of aerosol parameters over land surfaces have been performed using the Generalized Retrieval of Aerosol and Surface Properties (GRASP) algorithm. Methods for the validation of satellite data using ground-based observations of aerosol properties are also discussed. We assume that designing, building, and launching into orbit a multi-functional high-precision scanning polarimeter and an imager-polarimeter should make a significant contribution to the study of natural and anthropogenic aerosols and their climatic and ecological effects

New satellite project Aerosol-UA: Remote sensing of aerosols in the terrestrial atmosphere

International audienceWe discuss the development of the Ukrainian space project Aerosol-UA which has the following three main objectives: (1) to monitor the spatial distribution of key characteristics of terrestrial tropospheric and stratospheric aerosols; (2) to provide a comprehensive observational database enabling accurate quantitative estimates of the aerosol contribution to the energy budget of the climate system; and (3) quantify the contribution of anthropogenic aerosols to climate and ecological processes. The remote sensing concept of the project is based on precise orbital measurements of the intensity and polarization of sunlight scattered by the atmosphere and the surface with a scanning polarimeter accompanied by a wide-angle multispectral imager-polarimeter. Preparations have already been made for the development of the instrument suite for the Aerosol-UA project, in particular, of the multi-channel scanning polarimeter (ScanPol) designed for remote sensing studies of the global distribution of aerosol and cloud properties (such as particle size, morphology, and composition) in the terrestrial atmosphere by polarimetric and spectrophotometric measurements of the scattered sunlight in a wide range of wavelengths and viewing directions from which a scene location is observed. ScanPol is accompanied by multispectral wide-angle imager-polarimeter (MSIP) that serves to collect information on cloud conditions and Earth's surface image. Various components of the polarimeter ScanPol have been prototyped, including the opto-mechanical and electronic assemblies and the scanning mirror controller. Preliminary synthetic data simulations for the retrieval of aerosol parameters over land surfaces have been performed using the Generalized Retrieval of Aerosol and Surface Properties (GRASP) algorithm. Methods for the validation of satellite data using ground-based observations of aerosol properties are also discussed. We assume that designing, building, and launching into orbit a multi-functional high-precision scanning polarimeter and an imager-polarimeter should make a significant contribution to the study of natural and anthropogenic aerosols and their climatic and ecological effects