DEFORMATION PROPERTIES OF LIGHT SELF – COMPACTING CONCRETE

Аn article deformation properties of a light self – compacting concrete (LSCC) are considered. Its comparison with characteristics of light concrete on porous fillers is given. Creep and LSCC shrinkage are in detail analyzed. Conclusions on work are drawn

ASSESSMENT OF CEREBRAL PERFUSION IN PATIENTS WITH HEMODYNAMIC ISCHEMIC STROKE UNDERGOING RECONSTRUCTIVE BRACHIOCEPHALIC ARTERY INTERVENTIONS

The paper deals with the assessment of cerebral perfusion in patients in the acute period of acute cerebrovascular accident before and after revascularization surgery. It gives a clinical example of using contrast-free perfusion magnetic resonance imaging (MRI) in a patient with hemodynamic ischemic stroke. The use of this technique made it possible to determine indications for early carotid endarterectomy for the contralateral internal carotid artery and to evaluate positive postoperative changes in cerebral perfusion and the patient’s neurological status. The authors analyzed the current literature on this problem with a particular emphasis on the possibilities of using dynamic susceptibility contrast-enhanced and arterial spin-labeling contrast-free perfusion MRI in this category of patients. Carotid endarterectomy in the acute period of acute cerebrovascular accident can improve cerebral hemodynamics and the patient’s neurological status and prevent recurrent cerebral circulatory disorders. Indications for this surgery should be determined by taking into consideration the results of perfusion MRI techniques (single-photon computed tomography contrastenhanced and contrast-free perfusion MRI)

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.

Possibilities of three phase scintigraphy in the diagnosis of diabetic osteoarthropathy

Establishing informative of 3-phase scintigraphy in the evaluation of blood flow and identify pyo-inflammatory process in patients with neuropathic, ischemic, and mixed forms of diabetic foot. This study includes the results of three-phase scintigraphy of 76 patients with diabetes mellitus and with suspicion of osteomyelitis in diabetic foot. Results were verified with morphological study in 39 patient.In patients with diabetic foot the depression of the main vessels blood flow and blood flow prevalence the changes intraos­seous blood flow. Comparison of scintigraphy and morphological studies confirmed the highly informative three-phase scintigraphy in the evaluation of main and peripheral blood flow. 3-phase scintigraphy revealed a lower specificity (66.7%) in the diagnosis of osteomyelitis in patients with diabetes mellitus at the sensitivity (94.7%) and accuracy (73.7%).Three-phase scintigraphy is high-performance method in revealing the arterial and peripheral blood flow disorder in patients with diabetes mellitus. The low specificity of the three-phase scintigraphy with high sensitivity indicate the limited possibilities of the method in the identification of pyo-inflammatory process in patients with diabetes mellitus. The observed preservation of blood flow makes it possible to expand the employment of methods of nuclear medicines and apply scintigraphy with labeled leukocytes for indicating purulent infection in patients with complicated course