[Floating structure of the carotid artery as a cause of microembolism in the basin of cerebral arteries]. / Flotiruiushchaia struktura sonnoi arterii kak prichina mikroémbolii v basseine mozgovykh arterii.

This article describes a rare clinical and diagnostic case report regarding a female patient presenting with frequent transitory attacks in the basin of both middle cerebral arteries. Based on the findings of duplex scanning of the cervical arteries we revealed floating structures with the presence of pronounced slow turbulent blood flow. After excluding all known causes of cerebral artery microembolism, associated with heart pathology or with the presence of unstable atherosclerotic plaques, the leading hypothesis of transitory ischaemic attacks in the woman concerned was the formation of microthrombi in the zone of motility of the structures revealed. The results of bitemporal transcranial Doppler monitoring carried out during 30 minutes detected more than 10 microembolic signals in the middle cerebral artery, thus confirming the embolic nature of transitory ischaemic attacks.

[Mönkeberg's sclerosis: role of calcification in arterial lesions in patients with diabetes mellitus]. / Skleroz Menkeberga: rol' kal'tsinoza v porazhenii arterii u bol'nykh sakharnym diabetom.

The number of patients with diabetes mellitus has steadily been increasing. This disease is associated with the risk for the development of micro- and macroangiopathies. One of the variants of macroangiopathy is Mönkeberg's sclerosis characterized by the presence of calcification of the media of the arterial wall. This article is a literature review reflecting the role of calcification in arterial lesions in patients with diabetes mellitus, also covering the historical aspect of studying Mönkeberg's sclerosis. Special attention is paid to its morphological forms, aetiopathogenetic mechanisms of development, taking into account contemporary studies, demonstrating mechanisms of the effect of medial arterial calcification on haemodynamics and the risk for the development of cardiovascular complications. Also presented herein are the main non-invasive and invasive methods of its diagnosis.

[Human resources provision for maxillofacial surgery facilities]. / Obespechenie naseleniia kadrami vrachei po profiliu 'cheliustno-litsevaia khirurgiia'.

The aim of the study was to analyze the key trends of medical staff provision for maxillofacial surgery facilities. It is established that the provision of the population with maxillofacial surgeons staff has slightly decreased from 0.08 (year 2011) to 0.06 (year 2015). The amount of staff positions at this period has increased by 17.22%, the intensity of growth of employed positions has grown by 15.74%, which makes the understaffing rate equal to approximately 8-10%. The coefficient of part-time workers has also varied slightly from 1.4 in 2011 to 1.26 in 2015. Over 93% of maxillofacial surgeons work in hospitals. The qualification category was awarded to over 46.0% of specialists in this field, 97.6% of maxillofacial surgeons have a specialist certificate. The results indicate the need for a new project of personnel policy strategy for further training and professional growth of maxillofacial surgeons.

[Endovenous thermal interventions in treatment of patients with lower limb varicose veins]. / Éndovenoznye termicheskie vmeshatel'stva v lechenii bol'nykh varikoznoi bolezn'iu nizhnikh konechnostei.

The problem regarding treatment of patients suffering from lower limb varicose veins remains a matter of current concern and is important today because of high prevalence of the pathology concerned and a steadily growing number of newly diagnosed cases. Mention should be made that both Russian and foreign phlebologists along with an open surgical operation on veins have more and more often been using minimally invasive endovenous techniques in comprehensive management of patients presenting with varicose veins. The present article is a literature review dedicated to a detailed discussion of two most commonly performed and efficient procedures, namely, radiofrequency ablation of lower limb veins and endovasal laser coagulation. This is accompanied and followed by demonstrating advantages of these techniques, describing the immediate and remote results obtained, as well as possible complications, both typical and rarely occurring. The majority of specialists employing radiofrequency ablation of lower-limb veins and endovasal endovenous laser coagulation report high effectiveness of their use for treatment of patients with lower limb varicose veins, including those diagnosed with pronounced trophic impairments. The findings obtained by many authors while comparing efficacy of various endovenous procedures make it possible to assess them objectively and to correctly determine the indications for a particular intervention.

[Evolution of surgical and endonasal methods for correction of main-stem venous reflux in patients with primary varicosis of the lower extremities].

Adequate high-quality diagnostics of primary varicosis of the lower extremities is a challenging problem bearing in mind its high prevalence and social significance. This review focuses on historical aspects of the problem and current views of domestic and foreign specialists. Special attention is given to the treatment of main-stem venous reflux as a principal pathogenetic mechanisms of progressive venous insufficiency. The history of development and improvement of surgical methods for the treatment of the disease, from traumatic to minimally invasive outpatient interventions is expounded with the emphasis on modern endovasal techniques for correction of pathological venous reflux (radiofrequency obliteration and laser coagulation). The important role of phleboscleroobliteration in the treatment of primary varicosis is underscored. It is maintained that sclerotherapy remains an accessible effective method for the correction of varicose disease. Intraoperative catheter stem scleroobliteration of the main vessels yields good results provided the main principles of surgical intervention are met. Some unresolved problems include the choice of more informative indications for the treatment of primary varicosis of the lower extremities on an individual basis.

[Restenosis of carotid arteries after carotid endarterectomy: current aspects of the problem: (local and systemic risk factors). Part 1].

Carotid endarterectomy is currently the most effective surgical means of preventing ischaemic stroke. Despite the fact that this type of intervention is widely used, there seems to be no tendency toward decreased incidence of such a complication as restenosis of carotid arteries.The present review deals with the results of analyzing the literature on the problem concerning carotid artery restenosis after carotid endarterectomy. Considered herein are the problems of epidemiology and prevalence of the complication involved. Special attention is paid to local and systemic risk factors for the development of restenosis. Studying risk factors of restenosis after carotid endarterectomy is of considerable importance for both prevention and choice of pathogenetically targeted treatment of patients presenting with atherosclerotic lesions of brachiocephalic vessels.

[Hemorheologic disturbances in patients with obliterative atherosclerosis of peripheral arteries and type 2 diabetes mellitus].

The aim of this work was to assess hemorheologic variations and factors influencing them in 529 patients with obliterative atherosclerosis of the lower limbs and type 2 diabetes mellitus. Blood viscosity and hematocrit volume were measured. Statistical treatment of the results was performed using the STATISTICA 6.0program (StatSoft Inc., USA). Differences between observed and normal distributions were described in terms of medians and quartiles. Independent groups were compared using Mann-Whitney U-test, 2-sample Kolmogorov-Smirnov test, and Kruskal-Wallis method. Differences were considered significant atp < 0.05. Results of the study confirm disturbances in the hemorheologic system in patients with obliterative atherosclerosis of the lower limbs and diabetes. Variations of blood viscosity and hematocrit volume in these patients have multidimensional character and depend on such factors as age, gender, smoking, duration of diabetes, degree of compensation of metabolic processes, and severity of arterial circulation problems.

[The pathology of the foot in the atherosclerotic damage of lower extremities vessels in patients with type 2 diabetes mellitus].

The results of examination of 116 patients with atherosclerotic damage of lower extremities arteries caused by type 2 diabetes mellitus are presented. At the base of data of X-Ray examination the character, frequency and localization of damage of osteoarticular apparatus of the feet were been analyzed in disorders of main blood flow in cases with diabetes mellitus. Pathologic changes were recorded in 89.9% of cases with prevalence of isolated or combined hypertrophic processes. Destructive alterations, typical for osteoarticular apparatus of the feet in diabetes mellitus (diabetic osteoarthropathy), were absent. X-Ray signs of deformating osteoarthrosis of foot articulations were revealed in 48.4% of cases with maximal rate of damage of metatarsophalangeal joints. No relationship of osteoarticular apparatus lesions rate and a grade of circulation disorder in atherosclerotic vascular disturbances in type 2 diabetes mellitus was revealed (p > 0.05). The frequency of a set of X-Ray signs of osteoarthrosis--narrowing of joint space, subchondral osteosclerosis is associated with duration of diabetes mellitus more than 10 years. The relationship between frequency of development of atrophic processes (osteoporosis) of osteoarticular apparatus of the feet in cases with main vascular disorders and severity of course of diabetes mellitus (p < 0.01). Statistically confident prevalence of rate of osteoarticular apparatus of the foot was recorded in aggravation of metabolic disturbances.

[Modern views of diabetic angiopathy of the lower limbs (epidemiology, risk factor, etiopathogenesis, atherosclerosis of diabetes mellitus). Part I].

Today diabetes mellitus is one of the most important problems of modern medicine. This review provides an analysis of the reported data on the problem of vascular lesion in patients with diabetes mellitus. The authors consider the problems of diabetes mellitus epidemiology and the incidence of vascular pathology in patients with disorders of carbohydrate metabolism. Introduced the characteristics of the main etiopathogenetic aspects of the origination of diabetic angiopathies with regard to the latest studies into the given subject matter. Special attention is focused on the development of atherosclerotic lesion of lower limb arteries in the presence of diabetes mellitus. The authors review the most important causes of initiation and activation of the process of vessel wall lesion and formation of atherosclerotic plaques in diabetic patients. The study of risk factors of vascular pathology with delineation of the most substantial ones is of paramount importance for both prevention and sound pathogenetic treatment of the given pathology as well as for refinement of the results of surgical treatment of atherosclerotic occlusions associated with diabetes mellitus.