Objective. The purpose of our retrospective single-center study was assessing the long-term results of radiofrequency obliteration (RFO) in patients with varicose veins of the lower extremities and causes of disease recurrence. Design and methods. We included 406 patients with reflux in the great saphenous vein (GSV), who underwent RFO either alone (n = 81; 19.9 %) or in combination with miniphlebectomy (n = 284; 70 %) or sclerotherapy (n = 41; 10.1 %) during the period from 2013 to 2022. Results. Primary occlusion of the target vein was achieved in 406 (100 %) patients. 26 (6.4 %) patients had recurrent varicose veins (RVV). In 18 (4.4 %) patients with “early” relapses in a period of 3 to 6 months, we diagnosed the incompetence of the anterior accessory vein — 6 (1.5 %) or tributaries 12 (3 %). Among 8 patients (2 %) with “late” relapse in the period from 24 to 36 months, 6 (1.5 %) had recanalization of tributaries and 2 (0.5 %) had neovasculogenesis. In all cases of RVV patients underwent additional interventions with 100% technical success. Conclusion. The most important factors of RVV are tactical and technical errors associated with the primary underestimation of venous system anatomy; absence or insufficiently long postoperative observation; relapse associated with neovasculogenesis. Considering the main role of the first two reasons, their minimization can significantly reduce the risk of RVV.

Background: despite the great contribution of physical activity (PA) to the health of children after correction of congenital heart defects (CHD), in the literature there are only isolated data on PA and the performance of children after correction of congenital heart defects. Objective: to assess physical activity and physical performance in children after radical intervention for congenital heart disease. Material and methods. The study included 32 children after radical correction of congenital heart disease. In addition to standard research methods, all patients underwent a cardiopulmonary stress test (CPST), as well as a structured interview on physical activity. Results. According to the survey, 81 % of children did not achieve the recommended 60 minutes of daily PA. Only 44 % of children attended sports clubs or sections. The amount of sedentary time in children was 8.4 hours a day, while the duration of entertainment “screen time” was 3 hours. A separate analysis of physical performance was carried out in subgroups formed depending on physical training (PT) activities. In children who regularly engaged in PT, the threshold load power and heart rate at the height of physical activity were higher compared to children who did not engage in PT. In addition, they had higher VO_2peak and lower ventilator CO₂ equivalent (VE/VCO₂). Conclusion. Children with corrected congenital heart disease, without contraindications to physical education and sports, mostly lead a sedentary lifestyle and have insufficient physical activity and performance. However, regular physical training after radical correction of congenital heart disease significantly increases the performance of children due to an adequate increase in cardiac output and minute ventilation during physical activity.

Relevance. Acute ischemic stroke (AIS) is associated with a high level of mortality, disability and, therefore, corresponding economic costs. The effectiveness of treatment is directly dependent on the duration of the “therapeutic window”. Therefore, for the fastest diagnosis, dynamic control, timely adoption of tactical decisions and prediction of treatment results, an accessible, objective and reproducible diagnostic method is required. Purpose. To determine the possibilities of duplex ultrasound of extra- and intracranial arteries at the early stages of AIS treatment. Methods. The study included 460 patients with AIS before and after using various reperfusion methods: systemic thrombolytic therapy, thrombextraction, stenting, and its combinations. Clinical-radiological comparisons were made using clinical scales and radiological methods: computed tomography, computed angiography and radioangiography. Results. The study confirmed comparability of the results of vascular intracranial ultrasound with the data of angiography. The relationship between the presence and degree of stenoocclusive lesions of extracranial arteries and the functional and clinical outcome has been established. Hemodynamics in the intracranial arteries at the early stages after treatment were characterized by hyperperfusion, correlated with a favorable clinical outcome. Conclusion. Cerebral ultrasound in patients with AIS can serve as the method of choice for non-invasive primary diagnosis and monitoring the effectiveness of revascularization and predicting outcomes.

The most common type of cardiomyopathy is hypertrophic cardiomyopathy (HCM), determined by wall thickening of the left ventricle. Most often the reason of this type of cardiomyopathy are mutations in genes encoding sarcomere proteins. However, in most cases it is not possible to establish a clear cause of the development of HCMP due to the absence of mutations of causal genes. The development of pronounced myocardial hypertrophy stimulated investigation of intracellular processes of maintaining homeostasis, in particular autophagy. Being one of the main mechanisms of protein quality control in muscle cells, at the impairment of autophagy was previously discussed in the presence of sarcomere proteins mutations. This work is focused on studying expression changes among main biochemical markers associated with the autophagy process in myocardial tissue samples obtained from patients with diagnosed HCMP. The study group of patients was divided into several subgroups to compare the results obtained depending on the mutation found. It was found that the expression of autophagy markers and mitochondrial homeostasis in patients with HCMP associated with the presence of sarcomere mutations differed from the expression of these genes relative to the comparison group. While in the samples from patients with Z-disk genes mutations, as well as in the genes encoding lysosomal enzymes, no expression changes of the studied autophagy markers were found.

Background. Hemolysis is a pathological condition accompanied by the release of hemoglobin (Hbf) into the plasma, which has adverse effects. Intravascular hemolysis occurs in various diseases, and also complicates the postoperative period of surgical interventions using cardiopulmonary bypass. Objective. In an animal experiment, to study the effect of inhalation of nitric oxide (NO) on the cell-free hemoglobin (Hbf) concentration. Methods. The study included 10 pigs, which were randomized into two groups: control (n = 5) and experimental (n = 5). After induction of anesthesia and tracheal intubation, intravascular hemolysis was simulated in all animals by intravenous administration of Hbf. After modeling hemolysis, the animals of the experimental group were inhaled with NO at a dosage of 80 ppm. Animals from the control group did not receive NO. The dynamics of Hbf and methemoglobin were evaluated for 6 hours. Then euthanasia was performed. Results. The Hbf level in the experimental group was statistically significantly lower compared to the control group after 30 minutes (1.2 (1; 1.3) g/l vs. 1.7 (1.6; 1.9) g/l, p = 0.047), 60 minutes (0.9 (0.9; 1) g/l vs. 1.24 (1.2; 1.5) g/l, p = 0.046) and 90 minutes (0.7 (0.7; 0.8) g/l vs. 0.94 (0.9; 1.2) g/l, p = 0.035) after administration of Hbf. The level of methemoglobin in the experimental group was statistically significantly higher than in the control group throughout the study, but did not reach a toxic concentration of 5 %. Conclusion. Inhalation of NO at a dosage of 80 ppm reduces the level of Hbf. Inhalation of NO at a dosage of 80 ppm increases the level of methemoglobin within safe values.

Stress hyperglycemia is a physiological defense mechanism that manifests itself in an increase in glycemia in acute distress. Despite the fact that the presence of this phenomenon and its adverse effects on the body are not in doubt, there are still no algorithms for intraoperative management of patients without a history of diabetes mellitus: mandatory control of glycemia, frequency of control, intervention points for glucose, optimal insulin therapy regimen, methods for leveling glucose levels. This review discusses the definitions of stress hypoglycemia, pathogenesis, its effect on the human body, cut-off for glucose, predictors of hyperglycemia and possible ways to prevent adverse effects.

Danon’s disease (DD) is a rare multisystem disease caused by pathogenic variants in the LAMP2 gene. Men are characterized by a multisystemic Involvement, most often represented by a triad of symptoms: skeletal myopathy, cardiomyopathy (hypertrophic phenotype), and cognitive dysfunction. Women are more likely to have isolated heart disease. Given that women are less likely to have extracardiac manifestations, the diagnosis of the disease in females can be very difficult and untimely. In this article, we present 2 clinical cases of BD in adolescent girls, characterized by an early onset of the disease and a multisystem course.

Venous cerebral angiomas are one of the most common cerebrovascular anomalies and are often detected by neuroimaging in people with nonspecific complaints. It is generally accepted that venous angiomas have a benign course and do not require observation and treatment. At the same time, cases of spontaneous thrombosis of venous angiomas with the development of ischemic stroke are described, their possible participation in vasoneural conflict and epileptogenesis. The largest number of publications concern ruptures of venous angiomas with the formation of intracerebral hematomas. The article presents our own clinical observation of a young patient with intracerebral hemorrhage due to the rupture of a large venous angioma, which required surgical treatment. A review of scientific publications on the frequency of hemorrhages from venous angiomas, risk factors and management of such patients is also presented.