CAROTIDSCORE.RU-The first Russian computer program for risk stratification of postoperative complications of carotid endarterectomy.

GOAL: Presentation of the first Russian computer program (www.carotidscore.ru) for risk stratification of postoperative complications of carotid endarterectomy (CEE). MATERIAL AND METHODS: The present study is based on the analysis of a multicenter Russian database that includes 25,812 patients after CEE operated on from 01/01/2010 to 04/01/2022. The following types of CEE were implemented: 6814 classical CEE with plastic reconstruction of the reconstruction zone with a patch; 18,998 eversion CEE. RESULTS: In the hospital postoperative period, 0.18% developed a lethal outcome, 0.14%-myocardial infarction, 0.35%-stroke. The combined endpoint was 0.68%. For each factor present in patients, a predictive coefficient was calculated. The prognostic coefficient was a numerical indicator reflecting the strength of the influence of each factor on the development of postoperative complications. Based on this formula, predictive coefficients were calculated for each factor present in patients in our study. The total contribution of these factors was reflected in "%" and denoted the risk of postoperative complications with a minimum value of 0% and a maximum of 100%. On the basis of the obtained calculations, a computer program CarotidSCORE was created. Its graphical interface is based on the QT framework (https://www.qt.io), which has established itself as one of the best solutions for desktop applications. It is possible not only to calculate the probability of developing a complication, but also to save all data about the patient in JSON format (for the patient's personal card and his anamnesis). The CarotidSCORE program contains 47 patient parameters, including clinical-demographic, anamnestic and angiographic characteristics. It allows you to choose one of the four types of CEE, which will provide an accurate stratification of the risk of complications for each of them in person. CONCLUSION: CarotidSCORE (www.carotidscore.ru) is able to determine the likelihood of postoperative complications in patients undergoing CEE.

[Resection of lumbar arteriovenous malformation]. / Rezektsiya arteriovenoznoi mal'formatsii poyasnichnoi oblasti.

The authors present a 64-year-old patient with lumbar arteriovenous malformation 22´35´50 mm. Open resection under endotracheal anesthesia was carried out. Postoperative period was uneventful. The patient was discharged in 7 days after surgery. Surgical resection of lumbar AVM is preferable because this approach eliminates cosmetic defect without the risk of soft tissue necrosis. Such an invasive intervention can be performed in case of superficial afferent vessel whose ligation will reduce the risk of intraoperative bleeding.

[Long-term results of carotid endarterectomy and carotid artery stenting in patients with high bifurcation of common carotid artery: a multiple-center study]. / Otdalennye rezul'taty karotidnoi endarterektomii i karotidnoi angioplastiki so stentirovaniem u patsientov s vysokim raspolozheniem bifurkatsii obshchei sonnoi arterii. Rezul'taty mnogotsentrovogo issledovaniya.

OBJECTIVE: To analyze in-hospital and long-term results of eversion carotid endarterectomy (CEE), carotid endarterectomy with patch repair and carotid artery stenting (CAS) in patients with high bifurcation of common carotid artery. MATERIAL AND METHODS: A retrospective multiple-center open study included 1983 patients who underwent internal carotid artery (ICA) repair for severe stenosis between 2010 and 2021. Three groups of patients were distinguished depending on revascularization option: group 1 (n=638) - eversion CEE; group 2 (n=351) - CEE with patch repair; group 3 (n=994) - CAS. RESULTS: In-hospital postoperative mortality and incidence of stroke and myocardial infarction were similar. All bleedings (n=39) occurred after CEE. ICA thrombosis was diagnosed in groups 1 and 2 due to intimal detachment after insertion of temporary bypass tube. Incidence of laryngeal paresis, neuropathy of hypoglossal and glossopharyngeal nerves, Horner syndrome, damage to salivary glands was comparable in groups 1 and 2. Long-term mortality was the highest (n=10; 2.8%) after CEE with patch repair due to fatal stroke. In turn, the highest incidence of ICA restenosis and restenosis-induced ischemic stroke was observed after CEE with patch repair and CAS. CONCLUSION: 1. Classical and eversion CEE in patients with high CCA bifurcation is followed by high in-hospital incidence of damage to cranial nerves and salivary glands, laryngeal paresis, Horner syndrome, bleeding and risk of ICA thrombosis. 2. In patients with high CCA bifurcation, CAS and CEE with patch repair are accompanied by high incidence of ICA restenosis, restenosis-induced stroke and mortality in long-term postoperative period. 3. Eversion CEE demonstrates the lowest rates of all adverse cardiovascular events in long-term follow-up period.

[A multicenter study on the influence of different kinds of carotidal endarterectomy on the course of resistant arterial hypertension]. / Mnogotsentrovoe issledovanie vliyaniya razlichnykh vidov karotidnoi endarterektomii na techenie rezistentnoi arterial'noi gipertenzii.

OBJECTIVE: To analyze the dynamics of systolic blood pressure (SBP) and the results of various types of carotid endarterectomy (CEE) in patients with resistant arterial hypertension (RAH). MATERIALS AND METHODS: The study included 1577 patients with hemodynamically significant stenosis of the internal carotid artery (ICA) and RAH for more than 3 years. Patients were enrolled from January 2014 to December 2020. Depending on the implemented revascularization strategy, 5 groups were formed: group 1 (n=289 (18.3%)) with classical CEE with plasty of the reconstruction zone with a patch, group 2 (n=472 (29.9%)) with eversional CEE with cut-off of carotid glomus (CG); group 3 (n=109 (6.9%)) with the formation of a new bifurcation; group 4: (n=117 (7.4%)) with autoarterial reconstruction; group 5: (n=590 (37.4%)) with glomus-saving CEE. RESULTS: In the postoperative period, no significant differences were obtained in the frequency of deaths (0.34% for group 1; 0.63% for group 2; 0% for groups 3, 4 and 5), myocardial infarction (0.34%, 0.84%, 1.83, 0.85%, 0.33%, respectively); ischemic stroke (0.34%, 1.27%, 0.91%, 0.85%, 0.17%, respectively), hemorrhagic transformation (0%, 0.84%, 0.91%, 0.85%, 0%, respectively). However, according to the frequency of the combined endpoint (death + myocardial infarction + ischemic stroke + hemorrhagic transformation), the lowest rates were observed in the group of classical carotid endarterectomy with plasty of the reconstruction zone with a patch and glomus-sparing CEE (1.03%, 3.6%, 3.67%, 2.56%, 0.5%, respectively). This is due to the absence of cases of labile AH and hypertensive crises among patients of groups 1 and 5, which was ensured by the preservation of carotid glomus (CG). As a result, the number of patients with 2 and 3 degrees of hypertension in these groups decreased statistically significantly. The vast majority of patients after these operations achieved a stable target SBP. In groups 2, 3, and 4, there was a statistically significant increase in the number of patients with 2 and 3 degrees of AH, which is associated with excision of the CG. CONCLUSION: Classical CEE and glomus-sparing CEE techniques make it possible to achieve a stable target SBP level in patients with RAH as a result of CG preservation. Removal or traumatization of the latter during eversional CEE, the formation of a new bifurcation, autoarterial reconstruction is accompanied by the development of labile hypertension, an increase in the degree of hypertension and a high risk of hemorrhagic transformation in the brain. Thus, the most effective and safe types of CEE in the presence of RAH are classical CEE with plasty of the reconstruction zone with a patch and glomus-sparing CEE.

[Use of glomus-sparing techniques in surgery of carotid arteries]. / Primenenie glomussberegaiushchikh tekhnik v khirurgii sonnykh arterii.

The carotid glomus is an anatomical structure located in the bifurcation of the common carotid artery and consisting of chemo and baroreceptors. It is an important reflexogenic zone participating in provision of constancy of arterial pressure. Performing eversion carotid endarterectomy is accompanied by damage of the structures of the carotid glomus, which is followed by persistent arterial hypertension in the early postoperative period. This complication remains one of the unsolved tasks in surgery of carotid arteries. The article contains a review of the literature concerning the problem of the development of postoperative arterial hypertension in patients after carotid endarterectomy carried out with skeletization of the bifurcation of the common carotid artery and with damage to the structures of the carotid glomus. Many authors report a positive effect of surgical interventions performed with preservation of the carotid body. Further studies of the results of treatment by means of glomus-sparing techniques at a longer postoperative follow-up period are required.

Formation of self-trapping waveguides in bulk PMMA media doped with Phenanthrenequinone.

Experimental and theoretical investigations of light self-trapping waveguides in a bulk polymeric medium based on polymethylmethacrylate (PMMA) with photosensitive phenanthrenequinone (PQ)-molecules are examined. Self-channeling was generated for the first time in this nonlinear bulk PQ-PMMA media with a thickness up to several millimeters and 0.1 mol. % PQ-concentration. The experimental formation of volume waveguide structures with a length of 2 - 3 cm at different laser wavelengths (405 nm, 488 nm, and 514.5 nm) was demonstrated. The calculations based on a model for the laser beam propagation in the bulk PQ-PMMA medium with competitive nonlinearities are in a good agreement with the experiments.

Broadening of the light self-trapping due to thermal defocusing in PQ-PMMA polymeric layers.

The channel formation by the self-trapping of a (1 + 1)D beam in polymeric media based on a polymethylmethacrylate (PMMA) matrix containing phenanthrenequinone (PQ) molecules is predicted theoretically and observed experimentally for the first time. Particular attention is paid to the effect of thermal beam expansion, which in conjunction with the photorefractive nonlinearity of the medium results in the possibility to control optically the geometrical parameters of the generated channel.

[Comparative evaluation of productivity of several green cultures as potential higher plant components of bio-regenerative systems of life support].

Purpose of the investigation was to select, analyze and evaluate green plant species known for assisting resistance to diseases and improving physiological functions in humans, and to test allelopathic compatibility of selected species with basic systems for life support. Nutrient substrates were freshly made soil-like substrate (SLS) and clayite. Green cultures were 6 spinach species, 2 lettuces, 2 leaf cabbage species and ruccola. The investigations showed that plant productivity was either equal to or better on freshly made SLS than on clayite; however, the greens accumulated large quantities of nitrate nitrogen. The highest productivity distinguished leaf cabbage; the best antiradical properties was demonstrated by lettuces and the worst, by some spinach species. None of the species displayed a negative allelopathic effect on productivity of the reddish test culture.

Non-local response in glass-like polymer storage materials based on poly (methylmethacrylate) with distributed phenanthrenequinone.

The development of volume phase gratings written by two-wave-mixing in glass-like polymer storage materials based on poly (methylmethacrylate) and its thermostable derivative (copolymer with acrylic acid) with distributed phenanthrenequinone is investigated experimentally and theoretically. The maximal diffraction efficiency is considered in dependence on the grating period. The redistribution processes of the molecules are described with a one-dimensional diffusion model yielding the existence of a non-local response in the photopolymer layer, and the corresponding non-local response length of phenanthrenequinone is found experimentally.

Holographic volume absorption grating in glass-like polymer recording material.

We investigated the contribution of the absorption and phase gratings to the total diffraction efficiency of volume holographic gratings written in glass-like polymer recording materials based on poly(methyl methacrylate) and its thermostable derivative (copolymer with acrylic acid) with distributed phenanthrenequinone. The typical maximal diffraction efficiency was 0.5%-2.0% for the absorption grating and 22-32% for the phase grating. The modulation of the absorption coefficient varied between 10 cm(-1) and 100 cm(-1) and the modulation of the refractive index was about 10(-4)-10(-3).

Modified polymethylmethacrylate as a base for thermostable optical recording media.

A possibility to improve the thermal properties of holographic gratings in a photosensitive system based on polymethylmethacrylate (PMMA) and to enhance simultaneously the adhesion of the photopolymer to soda-lime glass is demonstrated. The modified PMMA was prepared by radical copolymerisation of methylmethacrylate (MMA) with acrylic acid (AA). Polymer films deposited from samples of the copolymer of MMA with AA containing 9,10-phenanthrenequinone additives were used as a photosensitive material for the recording of holographic gratings. It is possible to generate gratings that are thermally stable up to 200 masculineC using this modified PMMA. Dynamic thermogravimetry, differential thermal analysis and thermal mechanic analyses were used to determine the dependence of the thermal stability of the modified PMMA on the composition and the structure of its macromolecules.

Development of a root feeding system based on a fiber ion-exchange substrate for space plant growth chamber "Vitacycle".

Selecting a plant root nutrient delivery system is one of the key aspects of designing root modules for space plant growth chambers. This article examines a number of the nutrient delivery systems and shows the most suitable technique for providing nutrients to roots in microgravity, which to date are ion-exchange artificial soils. In addition, this article characterizes the ion composition and hydrophysical parameters of a new Russian artificial ion charged fiber substrate, BIONA-V3. The BIONA-V3 substrate is comprised of ion-exchange resin fibers. The experimental data concerning the effects of anionic and cationic components on plant biomass is presented. Preliminary experiments with BIONA-V3 showed that 1 kg of dry BIONA-V3 produces up to 2.4 kg (fresh mass) of cabbage leaf or 180 g of dry plant mass per 1 dm3 of the substrate. Therefore, the root zone volume can be as small as 120 cm3 per plant. Further optimizing the nutrient composition of the resin fibers can increase space plant growth chamber productivity.

[Characteristics of several artificial substitutes of soil for space flight greenhouses]. / Kharakteristiki nekotorykh iskusstvennykh zamenitelei pochvy dlia kosmicheskikh oranzherei tipa "Svet".

The analysis of the study associated with cultivating the leaf cabbage, small radish in the Russian-Bulgarian greenhouse "Svet" aboard Mir orbital space station in 1990 has demonstrated that under microgravity conditions the zeolite substrate "Balkanin" with particles dimensions of 1-3 mm placed in the root modules of the greenhouse "Svet" did not ensure the sufficient transfer of the water from moisture-saturated wicks to the periphery of the vegetation vessels what is attributable to the peculiarities of hydrophysical characteristics of the substrate used. There presented the results of experimental research on the hydrophysical and agrochemical characteristics of the ion-exchange substrates of two other types--"Biona 312" and "Biona V" prepared on the basis of the artificial ion-exchange resins: cationite--CU-2 and anionite EDE-10P. For these substrates there found the estimates of humidity correlating with the loss of gassy pores as well as there measured the specific weight of the solid phase and the volumetric weight. There presented data on the content of the nutrients as well as the results of assessing the biological productivity potential of the tested substrates in the "Svet" greenhouse root modules. The characteristics obtained are indicative of the possibility to use the mentioned substrates in space greenhouse of the "Svet" type.