Background. After breast cancer treatment, up to 90 % of patients suffer from various neurological and mental disorders, such as vertebrobasilar insufficiency, chronic pain syndrome, anxiety and depression. These disorders can cause structural changes in the white matter tracts of the brain, which can be detected using diffusion tensor magnetic resonance imaging (DT-MRI).Objective. To evaluate structural changes in the white matter tracts of the brain in patients with post-mastectomy syndrome using DT-MRI.Design and methods. The study was carried out on a tomograph with a magnetic field induction force of 3.0 T. 46 patients with neurological disorders in the long-term postoperative period (more than 6 months) after radical mastectomy, chemotherapeutic and/or radiation treatment for breast cancer were examined.Results. According to the results of an intergroup statistical analysis, all 46 patients with post-mastectomy syndrome had differences in quantitative fractional anisotropy in the white matter tracts of the brain compared with the control group (p < 0.01).Conclusion. The use of DT-MRI in patients with post-mastectomy syndrome makes it possible to identify changes in the white matter tracts of the brain that correlate with neurological disorders and a decrease in the quality of life in this cohort of patients. The results obtained indicate the need to improve treatment and rehabilitation approaches in patients receiving treatment for breast cancer.

Background. Most complications of vascular access for hemodialysis require surgical treatment and if ineffective lead to fistula loss and depletion of the vascular resource for the new fistula creation.Objective. To identify complications of permanent vascular access for hemodialysis which require surgical treatment and evaluate its results using duplex scanning.Design and methods. Ultrasonography, clinical and laboratory examinations were performed in 550 patients undergoing hemodialysis.Results. Complications of vascular access for hemodialysis were detected in 154 (28.0 %) patients, surgical treatment was performed in 96 (62.3 %) patients. The main indications for surgical treatment were: significant stenosis, occlusive thrombosis, non-occlusive thrombosis in combination with significant vein stenosis, aneurysm with increased access flow, ischemic steal syndrome of the hand and pulsating hematoma. The analysis of surgical interventions showed that the creation of a new access was more often performed (41.7 %) compared to other types of fistula reconstructions which leads to a decrease in the number of vessels in the upper extremities that can be used to create access in the future.Conclusion. Duplex ultrasound allows diagnosing vascular access for hemodialysis complications and evaluating the results of their surgical treatment.