Aim. To assess the ultrasonography role for diagnosis of atherosclerotic lesions of the extracranial carotid arteries.Material and methods. The study was conducted on the basis of the St. Petersburg Mariinsky Hospital. A total of 855 patients who were admitted to the regional vascular center due to ischemic stroke or transient ischemic attack were examined. The mean age of the patients was 68 years (min 18, max 107). All patients underwent ultrasound of the carotid arteries.Results. In 570 (66,6%) patients with neurological symptoms (according to clinical and neurological examination), hemodynamically insignificant carotid artery lumen stenosis up to 70-75% was revealed. Ultrasound imaging in all patients revealed signs of atherosclerotic plaque (ASP) instability in various combinations, except for hemorrhage. It was not possible to clearly visualize the finished hemorrhage in the ASP structure.Conclusion. Despite the high informative value of ultrasound, it is not possible to answer all clinical questions with its single use. At the moment, there is no classification of instability signs, reflecting the ASP embolism risk. It needs for paternal change the management of asymptomatic patients. More detailed study of ASP destabilization using various visualization methods is necessary.

Background. Neurosurgical pathology of the brain is an urgent problem of modern medicine. Existing models of cognitive rehabilitation are based on neuropsychological correction. The literature does not contain enough information about the effect of medical and physiotherapeutic techniques on higher nervous activity.Objective. To assess the effect of neurorehabilitation in cognitive impairment in patients with neurosurgical brain pathology.Design and methods. The dynamics of cognitive impairment was studied in 165 neurosurgical patients (72 men, 93 women, average age 52.82 ± 14.79 years) at the second stage of rehabilitation. The severity of the deficit of higher cortical functions was assessed upon admission and after 30 days in the rehabilitation department. Roschina test, MMSE, FAB, HDRS were used to detect depression.Results. When analyzing the dynamics of indicators for scoring higher cortical functions, it was found that in all groups of patients, cognitive rehabilitation led to positive results.Conclusion. The combined use of neuropsychological, medical and physiotherapeutic techniques can significantly improve the results of rehabilitation treatment.

Резюме Рентгенологическая диагностика респираторного дистресс-синдрома новорожденных (РДС) является актуальной задачей. В статье представлены клинико-рентгенологические параллели течения респираторного дистресс-синдрома новорожденных. Выделены рентгенологические критерии, определяющие степень тяжести РДС, позволяющие улучшить раннюю рентгенологическую диагностику. С учетом поставленных задач в Перинатальном центре ФГБУ «НМИЦ им. В. А. Алмазова» Минздрава России было проанализировано 143 рентгенограммы новорожденных за 2017 год с установленным диагнозом РДС (мальчиков n = 66, 46,2 %; девочек n = 77, 53,8 %). Гестационный возраст новорожденных составил: на сроке гестации до 32 недель-100 (69,9 %) детей, 32-34 недели-43 (30,1 %) детей. Масса тела новорожденных составила 1190 ± 510 г. Тяжесть состояния новорожденных с РДС обусловлена степенью выраженности острой дыхательной недостаточности, что определяет проведение рентгенографического исследования в первые 1-3 часа жизни ребенка для решения вопроса о выборе дыхательной поддержки и метода терапии сурфактантами. Ключевые слова: рентгенологическая диагностика, респираторный дистресс-синдром, неонатология.

The prospects for the use of functional magnetic resonance imaging methods in the diagnosis of cognitive and neuropsychiatric disorders in patients with tension headaches are quite wide, as they allow a more detailed study of the pathogenesis of the above disorders. To date, the effectiveness of osteopathy in the treatment of patients with tension headaches has been shown. It remains an open question to develop a generally accepted method of diagnosis and treatment, including the use of complementary therapies, neuroimaging objectification and determination of the state of functional connections of the brain for more accurate diagnosis and prediction of treatment effectiveness. The present review summarizes the current ideas about the etiopathogenesis of tension headache (including the study of the functional connections of the brain) and available data on the clinical efficacy of osteopathic correction.

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