In the third part of the article, the bronchodilation tests methodology was considered: indications, contraindications, test procedure, interpretation. The methods of the bronchodilatory response assessing were considered, the differences between modern Russian recommendations and ERS/ATS interpretive strategies the bronchodilatory response assessing were shown. The specifics of the test procedure and evaluation of bronchodilation tests in children were described separately

Relevance. Computed vector electrocardiography (VECG) is a method of visualization of the total electrical vector of the heart in 3‑dimensional space based on 12 leads and a known computational procedure. VECG may be an additional method to assess the severity and prognosis of patients with chronic heart failure (CHF).

Objective. To determine VECG parameters associated with unfavorable prognosis in patients with CHF with reduced ejection fraction (CHFpEF).

Materials and methods. VECGs of 100 patients with CHFpEF were analyzed. All patients underwent baseline clinical examination, echocardiography and natriuretic peptide (NT-proBNP) determination. Patients with both ischemic (55 patients, of whom 10 died) and non-ischemic (45 patients, of whom 6 died) etiologies were included. During follow-up for 24 months, fatal outcomes were recorded. The correlation of ECG and NT-proBNP parameters with patients’ prognosis was evaluated.

Results. A total of 16 patients died in the study. According to VECG data the surviving patients had lower spatial QRS-T angle in comparison with the deceased ones (p=0,025). There was a trend towards lower planarity index in the group of deceased patients (p=0.09). ROC-analysis was carried out, according to the results of which with sensitivity 76,5% and specificity 62,7% the cut-off value of 156º of QRS-T spatial angle was obtained, exceeding which the probability of lethal outcome will increase (p=0,002). There was a correlation between lethal outcome in patients with a QRS-T angle value greater than 156º and NT-proBNP level (p=0.017). The threshold value of unfavorable prognosis for NT-proBNP was 927.1 pg/ml.

Conclusion. The VECG method is available and promising in the diagnosis and monitoring of patients with CHFpEF. The most informative parameters of ECG for detection of suspicion of CHFpEF are spatial QRS-T angle and planarity index. The results obtained in this study allow us to speak about the prognostic value of the QRS-T angle for patients with CHFpEF.

Aim: to compare amplitude-temporal and vectorcardiographic (VCG) parameters calculated through most commonly used matrix transformations.

Materials and methods. Preliminary literature search revealed Kors and inverse Dower transformation to be the most commonly used matrices for converting ECG‑12 into Frank VCG. Trunov-Aidu matrix appeared to be the only one for deriving VCG in the McFee-Parungao lead system.The study included 1250 ECGs of patients at the National Medical Research Center of Cardiology with various cardiovascular diseases: arterial hypertension, coronary heart disease, post-infarction cardiosclerosis, aortic stenosis. For each patient, using the above transformations, three VCGs with an intact and three VCGs with an inverted direction of the Z axis (according to Ozol) were obtained. The comparison was carried out based on the main amplitude-temporal indicators of P-QRS-T, as well as on VCG parameters: spatial QRS-T angle, QRS loop area, QRS integral vector, fractional integrals P and QRS. A total of 9 pairwise comparisons of 134 indicators were carried out for each synthesized VCG

Results. The strongest (r > 0.9 or r < -0.9) significant (p < 0.001) linear correlation was found between the spatial metrics: P, QRS, T wave loop lengths, QRS loop area, QRS-T angle, ventricular gradient, and QRS shared integrals. Significant relationship between projection parameters and P-QRS-T amplitude and duration was observed in some cases. The largest number of correlations was noted between parameters calculated in McFee-Parungao and Frank lead system derived by Kors.

Conclusions. Strong linear relationship was found between the VCG parameters determined through Kors, Dower and Trunov-Aidu matrix transformations, which indicates the equivalence of the results obtained through these matrices.

Syndrome of dysplasia connective tissue are recorded as cerebrovascular structural abnormalities of the vascular system include (deformations of vessels) and they are predisposing factors of dyscirculatory hemodynamic cerebrovascular disturbances.

The studying of clinical and ultrasonic data of extra cranial part of brachiocephalic vessels at children allows to reveal the structural peculiarities and direction of internal carotid artery (deformations), its interrelation with cerebrovascular hemodynamic infringements.

Early revealing of vessels’ structural abnormalities allow to carry out in due time diagnostics and cerebrovascular pathology preventive maintenance at children’s age. The ultrasound methods are one of the key non-invasive methods in management algorithm of patients with cerebrovascular disturbances

One of the significant causes of disability and mortality both in Russia and around the world remains acute cerebral circulatory disorders, which combines ischemic and hemorrhagic strokes, and transient ischemic attack. Deep vein thrombosis (DVT) has a significant prevalence in patients with stroke, and venous thromboembolism (VTE) significant impact on the prognosis. The development of technologies, the emergence of new research methods made it possible to accurately determine the presence of DVT in patients with stroke using duplex ultrasound, using reserve methods, if necessary — CT, MRI, CV. However, there is currently no data that would allow to effectively determine the timing for the diagnosis of DVT in patients with stroke, as well as to identify patients who need such evaluation. Additional studies are needed to determine the timing of the screening for DVT, by assessing the prevalence of DVT in various periods of stroke, as well as evaluating the identifying factors.

Aim: to assess the functional state of the pelvic floor muscles and their innervation in patients with descending perineum syndrome, manifested simultaneously by obstructive defecation and chronic neurogenic pelvic pain.

Materials and methods: in 2022–2023, 51 patients (40 (78.4 %) women, 11 (21.6 %) men; age 50.9 ± 14.5 years) with pelvic organ prolapse, manifested by obstructive defecation and chronic neurogenic pelvic pain were examined at the Ryzhikh National Medical Research Centre for Coloproctology. All patients underwent high-resolution anorectal manometry and stimulation electroneuromyography according to a comprehensive neurophysiological protocol using a St. Mark’s electrode.

Results: manometric patterns of functional defecation disorders were detected in 40 (78.4 %) patients, in the rest they were confirmed by defecography data and a negative evacuation test according to the Rome criteria IV. With stimulation electroneuromyography, neuropathy was detected in 68.6 % of cases by increasing the latency of the M-response of the pudendal nerve on the right or left. Complex neurophysiological diagnostics made it possible to additionally identify neuropathy in another 25.5 % of patients: according to changes in the mixed reciprocating reflex response (mixed feedback-reflex response) (efferent pathway) — in 17.7 % of cases; according to changes in the bulbocavernous reflex (efferent and afferent pathways) — in 7.8 % of cases. That is, neuropathy was determined in 94.1 % of patients in total.

Conclusions:

1. Functional diagnostic methods are an effective tool for studying the state of the pelvic floor muscle structures and their innervation and make it possible to identify pathogenetic links of disorders, the clinical manifestations of which are anal incontinence, neurogenic pelvic pain and proctogenic constipation in the form of obstructive defecation.
2. Stimulation electroneuromyography makes it possible to detect disturbed innervation of the pelvic floor muscles and anal sphincter in the standard study of the M-response in 68.6 % of cases with perineal prolapse syndrome with a combination of proctogenic disorders and neurogenic pelvic pain. The use of a comprehensive neurophysiological protocol makes it possible to detect innervation disorders in 94.1 % of cases.

The work describes an original technique and presents for the first time thermal imaging phenomena that occur during hardware correction of disorders of the stomatognathic system.