Implementation of virtual patients allows avoiding risks for patient safety, using the standardized clinical situations repeatedly, and providing remote access to information. In order to create virtual patients, the project team comprised of specialists competent in the diverse subject areas. Every virtual patient is a structural model for a diagnostic and treatment process of a real patient augmented with textual and multimedia information. A sample comprising of 50 archival clinical charts of patients with typical cardiovascular diseases and rare pathology variants was formed. Textual information from medical records is supplemented with the multimedia results of instrumental and laboratory studies. Created data and knowledge base of virtual patients was designated for a demonstration of complete cardiovascular cases to the trainees in linear trajectory with an option of Web-access. The virtual patient repository will become a factual basis for problem-based distance learning of medical students and physicians.

The objective of the present study was to perform the efficacy analysis of the application of the sternal saw with the coldplasma tip compared to the standard saw. The study included 39 patients with the average age of 58±6.2 years. The patients were divided into two groups depending on the method of sternotomy: the main group included 20 patients (sternotomy by cold-plasma tip sternal saw); the control group included 19 patients (sternotomy by standard saw). In all the patients, we evaluated the initial condition of a sternal bone, the impact of coblation on the incised tissues, indicators of a postoperative sternal bone consolidation, individual intolerance to the method and the volume of blood loss during sternotomy. Application of the new device reduced the time of surgical approach; decreased the loss of blood volume during sternotomy by seven times on average; reduced the depth and extent of tissue damage according to the histological examination; reduced the pain intensity in the postoperative period (evaluated by the numerical rating scale). Application of the cold-plasma tip sternal saw for sternotomy compared to the standard method may be considered preferable due to its less traumaticity, shorter duration of sternotomy as well as less blood loss. It promotes faster healing of a sternum bone, reducing the incidence of postoperative complications.

Dynamics of hypertensive encephalopathy signs and brain perfusion under influence 6-month therapy by felodipine was estimated. The study included 29 patients having hypertension of the II stage. The treatment with felodipine resulted in decreased arterial pressure and signs of intracranial hypertension and increased blood flow in the area of periventricular edema. It is concluded that felodipine has expressed cerebroprotective efficacy besides its hypertensive action.

The analysis ofVRT reconstruction in CT formation of spatial image of anatomical structures of the lungs was given. Clinical assessment of the technique was carried out for 44 patients with suspected lung lesions not exceeding 10 mm in diameter. The CT analysis of the image was shown to permit new topographic information on anatomical lung structures to be obtained.

Influence of arterial hypertension and other risk factors on the course of ischemic heart disease in patients 40 patients aged 52,4 b6.9 years with history of coronary artery bypass grafting was studied. Biochemical study of blood, ultrasound study of the heart and vessels, coronary angiography, ventriculography and spiral computer tomography was carried out. Three years after coronary artery bypass grafting, statistically significant decrease of frequency of angina pectoris recurrences, advancing of coronary atherosclerosis and stenosing of grafts in patients with effective control of arterial pressure compared to patients who did not reach target levels of arterial pressure decrease.

OBJECTIVE To describe and apply a method for programmatically calculating central hemodynamic parameters from the data of dynamic contrast X-ray computed tomography (CT). MATERIAL AND METHODS A procedure is proposed to calculate cardiac output (CO) on the basis of the tracer dilution method as a ratio of the injected dose of a contrast agent (Urografin, Shering AG, Austria) to the area under the concentration-time curve derived for one of the cardiac chambers: [see text]. The blood concentration of the agent was estimated from the blood iodine (I) concentration-X-ray density (XD) regression dependence: [XD] = 0.49+22.07 x [I]. Thirty-three patients were studied on a multispiral X-ray Somatom Sensation 4 computed tomograph (Siemens), by injecting 15-20 ml of Urografin. The calculating method was realized as a software package for processing dynamic contrast CT data. RESULTS The proposed method could exactly determine the values of cardiac output: the correlation with the results of the reference technique (Doppler echo measurement) was highly significant (r = 0.95; p < 0.001) in the whole range of values. Moreover, the data on XD could accurately determine the blood concentration of both iodine (I): [XD] = 0.49+22.07 x [I] and gadolinium as a component of the contrast paramagnetic Gd-DTPA for which the solution concentration-XR dependence was as follows: XD 1.2+33.6 x [Gd]. CONCLUSIONS Thus, dynamic spiral CT may be also used for the estimation of cardiac output by the tracer dilution method.