The aim of study Based on computed tomography data, to determine the most characteristic criteria for true lumen (TL) and false lumen (FL) in aortic dissection. To identify the relationship of the studied features with the stage of aortic dissection.
Materials of the study Computed tomography (CT) data of 115 patients diagnosed with aortic dissection (AD) who were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine were analyzed. The average age of the patients was 54.5 years (median — 56 years), men predominated in the studied group. AD types according to the De Bakey classification were distributed as follows: Type I — in 47% of patients, Type II — in 16.5%, Type III — in 36.5%. Dissection in the acute stage occurred in 62% of the patient, in the subacute — in 16%, in the chronic — 22%.
Results In the studied group, FL in all cases prevailed over the TL by size, regardless of the stage and type of AD. Analysis of lumen ratio showed that in 63.55% of patients, FL occupied 75% or more of the aortic cross-sectional area. Location of FL: at the level of the ascending aorta, along the right and anterior walls of the aorta — 94.5%; in the descending thoracic aorta, along the posterior and left walls — 84%; in the abdominal aorta, along the posterior and left walls — 70%. Calcifications of the non- dissected part of the aortic wall, as a sign of a true lumen, were found in 59.1%. There was no correlation between calcification and the AD stage. Partial thrombosis of one of the lumens was detected in 59% (in FL — 85%, in TL — 13%, thrombosis of both lumens — 2%). The beak signs occurred in 85% of patients with AD, however, it was significantly more often detected in patients with acute and subacute AD stages than in the chronic stage (p<0.001). The cobweb sign was found in one third of patients with AD, however, it was statistically significantly more often determined in patients in acute and subacute stages (p<0.05).
Conclusion CT is reasonably considered a highly informative method of diagnosing AD. The signs of true and false lumen presented in the work, as well as their combination, make it possible to perform a quick and error-free marking of the aortic lumen with a high degree of probability. A number of the described CT signs correlate with the stage of AD.

Introduction This article deals with the problem of sarcopenia in patients after severe brain injury. It presents the results of the comparative analysis of a group of patients and a group of volunteers with performed muscle fiber ultrasound.
Relevance Sarcopenia is a serious complication in a critically ill patient. It appears early and progresses rather quickly during the patient’s critical condition. In order to diagnose sarcopenia, both radiation and ultrasound methods can be used. The use of ultrasound methods is less labor-intensive, energy-consuming, and economically costly and does not involve an increase in radiation exposure to the patient. The paper highlights the use and comparison of these methods in patients after severe brain injuries.
Aim of study To assess the severity of sarcopenia in patients after severe brain injuries.
Materials and methods 25 patients were included in this study with an average age of 56.75±19.84 years, ranging from 22 to 82 years, after severe brain injury in a minimally conscious state according to the FOUR (Full Outline of Unresponsiveness) scale, median 12 (12; 15) points. The assessment was carried out in the first 3 days from the moment of admission to the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology. For comparison purposes, the study included 19 volunteers aged 35.63±7.02 years, ranging from 21 to 47 years.
Results The data obtained indicate that patients after severe brain injuries had pronounced muscle fiber disorders affecting its thickness and echogenicity. The thickness of the biceps on the side of the brain injury was 0.93±0.27 cm (min 0.5; max 1.58) and the thickness of the biceps on the side opposite to the brain injury was 0.62±0.2 cm (min 0.27; max 0.93) with p=0.0007, statistically significant. In terms of echogenicity, the differences were not statistically significant (p=0.1). The thickness of the triceps on the side of the brain injury was 0.5±0.17 cm (min 0.25; max 0.82) and the thickness of the triceps on the opposite side to the brain injury was 0.38±0.14 cm (min 0.2; max 0.8) with p=0.028, statistically significant, while the degree of echogenicity according to the Modified Heckmatt scale on the side of the brain injury was 2.5 [2.0; 3.0] (min 2.0; max 4.0), and on the opposite side — 3.0 [3.0; 4.0] (min 2.0; max 4.0), p=0.01, statistically significant. The thickness of the brachioradialis on the side of the brain injury was 0.59±0.15 cm (min 0.39; max 0.92), on the opposite side — 0.50±0.17 cm (min 0.25; max 0.86), p=0.06, statistically significant; while the degree of echogenicity was 2.0 [2.0; 3.0] (min 1.0; max 4.0) on the side of the brain injury and on the opposite side to the brain injury — 2.5 [2.0; 4.0] (min 2.0; max 4.0), p=0.03, statistically significant. Pronounced statistically significant differences were also obtained in the thickness of the rectus femoris muscle (p=0.06) and its echogenicity (p=0.017). In comparing these indicators with the muscles of healthy volunteers for all indicated parameters p<0.05, in most cases p=0.000001, statistically significant. Using computed tomography of the lumbar spine, a decrease in the cross-sectional area of the psoas muscle was revealed. The following values were obtained from the patients: psoas muscle cross-sectional area on the right side: 7.66±2.72 cm²  (min 3.84; max 12.95), psoas muscle cross-sectional area on the left side: 7.85±2.64 cm²  (min 3.7; max 12.6), Skeletal Muscle Index: 53.33±15.34 (min 28; max 81).
Conclusion Diagnostic ultrasound methods to assess sarcopenia in patients after severe brain injuries have confirmed their effectiveness. In the present study, this method received a pronounced correlation with radiological techniques to identify patients affected by sarcopenia. We obtained statistically significant differences in the group of volunteers and patients, and some parameters differed by more than 2 times, which indicates the presence of severe sarcopenia in this group of patients.

BACKGROUND Irregularity and mosaicity in the depth of the burn skin lesion limits the possibility of performing precision tangential necrectomy in the early stages after injury. Non-radical necrectomy leads to lysis of transplanted autodermal grafts. This problem is most relevant in the treatment of victims with extensive dermal and deep burns.
AIM OF STUDY To study the relationship between microcirculation parameters in the burn wound and the outcomes of autodermal transplantation after tangential necrectomy.
MATERIAL AND METHODS 74 patients with extensive skin burns included in the study underwent tangential necrectomy with simultaneous autodermal transplantation. All operations were performed early (up to 10 days) after injury before the formation of the demarcation line. Microcirculation parameters in the burn wound were studied by laser Doppler flowmetry before and after tangential necrectomy and in healthy skin of the same anatomical region.
RESULTS Statistically significant differences (p≤0.001) were found between microcirculation parameters in the center of the burn wound after tangential necrectomy and in the control area of intact skin. In this case, the results of autodermal transplantation were characterized by a skin engraftment rate of up to 60–70%. In those areas of the body where there were no differences between microcirculation parameters , the engraftment exceeded 80%.
CONCLUSION Assessment of microcirculation by laser Doppler flowmetry can be a reliable method for diagnosing the condition and viability of a burn wound after tangential excision of dead tissues in the early stages of treatment — before the formation of a demarcation line. The diagnostic technique is easy to use, but requires skills in working with a flowmeter, unification of such devices and methods for their use in the practice of surgical treatment of burns.

Abstract Right hemicolectomy with the formation of primary ileotransverse anastomosis is the method of choice in emergency surgery as well.
Aim of the study Comparative evaluation of the results of urgent right hemicolectomy with the formation of a primary anastomosis and without the formation of a primary anastomosis at the first stage of surgical intervention.
Material and methods A retrospective cohort study included patients who underwent emergency right hemicolectomy. The database includes: demographic indicators, comorbidity, data on the general condition of the patient, the time of the surgical intervention, the time from the onset of the disease to hospitalization, laboratory parameters. The patients were divided into two groups. Group 1 included patients in whom the operation was performed with the formation of a primary anastomosis, which was applied manually; group 2 consisted of patients who underwent surgery with the formation of a separate double-barrel stoma and the 2nd stage of surgical intervention was planned. The Clavien–Dindo classification was used to assess postoperative complications.
Results The results of 112 right hemicolectomies performed according to emergency indications were analyzed. Group 1 (operations with the formation of a primary anastomosis) included 87 patients (77.7%); group 2 (n=25) included 18 patients (16.1%) who underwent two-stage operations: stage 1 — right hemicolectomy without primary anastomosis formation, stage 2 — restorative intervention, anastomosis formation; and 7 patients (6.2%), in whom the operation ended with the formation of a separate double-barreled intestinal stoma. In the 1st group, the patients were younger: the average age was 61 years versus 73 years in the 2nd group (p=0.021). Patients of the 2nd group were in a more serious condition upon admission (ASA III–IV) and had a higher comorbidity. The average duration of surgical intervention was 162±10.2 minutes in group 1 and 110±9.5 minutes in group 2 (p=0.038). Group 2 had more serious complications (IIIB–IVB according to Clavien–Dindo) compared to group 1 (p=0.001). The main factors that had a statistically significant impact on the risk of postoperative complications were: severe degree of comorbidity (odds ratio — OR 3.1; 95% confidence interval — CI 1.4–6.3; p=0.002), severe general condition upon admission — ASA III–IV (OR 2.7; 95% CI 1.2–7.4; p=0.01), anemia — Hb<90 g/l (OR 1.7; 95% CI 1.5– 6.1; Odd=0.004), time between the onset of the disease and admission more than 12 hours (OR 2.1; 95% CI 0.9–6.8; p=0.03), time to perform the operation (OR 2 .05, 95% CI 1.38–8.1, p=0.033).
Conclusion The presence of chronic diseases characterized by systemic lesions and comorbidity determines the choice of a primary treatment strategy for perforation, bleeding, acute mesenteric ischemia, where it is advisable to perform a right hemicolectomy without primary anastomosis, followed by recovery stage.

Aim of study To evaluate the immediate and medium-term (6 months) results of BVS Absorb biodegradable stents implantation in patients with chronic forms of coronary artery disease, taking into account their location in coronary vessels, morphological nature of the initial lesion of the coronary arteries and technical features of implantation as well.
Material and methods From June 2014 to December 2015, 199 biodegradable stents (Absorb Bioresorbable Vascular Scaffold — BVS; Abbott Vascular, CA, USA) were routinely installed in 114 patients treated at the Interventional Cardioangiology Center of I.M. Sechenov First Moscow State Medical University. The analysis of the obtained results was carried out depending on the type of coronary artery lesion, the length and diameter of the stents, and the details of the angioplasty procedure. To characterize the type of coronary artery lesion, the ACC/AHA classification was used: type A vascular lesion (95 coronary segments); type B vascular disease (68 coronary segments); type C vascular disease (36 coronary segments). The ultimate goal of the study was to study the frequency of thrombosis and in-stent stenosis of stented coronary arteries.
Results The immediate success of scaffold implantation was 98.2%. Complications in the early hospital period were 1.8% (acute stent thrombosis was observed in 2 cases on the first day after implantation). In the medium-term (~6 months), 102 patients (89.5%) with 172 previously placed stents underwent comparison selective coronary angiography. The rest of the patients with stents refused to undergo coronary angiography due to good health and underwent a telephone survey.
The satisfactory result of stenting in the medium-term (6 months) was a completely preserved lumen of the stented area, or with less than 50% stenosis of this place, which comprised 94.3%. The frequency of in-stent stenosis (narrowing of the lumen of the stented area by 50% or more) was 5.7%. In-stent stenosis was detected in groups of patients with type B and C lesions, respectively, in 4% and 1.7%. In the group with type A coronary artery disease, in-stent stenosis was not detected in the medium-term period.
Conclusion The immediate and medium-term results of stenting with the biodegradable BVS Absorb stent were successful in the vast majority of cases (94.3%). Only in 2 cases (1.8%), acute thrombosis of the stent was observed immediately after stenting.

Background The main method for preventing thrombotic complications in patients with coronavirus infection is anticoagulant therapy (ACT). However, its use is not always possible, in particular in patients with bleeding. The only method of prevention in this case is elastic compression (EC) of the lower extremities.
Aim of study To evaluate the effectiveness of lower extremity EC for the prevention of venous thromboembolic complications (VTEC) in patients with a new coronavirus infection.
Material and methods The study was approved by the local Ethics Committee of the Ryazan State Medical University of the Ministry of Health of Russian Federation and registered on the ClinicalTrials.gov platform (identifier NCT05143567). The study included 69 patients without prophylactic compression (Group 1) and 65 patients who used prophylactic compression stockings (Group 2). The patients were treated in the covid hospital from July to November 2021. All patients had verified coronavirus infection, they took ACT and underwent ultrasound duplex scanning of the veins of the lower extremities upon admission, in the intensive care unit and upon discharge. We assessed the frequency of venous thromboembolic complications (VTEC), hemorrhagic complications, and mortality. To assess the severity of bleeding, the classification of the Committee of the International Society on Thrombosis and Haemostasis (ISTH) was used.
Results In patients without prophylactic compression (Group 1) there were 7 VTEC cases (10.14%); deep vein thrombosis (DVT) — 4 (5.8%), pulmonary embolism (PE) — 3 (4.3%). All 6 cases (8.7%) with PE were fatal. It was noted that 2 cases of PE (2.8%) were verified upon autopsy, and not clinically. In patients of the 2nd group with the use of elastic compression, the overall incidence of VTEC was only one case (1.6%). When analyzing the frequency of bleeding in the 1st group, there was one pulmonary bleeding (1.4%), in the 2nd group there was also one case of intense intermuscular hematoma (1.6%). Significant bleeding was observed in one patient (1.4%) of the 1st group, and in 3 (4.8%) cases of the 2nd group. The minor bleeding was observed in 11 patients (15.9%) of the 1st group, and in 8 (12.7%) patients of the 2nd group. The mortality during hospitalization was 11 (15.9%) cases in patients of the 1st group (without EC) and 7 (11.1%) in patients of the 2nd group (with EC) (p=0.419).
Conclusions The mortality in patients with coronavirus infection without compression therapy is higher than in patients with compression stockings (p=0.419). Patients wearing compression stockings in the hospital had a low incidence of VTEC (1.6% of cases in group 2 versus 10.14% of cases in group 1, p=0.039). The study groups had the same frequency of bleeding (group 1 — one case (1.4%), group 2 — one case (1.6%). The use of preventive compression at the inpatient stage of treatment of a new coronavirus infection makes it possible to prevent VTEC in patients with bleeding when anticoagulant therapy is not possible.

Abstract The article presents results of a multicenter, randomized, double-blind, placebo-controlled clinical trial on the efficacy and safety of inosine glycylcysteinyl-glutamate disodium (Molixan®) in the treatment of acute severe ethanol poisoning.
The aim of the study To evaluate the efficacy and safety of inosine glycyl-cysteinyl-glutamate disodium in a new dosage regimen in the treatment of severe ethanol poisoning.
Material and Methods The material of the study is the data of 133 patients with severe ethanol poisoning. Inclusion criteria: age from 18 to 60 years, 1–2 coma stage (Glasgow-Pittsburgh coma scale of 14–27), ethanol in the blood of more than 2.5%. The patients were randomized into 2 groups: the Study Drug group (SD group) — 67 patients who, in addition to the standard therapy, were injected with the study drug - inosine glycyl-cysteinyl-glutamate disodium in a dose of 3.0 mg/kg; and the Placebo group — 66 patients who, in addition to the standard therapy, were injected with 0.9% sodium chloride solution in a dose of 3.0 mg/kg. Comparative intergroup and intragroup analyses were carried out according to the main clinical, laboratory parameters and EEG monitoring data.
Results The study showed a positive effect of the study drug — a reduction in the coma period was noted (from 137 (75; 180) minutes to 78 (50; 155) minutes (p<0.001)), higher values of the Glasgow-Pittsburgh scale were recorded after 3 and 6 hours from the start of the therapy (p<0.01), a reduction in the time of formation of EEG awakening patterns in patients with delta coma activity from 192.2 (161.9; 222.5) minutes to 112.5 (97.6; 127.6) minutes (p<0.001), a decrease in heart rate (p<0.02), a decrease in the number of complaints of weakness and dizziness (p<0.005), in patients with high ALT levels, the frequency of development and severity of tremor decreased (p<0.01). The hepatoprotective effect of the drug was revealed, it was manifested by a decrease in ALT (p<0.001), AST (p<0.001) and direct bilirubin (p<0.03); the effect of the drug on metabolic processes — a decrease in lactate (p<0.02), an increase in BE-ECF (p<0.01), glucose (p<0.01) 3 hours after drug administration, an increase in potassium after 24 hours (p<0.03). The analysis of safety data did not reveal statistically significant differences between the treatment groups, no serious adverse events were recorded.
Conclusion The study demonstrated the efficacy and safety of inosine glycyl-cysteinyl-glutamate disodium (Molixan®) in the treatment of severe ethanol poisoning in a single dose of 3.0 mg/kg administered intravenously

The problem of restoring the motor pattern in patients with facial nerve palsy (FNP) is a complex medical problem. The basis of effective treatment and rehabilitation in this case is not only scientifically based medical recommendations, but the selection of methods of exercise therapy is of great importance, which implies the active participation of the patient in the therapy process. Currently, there are no generally accepted documents aimed at raising awareness about FNP and teaching the patient specific methods of rehabilitation. In the N.V. Sklifosovsky Research Institute for Emergency Medicine patients with FNP have been receiving medical care under the Face Clinic program for more than a year. In addition to the algorithm of diagnostic and therapeutic measures, patients are trained starting from the first appointment. Specialists of the Research Institute developed a six-step rehabilitation education program for patients with FNP, aimed at lifestyle correction, prevention of complications, and also directly at teaching methods of daily physical impact (rehabilitation) at home. Patients receive information about individual risks of development and methods for self-identification of certain complications of the disease. The project specialists prepared training materials. The system of assistance within the framework of the Face Clinic program provides the patient with the opportunity to receive feedback from the attending physician quickly. The program is based on the concepts of functional systems (according to P.K. Anokhin), the concept of N.A. Bernstein on the physiology of activity and the principles of the school of rehabilitation training and neuropsychological rehabilitation (A.R. Luria–L.S. Tsvetkova).

Stereotactic radiosurgery is a modern treatment modality for patients with intracranial metastases. However, it has long been acknowledged that radiosurgery of large tumors results in limited efficacy and increased rate of complications. There have been still debates on the need of combination of radiosurgery and open surgery for intracranial metastases and the sequence of these modalities. The next question is about the proper treatment for metastases that could not be resected. There is a paucity of data describing the relationship between radiosurgical options and radiobiological effect, in particular how prescribed dose, type of fractionation, volume of irradiated tumor and morphology of cancer are related. The information presented in this review highlights opportunities of stereotactic radiosurgery for treatment of patients with large intracranial metastases in combination with open surgery as well as a stand-alone method when using hypofractionation regimen.

This literature review is devoted to the problem of spontaneous liver ruptures in pregnant women. Its goal was to raise awareness among physicians as one of the methods to improve the early diagnosis of the disease, as well as to consider the role of the hepatological surgeon in the surgical treatment of rare obstetric diseases. The main links of the pathogenesis of liver ruptures were considered, the problem of high maternal and perinatal mortality was disclosed. Based on the literature data, the most optimal obstetric and surgical treatment and diagnostic tactics for managing pregnant women with spontaneous liver ruptures were determined.

The leading positions in terms of frequency, severity of the course and high mortality belong to infectious forms of acute pancreatitis. However, not all pathophysiological mechanisms of the development of this disorder have been studied. Given that immune responses are an integral part of the pathogenesis of pancreatitis, it is extremely important to study the relationship between the mechanisms of inflammation and activation of the immune response. This review will discuss the role of various populations of innate immune cells, including macrophages, neutrophils, dendritic and mast cells, and regulatory immune cells in the pathogenesis of gland tissue destruction and the relationship between immune responses and systemic inflammatory response syndrome. Targeting innate immune cell populations and metabolite signaling pathways in acute pancreatitis may lead to a broader and ultimately more effective redirection of the treatment program towards disease resolution and improved clinical outcomes.

Background The frequency of cryptogenic stroke (CS) is about 30% of all cases of ischemic stroke (IS). Patients with CS represent a heterogeneous group of patients and require an individualized approach to antithrombotic therapy for secondary prevention. The frequency of development of repeated acute cerebrovascular events in patients with CS is 4.5% per year, which exceeds this indicator in patients with an established pathogenetic variant of IS. Until recently, the dominant point of view, suggesting that the main cause of CS is paroxysmal atrial fibrillation (AF) and for the secondary prevention of IS in this cohort of patients, oral anticoagulants may be more effective than antiplatelet agents, has not been confirmed. The causal relationship between IS and AF is currently not fully understood. Apparently, AF serves as a marker of atrial cardiomyopathy, which is the direct cause of IS.
Aim of study Raising the awareness of neurologists about the causes, pathogenetic mechanisms of development and methods for diagnosing IS in patients with atrial cardiomyopathy.
Material and methods To achieve this aim, the results of scientific studies on atrial cardiomyopathy as a risk factor for CS were analyzed. The literature search was carried out in electronic search systems Scopus, eLibrary, PubMed using the keywords: ischemic stroke, cryptogenic stroke, atrial cardiomyopathy, pathogenesis of ischemic stroke. Scientific articles published between 1957 and 2021 were selected to be analyzed. And 36% of the analyzed papers on the topic of CS were published no more than 5 years ago.
Conclusion The cumulative evidence suggests that atrial fibrillation is not the only cause of embolic events in patients with evidence of atrial dysfunction. Atrial cardiomyopathy can be the cause of thromboembolic syndrome and cryptogenic stroke, even in the absence of atrial fibrillation, therefore, the latter should be considered as a common manifestation of the underlying atrial cardiomyopathy. Since the majority of cardiac thrombi in patients with atrial fibrillation originate in the left atrium, it is likely that patients with atrial cardiomyopathy and cryptogenic stroke represent a group of patients who may be indicated for anticoagulant therapy as a secondary prevention of ischemic stroke and systemic embolism. However, this hypothesis needs to be confirmed.

The pandemic of the novel coronavirus infection (COVID-19) has had an enormous impact on the education system. Higher educational institutions were forced to adapt to remote interaction with students and urgently switch to online learning. Currently, there are many educational platforms, among which one of the leading is the Californian Coursera service. In 2020, Kazan Federal University developed and published the first Coursera course on first aid — “Staying Alive! First Aid in Emergency”. The purpose of the current study was to demonstrate the course results in one calendar year. We analyzed the general indicators of Coursera — the global online learning platform. We reviewed the course indicators from December 21, 2020, to December 21, 2021. The research assesses the advantages and disadvantages of using online courses in the medical education system. It was concluded that massive open online courses effectively teach theoretical disciplines. In case of implementation of applied courses, it is necessary to search and introduce new approaches for practical skill development.

The course of severe coronavirus infection is accompanied by hypercoagulability with micro- and macroangiopathy, which may be the cause of arterial and venous thrombosis. In March, 2021 — May 2021, 14 patients with COVID-19 and acute ischemia of the lower extremities due to arterial thrombosis were operated in the Infectious Pavilion of the N.V. Sklifosovsky Research Institute for Emergency Medicine. Retrombosis in the immediate postoperative period developed in 4 patients (26.7%). The amputation at the level of the thigh was performed in 2 patients (13.3%) due to the development of ischemic gangrene. The mortality was 71.4%, 10 patients died. The main cause of death was the progression of multiple organ failure in the course of severe viral-bacterial pneumonia. The best results were obtained with a combination of open surgery and endovascular technique, performing hybrid operations.

We report a case of successful treatment of a patient with multiple stab and cut wounds of chest and abdomen which resulted in the injuries of venous coronary sinus and abdominal organs. Surgical wound revision in the antishock unit, priorities of surgical accesses (thoracotomy and laparotomy) allowed timely cure the injury. A key feature of our case report is a coronary sinus trauma.
Coronary sinus suturing in a closed heart surgery is technically difficult. It has the potential hazard due to the proximity of coronary arteries, stricture and thrombosis of the coronary sinus after suturing. Extracorporeal circulation and cardioplegia ensure reliable hemostasis and intact patency of the coronary sinus. Clinical case of suturing coronary sinus injury in a closed heart surgery proves the reasonable use of autopericardial strengthening strips and local hemostatic made of regenerated cellulose.

Percutaneous interventions for the purpose of sanation of cavities of pancreatogenic destruction can be one of the ways to treat pancreatic necrosis. This leads to a rapid cleansing of the cavities and is an objective method of monitoring the stages of treatment. We present a case of successful treatment of infected pancreatic necrosis using minimally invasive, percutaneous, X-ray endovascular methods. Procedures performed: superselective embolization of the upper and lower pancreaticoduodenal arteries, embolization of the gastroduodenal artery, embolization of the splenic artery, selective catheterization and embolization of the left gastric artery with microemboli and coils.

We report a case of postoperative pain relief in a patient after total cement arthroplasty of the right hip joint in the early postoperative period. Pericapsular nerve group block (PENG-block) of the hip joint was suggested to provide adequate pain relief and reduce the risk of postoperative complications. This clinical case shows an example of effective pain relief in a patient in the early postoperative period after reconstructive plastic restoration of the right hip joint, performed for a fracture of the femoral neck. Severe pain syndrome, restriction of movements, forced position and volume of surgical intervention are risk factors for the development of thromboembolic complications. According to the literature, the incidence of thromboembolic complications after total cemented hip arthroplasty varies from 9.3 to 20.7%. Our observation indicates that pericapsular block of the hip joint is an effective method of pain relief in the early postoperative period after total hip replacement.

The study is dedicated to N.V. Sklifosovsky and aims to expand and preserve the historical memory of this outstanding scientist, surgeon and physiologist, teacher and public figure on the example of newly discovered and rare facts related to the life and creative achievements of N.V. Sklifosovsky.
As a result of our research, two new historical documents from the Poltava Regional Archive were introduced into scientific circulation for the first time: N.V. Sklifosovsky’s letters to his daughter Olga Sklifosovskaya-Yakovleva and his closest student, surgeon Mikhail P. Yakovlev, shedding light on their family relationships and providing facts about the construction and opening of the “Clinical town” on the Maiden’s Field (Devichye Pole). It follows from this correspondence that N.V. Sklifosovsky took an active part in its foundation. This side of his activity has not been reflected in the scientific and historical literature.
Other rare facts include a photograph of the coat of arms of Privy Councilor Nikolai Sklifosovsky, time of its approval and explanations for the symbols depicted on it. There are also photographs of the oil painting by A. Sidorov located in Vinnitsa which depicts the arrival of N.V. Sklifosovsky to Vishnya estate of the great Russian surgeon N.I. Pirogov, as well as the gravestone of N.V. Sklifosovsky’s son Vladimir with the first bars of P.I. Tchaikovsky.
For the first time in the scientific literature, photographs of a large, full-length portrait of N.V. Sklifosovsky by the artist E.V. Kudryavtsev (1947), as well as N.V. Sklifosovsky’s great-grandson Leon Birkett by this portrait (1975).
Thus, this article makes a new contribution to the history of Russian medicine.