Επιστημονικά άρθρα
RISK FACTORS AND INCIDENCE OF DEEP VEIN THROMBOSIS IN PATIENTS DIAGNOSED WITH COVID-19

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru

The 2019 Coronavirus Infection Pandemic (COVID-19) has caused major morbidity and mortality worldwide. In particular, thromboembolic complications have become a major threat to patients with COVID-19. Deep vein thrombosis is a common condition in patients with 2019 coronavirus infection (COVID-19). However, the risk factors and incidence of deep vein thrombosis remain unknown. In this work, we sought to assess the incidence and risk factors for deep vein thrombosis. The study included all patients diagnosed with COVID-19 who were in the COVID-19 wards. All patients underwent duplex examination of the lower extremity veins. Demographic information and clinical characteristics were collected retrospectively. A comparison between the groups with and without deep vein thrombosis was studied. The incidence of venous thrombosis was observed in 43 (38,73%) patients. The proximal form of deep vein thrombosis of the lower extremities was observed in 12 (27,90%) and the distal form in 31 (72,09%) hospitalized patients. This study demonstrates that coronavirus infection 2019 (COVID-19) is associated with a high incidence of deep vein thrombosis.

Keywords: deep vein thrombosis, COVID-19, risk factors, d-dimer, deep veins
EVALUATION OF THE EFFECTIVENESS OF THE USE OF COMPRESSION
KNITWEAR FOR THE PREVENTION AND TREATMENT OF OCCUPATIONAL
LOWER LIMB EDEMA IN HEALTHY INDIVIDUALS

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru
Relevance: occupational swelling of the lower extremities is an important factor in impaired quality of life. The aim of this study was to assess the efficacy of compression knitwear of different compression levels for prolonged sitting, standing and combined work for the prevention and treatment of occupational swelling of the lower extremities in healthy subjects during the work shift. Materials and Methods: A study of fifty-eight volunteers without venous diseases was performed. The volume of both lower extremities was measured at the beginning of the morning and at the end of the workday. Compression stockings were worn for 5 days at 18-21 mmHg and 23-32 mmHg, respectively. Volumes were measured every day at the same time at 7:00 am and 7:00 pm, and climatic conditions were the same for the 5 days. Participants were given a questionnaire about symptoms, quality of life, and
comorbidities. The difference between the leg volume measured at the end of the shift and the volume in the morning was called «occupational edema.» Results and discussion: professional swelling was reduced in both legs after wearing 18 to 21 mmHg compression stockings, while 23 to 32 mmHg compression stockings relieved swelling. Conclusions: compression stockings are effective for preventing occupational leg edema, directly improving quality of life and work.

Keywords: compression knitwear, occupational edema, lower extremities, edema, quality of life.
CLINICAL FEATURES AND INTEGRATED APPROACH TO THE TREATMENT OF TROPHIC ULCERS

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru
Venous trophic ulcers are a complex and serious problem that affects 1–2% of the world’s elderly population over the age of 65, and their incidence is constantly increasing. Venous ulcers account for the majority of all chronic ulcers of the lower extremities. The population with an increased risk of venous ulcers is the elderly. Venous trophic ulcers have a significant negative impact on patients’ quality of life. The problem of venous ulcers remains topical in modern medicine. The study established the clinical features of venous ulcers. The causes of venous ulceration are not fully studied but the risk factors leading to this pathology are such diseases as varicose veins of the lower limbs and post-thrombotic disease (PTB). The total duration of venous ulcerous defects in patients ranges from
2 months to 10 years. In the majority of patients the healing time of trophic ulcers is about two to four months, in some patients they do not heal for years. Relapses during conservative treatment are possible and observed. The area of the ulcerous defects varies among the patients and varies from 1 cm2 to more than 14 cm2. Localization of trophic ulcers varies, but they are mainly presented on the anterior surface of the tibia. The article presents the results of combined treatment methods of trophic ulcers of venous etiology.

Keywords: venous trophic ulcer, treatment, wound cove, chronic venous insufficiency, varicose veins post-thrombotic syndrome
PHLEBOLOGY IN ANCIENT GREECE AND BYZANTIUM

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru
The article describes in detail the history and development of knowledge about venous pathology in ancient Greece and Byzantium. Lower limb vein disease is one of the most common health problems in the world have been trying to solve for centuries. In ancient Greek medical literature, there are many reports of vein diseases and especially varicose veins. This fact allows us to understand that the veins were an instrument that was particularly worried by doctors of Antiquity and Byzantium, and that varicose veins were one of the main problems of that time, and therefore doctors used different methods and approaches in the treatment of vein diseases. The contribution of healers of antiquity to the emergence and development of modern phlebology is reflected. This disease was tried to be cured by prominent figures of antiquity and the Byzantine Empire in the field of medicine, such as Hippocrates,
Galen, Oribasius, Paul Aeginsky and others. The discoveries in the field of anatomy and pathology of the venous system are described in detail. Conservative methods are described, as well as the first vein surgeries, precursors of modern surgical interventions that were unique for that time and are still relevant today.

Keywords: history, phlebology, ancient Greece, Byzantium, varicose veins, outstanding physicians of antiquity, history of treatment of varicose veins
LOWER LIMB TELANGIECTASIA IN WOMEN IN THE AGE GROUP 20–65 YEARS:
PREVALENCE, RISK FACTORS AND FEATURES OF THE CLINICAL COURSE

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru
Teleangiectasia, vascular sprockets or meshes, are small dilated small blood vessels of skin smaller than
1.0 mm in diameter. They can occur anywhere throughout the body, but most often mainly in the lower extremities. The reasons for their development are currently unknown. However, there are risk factors such as family history, pregnancy, taking contraception and high body weight. Telangiectasia of the lower limbs is a very common pathology in women. The average age is 35 years. The frequency of telangiectasia increases in the 30-40 year old age group. Most patients are asymptomatic and sometimes the only reason to go to a doctor is a cosmetic defect, which is an aesthetic problem but not a health hazard. Only a small number of patients report symptoms such as a feeling of
heaviness and a sense of being crucified and swollen lower limbs. Telangiectasiasis is common in both lower limbs, mainly as followson the left. Telangiectasia localisation – the hamstring area, the middle third of the outer thigh surface, and the front and outer part of the lower leg.

Keywords: teleangiectasia, asterisks, vascular meshes, risk factors, prevalence
Method for stopping bleeding from sacral plexus veins

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru
Bleeding, its consequences, methods of first aid and treatment have been studied since the inception of medicine, a number of issues of this problem are still not completely solved, which often limits the possibilities of surgical treatment and can cause the death of the patient from acute anemia during extensive and severe surgical interventions.
Although significant progress has been achieved in modern angiology, nevertheless, the results of surgical interventions for wounds of the aorta and its main branches and large veins have not significantly changed over the last 20 years. This can be explained by the severity of trauma, accompanied by massive blood loss and the rapid development of irreversible organ dysfunctions caused by it. Moreover, not all specialized centers, let alone general surgical hospitals, have experience in surgical interventions for particularly severe vascular trauma.....
Method of stopping bleeding from large arterial vessels of the bottom of gastric and duodenal ulcer

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru
The problem of gastrointestinal bleeding has been one of the most pressing issues in modern medicine for many decades. Acute gastrointestinal bleeding (GERB) may be a complication of a number of diseases, according to different authors their frequency is 50-150 cases per 100 thousand people per year (Babak O.Y. 2007). For example, in the USA PBMC cause more than 300 thousand hospitalizations annually (Longstreth GF, Freitelberg S., 1995). Men have UGCC twice as often as women. Depending on the severity of clinical manifestations, bleeding can be overt or occult. Given the differences concerning diagnostic and treatment tactics, it is accepted to distinguish upper and lower gastrointestinal (GI) bleeding. Bleeding from the upper gastrointestinal tract accounts for about 90% of all cases of gastrointestinal bleeding. Over the past few years a persistently high mortality of these bleedings - at 8-10%, postoperative mortality ranged from 12 to 35%. With recurrent bleeding, postoperative complications and mortality increase by half to two times. The proportion of patients with recurrent acute gastroduodenal ulcer bleeding among all those who died from bleeding is 60-80%. Bleeding from lower parts of gastrointestinal tract is less common and makes up about 10-20% of all bleeding from gastrointestinal tract, somewhat more common in men and is a pathology of mostly elderly patients. In almost 70% of patients early bleeding recurrence occurs within the next 12-48 hours. All this should be taken into account when determining the timing of surgical treatment........
Lymphadenectomy in surgical treatment of left-sided colon cancer in patients over 60

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru
Colorectal cancer is one of the most common malignant tumors in civilized, economically developed countries. In the structure of oncological morbidity in the world, colorectal cancer currently ranks fourth. Annually in the world there are about 800 thousand patients with colorectal cancer, more than half of them (440 thousand) die. In Russia the population indices of colorectal cancer incidence in 1999 are the following: colorectal cancer - men 12.4 and women 10.7 per 100 thousand inhabitants; rectal cancer - men 11.8 and women 8.0 per 100 thousand inhabitants. In surgical treatment of colorectal cancer lymphadenectomies are used to increase the radicality of the intervention.......
Organ-preserving surgery in the treatment of ulcerative colitis and Crohn's disease

Aletzanidis Nikos
Kuban Medical Institute, Krasnodar, e-mail: nikos.grs@mail.ru
Ulcerative colitis and Crohn's disease are quite common in the West and in the United States. The incidence of ulcerative colitis in Russia is 10 per 100000 population - acute cases, and 40-117 per 100000 annually with a chronic course, and Crohn's disease incidence is 2-4 per 100000 population - acute cases and 40-50 per 100000 population - with a chronic course. The disease starts gradually and develops over 5 years. During the period of 2003-2008 the disease was progressively developed in the Federal State Institution "Russian Centers for Epidemiology and Control". At the Federal State Institution "Russian Center for Phthoracic Surgery of Roszdrav" 37 patients with non-specific ulcerative colitis and 14 patients with Crohn's disease (72,55 and 27,45 respectively) were under treatment.
In patients with ulcerative colitis, the predominant age at the first peak was 12-30 years, at the second peak about 50 years, and at the third peak after 50 years....