During the COVID-19 pandemic, the incidence of acute mesenteric ischemia (AMI) increased to 10.9 per 100 000 population. Here we discuss causes, symptoms, current diagnosis and treatment of AMI.Frequently, such patients suffer from stenosis or occlusion of superior mesenteric artery accompanied by coronary artery disease, chronic heart failure, or chronic brain ischaemia. The main clinical symptom is constant abdominal pain which is sharp in case of mesenteric artery thrombosis or dull if thrombosis is restricted to the branch of superior or inferior mesenteric veins. Conventionally, the diagnosis of AMI is verified by multislice computed tomography angiography and contrast-enhanced multislice computed tomography. Timely diagnosis with emergency surgery reduces mortality from 90% to 30-50%. The best treatment outcomes are observed after early revascularizations and minimally invasive endovascular interventions.

A multimodal approach to prevent the cognitive impairment in patients with cardiovascular diseases combines the control of major cardiovascular risk factors, cognitive recovery, and physical training. Here we discuss current advances in computer-aided (also called computer-assisted) cognitive recovery to prevent the cognitive impairment in patients with cardiovascular diseases, as this approach has a number of advantages in comparison with the conventional tools. We describe a cognitive training software to stimulate perception, attention, short-term memory, executive functions, speech, and thinking. Baseline neurological examination and neuropsychological testing are mandatory before starting a cognitive recovery. A particular attention is paid to the high prevalence of cognitive impairment in cardiac surgery patients. Around half of them have pre-operative cognitive impairments, and almost half of the patients suffer from a postoperative cognitive dysfunction. Among the brain regions, prefrontal and parietal cortex and hippocampus are the most sensitive to circulatory disorders as they are supplied by the terminal branches of the cerebral arteries. Therefore, cognitive rehabilitation of cardiac surgery patients should include computer-aided cognitive training tasks activating these brain regions.

Aim. To evaluate the incidence and causes of peptic ulcers of the gastrojejunal anastomosis to develop the corresponding preventive measures.Materials and Methods. We retrospectively analysed the case histories of the patients with peptic ulcer who have been admitted to our surgical unit during 1981-1996 and 2007-2021. A total of 62 patients with peptic ulcers of the anastomosis who underwent Billroth II resection were examined radiographically, endoscopically, and intraoperatively, including proteolysis and acidity measurements.Results. While the number of gastric operations has been reduced by 86%, the number of treated peptic anastomotic ulcers decreased by only 20%. The main cause of peptic ulcers was the high acidity and proteolytic activity of the gastric stump. In 22 out of 28 fully examined patients, duodenal ulcer was treated by hemiresection. The incidence of peptic ulcers of gastrojejunal anastomosis in Kemerovo in 2021 was 0.9 per 100,000 population, with 3.7 Billroth II surgeries per 100,000 population. A resection without vagotomy and insufficient acid reduction are the main causes of peptic ulcers of the gastrointestinal anastomosis, especially duodenal ulcers.Conclusion. A significant decrease in the number of distal resections of the stomach according to Billroth II over the past 25 years is not accompanied by a similar decline in the number of hospitalized patients with peptic ulcers of the gastrojejunal anastomosis.