females, alas, the only means of their salvation is not a horn, but rather a hoof, flight in general is a rumor. in the fallow deer, it is sharpened so much that it is able to smell the human spirit. or any other outsider at a distance of 300 steps, and if necessary, to escape with ease, jumping over even a two-meter barrier is not enough who is able to compete with them in a race. in the morning, when the air has not warmed up yet, you can see the most beautiful sight of the females, along with their cigarettes, went out for breakfast. such groupings can sometimes reach several dozen individuals, this is without taking into account the negligent. dad, the greater part of the year they prefer to stay apart in the company of their own kind of bachelors, they will join the herds only in the fall, when they will need to contemplate the most beautiful ritual of tournament fights and the subsequent ones. deer wedding. now, in the hot season, they cool off and

rest on leshkas, which are arranged in blue bushes. thus, not only escaping from the high plus, but also from the annoying bent. lanei gong in belarus falls on autumn this period lasts 2.5 month. and although by virtue of its southern origin. this is the latest date of its beginning among the deer nature, made sure that the cubs become independent, as soon as possible after 8 months. usually this happens in may , the long-awaited baby is born, during the first 10 days the female grazes not far from the strong, securely hidden in tall grass. quite weak. he quickly grows stronger on nutritious mother's milk and tries to walk already on the second day. a a few days later does it confidently for four months. he will gain weight while breastfeeding over time. switching to foods

inherent in adults as the first complementary foods, grass, which the baby begins to pinch on his own, then the mother will show. which leaves are the most delicious. only at 6 months the baby will refuse the breast of his mother, the calf will keep until the next calving. in 2016 , an attempt was made to release 300 individuals of the european fallow deer into the wild in northern belarus. how long the herd will last in the wild, and whether it will be able to adapt, remains unknown. keep your fingers crossed? hello

, the health program is on air, the quality of our life depends on it, but in the modern world it is not enough to know about it , you need to work on it with your advice in our studio experienced experts share. today, in the program of endovascular technologies for surgical treatment of atherosclerosis of the lower extremities, it is possible to insert tools to crush the plaque with a high-pressure balloon and install a metal structure at the site of the lesion, which will maintain the artery in an expanded state. to whom recommend adaptive physical education, even if we have people with the same dia. they come often , they have a program that differs depending

on the state of health, from physical fitness, from concomitant diseases, eating cucumber. not just water. and, by the way, saying columbus took on his long voyages, cucumbers, both fresh and pickled, so that his sailors would not kiss these and other topics in our program, we are starting. damage to the vessels of the legs is a very dangerous condition accompanied by various complications. as in time to diagnose the disease and treat it in detail, answer all questions in detail by an x-ray devascular surgeon. yan igorevich kirnozhitsky. hello we are glad to see you

in our studio. hello, today we will talk about obliterating atherosclerosis of the lower extremities, a very serious and severe diagnosis, because there are a lot of complications. that's what this disease is. and in general, why suddenly the vessels of the lower extremities begin to suffer. this is a systemic disease that affects all vessels in the human body. this is a multifactorial disease; there are a lot of factors that cause the development of atherosclerosis. this is an increase in the level of lipids in the blood. hyperemia due to an increase in total cholesterol due to an increase in bad cholesterol, the so-called low-density lymphoproteins. this is an increase in blood sugar levels against the background of sugar. vow a sedentary lifestyle. and, of course, bad habits of 90% of the department of our

vascular surgery department, these are courses. patients who smoke and have a fairly long history of chronic stress also an important reason for the development of diseases, but what i have listed are factors that we can somehow correct, there are factors that we do not correct and cannot influence them in any way. well, of course , age patients over 60 get sick much more often than a younger patient . this is gender, because according to some studies, men get sick many times more often than women. the ratio is four to one and the third factor is genetic predisposition. uh, if the patient has relatives with atherosclerosis with a heart attack, well that is, as a result of atherosclerotic disease, then with some degree of probability it can be

assumed that this patient also has a high risk of getting sick and having some complications. well, probably also arterial hypertension, right? this is also a disease that, let's say, hits the blood vessels like that. and if there are any other concomitant predisposing factors and genetic breakdowns, then here, you know, all the bad things converge in one place. yes, on the wall of vessels or ndetels and begin to form and grow those very harmful and bad atherosclerotic plaques. now let's take a closer look at the factors that we have listed, and they cause damage to the internal e, the layer of the wall of the artery, the so -called insima, which lines the artery from the inside, this month there is a focus of inflammation and in this place there are lumps of water-soluble lipids, that is, cholesterol, uh, attach to the wall of the artery in this

way, a small atherosclerographic plaque begins to form, which grows over the years, increases in size and causes narrowing of the artery. well, in the future , and complete clogging under the lumen. the most interesting thing is that lipids are not bad, as we think correctly. this, when there are a lot of them, there is a violation, not bad, but normal. our bodies need them for their own purposes, right for cell renewal and energy. so it turns out, as there is a defect in lipids, they enter there. there they become alien. this is where the immune system speaks. hey, something is wrong here, special cells come there, which start again and deal with these lipids. and then there is such a process of the dark demon, invisible, i would like you to pay attention, there are plaques that we always see on angiography, growing into the gaps. actually, clogging. and there are plaques that do not grow into the lumen of the vessel, but grow into the wall of the vessel, yes, and this is not always visible, but they are

the most critical because of them, heart attacks, and because of them , strokes. because of them, thrombosis. the so-called eccentric plaques, or flat. uh, a fairly large percentage of the total volume let's say atherosclerotic plaques in the vessels and indeed in the angelographic room, performing standard angiography in one projection. we may not see it. this is a flat plaque that is in two dimensions. it may not be visible. yes, in this case, of course, the methods of computed angiography help us. we will be able to make 3d models after the computed tomography. vessels of the patient and already on this 3d model you can clearly see that yes, this is a plaque, it is. it really slows down blood flow, either speeds up. it prevents blood flow below the level of vascular damage. but let's tell you in more detail. so obliterating

atherosclerosis of the lower extremities or enderteria, even so it is also called, because the process of inflammation will not stop. yes, that is, the process of vascular damage has already been started. but what are the symptoms telling about the symptoms of the disease. well, it probably matters to remember, after all, the stages of the development of the disease. there are only three of them, these are the three main stages. the first stage is an asymptotic section, when the patient does not have any symptoms, but the arteries are already affected by atherosclerotic plaques. it's just that this defeat is the initial stage. it still does not clog the lumen to some critical values ​​and the patient does not experience. no, you can’t call it healthy in this situation any discomfort. here, it is possible to tell, it is not surveyed correctly? well poorly examined most likely, the second stage of the disease is already intermittent claudication. this is a phenomenon that occurs in a patient during physical exertion when walking,

ranging from sore muscles. uh, if we're talking about the legs, it is most often the calf muscles. with higher lesions of the pelvic artery , all the femoral gluteal muscles can hurt, but the main symptom is intermittent claudication. the patient cannot walk a certain distance at a calm, unhurried pace. he has to stop to stand to rest for 2-3 minutes, in order for the pain in the muscles to go away, feelings of at least a feeling of cold in the legs in the feet, unification of the hairline , thinning of the skin, pale from the integument, these are quite significant symptoms, which are also you need to pay attention to the third stage. this is already a stage of critical critical limb ischemia. these are already severe skin lesions - these are necrosis. these are trophic ulcers. well,

gangrene, as the final steel for the disease, that is, people who bring themselves to the third stage of obliterating enderritis. it's just such here are those applicants for the fact that they were to lose their limbs, right because unfortunately at this stage. when already, as you said, there is gangrene, when already with necrotic changes due to the fact that the supply of important arteries is blocked, yes, that is, unfortunately, nothing can be done, of course, at an early stage it was possible to do it right at an early stage. yes, please tell us what modern diagnostic technologies exist today according to american european studies, but people. in the age group over 60 years, 20% of the asymptomatic course of acquiring atherosclerosis of these twenty percent, only two 2% complain of some kind of complaint, but this is not an intermittent mole after talking with the patient. it can be suspected that the second is

blood chemistry. increasing cholesterol levels. the atherogenic index is absolutely correct and the level of glucose in the blood is important at the moment. in common world practice, research is to determine the ankle brachial index measurement from historical ankle pressure on the arteries of the ankle and on the arteries of the shoulder. here, let's explain why yes , because many now, uh, viewers do not understand, and when the vessels are affected by atherosclerosis, the speed of the pulse wave, after all, it accelerates correctly elasticity is lost. these are simple laws of physics. that is, if we had a large diameter pipe, and it passes. i rub a pipe of small diameter, but it is natural that we say the speed of the pressure. first, it stands the same, then, naturally, in a pipe of a narrow diameter. the speed of fluid movement will be much higher than e in a vessel of larger diameter, therefore, of course, we see, first of all, the acceleration of blood flow

according to the ultrasound data of the leg artery. eh, this is clearly visible, and this is also quite such an informative informative method. ct scan. mri allows you to see eccentric plaques, flat ones and the degree of damage, the extent of the lesion, but still the gold standard is angeography . in hospital. you need to come to the operating room. yes, that is, a study is being done under intravenous anesthesia, so, of course, it is not entirely convenient, but it is very informative and allows you to sometimes solve big problems. you are doing an angiography. you see the place of narrowing is critical there 70-75%. here is your algorithm through the

catheter that we have already installed. a special metal conductor is brought into the service area. well, it functions as a rail for delivery from heavy artillery, let's say, tools that really treat. a special balloon is brought into the service area through this conductor. which is inflated to atmospheres of the order of nine ten, atmospheres, and a plaque, crushed, it is pressed against the walls of the artery. after that was. this is the so -called balloon angioplasty, then the balloon is removed to this place, a stand is started along the same rails and the stand is implanted. and there are different ones, some balloons are inflated, some straighten themselves. please show so that everyone understands how hmm jewelry work is. it's, uh, an alloy of nickel and titanium. in some

cases, tantalum material is absolutely not as priced as hypoallergenic. this stand is exactly in my hands. it's the expanding walls i.e. the manufacturer. i gave it a certain diameter, a certain length and packed it into a special system. the delivery system diameter of the delivery system is several times smaller than the diameter of the stent itself. approaching the affected area, we simply lower the cover with it, pull off the cover of the delivery system and the stand straightens itself out. yes , completely fulfilling the contours of the artery from the inside, the material turns out to be such that it remains there, yes, the endley grows into it, and it already performs. actually the function of such a foundation or frame, that is, in this critical place is already there will be no contraction. but if we talk about the situation, when you came in and looked, and there is the most terrible atherosclerosis. yes, even with calcifications, that is, the vessel wall is so

fragile that it is not something like a balloon? yes, even this net cannot be touched, because it will crumble, then. i understand you're already doing bypass surgery. we are now dividing the leg arteries into several floors. uh, the first floor is the pelvic arteries. that is, inside the pelvic location, then the next floor. these are the arteries of the thigh, third floor. these are the arteries below the level of the knee joint. well, at the moment, modern angiosurgery is already highlighting the fourth floor. these are the arteries below the level of the ankle joint in our hospital. we try to fit. uh, in such a way as to simultaneously perform a reconstructive recanalization operation on all floors on which we can intervene, if a person has a narrowing in the pelvic arteries, then a stand will be installed there, if

there is a lesion on the hip plus everything, as you described calcified massive and extended defeat, of course, it is better to perform a bypass operation in this place more efficiently, that is, take a synthetic tube or the patient's own vein and bypass the affected area, and already below the carousel of the knee joint. x-ray is connected again , supravascular surgery balloon angioplasty. uh, stenting is rarely done below the knee joint. well, in some situations, too, perhaps the most important stage is done on the foot. that is, we must open the arterial arches, in order for there to be a good exchange, good uh, outflow blood into the venous bed, if it is not. this will all end badly. that's how these operations have become so. here are streaming and

outpatient operations, if we are talking about balloons , angioplasty, or arterial prostration . after 12 hours, a person can get up and go, but still, let's scare everyone. let's highlight. how defeat. arteries are dangerously trophic ulcers, uh, which cause terrible discomfort, this is a patient, uh, with chronic constant pain in the area of ​​​​the trophic ulcer, which reduces quality of life standard of living drops significantly. well, as a result, specifically amputation from amputation is not just an operation. that is, we made a putiller for him, amputated his leg. the patient healed well, everything was fine, the person was discharged home. it doesn't end there. after all, international studies show that the frequency of surviving after amputation after 5 years is

50%, that is, 40% of patients under 5 years of age die after amputation. we have already spoken about industry. this is a systemic disease and development. cardiovascular complications it is very the high risk just goes off scale colossal, so, of course, this disease is very serious and to be treated. she needs to be taken very seriously. what is the prevention of atherosclerosis and how can the development of atherosclerosis of the lower extremities be prevented, including everything simply everything is based on risk factors, that is, the rejection of bad habits. this is smoking alcohol. the control of blood sugar levels is important, that is, for patients with diabetes mellitus, there are certain values ​​​​of the range of indicators that you need

try to stick to. control of the level of cholesterol and lipids in the blood, an active lifestyle , walking, cycling, if the physical condition allows, exercise therapy is very effective in terms of helping the patient, that is, physiotherapy increases the walking distance with intermittent information , increases the speed and against the background of this patient. self-esteem rises. he believes that, in principle, he is recovering, that is, in 4 weeks the effect is very colossal good , then in a timely manner, of course, an appeal to the doctor if there are any symptoms. refusal of fast food seems to me the trouble of the modern age, 21. and, of course, a good mood, because you are doctors of an angel surgeons. say that a very large number of diseases associated with

damage to the cardiovascular system is associated with stress and we are damaging the effects of stress hormones. this should not be forgotten. thank you so much for saving lives every day not only thanks to modern technologies, but also thanks to your professionalism. let me remind you that today our guest was an angel surgeon, head of the angiographic room of the tenth city clinical hospital. yan igorevich games nazhidsky do not switch, we continue to take care of your health. stay with us. this is a rubric of food with a plus sign. the quality of our life depends on what we eat victoria today there are a lot of cucumbers on our table from the point of view of nutrition, why cucumbers are still useful. it seems to me, nikolay, that we are so used to the fact that this vegetable is always on our

table that we hardly even think about how important and useful it is. it is for our body, by the way, and cucumber is a relative of pumpkin, zucchini and melon. and this is the same vegetable that we eat unripe. so a cucumber is a vegetable, but any person will say that, in fact, it may even be useless vegetables, because almost 90% of it consists of water, nikolai more. i would say that cucumbers are about 95% water, but this does not mean at all that there is no benefit from it, but not at all, because in dietology and in our nutrition, but, unfortunately, or fortunately no, no magic. there are no magical products, there are no useless products, a and our

health is determined by how much our food consists of natural healthy a and good products, and if 80% of our diet is represented by natural products, then most likely our body will have resources for in order to cope with twenty percent of some errors of some junk food. so if 95% is water, then as i understand it, five percent is just the same. perfect favor yes so here, let's talk about these five percent, the basis that gives that minimum calorie content from a cucumber is carbohydrates. uh, that's about three or four carbs. e grams of cucumber and we can say that a cucumber - this is truly a product of almost negative calorie content, because our body will spend much more energy on digesting this product. rather than midnight exactly than they will receive from this very cucumber.

oh, but also in cucumber. ah, there is a sufficient amount of fiber, relative to the mass of the cucumber. she doesn't seem right and a lot is up to 1 g per 100 g of fiber, but nevertheless, given that there are still many dissolved vitamins and minerals. we will get a cucumber from a cucumber, it can definitely be considered a superfood. and by the way, the main nutrients are sosre. it is in the peel and directly under the peel, therefore, by cutting the peel, we practically deprive the cucumber of all the most useful and important. now, if we talk about vitamins and minerals, i understand that there is a standard set for all vegetables of vitamin c and vitamin b and vitamin. e some antioxidants right zinc selenium e, calcium is a little bit of phosphorus, manganese, yes, that's right, but i would like, but separately, but hmm, pay attention to the fact that there is a lot

of vitamin c a in the cucumber and, by the way, saying columbus took it on his long voyages, cucumbers are like fresh , and salted so that his sailors do not have scurvy, but a disease associated with vitamin deficiency vitamin c and cucumbers - this is an excellent source of potassium of the very element that is important for the functioning of the heart for the normal functioning of blood vessels. and for excellent absorption of calcium in bones. well, now is the time for victoria to turn to kirill karmanov and ask what our wonderful chef will surprise us with today. well, for example, uh, what i know, you can eat a cucumber raw, you can eat it with honey, you can eat it with salt, you can pickle it. uh, you can ferment, then prepare a salad with other vegetables. here kirill and you today than us? surprise nikolai today i will cook a traditional old vietnamese

dish called name or as many of us call it uh, rice paper springle fresh red fish vegetables fruit in the form of cucumber and avocado. so cyril, you continue, but we are victoria let's go back to the cucumber, and the green color. there are antioxidants in there. after all, it is also very beneficial for our body. true, but remember that fruits and vegetables are the main source of antioxidants for our body. dioxidants are substances that prevent peroxidation, thereby preventing premature cell aging. a and the more varied colors of vegetables in our diet, the more different antioxidants. we will get. but the cucumber is such a green component. and by the way, it is very important to treat cucumber in the same way as people who take anti- clotting drugs treat greens. and this does not mean that green vegetables are not allowed - this means that you need to

determine some daily norm of green vegetables, or greens every day and stick to it while choosing, and doses of anticoagulants to drugs. well, if we talk about cucumbers in terms of combination with other products, here, if in nutrition some rules, about which we should know, but in general a combination of products. this direction is rather such folk dietology. a-a, a-la, you can’t, uh, herring ah-ah with milk, when we cook fish or herring, we add cream there correctly for weight. in fact, intolerance to certain combinations usually has a very individual character. that is, and i, for example, may have an individual intolerance, if i eat a cucumber along with cottage cheese, and you have nikolai, for example,

they will perfectly combine and digest these two components together with our cucumbers. e with cow's milk and melody remember in the village. it was such a super dish from grandparents, so it is very important to focus on your own feelings here. if somewhere you feel that some kind of discomfort has appeared. keep track of what you ate the day before and try to replace this one next time. something else and keep track, maybe next time. you will already feel better cucumbers with red fish. this is how this combination is right for our gastrointestinal tract is an excellent combination, in general, it seems to me, again, if there is no individual intolerance, then cucumbers are combined with absolutely all products. and we remember that a in order for our food to be balanced during the day. there must be proteins, that is, fish, and there must be vegetables, that is, cucumbers, so the combination

is wonderful. ok then. now. let's still remember that cucumber is 95% of liquids, but there is potassium, which also has a nasty effect, but nevertheless, we will decide to whom cucumbers in large quantities will still be contraindicated. yes , and an excellent question, nikolai, but i want to note that a we often cut off the dark one. cucumber chick because it is usually bitter it is bitter due to a special substance called cucurbitacin. this is a substance that gives bitterness, but it is not at all harmful. but just the same, it contributes to a better functioning of the gastrointestinal tract, in principle, cucumber juice contributes to activation. e, all the glands of the gastrointestinal tract and an increase in the acidity of gastric juice, and on the one hand hand it can increase appetite improve

digestion, but do you have chronic diseases, and the gastrointestinal tract in the herd of exacerbation, such as exacerbation of ulcers exacerbation of gastritis exacerbation of duodenal ulcers, and exacerbation of e hmm various inflammatory bowel diseases , then this in the case of fresh cucumbers , you should limit and again focus on your own tolerance. cyril, i see the dish is ready, we will try it together with sesame sauce, well victoria please. rate this dish. i would like to remember, and it is a very interesting fact that it is the women of the eastern countries of eurasia and japan and china that are considered the most slender due to the presence of a large amount of fish in their diet, so dear girls, dear

women, i highly recommend eating fish. at least twice a week to stock up, and a field of unsaturated fatty acids, and we also have fish and cream cheese in our saucer, vegetables are represented by avocado and cucumber, and carbohydrates are presented in a very small quantity in the form of rice paper. the dishes are balanced very healthy and i'm sure very tasty. it seems to me that this is food with a plus sign, eat right and be healthy.

we set off on an expedition through the patches of our country , leading for people that ashana is grabbing our indiscriminate asparagus. we won’t be slaughtered, raw foodists sideways or is it true that if all the wart’s fears are reduced to leave shima beach and here’s the soap of the grandfather’s garden, that you decided to prick his miners near the new york area, we’ll

investigate her history and meat images zahavali and back curling beard. dozhin's image. holyly supporting a sheaf of fullness of god's beard. that's what the news said. it's a bad day, stubble. let's give the second tradition a new life, but my heart, that you wash our thoughts , look, a project on pi. on our tv channel these people do everything to make our life comfortable. the work of the scientific road network, we try to achieve evenness of the surface, so that our drivers and not only our guests can comfortably move along our street , imagine what would happen if during there would be no electricity for a day, any emergency situation is eliminated within two hours, no more they work.