Relevance. Reconstructive operations on limb arteries are one of the most important areas of vascular surgery (>30,000 interventions in Russia, 2024). Antithrombotic therapy is critically important for thrombosis prevention in early and late postoperative periods, yet unified clinical guidelines for its optimization considering surgery type, graft material, and comorbidities are lacking. Aim: to analyze contemporary data on the efficacy and safety of various antithrombotic therapy regimens following reconstructive operations on limb arteries. Materials and methods. Analysis of scientific literature data was performed. Results from 15 key studies (including 7 randomized controlled trials, 2 meta-analyses, 1 Cochrane review, large registries, and clinical guidelines) focusing on antithrombotic therapy after reconstructive limb artery operations were systematized. Analysis addressed efficacy/safety of different regimens (antiplatelets, anticoagulants, combination therapy) based on intervention type (open/endovascular), graft material (autologous vein / synthetic prosthesis), and reconstruction site. Results. Endovascular interventions: long-term single antiplatelet therapy should be prescribed post-endovascular intervention. Dual antiplatelet therapy is recommended only as a short course (1 month) and may be extended for high rethrombosis risk. Open surgery: dual antiplatelet therapy is justified after open vascular reconstructions with elevated thrombosis/occlusion risk. Aspirin combined with rivaroxaban (2.5 mg BID) reduces graft occlusion risk. Adding warfarin to prolonged therapy may offer benefits (especially for high graft thrombosis risk) but increases hemorrhagic complications. Conclusion. Antithrombotic therapy after reconstructive vascular surgery is individualized. It depends on: surgical approach (open/endovascular), vascular lesion topography, graft material (autologous vein / synthetic prosthesis), and comorbidities. Determining therapy intensity/duration requires balancing treatment benefits against hemorrhagic complication risks.

Abstract. Objective of the study: development of a biocompatible, absorbable cava clip for the prevention of pulmonary embolism (PE) in patients with thrombosis of the iliocaval segment, which not only creates a barrier to thromboemboli while maintaining blood flow, but also undergoes resorption within a predetermined timeframe once the risk of PE has passed. Materials and methods. The production of the designed «Absorbable cava clips» was carried out through preliminary 3D modeling, followed by 3D printing. The experimental study was conducted in the Department of Experimental Surgery at the Republican Research Center of Emergency Medicine. The study included the following laboratory animals: 49 rats (25 white Vistar rats and 24 outbred rats), 6 outbred mice, and 3 guinea pigs. The purpose of the experiment was to perform a morphological study of the caudal vein and surrounding tissues after implantation of the absorbable clip, to determine the resorption period, and to evaluate toxicological safety indicators. Results. As a result of the study, a model of an «absorbable cava clip» made of PGLA was developed, which meets the requirements of toxicological safety. Morphological studies demonstrated signs of clip degradation on day 30 of the experiment, with complete resorption observed by day 60. Comparison of microscopic changes identified in the five experimental groups clearly demonstrated the course of a typical inflammatory process in the surrounding tissues and vessel wall, replacement of the inflammatory zone with connective tissue, and the absence of mural thrombosis or structural changes of the endothelium.

Abstract. Business planning has now become widespread in the field of healthcare. It is used not only in private, but also in public medical organizations. Business planning helps to link the guidelines of budgetary activities of medical organizations with market guidelines in the future. A business plan considers a wide range of different situations and helps you choose the most optimal development option. The purpose of the study: to systematize the existing modern methodological aspects of business planning in the field of healthcare, and to identify the distinctive features of business planning for medical organizations in comparison with manufacturing and commercial companies in the Russian business environment. The research method is: the study was conducted on the basis of content analysis and comparative analysis of methodological features of business planning in the healthcare system, which determine the need and effectiveness of this management tool. The results obtained can be used as methodological recommendations for more active application of business planning in the activities of public health organizations, taking into account the specifics of the healthcare industry.

Abstract. Objective: this paper presents a clinical case of successful treatment of a patient with a cervical pregnancy (CP) after in vitro fertilization using organ-preserving technologies. Case report. This paper presents the case report of a 36-year-old female patient admitted to a gynecological hospital with a diagnosis of progressive CP induced by in vitro fertilization (IVF) using intracytoplasmic sperm injection (ICSI). The patient's complaints, medical history, and general physical and genital parameters are presented in detail. The dynamics of pelvic ultrasound (US) results with color Doppler mapping (CDM) and laboratory parameters, including serum β-hCG levels, are presented. The examination resulted in the following clinical diagnosis «Progressive CP of 6 weeks, induced by IVF + ICSI. Primary infertility of tubal origin. Chronic endometritis». A decision was made to perform vascular selective uterine artery embolization (UAE), followed by monitoring serum β-hCG levels and ultrasound data over time. On the fifth day after UAE, the fertilized egg was removed under cervicoscopy, and the implantation site was electrocoagulated using a hysteroresectoscope. Total blood loss was 10 ml. The products of conception were sent for histological examination, which confirmed the clinical diagnosis. After a follow-up ultrasound and determination of serum β-hCG levels on the eighth day, the patient was discharged to the outpatient clinic in satisfactory condition under the supervision of a gynaecologist. The specific features of this clinical observation are: the occurrence of CP after the use of assisted reproductive technologies (ART), timely diagnosis, and the successful use of modern treatment technologies (UAE and hysteroresectoscopy), which allow the preservation of the woman's reproductive function.

The aim of the study was to evaluate the factors influencing the pulse wave propagation rate (CPV) and to determine its significance as an early marker of vascular aging and cardiovascular risk.

Materials and methods. The study included 139 people of two age groups (20–30 and 50–60 years old), who were assessed for anthropometric parameters, blood pressure, functional characteristics of elastic arteries and elastic modulus. Statistical data processing included descriptive statistical methods, nonparametric criteria for comparing independent groups, and Spearman's correlation analysis. The results demonstrated a significant increase in CPV with age, as well as its higher values in men at a young age. Participants with arterial hypertension were characterized by increased CPV and increased modulus of elasticity, which indicates the development of structural and functional remodeling of the arterial wall. Overweight individuals in the middle-aged cohort had higher CPV scores compared to participants with normal body weight, while the effect of BMI at a young age was less pronounced. The smoking status did not demonstrate a statistically significant effect. The results of the demonstration modeling showed that the inclusion of hemodynamic and metabolic parameters in addition to demographic indicators improves the discriminative ability of the predictive model when identifying individuals with a clinically significant increase in CPV. The orientation of all the identified associations is consistent with the data of modern population studies and emphasizes the practical importance of assessing CPV as a noninvasive marker of early vascular disorders. Conclusion. The study confirms that CPV is a sensitive integral indicator of the arterial wall condition and can be recommended for use in clinical practice for the purpose of early stratification of cardiovascular risk and diagnosis of premature vascular aging.

Abstract. The aim of the study is to find out the attitude of first- and fifth-year medical students to marriage, family and having children, to establish whether their life position on this issue corresponds to the general trend of the country's youth and to develop measures to correct the emerging crisis. Materials and methods. The study involved 576 students using the anonymous survey method according to the questionnaire we created, consisting of 40 questions reflecting the details of attention to the form of marriage, the choice of a life partner, intergenerational relationships in the family. Results. It was revealed that there is an insufficiently formed idea of the family. Childbearing is expected by the majority, but the number of children and the time of their appearance are determined not so much by the organic need for parenthood, as by the degree of financial security. Knowledge of what age is most favorable for having children is in conflict with plans for the timing of entering into family relationships. The study confirms the stability of the trend of narrowing the ideas of young people about responsibility for the strength of the family. Continuation of the family line as the most important function of marriage is recognized by a minority. Conclusion. The rationale for the need to strengthen the ability of medical education to influence the demographic beliefs and aspirations of student youth is provided.