Introduction. Peripheral artery disease (PAD) encompasses a group of syndromes characterized by arterial obstruction leading to limb ischemia. The prevalence of PAD, as determined by a reduced ankle­brachial index (ABI), is 2.5% in individuals aged 50–59 years and increases to 14.5% in those over 70 years. Among patients with diagnosed vascular disease in other locations, the prevalence may reach 26–40.5%. Alongside surgical revascularization, the cornerstone of treatment is antithrombotic therapy (ATT) utilizing various pharmacological agents. Optimal treatment regimens depend on disease stage, clinical presentation, and comorbid conditions, thus requiring individualized approaches. Currently, there are no comprehensive national clinical guidelines for antithrombotic therapy in PAD. Objective. The study aims to systematize key antithrombotic treatment strategies and develop optimized therapeutic algorithms for clinical practice. Materials and methods. A literature search was conducted in PubMed, Scopus, and Web of Science databases. An evidence­based analysis of studies on antithrombotic therapy for peripheral arterial diseases was performed. Results and discussion. The findings evaluate the efficacy of antithrombotic therapy, both as monotherapy and in combination regimens. Clinical guidelines and studies on the management of patients with varying clinical manifestations of PAD are reviewed. Conclusion. Based on this analysis, treatment algorithms for peripheral artery diseases are proposed.

Relevance. An increase in the number of cases of acute ischaemic cerebral circulatory disorders causes high mortality and a decrease in quality of life, as well as the risk of recurrent strokes, which requires active surgical tactics caused by atherosclerosis of carotid arteries especially in patients with concomitant cardiovascular pathologies. Objective. Estimation of the results of carotid endarterectomy in patients with concomitant cardiovascular pathology using various anesthetic techniques. Materials and methods. GALA trial, TROPICAR (Troponin In Carotid Revascularization), data from the American College of Surgeons National Surgical Quality Improvement Program, A. S. Hussain et al. (2017), J. Liu et al. (2014). An extensive search was also conducted in the electronic databases PubMed and Cochrane Systematic Reviews for the queries “anesthesia”, “general anesthesia versus local anesthesia”, “regional anesthesia”, “complications of regional anesthesia” in combination with the keywords “carotid endarterectomy” or “CEA”. Results and conclusions. Clinical studies, meta­analyses, and registry data have not revealed a significant statistical difference in the performance of carotid endarterectomy with different methods of anesthesia. The decision on the choice of the method is made by the vascular surgeon together with the anesthesiologist based on the capabilities of the medical institution.

Relevance. Currently, primary percutaneous coronary intervention (PCI) in myocardial infarction is the first choice option in the strategy of myocardial revascularization, improving the patient's status and survival prognosis [8]. However, in a significant proportion of patients who have received PCI, adequate myocardial reperfusion cannot be achieved due to the development of the no­reflow (NR) phenomenon [2].
The aim of the study was to analyze a group of patients who received PCI for ST­elevation myocardial infarction and subsequently developed the no­reflow phenomenon, as well as to identify possible laboratory and clinical predictors in comparison with the control group.
Materials and methods. 2 groups of patients were formed. Group 1 included 20 patients who developed the no­reflow phenomenon after successful PCI; group 2 included 20 patients who had adequate myocardial perfusion after PCI (normalization of the ST segment, blood pressure, heart rate, reduction of pain, angiographic picture TIMI­III). The predoperational parameters of serum troponin I, systolic blood pressure (SBP), age, degree of heart failure according to Killip, time from the onset of pain syndrome to the moment of reperfusion were analyzed.
Results. The group in which the no­reflow phenomenon was observed had a higher average age, lower SBP at admission, higher troponin I levels; and the prevalence of type 2 diabetes was higher in the no­reflow group. The time before reperfusion was longer in the no­reflow group. The proportion of patients with Killip class 3 and 4 was 25% in the no­reflow group versus 10% in the control group.
Conclusions. Analysis of the differences between the groups suggests that clinical and laboratory parameters may influence the likelihood of developing no­reflow syndrome.

Introduction. Cardiovascular diseases remain one of the leading causes of premature mortality and loss of working capacity worldwide. Following acute coronary events and cardiac surgical interventions, patients require not only pharmacological therapy but also comprehensive medical rehabilitation. However, traditional rehabilitation programs are often based on standardized protocols and insufficiently consider individual clinical, psycho­emotional, and social characteristics of patients. In this context, the implementation of personalized medical rehabilitation programs becomes particularly relevant, as they may improve clinical outcomes and enhance the efficiency of healthcare resource utilization.
Objective. To evaluate the economic effectiveness of implementing a personalized medical rehabilitation program for patients with cardiovascular diseases compared with the standard rehabilitation model.
Materials and methods. The study was conducted at Mariinsky Hospital and included 350 patients who had experienced acute coronary syndrome or undergone cardiac surgery. Patients were divided into two comparable groups: a standard rehabilitation group (n=175) and a personalized rehabilitation group (n=175). The personalized program involved the development of an individual rehabilitation pathway with the participation of a multidisciplinary team and the use of digital monitoring tools. Effectiveness was assessed based on direct medical costs, rehospitalization rates, exercise tolerance (six­minute walk test), and quality of life according to the EQ­5D and SF­36 questionnaires during a 12­month follow­up period. Economic effectiveness was evaluated using cost­effectiveness analysis and calculation of the incremental cost­effectiveness ratio (ICER, cost per QALY).
Results. The average cost of the standard rehabilitation program was 62,000 rubles per patient, whereas the personalized program required 84,000 rubles. The additional cost amounted to 22,000 rubles per patient. At the same time, the implementation of personalized rehabilitation was associated with a 32% reduction in rehospitalization rates, a 27% increase in the six­minute walk distance, and an 18% improvement in quality­of­life indicators. Economic analysis showed that the cost­effectiveness ratio reached 440,000 rubles per additional quality­adjusted life year (QALY), which meets the accepted cost­effectiveness thresholds for the healthcare system of the Russian Federation.
Conclusion. Personalized medical rehabilitation programs for patients with cardiovascular diseases provide greater improvements in functional status and quality of life compared with standard approaches. Despite higher initial costs, the personalized rehabilitation model demonstrates high economic efficiency due to reduced rehospitalization rates and improved clinical outcomes. The obtained results confirm the feasibility of implementing personalized rehabilitation programs in the healthcare system.

Export of medical services has become one of the drivers of economic development in Russia's regions in the modern world. This article provides an analysis of the export of medical services in the Chelyabinsk region from 2019 to 2024. It also examines the institutional mechanism for the development of the industry, particularly the activities of the Regional Coordinating Center (RCC), which was established in 2022 on the basis of the South­Urals State Medical University. The article describes the role of the RCC as an important tool for promoting the region's medical services in the international market and presents the successful experiences of other regions in developing medical service exports. The model of interaction between the RCC and the Ministry of Health, medical and public organizations is also presented. However, despite the established organizational framework, the issue of financing and staffing for the RCC remains unresolved. 

The aim. Was to develop clinical and anamnestic and clinical and laboratory models for predicting the risk of placental recurrence.
Materials and methods. A retrospective study involved 64 women with placental presentation (5 of them with PAS) and 30 with normal placental placement; a prospective (cross­sectional) study involved 42 patients with placental presentation (17 of them with PAS) and 28 women with correct placentation. The total sample size was 164 women: 58 pregnant women with a normal placenta position (group 1, control); 84 with placenta previa without its ingrowth (group 2); 22 with a placenta accretion spectrum (group 3). The features of the family and personal somatic and obstetric­gynecological anamnesis, the course of pregnancy and the outcomes of childbirth were studied. In pregnant women who participated in the prospective study, the level of ghrelin in the blood serum (mmol/ml) was determined by competitive enzyme immunoassay using the “ELISA ghrelin detection kit” (GHRL) (“Cloud­Clone Corp.”, China). The diagnosis of “placenta accreta” was confirmed histologically after childbirth. The multiple logistic regression method was used to evaluate the independent relationship of factors with placental growth (1/0). The probability of occurrence of the event P(G) and 95% confidence interval (95% CI) were calculated for each of the factors. Beta standardized coefficients (β) and their standard errors (SE) were used to study the contribution of each marker to event prediction. 
Results and conclusions. The developed clinical and anamnestic model of PAS prognosis allows us to identify a high­risk group of this pathology with a specificity of 94.0%, sensitivity of 68.2% and accuracy of 88.7%. The clinical and laboratory model for predicting the risk of placental recurrence, which takes into account clinical and anamnestic determinants and the serum biomarker of ghrelin, has a specificity of 96.0%, sensitivity of 94.1% and accuracy of 95.1%.

The Order of the Government of the Russian Federation dated 05.07.2025 No. 1805­r “On the strategic direction in the field of digital transformation of the science and higher education industry until 2030” outlines the lag in the use of data analytics based on artificial intelligence, despite the overall 45% level of digitalization, and defines artificial intelligence as a key tool for the transition to data­based management and personalization of learning [4]. Therefore, the purpose of the study was to examine the current practices of using artificial intelligence in educational organizations and the attitude of teachers towards them.
The study was conducted in 4 educational organizations in Chelyabinsk in 2025, involving 105 teachers who completed a questionnaire developed by the authors. The results showed that 60% of the teachers surveyed already use artificial intelligence in their professional activities, 44.8% use the technology occasionally, 15.2% use it regularly, and 78.1% report a reduction in preparation time for classes, while 75.2% report an increase in student motivation. At the same time, 71.4% of teachers record a decrease in critical thinking among students, and 84.8% note problems of visual fatigue.
A set of measures to optimize the use of artificial intelligence in educational organizations is proposed.