Relevance. Thoracic endovascular aortic repair (TEVAR) is rapidly evolving, with expanding clinical indications. These include Stanford type B aortic dissection, aortic arch pathology (non-A, non-B type) managed with endovascular and hybrid techniques (including debranching), as well as aneurysms, penetrating atherosclerotic ulcers, and thoracic aortic ruptures.
Objective. To investigate the mechanical properties of different types of stent grafts and to assess their potential clinical implications.
Materials and Methods. The study included two types of thoracic endografts available on the available commercially medical device market, differing by graft material: polytetrafluoroethylene (PTFE) and polyester. Considering that oversizing (i.e., selecting an endograft diameter exceeding that of the native vessel) is used during procedural planning to ensure sealing, an experimental assessment of the degree of radial compression of stent grafts was performed using a mechanical press. The force required to deform the devices was evaluated as an indirect indicator of radial force on the aortic wall.
Results. Minimal radial force values were observed in the proximal uncovered segments of the endografts, followed by an increase toward the distal direction within the covered portion. The radial force values were recorded in the distal segments of the stent graft with monofilament polyester covering, whereas the lowest values were observed in the proximal region of the PTFE-covered device.
Conclusion. Radial load in the covered segments of the stent graft exceeds that in the uncovered proximal portion. This finding supports the need to position the proximal part of the endograft within the least diseased segment of the aorta to reduce the risk of complications.

Background. The relevance of the topic is determined by the prevalence of the pathology, the objectives of improving quality of life in patients after inguinal hernioplasty, and the insufficient amount and low level of the evidence of the available data on the studied problem.
Objective: to study the condition of blood flow through the vessels of the spermatic cord in patients with inguinal hernias before and after transabdominal preperitoneal hernioplasty (TAPP).
Design and methods: The speed indicators of testicular blood flow were studied in 83 men with inguinal hernias before surgery and on the day 7 after TAPP. The speed indicators of arterial and venous blood flow were determined using the Toshiba aplio 500 device. The EHS classification was used, and the patients were divided into subgroups based on the method of endoprosthesis fixation. The first subgroup included 27 (32.5 %) patients with endoprosthesis fixation using the original method. The second group included 30 (36.1 %) patients with endoprosthesis fixation using an endostapler. The third subgroup consisted of 26 (31.3 %) patients who did not undergo endoprosthesis fixation. The data were processed using nonparametric statistical methods.
Results: Before the operation, arterial and venous blood flow disorders were detected in the vessels of the spermatic cord, which were most pronounced in recurrent hernias with a hernia opening diameter of more than 3 cm. Seven days after the operation, the increase in arterial linear blood flow was 56.4 %, and the increase in volumetric blood flow was 53.7 %. This was accompanied by a significant increase in venous outflow velocities. The best results were obtained in the subgroup with the original method of endoprosthesis fixation.
Conclusion: Recurrent inguinal hernias with a hernia ring diameter of more than 3 cm cause the most pronounced disorders of arterial and venous blood flow through the vessels of the spermatic cord. TAPP leads to a rapid and reliable restoration of the speed indicators of testicular blood flow to normal values, which improvemes in the reproductive health and quality of life of patients in the long-term postoperative period.

Introduction. Postoperative peritoneal adhesion remains a common complication. The lack of uniform, pathogenetically justified scoring scales that consider the timing of the experiment hinders the comparability of results.
Aim. To develop a universal scoring scale for the adhesive process based on an analysis of existing scales.
Materials and methods. Eight scales (Mazuji, Leach, Atta, adhe/ADHE, Moreno, Binda, Shurygina et al., Akentyeva et al.) were analyzed. Criteria included vascularization, ability to separate, macroscopic structure, area, number, length, bowel deformation, and adhesion type.
Results (proposed scale). A scale for the early period (days 3–5) includes fibrin deposits, peritoneal layer involvement, and affected area (%). For the late period (≥14 days), criteria include structure (membranous/loose/dense), separation ability (traction/blunt/sharp), area, and histological type (membranous/stringy).
Conclusion. The proposed scoring scale standardizes adhesion assessment in experiments, accounts for pathogenesis and timing, and is applicable to any laboratory animal.

Оbesity treatments goal is to reduce body weight to a level that maximizes possible reduction in health risks and improves the course of obesity–related diseases. There are many ways to achieve this: from debilitating physical activity (FA) and strict calorie restriction to metabolic (bariatric) surgery. After bariatric surgery, the patient’s body weight gradually decreases to 40–50 % within 1–2 years due to a forced reduction in amount of food consumed. However, any surgical intervention is fraught with the risk of complications. The frequency of adverse events depends on the qualifications and experience of the surgeon, and the patient’s adherence to recommendations regarding, in particular, physical training and diet. Complications of bariatric surgery: bleeding, anastomosis divergence, stenosis, infections and inflammation, emetic syndrome, constipation, dumping syndrome, vitamin and micronutrient deficiencies. At the same time, it remembered that micronutrient deficiencies are often initially present in most obese patients against the background of an excess intake of simple carbohydrates and other dietary errors. All of the above complications can significantly impair the quality of life (QOL). Patients who have undergone bariatric surgery can improve their quality of life, exercise tolerance, and other cardiometabolic parameters through physical activity. Clinical guidelines for physical rehabilitation (FR) of patients after BO have not developed. The purpose of this review is to analyze the effectiveness and safety of existing physical rehabilitation programs for obese patients who have undergone bariatric surgery based on the results of clinical trials.

With each decade, the incidence of ischemic stroke among young people is increasing. After conducting a literature review, it was found that generally accepted causes of ischemic stroke relate more to people over the age of 45, while for young patients, the presence of hidden genetic pathology is more characteristic. The most common genetic causes are patent foramen ovale, arterial dissection, antiphospholipid syndrome, and hyperhomocysteinemia. In the clinical case under consideration, the patient experienced an ischemic stroke twice at a young age. The first stroke occurred due to uncontrolled hyperhomocysteinemia, the provoking factor of which was a sharp rise in temperature to 39.9 oC and a large amount of stress load on the body. The cause of the second venous cerebral infarction was low adherence to the prescribed medications, which led to the self-discontinuation of antiplatelet agents. We analyzed this clinical case and reviewed relevant literature on the mechanisms linking hyperhomocysteinemia to stroke. Key aspects of the management tactics for patients who have suffered an ischemic stroke against the background of hyperhomocysteinemia have been identified, which depends on the type of metabolic disorder: pyridoxine therapy, a lifelong low-protein diet, and the prescription of betaine. Primary care physicians are recommended to manage young patients with special attention to the specifics of the clinical presentation and adherence to therapy. The prospects for further research include the development of scales for identifying risk groups for hereditary pathology capable of leading to ischemic stroke at a young age, as well as the creation of unified, convenient, and effective methods for monitoring adherence to secondary prevention of acute neurological catastrophes and a system of active observation for this cohort of patients.

Background. The extracellular matrix plays a key role in maintaining homeostasis and bone tissue regeneration by defining the conditions for cell differentiation and intercellular interactions. The native extracellular matrix is a complex three-dimensional network of structural proteins, glycoproteins, and proteoglycans that provide mechanical support to cells and transmit regulatory signals. 2D-culture systems do not reproduce the complex organization of the cellular microenvironment; therefore, the development of 3D-systems for bone tissue differentiation and remodeling in vitro remains an important challenge. Objective. To evaluate the biocompatibility of the hydrogel based on a tissue extract of uterine leiomyoma and its potential to regulate osteogenic differentiation and mineralization of osteoblasts in mono- and co-culture with endothelial cells. Materials and Methods. The tissue extract of uterine leiomyoma was obtained using a modified protocol originally developed for producing Matrigel®. Osteoblasts were cultured within the hydrogel in mono- and co-culture with endothelial cells under osteogenic conditions. Cell viability and morphology were assessed by live-cell microscopy. Mineralization of the extracellular matrix was evaluated using Alizarin Red S staining. Results. The hydrogel based on tissue extract of uterine leiomyoma demonstrated high biocompatibility toward osteoblasts, supporting their viability, promoting differentiation into osteocyte-like cells, and enhancing extracellular matrix mineralization. In co-culture with endothelial cells, these effects were further enhanced, indicating the important role of intercellular interactions. Conclusion. The hydrogel based on tissue extract of uterine leiomyoma represents a promising 3D culture model for the studying osteogenic differentiation of osteoblasts.

Introduction. Ruxolitinib is a selective inhibitor of Janus kinases 1 and 2, suppressing JAK/STAT-dependent signaling involved in inflammation, immune response, and cell proliferation. In addition to systemic use, inhalation administration is of interest, potentially increasing local lung exposure and reducing systemic exposure. This study aimed to develop a method for radioisotope labeling of ruxolitinib with carbon-11 to investigate its biodistribution via different administration routes.
Materials and Methods. N-[¹¹C]-methylruxolitinib was obtained by a one-step methylation reaction of ruxolitinib using a fully automated, home-made module. The product was purified by solid-phase extraction, and radiochemical purity and identity were confirmed by radio- HPLC. Biodistribution was studied ex vivo in healthy male Wistar rats after intravenous and inhalation administration of the radioligand. Radioactivity accumulation in organs was assessed at 5, 10, 40, 60, and 80 minutes after administration.
Results. N-[¹¹C]-methylruxolitinib was obtained with a radiochemical yield of 40 % (when calculated as [¹¹C]CH3I), a radiochemical purity of ≥97 %, and a molar activity of 6‒10 GBq/μmol. A pilot study found that with inhalation administration, a tendency toward higher radioligand accumulation in the lungs was observed 5 minutes after administration compared to intravenous administration. In contrast, with intravenous administration, a tendency toward higher accumulation in the liver was observed at the same time point. However, by the 10^th minute, significant differences in biodistribution between the two routes of administration had disappeared.
Conclusions. In this study, the radiosynthesis of the N-[¹¹C]-methylated analogue of ruxolitinib is described for the first time, and a comparative assessment of its biodistribution by systemic and inhalation routes of administration is conducted.