Purpose of the study. To assess the relationship between anthropometric parameters and local bioimpedance analysis data and the cross-sectional areas of subcutaneous and visceral adipose tissue measured by computed tomography.

Patients and methods. Forty-seven volunteers (31 women and 16 men) aged 20–77 years were examined. The assessment included anthropometry, bioimpedance analysis of body composition with measurement of resistance and reactance in “subcutaneous” and “visceral” leads, and abdominal CT with calculation of subcutaneous and visceral adipose tissue areas at the L4 level.

Results. Sex-related differences were found in body fat percentage and body height. Significant positive correlations were identified between most of the studied parameters. An almost linear relationship with CT-measured subcutaneous fat area was observed for fat mass, R50sc, sagittal abdominal diameter, waist circumference, and body weight (r = 0.898–0.967). Visceral fat showed the strongest relationships with waist circumference, sagittal abdominal diameter, R50sc, and body weight. Parameters obtained from the “visceral” lead showed no significant correlations with most variables, except for R50sc.

Conclusion. Local bioimpedance analysis and anthropometry are consistent with CT assessment of abdominal fat. CT-measured subcutaneous adipose tissue area correlates well with fat mass determined by bioimpedance analysis. Waist circumference, sagittal abdominal diameter, and R50sc are the most informative parameters for assessing visceral fat. The method may be used for screening and monitoring abdominal obesity.

Despite the introduction of new drugs for the treatment of multiple myeloma, the disease remains incurable. Secondary plant metabolites capable of modulating tumor cell signaling cascades and increasing their sensitivity to standard cytostatic agents are promising.

Purpose of the study. To comparatively evaluate the effects of berberine, corinan, and curcumo-berberine on the number and viability of RPMI8226 multiple myeloma cells and peripheral blood mononuclear cells from patients with multiple myeloma, and to determine the nature of their interaction with vincristine in vitro using the Bliss independence model.

Materials and methods. The study was performed using cultures of the established RPMI8226 multiple myeloma cell line and peripheral blood mononuclear cells from patients with multiple myeloma. Five patients participated in the study. The antiproliferative effects of the tested compounds were evaluated by constructing dose–response curves based on direct counting of viable and dead cells in the wells of 96‑well plates after staining the cultures with a mixture of the nuclear dyes Hoechst 33342 (1 mg/mL) and ethidium bromide (10 mg/mL). Cells were exposed to the compounds for 72 h. The number and proportion of viable cells relative to the untreated control were assessed. For combinations with vincristine (0.04 μM), the synergy score was calculated according to the Bliss independence model using SynergyFinderPLUS.

Results. The study demonstrated that corinan and berberine exhibited pronounced antiproliferative activity against RPMI8226 multiple myeloma cells. At low concentrations (up to 30 μM), corinan and berberine markedly reduced the total number of viable tumor cells while remaining non-toxic to peripheral blood mononuclear cells from patients with multiple myeloma. Conjugation of a curcumin molecule to berberine reduced its antiproliferative and cytotoxic activity. When combined with vincristine, the studied plant secondary metabolites enhanced its cytostatic effect; however, this enhancement was additive rather than synergistic.

Conclusion. These findings support further investigation of plant secondary metabolites as potential adjuvants to anticancer therapy.

Purpose of the study. To investigate the morphological features of induced An3Ca endometrioid carcinoma and visceral organs in BALB/c nude mice under conditions of diabetes mellitus.

Materials and methods. Female BALB/c nude mice weighing 25 ± 2.5 g were used to model uterine tumor growth under conditions of diabetes mellitus. The animals were divided into two experimental groups: group 1 (control) – intrauterine growth of endometrioid carcinoma (n = 5); group 2 (study group) – intrauterine growth of endometrioid carcinoma in the presence of diabetes mellitus (n = 5). Sections of the tumor nodules and organs (uterus, ovaries, liver, lungs, thyroid gland, adrenal glands, and pancreas) were examined microscopically, with images captured using a digital camera.

Results. Tumor growth without alloxan administration resulted in the formation of a single tumor nodule in the right uterine horn, with preservation of the main morphological features of its architecture. In contrast, alloxan administration was associated with the formation of a tumor consisting of several separate nodules that completely obliterated the structure of the right ovary and replaced it with tumor tissue. Metastatic involvement of the liver accompanied by vascular congestion of the parenchyma was observed. In the lungs, destruction of the alveolar and bronchial structures was accompanied by vascular congestion, foci of hemorrhage, mucus accumulation in the airway lumens, and the presence of tumor cells. Marked thickening of the colloid was observed throughout the thyroid follicles. Involutional changes were noted in the X-zone and zona glomerulosa of the adrenal cortex, with focal expansion of the zona fasciculata. Diabetes modeling resulted in almost complete loss of the exocrine pancreatic parenchyma, exposing the stromal framework of the organ. Its morphological identity could be established only from isolated small areas of degeneratively altered acini and rare remnants of the islets of Langerhans.

Conclusion. In the experimental bimodal model combining two pathological processes, cancer and diabetes mellitus, morphological evidence of mutually reinforcing mechanisms of adverse systemic effects involving multiple organs was observed. This pronounced synergistic effect was manifested by stimulation of tumor progression and pathological changes in visceral organs, expanding our understanding of cancer pathogenesis in the presence of comorbid disease.

Assessment of erectile function in patients with prostate cancer is essential when planning nerve-sparing radical prostatectomy. However, reliance solely on validated questionnaires may result in biased estimates because of the subjective nature of self-assessment and the psychological impact of a cancer diagnosis. Therefore, comparing questionnairebased findings with objective methods of erectile function assessment and evaluating factors that may influence erectile function, including arterial hypertension and antihypertensive therapy, is clinically important.

Purpose of the study. To evaluate preoperative erectile function in patients with low- and intermediate-risk prostate cancer scheduled for robot-assisted nerve-sparing radical prostatectomy and to assess the impact of hypertension, hypertension grade, and antihypertensive therapy on erectile function.

Patients and methods. This prospective study included 150 patients with prostate cancer. Erectile function was assessed using the International Index of Erectile Function‑5 (IIEF‑5), the Erection Hardness Score (EHS), the Sexual Encounter Profile (SEP), and nocturnal penile tumescence (NPT) monitoring with the Androscan MIT device. Statistical analysis was performed using StatTech version 4.13.0.

Results. The presence of hypertension was significantly associated with a greater severity of erectile dysfunction (ED), as assessed both by IIEF‑5 (p = 0.030) and NPT data (p = 0.023). The stage of hypertension and the grade of arterial hypertension were associated with deterioration of objective NPT parameters (p = 0.047 and p = 0.031, respectively). Among antihypertensive medications, the use of ACE inhibitors/angiotensin receptor blockers (ARBs), calcium channel blockers, and diuretics (predominantly indapamide) was associated with a significant reduction in NPT duration; statins, classified separately as lipid-lowering rather than antihypertensive therapy, showed no significant association. ED severity categories assigned by IIEF‑5 and by Androscan did not match in 62.2 % of cases.

Conclusion. Arterial hypertension is an independent preoperative risk factor for erectile dysfunction in patients with prostate cancer. Objective NPT monitoring identifies a substantially higher prevalence of erectile function impairment compared with self-assessment using the IIEF‑5. These findings may be useful in selecting candidates for nerve-sparing prostatectomy.

Purpose of the study. To perform a morphofunctional assessment of the pancreas following administration of a combination of semaglutide + omeprazole + gamma-aminobutyric acid in a db/db mouse model of type 2 diabetes mellitus.

Materials and methods. The experiment was conducted in 16‑week-old male db/db (C57BL/KsJ-Leprdbtb) mice (n = 192), which received the following agents orally every day for 90 days: A – semaglutide, B – omeprazole, and C – gamma-aminobutyric acid. The animals were divided into eight groups: group 1 (n = 26) – diabetic control; group 2 (n = 26) – A + B + C combination; group 3 (n = 26) – A + B combination; group 4 (n = 26) – agent C; group 5 (n = 10) – C57Bl/6 mice; groups 6, 7, and 8 (n = 26 in each group) – intact animals receiving A + B + C, A + B, and C, respectively. Animals were euthanized on days 30 and 90 of the experiment.

Results. Group 1 exhibited disruption of pancreatic histoarchitecture characteristic of type 2 diabetes mellitus, accompanied by increased levels of insulin (1.5‑fold), HbA1c (1.3‑fold), C-peptide (3.9‑fold), leptin (1.4‑fold), total cholesterol (1.1‑fold), and triglycerides (1.2‑fold), as well as a 2.3‑fold decrease in adiponectin levels. Results were considered statistically significant at p < 0.05. In group 2, administration of the A + B + C combination was associated with less pronounced pancreatic damage compared with all other groups. Conclusion. Morphofunctional assessment demonstrated restoration of pancreatic histoarchitecture following administration of the A + B + C combination, supporting the β-cell cytoprotective effect of this therapy. Keywords: type 2 diabetes mellitus, semaglutide, omeprazole, gamma-aminobutyric acid, pancreatic islets> < 0.05. In group 2, administration of the A + B + C combination was associated with less pronounced pancreatic damage compared with all other groups.

Conclusion. Morphofunctional assessment demonstrated restoration of pancreatic histoarchitecture following administration of the A + B + C combination, supporting the β-cell cytoprotective effect of this therapy.

Acute mesenteric ischemia is a group of conditions characterized by an acute impairment of intestinal blood supply, resulting in critical ischemia and necrosis of the affected bowel segments.

Purpose of the study. To analyze the diagnostic and treatment outcomes of patients with acute mesenteric ischemia in a multidisciplinary hospital and to evaluate the outcomes of surgical treatment strategies incorporating endovascular techniques.

Patients and methods. A retrospective analysis was performed of the diagnostic and treatment outcomes of 73 patients admitted to a multidisciplinary hospital between 2021 and 2023. The study included 50 (68.49 %) women and 23 (31.51 %) men. The mean age of the patients was 75.3 ± 9.05 years. The time from the onset of the first symptoms to transport by ambulance and hospital admission was up to 6 h in 23 patients (31.5 %), 6–24 h in 20 patients (27.4 %), and more than 24 h in 30 patients (41.1 %). Depending on the diagnostic and treatment strategy used, the patients were divided into five groups.

 Results. The overall mortality rate in the study cohort was 69.86 %. Mortality rates varied according to the diagnostic and treatment strategy. The lowest mortality rate was observed in the group receiving endovascular treatment alone (44.4 %). Mortality was 54.55 % in the group undergoing combined endovascular and open surgical treatment, 71.4 % in the group undergoing surgical treatment alone, 100 % in the group undergoing combined open vascular and surgical interventions, and 100 % in the group receiving conservative treatment.

Conclusion. Rapid transport of patients with acute mesenteric ischemia to a multidisciplinary hospital and timely CT angiography improve diagnostic accuracy, shorten the time to diagnosis, facilitate the selection of an appropriate treatment strategy, and reduce the risk of adverse outcomes. The use of endovascular techniques to restore mesenteric vessel patency as part of the comprehensive treatment of acute mesenteric ischemia reduces mortality.

The increasing global cancer burden is driven by population aging and growth, as well as by changes in exposure to cancer risk factors. Knowledge of the current population-level characteristics of preventable cancer risk factors and their temporal trends is essential for predicting future cancer incidence and developing effective prevention strategies and public health policies.

Purpose of the study. To analyze changes in the population-level characteristics of major cancer risk factors in Russia during the 21^st century and assess their potential impact on future cancer incidence.

Materials and methods. A literature search was conducted in NCBI Medline (PubMed), Scopus, and Web of Science databases, in accordance with the study objective. Time-based changes in population exposure to major cancer risk factors were analyzed using data from official documents, reports, original studies, meta-analyses, narrative reviews, and systematic reviews.

Results. An analysis of the current status and dynamics of key cancer risk factors and their subsequent impact on cancer incidence is conducted. These factors included population aging, air and water pollution, exposure to ultraviolet and ionizing radiation, lifestyle-related factors, and occupational exposure to carcinogens. In Russia, these factors demonstrated pronounced and multidirectional trends during the 21^st century, suggesting a potentially substantial impact on population health. Declines in alcohol consumption and smoking prevalence were observed, whereas the prevalence of overweight and obesity increased markedly. Government measures aimed at reducing the adverse effects of modifiable risk factors on population health are also discussed.

Conclusion. The findings demonstrate considerable variability in the population-level characteristics of major cancer risk factors in Russia during the 21^st century. Modifiable risk factors can and should be addressed through a broad range of preventive and regulatory measures, thereby reducing future cancer risk at the population level.

Pancreatic cancer is typically diagnosed at an advanced stage and predominantly affects older adults. Given population aging and improvements in the overall health status of older individuals, the appropriateness, safety, and patient selection criteria for pancreaticoduodenectomy in patients aged ≥ 75 years are becoming increasingly important clinical considerations.

Purpose of the study. To systematize current evidence on the short- and long-term outcomes of pancreaticoduodenectomy in patients aged ≥ 75 years, identify key risk factors for adverse outcomes, formulate criteria for selecting candidates for surgical treatment, and assess the effectiveness of alternative therapeutic approaches in this patient population.

Materials and methods. A systematic search and analysis of current Russian and international publications, including original studies, systematic reviews, meta-analyses, and clinical guidelines, were performed. The literature search covered the PubMed/MEDLINE, Scopus, Web of Science, and eLIBRARY.RU databases for the period from 2010 to 2025. Postoperative mortality, complication rates, long-term survival, quality of life, and factors influencing clinical decisionmaking were critically evaluated.

Results. Chronological age alone was not found to be an independent predictor of adverse outcomes after pancreaticoduodenectomy. The principal risk determinants were biological age, assessed using the ASA physical status classification and ECOG performance status, frailty, and nutritional deficiency. Perioperative chemotherapy was identified as a major independent prognostic factor capable of mitigating the adverse impact of age. Comprehensive geriatric assessment, ERAS protocols, prehabilitation, and minimally invasive surgical approaches may improve treatment outcomes. Effective alternatives for high-risk patients include systemic chemotherapy, stereotactic body radiotherapy, radiofrequency ablation, electroporation of pancreatic tumors, photodynamic therapy for distal common bile duct tumors, and endoscopic resection of major duodenal papilla neoplasms.

Conclusion. The appropriateness of pancreaticoduodenectomy in patients aged ≥75 years should be determined not by chronological age but by an integrated assessment of the patient’s functional reserve, or biological age, tumor biology, and eligibility for multimodal treatment, including chemotherapy. Clinical decision-making requires a mandatory multidisciplinary approach involving a geriatrician and should be based on contemporary risk-stratification algorithms and the principles of personalized medicine.

Purpose of the study. To analyze the literature on the use of indocyanine green in medicine.

Materials and methods. A literature review was conducted using the PubMed, Google Scholar, and eLibrary databases, covering the period from 1995 to 2026.

Results. Indocyanine green (ICG) is a water-soluble fluorescent dye developed in the mid‑20th century and approved for clinical use in the late 1950s. It is now widely used in various fields of medicine. In oncology, ICG is used for sentinel lymph node mapping to facilitate the detection of metastatic spread. In reconstructive and plastic surgery, intraoperative assessment with ICG reduces the risk of complications associated with autologous and implant-based reconstruction by enabling the identification of poorly perfused tissue and thereby reducing the incidence of tissue necrosis. In ophthalmology, ICG enables visualization and assessment of the fundus vasculature, particularly the choroidal circulation, in various ocular diseases. In cardiology and cardiac surgery, ICG is used to determine cardiac output and to assess anastomoses and coronary artery bypass grafts. In neurosurgery, ICG is used to visualize vascular structures, assess tissue perfusion and tumor margins, and assist in peripheral nerve reconstruction. In abdominal surgery, ICG facilitates assessment of anastomotic perfusion and visualization of tumor resection margins, thereby reducing the risk of postoperative complications, and may aid in the detection and differentiation of liver metastases.

Conclusion. Indocyanine green is a versatile agent used for both intraoperative navigation and the assessment of surgical treatment outcomes. Advances in diagnostic and imaging technologies continue to create new opportunities for expanding the clinical applications of this method.

Purpose of the study. To analyze the results of studies on the use of biological grafts in the treatment of chronic osteomyelitis and to determine the optimal method for bone defect reconstruction.

Materials and methods. A retrospective review of Russian literature indexed in the electronic databases PubMed, eLIBRARY, Google Scholar, and CyberLeninka was performed. The search was conducted using the keywords “chronic osteomyelitis”, “bone defect reconstruction” and “growth factors.” Both experimental and clinical studies were considered.

Results. Bone defect reconstruction is one of the key stages in the treatment of chronic osteomyelitis. To enhance regenerative capacity at the affected site, implants containing growth factors, including FGF, VEGF, IGF, TGF-β, PDGF, and BMP, should be used. These growth factors are found in autografts, platelet-rich plasma, mesenchymal stem cells, and adipose tissue. Growth factors may also be added to allografts or other graft materials to enhance their osteoinductive properties. In addition, these biomaterials can be used for bone defect reconstruction as local drug-delivery systems, enabling high local concentrations of antibiotics and thereby improving the treatment of osteomyelitis.

Conclusion. Autologous bone grafting remains the “gold standard” for the reconstruction of bone defects in chronic osteomyelitis; however, it is associated with additional donor-site morbidity. Favorable outcomes have also been reported with platelet-rich plasma (PRP), xenogeneic implants, and maral antler-derived materials, which may be attributed to their high content of growth factors. Combining an implant with an antibacterial agent may improve treatment outcomes.

Combat trauma to major limb vessels remains a pressing issue in military field surgery, often leading to disability in patients of working age. The formation of false aneurysms is a characteristic but not always obvious complication of shrapnel wounds, particularly in the absence of a tourniquet and with preserved distal blood flow.

To present a clinical case of the incidental diagnosis and successful surgical treatment of a false aneurysm of the radial artery in a service member with combined shrapnel wounds to the forearm and thigh. A 39‑year-old male patient was admitted to a forward medical unit 2 days after sustaining shrapnel wounds to the right forearm and right thigh. Upon admission, he complained of pain in the wound areas. The primary clinical finding was an extensive subcutaneous hematoma of the forearm extending to the lower third of the arm. A pulsatile mass, 3 cm in diameter, was detected upon palpation only during a targeted examination. Ultrasound angioscanning (USAS) revealed a false aneurysm of the radial artery with a volume of 10 mL. Surgical intervention was performed: resection of the aneurysm and repair of the arterial wall with a lateral suture. The thigh wound was managed concurrently. Intraoperatively, a 3 mm defect in the arterial wall was confirmed. Blood flow through the main arteries of the forearm was fully restored. The postoperative period was uneventful. The patient was evacuated to the next level of specialized care on the third postoperative day with satisfactory blood flow and complete restoration of active movements.

This case highlights the importance of maintaining a high index of suspicion for vascular pathology in all patients with mine-blast and shrapnel injuries, even in the absence of classic signs of acute ischemia or bleeding. Early use of USAS enables timely diagnosis of false aneurysms and allows for limb-saving surgery, thereby preventing patient disability.