Georgian medical news最新文献

The human immunodeficiency virus (HIV) is one of the major medical problems in the world. For almost forty years, it has had catastrophic effects on the body of infected people with variable pathogenesis of mortality. The purpose of the work is to analyse the importance of psychological assistance for the social adaptation of HIV-infected patients.

Materials and methods: The empirical basis of the study was the analysis of 30 medical records of inpatients. The majority were patients of working age, namely 25 people (83.3%), while the average age of the patients was (28.5±5.5) years old. During the study, patients were divided into groups depending on the receipt of psychological help, psychoemotional disorders, and signs of social maladjustment.

Results: The first group of patients consisted of 10 (33.3%) patients who refused psychological help. The second group, namely 20 (66.7%) patients, consisted of patients who received psychological help immediately after the diagnosis of HIV infection and had milder disorders. During the research, a set of methods was used: clinical and anamnestic method; to assess the presence of depression in patients, the Montgomery-Asberg Depression Rating Scale (MADRS) was used; the Spielberger-Khanin anxiety questionnaire was used to determine the level of anxiety in patients; patients' adherence to treatment was determined using the Morisky-Goin compliance assessment scale.

Conclusions: The issue of adaptation of HIV-infected patients in society is a significant problem caused by the low level of awareness of HIV infection and the ways of its transmission. The obtained results indicate the need for psychological assistance to HIV-infected persons at every stage, both at the time of the announcement of the diagnosis (prevention of the development of depression, suicidal intentions), and during drug treatment (debriefing of the methodology, creation of peer-to-peer support groups), thanks to which the social adaptation of patients and the effectiveness of medical treatment are accelerated.

The aim of the article is to study the role of information and communication technologies, in particular mass media and social media, in shaping the legal regulation of biomedical activities.

Materials and methods: The empirical basis of the study is formed by the literary sources of Ukrainian and international scholars, Ukrainian and foreign legislation, as well as materials from media websites and social networks. The article uses general theoretical and special methods of scientific cognition: theoretical analysis, systemic and structural, analysis and synthesis, sociological and statistical, logical and semantic, comparative and legal, method of ascent from the abstract to the concrete, forecasting and generalization.

Results: The concept of biomedical technologies and the need to develop new or improve existing legal regulation in the specified area are examined in the article. The role of mass media in informing the population about biomedical issues is analyzed, which allows for its public discussion and reflects the attitude of society towards certain biomedical technologies, which in turn affects the direction of their state regulation. Emphasis is placed on the expanding influence of social media and their ability to enhance the interaction of public authorities with the public, which is an advantage for research on public attitudes in the field of biomedicine. The increase in the amount of media content related to the process of biomedicalization is emphasized. Specific cases of the influence of public discussions of biomedical technologies in social media on the development and introduction of changes to legislation are given.

Conclusions: Conclusions are drawn about the importance of the role of the media in informing the public about the main scientific discoveries in the field of biomedical technologies, as well as in reflecting their public perception or rejection, which forms the vector of public policy in the relevant rulemaking activities.

The relationship between follicle size, oocyte quality, and blastocyst ploidy is not fully established. This question becomes especially important for poor responders and older reproductive age women, where optimal follicle size and oocyte quantity cannot always be achieved during ovarian stimulation. The aim of this study is to determine the relationship between follicle size, oocyte maturation, blastocyst formation, blastocyst ploidy, and pregnancy outcomes in young women undergoing in vitro fertilization (IVF).

Materials and methods: The study involved 32 oocyte donors aged 19 to 35. For ovarian stimulation, a protocol with GnRH-antagonists was used, employing downregulation with oral contraceptives. The ovulation trigger was administered when 20% of follicles reached 18 mm. Aspiration was performed 35 hours after the ovulation trigger was administered. Follicle size was measured immediately before the aspiration needle was inserted and follicle fluid was aspirated; data (follicle size and oocyte from this follicle) were recorded individually by the embryologist. The resulting blastocysts underwent preimplantation genetic testing for aneuploidy (PGT-A) using NGS. Pregnancy outcomes were assessed by biochemical indicators, miscarriages, and live births.

Results: Out of 555 measured follicles, 508 oocytes were obtained (91.5%). The number of mature oocytes (MII) was 411 (80.9%), and there were 97 immature oocytes (19.2%). Out of the 97 immature oocytes, 51 were germinal vesicle (GV) oocytes (10.04%), and 46 (9.06%) were MI oocytes without a polar body. Follicles were divided into four groups based on size: Group I - <15 mm, Group II - 15-18 mm, Group III - 18-20 mm, Group IV - >20 mm. There were significantly more mature oocytes in the second, third, and fourth groups compared to the first, indicating that follicle size has a substantial impact on retrieving MII oocytes (p<0.0001). Especially high number of mature oocytes were observed in the second and third groups. Fertilization and blastocyst formation from oocytes obtained from larger follicles were higher than from smaller follicles (p<0.0001). The frequency of obtaining euploid blastocysts did not significantly differ between the groups, and no significant relationship was found between follicle size and the formation of euploid blastocysts. Women who underwent genetic testing of embryos and transferred euploid embryos had significantly lower rates of biochemical pregnancy and miscarriages, as well as significantly higher live birth rates compared to those who did not undergo genetic testing of embryos.

Conclusion: Oocyte maturation, fertilization, and blastocyst formation depend on follicle size. However, follicle size is not an indicator of blastocyst euploidy. Preimplantation genetic testing for aneuploidy (PGT-A) significantly increases pregnancy success and live birth rates while reducing miscarriage rates.

Active vitamin D-1.25OHD (1,25Dihydroxyvitamin D, calcitriol) in the endometrium of women with endometriosis seems to be enhanced compared to healthy controls. Evidence is insufficient on how this process reflects vitamin D metabolites-25OHD (25 Hydroxyvitamin D, calcifediol), 1.25OHD, and calcium blood concentrations.

Aim: Determination of vitamin D's significance in the pathogenesis of endometriosis by analyzing the levels of 25OHD, 1.25OHD, and calcium in patients with endometriosis before and after laparoscopic treatment.

Materials and methods: This study is an anterograde comparative analysis, that investigates the variation of vitamin D metabolite and calcium levels between the preoperative assessment and the subsequent measurement following surgical treatment of endometriosis. Results before the intervention were also compared to the healthy control group. Levels of 25OHD,1.25OHD, and calcium before required surgical treatment and 3 months post-laparoscopy were measured. Data analyses were made using IBM SPSS 27.

Results: Women with endometriosis have significantly lower mean 25OHD (p-0.002) and a higher 1.25OHD (p<0.001) and total calcium levels (p-0.03) compared to controls. The endometriosis stage and size of endometrioma negatively correlate with 25OHD levels (p<0.001). After surgical removal of endometriotic lesions, 1.25OHD, and calcium showed a significant decrease whereas 25OHD blood concentrations increased statistically significantly.

Conclusion: Women with endometriosis have a lower 25OHD, a higher 1.25OHD, and total calcium levels in the bloodstream compared to the control group. Usually, a low concentration of 25OHD is characterized by low/normal 1.25OHD and hypocalcemia. Hypercalcemia in the study group may be attributed to increased levels of active vitamin D- 1.25OHD, which seems to be the result of a higher conversion rate of 25OHD to 1.25OHD in the endometrium of women with endometriosis. Removal of endometriotic heterotopies was followed by significant changes, which could indicate that the levels of vitamin D metabolites have been influenced by endometriosis. It is reasonable to conclude, that diminished levels of 25OHD might be interpreted as an outcome of a high demand in endometriosis, instead of a risk factor.

The proposed scientific article discusses the results of evaluating the medical and social effectiveness of innovative high-tech cardiac surgery for patients who have suffered an acute myocardial infarction. It was established that the inpatient mortality rate of patients who did not receive innovative high-tech cardiac surgery is significantly higher than in those patients who received it. These differences are particularly noticeable when comparing data among the elderly.

Material and methods: A comprehensive assessment of the effectiveness of implementing high-tech medical services in the field of cardiovascular system includes an analysis of medical and statistical, sociological methods, financial and economic, organizational and managerial methods, as well as an assessment of the level of application of relevant regulations.

Results: The results of a study using a logarithmic test showed that stenting of coronary vessels and aorta-coronary bypass surgery significantly reduce hospital mortality in patients with myocardial infarction in all age groups. The hospital mortality rate among patients of the main (who have received HTMC) age group was 0.96%, and among patients of the control (who haven't received HTMC) group - 11.84% (p=0.002). There was no significant reduction in mortality among the group of old patients (p=0.779). Thus, the largest difference in hospital mortality between the main and control groups was found only in elderly patients, p=0.002.

Conclusion: the effectiveness of the achieved success depends not only on the introduction of innovative technology, but also on the availability of highly qualified cardiac surgeons and basic medical material and technical resources.

Kidney stones are a common disorder that affects men and women. Stones are hard, abnormal deposits that form inside the kidneys. They are also known as kidney stones or urinary stones. The incidence of kidney stones has increased significantly, and their prevalence is increasing worldwide. Osteoprotegerin (OPG) is a biochemical variable that plays an important regulatory role in predicting various kidney diseases. KIM-1 also known as HAVcr-1, and TIM-1 is a sensitive and specific biomarker for kidney injury due to its great importance. United States of America, Food and Drug Administration, and European Medicines Agency have adopted KIM-1 as a biomarker in urine to detect kidney injuries.

The influence of oxytocin on spontaneous electrical activity of the ovarian horn areas as well as the uterine corpus has been studied. Analysis of the main characteristics of activity parameters (amplitude of action potentials, spike generation frequency and total duration of bursts in 1 minute time frame) revealed some notable differences between above mentioned areas. In norm, the highest values of automatism indicators were noted for the left horn. Oxytocin, however, significantly enhances all three parameters. Under its influence, the indicators of the right horn predominate over the values of their own norm, thus emerging among all rhythmogenic loci. Perhaps oxytocin contributes to the activation not only of both fallopian tubes but also of the uterine corpus itself, facilitating the regulation of activity in all three areas.

Steatotic liver disease (SLD) includes a spectrum of liver situations together with alcohol-associated liver disease (ALD) and metabolic dysfunction associated steatotic liver disease (MASLD), representing a growing global health. The current gold standard for diagnosing SLD is a liver biopsy, which, despite its accuracy, is invasive, highly- expensive, and carries the risk of headaches. Other imaging techniques and traditional liver feature assessments fall short of accurately diagnosing and staging SLD. Consequently, there's an urgent need for non-invasive biomarkers that can appropriately diagnose, stage, and prognosticate SLD.

Objectives: To evaluate the ranges of pentraxin-3 (PTX3) and the triglyceride-glucose (TYG) index, compare those markers among ALD, MASLD, and wholesome controls along liver enzymes, and compare their diagnostic application in distinguishing ALD from MASLD.

Materials and methods: A case-management study was carried out inside the Digestive System and Liver Department of the Medical City in Baghdad from November 2023 to January 2024. The study covered 124 participants: 20 with ALD, 50 with MASLD, and fifty-four healthy controls. Serum degrees of alanine transaminase (ALT), γ-glutamyl transpeptidase (GGT), PTX3, TYG index, and diverse lipid profiles have been measured.

Results: The effects show huge variations among ALD and MASLD in terms of liver enzymes, PTX3, TYG index, and lipid profiles. Elevated PTX3 and TYG index tiers in ALD endorse improved irritation and lipid metabolism abnormalities, differentiating it from MASLD.

Conclusion: PTX-3 and the TyG index come to be promising non-invasive biomarkers for diagnosing and distinguishing ALD and MASLD from wholesome controls.

Paracetamol-induced liver toxicity in rats is a well-studied model for liver damage. The present study investigates the morphological changes in hepatic blood vessels and the protective effects of hydroponically grown Radish (Raphanus sativus L.) pretreatment in rats with paracetamol-induced liver damage. The results indicate significant alterations in vascular morphology and liver enzyme levels, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST), which serve as indicators of hepatotoxicity. The findings suggest that hydroponic Radish may mitigate the adverse effects of paracetamol on liver health, highlighting the importance of dietary components in preventing micronutrient deficiencies and promoting overall health.

This study aims to identify the predictors of ineffectiveness in antiviral therapy for chronic hepatitis C (CHC) in Kazakhstan. The rising prevalence and mortality rates associated with CHC globally and within Kazakhstan underscore the need for effective antiviral treatment strategies. Despite the introduction of direct-acting antiviral agents (DAAs) with high cure rates, a subset of patients fails to achieve a sustained virological response (SVR). We conducted a multicenter retrospective matched case-control study across 13 regions of Kazakhstan, including 812 patients with CHC. The study involved patients registered in healthcare organizations who had received DAAs, focusing on those who did not reach SVR. Variables such as demographic characteristics, virological status, stage of liver disease, comorbidities, lifestyle factors, therapy regimen, and patient adherence were analyzed. Logistic regression analysis identified multiple factors associated with increased risk of non-response to therapy, including comorbid conditions like arterial hypertension, hepatocellular carcinoma, and lifestyle factors. The study highlights the complexity of CHC treatment in Kazakhstan, emphasizing the need for personalized treatment plans and addressing comorbid conditions and lifestyle factors. This research contributes to understanding the multifaceted nature of CHC treatment response and aids in optimizing therapeutic strategies in similar healthcare settings.