Georgian medical news最新文献

The article presents epidemiological data characterizing the development of the influenza A epidemic in Kazakhstan. The rates of increase and decrease of influenza morbidity are shown. During most of the COVID-19 pandemic (2020-2022), influenza circulation in Kazakhstan and neighbouring Russia declined, but then returned with higher transmission rates in autumn 2022. While H3N2 strains dominated the 2022-2023 season as a whole, in autumn 2022, A/H1N1 pdm09 strains dominated in Russia. В December 2022 г. we detected the strain /Karaganda/ 06/2022 (H1N1) pdm09 in the nasopharyngeal swab of a patient (age=3 years, 3 months, sex=male) admitted to the Infectious Disease Centre of the Regional Clinical Hospital of Karaganda city with clinical symptoms of respiratory disease. A detailed description of this clinical case in a child is given.

Background: Radiotherapy is a key treatment for stage III non-small cell lung cancer (NSCLC), but tumor proximity to critical structures-such as the heart, esophagus, and spinal cord and respiratory motion complicates dose delivery. The Deep Inspiration Breath Hold (DIBH) technique actively controls respiratory motion, potentially improving treatment precision.

Methods: This retrospective study included 56 patients with stage III NSCLC. Each underwent two CT scans: one during free breathing (FB) and one using DIBH. Dosimetric parameters for organs at risk (OARs) were compared between FB (with a 6 mm internal target volume margin) and DIBH plans using paired Student's t-tests.

Results: DIBH increased total lung volume by 28% and reduced heart volume by 12.5%. Lung dose metrics improved significantly with DIBH, including V5, V20, and mean lung dose (all P < 0.001). Heart dose parameters (V10, V40, mean dose) also decreased. DIBH significantly reduced both maximum and mean doses to the esophagus and maximum dose to the spinal cord.

Conclusions: In stage III NSCLC, DIBH significantly lowers radiation exposure to OARs and enhances dose delivery accuracy. By expanding lung volume, it may reduce the risk of radiation-induced pneumonitis.

The audiogenic seizure (AGS) model is one of several experimental models used to study epilepsy and identify underlying mechanisms. Dopamine plays an important role in epileptogenesis and dopaminergic neurons of ventral tegmental area (VTA) have extensive connections with many brain structures. Despite of this there are no data on the influence of this structure on the audiogenic seizure responses of the brain. The main aim of our study was to investigate the influence of the VTA on the development of audiogenic seizure reactions in genetically epilepsy-prone rats. The novelty of these article lies not only in the observation of changes in the development/course of audiogenic seizure reactions caused by stimulation of the VTA, but also in taking into account the localization of the epileptogenic focus, which, in our opinion, is especially important for the scientific analysis of this type of research. The inferior and superior colliculus has prominent descending projections to several areas of the reticular formation, which may sub serve the direct AGS efferent pathway. The experiments conducted showed that in response to stimulation of the VTA, the latency and duration of the first wild run do not undergo significant changes. The experiments showed a significant increase in the duration of the pause between the first and second wild runs and a significant decrease in the duration of the second wild run. Furthermore, we observed a significant decrease in behavioral seizure activity after the second wild run, leading to its complete disappearance. Structures receiving synaptic inputs from the ventral tegmental area deserve special attention. One such structure is the reticular nucleus of the thalamus (TRN). It has been shown that stimulation of TRN causes inhibition of neurons in those brainstem structures that are involved in motor reactions of the spinal cord. Therefore, it can be hypothesized that the TRN modulate the brainstem regions responsible for motor responses during audiogenic seizures. From our results we can conclude: The VTA plays an important role in epileptogenesis, which is apparently associated with the inhibitory effect of dopamine on the motor manifestations of seizures. Therefore, VTA as a brain dopaminergic nucleus, may be a suitable target for DBS anticonvulsant action.

The impact of pathogenic factors caused by the consequences of the Chernobyl disaster on the blood system and hemostasis is of great interest. Deviations identified in the first years after exposure to ionizing radiation are primarily restorative and adaptive in nature. This paper presents the results of the monitoring of the changes in each separately studied indicator in the early (1987-1988) and late (2019-2020) periods after the exposure to radiation. Regression equations were obtained that describe the dynamics of changes in certain blood indicators, which make it possible to predict changes over many years after the accident. The hemoglobin and erythrocyte content, compared with the control group (donors), remained within the physiological norm until 1991. A significant decrease in the number of erythrocytes from 1991 to 1997, naturally, should have been reflected in the hemoglobin content, which was manifested in a decrease in their content. In the subsequent years of observations until 2001, a significant decrease in the number of erythrocytes corresponded to a decrease in the hemoglobin content. From 2001 to the present day, the content of erythrocytes and hemoglobin is approaching the boundaries of the physiological norm, albeit with some lag. Changes in blood counts are also influenced by factors that determine a liquidator's susceptibility to certain illnesses. Despite the fluctuating nature of changes in white blood cell counts, an overall trend of decline is nevertheless observed. Stable moderate leukopenia has been observed since 1995. A left shift of granulocytes is observed due to a decrease in the agranulocyte component of blood cells. Thus, it can be concluded that blood cells remain affected by the radiation caused by the Chernobyl accident even at late observation times.

This study's objective was to elucidate the molecular mechanism of hemp seeds against osteoporosis using a network pharmacology approach. The methodology entailed the retrieval of active components and targets of hemp seeds from the TCMSP database, as well as OP-related targets from GeneCards, TTD, Drugbank, and OMIM databases, followed by identifying their intersection. Network construction and enrichment analyses were performed using Cytoscape and Metascape. Finally, molecular docking was utilized to validate the binding capacity between the core active ingredients and the key targets. As a result, six active components and 96 potential targets of hemp seeds were identified, which intersected with 1,745 OP-related targets to yield 53 common targets. GO enrichment analysis revealed that these targets were primarily involved in biological processes such as inflammatory response, while KEGG analysis highlighted significant pathways including the AGE-RAGE and PI3K-Akt signaling pathways. Notably, a subsequent analysis of the protein-protein interaction (PPI) network topology identified AKT1, TNF, and IL6 as pivotal targets within the therapeutic mechanism. In summary, the present study initially revealed the potential mechanism of OP treatment with hemp seeds and provided a reference for conducting experimental studies.

Background: Magnetic Resonance Imaging (MRI) is a cornerstone of modern diagnostic imaging, offering high-resolution, non-ionizing visualization across diverse clinical specialties. Despite its advantages, MRI raises safety concerns, including projectile risks, radiofrequency burns, and adverse reactions to contrast agents, as well as challenges in patient awareness and compliance. While multiple studies have addressed MRI safety and education, a structured bibliometric analysis of global research trends in this area remains limited.

Objective: This study aimed to conduct a bibliometric analysis of global research on MRI safety and patient awareness published between 2000 and 2025. Specific objectives included examining publication trends, identifying leading contributors, mapping research themes, and highlighting gaps for future investigation.

Methods: Data were retrieved from the OpenAlex database in August 2025 using controlled vocabulary and Boolean search strategies. Eligible documents included peer-reviewed original and review articles published in English between 2000 and 2025. Bibliometric indicators were extracted and analyzed using VOSviewer, Bibliometrix R, and Microsoft Excel. Analyses included co-authorship networks, citation impact, keyword co-occurrence, and country-level contributions.

Results: A total of 4,342 records were retrieved, with the United States leading global output (979 publications, 19,976 citations), followed by Germany (188 publications, 4,547 citations) and the United Kingdom (147 publications, 2,461 citations). Case Western Reserve University (46 publications, 1,371 citations) and Johns Hopkins University (41 publications, 1,181 citations) ranked among the top institutions. Influential researchers included Joseph W. Boggs (28 publications, 1,140 citations) and Frank G. Shellock (27 publications, 1,069 citations). Keyword analysis revealed research clusters focused on "MRI safety," "patient awareness," "contrast agents," and "screening protocols." Recent trends emphasized digital health applications and workflow optimization in MRI safety practices.

Conclusion: Global research on MRI safety and patient awareness has expanded significantly over the past 25 years, shifting from technical risks to patient-centered approaches and digital health integration. Despite progress, gaps remain in international collaboration and research from low-resource settings. Future work should prioritize standardized safety protocols, educational interventions, and equitable implementation of MRI safety practices worldwide.

Background: Infection prevention and control (IPC) is crucial for ensuring patient safety and healthcare quality. In Kazakhstan, thorough assessments of IPC capacity remain limited due to the scarce use of standardized international tools. This study examined the readiness of IPC systems in selected healthcare facilities, utilizing the WHO Infection Prevention and Control Assessment Framework (IPCAF).

Methods: The research involved a cross-sectional assessment conducted in four healthcare facilities. The WHO IPCAF tool from 2018 was employed to evaluate eight essential IPC components. Each facility collectively completed the questionnaire with a team of IPC specialists, including epidemiologists, infection control practitioners, and quality managers. IPCAF scores were grouped into basic (201-400), intermediate (401-600), and advanced (over 600) categories.

Results: The assessment revealed that IPC capacity differed among the four facilities. Two facilities reached an intermediate IPC level, while the other two were at a basic level. No facility was classified as advanced. The strongest areas were identified in CC8, focusing on infrastructure, materials, and equipment, and CC3, which centered on training and education. The weakest results appeared in CC1 (IPC program) and CC6 (monitoring, audit, and feedback). Moderate performance in CC4 (HAI surveillance) and CC5 (multimodal strategies) indicated partial readiness but also highlighted operational and diagnostic challenges.

Conclusion: The study's conclusions reveal that basic IPC foundations are set in several facilities, yet significant gaps remain in governance, monitoring, and surveillance. These insights underline the necessity for stronger leadership, sustained financing, improved microbiological capabilities, and systematic implementation of multimodal IPC strategies. This research provides key baseline evidence to bolster national efforts to reinforce IPC systems in Kazakhstan.

Objective of the study: Computed tomography (CT) perfusion provides a non-invasive approach to assessing hemodynamic alterations in chronic liver diseases. While its usefulness has been demonstrated in viral hepatitis, evidence regarding autoimmune hepatitis (AIH) remains limited. This study aimed to compare CT perfusion parameters - arterial flow (AF), portal flow (PF), and perfusion index (PI) - in patients with AIH - related fibrosis and cirrhosis versus healthy controls (potential liver donors).

Materials and methods: In this single-center prospective study, 21 patients with AIH-related fibrosis and 17 patients with AIH-related cirrhosis were compared with 20 potential living liver donors, i.e. the control group. CT perfusion parameters, including AF, PF and PI were calculated.

Results: Histological staging identified fibrosis stages (F1-F3 stage fibrosis) in 21 patients and cirrhosis (F4) in 17 patients. Inflammatory activity grades ranged from A1 to A4. AF was significantly elevated in both AIH-fibrosis (p<0.001) and AIH-cirrhosis (p=0.001) compared with the control group, but did not differ significantly between fibrosis and cirrhosis (p=0.294). PF was significantly reduced in AIH-fibrosis (p=0.001) and AIH-cirrhosis (p<0.001) compared with controls, with no significant difference between fibrosis and cirrhosis (p=0.084). Both AF and PF demonstrated high sensitivity (95%) in differentiating patients for both AIH-related fibrosis and cirrhosis from the control group.

Conclusion: Increased AF and reduced PF, already evident at the fibrosis stage, may serve as non-invasive markers of AIH-related liver injury severity.

Acromegaly is a chronic neuroendocrine disorder caused by excessive secretion of growth hormone and insulin-like growth factor-1, leading to systemic metabolic and organ dysfunction, substantial comorbidity, and an increased risk of premature mortality. This article presents a clinical case of a 47-year-old woman with a somatoprolactinoma in whom delayed diagnosis of acromegaly resulted in multiple complications. The disease began at a young age, manifesting as amenorrhea and progressive changes in appearance. Despite comprehensive treatment-including transsphenoidal adenomectomy, stereotactic radiosurgery (CyberKnife), and therapy with somatostatin analogues-sustained normalization of growth hormone, IGF-1, and prolactin levels was achieved; however, the patient continues to exhibit significant complications, including optic nerve atrophy, hypopituitarism, cardiomyopathy, and arthropathy. Immunohistochemical analysis was not performed at the initial surgery in 2004. However, in 2012, a re-evaluation of archival histological slides was conducted, including a complete immunohistochemical workup, which demonstrated strong expression of growth hormone and prolactin. Thus, the tumor was definitively classified as a pituitary somatoprolactinoma. This clinical case highlights the diagnostic and therapeutic challenges associated with acromegaly, the necessity of a multidisciplinary approach, the importance of early diagnosis, and the value of long-term dynamic follow-up of patients.

Background/objectives: Familial hypercholesterolemia (FH) is a common inherited disorder characterized by lifelong elevation of LDL-cholesterol. While FH prevalence is well described in coronary populations, its contribution to cerebrovascular disease is less clear. This study aims to address this gap by systematically reviewing and synthesizing available evidence to estimate the prevalence of FH in patients with ischemic stroke or transitory ischemic attack overall and across key subgroups.

Methods: This systematic review included original observational studies, with data on stroke and FH. The protocol was registered in PROSPERO with the ID CRD420251162340. Two reviewers independently screened records, extracted study characteristics and assessed risk of bias.

Results: Four studies involving 389272 stroke/transient ischemic attack (TIA) patients (2083 with FH) met eligibility criteria. The pooled prevalence of FH was 0.96% (95% CI 0.11-7.63), with significant between-study heterogeneity (I²=95.3%, τ²=1.7139, p<0.0001). Among patients with large artery atherosclerosis (LAA) strokes, FH prevalence was 2.89% (95% CI 0.05-63.28%), also with highheterogeneity (I²=93.9%, τ²=2.4854, p<0.0001).

Conclusions: The evidence linking FH to stroke remains limited and highly heterogeneous, preventing firm quantitative conclusions. However, the available studies offer preliminary signals that FH may have relevance beyond cardiology and should be considered in discussions of cerebrovascular risk. Given the small number of studies and their methodological variability, further research with standardized diagnostic criteria and larger, well-designed cohorts is needed to clarify this relationship and to determine whether improved detection and management of FH in stroke populations could help reduce the broader burden of atherosclerotic disease.