Georgian medical news最新文献

Throughout their existence, people have sought to know what tomorrow holds for them. It was especially important to learn about a full life, illness or death. Science is the essence of human knowledge, which is organized according to certain principles, a real connection of judgments, predictions and problems of reality and its individual spheres or aspects. Various indexes are used in modern periodontology. Index assessment allows you to succinctly and conveniently display the static state of periodontal tissues in quantitative terms. With their help, you can get an idea of the prevalence, degree of severity, the course of the inflammatory-destructive or dystrophic process, evaluate the effectiveness of the treatment and the quality of dispensary work in a specific patient or dispensary group. Among the indices, clinical ones are especially defined. They are the main group of indices that allows the clinician to assess the state of the periodontal tissues in a variety of ways. With their help, you can get a general idea of the nature of the course of the disease, plan the amount of medical interventions, evaluate the effectiveness of the treatment and dispensation. Various indexes are used in modern periodontology. Index assessment allows you to succinctly and conveniently display the static state of periodontal tissues in quantitative terms. With their help, you can get an idea of the prevalence, degree of severity, the course of the inflammatory-destructive or dystrophic process, evaluate the effectiveness of the treatment and the quality of dispensary work in a specific patient or dispensary group. Among the indices, clinical ones are especially defined. They are the main group of indices that allows the clinician to assess the state of the periodontal tissues in a variety of ways. With their help, you can get a general idea of the nature of the course of the disease, plan the amount of medical interventions, evaluate the effectiveness of the treatment and dispensation.

Aim: to evaluate the efficacy of an integrated management approach for ovarian endometriomas using Dienogest administered both before and after laparoscopic cyst enucleation in women with infertility.

Materials and methods: The prospective, comparative clinical trial included 44 patients aged 18-35 years with ovarian endometriomas and infertility. Patients were randomly divided into two groups: the study group (20 participants) received Dienogest for six months before and after laparoscopic cyst enucleation, while the control group (24 participants) underwent laparoscopic cyst enucleation without additional hormonal treatment. Outcomes measured included: cyst size (before treatment and after six months of Dienogest administration in the study group), serum levels of anti-Müllerian hormone (AMH), antral follicle count (AFC) in both groups (before and six months after surgery), pregnancy rates, and recurrence rates of endometriomas within a 1-year follow-up.

Results: Study Group: Dienogest treatment resulted in a significant reduction in cyst size before surgery. AFC and AMH levels remained stable before and after surgery. At the 1-year follow-up, 13 participants (65%) achieved pregnancy, and endometrioma recurrence was observed in 3 participants (15%).

Control group: Six months post-surgery, AFC and AMH levels were significantly lower than pre-surgery levels. During the follow-up, 7 participants (29.2%) achieved pregnancy, and endometrioma recurrence was noted in 19 participants (79.2%).

Conclusion: The integrated management approach using Dienogest administered both before and after laparoscopic cyst enucleation has proven to be effective in improving reproductive outcomes and reducing recurrence rates of ovarian endometriomas in women with infertility.

The neoplasms of the organ of vision are characterized by significant polymorphism, which is due to the histological diversity of the structures in the eye socket. Almost all types of neoplasms described in humans are found in the orbit. The study aimed to determine the diagnostic value of magnetic resonance imaging in patients with tumors in the eyeball and the eye socket, as well as to determine the superiority of the MRI procedure compared to other instrumental methods of research. The paper presents the results of the study of 67 patients with pathological processes of the orbit, whose ages ranged from a few months to 81 years. Of them, 23 (34.3%) were men and 44 (65.7%) were women. Magnetic resonance imaging was performed on a Siemens MAGNETOM Vida 3T device in three projections. As a result of the analysis of MRI semiotics of primary tumors of the orbit and eyeball, their common features were revealed: the predominance of oval-shaped tumors. Also, in most cases, the contours of the tumors were regular and clear. The structure of the pathological formation was homogenous. The heterogeneity of the structure of the tumors was revealed in 25.6% of cases, while in more than half of the patients, no additional inclusions were detected, and in the rest, the presence of areas of fat density and calcinates was determined. During studies under intravenous bolus contrast with cyclolux and Gadovist, 62.8% showed an active high accumulation of contrast in the tumor, indicating a developed vascular network in the tumor formation. Of all tissue imaging methods, the magnetic resonance imaging procedure provides the most complete pathoanatomical picture and allows for conducting non-invasive angiographic examination and obtaining diffusion, perfusion, and spectroscopy images.

Introduction: The annual growth of psychiatric and neurodegenerative diseases requires new therapeutic strategies for delivering active pharmaceutical molecules to the brain. Non-invasive intranasal drug delivery is a promising method that allows bypassing of the blood-brain barrier and the liver de-toxification system.

Results: The review discusses the main results of experimental studies of the effect of intranasal substances of amino acid and peptide nature on the monoamine systems of the brain. The main attention is paid to understanding the transport mechanisms of potential amino acid and peptide drugs in the nose-to-brain projection and assessing their therapeutic efficacy.

Conclusion: The obtained results indicate the possibility of creating, along with buccal, in-halation, transdermal and ocular preparations, intranasal non-invasive drugs that provide more effective therapy for psychiatric and neurodegenerative diseases, such as schizophrenia, depression, anxiety, ADHD, Alzheimer disease and Parkinson disease.

Objective of the study: The study focuses on the importance of quality nursing care in internal medicine, especially for patient recovery in complex cases. Variability in nursing practices can lead to inconsistent outcomes, and Evidence-Based Practice (EBP) is suggested as a strategy to standardize care and improve quality of service. The study evaluates the quality of nursing care in the province of Tungurahua, Ecuador from the perspectives of nurses and patients.

Material and methods: Using the SERVQUAL model, the study evaluates the quality of nursing services through surveys focused on dimensions such as tangibility, reliability, responsiveness, safety, and empathy. The HS-EBP questionnaire was adapted to measure EBP among nurses. The study included 137 patients and 12 nurses from the Internal and General Medicine Service.

Results: A moderate positive correlation was found between nursing education and perceived quality of service (r=0.430), and between the use of research and perceived reliability of care (r=0.405). However, there are barriers to the systematic application of EBP, and the study emphasizes the need to focus on both technical evaluation and empathy to improve service quality.

Conclusions: The integration of EBP is essential to improve the quality of nursing care in internal and general medicine, but it is also important to address the organizational and interpersonal factors that affect patients' perceptions. A holistic approach that combines professional development, evidence-based practices, and patient-centered care is recommended to improve standards in internal medicine.

Background: The use of beta-blockers in treating resistant hypertension remains poorly understood. While PATHWAY-2 showed a systolic blood pressure benefit with bisoprolol, further research is needed to evaluate other beta-blockers in terms of the effect of systolic blood pressure, assess diastolic blood pressure effects, and guide management in patients intolerant to CCBs as well.

Objectives: Our study aimed to evaluate the efficacy of Carvedilol (non-selective beta-blocker with alpha-1 blocking function) in the management of resistant hypertension, including in patients intolerant to calcium channel blockers. The study compared the efficacy of carvedilol in two groups: patients newly initiated on carvedilol and patients switched from another beta-blocker to carvedilol.

Methods: We create two groups: 1. Add Carvedilol group (when add Carvedilol in beta blocker naïve patients with resistant hypertension, PATHWAY 2 like patients with triple therapy of CCB, RAAS inhibitor and diuretic) and 2. Switch to Carvedilol group (CCB intolerant patients with RAAS inhibitor, diuretic and beta blocker, when beta blocker bisoprolol is replaced with carvedilol). The primary endpoint was the change in systolic (SBP) and diastolic (DBP) blood pressure from baseline to the end of the study. Secondary endpoints included the correlation between blood pressure reduction and gender, BMI, and age, also safety parameters (hypotension, bradycardia, new onset type 2 diabetes mellitus) Results: The study results demonstrated significant reductions in both SBP and DBP in both treatment groups, including those with group 1 - Add Carvedilol (on RAAS inhibitors, CCBs, and diuretics) and those with group 2 - Switch to Carvedilol (those with CCB intolerance, on RAAS inhibitor, diuretic, and beta blocker-Bisolrolol). Carvedilol was well-tolerated, with no significant adverse events reported.

Conclusions: This study provides evidence supporting the use of carvedilol in patients with resistant hypertension, including those intolerant to CCBs.

Introduction: Interproximal attachment has received much attention in modern periodontology because it is a key diagnostic and prognostic factor. Currently, we can find many articles with results of bare root coverage, but few data and studies that describe root closure and obtaining interproximal attachment at the same time.

Objectives: The purpose of this study is to introduce a double-layer tunnel surgical technique for gingival papilla reconstruction and regeneration of the supraalveolar interproximal attachment.

Materials and methods: The technique is described step by step and demonstrated in a clinical case of multiple bilateral recessions, on the mandible with follow-up results up to 1 year.

Results: Four proximal, midvestibular, and midlingual recession teeth were treated. The average root coverage in the proximal region reached 85%.

Conclusion: This study demonstrates the feasibility of treating gingival recession with a papilla defect in the anterior region of the mandible, achieving significant clinical improvement with long-term stability.

Endosalpingiosis occurs in relatively young women. The incidence of endosalpingiosis exceeds that of other diseases affecting female tissues. As endosalpingiosis is a benign tumor, several women with endosalpingiosis are asymptomatic. Endosalpingiosis is a lesion characterized by the presence of ectopic glandular tissues lined with epithelium similar to the tubal-type epithelium. Therefore, the development of endosalpingiosis is frequently incidentally discovered during abdominal surgery for other diseases. A definitive diagnosis of endosalpingiosis is made by pathological diagnosis and pathological findings on the surgically removed tissue. In some cases, glandular structures comprising a single layer of columnar to cuboidal epithelial cells are observed in surgically removed tissues of the uterine body, bilateral peritoneal tissues, omental tissues, and even lymph node tissues. Recently, our medical staff has experienced cases of endosalpingiosis with a history of breast cancer, which rarely has clinically significant consequences. Elucidating the mechanism of endosalpingiosis will facilitate understanding of the origin of primary tumors in the ovaries and peritoneum. Furthermore, to prevent unnecessary additional surgical treatments (e.g., chemotherapy), differentiating endosalpingiosis from ovarian borderline (low-grade) tumors or dissemination of malignant tumors and from endosalpingiosis and primary peritoneal mesothelioma or serous tumors is essential. We here discuss the historical and medical aspects of tubal endometriosis, which was discovered as an intraabdominal mass and incidentally diagnosed.