Georgian medical news最新文献

Clopidogrel is a second generation thienopyridine that's used as a prophylactic anti-platelets following percutaneous coronary intervention (PCI) for patients with coronary heart disease. Not all patients who receive this medication show effective response as literatures have reviewed clopidogrel resistance as an issue on needs of further follow-up and study. The aim of this article was to assess clopidogrel resistance among a group of patients who underwent PCI. This study was conducted as a cross-sectional study during the period of one year. A total of 106 patients who underwent Primary PCI and were placed on clopidogrel for at least 7 days were assessed. Their blood sample was obtained and asses for platelets aggregation test. The mean age of the patients with CAD who underwent PCI was 58.5 between 31 and 80 years old. 68.9% of them were males and 31.1% were females. From the total 106 CAD patients, 70.5% of them responded to the Clopidogrel positively and 12.4% responded in a suboptimal way while 19 patients (17.1%) were clopidogrel resistant. No significant correlation were found between clopidogrel response and gender or age; P values respectively were 0.2324 and 0.4159. subsequently, genetic report was done for resistant cases and they showed no significant correlation with age (P=0.8914) and gender (P=0.2524). Clopidogrel resistance and poor response is of a significant value among patients and can be encountered. There was no correlation of clopidogrel to age or gender, yet further studies are indicated for the assessment of the genetic material and response profile.

Background: Acanthosis nigricans (AN) is a cutaneous marker of insulin resistance and obesity, serving as an early warning sign for type 2 diabetes mellitus (T2DM). Limited epidemiological data exist on the prevalence of AN among young populations in Saudi Arabia.

Objective: To determine the prevalence of AN and its association with obesity and diabetes-related risk factors in a community-based sample in Qassim, Saudi Arabia.

Methods: A multicenter cross-sectional study was conducted between February and May 2025 in Qassim. Although the study recruited participants aged ≥10 years, the sample predominantly consisted of adults, and only about one-quarter fell within the WHO-defined youth category (10-24 years). A structured, validated questionnaire was administered to 420 participants. Obesity and AN were assessed using self-report rather than clinical examination, which may introduce misclassification bias. Fasting glucose and HbA1c values were recorded when available; however, laboratory data were only accessible for a small subset of participants and were therefore interpreted cautiously.

Results: The mean age of participants was 35.1±14.3 years. The overall prevalence of AN was 17.3%, and self-reported obesity was 24.0%. Because laboratory values were available for only a minority, related findings are considered exploratory rather than representative of the total sample. AN was significantly associated with obesity (p=0.005).

Conclusion: AN was relatively common in this mixed-age population. Given that only a small proportion of participants met the youth definition, results should not be interpreted as representing "young people" exclusively.

The high prevalence of musculoskeletal disorders among children and adolescents determines significant interest from researchers and clinicians in these conditions. Among their causes are reduced bone mineral density (BMD) and undifferentiated connective tissue dysplasia (UCTD). The pathogenesis of both conditions may be associated with trace element imbalances.

Aim of the study: To determine the frequency and pathogenetic relationships between UCTD and osteopenic syndrome in children.

Materials and methods: The group of examined children included 375 respondents (137 boys and 238 girls) from 3 to 16 years old (average age - 10.8±0.2 years). The diagnosis of UCTD was made according to the criteria of the guidelines for "Hereditary Disorders of Connective Tissue Structure and Function." All children had determined their daily calcium and vitamin D intake. Objective criteria included blood levels of 25-hydroxyvitamin D (25(OH)D), calcium, and magnesium. Densitometry of the calcaneus was performed using a Sunlight 2000 device. The χ2 criterion was used to analyze contingency tables, including for arbitrary tables.

Results: A strong association between osteopenic syndrome and the presence of UCTD was identified. When analyzing the effect of UCTD on the frequency of decreased BMD, the following statistically significant indicators were determined: χ²=37.580, critical value χ²=9.21, p<0.001. This level of significance was found between all three groups-absence of UCTD, grade 1, and grades 2-3. A significant increase in the frequency of insufficient dietary intake of vitamin D was observed in children with reduced BMD (χ²=15.848, critical value χ²=13.277, p=0.004). Similar associations were found for calcium intake (χ²=15.043, critical value χ²=13.277, p=0.005). Reduced magnesium levels were more characteristic of the subgroup of children with UCTD. For all three parameters, the highest frequency of deficiency was found in the group with a combination of osteopenic syndrome and UCTD. Differences compared to the group without pathological conditions were as follows: for 25(OH)D - RR=3.38 (χ²=47.408, critical value in all cases χ²=11.345; p<0.001), for calcium - RR=3.38 (χ²=35.831; p<0.001), and for magnesium - RR=3.38 (χ²=20.802; p<0.001).

Conclusion: The identified features of vitamin D, calcium, and magnesium intake and metabolism in children with combined decreased BMD and UCTD require special attention, as they may represent additional risk factors for the progression of these conditions and the development of complications. Their correction requires comprehensive pharmacological prevention with periodic monitoring of results.

The quality of life of healthcare workers is an important indicator of the state of the healthcare system and the quality of services provided. This study focuses on analyzing the factors affecting the quality of life of general practitioners working in urban polyclinics in Kazakhstan.

Objective: To assess the quality of life of general practitioners and identify key factors determining their physical and psychological well-being.

Methods: A cross-sectional study was conducted using the validated Russian-language version of the SF-36 questionnaire. A total of 203 physicians from five cities in Kazakhstan participated in the survey. Statistical tests, including analysis of variance and correlation analysis, were applied for data processing.

Results: The average overall SF-36 index was 58.2%. The lowest scores were recorded in the domains of social functioning and role limitations due to emotional problems. Age and marital status were found to influence specific quality-of-life domains. The proposed model for improving quality of life emphasizes the optimization of working conditions and the introduction of psychological support.

Conclusion: The results of the study demonstrate the need for systemic changes in the organization of work for general practitioners. The proposed measures may be used to improve quality of life and enhance the efficiency of healthcare professionals. A limitation of the study is the pronounced gender imbalance of the sample (92.6% women), which may affect the generalizability of the results.

Quaternary ammonium compounds (QACs) are widely used cationic surfactants known for their strong antimicrobial activity. Their utility in healthcare, consumer products, and industrial settings stems from their ability to disrupt bacterial membranes rapidly. However, increased use raises concerns about bacterial resistance and environmental persistence. The study aims to synthesize and evaluate a new series of 2-(alkyloxy)-N-(2,5-dimethylbenzyl)-N,N-dimethyl-2-oxoethanammonium chlorides (C6-C12) for antibacterial activity. Developing structurally optimized QACs may improve antibacterial potency while minimizing environmental impact and resistance selection. Tailoring the alkyl chain length and introducing degradable moieties like alkoxycarbonylmetհyl could enhance efficacy and biodegradability. The compounds were synthesized by the alkylation of N,N-dimethyl-3,6-dimethylbenzylamine with the corresponding alkyl chloroacetate. QACs were purified and characterized by IR, 1H- and 13C-NMR, and mass spectrometry. Biological activity was assessed by agar diffusion and broth microdilution assays against representative Gram-positive (Staphylococcus aureus, Bacillus subtilis) and Gram-negative (Escherichia coli, Shigella flexneri) bacteria. Comparative activity was evaluated against furazolidone. All compounds exhibited antibacterial effects using the agar-diffusion method, with inhibition zones of up to 35mm. However, the MIC values of the compounds were higher than those of the reference furazolidone. These results indicate that quaternary ammonium compounds combining a 2,5-dimethylbenzyl moiety with an alkyloxycarbonylmethyl chain exhibit moderate broad-spectrum antibacterial activity, making them promising candidates for topical and environmental applications.

Purpose: The study aimed to identify the relationship between speech characteristics and anxiety levels to identify psycholinguistic markers that can serve as diagnostic tools in psychotherapy practice.

Methods: A sample of 160 participants was stratified by anxiety level (high, medium, low) using standardized methods (STAI, BAI). Quantitative analysis showed significant differences in the speech of the groups: participants with high anxiety used shorter sentences, were characterized by a lower level of lexical diversity, more frequent use of negatively colored vocabulary and the pronoun "I", and also used future tense forms less often.

Results: Correlation and regression analyses confirmed the close relationship of these speech indicators with anxiety levels, which explained up to 48% of the variation on the BAI scale. The results suggest that speech analysis can be a reliable indicator of anxiety levels and can be integrated into psychotherapy practice as an additional diagnostic tool. The resulting speech profile of a highly anxious individual-negative vocabulary, self-referentiality, cognitive simplification, and low future orientation-can be used to individualize psychotherapeutic interventions and monitor therapy dynamics.

Conclusions: Practical applications include regular speech analysis, working with written texts, and integrating automated analysis systems into clinical and online environments. A promising direction is to expand the sample and test the cross-cultural validity of the resulting model.

Background: Frailty is increasingly recognized as a major determinant of poor outcomes in elderly patients undergoing vascular interventions. With global population aging, the intersection between frailty and vascular disease has become a pressing clinical and research priority. However, research in this domain remains scattered, and no bibliometric synthesis has systematically mapped global trends.

Objectives: This study aimed to (1) analyze global research trends on vascular interventions in frail elderly patients (2000-2025), (2) identify the most productive countries, institutions, authors, and journals, (3) evaluate co-authorship, keyword co-occurrence, and citation impact, and (4) highlight clinical outcomes studied and areas for future research.

Methods: A bibliometric analysis was conducted using PubMed, Medline, and Embase databases covering 2000-2024. The search strategy combined terms such as "vascular intervention," "frail elderly," "endovascular procedures," and "geriatric vascular surgery." A total of 276 relevant publications were included. Bibliometric indicators assessed annual scientific production, source impact (Bradford's Law), author productivity (Lotka's Law), institutional and country-level contributions, keyword evolution, and collaboration networks. Analytical tools included Bibliometrix (R package) for mapping and VOSviewer for visualization.

Results: Research output demonstrated steady growth, with fewer than 10 publications annually before 2005, rising sharply after 2016, and peaking at 28 articles in 2025. The Journal of Vascular Surgery (n=23), Annals of Vascular Surgery (n=14), and Journal of Neurointerventional Surgery (n=11) were the most prolific sources. Author productivity was highly skewed, with 88.1% contributing only one article, while Pol RA and Brooke BS emerged as leading figures. Sichuan University (43 articles), the University of Utah (34), and Yale University (27) were the most productive institutions. By country, China (298 articles) and Japan (198) dominated total output, surpassing the USA (171). Keyword analysis revealed strong emphasis on "treatment outcomes," "risk factors," and "aged ≥80," but frailty-specific terms were underrepresented. Collaboration mapping showed strong Asia-Pacific ties, while US research remained largely domestic.

Conclusions: This is the first bibliometric study to systematically examine global research on vascular interventions in frail elderly patients. Findings demonstrate accelerated growth since 2016, with Asia emerging as a global leader. Despite rising output, gaps remain in standardized frailty assessment and integration of geriatric principles. Future research should prioritize consistent frailty evaluation, sustained collaborations, and clinical trials aligning vascular care with geriatric best practices.

Data retrieval underpins the success of clinical audits, quality improvement initiatives, and research. Over recent decades, healthcare systems have transitioned from manual chart review to electronic patient record (EPR) systems, informatics-driven queries, and now artificial intelligence (AI)-assisted methods. Each stage has brought improvements in scale and efficiency but has also introduced new challenges in accuracy, coding reliability, and access to clinically meaningful detail. This review traces the evolution of data sourcing methods, from manual extraction to digital workflows, examines the balance between structured and unstructured data, and highlights the emerging role of prompt engineering and natural language processing (NLP). By combining insights from literature and clinical practice, it outlines the limitations of current systems and the opportunities that future innovations may provide.

Background: Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare autosomal dominant vascular disorder. It is characterized by abnormal blood vessel formation, leading to arteriovenous malformations (AVMs) and telangiectasias, which can cause chronic or acute bleeding. This report presents the case of a 44-year-old Saudi female with severe recurrent iron deficiency anemia (IDA) of an unknown etiology, highlighting the diagnostic challenges and the importance of a thorough clinical and family history.

Objective: The primary objective of this case study is to present the clinical presentation, diagnostic approach, and definitive diagnosis of HHT in a patient with recurrent, severe IDA secondary to chronic blood loss. The case emphasizes the classic triad of recurrent epistaxis, a strong family history, and the presence of mucocutaneous telangiectasias as key indicators for this diagnosis.

Methods: A systematic diagnostic approach was undertaken to investigate the underlying cause of the patient's chronic anemia. This included consultations with gastroenterology and hematology, upper and lower endoscopies to exclude occult gastrointestinal bleeding, and specific laboratory tests such as platelet function and von Willebrand factor assays to rule out other hereditary bleeding disorders. A fiber optic nasopharyngoscopy was performed to visualize the nasopharyngeal mucosa. The diagnosis was ultimately confirmed by fulfilling the Curaçao diagnostic criteria for HHT, based on a comprehensive evaluation of her clinical and family history.

Conclusion: This case underscores the importance of considering HHT in the differential diagnosis of patients with severe, chronic iron deficiency anemia, particularly when accompanied by recurrent epistaxis and a positive family history. The successful diagnosis was contingent upon a high index of suspicion and a systematic investigation that fulfilled the established clinical criteria.