Pub Date : 2021-01-30DOI: 10.31082/1728-452x-2020-221-222-11-12-35-42
Togzhan Abdikalikova, L. Turgunova, B. Baidildina, Z. Mursalova
The relevance of the work is due to the high prevalence of chronic kidney disease (CKD) among the population and high mortality from cardiovascular disease (CVD) in this population. In this connection, it is necessary to search for new biomarkers in order to early identify individuals with cardiovascular risk in patients with CKD. The purpose of this study to assess the endocan level in patients with CKD depending on the glomerular filtration rate (GFR), to study the relationship between the endocan level and other cardiovascular risk factors in patients with CKD. Material and methods. 153 respondents with various stages of CKD were examined. The study included socio-demographic, anthropometric data, blood pressure measurements, cholesterol, high density lipoprotein (HDL), triglycerides (TG), glucose and endocan. Data analysis was performed using the statistical software package SPSS 22. Results and discussion. The respondents in the groups did not differ in such indicators as gender, age, marital status, frequency of active smoking, diabetes, body mass index (BMI). Significant differences were found in the level of education (p=0.04), income (p=0.008), systolic pressure (SBP) (p=0.0001) and diastolic blood pressure (DBP) (p=0.0001). Levels of total cholesterol (cholesterol), (p=0.0001), uric acid (p=0.0001), cystatin C (p=0.0001) and endocan (p=0.0001) also had significant differences depending on GFR. Conclusion. A comparative analysis of the frequency of “traditional” cardiovascular risk factors among patients with various stages of CKD showed the absence of differences in the frequency of active smoking, diabetes mellitus, obesity and the presence of significant differences in blood pressure and total cholesterol (p = 0.0001). Evaluation of the endocan level depending on the stage of CKD showed that with the progression of CKD, the endocan level increases significantly (p = 0.0001), which may indicate the progression of endothelial dysfunction with impaired renal function. Further studies are needed to determine the prognostic value of endocan in the development of cardiovascular events in patients with CKD. Keywords: chronic kidney disease, cardiovascular disease, glomerular filtration rate, biomarkers, endocan.
{"title":"Endocan level in patients with chronic kidney disease","authors":"Togzhan Abdikalikova, L. Turgunova, B. Baidildina, Z. Mursalova","doi":"10.31082/1728-452x-2020-221-222-11-12-35-42","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-221-222-11-12-35-42","url":null,"abstract":"The relevance of the work is due to the high prevalence of chronic kidney disease (CKD) among the population and high mortality from cardiovascular disease (CVD) in this population. In this connection, it is necessary to search for new biomarkers in order to early identify individuals with cardiovascular risk in patients with CKD. The purpose of this study to assess the endocan level in patients with CKD depending on the glomerular filtration rate (GFR), to study the relationship between the endocan level and other cardiovascular risk factors in patients with CKD. Material and methods. 153 respondents with various stages of CKD were examined. The study included socio-demographic, anthropometric data, blood pressure measurements, cholesterol, high density lipoprotein (HDL), triglycerides (TG), glucose and endocan. Data analysis was performed using the statistical software package SPSS 22. Results and discussion. The respondents in the groups did not differ in such indicators as gender, age, marital status, frequency of active smoking, diabetes, body mass index (BMI). Significant differences were found in the level of education (p=0.04), income (p=0.008), systolic pressure (SBP) (p=0.0001) and diastolic blood pressure (DBP) (p=0.0001). Levels of total cholesterol (cholesterol), (p=0.0001), uric acid (p=0.0001), cystatin C (p=0.0001) and endocan (p=0.0001) also had significant differences depending on GFR. Conclusion. A comparative analysis of the frequency of “traditional” cardiovascular risk factors among patients with various stages of CKD showed the absence of differences in the frequency of active smoking, diabetes mellitus, obesity and the presence of significant differences in blood pressure and total cholesterol (p = 0.0001). Evaluation of the endocan level depending on the stage of CKD showed that with the progression of CKD, the endocan level increases significantly (p = 0.0001), which may indicate the progression of endothelial dysfunction with impaired renal function. Further studies are needed to determine the prognostic value of endocan in the development of cardiovascular events in patients with CKD. Keywords: chronic kidney disease, cardiovascular disease, glomerular filtration rate, biomarkers, endocan.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77589108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-30DOI: 10.31082/1728-452x-2020-221-222-11-12-8-12
S. Kenzhebekova, S. Sakhanov, Dulat Turebaev, Gauhar Nurtazinova, S. Urazova, Dariyana Kulmirzaeva, Akmaral Amanshayeva, Z. Bilyalova, M. Izimbergenov, S. Kozhakhmetov, N. Igissinov
Nonspecific ulcerative colitis is a chronic inflammatory bowel disease of an immune nature with frequent localization in the large intestine. A pattern is noted that in the northern and western continents they suffer more often than in Asia. To identify risk factors in a population, epidemiological studies must firstly assess the incidence of disease. Aim. To study the trends of nonspecific ulcerative colitis (NUC) incidence in Kazakhstan. Material and methods. The research material was compiled summary reporting form number 12 of the Ministries and the Health of the Republic of Kazakhstan on new cases of nonspecific ulcerative colitis (ICD-10 – K51), established for the first time. A retrospective study was used as the main method for studying the incidence of NUC. According to generally accepted methods of biomedical statistics, extensive, intensive and equalized indicators of the incidence of NUC were calculated. Results and discussion. For 2013-2018 14,079 new cases of NUC were registered in the republic, of which 15 were in children – 15.3%, teenagers – 4.8% and adults – 79.8%. The average annual incidence rate of NUC in the entire population of Kazakhstan was 13.5±2.10/0000 (95% CI=9.4-17.50/0000), and for population groups having been studied was: in children – 7.2±2.10/0000 (95%CI=3.8-12.00/0000), among teenagers – 18.7±5.00/0000 (95% CI=9.0-28.50/0000) and the adult population 15.4±1.90/0000 (95% CI=11.8-19.10/0000). The difference in morbidity between groups was statistically significant. Disease tended to decrease in all age groups: in the adult population (Т=−12.3%), children (Т=−43.7%) and in adolescents (T=-50.1%). Conclusion. According to the dynamics, NUC incidence in Kazakhstan has a decreased tendency due to the child and adolescent population. The results obtained are recommended to be taken into account by health authorities when making managerial decisions. Keywords: nonspecific ulcerative colitis, morbidity, trends, Kazakhstan.
{"title":"Tendency Of Incidence With Nonspecific Ulcerative Colitis In Kazakhstan","authors":"S. Kenzhebekova, S. Sakhanov, Dulat Turebaev, Gauhar Nurtazinova, S. Urazova, Dariyana Kulmirzaeva, Akmaral Amanshayeva, Z. Bilyalova, M. Izimbergenov, S. Kozhakhmetov, N. Igissinov","doi":"10.31082/1728-452x-2020-221-222-11-12-8-12","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-221-222-11-12-8-12","url":null,"abstract":"Nonspecific ulcerative colitis is a chronic inflammatory bowel disease of an immune nature with frequent localization in the large intestine. A pattern is noted that in the northern and western continents they suffer more often than in Asia. To identify risk factors in a population, epidemiological studies must firstly assess the incidence of disease. Aim. To study the trends of nonspecific ulcerative colitis (NUC) incidence in Kazakhstan. Material and methods. The research material was compiled summary reporting form number 12 of the Ministries and the Health of the Republic of Kazakhstan on new cases of nonspecific ulcerative colitis (ICD-10 – K51), established for the first time. A retrospective study was used as the main method for studying the incidence of NUC. According to generally accepted methods of biomedical statistics, extensive, intensive and equalized indicators of the incidence of NUC were calculated. Results and discussion. For 2013-2018 14,079 new cases of NUC were registered in the republic, of which 15 were in children – 15.3%, teenagers – 4.8% and adults – 79.8%. The average annual incidence rate of NUC in the entire population of Kazakhstan was 13.5±2.10/0000 (95% CI=9.4-17.50/0000), and for population groups having been studied was: in children – 7.2±2.10/0000 (95%CI=3.8-12.00/0000), among teenagers – 18.7±5.00/0000 (95% CI=9.0-28.50/0000) and the adult population 15.4±1.90/0000 (95% CI=11.8-19.10/0000). The difference in morbidity between groups was statistically significant. Disease tended to decrease in all age groups: in the adult population (Т=−12.3%), children (Т=−43.7%) and in adolescents (T=-50.1%). Conclusion. According to the dynamics, NUC incidence in Kazakhstan has a decreased tendency due to the child and adolescent population. The results obtained are recommended to be taken into account by health authorities when making managerial decisions. Keywords: nonspecific ulcerative colitis, morbidity, trends, Kazakhstan.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90341465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-30DOI: 10.31082/1728-452x-2020-221-222-11-12-13-21
Tolegen Magauov
Currently, in the healthcare of the Republic of Kazakhstan and many other countries, ISO standards are mandatory, and also in some countries the Lean Production System is used. In the Republic of Kazakhstan, the Ministry of Health issued guidelines for the implementation of lean technologies in healthcare organizations in 2017. However, the introduction of Lean technologies is not yet mandatory and has not become widespread in medical organizations in our country. In this regard, information on Lean technologies, experience of their application and effectiveness in healthcare organizations is useful for our medical managers and workers. Goal. Analysis of literature data on ISO and Lean quality management systems, their comparison, experience of application in healthcare organizations and efficiency. Material and methods. For this analysis, we searched for information on the issue with a depth of up to 20 years. Search for publications on the topic of the review was carried out in the databases of PubMed / MEDLINE, PMC, EMBASE, Web of Since, as well as a broad search through the browsers Google.com and Yahoo.com. The search criteria were combinations of terms: quality management system, healthcare, and lean production. Results and discussion. The description of the main features of the quality management systems ISO and Lean, as well as their comparison have been made. Information on the use of these systems in healthcare organizations is given. Currently, the Lean manufacturing system has been implemented in all healthcare organizations in the province of Saskatchewan (Canada), and a large-scale implementation has begun in the Russian Federation. Many medical organizations are implementing Lean system on their own initiative. Most publications have positive feedback on the Lean application. However, there are also several critical articles that the published positive reports lack a strong evidence base. In addition, it is impossible to compare the reports of different organizations due to the lack of a unified system for evaluating the effectiveness of Lean. Conclusion. The Lean manufacturing system is increasingly being used in healthcare organizations. Mostly positive results of Lean application are reported. However, the issue of its effectiveness in healthcare requires further research, since most of the reports cannot be considered as hard evidence. Keywords: quality management system, quality of care, lean management, customer satisfaction
目前，在哈萨克斯坦共和国和许多其他国家的医疗保健中，ISO标准是强制性的，并且在一些国家也使用精益生产系统。在哈萨克斯坦共和国，卫生部于2017年发布了在卫生保健组织实施精益技术的指导方针。然而，精益技术的引入还不是强制性的，在我国的医疗机构中还没有普及。在这方面，关于精益技术的信息，它们在医疗保健组织中的应用经验和有效性，对我们的医疗管理人员和工作人员是有用的。的目标。ISO和Lean质量管理体系的文献资料分析、比较、在医疗机构的应用经验和效率。材料和方法。为了进行这项分析，我们搜索了有关该问题的信息，其深度可达20年。在PubMed / MEDLINE、PMC、EMBASE、Web of Since等数据库中搜索了与该综述主题相关的出版物，并通过浏览器Google.com和Yahoo.com进行了广泛的搜索。搜索标准是术语的组合:质量管理体系，医疗保健和精益生产。结果和讨论。介绍了ISO和精益质量管理体系的主要特点，并对两者进行了比较。给出了在医疗机构中使用这些系统的信息。目前，精益生产系统已在萨斯喀彻温省(加拿大)的所有医疗保健组织中实施，并已在俄罗斯联邦开始大规模实施。许多医疗机构都在主动实施精益体系。大多数出版物对精益应用都有积极的反馈。然而，也有一些批评文章认为，发表的积极报道缺乏强有力的证据基础。此外，由于缺乏一个统一的系统来评估精益的有效性，不可能比较不同组织的报告。结论。精益生产系统越来越多地被用于医疗保健组织。精益应用的结果大多是积极的。然而，其在医疗保健中的有效性问题需要进一步研究，因为大多数报告不能被视为确凿的证据。关键词:质量管理体系，质量关怀，精益管理，顾客满意
{"title":"ISO and Lean Quality Management Systems in Healthcare","authors":"Tolegen Magauov","doi":"10.31082/1728-452x-2020-221-222-11-12-13-21","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-221-222-11-12-13-21","url":null,"abstract":"Currently, in the healthcare of the Republic of Kazakhstan and many other countries, ISO standards are mandatory, and also in some countries the Lean Production System is used. In the Republic of Kazakhstan, the Ministry of Health issued guidelines for the implementation of lean technologies in healthcare organizations in 2017. However, the introduction of Lean technologies is not yet mandatory and has not become widespread in medical organizations in our country. In this regard, information on Lean technologies, experience of their application and effectiveness in healthcare organizations is useful for our medical managers and workers. Goal. Analysis of literature data on ISO and Lean quality management systems, their comparison, experience of application in healthcare organizations and efficiency. Material and methods. For this analysis, we searched for information on the issue with a depth of up to 20 years. Search for publications on the topic of the review was carried out in the databases of PubMed / MEDLINE, PMC, EMBASE, Web of Since, as well as a broad search through the browsers Google.com and Yahoo.com. The search criteria were combinations of terms: quality management system, healthcare, and lean production. Results and discussion. The description of the main features of the quality management systems ISO and Lean, as well as their comparison have been made. Information on the use of these systems in healthcare organizations is given. Currently, the Lean manufacturing system has been implemented in all healthcare organizations in the province of Saskatchewan (Canada), and a large-scale implementation has begun in the Russian Federation. Many medical organizations are implementing Lean system on their own initiative. Most publications have positive feedback on the Lean application. However, there are also several critical articles that the published positive reports lack a strong evidence base. In addition, it is impossible to compare the reports of different organizations due to the lack of a unified system for evaluating the effectiveness of Lean. Conclusion. The Lean manufacturing system is increasingly being used in healthcare organizations. Mostly positive results of Lean application are reported. However, the issue of its effectiveness in healthcare requires further research, since most of the reports cannot be considered as hard evidence. Keywords: quality management system, quality of care, lean management, customer satisfaction","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90252088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-30DOI: 10.31082/1728-452x-2020-221-222-11-12-27-34
K. Akhmetov, Yerkezhan Zhadykova, A. Sadykov, Yerzhan Adilbekov, A. Jaxybayeva, S. Akshulakov, N. Igissinov
Traumatic brain injury (TBI) is one of the most severe and common forms of damage to the central nervous system. At the same time, traumatic subdural hemorrhage refers to severe TBI leading to severe disability and death. Aim of the research. To study the epidemiological features of mortality from traumatic subdural hemorrhage in Kazakhstan. Material and Methods. The study was retrospective, 2009-2018, the material was data on cases of death from traumatic subdural hemorrhage in the country, descriptive and analytical methods of epidemiology were used. Results and discussion. It is established that the average age of those who died from traumatic subdural hemorrhage in men (44.5±0.78 years) was younger than in women patients (47.6±1.17 years). The crude and standardized mortality rates for men (1.33±0.070/0000 and 1.39±0.070/0000, respectively) were higher than for women (0.45±0.040/0000 and 0.42±0.040/0000, respectively). Age indicators had a unimodal increase with a peak of mortality in the group of 70 years and older in both men (2.8±0.38) and women (1.05±0.14). Trends in age-related indicators in men and women tended to increase, with the most pronounced growth rates of the equalized indicators being at the age of 70 years and older in men (Tgr=+7.1%), and in women (Tgr=+9.2%). Conclusions. The analysis of mortality from traumatic subdural hemorrhage indicates a gender difference and an increase in mortality in all the studied population groups. The obtained data are recommended to be used for monitoring and evaluation of diagnostic and therapeutic measures in this pathology. Keywords: traumatic subdural hemorrhage, mortality, Kazakhstan
{"title":"Assessment of mortality from traumatic subdural hemorrhage in Kazakhstan","authors":"K. Akhmetov, Yerkezhan Zhadykova, A. Sadykov, Yerzhan Adilbekov, A. Jaxybayeva, S. Akshulakov, N. Igissinov","doi":"10.31082/1728-452x-2020-221-222-11-12-27-34","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-221-222-11-12-27-34","url":null,"abstract":"Traumatic brain injury (TBI) is one of the most severe and common forms of damage to the central nervous system. At the same time, traumatic subdural hemorrhage refers to severe TBI leading to severe disability and death. Aim of the research. To study the epidemiological features of mortality from traumatic subdural hemorrhage in Kazakhstan. Material and Methods. The study was retrospective, 2009-2018, the material was data on cases of death from traumatic subdural hemorrhage in the country, descriptive and analytical methods of epidemiology were used. Results and discussion. It is established that the average age of those who died from traumatic subdural hemorrhage in men (44.5±0.78 years) was younger than in women patients (47.6±1.17 years). The crude and standardized mortality rates for men (1.33±0.070/0000 and 1.39±0.070/0000, respectively) were higher than for women (0.45±0.040/0000 and 0.42±0.040/0000, respectively). Age indicators had a unimodal increase with a peak of mortality in the group of 70 years and older in both men (2.8±0.38) and women (1.05±0.14). Trends in age-related indicators in men and women tended to increase, with the most pronounced growth rates of the equalized indicators being at the age of 70 years and older in men (Tgr=+7.1%), and in women (Tgr=+9.2%). Conclusions. The analysis of mortality from traumatic subdural hemorrhage indicates a gender difference and an increase in mortality in all the studied population groups. The obtained data are recommended to be used for monitoring and evaluation of diagnostic and therapeutic measures in this pathology. Keywords: traumatic subdural hemorrhage, mortality, Kazakhstan","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84691396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-20DOI: 10.31082/1728-452x-2020-219-2220-9-10-34-38
M. Temirova, S. Iskakov
The problem of an acceptable choice of the method of delivery for symphysis pubis dysfunction is relevant in modern obstetrics. Since the incidence of this condition varies between 1 in 300 and 1 in 30,000 pregnancies. And such a large variation in the frequency of symphysis pubis dysfunction is explained by the lack of a clear terminology for this disease, pathogenesis, and uniform diagnostic criteria. Purpose of the study. Analysis and comparative characteristics of pregnant women with pubis symphysis diastasis and clinical dysfunction of the pubis symphysis and without it. Material and methods. A retrospective analysis of 1210 birth histories and exchange cards of pregnant women in the period from 2015 to 2019. Results and discussion. In the group with clinical manifestations of pubic symphysis dysfunction, with overweight and obese of I, II, III degrees, as well as with diseases of the blood, cardiovascular system and endocrine disorders. And the group without clinical manifestations of pubic symphysis dysfunction consisted of multigravida with normal body weight. Conclusions. Vaginal delivery preferred by method of delivery for pregnant women with or without clinical manifestations of pubic symphysis, associated with minimal risk of pubis symphysis rupture. Keywords: pubis dysfunction, pregnancy, delivery.
{"title":"Comparative characteristics of pregnancy-related symphysis pubis dysfunction","authors":"M. Temirova, S. Iskakov","doi":"10.31082/1728-452x-2020-219-2220-9-10-34-38","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-219-2220-9-10-34-38","url":null,"abstract":"The problem of an acceptable choice of the method of delivery for symphysis pubis dysfunction is relevant in modern obstetrics. Since the incidence of this condition varies between 1 in 300 and 1 in 30,000 pregnancies. And such a large variation in the frequency of symphysis pubis dysfunction is explained by the lack of a clear terminology for this disease, pathogenesis, and uniform diagnostic criteria. Purpose of the study. Analysis and comparative characteristics of pregnant women with pubis symphysis diastasis and clinical dysfunction of the pubis symphysis and without it. Material and methods. A retrospective analysis of 1210 birth histories and exchange cards of pregnant women in the period from 2015 to 2019. Results and discussion. In the group with clinical manifestations of pubic symphysis dysfunction, with overweight and obese of I, II, III degrees, as well as with diseases of the blood, cardiovascular system and endocrine disorders. And the group without clinical manifestations of pubic symphysis dysfunction consisted of multigravida with normal body weight. Conclusions. Vaginal delivery preferred by method of delivery for pregnant women with or without clinical manifestations of pubic symphysis, associated with minimal risk of pubis symphysis rupture. Keywords: pubis dysfunction, pregnancy, delivery.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87108193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-20DOI: 10.31082/1728-452x-2020-219-2220-9-10-11-16
Yerkezhan Zhadykova, S. Sakhanov, D. Turebayev, D. Kulmirzayeva, S. Urazova, Akmaral Amanshayeva, Z. Bilyalova, S. Kozhakhmetov, N. Igissinov
About 3.15 million new cases of colorectal cancer (CRC) are predicted and it is expected that about 1.62 million human will die from this pathology, according to the forecasts of the International Agency for Research on Cancer in 2040. To this aim, an analysis studying studying the indicators of the oncological service for CRC also makes it possible to evaluate the ongoing anti-cancer measures in East Kazakhstan region. Aim. Evaluate some indicators of the oncological service at CRC in East Kazakhstan region in 2009 to 2018. Materials and methods. The research material was data from the Ministry of Health of the Republic of Kazakhstan – annual form No. 7 and 35 regarding CRC (ICD 10 – C18-21) for 2009-2018 in East Kazakhstan region – incidence, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. Results and discussion. For 2009-2018, 3,661 new cases of CRC were registered in East Kazakhstan region for the first time. The incidence of CRC was 25.30/0000 and in dynamics tended to increase from 21.90/0000 (2009) to 25.70/0000 in 2018, the difference was statistically significant (t=1.99 and p=0.047). The mortality rate from CRC tended to decrease from 15.50/0000 to 14.70/0000 (p=0.591), and the average annual mortality rate from CRC was 15.60/0000. The indicators of early diagnosis (the proportion of patients with stage I-II) improved from 58.8% (2009) to 62.3% in 2018, and, accordingly, the indicators of the proportion of neglected patients significantly decreased with stage III (from 25.5% to 20.8%), while with stage IV (from 15.7% to 16.9%) there is a slight increase. The indicators of morphological verification in CRC improved from 90.5% to 98.6% during the studied years. Conclusion. An improvement in the indicators of morphological verification and early diagnosis of CRC was found. The obtained results are recommended to be used for monitoring anti-cancer measures in the region. Keywords: colorectal cancer, incidence, mortality, early diagnosis, neglect, morphological verification.
根据国际癌症研究机构(International Agency for Research on cancer)的预测，到2040年，预计约有315万结直肠癌(CRC)新病例，预计约有162万人将死于这种病理。为此，一项研究CRC肿瘤服务指标的分析也使评估东哈萨克斯坦地区正在进行的抗癌措施成为可能。的目标。评价2009 - 2018年东哈萨克斯坦地区CRC肿瘤服务的部分指标。材料和方法。研究材料是哈萨克斯坦共和国卫生部2009-2018年东哈萨克斯坦地区CRC (ICD 10 - C18-21)年度表格第7号和第35号的数据——发病率、死亡率、早期诊断、忽视、形态学验证。采用生物医学统计学的描述性和分析性方法进行回顾性研究。结果和讨论。2009-2018年，东哈萨克斯坦地区首次登记了3,661例结直肠癌新病例。结直肠癌发病率为25.30/0000，动态趋势由2009年的21.90/0000上升至2018年的25.70/0000，差异有统计学意义(t=1.99, p=0.047)。结直肠癌死亡率从15.50/0000下降至14.70/0000 (p=0.591)，年平均死亡率为15.60/0000。早期诊断指标(I-II期患者占比)从2009年的58.8%提高到2018年的62.3%，相应的，被忽视患者占比指标在III期显著下降(从25.5%下降到20.8%)，在IV期略有上升(从15.7%下降到16.9%)。在研究期间，结直肠癌的形态学验证指标从90.5%提高到98.6%。结论。结直肠癌的形态学验证和早期诊断指标均有改善。建议将所得结果用于监测该地区的抗癌措施。关键词:结直肠癌，发病率，死亡率，早期诊断，忽视，形态学验证。
{"title":"Evaluation Changes in Indicators of Oncological Service in Colorectal Cancer in East Kazakhstan Region","authors":"Yerkezhan Zhadykova, S. Sakhanov, D. Turebayev, D. Kulmirzayeva, S. Urazova, Akmaral Amanshayeva, Z. Bilyalova, S. Kozhakhmetov, N. Igissinov","doi":"10.31082/1728-452x-2020-219-2220-9-10-11-16","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-219-2220-9-10-11-16","url":null,"abstract":"About 3.15 million new cases of colorectal cancer (CRC) are predicted and it is expected that about 1.62 million human will die from this pathology, according to the forecasts of the International Agency for Research on Cancer in 2040. To this aim, an analysis studying studying the indicators of the oncological service for CRC also makes it possible to evaluate the ongoing anti-cancer measures in East Kazakhstan region. Aim. Evaluate some indicators of the oncological service at CRC in East Kazakhstan region in 2009 to 2018. Materials and methods. The research material was data from the Ministry of Health of the Republic of Kazakhstan – annual form No. 7 and 35 regarding CRC (ICD 10 – C18-21) for 2009-2018 in East Kazakhstan region – incidence, mortality, early diagnosis, neglect, morphological verification. A retrospective study using descriptive and analytical methods of biomedical statistics was used as the main method. Results and discussion. For 2009-2018, 3,661 new cases of CRC were registered in East Kazakhstan region for the first time. The incidence of CRC was 25.30/0000 and in dynamics tended to increase from 21.90/0000 (2009) to 25.70/0000 in 2018, the difference was statistically significant (t=1.99 and p=0.047). The mortality rate from CRC tended to decrease from 15.50/0000 to 14.70/0000 (p=0.591), and the average annual mortality rate from CRC was 15.60/0000. The indicators of early diagnosis (the proportion of patients with stage I-II) improved from 58.8% (2009) to 62.3% in 2018, and, accordingly, the indicators of the proportion of neglected patients significantly decreased with stage III (from 25.5% to 20.8%), while with stage IV (from 15.7% to 16.9%) there is a slight increase. The indicators of morphological verification in CRC improved from 90.5% to 98.6% during the studied years. Conclusion. An improvement in the indicators of morphological verification and early diagnosis of CRC was found. The obtained results are recommended to be used for monitoring anti-cancer measures in the region. Keywords: colorectal cancer, incidence, mortality, early diagnosis, neglect, morphological verification.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73336729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-20DOI: 10.31082/1728-452x-2020-219-2220-9-10-44-51
A. Zhangabylov, B. Bimbetov, Nurlan Jainakbayev, Каramyat Zordinova
Phospholipids (PL) – lipids that are not involved in accumulation of fatty deposits play a significant role and serve various functions. Firstly, as a component of cell membranes of all cells in the organism. In clinical practice, for the past decades, phospholipids were primarily used as hepaprotective substances, going by the name of “essential phospholipids (EPL)”. Becoming a popular, demanded, well-promoted remedy for the treatment of liver diseases. However, despite the many years of approbation, the existing and sufficientclinicalexperience, discussions regarding their benefits, effectiveness, safety and reliability are still underway and have brought up diametrically opposed views. From complete rejection of EPL as medicinal means, to full recognition of the advertised properties of EPL drugs based on the given manufacturer’s descriptions. For this reason, to clarify the issuing situation, we have conducted a literature search on the object of investigation. Purpose of the study. Search and critical analysis of modern literature sources on the topic of work using the principles of evidence-based medicine. Material and Methods. A critical online review of the literature sources chosen for the research has been carried out in the Web of Science Thompson Reuters, Springer Link and Pubmed databases, as well as in research works and online articles 10 years deep. Inclusion criteria: research papers with a high index of evidence base. Exclusion criteria: literature sources with no evidence, low quality works. Results and Discussion. The articleoutlines the natural role of proteins, lipids and the function of the cytolemma of intracellularorganoids in the restoration of damaged membranes of hepatocytes - de novo. Substantiating the obvious uselessness of using essential phospholipids in the treatment of liver diseases in general, fatty hepatosis in particular. The inability of penetration into liver cells for phospholipids in their native form and their alignment in thehepacyte membrane is indicated, since they belong to different biological species and have a mutually closed genetic system. In the literature search undertaken by us on this issue, the analytical and critical review of scientific literature have also shown that when ingested, essential phospholipids have low bioavailability, as the phospholipids in the chylomicrons do not directly enter the liver, but first the lymphatic system through which they are transported to the adipose tissue of the organism, where they are accumulated and metabolized. With parenteral administration, EPL spreading through the bloodstream can accumulate in other organs, systems, without reaching the liver tissue. For example, the largest amounts of EPL are usually found in the cell membranes of the nervous tissue and the brain. Conclusion. Essential phospholipids in the form of soy lecithin products cannot replace the endogenous phospholipids of the human body - in principle. Keywords: essentialphospholipid
{"title":"Current view of the yesterday's medicine (review)","authors":"A. Zhangabylov, B. Bimbetov, Nurlan Jainakbayev, Каramyat Zordinova","doi":"10.31082/1728-452x-2020-219-2220-9-10-44-51","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-219-2220-9-10-44-51","url":null,"abstract":"Phospholipids (PL) – lipids that are not involved in accumulation of fatty deposits play a significant role and serve various functions. Firstly, as a component of cell membranes of all cells in the organism. In clinical practice, for the past decades, phospholipids were primarily used as hepaprotective substances, going by the name of “essential phospholipids (EPL)”. Becoming a popular, demanded, well-promoted remedy for the treatment of liver diseases. However, despite the many years of approbation, the existing and sufficientclinicalexperience, discussions regarding their benefits, effectiveness, safety and reliability are still underway and have brought up diametrically opposed views. From complete rejection of EPL as medicinal means, to full recognition of the advertised properties of EPL drugs based on the given manufacturer’s descriptions. For this reason, to clarify the issuing situation, we have conducted a literature search on the object of investigation. Purpose of the study. Search and critical analysis of modern literature sources on the topic of work using the principles of evidence-based medicine. Material and Methods. A critical online review of the literature sources chosen for the research has been carried out in the Web of Science Thompson Reuters, Springer Link and Pubmed databases, as well as in research works and online articles 10 years deep. Inclusion criteria: research papers with a high index of evidence base. Exclusion criteria: literature sources with no evidence, low quality works. Results and Discussion. The articleoutlines the natural role of proteins, lipids and the function of the cytolemma of intracellularorganoids in the restoration of damaged membranes of hepatocytes - de novo. Substantiating the obvious uselessness of using essential phospholipids in the treatment of liver diseases in general, fatty hepatosis in particular. The inability of penetration into liver cells for phospholipids in their native form and their alignment in thehepacyte membrane is indicated, since they belong to different biological species and have a mutually closed genetic system. In the literature search undertaken by us on this issue, the analytical and critical review of scientific literature have also shown that when ingested, essential phospholipids have low bioavailability, as the phospholipids in the chylomicrons do not directly enter the liver, but first the lymphatic system through which they are transported to the adipose tissue of the organism, where they are accumulated and metabolized. With parenteral administration, EPL spreading through the bloodstream can accumulate in other organs, systems, without reaching the liver tissue. For example, the largest amounts of EPL are usually found in the cell membranes of the nervous tissue and the brain. Conclusion. Essential phospholipids in the form of soy lecithin products cannot replace the endogenous phospholipids of the human body - in principle. Keywords: essentialphospholipid","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90600250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-20DOI: 10.31082/1728-452x-2020-219-220-9-10-2-10
Z. Ismet, Kamila Sharmetova, Zh B Baymakhanov, E. Serikuly, Shokan Kaniev, A. Skakbayev, M. Seisembayev, A. Chormanov, B. Baymakhanov, Galina Kaussova, Ardak Auezova, M. Brimzhanova, Maksat Doskhan, Zhanargul Kabdekenova, D. Mukazhanov, B. Askeev
Goal. Find out the opinion of the Kazakh population about post-mortem organ donation to save the lives of patients with terminal diseases of organs in need of transplantation. Material and methods. The survey was conducted in the form of an anonymous online questionnaire. Our study involved 1176 people, of these, 309 are male and 867 are female. The survey participants were citizens of different regions of the country and different nationalities, the average age of the participants was 38.7±1 years (18-73 years). Results and discussion. 422 participants (36%) agreed to become a posthumous donor, and 644 (55%) refused to donate. 88 (7.6%) of the participants doubted their choice, the other 22 participants did not answer this question. During the survey, out of 1,176 respondents, 991 (84%) participants know that organ transplantation is being carried out in the country, of which 384 (38.7%) participants agree to post-mortem donation, and 607 (61.2%) participants refuse post-mortem donation. 185 (16%) participants are not informed that organ transplantation is being performed in the country, of which 49 (26.5%) participants agree to post-mortem donation, and 136 (73.5%) participants refuse post-mortem donation. As a result, it was found that informed participants agreed to post-mortem donation in 38.7% of cases, and uninformed participants agreed in only 26.5% of cases. Conclusion. For the development of organ transplantation from a cadaveric donor in Kazakhstan, it is necessary to inform the population about organ transplants carried out in large transplant centers of the country, and with good long-term results, to inform the population about the laws of the Republic of Kazakhstan on organ transplantation. It is very important for the population to guarantee security and huge support from the government of the country. In addition, for the development of organ transplantation from a posthumous donor in Kazakhstan, a lot depends not only on the population of the country itself, but also on social, moral, ethical, economic, and humanitarian support from the state government. Organ transplantation from a post-mortem donor is one of the most complex types of medical care, requiring a high level of professional and material support and coordinated actions at all levels of management. This area cannot develop without the support of society, the government, as well as without a positive view of the population. Keywords: organ transplantation, donor, opinion of the population of Kazakhstan.
{"title":"Study of public opinion on post-mortem donation in the Republic of Kazakhstan","authors":"Z. Ismet, Kamila Sharmetova, Zh B Baymakhanov, E. Serikuly, Shokan Kaniev, A. Skakbayev, M. Seisembayev, A. Chormanov, B. Baymakhanov, Galina Kaussova, Ardak Auezova, M. Brimzhanova, Maksat Doskhan, Zhanargul Kabdekenova, D. Mukazhanov, B. Askeev","doi":"10.31082/1728-452x-2020-219-220-9-10-2-10","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-219-220-9-10-2-10","url":null,"abstract":"Goal. Find out the opinion of the Kazakh population about post-mortem organ donation to save the lives of patients with terminal diseases of organs in need of transplantation. Material and methods. The survey was conducted in the form of an anonymous online questionnaire. Our study involved 1176 people, of these, 309 are male and 867 are female. The survey participants were citizens of different regions of the country and different nationalities, the average age of the participants was 38.7±1 years (18-73 years). Results and discussion. 422 participants (36%) agreed to become a posthumous donor, and 644 (55%) refused to donate. 88 (7.6%) of the participants doubted their choice, the other 22 participants did not answer this question. During the survey, out of 1,176 respondents, 991 (84%) participants know that organ transplantation is being carried out in the country, of which 384 (38.7%) participants agree to post-mortem donation, and 607 (61.2%) participants refuse post-mortem donation. 185 (16%) participants are not informed that organ transplantation is being performed in the country, of which 49 (26.5%) participants agree to post-mortem donation, and 136 (73.5%) participants refuse post-mortem donation. As a result, it was found that informed participants agreed to post-mortem donation in 38.7% of cases, and uninformed participants agreed in only 26.5% of cases. Conclusion. For the development of organ transplantation from a cadaveric donor in Kazakhstan, it is necessary to inform the population about organ transplants carried out in large transplant centers of the country, and with good long-term results, to inform the population about the laws of the Republic of Kazakhstan on organ transplantation. It is very important for the population to guarantee security and huge support from the government of the country. In addition, for the development of organ transplantation from a posthumous donor in Kazakhstan, a lot depends not only on the population of the country itself, but also on social, moral, ethical, economic, and humanitarian support from the state government. Organ transplantation from a post-mortem donor is one of the most complex types of medical care, requiring a high level of professional and material support and coordinated actions at all levels of management. This area cannot develop without the support of society, the government, as well as without a positive view of the population. Keywords: organ transplantation, donor, opinion of the population of Kazakhstan.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76061880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-20DOI: 10.31082/1728-452x-2020-219-220-9-10-39-43
T. Teleuova, F. Zhumageldiyeva, Z. Meyrmanova, Jamilya Issakhanova, Indira Tnalieva
Glaucoma is a leading cause of irreversible blindness and visual impairment. Preventing of amblyopia and blindness can be a cost-effective intervention by health services and primary health- social care services. According to A.P. Nesterov (2008), the term 'glaucoma' encompasses a large group of eye diseases with a predominantly chronic course and serious prognosis. Despite the fact that in Kazakhstan modern achievements of science and technology of glaucoma are developed and introduced into practical healthcare the number of patients blinded due to glaucoma does not decrease. Aim. To carry out an analysis of data on visual impairment due to glaucoma in Almaty for three years (2016 - 2018). Material and methods. The data of primary visual impairment of Almaty city population of according to MSE 2016 - 2018 were studied. In 2016, 204 out of 948 primary visually impaired patients were diagnosed with glaucoma, in 2017 respectively out of 1331 patients 279 were disabled, and in 2018 256 out of 1018 disabled patients were diagnosed with glaucoma. A total of 739 disabled patients were analysed over three years. Results and discussion. In comparative analysis of data by disability group, it was found that primary open-angle glaucoma was the main cause of disability during the last years studied. Consequently, the vision of the better seeing eye ranged from zero to 0.04 with optimal vision correction. Moreover, the proportion of group one disability gradually increased from 68.7% in 2016 to 86.8% in 2018, while group two data, on the contrary, decreased from 80.7% to 67.3% (terminal stage from 89.5% to 59.1%); group three figures were 65.0 to 71.2% and 76.3% to 80.5% respectively. The increase in the group III disabilities was slow (from 65.0% to 71.2%). The analysis of disability groups over the years under study has shown that the leading cause of disability is a primary open-angle glaucoma, followed by primary closed-angle, secondary and congenital glaucoma. Moreover congenital glaucoma has been reported since 2017 with a decreasing trend (3.2% to 1.2%). Conclusion. Timely detection and observation in dynamics, regular supportive therapy in patients with primary glaucoma regardless of the type and stage of the disease (except for the terminal stage), treatment of existing general, especially vascular disease at the place of residence at least twice a year would contribute to preserving of visual functions and decreasing the number of the visually impaired people. Key words: glaucoma, open-angle, closed-angle, secondary, congenital, disability groups, visual impairment.
{"title":"Visual disability due to glaukoma according to the data of the medical and social examination of the city of Almaty","authors":"T. Teleuova, F. Zhumageldiyeva, Z. Meyrmanova, Jamilya Issakhanova, Indira Tnalieva","doi":"10.31082/1728-452x-2020-219-220-9-10-39-43","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-219-220-9-10-39-43","url":null,"abstract":"Glaucoma is a leading cause of irreversible blindness and visual impairment. Preventing of amblyopia and blindness can be a cost-effective intervention by health services and primary health- social care services. According to A.P. Nesterov (2008), the term 'glaucoma' encompasses a large group of eye diseases with a predominantly chronic course and serious prognosis. Despite the fact that in Kazakhstan modern achievements of science and technology of glaucoma are developed and introduced into practical healthcare the number of patients blinded due to glaucoma does not decrease. Aim. To carry out an analysis of data on visual impairment due to glaucoma in Almaty for three years (2016 - 2018). Material and methods. The data of primary visual impairment of Almaty city population of according to MSE 2016 - 2018 were studied. In 2016, 204 out of 948 primary visually impaired patients were diagnosed with glaucoma, in 2017 respectively out of 1331 patients 279 were disabled, and in 2018 256 out of 1018 disabled patients were diagnosed with glaucoma. A total of 739 disabled patients were analysed over three years. Results and discussion. In comparative analysis of data by disability group, it was found that primary open-angle glaucoma was the main cause of disability during the last years studied. Consequently, the vision of the better seeing eye ranged from zero to 0.04 with optimal vision correction. Moreover, the proportion of group one disability gradually increased from 68.7% in 2016 to 86.8% in 2018, while group two data, on the contrary, decreased from 80.7% to 67.3% (terminal stage from 89.5% to 59.1%); group three figures were 65.0 to 71.2% and 76.3% to 80.5% respectively. The increase in the group III disabilities was slow (from 65.0% to 71.2%). The analysis of disability groups over the years under study has shown that the leading cause of disability is a primary open-angle glaucoma, followed by primary closed-angle, secondary and congenital glaucoma. Moreover congenital glaucoma has been reported since 2017 with a decreasing trend (3.2% to 1.2%). Conclusion. Timely detection and observation in dynamics, regular supportive therapy in patients with primary glaucoma regardless of the type and stage of the disease (except for the terminal stage), treatment of existing general, especially vascular disease at the place of residence at least twice a year would contribute to preserving of visual functions and decreasing the number of the visually impaired people. Key words: glaucoma, open-angle, closed-angle, secondary, congenital, disability groups, visual impairment.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87521247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-20DOI: 10.31082/1728-452x-2020-219-2220-9-10-28-33
M. Beketova, S. Iskakov
Intrahepatic cholestasis of pregnancy is associated with a higher incidence of adverse neonatal outcomes, including preterm birth, neonatal respiratory distress syndrome, meconium aspiration syndrome (MAS), and stillborn foetuses. Despite the successes achieved in the problem of Intrahepatic cholestasis of pregnant women (ICPW), a significant number of unfavorable outcomes for the mother and the fetus are associated with insufficiently developed possibilities for predicting them. Unsatisfactory results of pregnancy, childbirth and perinatal indicators, which cause a number of medical and social problems, can be reduced with the availability of effective methods for predicting and, if it, successful prevention and treatment of ICPW. Purpose of the study. To study the relationship between clinical and laboratory parameters in pregnant women with ICP W with obstetric and perinatal outcomes. Material and methods. A retrospective analysis of 600 birth histories and exchange cards of pregnant women in the period from 2015 to 2019 with ICPW was carried out, of which 301 pregnant women with intrahepatic cholestasis in the main group, and 299 pregnant women without intrahepatic cholestasis in the control group. Results and discussion. The most frequent complications of pregnancy and childbirth in ICPW were preterm labor, threatening fetal healthcare, preeclampsia, and postpartum hemorrhage. In patients with ICPW, an increase in the level of hepatic transaminases was significantly associated with a high perinatal risk. Respiratory disorders prevailed in the structure of diseases in newborns. An increase in the incidence of unfavorable neonatal outcomes (fetal distress, low Apgar score, low gestational age) is associated with severe hyperenzymemia in severe forms of ICPW. Conclusions. An increase in the level of hepatic transaminases is significantly associated with a high perinatal risk. The isolated use of ultrasound doppler in ICPW does not allow to reliably assess the risk of unfavorable perinatal outcomes. Analysis of the results of ultrasound doppler, with an increase in the level of transaminases, is insufficient to assess the degree of risk of antenatal death or a threatening condition of the fetus. Keywords: Intrahepatic cholestasis, pregnancy, perinatal outcomes.
{"title":"Comparative analysis of perinatal complications in intrahepatic cholestasis of pregnant women","authors":"M. Beketova, S. Iskakov","doi":"10.31082/1728-452x-2020-219-2220-9-10-28-33","DOIUrl":"https://doi.org/10.31082/1728-452x-2020-219-2220-9-10-28-33","url":null,"abstract":"Intrahepatic cholestasis of pregnancy is associated with a higher incidence of adverse neonatal outcomes, including preterm birth, neonatal respiratory distress syndrome, meconium aspiration syndrome (MAS), and stillborn foetuses. Despite the successes achieved in the problem of Intrahepatic cholestasis of pregnant women (ICPW), a significant number of unfavorable outcomes for the mother and the fetus are associated with insufficiently developed possibilities for predicting them. Unsatisfactory results of pregnancy, childbirth and perinatal indicators, which cause a number of medical and social problems, can be reduced with the availability of effective methods for predicting and, if it, successful prevention and treatment of ICPW. Purpose of the study. To study the relationship between clinical and laboratory parameters in pregnant women with ICP W with obstetric and perinatal outcomes. Material and methods. A retrospective analysis of 600 birth histories and exchange cards of pregnant women in the period from 2015 to 2019 with ICPW was carried out, of which 301 pregnant women with intrahepatic cholestasis in the main group, and 299 pregnant women without intrahepatic cholestasis in the control group. Results and discussion. The most frequent complications of pregnancy and childbirth in ICPW were preterm labor, threatening fetal healthcare, preeclampsia, and postpartum hemorrhage. In patients with ICPW, an increase in the level of hepatic transaminases was significantly associated with a high perinatal risk. Respiratory disorders prevailed in the structure of diseases in newborns. An increase in the incidence of unfavorable neonatal outcomes (fetal distress, low Apgar score, low gestational age) is associated with severe hyperenzymemia in severe forms of ICPW. Conclusions. An increase in the level of hepatic transaminases is significantly associated with a high perinatal risk. The isolated use of ultrasound doppler in ICPW does not allow to reliably assess the risk of unfavorable perinatal outcomes. Analysis of the results of ultrasound doppler, with an increase in the level of transaminases, is insufficient to assess the degree of risk of antenatal death or a threatening condition of the fetus. Keywords: Intrahepatic cholestasis, pregnancy, perinatal outcomes.","PeriodicalId":14842,"journal":{"name":"Journal \"Medicine\"","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72995361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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