Colorectal cancer (CRC) has attracted the attention of scientific communities as one of the leading causes of death in humans

Background: Pancreatic cancer (PC) has an extremely poor prognosis and is growing worldwide. In Kazakhstan, it is among the five leading causes of cancer death. However, local epidemiological studies of PC are scarce. A retrospective population-based study was conducted to investigate the PC incidence, mortality, and survival in Kazakhstan, using data from the Electronic Registry of Oncological Patients for the period 2014–2023. Methods: Incidence, prevalence, and crude mortality rates were calculated per 100,000 population. The all-cause mortality rate per 1000 person-years (PY) was obtained based on socio-demographic and medical characteristics and for different regions. Survival analysis was performed using the Kaplan–Meier method and Cox regression models. Results: A total of 11,934 cases were analyzed. The annual incidence rate significantly increased from 5.9 to 6.9 per 100,000. The mortality rate per 100,000 also increased from 4 to 6. The highest incidence was observed in the 60–74 age group (49.2%), with an equal sex distribution. The mortality rate was the highest in patients aged 75 and older. Northern and central regions had the highest incidence rates as of 2023. Atyrau, West Kazakhstan, Pavlodar, and Abay had the highest mortality rates per 1000 PY. The five-year survival rate was 10.9%. An older age, a male sex, advanced cancer stages, and a Russian ethnicity significantly increased the risk of death. Conclusions: PC represents a significant healthcare problem in Kazakhstan, with late diagnosis and poor survival being the main challenges. This study highlights the need to improve the timely detection of PC and address the identified disparities.

Background/Objectives: Chemotherapy-induced cardiotoxicity is a serious complication in breast cancer treatment, particularly with anthracyclines and HER2-targeted therapy. To evaluate the association between early elevations of cardiac markers (troponin and NT-proBNP) and the development of chemotherapy-induced cardiotoxicity in adult patients with breast cancer. Methods: This systematic review and meta-analysis were conducted according to PRISMA guidelines and registered with PROSPERO (CRD420261301170). A systematic search of PubMed/MEDLINE, Cochrane CENTRAL, and Web of Science databases was conducted. Studies evaluating cardiac markers in breast cancer patients receiving chemotherapy were included in the review. Results: Fourteen studies were included in the qualitative synthesis. Five studies were included in the meta-analysis. Elevated troponin levels were associated with higher odds of subsequent cardiac dysfunction; however, the pooled association was not statistically significant [OR = 3.40, 95% CI 0.69–16.67, p = 0.13] and showed substantial heterogeneity [I² = 86.97%]. A leave-one-out sensitivity analysis was used to identify a study that exerted a substantial influence; its exclusion eliminated between-group heterogeneity and attenuated the pooled effect estimate. Conclusions: Early troponin elevation may provide a biological signal of myocardial injury during cancer therapy. However, the association between elevated troponin level and cancer therapy-related cardiac dysfunction did not reach the threshold of statistical significance and showed substantial heterogeneity. Troponin and NT-proBNP may provide complementary information to cardiac imaging, but their predictive performance and clinical utility require further prospective validation.

Introduction: Improving the quality and accessibility of medical care is a key priority for the healthcare system of the Republic of Kazakhstan. Standards for the organization of specialized medical care are important tools for unifying clinical approaches and optimizing patient routing. The purpose of this study is to assess the knowledge, practical application and barriers to the implementation of these standards of medical care organization among practicing healthcare professionals in five priority clinical profiles. Methods: Using an anonymous online platform (Google Forms), a cross-sectional survey was conducted among doctors in 46 medical organizations in 13 regions of Kazakhstan. The study was conducted in five clinical profiles: cardiology and cardiac surgery, rheumatology, gastroenterology/hepatology, nephrology and traumatology and orthopedics. The questionnaires assessed the level of knowledge about standards, estimated the perceived importance of patient satisfaction and equipment compliance. Statistical analysis was performed using STATA v.18. Results: A total of 323 out of 400 invited specialists participated in the survey (a response rate of 80.8%). In total, 267 of the 323 respondents (82.7%) reported that they use these standards in their daily work. Knowledge levels were assessed separately for each clinical profile, as the questionnaires varied in terms of the number and content of the questions. Overall, 300 out of 323 respondents (92.9%) indicated that patient satisfaction is one of the top priorities in their organization. Conclusion: Most of the physicians surveyed reported that they follow the Standards on a daily basis; however, the survey results revealed variations in the knowledge level of the Standards specific to individual medical specialties. Because the questionnaires differed in content and scope, the data obtained do not allow for the ranking of clinical specialties based on their overall level of knowledge. These findings underscore the need for further research into how well physicians understand the relevant regulatory requirements, as well as the need for an objective assessment of the implementation of these standards. When interpreting the results, it should be noted that the sample was selected purposively, and several indicators were based on the respondents' own subjective assessments.

Phantom pain is a common problem in patients with amputated limbs. It can lead to symptoms of depression for its chronicity and high intensity. It also interferes with prosthetic rehabilitation and reduces the quality of life of patients. Due to the complex pathogenesis, there is no generally accepted method of treatment for phantom pain. We present in this article the case of using mirror therapy in a University Hospital, the positive clinical result of which has been proven in multiple studies. Фантомная боль является распространенной проблемой у пациентов с ампутированными конечностями. Она может приводить к симптомам депрессии из-за своей хронизации и высокой интенсивности. Она препятствует протезной реабилитации и снижает качество жизни пациентов. Из-за сложного патогенеза общепринятого метода лечения фантомных болей не существует. В этой статье мы приводим случай использования зеркальной терапии в университетской клинике, положительный клинический результат которой был доказан в многочисленных исследованиях. Фантомдық ауырсыну - дене мүшесі ампутацияланған науқастарда кең таралған мәселе. Ол созылмалылығы мен жоғары қарқындылығы үшін депрессия симптомдарына әкелуі мүмкін. Протездік реабилитацияға да кедергі келтіріп, науқастардың өмір сүру сапасын төмендетеді. Патогенезі күрделі болғандықтан фантомдық ауырсынудың емінде жалпыға ортақ қабылданған әдіс жоқ. Біз бұл мақалада оң клиникалық нәтижесі көптеген зерттеулерде дәлелденген айна терапиясын университет ауруханасында қолданған жағдайды келтіреміз.

Introduction. Stenosis of intra- and extracranial arteries due to atherosclerosis is one of the most frequent causes of ischemic stroke and mortality worldwide. Stenting of these vessels might be an effective treatment option in symptomatic cases. Research method. A retrospective study was conducted, including 93 patients with symptomatic atherosclerotic stenoses of intra- and extracranial arteries who underwent stenting. The follow-up period was six years. Stroke, infarction, and death were accepted as primary outcomes. Statistical analysis was carried out using parametric and nonparametric analysis and regression analysis based on the Cox model. Results. A statistically significant effect of age on mortality rate was revealed. The analysis showed that an increase in blood pressure during the surgery increased the risk of mortality; however, its degree did not have a statistically significant influence on the risk of postoperative stroke. Also, the effect of cholesterol level on mortality was not statistically significant. Conclusion. Analysis of the risk factors revealed a significant impact of the hypertensive crisis on the mortality of patients, increasing it substantially. Correction and control of blood pressure pre-operatively can reduce the risks of stroke and mortality after stenting over a long period of time. Введение. Стеноз интра- и экстракраниальных артерий вследствие атеросклероза является одной из наиболее частых причин ишемического инсульта и смертности во всем мире. Стентирование этих сосудов может быть эффективным методом лечения в симптоматических случаях. Методы исследования. Проведено ретроспективное исследование, включающее 93 пациента с симптоматическими атеросклеротическими стенозами интра- и экстракраниальных артерий, которым было выполнено стентирование. Период наблюдения составил шесть лет. В качестве первичных исходов были приняты инсульт, инфаркт и смерть. Статистический анализ проводился с использованием параметрического и непараметрического анализа, а также регрессионного анализа на основе модели Кокса. Результаты. Выявлено статистически значимое влияние возраста на смертность. Анализ показал, что повышение артериального давления во время операции увеличивало риск смертности, однако его степень не оказывала статистически значимого влияния на риск развития послеоперационного инсульта. Влияние уровня холестерина на смертность также не было статистически значимым. Заключение. Анализ факторов риска выявил значительное влияние гипертонического криза на смертность пациентов, существенно ее увеличивая. Коррекция и контроль артериального давления на дооперационном этапе могут снизить риск развития инсульта и смертности после стентирования в течение длительного времени. Кіріспе. Атеросклерозға байланысты интракраниальды және экстракраниальды артериялардың стенозы бүкіл әлемде ишемиялық инсульт пен өлімнің жиі кездесетін себептерінің бірі болып табылады. Бұл тамырларды стенттеу симптоматикалық жағдайларда тиімді емдеу нұсқасы болуы мүмкін. Зерттеу әдістері. Ретроспективті зерттеу жүргізілді, оның ішінде интракраниальды және экстракраниальды артериялардың симптоматикалық атеросклеротикалық стенозы бар 93 пациент стенттелген. Бақылау мерзімі алты жыл болды. Негізгі нәтижелер инсульт, инфаркт және өлім болды. Статистикалық талдау параметрлік және параметрлік емес талдауды, сонымен қатар Кокс үлгісіне негізделген регрессиялық талдауды қолдану арқылы орындалды. Нәтижелер. Өлімге жастың статистикалық маңызды әсері анықталды. Талдау көрсеткендей, операция кезінде қан қысымының жоғарылауы өлім қаупін арттырды, бірақ оның дәрежесі операциядан кейінгі инсульт қаупіне статистикалық маңызды әсер етпеді. Холестерин деңгейінің өлімге әсері де статистикалық маңызды емес. Қорытынды. Тәуекел факторларын талдау гипертониялық криздің пациенттердің...