Введение. По данным Всемирной организации здравоохранения, более 1,5 миллиарда взрослых во всем мире страдают от повышенного артериального давления, причем почти две трети из них проживают в странах с низким и средним уровнем дохода. Артериальная гипертензия затрагивает около 25–30% взрослого населения Казахстана, что соответствует среднемировым показателям. Однако смертность от сердечно-сосудистых заболеваний в Казахстане значительно выше по сравнению с Европейским Союзом и США. Цель исследования. Оценить эффективность внедрения программы управления заболеваниями у пациентов с артериальной гипертензией в Казахстане и провести сравнительный анализ с другими странами. Стратегия поиска. Проведён анализ данных государственных статистических сборников о здравоохранении Казахстана за период 2013–2025 гг, а также публикаций отечественных и зарубежных авторов. Поиск литературы проводился в базах данных PubMed, Google Scholar, Scopus, Web of Science и e-Library. В обзор включены первичные исследования (описательные и аналитические), вторичные исследования (метаанализы и систематические обзоры), клинические рекомендации, а также полнотекстовые публикации на русском и английском языках, опубликованные за последние 20 лет по программе управления заболеванием. Результаты. В Казахстане по итогам 2019 года доля пациентов, достигших целевого уровня артериального давления (140/90 мм рт. ст.), увеличилась до 62,7%. Госпитализация, связанная с хронической сердечной недостаточностью, снизилась на 14,5%. Внедрение ПУЗ позволило снизить смертность от ССЗ на 6% за первый год реализации. Однако сохраняются вызовы, включая низкий уровень контроля давления, ограниченность профилактических программ и недостаточную доступность медицинской помощи в сельских регионах. Выводы. Для достижения уровня развитых стран необходимы: разработка комплексной программы профилактики и лечения АГ; повышение приверженности пациентов лечению; внедрение телемедицины и унификация клинических подходов; усиление взаимодействия между пациентами и медицинскими работниками. Introduction.According to the World Health Organization, more than 1.28 billion adults worldwide suffer from elevated blood pressure, with almost two-thirds residing in low- and middle-income countries. Hypertension affects approximately 25–30% of the adult population in Kazakhstan, which is consistent with global averages. However, mortality from cardiovascular diseases in Kazakhstan is significantly higher compared to the European Union and the United States. Aim. To evaluate the effectiveness of implementing a disease management program for patients with hypertension in Kazakhstan and conduct a comparative analysis with other countries. Search strategy. The study analyzed data from Kazakhstan's state healthcare statistical reports for the period of 2013–2025, along with publications by both domestic and foreign researchers. A comprehensive literature search was conducted in databases such as PubMed, Google Scholar, Scopus, Web of Science, and e-Library. The review includes primary studies (descriptive and analytical), secondary studies (meta-analyses and systematic reviews), clinical recommendations, as well as full-text publications in Russian and English published over the past 20 years under the disease management program. Results. In Kazakhstan, at the end of 2019, the share of patients who reached the target blood pressure level (140/90 mm rt. st.) increased to 62.7%. Hospitalization, associated with chronic heart failure, decreased by 14.5%. The implementation of the disease management program reduced CVD mortality by 6% in the first year of implementation. However, challenges remain, including low blood pressure control levels, limited preventive programs, and insufficient access to medical care in rural areas. Conclusions. To achieve the level of developed countries, the following measures are necessary: the development of a comprehensive program for the prevention and treatment of hypertension; increasing patient adherence to treatment; the introduction of telemedicine and the unification of clinical approaches; and strengthening collaboration between patients and healthcare professionals. Кіріспе. Дүниежүзілік денсаулық сақтау ұйымының мәліметі...

Liver cancer is characterized by high mortality and low survival rates in most countries of the world. According to the WHO data, more than 1.3 million people with liver cancer die annually in the world and according to the data of the 9th volume of

Введение. Острый коронарный синдром остается ведущей причиной смертности и заболеваемости во всем мире, необходимости оказания неотложной помощи и скорейшего оперативного лечения. Традиционно диагноз острого коронарного синдрома основывается на клиническом анамнезе, электрокардиографических изменениях и сердечных биомаркерах, но в спектре острого коронарного синдрома существуют тонкие нетипичные проявления, которые возможно не суметь диагностировать и, следовательно не оказать необходимую помощь. Синдром Велленса и паттерн Аслангера является одним из таких примеров, при котором у пациента могут наблюдаться изменения ЭКГ, не характерные для ишемии миокарда, и даже отрицательные сердечные биомаркеры. Цель исследования. Изучить распространенность, диагностические критерии, гемодинамические показатели и тактику ведения пациентов с паттерном Аслангера и синдромом Велленса. Методы. Нами был проведен аналитический обзор руководства европейского общества кардиологов с 2020года по 2023год, а также источников в открытом доступе из научных баз данных Scopus, PubMed, Google Scholar, Web of Science, e-library. Для поиска были использованны ключевые слова: «острый коронарный синдром», «паттерн Аслангера», «синдром Велленса», «антиагрегантная терапия», «антикоагулянтная терапия». Публикации, включенные в обзор литературы, были полнотекстовые статьи на английском языке. Результаты и выводы. Всего было проанализировано 212, из них цели исследования и критериям включения соответствовали 73. Паттерн Аслангера и синдромом Велленса являются острыми коронарными синдромами высокого риска и их своевременное выявление имеет важное диагностическое и прогностическое значение. Таким образом, эти синдромы и паттерны считается эквивалентом острого инфаркта миокарда с подъемом сегмента. Introduction. Acute coronary syndrome remains a leading cause of mortality and morbidity worldwide, requiring emergency care and prompt surgical treatment. Traditionally, the diagnosis of acute coronary syndrome is based on clinical history, electrocardiographic changes and cardiac biomarkers, but within the spectrum of acute coronary syndrome there are subtle atypical manifestations that may be missed and therefore not treated. Wellens syndrome and the Aslanger pattern are one such example, in which the patient may have ECG changes not consistent with myocardial ischemia and even have negative cardiac biomarkers. Aim. Study of the prevalence, diagnostic criteria, hemodynamic parameters and management tactics of patients with the Aslanger pattern and Wellens syndrome. Research strategy. We conducted an analytical review of the guidelines of the European Society of Cardiology from 2020 to 2023, as well as open access sources from scientific databases Scopus, PubMed, Google Scholar, Web of Science, e-library. The following keywords were used for the search: “acute coronary syndrome”, “Aslanger pattern”, “Wellens syndrome”, “antiplatelet therapy”, “anticoagulant therapy”. Publications included in the literature review were full-text articles in English. Results and Conclusion. A total of 212 were analyzed, of which 70 met the study objectives and inclusion criteria. The Aslanger pattern and Wellens syndrome -these syndromes and patterns are high-risk acute coronary syndromes and their timely detection has important diagnostic and prognostic significance. Thus, these syndromes and patterns are considered equivalent to acute elevation myocardial infarction. Кіріспе. Жедел коронарлық синдром бүкіл әлемде өлім мен сырқаттанушылықтың жетекші себебі болып қала береді, шұғыл көмек пен жедел хирургиялық емдеуді қажет етеді. Дәстүрлі түрде жедел коронарлық синдромның диагностикасы клиникалық тарихқа, электрокардиографиялық өзгерістерге және жүрек биомаркерлеріне негізделген, бірақ жедел коронарлық синдромның спектрінде өткізілмеуі мүмкін, сондықтан емделмейтін нәзік атипикалық көріністер бар. Велленс синдромы және Аслангер үлгісі пациентте миокард ишемиясына сәйкес келмейтін ЭКГ өзгерістері және тіпті...

Thyroid nodules are highly prevalent, particularly among women. Palpation detects nodules in 2–7% of cases, whereas high-resolution ultrasound (US) identifies them in 20–76% of individuals. In most cases, thyroid nodules are benign and incidentally detected, causing no clinical symptoms. But when clinical symptoms begin to appear, it is necessary to make a decision on the tactics of further management. Surgical treatment is often used, including hemithyroidectomy or total thyroidectomy, poses several limitations, such as prolonged hospital stay, airway obstruction, recurrent laryngeal nerve paralysis, iatrogenic hypothyroidism, and challenges associated with reoperation. Microwave ablation is used today, is a minimally invasive method used to treat various benign and malignant tumors, including those of the thyroid, liver, and lungs.

According to Globocan, in 2022, the highest incidence of hepatocellular carcinoma (HCC) was observed in Asia, which accounted for 75% of the global burden of liver cancer 1. In the Republic of Kazakhstan in 2022, the incidence of liver cancer was 5.1 per 100,000 population, with a mortality rate of 2.9, respectively. For the period 2014-2022, HCC had the lowest five-year survival rate among all malignant neoplasms in Kazakhstan2,3. The treatment of HCC across various stages involves a range of clinical strategies4. Sorafenib is currently the primary drug in the treatment of HCC 4,5 and doxorubicin is used in transarterial hepatic artery chemoembolization (TACE)8. However, their use results in cardiotoxicity leading to cancer therapeutics-related cardiac dysfunction (CTRCD)9. CRTCD manifests as cardiovascular disease symptoms in patients with HCC, reflecting irreversible structural changes in the myocardium10. BJMS, Vol. 24 No. 04 October’25 Page : 1189-1196

The purpose of this research: to conduct a retrospective analysis of patient data after transarterial chemoembolization of the hepatic artery. Methods. A retrospective study was carried out. In the general structure of oncological patients with liver cancer during the observed period, there were 456 patients, of which 137 underwent courses of transarterial chemoembolization of the hepatic artery, the prevailing majority of which are men - 81 people. The average age of patients in the sample was 64.6±7.82 years. Results. n the group of patients undergoing transarterial chemoembolization of the hepatic artery, in addition to primary liver cancer, there were also metastatic liver lesions - 42 cases, of which cancer of the rextosigmoid junction predominated (26 cases). The average duration of the disease was 19.2±5.2 months, the median was 17.6 months. The most common diseases were arterial hypertension (45 cases) and chronic heart failure (33 cases). 22 patients received targeted therapy, 33 patients received multicomponent chemotherapy, 113 patients received transarterial chemoembolization of the hepatic artery, and 12 patients underwent surgical treatment. Conclusions. According to the results of a retrospective analysis of patient data after transarterial chemoembolization of the hepatic artery, the most common comorbidities were arterial hypertension and chronic heart failure, most patients received doxorubicin and irinotecan more often.