Disorder of Endothelia Vessels' Functional State with Malignant Tumors in Patients Exposed Anthropogenic Radiation Radiation;cancer;endothelium; The aim of this research is to determine the characteristics of endothelial factors and the hemostatic system conditions with malignant neoplasms patients, which were exposed to ionizing radiation. Total number of examined people is 223, 153 of them are patients with gastrointestinal tract oncopathology. The article presents the results of the analysis of numerical indicators of endothelial condition and platelet hemostasis of patients, who had cancer. They lived in the regions of Kazakhstan, subjected to contamination of radionuclides as a result of nuclear weapons tests, which took place in this region from 1949 to 1989. These results then were compared to cancer patients and healthy individuals with no radiation risk. The study revealed the presence of higher levels of endothelial dysfunction and following trigger of the hemostatic system in patients with malignant tumors of the gastrointestinal tract. In particular, the defined high degree of endothelial dysfunction include endothelium-dependent vasodilation, content desquamated endothelial cells in peripheral blood and von Willebrand factor. These indicators have a clear correlation with the degree of disorder of studied parameters of the hemostasis, which can cause the development of thrombotic complications.

Introduction. Coronavirus infection is a risk factor for vascular thrombosis. This is of particular importance for patients undergoing myocardial revascularization since this infection can be a trigger for the formation of restenosis in the area of a previously implanted coronary stent. Understanding the risk factors for stent thrombosis and restenosis is of particular importance in individuals at risk for adverse outcomes. The rarity of such situations makes the present study unique. Objective. Studying the peculiarities of restenosis and thrombosis of the coronary arteries in patients after coronavirus infection. Methods. The study was performed in the Department of Cardiovascular Surgery of Emergency Hospital, Semey City, in 2021. We have examined the medical records of 10 consecutive patients with restenosis of coronary arteries after coronavirus infection and 10 matched-by-age patients with similar restenosis of coronary arteries who did not have coronavirus infection as a comparison group. To determine statistically significant differences between independent samples, we calculated the Mann–Whitney U test. Results. The average age of patients was 65.7 years. Only one case was classified as early restenosis (within 8 days of previous revascularization), two cases represented late restenosis, and seven cases were very late restenoses. In 70% of cases, restenosis was localized in the left anterior descending artery, in 30% of cases, it was in the right coronary artery, and in 40% of cases, it was in the left circumflex artery. In comparison with patients who did not have a coronavirus infection, there were statistically significant differences regarding IgG ( ) and fibrinogen ( ). Conclusion. Patients with myocardial revascularization in the past have a higher risk of stent restenosis against the background of coronavirus infection due to excessive neointimal hyperplasia, hypercoagulability, increased inflammatory response, and endothelial dysfunction.

Background. According to the IHME data, 1 in 10 people in Kazakhstan suffer from mental disorders, predominantly depression and anxiety. Numerous studies of academic medicine have shown that faculty experience higher rates of psychological distress compared with the general population. Aim. To assess the psychometric reliability of the DASS-21 and its applicability in Kazakh academic faculty sample. Materials and methods. The study was conducted in May 2021 at Semey Medical University. The DASS-21 was selected for the current validation study. The validation procedure was performed in accordance with the WHO guidelines on translation and adaptation of instruments and committed in 3 phases, which included forward translation, discussion, and back translation. The Kazakh version of the DASS-21 was applied to the pilot group of 30 volunteers. Results. The vast majority of the responders were females (73.33%). The mean age was 38.17. Overall Cronbach’s alpha for the DASS-21 obtained 0.898. Cronbach’s alphas for the subscales of depression, anxiety, and stress were 0.743, 0.847, and 0.747, respectively. Test-retest reliability as measured in ICC was 0.712 for depression, 0.761 for anxiety, and 0.715 for stress subscales. Conclusions. Our study supports the psychometric properties of the DASS-21 and recommends it as a suitable tool for screening general symptoms of depression, anxiety, and stress. Введение. По данным IHME, каждый десятый человек в Казахстане страдает психическими расстройствами, преимущественно депрессией и тревожностью. Многочисленные исследования в области академической медицины показали, что преподаватели испытывают более высокий уровень психологического дистресса по сравнению с населением в целом. Цель. Оценка психометрической надежности DASS-21 и ее применимости к выборке казахстанских преподавателей. Материалы и методы. Исследование проводилось в мае 2021 года в Медицинском университете Семей. Шкала DASS-21 была использована в качестве инструмента для пилотного исследования. Процедура валидизации проводилась в соответствии с рекомендациями ВОЗ по переводу и адаптации инструментов и состояла из 3 этапов, включая прямой перевод, обсуждение и обратный перевод. Казахская версия DASS-21 была апробирована напилотной группе из 30 добровольцев. Результаты. Подавляющее большинство респондентов принадлежали женскому полу (73,33%). Средний возраст опрошенных составил 38,17. Общая альфа Кронбаха по шкале DASS-21 составила 0,898. Альфа Кронбаха для подшкал депрессии, тревоги и стресса составила 0,743, 0,847 и 0,747, соответственно. Тест-ретестовая надежность составила 0,712 для депрессии, 0,761 для тревожности и 0,715 для стресса. Выводы. Наше исследование подтверждает психометрические свойства DASS-21 и рекомендует в качестве подходящего инструмента для выявления общих симптомов депрессии, тревожности и стресса. Кіріспе. IHME мәліметтері бойынша, Қазақстанда 10 адамның 1-і психикалық бұзылулардан, негізінен депрессия мен мазасыздықтан зардап шегеді. Академиялық медицина саласындағы көптеген зерттеулер көрсеткендей, оқытушылар жалпы халықпен салыстырғанда психологиялық күйзелістің жоғары деңгейіне ие. Мақсаты. Біздің зерттеуіміз DASS-21 психометриялық сенімділігін және оның қазақстандық оқытушылар іріктемесінде қолданылуын бағалауға бағытталған. Материалдар мен әдістері. Зерттеу 2021 жылдыңмамырында Семей медициналық университетінде жүргізілді. DASS-21 шкаласы пилоттықзерттеу құралы ретінде пайдаланылды. Валидизация рәсімі ДДҰ-ның құралдарды аудару және бейімдеу жөніндегі ұсынымдарына сәйкес жүргізілді және тікелей аударма, талқылау және кері аударманы қоса алғанда, 3 кезеңнен тұрды. DASS-21 қазақ нұсқасы 30 еріктіден тұратын пилоттықтопта сыналды. Нәтижелері. Сауалнамаға қатысқандардың орташа жасы 38,17 құрады. DASS-21 шкаласы бойынша жалпы Кронбах альфасы 0,898 құрады. Депрессия, мазасыздық және стресстің кіші шкаласы үшін Кронбах альфасы сәйкесінше 0,743, 0,847 және 0,747...

Aim: The present study aimed to perform validation and assessment of psychometric indicators of the Kazakh version of the Brief Index of Affective Job Satisfaction on the academic faculty staff. Material and methods: The translation of the Brief Index of Affective Job Satisfaction was performed following the World Health Organization guidelines on the translation and adaptation of research instruments. 715 medical educators of Kazakhstani medical universities represented the study population. Preliminary statistical analysis included Cronbach’s alpha calculation. The psychometric properties of the instrument were examined using exploratory and confirmatory factor analysis. Results: Cronbach’s alpha obtained 0.83. The Kaiser-Meyer-Olkin index reached 0.830, which indicated meritorious sample adequacy. CFA identified good factorial validity of the scale: all model fit indices exceeded the threshold values. The inter-item correlation index varied between r=0.616 and r=0.716, designating an acceptable correlation between variables. The total job satisfaction level was moderate (3.15±0.78). Women reported lower rates of job satisfaction, although the difference was not statistically significant (p<0.284). Conclusion: Our findings provide support to the psychometric properties of the Kazakh version of the BIAJS as an instrument for the assessment of job satisfaction. The major advantages of the BIAJS are that it is optimally brief, highly affective, and has good internal validity.

Введение. Критическая ишемия нижних конечностей является наиболее тяжелой стадией заболевания периферических артерий и зачастую служит показанием для ампутации. Заболевания периферических артерий и сахарный диабет считаются причинами ампутаций конечностей более чем в 50 % случаев. Целью исследования является анализ литературных данных по эпидемиологическим и клиническим аспектам ампутаций нижних конечностей, а также вопросам ведения больных после ампутаций. Стратегия поиска. Был проведен поиск в базах данных PubMed, Web of Science, Embase, и Кокрановском центральном регистре контролируемых испытаний до 20 декабря 2022 г. Составлена комбинация соответствующих ключевых слов и терминов медицинских предметных рубрик (MeSH). Поиск выявил 376 публикаций. После удаления дубликатов, исследований, проведенных на животных, исследований низкого качества обзор включает 59 публикаций. Результаты. Ранняя послеоперационная смертность колеблется от 4% до 22% после большой ампутации конечности по любой причине. Успешная реабилитация после ампутации ниже колена достигается менее чем у двух третей пациентов и менее чем у половины после ампутации выше колена; в целом, менее 50% всех пациентов, нуждающихся в ампутации, смогут когда-либо достичь полной мобильности. У взрослых пациентов сложности с установкой и фиксацией протеза возрастают тем больше, чем проксимальнее ампутация. Поэтапная ампутация имеет более высокий уровень успешности, более низкую периоперационную смертность и более низкую 30-дневную смертность. Пациенты с малой ампутацией имеют лучшие показатели физического функционирования, общего здоровья, эмоционального и психического здоровья (p<0,001). Однако они имеют худшие показатели болевого компонента и социального функционирования (p<0,001). Заключение. Независимо от этиологии взвешенный подход к ампутации и постампутационной реабилитации в сочетании с оптимальным подбором протеза, может способствовать в достижении улучшения мобильности пациентов. Introduction. Critical limb ischemia is the most severe stage of peripheral arterial disease and is often an indication for amputation. Peripheral arterial disease and diabetes mellitus are considered the causes of limb amputations in more than 50% of cases. The aim of the study is to analyze the literature data on the epidemiological and clinical aspects of lower limb amputations, as well as the management of patients after amputations. Search strategy. The PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to 20 December 2022. A combination of relevant keywords and Medical Subject Heading (MeSH) terms was generated. The search revealed 376 publications. After removal of duplicates, animal studies, low quality studies, the review includes 59 publications. Results. Early postoperative mortality ranges from 4% to 22% after major limb amputation for any reason. Successful rehabilitation after amputation below the knee is achieved in less than two-thirds of patients and less than half after amputation above the knee; overall, less than 50% of all patients requiring amputation will ever achieve full mobility. In adult patients, the more proximal the amputation is, the more difficult it is to install and fix the prosthesis. Staged amputation has a higher success rate, lower perioperative mortality, and lower 30-day mortality. Minor amputation patients have better indicators of physical functioning, general health, emotional and mental health (p<0.001). However, they have worse indicators of the pain component and social functioning (p<0.001). Conclusion. Regardless of etiology, a balanced approach to amputation and post-amputation rehabilitation, combined with optimal prosthesis selection, can help achieve improved patient mobility. Кіріспе. Аяқтардың критикалық ишемиясы перифериялық артерия ауруларының ең ауыр кезеңі болып табылады және жиі ампутацияның көрсеткіші болып табылады. 50% -дан астам жағдайда аяқ-қолдың ампутациясының себебі перифериялық артерия ауруы және қантдиабеті болып саналады. Зерттеудің мақсаты – төменгі...