The present study is a retrospective analysis of the activities of a tertiary stroke center (SC) operating on the basis of Akzhan Clinic in Karaganda Region during the year 2024. The primary objective of this study was to examine the epidemiological features, the structure of stroke morbidity, and the efficacy of thrombolytic therapy (TLT) in patients with ischemic stroke (IS). The study included data from a total of 585 patients, out of which 437 had been hospitalized with acute cerebrovascular disorders, and 104 of these patients had received TLT for IS. The analysis revealed a high level of utilization of TLT (23.8%), which was significantly higher than the average regional and national figures, owing to the efficient organization of prehospital and in‐hospital stages, availability of skilled personnel, and a state‐of‐the‐art technical infrastructure. Additionally, mechanical thrombectomy (MT) was performed in 100 instances, further confirming the high level of adoption of advanced treatment modalities. The proportion of hemorrhagic transformations (7.69%) and mortality (6.7%) was comparable to or lower than international benchmarks. The results demonstrate the high effectiveness of the performance of the SC “Akzhan” and the need for the further expansion of similar facilities in order to improve the accessibility and quality of stroke treatment in Kazakhstan.

Background: Parkinson’s disease (PD) is a neurodegenerative disease associated with the gut microbiome. Objective: Conducting a comparative analysis of the intestinal microbiome in PD patients from different geographical regions. Methods: Two researchers conducted a systematic literature review of the Web of Science, PubMed, and Scopus databases, using specific search terms and defined inclusion and exclusion criteria to select studies. This is the first systematic review that conducted an analysis of the gut microbiota of PD patients from all continents. Results: The α‐diversity of PD patients does not differ significantly from healthy individuals in Europe and America, in contrast to Asia and Australia. β‐Diversity varies among PD patients in different continents. In all regions, there has been an increase in Proteobacteria and Lactobacillaceae and a decrease in Lachnospiraceae and Roseburia . In Europe, Asia, and America, PD patients have shown an increase in Bifidobacteriaceae, Desulfovibrio , Verrucomicrobia, Bilophila , and Akkermansia and a decrease in Lachnospira . In Asia, America, and Australia, there has been a decrease in Fusicatenibacter and Lachnospiraceae ND3007 , while in Europe, America, and Australia, there has been a reduction in Butyricicoccus . Conclusions : There were no consistent patterns in the changes in α‐ and β‐diversities of the gut microbiota among PD worldwide. Across all continents, there was an increase in Proteobacteria and Lactobacillaceae and a decrease in Lachnospiraceae and Roseburia . Despite these similar trends, there were also differences that may be attributed to factors such as ethnic background, geography, and dietary habits. These differences suggest that individualized approaches to treatment may be necessary to effectively manage PD‐related gastrointestinal symptoms.

Introduction: Acute cerebrovascular disorders are a major contributor to adult disability. The underlying processes that contribute to their development include inflammation, excitotoxicity, oxidative stress, and dysregulation of the tryptophan–kynurenine pathway, which is essential for neuronal survival. However, the precise mechanisms and significance of these processes are not fully comprehended, and their influence on the efficacy of therapeutic approaches remains uncertain. The aim of this study is to investigate the role of the tryptophan-kynurenine metabolic pathway in the development of stroke and its potential as a biomarker and therapeutic target. Results and Conclusions: Tryptophan metabolism primarily occurs through the kynurenine pathway. Among its metabolites, kynurenine, kynurenic and choline acids are the most significant. Them have both neuroprotective and neurotoxic effects. Activation of the kynurenine pathway is linked to chronic inflammation, increasing the risk of cardiovascular and neurodegenerative conditions. Kynurenic and choline acids regulate N-methyl-D-aspartate receptor activity and oxidative stress. The increased production of choline and 3-hydroxyanthranilic acid due to oxidative stress is a major mechanism of neuronal damage under ischemic. The regulation of the balance between the neuroprotective and neurotoxic properties of metabolites produced by the kynurenine pathway is essential for normal brain function.

Introduction: Long COVID is known to be associated with prolonged multiple organ symptoms and decreased health-related quality of life (HRQoL), but the pathogenesis and relationship between immune, inflammatory, and metabolic biomarkers and HRQoL remains poorly understood. This systematic review aims to synthesize the evidence on the health-related quality of life of patients with Long COVID and to summarize the reported associations between health-related outcomes and biomarkers. Methods: We conducted a systematic search in PubMed, Web of Science, and Scopus in search of studies that evaluated immune, inflammatory, or metabolic biomarkers and HRQoL in patients with Long COVID. This review included case–control and cohort studies with a control group. The Rayyan tool was used to select studies, and full-text articles were evaluated for compliance with the criteria. Information was obtained on biomarkers, analytical methods, tools for assessing the HRQoL, and the relationship between HRQoL and biomarkers. Due to the high heterogeneity of the methods, the results were summarized in a descriptive form. Results: Ten studies were included, involving 1,078 patients with Long COVID and 768 healthy controls. Most studies that used various methods to assess HRQoL consistently reported long-term deterioration after COVID, with the greatest deterioration observed in the areas of physical functioning, vitality, fatigue, daily activities, pain, discomfort, and respiratory distress. The most frequently measured markers were related to inflammation and endothelial/coagulation pathways, including CRP, hsCRP, IL-6, TNF- α , D-dimer, and VCAM-1. Autoimmune, metabolic, intestinal barrier, and omics-based markers were measured less frequently, but indicated phenotype-specific biological heterogeneity. Only a few studies have identified a direct link between biomarkers and HRQoL. Lower HRQoL indicators were associated with increased neurotoxicity, decreased calcium levels, systemic inflammation, endothelial dysfunction, and signals from individual autoantibodies. Conclusion: Our results indicate that Long COVID is consistently associated with a long-term decline in HRQoL, especially in the physical and functional areas. The available data indicate the presence of a strong signal regarding inflammatory processes and endothelial coagulation, while autoimmune, metabolic, and genetic data indicate phenotype-specific heterogeneity. Systematic review registration: Unique identifier: CRD420251239371, URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251239371 .

Introduction: Early differential diagnosis of acute cerebrovascular events remains a key clinical challenge, particularly during the hyperacute phase. This study aimed to assess plasma amino acid profiles and their dynamic changes as potential biomarkers and to evaluate their contribution to diagnostic accuracy. Methods: This prospective observational clinical and laboratory study included 297 participants: 122 patients with acute ischemic stroke (AIS), 50 with hemorrhagic stroke (HS), 50 with transient ischemic attack (TIA), and 75 control participants. Plasma concentrations of six amino acids were determined using high-performance liquid chromatography coupled with mass spectrometry (HPLC-MS). Patients with acute cerebrovascular disease were sampled at 3-4.5 h and 12 h after symptom onset, whereas control participants provided a baseline sample only. Statistical analyses included non-parametric tests, correlation analysis, ROC curve analysis, and multivariable logistic regression. Results: Significant between-group differences in amino acid concentrations were observed, particularly during the hyperacute phase. Individual amino acids showed limited discriminative ability when assessed in isolation (AUC approximately 0.61-0.65). Analysis of temporal changes identified additional subtype-related metabolic patterns, particularly in the differentiation of AIS and TIA. Addition of metabolomic variables to the clinical model increased the AUC from 0.734 to 0.803 (DeLong p = 0.007). Discussion: Plasma amino acid profiles are associated with systemic metabolic alterations during acute cerebrovascular events. Although individual metabolites have limited diagnostic utility as standalone biomarkers, their integration with clinical variables and assessment of temporal changes may provide complementary information for early diagnostic differentiation.

Background: The prognostic relevance of comorbidity burden in patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis (IVT) remains uncertain. This study examined the association between four comorbidity indices and early in‐hospital outcomes. Methods: This single‐center retrospective study included 106 patients with AIS treated with IVT between January and December 2024. Comorbidity burden was assessed using the Charlson Comorbidity Index (CCI; 1987 and 2011 versions) and the Elixhauser Comorbidity Index (ECI; 2009 and 2017 versions). The primary outcome was unfavorable functional status at discharge, defined as a modified Rankin scale (mRS) score of 3–6. Multivariable logistic regression was used to identify factors associated with the primary outcome, and receiver operating characteristic (ROC) analyses assessed the discriminatory performance of the indices. Mortality comparisons were exploratory because only 10 in‐hospital deaths occurred. Results: The median age was 68 years, and 60 patients (56.6%) were men. Unfavorable functional outcome (mRS 3–6) occurred in 73 patients (68.9%). Higher admission National Institutes of Health Stroke Scale (NIHSS) scores and glucose levels were independently associated with unfavorable functional status at discharge, whereas none of the four comorbidity indices remained significant after multivariable adjustment. The comorbidity indices showed limited to modest discriminatory performance, with an AUC of 0.645 (95% CI 0.531–0.760) for CCI 1987. Hemorrhagic transformation (HT) occurred exclusively in patients with an unfavorable outcome and was more frequent among nonsurvivors. Exploratory comparisons also showed higher prestroke mRS, admission NIHSS, CCI 1987, and CCI 2011 scores among nonsurvivors; no multivariable mortality analysis was performed. Conclusions: None of the evaluated comorbidity indices was independently associated with functional status at hospital discharge. Their discriminatory performance was modest, whereas admission stroke severity and glucose level showed stronger associations with short‐term outcome. Given the retrospective single‐center design, modest sample size, and limited number of deaths, the findings should be considered exploratory and hypothesis‐generating and require confirmation in larger prospective studies.