The most common complications after percutaneous vascular interventions are complications at the site of access. The use of retrograde tibial-pedal access could reduce the risks of significant complications at the puncture site compared to traditional femoral access.
Purpose: In this study, we aimed to determine the efficacy and safety of primary tibial-pedal access for revascularization of chronic total occlusion of the femoral-popliteal and infrapopliteal segments in patients with critical lower limb ischemia.
Materials and Methods: We conducted a retrospective analysis of 18 patients from January 2022 to August 2024. Patients were selected according to the following criteria: patients with categories 3, 4, 5 according to the Rutherford classification and stages 3,4 according to the Fontaine classification; femoropopliteal (FP) lesion with or without involvement of the infrapopliteal (IP) segment; the presence of blood flow in one or more distal or pedal segments of the main arteries of the leg and foot; informed consent of patients for the intervention.
Results: The overall procedural success rate of the intervention was 100%. The average age of patients was 74±5 years. The majority of the subjects were women (66.7%). Comorbidities such as diabetes mellitus (66.7%), arterial hypertension (55.5%), coronary artery disease (38.9%), and hyperlipidemia (77.8%) were diagnosed. The artery of choice in the majority of cases was the anterior tibial artery 13 (72.2%) Balloon angioplasty combined with stent placement was performed in 14 cases (77.8%). Minor bleeding at the puncture site occurred in 1 case (5.5%). There were no signs of major bleeding, hematomas, MALE, MACE, or death in any case. All patients experienced relief of pain of ischemic origin.
Conclusion: Retrograde tibial-pedal access is technically easier with a tendency to fewer complications. This technique can be used as a primary procedure or as an alternative to antegrade femoral access in complex patients with a high risk of hematoma formation

Modern medicine is rapidly evolving, introducing new technologies and approaches aimed at improving patients' quality of life. In oncology care, where patients face serious physical and emotional challenges, special attention should be given to human-centered technologies and methods.
Cancer remains one of the leading causes of mortality worldwide, and Kazakhstan is no exception. As the number of cancer cases rises, so does the need for effective and high-quality medical care. In this context, it is crucial not only to treat the disease but also to support patients throughout their treatment, ensuring their psychological comfort and enhancing their quality of life
The objective is to assess the level of satisfaction among medical personnel specializing in oncology in the Almaty region. A survey was conducted for this purpose. The study was observational, non-interventional, and carried out openly.
The main factors that most adversely affect the health of healthcare workers are related to high levels of stress, inconvenient work schedules, and significant physical strain. These findings highlight the need to implement stress management programs, optimize work schedules, and improve working conditions to mitigate the negative impact on healthcare workers' health.

The palatine tonsils are glandular structures consisting of lymphoid tissue and forming an important part of the pharyngeal lymphoid ring, the main task of which is the protective immune function. The presence of lacunae provides a large area of contact between the lymphoid tissue and infectious agents, which allows for a faster and more complete immune response. However, this same anatomical feature can lead to the accumulation and difficult removal of food debris, leukocytes, desquamated epithelium, mucus, bacteria and their decomposition products from the depths of the lacunae. Over time, the soft masses become denser and can calcify. In the vast majority of cases, the stones contain calcium carbonate, less often sulfates, nitrates of magnesium, potassium, sodium, which depends on the characteristics of nutrition, smoking and the environment in the oral cavity. Small tonsil stones may not cause any symptoms. Larger ones can cause various symptoms from bad breath to a foreign body sensation and difficulty swallowing. Bad breath is caused by volatile sulfur compounds released by microorganisms and also contained in tonsilloliths. The presence of a stone may also cause a sore throat and cough. Large stones may cause difficulty swallowing and radiating pain in the ear.
This article presents a clinical case of detection and removal of a large asymptomatic tonsillolitis. The uniqueness of the described case is the size of the removed stone - 2.5 x 1.5 cm, as well as the asymptomatic course. Tonsilloliths of this size most often cause pain and discomfort when swallowing, but the described stone was asymptomatic. In the described case, the stone was discovered as an accidental finding during a routine examination

Relevance. Among the most common TORCH infections is Cytomegalovirus infection, which accounts for 0.2-10 % of newborns. It is known that the frequency of neurological disorders in this disease reaches 10-89.3 %, the respiratory organs are involved in the process in 30-40.6 %, damage to the cardiovascular system is diagnosed in 27.9 % of patients, liver damage - in 40-63.3 % and the gastrointestinal tract – in 48 % of children. In this regard, there is an interest in studying the features of clinical, laboratory and instrumental data, knowledge of which will help the doctor timely diagnose and treat patients with this disease.
The purpose - study and analyze clinical, laboratory and instrumental indicators of Cytomegalovirus infection in children in order to predict the risk of developing a severe disease and unfavorable outcome. Materials and methods. To write this article, a literature review was conducted on PubMed, Cyberlinka, Medline, WHO, CDC and Medscape.
Conclusion. In-depth knowledge on this topic will help in the development of a prognostic algorithm for diagnosing severe forms of CMV infection

The systematic review summarizes modern studies of the effect of plant phenols and certain drugs on the intracellular biochemical cascade in the formation of anti-cancer immunity. In addition, it explores potential clinically available methods for assessing immunity that can be applied in the context of integrative medicine to personalize rehabilitation therapy for cancer patients after chemotherapy and surgery.
The search depth is 6 years (from 2017 to 2023). The search includes research from peer-reviewed journals and non-peer-reviewed publications. The systematic review mainly includes basic research and review articles published in six electronic databases: PubMed/MEDLINE (https://pubmed.ncbi.nlm.nih.gov/), The Cochrane Library (https://www.cochranelibrary.com/), ScienceDirect (https://www.sciencedirect.com/), Google Scholar (https://scholar.google.com.mx /), eLibrary (https://elibrary.ru/), Web of Science (https://www.webofscience.com/).
As a result, 64 studies were selected, of which 29 were original (11 animal studies, 8 cell culture studies and 10 studies on 1,344 adults).
Conclusions. For the correct selection of a nutrition regimen and rehabilitation therapy, it is very important to pay attention to the state of physiological stress, the degree of mitochondrial dysfunction, the quantitative and qualitative state of neutrophils and lymphocytes. Based on these indicators, it is possible to reliably personalize the dose, the duration of therapy and monitor the effectiveness. It turned out that the immune system is even more complicated than the nervous and functional activity of leukocytes can also reflect the homeostasis of the entire inner world of a person, and according to the state of granulocyte function, it is possible to judge the function of most cells of the whole organism and evaluate the «immunological control of the tumor» in the key of the state of the "tumor microenvironment" proposed by Eggermont AMM.

The paper aims to identify the effectiveness of CardioVisor for cardiovascular assessment in adolescents. For this purpose, the authors of the paper conducted a literature review on previously published papers in rezessable journals. The results of this literature review revealed the efficacy of the use of CardioVisor and the accuracy of this device to assess cardiovascular health in adolescents by 95%-98%, compared to traditional assessment methods such as ECG. Given the age-related changes in children and adolescents, the CardioVisor device allows for more accurate training, taking into account the individual characteristics of each subject, as well as minimising the risks of overloading the cardiovascular system. However, there are higher costs associated with the use of this device, including skilled specialised interpretation of the data obtained. Further studies are recommended to evaluate the long-term effects and optimise the CardioVisor device