Objective: to determine the effect of preoperative transcatheter arterial embolization (pTAE) on intraoperative blood loss and surgery time for endoscopic transnasal resection of juvenile nasopharyngeal angiofibroma (JNA).

Methods: A retrospective analysis was conducted on thirty adolescent male patients who received surgical treatment at the University Medical Center (UMC) from February 2014 to December 2023. The cohort was divided into two groups: those who underwent preoperative transcatheter arterial embolization (n=19) and those who did not (n=11).  The characteristics that were compared included blood loss and duration of surgery.

Results: Patients who received pTAE had a significant reduction in intraoperative blood loss for all stages of JNA. Although pTAE reduced the amount of time needed for surgery, the results were not statistically significant.

Conclusions: Preoperative pTAE greatly enhances surgical results by successfully reducing intraoperative bleeding during JNA resection.

Relevance. Post-COVID syndrome in elderly patients with arterial hypertension remains insufficiently studied, particularly in terms of autonomic dysfunction. The systemic effects of SARS-CoV-2 and its influence on cardiovascular regulation make the identification of such disorders a relevant issue in modern medicine.

Objective of the Study. To investigate autonomic nervous system dysfunction in elderly patients with arterial hypertension and post-COVID syndrome.

Materials and Methods. As part of outpatient follow-up at the clinical bases of the Kazakhstan-Russian Medical University, a study was conducted to assess autonomic dysfunction in elderly patients with arterial hypertension and post-COVID syndrome. The examination included interviews, physical examinations, assessment using the A.M. Wayne scale, and heart rate variability (HRV) analysis using the “CardioVisor” module. Time and frequency domain parameters were evaluated: SDNN, rMSSD, pNN50, LF, HF, LF/HF, the stress index, and the regulatory systems activity index (PARS).

Results. The study included 141 patients divided into two groups. The mean age in the main group was 70.81 ± 5.36 years, compared to 74.00 ± 6.06 years in the control group (p = 0.003). The proportion of patients aged 60–74 years was higher in the main group (p = 0.006). Grade 1 arterial hypertension was more common in patients with post-COVID syndrome, while grades 2 and 3 were more frequent in the control group (p = 0.042). Patients with post-COVID syndrome more often reported fatigue (38.36%), anxiety (19.18%), memory impairment (21.92%), and excessive sweating (26.03%) (p ≤ 0.001). According to the Wayne scale, respiratory symptoms during emotional stress were more prevalent (p = 0.014). Among HRV indicators, a significant difference was observed in the LF/HF ratio (1.8 vs 1.5; p = 0.049).

Conclusion. In elderly patients with arterial hypertension, post-COVID syndrome is accompanied by characteristic complaints and signs of autonomic dysfunction, highlighting the need for further investigation into its impact on chronic conditions.

Relevance: The prevalence of such a disease as adenoid hypertrophy (AH) is a pathology with a tendency to increase. A number of authors believe that the increase in the prevalence of AH is facilitated by the increasing antigen load, environmental and other factors [1, 2, 3, 4]. However, despite all the variety of causes of AH, there is another problem that requires close attention of the world medical community - the problem of the presence of myofunctional disorders and dentoalveolar anomalies (DA) in children after surgery for AH. 

Objective: to study the condition of children after adenotomy from an orthodontic point of view.

Materials and methods: A survey of 80 patients with the diagnosis of "Distal bite" who sought orthodontic dental care was conducted. All patients had previously undergone surgery for adenoid hypertrophy.

This study is part of a controlled clinical trial.  The children of main group was under the supervision of an otolaryngologist and received orthodontic treatment. In the comparison group, patients after adenotomy are only under the supervision of an otolaryngologist. The diagnostic procedures described in this article are a stage of the study before dividing patients into the main group and the comparison group, therefore, all 80 cases studied are described below.

Results: The diagnostics carried out using functional tests and X-ray examinations of the maxillofacial region showed that the majority of patients had myofunctional disorders - oral or mixed breathing and a dentofacial anomaly: "Distal bite".

Conclusion: The results of our studies are of significant scientific and practical interest and require further in-depth study. The authors hope that the above will facilitate the early diagnosis of myofunctional disorders and dentofacial anomalies in children after adenotomy for specialists in various fields.

Аbstract

Objective

To study the impact of electronic health records systems in primary health care facilities on improving the quality of care to ensure a sustainable organizational structure as an essential public health function of public health.

Materials and methods

The search was carried out in the MEDLINE, EMBASE, CINAHL databases and in the Cochrane Central Register of Controlled Trials. The search strategy was based on the PICO Framework. The studies selected for the meta-analysis were published between 01/01/2010 and 05/01/2023. Two authors independently reviewed article titles and abstracts for eligibility. Information from the search was deduplicated using EndNote X9, imported into Covidence Systematic Review for review. Statistical processing was performed in RStudio 2023.03.1 Build 446 (Posit Software, PBC).

Results

A literature search identified 640 studies, and 11 manuscripts were included in the review. Meta-analysis showed that the use of electronic health records (EHRs) helps to reduce the time to complete medical records by 33.4% (95% CI = 0.8% to 1.2%; p < 0.007), promotes adherence to clinical recommendations (RR 1.30; 95% CI = 1.04 to 1.79; p = 0.05) and reduces prescribing errors (RR 0.44; 95% CI = 0.34 to 0.53; p < 0.001), which undoubtedly improves the quality of medical care.

Conclusion

This study validates EHRS's positive influence on enhancing care quality in PHC settings, chiefly by streamlining documentation, decreasing prescription errors, and aligning workflow with clinical guidelines. Findings aid informed EHRS adoption decisions for healthcare and public health professionals.

Abstract

Relevance. Being one of the most common types of cancer, prostate cancer requires a specific diagnosticapproach, using modern, highly sensitive and specific diagnostic methods. An analysis of existing methods will allow us to determine the most effective strategies for early detection and control of the disease.

Objective. To summarize existing data on the diagnostic algorithm for prostate cancer, identify the strengths andweaknesses of each of the procedures used, and evaluate the impact and effectiveness of modern diagnostic methods.

Methods and materials. Information was searched and analyzed in Google Scholar, PubMed, Elsevier, Web ofScience, and Medline databases. The review includes data from meta-analyses, randomized controlled trials, systematicreviews, and clinical trials. Duplicate articles have been deleted, information verified, and irrelevant works excluded. As aresult, 75 full-text documents and abstracts were selected, providing a comprehensive analysis of the problem under consideration.

Conclusion. Combined approaches increase the accuracy of pancreatic cancer diagnosis. PSMA-PET improvesthe detection of metastases, but remains expensive and difficult to access in developing countries. A liquid biopsy haspotential, but requires improved sensitivity. Transrectal ultrasound remains an important tool, but its diagnostic value is limited. An magnetic resonance imaging targeted biopsy reveals more clinically significant prostate cancer than a systematic biopsy. Artificial intelligence in diagnostics requires development, but its use should be clearly regulated.