Journal of Clinical Medicine of Kazakhstan

J Clin Med Kaz 2017;2(44):6-9 doi:10.23950/1812-2892-JCMK-00433

Authors: Bekbolat Zholdin, Nurlan Yeshniyazov, Vadim Medovchshikov, Iliada Talipova

In 2016 a new edition of the European guidelines on cardiovascular disease prevention in clinical practice was published. Guidelines based on evidence-based medicine are a guide to primary and secondary prevention of cardiovascular diseases for health workers. The ofcial translation of the Russian version is expected in July 2017. This article is devoted to a review of the main provisions of these guidelines. In the updated version, compared with the version of 2012, more attention is paid to the population approach, specifc interventions, special groups of patients, the classes of evidence have been changed for a number of recommendations, and emphasis is placed on a multidisciplinary approach to the prevention of cardiovascular diseases. For the frst time, experts point out the inexpediency of assessing cardiovascular risk in men under 40 and women under 50 without known risk factors due to possible false positive results. Patients with erectile dysfunction are not recommended to conduct routine screening of cardiovascular diseases. In addition, much attention is paid to the defnition of quality of life, diagnosis and treatment of anxiety and depression of the patient, as these conditions increase cardiovascular risk and affect patient adherence to therapy

J Clin Med Kaz 2017;2(42):15-18 doi:10.23950/1812-2892-JCMK-00444

Authors: Aliya Yermagambetova, Abay Makishev, Khalel Imanbayev

Sentinel lymph nodes (SLN) biopsy is currently the standard procedure for axillary staging in patients with invasive breast cancer and clinically negative lymph nodes (cN0). Historically, all patients with a positive sentinel lymph node (SLN) undergo classical axillary lymph node dissection (ALND). A randomized clinical trial in patients with breast cancer with clinical T1-2N0M0, with positive SLN afterwards undergo classical ALND showed that women diagnosed with T1-T2 and cN0 who underwent breast-conserving surgery and radiation therapy can safely avoid ALND. The main goal of SLN examination should be the detection of all macrometastases (> 2 mm). The role and timing of SLN in patients who received neoadjuvant polychemotherapy is still controversial and continues being studied in clinical trials.

J Clin Med Kaz 2017;2(44):33-35 doi:10.23950/1812-2892-JCMK-00440

Authors: Gülbahar Saraç, Tuba Tülay KOCA, Serpil Şener, Hülya Cenk

Study Objective: It is a common opinion that vitamin D plays a role in many immune system disorders. This study aimed to determine vitamin D levels in patients with acne vulgaris. Methodology: The study sample included 90 patients who came to the outpatient dermatology clinic of Malatya Public Hospital between March 2015 and June 2015, and were diagnosed with cystic nodular acne clinically. The control group included 67 voluntary healthy individuals. The 25-hydroxyvitamin D3 [25-(OH) vit D3] levels were recorded for both groups. Findings: In the group of patients with acne, the 25-(OH) vit D3 level was 18.28±9.92 (reference interval 10–40 ng/mL), and it was 15.40±10.92 in the control group. When the two values were compared statistically, the result was p:0.924 (p>0.05) and there was no statistically signifcant difference. Conclusion: It is believed that vitamin D plays a role in the etiopathogenesis of acne vulgaris due to its anti-inflammatory and antimicrobial properties. The studies conducted with larger patient sets canprovide a clearer view of the correlation between vitamin D and acne.

J Clin Med Kaz 2017;2(44):42-46 doi:10.23950/1812-2892-JCMK-00374

Authors: Timur Sarsengaliyev, Boris Tsoy, Elmira Chuvakova

Objective: Multislice computed tomography (MSCT) prior to liver transplantation is an important aspect of the diagnosis of changes in the liver as fat infltration, as well as visualization of the individual vascular anatomy and calculation of liver volume. The aim of our study was to analyze the results of the single center experience to conduct liver MSCT of donors who are preparing for the transplant donation. Methods: We studied the MSCT evaluation results of 39 (25 male and 14 female) potential liver donors’ during the 2015 - 2016 years. Liver MSCT with various standard renovations were used for more detailed visualization of blood vessels in each liver segment. Images were obtained on 64-slice MSCT (Aquilion; Toshiba Medical Systems, Tokyo, Japan). Interpretation of the results provided in accordance with embodiments of origin of the hepatic artery, portal vein anatomy and drainage of the hepatic veins. Results: The main results of the anatomy of the hepatic artery, portal and hepatic veins are shown in Table 1, 2, 3. Based on the MSCT of 39 donor’s liver, 24 donors were identifed as appropriate for donation. 15 donors were contraindicated for donation due to: in 8 - were signs of fatty infltration, 2 donors - vascular anomaly of the portal vein, benign growths were detected in 5 donors. Conclusion: MSCT is a primary diagnostic method for the preoperative planning of surgical resection of the liver, as well as preliminary identifcation of hepatic pathology. According to the results and experience of our center, in 61.5% cases, liver donors were selected for donation and remaining 38.5% of the donors were excluded from organ donation, in connection with the identifed contraindications.