Journal of Clinical Medicine of Kazakhstan

J Clin Med Kaz 2018;3(49):15-23 doi:10.23950/1812-2892-JCMK-00578

Authors: Assem Nogaibayeva, Bagdat Sultanova, Myrzabek Makhmutov

Pathophysiological, pathomorphological and functional changes in the kidneys after left ventricular assist device implantation have not yet been fully understood and represent an actual problem of our time. Changes in renal function following left ventricular assist device implantation have been disclosed in many studies with inconsistent results. Some studies have shown that patients with renal dysfunction after left ventricular assist device implantation had worse outcomes, despite stabilization or even improvement of kidney function during the postoperative period, other studies have shown the progression of chronic kidney disease requiring renal replacement therapy.

J Clin Med Kaz 2018;3(49):28-31 doi:10.23950/1812-2892-JCMK-00581

Authors: Gulbarshin Darisheva, Bolat Saktashev, Aigul Brimova

This article is devoted to the problem of mastopathy in the post-Soviet space. Analysis of clinical observation, literature data shows a different approach in describing this condition, methods of diagnosis and treatment. Often, a purposeful motivational assignment of certain groups of drugs from biologically active food supplements, iodine preparations to the administration of antiestrogens, etc. is often used to correct this condition. This problem requires a careful approach to etymology, diagnosis and principles of conducting similar processes.

J Clin Med Kaz 2018;3(49):35-41 doi:10.23950/1812-2892-JCMK-00584

Authors: Fatma Kulali

Aim: Differentiating benign from malignant vertebral fracture is sometimes difficult in geriatric oncology patients. Accurate diagnosis is necessary for treatment planning. Therefore, we aimed to investigate the role of quantitative evaluation of diffusion-weighted imaging (DWI) at multiple b-values of 200, 400 and 600 s/mm2 in differentiating benign from malignant thoracolumbar vertebral fractures and to determine an optimal b-value. Methods: Forty-four patients with 72 vertebral fractures were enrolled. Magnetic resonance imaging (MRI) findings combined with DWI at b-values of 200, 400 and 600 s/mm2 were evaluated. Apparent diffusion coefficient (ADC) and normalized ADC values were obtained. Radiological and histopathological/follow-up results were compared. Results: Of 72 vertebral fractures, 22 were benign and 50 were malignant. Mean ADC and normalized ADC values of malignant group were lower than benign group’s in all b-values (p<0.05). Despite of no significant difference between ADC values at b-values of 200, 400 and 600 s/mm2 within each group, normalized ADC values were lower at b-value of 200 s/mm2 than those of at 600 s/mm2 in malignant group (p<0.05). Conclusion: MRI combined with DWI is a problem solving modality especially in geriatric oncology patients. Performing DWI at b-value of 200 s/mm2 and estimation of normalized ADC value for optimization of data are recommended.

J Clin Med Kaz 2018; 3(49):46-49 doi:10.23950/1812-2892-JCMK-00580

Authors: Nariman Zhambayev, Ulanbek Zhanbyrbekuly, Yernur Ainayev, Gafur Khairli, Ravil Sherkhanov, Ulan Zhaparov, Aleksey Sushchenko

Aim: Describe a clinical case and compare the difference in treatment methods at pelvic-dystopic kidney. The article describes the clinical case of urolithiasis, in the pelvic - dystopic kidney. The stages of diagnosis and treatment reflected in the article testify to the present possibilities of modern medicine. Recovering the patient is the result of timely, skillfully chosen conservative and operational techniques.

J Clin Med Kaz 2018;4(50):15-20 doi:10.23950/1812-2892-JCMK-00586

Authors: Zarina Babaeva, Yerzhan Uteuliyev, Latina Tekebaeva, Kairat Karibaev

Strokes, being a heterogeneous syndrome, are the result of multifactorial accumulative disorders of the body. The urgency of the problem of cerebral stroke is due to the high level of occurrence and prevalence on a global scale, as well as the consequences. Thus, vascular diseases of the brain vessels occupy the second place in the structure of mortality from diseases of the circulatory system and total mortality of the population. The expected aging of the population, coupled with a decrease in mortality from stroke, creates a predisposition to an increase in the burden of strokes in the form of an increase in the number of victims. In Kazakhstan, as in most countries of the world, ischemic strokes prevail, which are the main cause of disability of the working-age population. Despite certain advances in the treatment of brain catastrophes caused by the introduction of protocols for early diagnosis and the development of algorithms for urgent actions, as well as the development of innovative pharmaceutical approaches, prevention of stroke development remains the most effective approach in all respects - medical, economic, social. Risk factors for stroke can be classified as changeable (modifiable) and not subject to change (non-modifiable, or risk markers). Age, gender and race, ethnicity, genetic predisposition are unchangeable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet and physical inactivity are among the most common modifiable risk factors. Stroke prevention mainly focuses on managing variable risk factors. Lifestyles and behavior modification, such as changes in diet or smoking cessation, not only reduce stroke risk, but also reduce the risk of other cardiovascular diseases. Other preventive areas include the identification and treatment of diseases that increase the risk of stroke, such as hypertension, diabetes and atrial fibrillation.

J Clin Med Kaz 2018;4(50):30-33

Authors: Mykola Gryshchenko, Andrey Lutskiy

Aim: To increase the frequency of pregnancy and delivery rate in in vitro fertilization cycles using native and vitrified donor oocytes. Methods: Analyzing the results of in vitro fertilization in 62 patients who had oocyte donation programs. Patients were divided into 2 groups: the 1st group included 27 women who had used vitrified donor oocytes, and the 2nd group - 35 patients to whom the native oocytes of the donor were used in the in vitro fertilization cycle. The obtained oocytes were vitrified according to the standard technique using the Cryotech Vitrification kit. To prepare the endometrium for the transfer of embryos, a preparatory hormonal therapy regimen was used and the embryos were transferred in a modified menstrual cycle. Results: Studies have shown that the application of the vitrification method in assisted reproductive technology programs allows to achieve clinical results that are not inferior and even significantly exceed the effectiveness of treatment in cycles with native donor oocytes in such parameters as clinical pregnancies, implantation rate and labor. Conclusion: Vitrification is an effective method of cryopreservation of oocytes, which allows to preserve the functional properties of the eggs and, after their fertilization, to obtain embryos with high implantation potential.