Journal of Clinical Medicine of Kazakhstan

J Clin Med Kaz 2019;1(51):8-11 doi:10.23950/1812-2892-JCMK-00657

Authors: Dinara Amanzholova, Valentina Sirota

Contemporary diagnostics methods can suspect the presence of tumors in mammary gland of minimal size. The current world trend in the treatment of breast cancer, especially early breast cancer, is the use of organ conserving treatment as a method that improves patient’s quality of life with preserving mammary glands. This study systematizes results of recent researches which studied long-term results of treatment after radical mastectomy and breast conserving surgery.

J Clin Med Kaz 2019;1(51):16-20 doi:10.23950/1812-2892-JCMK-00664

Authors: Mereke Maratkyzy, Aruna Kosybaeva, Naylya Kabildina, Anelya Beisenaeva

Views on the role of extracellular neutrophilic traps in oncology vary greatly. On the one hand, there is evidence of the anticarcinogenic properties of neutrophil networks associated with the direct destruction of tumor cells and stimulation of the immune system. Cytotoxicity towards tumor cells is manifested by trap components (myeloperoxidase, proteinases and histones), while DNA strands are considered as a kind of tool for capturing tumor cells and limiting their further spread.

J Clin Med Kaz 2019;1(51):27-31 doi:10.23950/1812-2892-JCMK-00659

Authors: Hülya Nazik, Mehmet Kamil Mülayim, Derya Korkut Saridağ, Perihan Öztürk

Objective: Psoriasis is a chronic inflammatory skin disease with a complex etiopathogenesis including genetic predisposition, immune dysfunction and environmental factors. Chronic inflammation leads to the development of vascular and metabolic disorders. The bioimpedance method is an easy and useful method for evaluating of body composition. In this study, it was aimed to investigate body composition, demographic, clinical and laboratory data in patients with psoriasis and to compare them with healthy controls. Material and Methods: Sociodemographic characteristics of the participants, duration of disease, concomitant systemic diseases, family history of psoriasis, presence of psoriatic arthritis and current treatments were questioned. Body composition of the participants was determined by Tanita Body Composition Analyzer type BC-418 (Tokyo, Japan), and in blood samples glucose, total cholesterol, HDL, LDL, triglyceride and insulin levels were determined by autoanalysers. Results: HOMA-IR, triglyceride, BMI, metabolic age and fat percentage were significantly higher in the psoriasis group, whereas the control group had higher body density, lean mass, mineral percentage and total body fluid. In this study, it was found that as the insulin resistance, BMI and fat ratio increased, the severity of the disease increased in patients with psoriasis. Also BMI increased in patients with longer disease duration. Topical and conventional therapies had no significant effect on laboratory and body composition parameters. Conclusion: In the light of the data obtained in this study, it was concluded that some metabolic markers and body composition parameters were negatively affected in patients with psoriasis and were associated with disease severity.

J Clin Med Kaz 2019;1(51):37-43 doi:10.23950/1812-2892-JCMK-00666

Authors: Safiye Sanem Dereli Bulut, Fuad Nurili, Hadi Sasani, Omer Aras, Yasar Bukte

Objective: To evaluate T2-weighted BLADE tecnique for evaluating intra-abdominal organs and lesions, especially the gastrointestinal wall and pathologies, and to compare the findings with HASTE. Material and Methods: Sixty patients (mean age: 47.2 years, range 19-88) (32 males, 28 females) referred to our institution for upper abdominal Magnetic Resonance Imaging (MRI) examinations with various indications between January 2015 and May 2015 were included in our study. All examinations were performed on a 1.5 Tesla MR device and no anti-peristaltic drug was administered. Images were retrospectively and independently evaluated by two radiologists. A qualitative evaluation was performed to assess images regarding the presence of artifacts and diagnostic quality, the anatomical detail of the upper abdominal organs and structures (contour sharpness, contrast of tissue, parenchyma and internal wall structure) and any present pathologies and lesions in the organs (lesion contour sharpness and size, internal structure properties, morphological characteristics). A quantitative evaluation was performed to calculate the contrast-to-muscle ratios (CMR) of the internal organs and lesions. The distribution of the variables was statistically checked by Kolmogorov Smirnov test. Paired-samples t- test was used for quantitative data. Results: BLADE was significantly associated with reduced artifacts (p <0.0001) and increased image quality compared with HASTE. The highest agreement between both observers was that motion artifacts were reduced (Gwet's AC2 = 0.94). In addition, observers agreed that the parenchymal structure of the upper abdominal solid organs and the anatomic details of the stomach wall structure were better with BLADE (Gwet's AC2 = 0.87). In most cases, both observers preferred BLADE (p <0.0001) for evaluating images and lesion morphology. Conclusion: In upper abdominal MRI examination, artifacts, especially movement artifacts, were significantly reduced by BLADE, yielding more valuable data for the evaluation of the gastrointestinal system wall structure and its pathologies, especially considering the organs near to the diaphragm and retroperitoneal organs as well as vascular structures.

J Clin Med Kaz 2019;1(51):50-55 doi:10.23950/1812-2892-JCMK-00662

Authors: Saule Urazalina, Aisulu Musagalieva, Assel Issabekova, Kulzida Koshumbayeva, Bagdat Akhit

Aim: To conduct a one-stage multicenter study in South-Kazakhstan Region to obtain baseline prevalence of comorbidity of chronic noninfectious diseases and their risk factors. Material and methods: 1400 persons at the age of 18-69, living in the South-Kazakhstan region. Epidemiological part consisted of: interviewing, physical examination and laboratory tests. For statistical analysis were used MSAccess and SPSS22.0. computer programs. Results: 12.7% of respondents in South-Kazakhstan region smoke, which statistically significantly less than number of nonsmoking (87.3%; p<0.01) ones. The number of alcohol drinkers is 28.4%, which also less than number of nondrinkers (71.6%; p<0.01). The 48.3% of people included in the study had physical inactivity, while 51.7% had sufficient physical activity. More than half of respondents had abdominal obesity (67.9%), which higher than number of people without obesity (32.1%; p<0.01). The 72.1% had chronic noninfectious diseases (1009 of 1400). Comorbidity with two diseases – 48.2% (676 of 1400). Most common disease was arterial hypertension (45.9%: 464 of 1009). Less common – chronic kidney disease (2.4%:24 of 1009). The most common comorbidity – arterial hypertension and diabetes mellitus (72.3%). The less common – obesity and chronic obstructive pulmonary diseases (2.3%). Conclusions: 1. The most common risk factors of chronic noninfectious diseases in South-Kazakhstan region are improper diet, obesity, physical inactivity. 2. The frequency of chronic noninfectious diseases in South-Kazakhstan region was 72.1%. And the most common disease was arterial hypertension. 3. The most common comorbidity – combination diabetes mellitus with arterial hypertension while the less common – combination obesity with chronic obstructive pulmonary disease.

J Clin Med Kaz 2019; 1(51):61-64 doi:10.23950/1812-2892-JCMK-00660

Authors: Akylbek Tussupkaliyev, Svetlana Tuitebayeva, Andrey Gaiday, Ulbolsyn Kairbaeva

To date, in order to better understand the mechanisms for the development of terminal states associated with pregnancy, and to correctly assess the allowable costs in the organization of observation and intensive treatment, it is increasingly taking into account and analyzing not only deaths, but also cases of successful elimination from a critical condition, so called “near-miss cases”. The given clinical case can be attributed to those. We observed a case of a positive outcome with an embolism of amniotic fluid of the lightning form, accompanied by cardiopulmonary shock with a double cardiac arrest, DIC - syndrome, postresuscitation disease. As practice shows, one of the most effective opportunities to shorten the way to success, is to use the experience of those, who have already traveled this