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Maharramova A.E., Mammadova A.G., Yusifov A.I.
SIGNAL TRANSDUCTION AT THE CELLULAR LEVEL IN PATIENTS WITH VENOUS THROMBOSIS DUE TO THROMBOLYTIC MUTATIONS
Abstract: Venous thrombosis is a very common and financially challenging disease. Deep vein thrombosis can cause permanent damage to the venous system and lead to swelling, ulcers, gangrene and other symptoms in the affected organ. In addition, more than half of pulmonary embolisms are caused by venous thrombosis, which is the most serious cause of death in patients with ischemic heart disease and stroke. It seems that deep vein thrombosis has become a serious disease affecting human health. In recent years, an increasing number of studies have led to the belief that inflammatory responses cause venous thrombosis. Here, the transcription factor NF-κb is a central mediator of inflammation and the NF-κb signaling pathway may regulate the proinflammatory and coagulation response. Therefore, investigating and exploiting this mechanism may help to find a new solution for the prevention and treatment of thrombosis.
Keywords: Thrombosis, NF-κB signaling pathway, inflammation, TNF-α, IL-6, transcription factor, VCAM
Gasimova F.N., Babayeva L.K., Atakishiyeva V.N., Guliyeva I.M., Mammadov M.Y.
CARDIOVASCULAR PATHOLOGY IN PATIENTS WITH ANCA-ASSOCIATED VASCULITIS
Abstract: The article deals with the peculiarities of cardiovascular pathology in patients with ANCA associated vasculitis (AAV), where special attention is paid to the mechanism of its formation and its influence on the clinical prognosis of patients. The author analyses the data on the frequency of cardiovascular diseases in patients with this type of vasculitis and emphasises that vascular inflammation and chronic inflammatory process may contribute to accelerated development of atherosclerosis and increased risk of cardiovascular complications in these patients. The article points out the importance of cardiovascular risk factors in the treatment of patients with AAV and the need for an integrated approach in the diagnosis and therapy of these patients to improve their quality of life and to predict the outcomes of the disease.
Keywords: ANCA associated vasculitis, vascular inflammation, cardiac lesions, complications
Babaeva M.Y., Huseynova G.A., Kazımova A.U.
TAXIFOLIN IN MEDICAL PRACTICE
Abstract: The article provides information about Taxifolin, which plays an important role in the prevention and treatment of various diseases. Studies have revealed a wide range of pharmacological activities of taxifolin: antioxidant, anti-inflammatory, hepatoprotective, antiangiogenic properties, antidiabetic, cardioprotective, neuroprotective, etc. By inhibiting enzymes responsible for the infection and inflammatory response in the brainstem, Taxifolin also plays a neuroprotective role supporting its activity against Alzheimer's disease. Taxifolin has been shown to have excellent antioxidant activity, preventing lipid peroxidation, causing cleavage of poly(ADP-ribose) polymerase by H2O2.
Keywords: Taxifolin, flavonoid, antioxidant activity, oxidative stress
Jahangirli J.N.
ANALYSIS OF THE MAIN CHARACTERISTICS OF DRUG USERS BY CLINICAL AND PSYCHOLOGICAL PARAMETERS
Abstract: The research work was conducted to study the health characteristics of drug addicts in the modern era by important clinical, psychological and emotional parameters. The study included 43 drug addicts who had been using various drugs (opioids, cЫгььфкнocaine, amphetamines and hallucinogens) for more than 5 years. A clinical examination of all individuals included in the study was conducted, and a detailed anamnesis was collected based on interviews with them. As a result of the study, severe clinical symptoms were found in drug addicts, as well as long duration and high severity. They were found to have insomnia, speech disorders, high blood pressure, memory and attention disorders. At the same time, the behavior and behavioral disorders of these individuals were extremely noticeable.
Keywords: narcotic substance, drug addict, clinical trial, mental disorders
Jalalov M.R.
CLINICAL EVALUATION OF THE EFFECTIVENESS OF TELEMEDICINE APPLICATION IN PATIENTS WITH ACUTE CORONARY SYNDROME
Abstract: Introduction. One of the pressing issues in modern medicine remains the enhancement of the effectiveness of emergency medical care for patients with acute coronary syndrome, especially in life-threatening conditions such as myocardial infarction. The use of telemedicine in this field represents a promising direction. The aim of this study was to clinically evaluate the effectiveness of remote consultative support provided through telemedicine to patients who sought emergency medical care for acute coronary syndrome. Materials and Methods. The study included both retrospective and prospective parts and covered 1,115 patients who sought care at the Republican Center for Emergency and Urgent Medical Aid between 2015 and 2020. During the study, the treatment outcomes of patients were assessed using binary logistic regression analysis in the SPSS program. In the prospective group, remote consultative support was provided using telemedicine capabilities. Results. The study results demonstrated that remote consultative support provided via telemedicine significantly improved the effectiveness of treatment for patients with acute coronary syndrome. Hemodynamic indicators (pulse, systolic, and diastolic blood pressure) in patients who received treatment in the prospective group were significantly better compared to those who received traditional treatment. Conclusion. The effectiveness of initial medical care provided via telemedicine to patients with acute coronary syndrome was proven. The remote specialist support and the adequate implementation of instructions by emergency medical personnel led to positive outcomes. This study once again confirms the importance of expanding and implementing telemedicine services in Azerbaijan.
Keywords: coronary syndrome, emergency care, telemedicine, remote consultation, treatment
Babayeva G.H., Mahmudov U.R., Mammadov E.E., Guliyev F.V., Verdiyev E.Kh., Machanov U.R., Ibishov R.F., Huseynov H.M., Zalov Z.S.,
Ismayilova S.Y., Hasanov R.A., Ibrahimli H.I., Cano-Català A., Parra P. Moreira L., Nyssen O.P., Mégraud F., O'Morain C., Gisbert J.P.
EFFECTIVENESS OF FIRST-LINE EMPIRICAL TREATMENT IN AZERBAIJAN: RESULTS FROM THE EUROPEAN REGISTRY ON HELICOBACTER PYLORI MANAGEMENT (HP-EUREG)
Abstract: Background. Gastric lesions associated with Helicobacter pylori, eradication issues and problems of its sometimes-insufficient therapeutical effectiveness continue to remain one of the most pressing topics in digestive healthcare. The aim of the study was to evaluate the frequency of use, the effectiveness and the safety of empirical first-line treatments in the management of H. pylori infection in Azerbaijan. Materials and methods. Data were collected at AEG-REDCap from the European Registry on the management of Helicobacter pylori infection (Hp-EuReg) and quality reviewed from January 2020 to May 2023. All treatment-naïve cases were assessed for effectiveness by modified intention-to-treat (mITT), per-protocol (PP) analyses, and a separate multivariate analysis was performed. Results. The study included 3,898 patients (67% reported dyspepsia). Triple regimens were most often prescribed (82%), the PPI-clarithromycin-amoxicillin scheme being used in 54% of patients. Duration of treatment was of 14 days (56%), 10 days (27%) and 7 days (17%). Optimal (>90%) mITT effectiveness was obtained with following 14-day therapy schemes: PPI-clarithromycin-amoxicillin (94%), PPI-clarithromycin-metronidazole (97%), PPI-clarithromycin-metronidazole-bismuth (96%), and PPI-clarithromycin-amoxicillin-bismuth (98%); when combined with standard-dose PPIs: PPI-amoxicillin-tetracycline (96%) and PPI-clarithromycin-amoxicillin-bismuth (96%); and with high-dose PPIs: PPI-clarithromycin-amoxicillin (94%), PPI-clarithromycin-metronidazole (97%), PPI-clarithromycin-metronidazole-bismuth (100%), and PPI-clarithromycin-amoxicillin-bismuth (99%). Adverse events were reported in 12% of cases. Conclusion. The prescribed H. pylori eradication regimens during the period 2020–2023 in Azerbaijan adhered partially to the Maastricht VI recommendations and were reported highly effective (≥90%), providing a good safety profile.
Keywords: Hp-EuReg, Helicobacter pylori, antisecretory therapy, first-line treatment, bismuth, eradication rate, effectiveness, safety
Haqverdiyev G.O., Gafarov L.J., Suleymanova S.F., Hadjizadeh F.Sh., Hagverdiyeva S.I., Muradova M.R., Huseynova S.B., Jabbarova Y.H., Ibrahimova N.V.
RISK ASSESMENT OF OBESITY IN CHILDREN IN BAKU CITY
Abstract: The article presents the results of the risk assessment of obesity among children in Baku. The purpose of the study is to monitor the prevalence of obesity among children in Baku and to identify risk factors. The study was conducted on the basis of a semi-vertical design. The epidemiological control system included school children aged 6.0-6.9, 7.0-7.9, 8.0-8.9 and 9.0-9.9. The selection was made in accordance with the COSI protocol of the WHO European regional office. A two-stage stratified cluster sampling method was used as primary sampling elements were schools, and secondary - third classes. The number of children participating in the research in Baku city was 965 (500 of them were boys and 465 were girls). According to the results of the COSI study in Azerbaijan, the prevalence of thinness among 8-year-old children in Baku was 4.1%, overweight (including obesity) was 34.8%, and obesity alone was 14.6% (proposed by WHO in 2007 according to the criteria of physical development).
Keywords: obesity; children; childhood obesity surveillance initiative; epidemiological surveillance
Aliyeva A.M., Guliyev F.A., Aliyev E.Sh.
INDICATORS OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH CORONARY HEART DISEASE WITH ARTERIAL HYPERTENSION IN THE EARLY PERIOD AFTER CORONARY ARTERY BYPASS GRAFTING
Abstract: The article presents the results of determining the level of markers of endothelial dysfunction in patients with coronary heart disease (CHD) with arterial hypertension (AH) before and after coronary artery bypass grafting (CABG) in the near term. 50 patients with CHD and AH were examined, divided into two groups: group I, 30 patients with CHD and AH who underwent CABG, group II, 20 patients with CHD and AH who did not undergo CABG. Clinical examination included clarification of complaints, collection of anamnesis, physical examination, ECG, echocardiography. Concentrations of endothelin-1 (ET-1) and nitric oxide (NO) were determined in the blood. The concentration of ET-1 in group I patients 12 months after CABG decreased by 28.4% compared to the baseline (t=1.84, p=0.071). In patients of group II, an increase in the concentration of ET-1 was noted after 12 months compared with the baseline by 18.1% (t=1.27, p=0.213). The ET-1 index in group I after 12 months was 43.0% lower than in group II (t=3.14, p=0.003). The blood content of the NO metabolite in group I patients after CABG increased by 21.7% compared with the baseline (t=2.05, p=0.044). The concentration of NO after 12 months in group I patients exceeded that in group II patients by 27.1% (t=2.68, p=0.010). Thus, in patients with coronary artery disease with arterial hypertension after coronary artery bypass grafting in the early postoperative period after 12 months, there is a significant improvement in endothelial function, which is expressed by a decrease in endothelin-1 and an increase in nitric oxide. The results of this study can be used to optimize the conservative treatment of coronary heart disease in patients after CABG for the prevention of complications.
Keywords: coronary heart disease, arterial hypertension, endothelial dysfunction, coronary artery bypass grafting, endothelin-1, nitric oxide
Babayev P.N., Askerov Z.A.
THE ROLE OF PASSIVE SMOKING IN GLOBAL CLIMATE CHANGE AND THE NEGATIVE IMPACT OF THIS PHENOMENON ON THE HEALTH AND DEVELOPMENT OF CHILDREN
Abstract: Objective. To study the impact of harmful components of tobacco smoke, to show the danger of passive smoking on the body of children and adolescents, based on a generalized review of literary sources and data obtained as a result of a social survey of the population. Material and methods. We decided to determine the measurements of height, weight and chest volume by dividing schoolchildren into two groups - exposed and not exposed to passive smoking. Along with questionnaires in district clinics, we used the immunochromatographic analysis test "ImunoChrom-Cotinine-Express" for high-quality in vitro detection of cotinine - a nicotine metabolite in the urine of children, and also examined outpatient cards of children. Results and discussion. Schoolchildren exposed to passive smoking are not distinguished by physical activity, lead a sedentary lifestyle, as a result of which they gain weight. We calculated the arithmetic mean weighted total for all observed groups without age differences. Increased body weight also leads to a parallel increase in chest circumference–it is 2.53±0.16 cm larger in boys. We also observe an increase in ophthal-mological morbidity. Conclusions. During the 20th century, climate parameter changes were objectively recorded and systematically analyzed for the first time. Socially vulnerable members of society face a triple burden: low quality of life, unsatisfactory environmental quality, and poor health. Preventive measures are needed to improve environmental conditions.
Keywords: schoolchildren's appeal rate, passive smoking of schoolchildren, physical development of schoolchildren
Hajiyev E.S., Ibrahimov S.A., Rahimov U.A., Mamedov G.A.
THOD OF OBTURATOR NERVE BLOCK DURINRANSURETHRAL\2RESECTIONOF TUMORS OF THE LATERAL WALL OF THE BLADDER
Abstract: In 44 men diagnosed with lateral bladder wall tumors, general anaesthesia and obturator nerve block combined with spinal anaesthesia were used for pain control during transurethral resection (TUR). The patients were divided into two groups: the control group, consisting of 21 patients, received general anaesthesia, while the second group, consisting of 23 patients, received spinal anaesthesia combined with an obturator nerve block. Confirmation of the obturator nerve through electrical stimulation, followed by its blockade in conjunction with spinal anaesthesia,proved to be an effective, reliable, and safe method of anaesthetic support during TUR on the lateral wall of the bladder. In contrast to TUR performed under general anaesthesia, normosystolic central hemodynamics of the eukinetic type, which leads to arterial hypotension, were observed during the combined use of spinal anaesthesia and obturator nerve block. This combined approach resulted in a reduction in both the duration of the operation and the lengtheients' hospital stay postoperatively. Additionally, it led to a unnecessary expenditures on medications and postoperative monitoring.
Keywords: transurethral resection, general anaesthesia, spinal anesthesia with an obturator nerve block
Mammadov R.A., Abbasaliyev B.B.
EFFECTIVENESS OF LASEROTHERAPY AND COMBINED APPLICATION OF “VENOCORYL” OINTMENT IN THE TREATMENT OF CHRONIC VENOUS ULCER IN THE LOWER EXTREME
Abstract: The aim of the study was a comparative histomorphological evaluation of the results of laser-technological treatment of patients with varicose veins of the lower extremities. The study planned to examine the effectiveness of the combined use of endovascular laser ablation (EVLA), Venocoryl ointment and low-intensity laser beams in the treatment of trophic wounds caused by varicose veins of the lower extremities, as well as morphological changes in the skin and subcutaneous tissue in the ulcer area. Patients were randomized into 3 groups of 25 patients each: Group I – EVLA and mini-phlebectomy were performed together. Group II – EVLA, Venocoryl ointment and low-intensity laser beams were used in complex treatment. Group III – EVLA, miniphlebectomy and Venocoryl ointment were prescribed together for treatment. During the experiment, the morphological changes recorded in different groups were mostly identical and their dynamics were parallel. During this period, many morphological parameters representing tissue damage disappeared, especially in biopsies taken on the 7th day. Based on the above indicators, it can be said that in dynamic observation, the combined application of EVLA, Venocoryl ointment and low-intensity laser beams in the main group has almost the same effect as other treatment methods, but the faster reduction of thrombi in the microcirculation in the main group allows us to say that this organization of treatment provides earlier restoration of microcirculatory circulation. Therefore, it can be successfully applied in the treatment of varicose veins as an alternative treatment plan.
Keywords: trophic ulcers, lower extremity venous diseases, endovasal laser ablation, morphological studies
Mirzayev A.H.
BIOSTATISTICS OF THE EPIDEMIOLOGY OF MYCOSES IN THE REGIONS OF AZERBAIJAN
Abstract: The aim of the presented article is to study the epidemiology of the most common superficial fungal skin diseases in Azerbaijan (in various cities and regions), assess the current situation, and forecast their spread. Materials and Methods. The cities of Baku, Ganja, Lankaran, and Kurdamir were selected for the study. Several medical institutions in these cities were considered as primary research sites. The article examines superficial skin diseases caused by Trichophyton (T), Candida (C), Epidermophyton (E), and Microsporum (M). To organize the survey, questionnaires and patient examination cards were developed. A total of 587 individuals participated in the experiment, and pathological material was randomly collected from 126 individuals in Ganja and 81 individuals in Kurdamir, which was then subjected to laboratory examination. The Statistika-7 software package was used for statistical data processing. Results and Discussion. As a result of the study, a monitoring system for the epidemiology of mycoses was developed, which, using time series analysis, allows assessing the current situation and making predictions. It was established that individuals with weakened immune systems, working and living in unfavorable conditions, are at the highest risk of contracting superficial fungal skin diseases. Conclusion. The developed electronic forecasting system can be applied in various regions of the country, considering factors such as climate, population size, social conditions, and other variables. Based on this system, it is possible to create an electronic epidemiological map of mycoses in the Republic of Azerbaijan. Such a map could be useful not only for dermatologists but also for physicians of other specialties, serving as a first step towards the development of similar maps for other diseases in the future.
Keywords: mathematical model, mycoses, random variables, time series, trend line, biostatistics methods
Shyukyurov S.D., Mirzazade V.A.
DETERMINATION OF THE ODDS RATIO FOR DETECTION OF MICRO- AND MACROPROLACTINOMA DEPENDING ON THE LEVEL OF HYPERPROLACTINAEMIA
Abstract: This study examines the determination of the odds ratio of detecting micro- and macroprolactinomas according to the level of hyperprolactinaemia. Purpose. To determine the odds ratio for detection of microprolactinoma and macroprolactinoma depending on the level of hyperprolactinaemia. Material and methods. 139 patients were included in the study and divided into 2 groups: group 1-hyperprolactinaemia without pituitary adenoma (n=26) and group 2-hyperprolactinaemia with pituitary adenoma (n=113). Of 113 patients in group 2, 60 had microadenoma and 53 had macroadenoma. Results. The results show that with prolactinaemia levels above 349 ng/ml, the odds of detecting pituitary macroadenoma increases significantly, while the odds of detecting microadenoma decreases. Statistical analysis revealed that the odds ratio for microadenoma was 0.597 and for macroadenoma was 1.674, but neither value reached statistical significance. This data emphasis the importance of considering the level of prolactinaemia in the diagnosis of pituitary adenomas. Conclusions. Prolactinaemia levels of 349 ng/ml’ were characteristic of pituitary macroadenoma as evidenced by a statistically significant (p<0.05) microprolactinoma odds ratio value of 76.957 (95% CI 9.909; 597.687) with an odds ratio value for macroprolactinoma of 0.013 (95% CI 0.002; 0.101).
Keywords: hyperprolactinemia, prolactinoma, pituitary adenoma, odds ratio
Hatamzada E.M., Isgandarova G.N.
DIAGNOSIS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN PRIMARY HEALTH CARE
Abstract: Objective of this study to assess the underdiagnosis of chronic obstructive pulmonary disease (COPD) and identify possible factors associated with it. Materials and methods. The selection of patients in the polyclinic was carried out during spontaneous routine or planned visits, as a result of which 122 patients with obstructive ventilation disorders were selected and invited for further examination. The control group consisted of 20 volunteers without COPD and other pulmonary and severe somatic diseases. Analyzed indicators such as gender, age, smoking factor, severity of COPD. Spirometry was performed using a portable ultrasonic spirometer. Results. The average age of patients with COPD was 55.9±4.4 years, men accounted for 59.0%, women - 41.0%. At the time of the study, smokers accounted for 57.4%. The results of spirometry were 41.8% of patients, 58.2% of patients did not undergo spirometry. After spirometry, the severity of COPD was overestimated: stage I was classified in 36.1% of patients, stage II - in 32.0%, stage III - in 6.5% of patients. In 25.4% of cases, the diagnosis was overestimated after spirometry. In the age group of 40-45 years, the chance to find the risk of developing COPD in the main group was 0.208, in the control group – 0.250 (p>0.05), in the group of 46-49 years: 0.326 and 0.333 (p>0.05), 50 -55 years old: 0.402 and 0.538 (p>0.05), 56-60 years old: 0.419 and 0.250 (p>0.05), respectively. In patients aged 56-60 years, OR=1.674 (95% CI 0.523-5.356, p<0.05). In the smokers group, OR=1.645 (95% CI 0.636-4.260, p<0.05). The chance of finding a risk factor in smokers in the main group was 1.346, in the control group - 0.818 (p<0.05). Conclusion. Identification of patients at risk is feasible in the practice of family medicine. The use of spirometry contributes to the early detection of undiagnosed COPD and the correct classification of the degree of the disease.
Keywords: chronic obstructive pulmonary disease, diagnosis, spirometry, odds ratio, primary health care
Musayev T.N.
RESULTS OF RADICAL SURGICAL TREATMENT OF PATIENTS WITH BLADDER CANCER
Abstract: The immediate (intra- and early postoperative complications) and long-term results (overall, adjusted and relapse-free survival rates) and quality of life of patients were studied in a series of 257 consecutive radical cystectomies with various types of urine diversion for muscle-invasive bladder cancer at the clinic of the National Oncology Center of the Ministry of Health of the Republic of Azerbaijan in the period from 2008 to 2017. Factors that have a significant impact on the frequency and nature of complications and survival rates were also identified. Intraoperative mortality was 0.4%, the complication rate was 13.2%. In the early postoperative period, 191 complications of varying severity were recorded in 111 (43.2%) patients. In the multivariate analysis, independent predictors of any postoperative complications after RC were local cT4 tumor extent (OR 4.52; p=0.002), age (OR 1.87; p=0.017), positive urine culture (OR 2.16; p=0.032), and the number of RCs performed by the surgeon (OR 0.89; p=0.038). The 5-year survival to the first clinical event, which was understood as the development of local recurrence or distant metastases, was 63.1% (SE 3.2%), the median RFS was not reached. The 5-year SFS was 65.3% (SE 3.2%), the median was also not reached. The 5-year OS was 54.1% (SE 3.2%), the median OS was 65.7 months. In our study, independent factors statistically significantly associated with the risk of developing complications after RC were local prevalence of cT4 tumor, age, positive urine culture before the intervention, and a small number of surgeries performed by the surgeon or positive urine culture and age, respectively. In addition to demographic indicators (gender and age) and tumor process indicators, survival rates are significantly affected by factors such as ICC (p<0.01) and the experience of the surgical team (p<0.01).
Keywords: Bladder cancer, radical cystectomy, complications, survival
Hajiyeva I.E., Mammadbayli A.K.
DEPENDENCE OF CLINICAL FORMS OF INFANTILE CEREBRAL PALSY ON THE GENERAL MOTOR FUNCTIONAL SYSTEM
Abstract: Objective of the Study. To assess the dependence of various clinical forms of cerebral palsy (CP) on the classification system of Gross Motor Function (GMFCS). Materials and Methods. The assessment of gross motor skills in children with different clinical forms of CP (a total of 71 children) was conducted according to the GMFCS classification. A multivariate linear regression analysis was performed to examine the relationship between several predictive variables, including GMFCS levels (mild and severe) and CP forms. To more accurately analyze differences in total scores between GMFCS levels, a post hoc analysis was conducted using Tukey's Honestly Significant Difference (HSD) test. Results. The analysis did not reveal significant differences between the clinical forms of CP and the scores obtained from the Gross Motor Function Classification System. Conclusion. The level of motor impairment in cerebral palsy is a more critical factor than age or diagnosis.
Keywords: gross motor skills, cerebral palsy, child
