Georgian medical news最新文献

{"title":"SPORADIC CREUTZFELDT-JAKOB DISEASE: CLINICAL FEATURES, DIAGNOSIS AND THERAPEUTIC HORIZONS.","authors":"A Shala, N Shala, F Jashari, B Jashari, R Jashari","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare, rapidly progressive, and fatal prion disease that remains a major diagnostic and therapeutic challenge. Its presentation often overlaps with other causes of rapidly progressive dementia, making early recognition essential, particularly to exclude potentially reversible conditions. This review provides an updated overview of the diagnostic tools, cerebrospinal fluid (CSF) biomarkers, prognostic factors, clinical progression, differential diagnosis, and current management strategies in sCJD. A literature-based review was conducted using PubMed and Scopus for articles published between October 1, 2015, and October 1, 2025, focusing on patients with suspected or confirmed CJD. Clinical features, magnetic resonance imaging (MRI), electroencephalography (EEG), CSF biomarkers, prognostic indicators, and therapeutic approaches were synthesized. Current diagnosis of sCJD relies on the integration of clinical presentation with MRI, EEG, and CSF testing. Diffusion-weighted MRI and real-time quaking-induced conversion (RT-QuIC) have substantially improved antemortem diagnostic accuracy, while traditional biomarkers such as 14-3-3 protein and total tau remain useful supportive tests. Prognosis is uniformly poor, with median survival usually limited to a few months, although disease course varies according to age, PRNP codon 129 polymorphism, and molecular subtype. Important differential diagnoses include autoimmune encephalitis, viral encephalitis, vascular cognitive impairment, and other neurodegenerative disorders presenting with rapidly progressive dementia. No disease-modifying therapy has shown definitive benefit, and management remains primarily supportive and symptom-directed. Advances in biomarkers and greater understanding of molecular heterogeneity may improve early diagnosis, prognostication, and future therapeutic development.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"181-189"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMPACT OF GESTATIONAL DIABETES MELLITUS ON NEONATAL BIRTH WEIGHT, LENGTH, AND GESTATIONAL AGE: A RETROSPECTIVE CASE-CONTROL STUDY.","authors":"J Gobadze, M Nagervadze, T Gogitidze, N Bejanidze, N Zarnadze, K Dolidze","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Gestational diabetes (GDM) in pregnant women leads to the development of macrosomia in newborns and also influences the characteristics of neonatal length development. It is worth noting that findings regarding the association between GDM and gestational age at birth vary, and there is no evidence to support treating GDM as an independent risk factor for determining gestational age at birth. The aim of this study was to determine the impact of GDM on neonatal physical parameters, including birth weight and length, as well as gestational age at birth. Data were collected using a standardized questionnaire. A total of 220 pregnant women were evaluated: 110 with GDM and 110 healthy pregnant women. The newborns of both groups - those with GDM and the healthy controls - were also assessed. The data were processed using statistical analysis software. The chi-square (χ²) test for comparative analysis; a p-value of <0.05 was considered statistically significant. Our study showed that newborns of mothers with GDM are at higher risk of developing either very high or low birth weight; in contrast, newborns of healthy mothers are predominantly born with a normal weight (OR=0.25, χ²=11.28, p=0.0036). GDM increases the risk of delivering newborns who are either very large or relatively short (95% CI=0.73; 3.68, OR=1.64, χ²=6.19, p=0.045); however, it should be noted that although deviations in length from the norm were observed more frequently in the GDM group, the Odds Ratio analysis did not confirm a statistically significant association. The difference in the distribution of gestational age at birth between newborns of mothers with GDM and healthy mothers is not statistically significant (χ²=1.33, p=0.515). The newborns are predominantly full-term, and the observed difference is minor and random in nature. Multivariate logistic analysis revealed statistical significance regarding weight (P<0.001), length (P=0.007), and gestational age at birth (P=0.008), while linear regression demonstrated a statistically significant effect of maternal age on fetal length (β=0.051; p=0.025). Based on the study results, we can conclude that GDM is associated with extreme physical parameters in newborns. Among these parameters, an increased risk of high birth weight was found to be closely linked to GDM. A strong association was also established between GDM and the length of newborns; specifically, cases of both short and long newborns are observed more frequently among mothers with GDM.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"144-151"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LOW-FREQUENCY ULTRASOUND AND OZONE/NO TECHNOLOGIES IN THE COMBINED TREATMENT OF EXUDATIVE HEMISINUSITIS USING THE YAMIK-3 SINUS CATHETER.","authors":"M Ospanova, S Ospanova, A Yernazarov, R Amanbaev, U Rakhmankulov","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim of study: </strong>To evaluate the clinical efficacy and rate of inflammatory process regression using the YAMIK-3 sinus catheter combined with low-frequency ultrasound (LFUS) and ozone/NO technologies in the treatment of acute purulent hemisinusitis (APHS).</p><p><strong>Material and methods: </strong>A prospective controlled clinical study enrolled 51 patients with confirmed APHS. The main group (n=25) received YAMIK-3 sinus drainage with instillation of ozone/NO-enriched physiological saline followed by combined LFUS and ozone/NO mucosal exposure. The control group (n=26) received YAMIK-3 drainage with 0.01% Miramistin instillation. Clinical symptoms, videoendoscopic findings, microbiological cultures, endogenous intoxication markers (tyrosine-containing peptides [TCP] and tryptophan-containing peptides [TrCP]), and radiological sinus pneumatisation were assessed before and after treatment.</p><p><strong>Results and conclusions: </strong>Sterile post-treatment cultures were achieved in 23/25 (92.0%) of main-group patients versus 20/26 (76.9%) of controls. Pathological exudate clearance occurred 3.0±0.8 days earlier and pain/mucosal oedema resolved 2.4±0.3 days earlier in the main group. Plasma TCP and TrCP concentrations, elevated 2.6-fold before treatment, normalised following combined therapy. Complete sinus pneumatisation at 3 months was achieved in 100% of main-group patients versus 88.5% of controls. Hospital stay was reduced by approximately three days. No treatment-related adverse events were observed in either group. The combined use of YAMIK-3, LFUS, and ozone/NO technologies represents a highly effective and well-tolerated treatment strategy for APHS.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"428-432"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"APPLICATION OF THE FAILURE MODE AND EFFECTS ANALYSIS METHOD IN HEALTHCARE: A CASE STUDY OF A UNIVERSITY MEDICAL CENTER IN KAZAKHSTAN.","authors":"N Issatayeva, S Duisekova, M Saberbekova, R Tumanova, L Guruleva, S Mukanova","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Patient safety remains a major concern for healthcare systems worldwide, requiring proactive risk management approaches to prevent adverse events. Failure Mode and Effects Analysis (FMEA) is a well-recognized tool; however, published data on its application in healthcare settings in Central Asia are extremely limited.</p><p><strong>Aim of study: </strong>The aim of this study was to analyze the application of FMEA in the process of prescribing and administering medications at a University Medical Center in Kazakhstan and to evaluate the impact of FMEA-based interventions on the frequency of medication errors.</p><p><strong>Material and methods: </strong>The study was conducted as a quality improvement project with two components. First, a narrative literature review was performed using the PubMed and Web of Science databases (2020-2026): of 917 identified records, 34 articles meeting the inclusion criteria were selected and analyzed. Second, a prospective FMEA study was conducted at the University Medical Center (UMC) in Astana, Kazakhstan, from December 2023 to March 2024. A multidisciplinary expert team, consisting of healthcare professionals and quality management specialists (medical director, head of the quality management unit, head of pharmaceutical services, head of nursing, and two clinical pharmacologists), assessed failure modes in the medication prescribing and administration process using standard scales of Severity (S), Occurrence (O), and Detectability (D) (each scored on a 10-point scale). Risk Priority Numbers (RPNs) were calculated, and targeted corrective actions were implemented for high-risk failure modes. A follow-up reassessment was conducted in January 2026.</p><p><strong>Results: </strong>Seven failure modes were identified across six stages of the process. Baseline RPN values ranged from 150 to 400 (total RPN=1990). The highest risks were associated with discrepancies between medication orders in the medical record and the medication chart (RPN=400) and prescribing errors (RPN=350). Following the implementation of corrective measures-including electronic prescribing, physician self-check checklists, and mobile medication verification-the total RPN decreased by 57.8% to 840. The number of reported medication errors decreased by 49% in 2025 compared to 2024, while the proportion of errors detected before drug administration increased from 30% to 70%.</p><p><strong>Conclusions: </strong>FMEA demonstrated its effectiveness as a proactive tool for identifying and reducing medication safety risks at UMC. The findings support broader implementation of this method in healthcare systems across Central Asia; however, its generalizability to resource-limited settings requires further investigation.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"223-237"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BIOMARKER-ORIENTED REHABILITATION IN CHRONIC CEREBRAL ISCHEMIA.","authors":"F Obidov, E Shamsiev, F Samatov, D Naimov, F Khalimova, I Marwan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic cerebral ischemia (CCI) is a clinically significant form of chronic cerebrovascular disease associated with cognitive decline, impaired daily functioning, and reduced quality of life. In routine clinical practice, the effectiveness of rehabilitation in CCI is often assessed mainly by subjective clinical dynamics, whereas biomarkers and MRI with DTI/SWI may serve as objective indicators of the biological response to restorative treatment.</p><p><strong>Material and methods: </strong>A prospective controlled comparative study was conducted in 115 patients aged 40-65 years with stage I-II CCI. Allocation to the main group (MG, n=55) and comparison group (CG, n=60) was performed after baseline stratification by disease stage, sex, and age; randomization and complete blinding of outcome assessment were not performed, which was considered a methodological limitation. The MG received a personalized biomarker-oriented program, whereas the CG received standardized therapy. A control group without CCI (n=65) was used only for baseline biomarker comparison. MoCA, MMSE, ADL, IADL, SF-36, IL-6, TNF-alpha, CRP, BDNF, NSE, and D-dimer were assessed at baseline, 3 months, and 6 months; DTI/SWI MRI was performed at baseline and at 6 months.</p><p><strong>Results: </strong>Compared with stage I CCI, stage II CCI was associated with increased IL-6 (from 5.29 to 6.81 pg/mL), TNF-alpha (from 4.68 to 5.90 pg/mL), CRP (from 3.49 to 5.02 mg/L), NSE (from 18.3 to 23.1 ng/mL), and D-dimer (from 0.308 to 0.423 μg/mL), as well as decreased BDNF (from 11.4 to 9.7 ng/mL; p<0.001). At 6 months, the MG showed more pronounced favorable dynamics than the CG in MoCA (+22.4% vs +7.1%; p<0.001), MMSE (+12.1% vs +4.3%; p<0.001), IL-6 (-34.4% vs -11.1%; p<0.001), BDNF (+23.3% vs +5.8%; p<0.001), NSE (-22.1% vs -5.8%; p<0.001), D-dimer (-27.0% vs -10.8%; p=0.004), FA (+20.5% vs +5.0%; p=0.003), ADL (+39.6% vs +14.3%; p<0.001), IADL (+41.2% vs +16.0%; p<0.001), and SF-36 physical functioning (+51.3% vs +20.2%; p<0.001).</p><p><strong>Conclusion: </strong>Integrating IL-6, BDNF, NSE, and D-dimer with MoCA/MMSE, ADL/IADL, SF-36, and DTI/SWI MRI makes it possible to objectify CCI severity and monitor rehabilitation effectiveness. The personalized program was associated with more pronounced favorable clinical, laboratory, functional, and neuroimaging dynamics; however, the results should be interpreted cautiously because of the non-randomized design, the absence of complete blinding, and the 6-month follow-up period.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"115-122"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149107760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IN VITRO INVESTIGATION OF THE POTENTIAL OF C60 FULLERENES AS ADJUVANTS OF NONSPECIFIC IMMUNITY.","authors":"M Makhmudova, T Kerimbekov, Z Berikbayeva, D Turebekova, L Akhmaltdinova, Y Alisseiko, O Avdienko, M Rashova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The paper shows the immunomodulatory potential of fullerenes C60 against human neutrophils under antigenic load in vitro. Venous blood samples from 13 healthy volunteers evaluated the effects of C 60 aqueous dispersion on cell viability and proteinase-3 (Pr3) secretion. It was shown that with bacterial stimulation, the survival rate of neutrophils decreases to 81.32%, while the addition of fullerenes C60 has a protective effect, increasing viability to 86.73%. This cytoprotection is probably due to the antioxidant properties of the fullerene scaffold and its ability to inactivate free radicals. In addition to survival, the experimental group showed an almost twofold increase in Pr3 secretion compared to the stimulation control, reaching 2, 14 ng/ml. Statistical analysis by RM-ANOVA confirmed the significance of these differences, indicating that C 60 actively stimulates degranulation. Morphological observations are consistent with these data: in the presence of nanoparticles, there is a tendency to normalize nuclear segmentation and a decrease in toxic grain size. The lack of correlation between cell death and enzyme yield suggests that Pr3 is secreted by active exocytosis rather than passive membrane disruption. Therefore, C60 fullerenes act as functional stimulants enhancing antimicrobial potential without depleting the neutrophil pool. These results position C60 as a promising candidate for the development of new adjuvants and approaches to the regulation of innate immunity. Overall, the study confirms that water-soluble fullerenes are able to simultaneously maintain cell viability and enhance the effector functions of the primary immune response.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"164-168"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PREDOMINANCE OF FOLLICULAR ADENOMA AND PAPILLARY CARCINOMA IN THYROID NEOPLASMS.","authors":"M Hayawi, D Al-Nafoly","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This retrospective study was conducted to accomplish the objectives of this study for the period from first of February until 30th March 2026. The study was conducted at the histopathological lab. of Al-Jumhori Teaching Hospital to search document files for patients who were already diagnosed with thyroid tumour (benign and malignant) by histopathological examination for the years 2023 - 2025. Name, age, and gender, with special concentration on the presence of thyroid tumour, were searched for in the document files. Twenty-seven patients were found to be affected by thyroid tumours. The ages of most of the patients were distributed between 21-60 years, with the highest percentages in the age period between 21- 30 years (37%), followed by the age period 31- 40 years (29.7%). Most of our patients were female (96.3%); only one patient was male (3.7%). Most thyroid tumours were benign (66.7%), while malignant tumours represented 33.3%. Regarding all thyroid tumours (benign &malignant), Follicular adenoma was the most predominant thyroid tumour and represented the highest percentage (59.3%), followed by papillary carcinoma (25.9%). Papillary carcinoma was the most prevalent malignant thyroid tumor, representing 77.8%, followed by anaplastic and medullary carcinoma, with 11.1% for each.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"399-403"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149107809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSOCIATION BETWEEN INFLAMMATORY MARKERS, LIVER ENZYMES, LIPID PROFILE, AND VITAMIN D STATUS IN ADULTS WITH OBESITY: A CROSS-SECTIONAL STUDY.","authors":"A Albayaty, A Sadiq, A Al Qaissi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D has pleiotropic effects on insulin secretion, lipid metabolism, immune modulation, and blood pressure regulation through ubiquitously expressed vitamin D receptors.</p><p><strong>Objective: </strong>This cross-sectional study sought to investigate the associations between inflammatory markers, liver enzymes, lipid profile, glycemic parameters, hemodynamic measures, and vitamin D status in adults with obesity.</p><p><strong>Methods: </strong>A total of 68 adults with obesity were enrolled and stratified by age younger than 40 years versus older than 40 years and BMI (normal weight BMI<25 kg/m² versus overweight BMI ≥25 kg/m², or both. Demographic characteristics, smoking status, and anthropometric measurements were recorded. Lipid profile, glycemic control, liver enzymes, vitamin D, and inflammation markers were measured.</p><p><strong>Results: </strong>Adults older than 40 years had significantly higher systolic blood pressure (p=0.016), fasting serum glucose (p=0.017), and HbA1c (p=0.005) compared to younger adults. Overweight individuals demonstrated significantly higher CRP levels (p=0.040) compared to normal-weight individuals. Triglycerides (AUC=0.638) and systolic blood pressure (AUC=0.634) demonstrated a weak association with vitamin D deficiency.</p><p><strong>Conclusions: </strong>These results demonstrated the multifactorial nature of vitamin D regulation in obesity and reflect the unreliability of measuring serum vitamin D in clinical settings as a diagnostic tool in obese individuals, particularly when coexisting with ageing.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"99-104"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149107211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BRIDGING THE COVERAGE-PARTICIPATION GAP: BEHAVIORAL DETERMINANTS OF CERVICAL CANCER SCREENING AMONG WOMEN IN ADJARA, GEORGIA.","authors":"K Kamashidze, T Beruchashvili, I Nakashidze, S Ahmad, T Peshkova","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Cervical cancer (CCa) is largely preventable through human papillomavirus vaccination, organized screening, and timely management of precancerous lesions; however, screening participation may remain suboptimal even when services are formally available. This cross-sectional, questionnaire-based study examined behavioral and perceptual determinants of CCa screening participation among women in the Adjara region of Georgia. A total of 520 women aged 18-60 years from urban and rural municipalities were recruited using a convenience sampling approach; screening participation was interpreted primarily with reference to the nationally recommended screening age group of 25-60 years. Data were collected from October to December 2024 and analyzed between January and March 2025. The questionnaire was developed using a Health Belief Model-based framework supplemented by selected Knowledge, Attitudes, and Practices components. The primary outcome was self-reported CCa screening participation, defined as having undergone screening at least once. Descriptive statistics, Spearman's rank correlation analysis, and multivariable logistic regression were used. Overall, 33.3% of participants reported previous cervical cancer screening. HPV vaccination coverage was 22.7%, while 43.8% of participants expressed willingness to receive vaccination. Perceived barriers were the most frequently reported Health Belief Model construct, followed by perceived benefits and positive attitudes toward screening. Screened women more frequently reported perceived benefits, positive attitudes, perceived susceptibility, cues to action, and healthcare provider recommendation than non-screened women. Spearman's rank correlation analysis showed that perceived benefits and self-efficacy were positively associated with screening participation, whereas perceived barriers were inversely associated with participation. In multivariable logistic regression analysis, perceived benefits were associated with increased odds of screening participation (aOR=1.80, 95% CI: 1.59-2.05, p&lt;0.001), whereas perceived barriers were associated with reduced odds of participation (aOR=0.83, 95% CI: 0.77-0.89, p&lt;0.001). Positive attitudes toward screening were also independently associated with screening uptake (aOR=1.24, 95% CI: 1.11-1.39, p&lt;0.001). Knowledge score and perceived severity were not significant independent predictors. These findings indicate a persistent coverage-participation gap in Adjara and suggest that CCa screening uptake is associated mainly with behavioral, perceptual, and communication-related factors rather than knowledge or service availability alone. Thus, behaviorally informed, patient-centered, and provider-supported strategies are needed to reduce perceived barriers, strengthen perceived benefits and self-efficacy, and promote consistent healthcare provider recommendations. The low HPV vaccination rate and moderate willingness to be vaccinated further support the need for integra","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"266-273"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149107920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BIOMARKERS OF BONE REMODELING AND INFLAMMATION IN CHRONIC PERIAPICAL LESIONS: A NARRATIVE REVIEW.","authors":"F Sahiti, A Veseli, M Petreska, S Kosumi, N Berisha, E Veseli, K Veseli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic periapical lesions are inflammatory conditions that cause ongoing destruction of the alveolar bone. While microbial infection is known to be the initial cause, the complex interplay between the types of microbes present, immune responses, factors affecting the whole body, and bone remodeling processes is not yet fully understood.</p><p><strong>Objectives: </strong>This narrative review summarizes current evidence on how bone metabolism changes in chronic periapical lesions. It also examines the roles of inflammatory mediators, osteoimmune pathways, systemic factors, and imaging techniques in understanding how the disease progresses and how well it can heal.</p><p><strong>Methods: </strong>A narrative search was performed across electronic databases, including PubMed, Scopus, and Web of Science, for relevant studies. These studies investigated chronic periapical lesions, bone metabolism markers, inflammatory pathways, vitamin D levels, systemic factors, and imaging assessments. We analyzed evidence concerning biomarkers of bone formation and resorption, osteoclast activation, and bone remodeling mechanisms.</p><p><strong>Results: </strong>Current evidence shows that biofilms in root canals trigger the release of pro-inflammatory substances. This leads to higher levels of RANKL and lower levels of osteoprotegerin (OPG), which encourages the development of osteoclasts and the breakdown of bone matrix. Markers of bone resorption, such as CTX and TRACP5b, are frequently reported as elevated, while markers of bone formation, including BALP, osteocalcin, and PINP, show variable or minor changes. Systemic factors like vitamin D deficiency, diabetes, smoking, and alcohol consumption are observationally associated with impaired healing. Cone-beam computed tomography (CBCT) offers a better volumetric assessment compared to traditional X-rays.</p><p><strong>Conclusions: </strong>Chronic periapical lesions are characterized by a complex osteoimmune imbalance. While integrating biomarkers with advanced imaging represents a promising research avenue, further validation is required before these strategies can be implemented in routine clinical practice.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 376-377","pages":"466-473"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}