Georgian medical news最新文献

{"title":"PREVENTION OF LOCAL POSTOPERATIVE COMPLICATIONS IN THE SURGICAL TREATMENT OF CHRONIC VENOUS INSUFFICIENCY OF THE LOWER EXTREMITIES (CEAP C3-C5).","authors":"Y Salmenbayev, Y Massalimov, A Dyussupov, N Omarov, A Kazangapova","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic venous insufficiency of the lower extremities remains one of the most significant problems of modern vascular surgery and angiology because of its high prevalence, progressive course, and association with edema, trophic skin changes, and impaired quality of life. In patients with CEAP C3-C5 disease, the outcome of surgical treatment depends not only on elimination of pathological venous reflux, but also on the degree of surgical trauma and the risk of local postoperative complications.</p><p><strong>Aim: </strong>To evaluate the effect of a modified dissection technique for incompetent perforating veins with preservation of the accompanying artery on the incidence of local postoperative complications in patients with CEAP C3-C5 chronic venous insufficiency of the lower extremities.</p><p><strong>Materials and methods: </strong>A single-center prospective non-randomized comparative clinical study was conducted at the Department of Cardiovascular Surgery of the Medical Hospital of Semey State Medical University in 2018-2021. The study included 62 patients aged 22 to 48 years with clinically significant chronic venous insufficiency of the lower extremities CEAP C3-C5 who required surgical treatment. The main group consisted of 32 patients who underwent modified dissection of incompetent perforating veins with preservation of the accompanying artery, whereas the comparison group included 30 patients operated on using the conventional technique. Preoperative assessment included clinical examination, duplex ultrasound scanning, CEAP classification, and VCSS scoring. The primary endpoint was the overall incidence of local postoperative complications; the secondary endpoint was the change in VCSS over follow-up. Statistical analysis was performed using Fisher's exact test and the Mann-Whitney U test; p<0.05 was considered statistically significant.</p><p><strong>Results: </strong>The groups were comparable at baseline in age, CEAP clinical class distribution, and initial VCSS values. In the comparison group, local postoperative complications occurred substantially more often than in the main group. Subcutaneous hematomas were observed in 26.7% versus 6.3% of patients (p=0.040), postoperative limb edema in 40.0% versus 3.1% (p<0.001), ecchymosis in 10.0% versus 0, and skin necrosis in 6.7% versus 0, respectively. The overall incidence of at least one local postoperative complication was 53.3% in the conventional surgery group and 9.4% in the modified surgery group (p=0.00024). Absolute risk reduction was 43.9%, relative risk was 0.18, relative risk reduction was 82.4%, and the number needed to treat was 2.3. VCSS dynamics also favored the modified technique: at 6 months the score was 5 [4;6] versus 6 [5;8] (p=0.028), and at 12 months it was 4 [3;5] versus 6 [5;7] (p=0.011) in the main and comparison groups, respectively.</p><p><strong>Conclusions: </strong>The modified dissection of incompetent perforating veins w","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"212-221"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757785","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":"STANDARDIZED PATIENT-BASED TRAINING AND CLINICAL DIAGNOSTIC COMPETENCE AMONG MEDICAL STUDENTS: A RANDOMIZED COMPARATIVE STUDY.","authors":"D Malidze, L Dolidze, N Jojua, T Gognadze, A Jabauri, E Kokhreidze, L Melia, T Chanturia, T Chkoidze, S Charles Jones","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim of the study: </strong>The aim of this study was to compare standardized patient-based training with traditional didactic and manikin-based instruction in developing clinical diagnostic competence among mid-level medical students, and to assess whether baseline academic performance influenced this effect.</p><p><strong>Material and methods: </strong>A single-center randomized comparative educational study was conducted among 498 medical students. Participants were assigned to either standardized patient-based training or traditional didactic and manikin-based instruction. Clinical diagnostic performance was assessed using the Objective Structured Clinical Examination (OSCE). Baseline academic performance was evaluated by grade point average (GPA). Subgroup analyses were performed according to academic performance. Statistical significance was set at p<0.05, and effect size was calculated using Cohen's d.</p><p><strong>Results: </strong>Baseline GPA was comparable between groups. Students trained with standardized patients achieved higher OSCE scores than those receiving traditional instruction, with mean scores of 8.39 and 6.93, respectively. The effect size was large (Cohen's d=1.07). The greatest benefit was observed among students with average or lower baseline GPA, whereas high-performing students showed comparable outcomes across instructional modalities. Questionnaire responses from students in the standardized patient-based training group, lecturers and OSCE examiners favored standardized patient-based training for diagnostic reasoning, communication skills and clinical confidence, while manikin-based instruction was preferred for procedural skills.</p><p><strong>Conclusions: </strong>Standardized patient-based training was associated with improved clinical diagnostic performance, particularly among students with average or lower academic standing. These findings support the integration of standardized patients into hybrid clinical curricula to strengthen diagnostic competence and communication skills.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"43-50"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758723","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":"CEREBROVASCULAR EVENTS AND NEUROCOGNITIVE IMPAIRMENTS WITH ALTERATIONS IN POLYSOMNOGRAPHIC INDICATORS FOLLOWING CARDIAC SURGERY.","authors":"E Tsitlidze, I Rukhadze, I Verulashvili, D Minyao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac surgery involving cardiopulmonary bypass (CPB) is frequently associated with a spectrum of postoperative neurological complications, ranging from transient neurocognitive decline to permanent cerebrovascular damage. These events are often accompanied by significant disruptions in sleep architecture, which may further impede the brain's recovery process. Despite the prevalence of these issues, the correlation between postoperative sleep parameters and neurocognitive outcomes remains insufficiently explored.</p><p><strong>Objective: </strong>The primary goal of this prospective study was to evaluate the relationship between postoperative cerebrovascular and cognitive dysfunctions and alterations in polysomnographic (PSG) parameters in patients undergoing cardiac surgery.</p><p><strong>Methods: </strong>A total of 507 patients scheduled for cardiac surgery were screened, of whom 104 patients met the strict inclusion criteria and underwent comprehensive neurological and polysomnographic assessment. Patients were divided into two groups: Group I (n=52) received Citicoline as part of their perioperative management, while Group II (n=52) served as the control group. Cognitive function was assessed using the MMSE and MoCA scales. PSG parameters, including sleep latency, REM latency, and arousal index, were recorded preoperatively and postoperatively (at Day 10 and 1 month), while acute neurological evaluations were performed at Day 3.</p><p><strong>Results: </strong>Pre-operative screening revealed internal carotid artery stenosis or occlusion in 28.8% (n=30) of the enrolled cohort. Acute postoperative neurological complications were documented in 35.6% (n=37) of the patients on Day 3. PSG data revealed profound alterations in sleep architecture, characterized by increased sleep latency and an elevated arousal index on Day 10, closely correlating with cognitive impairment. Notably, within the subgroup analysis of patients with POCD, Group I (Citicoline) demonstrated a significant recovery in MoCA scores and faster structural stabilization of sleep parameters compared to the control group by Day 30 (p=0.0016).</p><p><strong>Conclusion: </strong>The study demonstrates that polysomnography is a sensitive tool for detecting early neurocognitive dysfunction following cardiac surgery. The inclusion of Citicoline in the perioperative protocol significantly mitigates neurocognitive decline and facilitates the stabilization of sleep-wake cycles. PSG parameters may serve as reliable objective markers for predicting long-term neurological outcomes in cardiac surgery patients.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"6-15"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758430","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":"CLINICAL CHARACTERISTICS AND RISK FACTORS FOR ADVERSE OUTCOMES IN ELDERLY PATIENTS WITH SEVERE COVID-19.","authors":"H Zhetpisbayeva, K Askarova, A Tolendiyeva, K Kupenova, B Zharmagambetova, N Imambayeva, Z Zhaypova","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To identify key clinical, laboratory, and imaging predictors of adverse outcomes in elderly patients aged 60-74 years with COVID-19.</p><p><strong>Materials and methods: </strong>A comprehensive retrospective analysis was conducted among elderly patients diagnosed with COVID-19. The participants were divided into two groups: survivors (n=50) and non-survivors (n=140). The study was conducted from May to October 2021 at the City Clinical Infectious Diseases Hospital No.3 in Astana, Kazakhstan. Statistical analysis was performed using non-parametric methods, including the Mann-Whitney U test.</p><p><strong>Results: </strong>Elderly patients aged 60-74 years accounted for 48% of all in-hospital deaths during the study period (140 of 292 deaths). Adverse outcomes were strongly associated with the development of a systemic inflammatory response. In the non-survivor group, critical median values were identified for C-reactive protein (CRP) - 97.9 mg/L, interleukin-6 (IL-6) - 38.15 pg/mL, and the lung involvement on CT imaging - 45.0% (IQR: 30.0-60.0%). Concomitant chronic bronchopulmonary pathology was also more frequent in the non-survivor group than in the survivor group (31% vs. 8%). Statistically significant differences between non-survivors and survivors were found for CRP levels (p=0.001), IL-6 levels (p=0.024), CT -assessed lung involvement (p=0.032), and chronic bronchopulmonary pathology (p=0.001).</p><p><strong>Conclusion: </strong>This study identified critical markers of clinical decompensation in COVID-19 patients aged 60-74 years: lung involvement≥ 45% on CT imaging (CT-2/CT-3), IL-6 >40 pg/mL, and CRP >100 mg/L. Concomitant bronchopulmonary pathology was significantly more frequent among non-survivors than among survivors (31% vs. 8%) and was associated with an adverse outcome. These findings support the need for early targeted therapy when the specified threshold values are reached.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"166-174"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760260","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":"DUAL-SOFTWARE INTEGRATION IN MEDICAL STATISTICS TEACHING: A CASE-BASED APPROACH TO F-DISTRIBUTION WITH DOUBAO AI AND R.","authors":"Ling-Ling Zhou, Lian-Ping He","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To address the challenges of abstract theoretical concepts and low practical application in medical statistics teaching, this study proposes an innovative teaching model integrating Doubao AI and R software, focusing on the F-distribution with numerator degrees of freedom (df₁) =2 and denominator degrees of freedom (df₂) =27.</p><p><strong>Methods: </strong>A comparative teaching experiment was conducted among 52 medical students, divided into an experimental group (n=26) adopting the dual-software integrated model and a control group (n=26) using traditional teaching methods. The teaching process included AI-assisted theoretical interpretation, R-based data simulation, and case-driven practical application. Academic performance, task completion efficiency, and student satisfaction were evaluated. Task completion efficiency and student satisfaction were evaluated.</p><p><strong>Results: </strong>The average time for the experimental group to complete the teaching process of F-test was 10±2 minutes, shorter than the traditional instruction's 30±5 minutes. The duration required for this teaching process is shorter than that of traditional instruction.100% of students in the experimental group believed that the dual-software integration helped them understand the application of F-distribution (df₁=2, df₂=27) in clinical research.</p><p><strong>Conclusion: </strong>The integration of Doubao AI and R software effectively bridges the gap between theory and practice in F-distribution teaching, improves students' statistical thinking and operational capabilities as well as learning efficiency and satisfaction, and provides a replicable solution for the digital reform of medical statistics courses.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"96-99"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764691","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":"MANAGEMENT OF CHRONIC APICAL PERIODONTITIS WITH FURCATION INVOLVEMENT USING HIGH-TEMPERATURE SODIUM HYPOCHLORITE IRRIGATION: A CASE REPORT.","authors":"Z Khabadze, M Gasbanov, N Akhmedov, D Babakhanov, Kh Umarov, N Dolzhikov, E Kakabadze, N Khachatryan, V Slonova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Furcation involvement in multirooted teeth represents a significant challenge for endodontic treatment due to anatomical variability, the presence of accessory canals, and limited accessibility for adequate disinfection. This article presents a clinical case of non-surgical single-visit endodontic treatment of chronic apical periodontitis associated with furcation involvement in tooth 4.7. Root canal disinfection was performed using 3.25% sodium hypochlorite with intracanal heating up to 150 °C plugger. After chemo-mechanical preparation, definitive root canal obturation was carried out using the warm vertical compaction technique. A review of contemporary literature regarding the efficacy and safety of high-temperature irrigation protocols in endodontics was also performed. The presented clinical case demonstrates the potential for successful resolution of inflammatory lesions and promotion of bone healing in both periapical and furcation regions without additional surgical intervention. The obtained findings support the application of high-temperature sodium hypochlorite irrigation protocols for improving disinfection efficiency in complex root canal systems associated with chronic apical periodontitis and furcation involvement.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"161-165"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766297","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":"ANTIMICROBIAL SUSCEPTIBILITY PATTERNS OF ESCHERICHIA COLI AND ENTEROBACTER SPP. CAUSING COMMUNITY-ACQUIRED INFECTIONS IN MÉRIDA, VENEZUELA.","authors":"M Alviárez, M Balseca, A Romero, B Armijo, E Ruiz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Enterobacterales are among the leading causes of community-acquired infections and represent an increasing public health concern due to the emergence of antimicrobial resistance. This study aimed to characterize the antimicrobial susceptibility profiles and resistance phenotypes of Escherichia coli and Enterobacter spp. isolates recovered from clinical specimens processed in a microbiology laboratory in Mérida, Venezuela, between January 2017 and May 2021. A descriptive, retrospective, cross-sectional study was conducted, including 39 clinically relevant isolates corresponding to E. coli (n=17) and Enterobacter spp. (n=22). Bacterial identification was performed using conventional biochemical methods, and antimicrobial susceptibility testing was carried out by disk diffusion according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Phenotypic detection of extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases was also performed. Escherichia coli was the predominant pathogen isolated from urine samples (58.8%), whereas Enterobacter spp. predominated in skin and wound secretion specimens. Ten antimicrobial susceptibility profiles were identified among E. coli isolates and eight among Enterobacter spp., revealing substantial phenotypic diversity. E. coli isolates exhibited high susceptibility to cefepime, aztreonam, imipenem, and meropenem, but showed high resistance rates to ampicillin, cefuroxime, and trimethoprim-sulfamethoxazole. In addition, susceptibility patterns compatible with ESBL production and multidrug-resistant phenotypes were identified. Enterobacter spp. isolates retained susceptibility to third- and fourth-generation cephalosporins, monobactams, and carbapenems, while displaying frequent resistance to β-lactam/β-lactamase inhibitor combinations, a pattern consistent with inducible chromosomal AmpC production. No isolate exhibited a phenotype compatible with carbapenemase production. These findings demonstrate the circulation of Enterobacterales with diverse resistance profiles in community-acquired infections and highlight the importance of continuous microbiological surveillance to support empirical antimicrobial therapy and prevent the dissemination of emerging resistance mechanisms.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"183-188"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757795","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":"ASSESSMENT OF SUBCLINICAL RENAL INSULT IN SHORT- AND LONG-TERM UNCONTROLLED HYPERTENSION USING MOLECULAR BIOMARKERS OF NGAL AND KIM-1.","authors":"R Alathary, N Jabbar, S Hamzah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Uncontrolled Hypertension (UHTN) is a major cause of rapidly deteriorating kidney function. Typical clinical indicators often lack the sensitivity necessary for early detection of tubular changes preceding irreversible damage to the nephrons.</p><p><strong>Objective: </strong>To evaluate the diagnostic performance of a novel kidney damage index derived from the integrated values of Neutrophil gelatinase-associated lipocalin (NGAL) and Kidney injury molecule-1 (KIM-1), alongside Caspase-3 and Advanced protein oxidation products (AOPP), focusing on how disease duration of UHTN influences these molecular signatures of kidney injury.</p><p><strong>Methods: </strong>90 participants were categorized into three groups (n=30): healthy controls, short-term UHTN (<5 years), and long-term UHTN (>10 years). NGAL, KIM-1, Caspase-3, and AOPP were quantified using ELISA.</p><p><strong>Results: </strong>Significant progressive elevations in serum NGAL, KIM-1, and Caspase-3 were observed in UHTN patients compared to controls (P<0.05).</p><p><strong>Conclusion: </strong>UHTN triggers 'silent' tubular deterioration. These structural markers offer a superior diagnostic advantage by detecting subclinical damage at an early stage of UHTN. The clinical application of these sensitive biomarkers could be instrumental in preventing the rapid progression of HTN to overt chronic kidney disease and avoiding long-term complications.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"147-152"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759121","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":"COGNITIVE IMPAIRMENT AFTER CORONARY ARTERY BYPASS GRAFTING: THE ROLE OF MEDICAL REHABILITATION - A LITERATURE REVIEW.","authors":"A Rakhmetullina, A Alimbayeva, A Orekhov, Y Dairbekov, A Rakhmetullin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in cardiac surgery, extracorporeal circulation techniques, and perioperative care have significantly improved survival following coronary artery bypass grafting (CABG). However, the increasing number of postoperative survivors has led to a growing burden of long-term complications, among which cognitive impairment represents a major yet underrecognized clinical problem.</p><p><strong>Objective: </strong>To critically synthesize current evidence on the prevalence, mechanisms, and clinical significance of cognitive impairment after CABG, as well as to evaluate the role of medical rehabilitation in its prevention and management.</p><p><strong>Methods: </strong>A structured literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies published within the last five years. Study selection was performed based on predefined inclusion criteria, and elements of the PRISMA framework were applied to enhance transparency. A total of 55 studies were included in the final analysis.</p><p><strong>Results: </strong>Postoperative cognitive impairment remains one of the most common neurological complications following CABG, affecting approximately 30-60% of patients in the early postoperative period, with persistent deficits observed in a substantial proportion of cases. Its pathogenesis is multifactorial and involves preoperative vulnerability, intraoperative cerebral hypoperfusion and microembolization, systemic inflammation, and postoperative complications. Despite its clinical relevance, cognitive impairment is frequently underdiagnosed and insufficiently addressed within standard rehabilitation programs.</p><p><strong>Conclusions: </strong>Current rehabilitation models lack systematic approaches to the assessment and management of cognitive dysfunction after CABG. Integrative strategies combining cognitive training, physical rehabilitation, and multimodal interventions demonstrate promising potential for improving cognitive outcomes and quality of life. Further high-quality studies are required to develop standardized rehabilitation protocols with mandatory inclusion of cognitive endpoints.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"63-72"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759907","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":"THE EFFECTIVENESS OF INTRAOPERATIVE ULTRASOUND IN GLIAL TUMOR SURGERY.","authors":"Gr Tchatchia, I Chelishvili, G Chutkerashvili, N Inauri, T Mermanishvili","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Glial tumors constitute a significant proportion of central nervous system neoplasms. The main treatment modalities include surgery, radiotherapy, and/or chemotherapy. Patient prognosis depends on tumor grade, the extent of surgical resection, and, when indicated, the effectiveness of adjuvant treatment. The use of intraoperative ultrasound (IOUS) may provide real-time information during surgery and may facilitate maximal safe resection.</p><p><strong>Objective: </strong>The aim of this retrospective study was to evaluate the role of IOUS in glial tumor surgery, with particular attention to residual tumor detection, postoperative edema, and neurological outcome in patients operated on with and without IOUS guidance.</p><p><strong>Methods: </strong>The study included 35 patients with histologically confirmed glial tumors who underwent surgical treatment between 2020 and 2026. Twenty patients underwent surgery with IOUS guidance, whereas 15 underwent microsurgical resection without IOUS. IOUS was performed using SONOLINE G50 (Siemens) and ACUSON X300 (Siemens) systems with 5-10 MHz transducers. Preoperative and postoperative neurological status was assessed clinically by neurosurgeons and neurologists. Postoperative CT was performed on the second postoperative day; contrast-enhanced MRI was performed later, within 21 days to 1 month after surgery. Because standardized KPS or mRS scores and early MRI within 48 hours were not available in this retrospective series, radiological and neurological outcomes were analyzed as descriptive clinical categories.</p><p><strong>Results: </strong>High-grade tumors (WHO grade III-IV) were diagnosed in 25 patients and low-grade tumors (WHO grade I-II) in 10 patients. In the IOUS group, 16 patients had high-grade and 4 had low-grade tumors; in the non-IOUS group, 9 patients had high-grade and 6 had low-grade tumors. Residual tumor was detected in 7 of 20 patients in the IOUS group and in 9 of 15 patients in the non-IOUS group. Neurological status improved in 12 patients, remained unchanged in 7, and worsened in 1 in the IOUS group; in the non-IOUS group, neurological status improved in 1 patient, remained unchanged in 13, and worsened in 1. Overall postoperative edema increased in 2 cases, remained unchanged in 22, and decreased in 11.</p><p><strong>Conclusion: </strong>IOUS is a useful adjunct in glial tumor surgery because it provides real-time intraoperative information regarding tumor localization, internal structure, and relationship to surrounding brain tissue. In this retrospective cohort, IOUS was associated with a lower frequency of residual tumor and a more favorable trend in neurological outcome, although the absence of volumetric early postoperative MRI and standardized neurological scores limits definitive conclusions.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"55-62"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758439","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}