Georgian medical news最新文献

{"title":"PSYCHOMETRIC ASSESSMENT OF AN ADAPTED BILINGUAL (RUSSIAN-KAZAKH) VERSION OF THE UW-QOL V4.1 QUESTIONNAIRE AND ANALYSIS OF FUNCTIONAL REHABILITATION OUTCOMES IN PATIENTS OF THE REPUBLIC OF KAZAKHSTAN.","authors":"A Saipudinkyzy, A Yessirkepov, Z Aitbayev, M Laktionova, M Baimuratova","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Surgical treatment of tumours of the maxilla and hard palate is often associated with persistent functional and psychosocial impairment, making quality-of-life assessment an important component of rehabilitation evaluation. The objective of the present study was to assess the applicability and psychometric characteristics of an adapted bilingual (Russian-Kazakh) version of the UW-QOL v4.1 questionnaire in patients after surgical treatment of tumours of the maxilla, hard palate, and adjacent anatomical regions, as well as to analyse quality-of-life outcomes depending on the method of functional rehabilitation.</p><p><strong>Materials and methods: </strong>A cross-sectional study included 104 patients after surgical treatment of maxillary and hard palate tumours. Translation and cultural adaptation were performed using forward translation, expert consensus, and pilot testing. Internal consistency, test-retest reliability, and construct validity were assessed using standard psychometric methods. Statistical analysis was performed using IBM SPSS Statistics 26.0.</p><p><strong>Results: </strong>The overall Cronbach's α coefficient for the 14 questionnaire domains was 0.878, indicating high internal consistency. Test-retest reliability demonstrated strong correlations across all domains (r=0.904-0.983; p<0.001). The lowest quality-of-life scores were observed in the \"Saliva\" (41.3±21.2) and \"Taste\" (43.6±21.5) domains. Patients with advanced-stage disease and those who underwent multimodal treatment had significantly lower Physical Function and Social-Emotional Function scores compared with patients with early-stage disease and monotherapy (p≤0.001). Patients using obturator prostheses demonstrated significantly higher quality-of-life scores than patients without prosthetic rehabilitation (p<0.001). Financial limitations were the most common reason for refusal of obturator rehabilitation (55.6%).</p><p><strong>Conclusions: </strong>The adapted bilingual version of the UW-QOL v4.1 questionnaire used in the present study demonstrated good psychometric properties and may be applied for quality-of-life assessment in patients after surgical treatment of maxillary and hard palate tumours in the Republic of Kazakhstan. The findings also highlight the importance of accessible functional rehabilitation in this patient population.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"118-127"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765791","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":"ASSESSING THE EFFECTIVENESS OF LIFESTYLE CLINIC INTERVENTIONS ON CARDIOMETABOLIC RISK FACTORS: A RETROSPECTIVE STUDY.","authors":"Z Althumali, J Khouja, R Alnemari, M Alotaybi, F Roublah, A Alahmari, A Jabbad, A Almohammadi, H Alsolami","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic disorders, including diabetes mellitus, hypertension, dyslipidemia, and obesity, represent a significant global health burden. While lifestyle interventions are recommended, evidence from real-world clinical settings in Saudi Arabia remains limited.</p><p><strong>Objective: </strong>To evaluate the association between participation in a comprehensive lifestyle clinic intervention on cardiometabolic risk factors among adult patients in Saudi Arabia over a six-month period.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from 281 participants enrolled at the Lifestyle Clinic of King Abdulaziz Medical City, Jeddah. Participants were categorized into metabolic (n=137) and smoking cessation (n=144) cohorts. Longitudinal changes in BMI, systolic blood pressure, HbA1c, and total cholesterol were assessed at baseline, 3 months, and 6 months using linear mixed-effects models. Smoking cessation outcomes were evaluated using generalized estimating equations.</p><p><strong>Results: </strong>At 6 months, participants demonstrated significant reductions in BMI (-0.92 kg/m², 95% CI -1.79 to -0.05; p=0.036) and total cholesterol (-0.25 mmol/L, 95% CI -0.48 to -0.03; p=0.022) in adjusted analyses. Among active smokers at baseline, 24.1% had quit smoking at 6 months. No significant changes were observed in systolic blood pressure or HbA1c levels.</p><p><strong>Conclusion: </strong>Participation in a structured lifestyle clinic program was associated with improvements in BMI and lipid profile among Saudi adults with cardiometabolic risk factors over 6 months. These findings support the potential role of comprehensive lifestyle programs in routine clinical practice to address the growing burden of metabolic diseases in Saudi Arabia.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"230-237"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759245","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":"SKIN-TO-SKIN CONTACT IN NEONATAL CARE: CLINICAL SIGNIFICANCE, IMPLEMENTATION CHALLENGES, AND LONG-TERM OUTCOMES IN GEORGIA.","authors":"N Totadze, N Adamia, M Kobakhidze, I Kekelidze, J Kikvadze, L Tchelidze","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Skin-to-skin contact (SSC) is a crucial component of neonatal care, playing a vital role in early physiological stabilization, neurodevelopment, and the formation of maternal-infant bonding. A growing body of evidence indicates that deprivation of SSC, particularly during the immediate postnatal period, is associated with long-term adverse outcomes, including emotional dysregulation, behavioral difficulties, and impaired cognitive development. Importantly, the absence of early SSC has also been shown to negatively affect the initiation and continuation of breastfeeding, thereby limiting its well-documented benefits for both infants and mothers. Our research focuses on the clinical condition of children in Georgia who were deprived of early skin-to-skin contact. The study was conducted by member physicians of a professional association - the Georgian Children's Health Care Association. (The study was conducted by the authors, whose professional backgrounds include pediatrics, allergy, and clinical immunology, and doctoral-level training in public health.) using a survey-based approach and obtaining informed parental consent. Over two years, 168 parents were interviewed during routine pediatric visits. The questionnaire included key variables such as: (1) mode of delivery (vaginal vs. cesarean section, elective or medically indicated), (2) whether SSC was initiated within the first hour after birth, and (3) type of feeding (breastfeeding vs. formula feeding). In cases of artificial feeding, additional data were collected regarding the use of specialized therapeutic formulas, particularly cow's milk protein allergy formulas, given their notably high usage in Georgia. For the clinical component of the study, a total of 168 children were initially assessed. From this cohort, 16 children aged 4-6 years were identified and selected for detailed evaluation, based on parental reports of limited SSC during the neonatal period, with maternal-infant separation lasting from one week to two months. These children presented with a range of developmental and behavioral challenges. From this group, 11 children aged 4-6 years were selected as a subgroup for detailed evaluation. These children presented with a range of behavioral disturbances, anxiety, difficulties in social interaction, attention deficits, and sleep disturbances, 5 children were selected as another subgroup who had developed behavioral challenges, including delayed speech development, emotional dysregulation, and were referred for psychological intervention. Additionally, from the same cohort of 168 children, 15 children aged 4-6 years were selected who did not have early skin-to-skin contact deficits but had similar behavioral difficulties. and were referred for psychological intervention. Following 6-7 months of therapy, significant improvement was observed across multiple domains. Although this issue requires further in-depth investigation and large-scale analysis, our findings, even with","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"189-198"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759563","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":"NEUROPROTECTIVE FITNESS OF LOSARTAN AGAINST DOXORUBICIN INDUCED NEUROTOXICITY IN WHITE ALBINO RATS.","authors":"S Yonus, S Othman, S Yousif, M Merkhan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Doxorubicin (Dox) is clinically effective anticancer agent with cytotoxic downside features of neurotoxicity. Losartan (LST), an angiotensin II type 1 receptor blocker (ARB), is antihypertensive with reported pleiotropic effects, hence, the current study was sought to identify the protective effects of losartan in mitigating Dox-induced neurotoxicity in a white Albino rat model.</p><p><strong>Methods: </strong>Fifty-six adult rats were sub-classified into males and females for each intervention. The groups include control, Dox alone, LST alone, combined Dox and SLT. After sacrificing, the brain was harvested for preparation of slides. Slides were stained and images captured.</p><p><strong>Results: </strong>Sections from control groups and LST alone were intact in both sexes. Sections from Dox groups in either sex demonstrated moderate to severe tissue changes represented as vascular congestion, glial activation, and focal gliosis. The combination groups of Dox and LST demonstrated restored architecture represented by reduced congestion and gliosis in dose dependent manner with female showing better positive response compared to male.</p><p><strong>Conclusion: </strong>LST provided histological notable protective effects against Dox insults neurotoxicity in white Albino rats.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"77-83"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760745","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":"TRENDS IN GENERAL SURGERY PROCEDURE TYPES AND THEIR OUTCOMES FOR A NEWLY COMMISSIONED HOSPITAL.","authors":"S Alsuwaydani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>We sought to describe the types and frequencies of surgeries conducted in our newly commissioned hospital and to correlate procedure types with length of hospital stay and postoperative complications.</p><p><strong>Material & methods: </strong>This study is a retrospective quantitative chart review design, using patient records. It's conducted in a newly commissioned tertiary care academic hospital. Following systematic screening of medical records, approximately 377 patients were expected to satisfy the eligibility criteria. All extracted data were coded and entered into Microsoft Excel for initial collection and verification. Statistical analysis was completed using IBM SPSS Statistics, version 27.</p><p><strong>Results: </strong>A total of 377 patients underwent general surgical procedures, with a mean age of 35.81 years (SD±14.44). Male patients comprised 58.9% and Saudi nationals 82.8%. The most common procedures were laparoscopic cholecystectomy (22.8%), inguinal hernia repair (13.3%), and epidermal cyst excision (13.0%). General anaesthesia predominated (44.0%), with a significant association between anaesthesia type and procedure (p<0.001). Most cases (94.4%) were managed as day surgery (p=0.035). we noted that no postoperative complications were recorded at 30-day follow-up, as zero incidence of surgical site infection, urinary tract infection, deep vein thrombosis, readmission, or reoperation.</p><p><strong>Conclusions: </strong>This study documents the primary surgical profile of a recently commissioned tertiary hospital, revealing a diverse, mainly elective cases with zero postoperative complications, readmissions, or reoperations. These results reproduce effective perioperative preparation from the beginning and found a respected starting point for ongoing excellence benchmarking and hospital development.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"16-20"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766285","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":"HODGKIN LYMPHOMA DIAGNOSED DURING THE SECOND TRIMESTER OF PREGNANCY AND TREATED WITH ABVD CHEMOTHERAPY WITH FAVORABLE MATERNAL AND NEONATAL OUTCOMES: A CASE REPORT.","authors":"N Ghukasyan, M Melik-Andreasyan, L Sahakyan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Hodgkin lymphoma (HL) during pregnancy is rare and presents diagnostic and therapeutic challenges. Optimal management requires balancing maternal oncologic benefit and fetal safety through a multidisciplinary approach.</p><p><strong>Case presentation: </strong>A 25-year-old Armenian woman presented at 26 weeks' gestation with fatigue, night sweats, and significant weight loss. Magnetic resonance imaging without contrast revealed an anterior mediastinal mass. Histopathology confirmed classical Hodgkin lymphoma, nodular sclerosis subtype. Following multidisciplinary discussion, antenatal chemotherapy with the ABVD regimen was initiated. Two cycles were administered during pregnancy with close maternal and fetal monitoring. Pregnancy progressed uneventfully to 37 weeks, when a planned cesarean section was performed. A healthy male neonate was delivered with good Apgar scores. Postpartum, the mother completed chemotherapy and achieved complete remission.</p><p><strong>Conclusions: </strong>This case demonstrates that Hodgkin lymphoma diagnosed during the second trimester can be safely treated with ABVD chemotherapy during pregnancy when managed by a multidisciplinary team, resulting in favorable maternal and neonatal outcomes.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"51-54"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758157","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":"SAFETY OF TAMSULOSIN ALONE OR IN COMBINATION WITH 5Α-REDUCTASE INHIBITORS ON LIPID PROFILE, RENAL FUNCTION, AND LIVER PARAMETERS.","authors":"A Sheet, M Alnori","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Tamsulosin and 5α-reductase inhibitors (finasteride and dutasteride) are widely prescribed for benign prostatic hyperplasia (BPH). However, their systemic effects on metabolic, renal, and hepatic functions remain incompletely understood.</p><p><strong>Objective: </strong>To evaluate the safety profile of tamsulosin monotherapy compared with combination therapies (tamsulosin plus finasteride or dutasteride) on lipid profile, renal function, liver enzymes, and bilirubin levels in men with BPH.</p><p><strong>Methods: </strong>This cross-sectional study included 102 male participants aged >50 years, divided into five groups: healthy controls (n=26), newly diagnosed treatment-naïve BPH (n=25), BPH receiving tamsulosin monotherapy >3 months (n=26), BPH receiving tamsulosin+finasteride >3 months (n=11), and BPH receiving tamsulosin+dutasteride >3 months (n=14). Serum lipid profile (total cholesterol, triglycerides, HDL-C, LDL-C, VLDL, atherogenic index), renal function (urea, creatinine, eGFR, uACR), liver function (ALT, AST, ALP, GGT, albumin), and bilirubin fractions (total, direct, indirect) were measured using standardized automated methods.</p><p><strong>Results: </strong>Lipid profile parameters showed no significant differences between treatment groups and controls, with all values remaining within desirable ranges. Renal function tests, including serum urea, creatinine, eGFR, and urinary albumin-to-creatinine ratio, demonstrated no clinically significant alterations across all BPH treatment groups compared to controls. Liver enzymes (ALT, AST, ALP, GGT) and serum albumin levels remained within normal limits across all groups. Total, direct, and indirect bilirubin concentrations showed no significant elevation, indicating preserved hepatic excretory function. Notably, no statistically significant differences were observed between tamsulosin monotherapy and combination therapy groups for any of the measured parameters.</p><p><strong>Conclusion: </strong>Tamsulosin administered alone or in combination with finasteride or dutasteride for more than three months demonstrated non-significant differences in the measured biochemical parameters among the studied groups represented by no adverse effects on lipid metabolism, renal function, liver enzymes, or bilirubin homeostasis. These findings support the safe use of these therapeutic regimens in elderly BPH patients, including those with underlying metabolic or organ function concerns. Further prospective longitudinal studies with larger sample sizes are warranted to confirm these observations.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"222-229"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759182","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 THE FIRST TRIMESTER PREECLAMPSIA SCREENING TEST ON THE OUTCOME OF PREGNANCY BETWEEN THE PATIENTS WITH OR WITHOUT THE DIAGNOSIS OF INFERTILITY.","authors":"G Okropiridze, A Gvenetadze, R Sulukhia, R Gvenetadze, D Chanukvadze, L Iremadze, A Gvenetadze, M Gegechkori, N Kikvadze","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hypertensive disorders are one of the leading causes of maternal and perinatal morbidity and mortality worldwide. It is responsible for around 16% of maternal deaths globally, in 2023 this was the equivalent to around 42 000 deaths. Pre-eclampsia is a hypertensive disorder that affects 3-8% of women who give birth worldwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To assess the effectiveness of the first-trimester preeclampsia screening test on Caucasian population and define the impact of conception method on the risk of preeclampsia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective observational study was conducted at the Zurab Sabakhtarashvili Reproductive Clinic (ZSRC) on the pregnant women from 2021 (January)-2025 (November). All of the participants of the study underwent preeclampsia (PE) first-semester screening test provided by FMF (Fetal Medicine Foundation). Additionally, 8092 deliveries were investigated from Ghudushauri National Center (GNC) (2020-2024 years). Patients who were common for ZSRC and GNC were excluded from study, thus only the patients from GNC who did not underwent first trimester screening of PE were selected. 537 pregnant women, who were conceived with artificial reproductive technology (In vitro fertilization and ovarian stimulation) were chosen as group l. 407 woman who had a spontaneous pregnancy were chosen as a control group (group II). Logistic regression was used to exclude confounding factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In 01.01.2021 - 31.11.2025, 988 preeclampsia screening tests were performed at ZSRC. In 520 cases were confirmed a high risk (52.63%). 352 pregnant women who underwent first-trimester screening test were investigated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;133 patient - fertile (37,8%), 219 patient - infertile (62,2%), 199 - low risk of PE (56,5%), 153 - high risk of PE (43,5%), 23 - case of PE (6,5%). No maternal or fetal death recorded. GNC provided 8092 deliveries of unscreened pregnant women between 2020-2024 years. 931 cases of PE were recorded (11,5%). In 862 cases PE had complications (maternal and fetal death and s.o.) For another direction of the study was created group 1 (women who were conceived with assisted reproductive technology) and it was separated into three subgroups. Subgroup 1 - method of conception in vitro fertilization (IVF) and frozen embryo transfer (FET) (240 women). Subgroup 2 - method of conception in vitro fertilization (IVF) and fresh embryo transfer (ET) (149 women). Subgroup 3 - method of conception - ovulation drugs (OVD) (148 women). For control group (group 2) were selected women with spontaneous pregnancy (407 women). The difference in subgroup 1 and subgroup 2 (IVF and FET vs IVF and ET) was not significant (p value=0.47). The difference between group 1 and group 2 (Assisted reproductive technology vs spontaneous pregnancy) was significant (p value=0.002).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;First trimester screening of PE is very useful for f","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"207-211"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758109","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":"BEYOND THE GENETIC CODE: SYSTEMIC REGULATORY MELTDOWN AS A FRAMEWORK FOR PRIMARY EPIGENETIC DISEASES.","authors":"D Maltsev","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Modern medicine is increasingly encountering multisystemic disorders that do not fit into traditional genetic or organ-specific nosologies. This study proposes and validates the concept of \"primary epigenetic disease\" (PED) as a distinct clinical entity.</p><p><strong>Objective: </strong>to define the molecular mechanisms, genetic foundations, and clinical manifestations of PED, and to establish a standardized diagnostic framework using autism spectrum disorder (ASD) and chronic fatigue syndrome (CFS) as primary models.</p><p><strong>Materials and methods: </strong>A narrative review was conducted using PubMed and Scopus databases (predominantly 2021-2026). Evidence was synthesized from meta-analyses, randomized controlled trials, and large-scale genomic studies focusing on DNA methylation, histone modifications, and microRNA networks.</p><p><strong>Results: </strong>We identified that PED emerges from a synergistic failure of the epigenetic machinery, often driven by a high load of common single nucleotide polymorphisms (SNPs) in genes such as MTHFR, DNMTs, and HDACs. We established a 30-point diagnostic matrix comprising 15 clinical criteria (e.g., developmental delays, connective tissue dysplasia, and paradoxical drug sensitivity) and 15 laboratory criteria (e.g., SAM/SAH imbalance, mitochondrial dysfunction markers, and global DNA hypomethylation). The application of this matrix to ASD and CFS demonstrates a shared pathogenic core: systemic biological desynchronization, barrier failure, and persistent low-grade inflammation.</p><p><strong>Conclusion: </strong>Primary Epigenetic Disease represents a \"regulatory meltdown\" of the genome. Effective management requires a paradigm shift from symptomatic treatment to \"epigenetic rehabilitation,\" which combines systemic genomic modulation with precision biochemical correction of identified bottlenecks. This framework provides a robust toolkit for the identification and management of multisystemic patients in the era of systems medicine.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"21-42"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758463","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":"CRYOTHERAPY FOR THE PREVENTION OF TAXANE-INDUCED PERIPHERAL NEUROPATHY IN BREAST CANCER: A PROSPECTIVE MULTICENTER STUDY.","authors":"N Chikladze, S Kordzaia, L Svanadze, T Rukhadze, C Centeno","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity of taxane-based chemotherapy in breast cancer. Cryotherapy using cooling gloves and socks has been investigated as a preventive strategy, although evidence remains inconsistent. This study evaluated the effect of preventive cryotherapy on neuropathy-related pain and symptom burden in patients receiving taxane-containing chemotherapy.</p><p><strong>Methods: </strong>This prospective multicenter controlled study included patients with stage I-IV breast cancer treated with taxane-based chemotherapy between March 2023 and September 2025. Patients either received cryotherapy during chemotherapy infusion or standard treatment without cryotherapy. Outcomes were assessed using the Edmonton Symptom Assessment System (ESAS) and EORTC QLQ-CIPN20 questionnaire. The primary outcome was final ESAS pain score. Secondary outcomes included clinically meaningful pain (ESAS ≥4), change in pain from baseline, neuropathy-related extremity pain, overall symptom burden, and functional impairment.</p><p><strong>Results: </strong>A total of 190 patients were included (95 cryotherapy; 95 control) in the final analysis. No statistically significant difference was observed in adjusted final ESAS pain scores between groups, although a trend toward higher pain scores was observed in the cryotherapy group. Clinically meaningful pain (ESAS≥4) was more frequent in the cryotherapy group (20.0% vs 8.4%; p=0.022). Adjusted analyses demonstrated higher neuropathy-related extremity pain scores in the cryotherapy group. No significant differences were observed in overall symptom burden or functional impairment.</p><p><strong>Conclusion: </strong>Preventive cryotherapy did not demonstrate a significant reduction in neuropathy-related pain in patients receiving taxane-based chemotherapy. Neuropathy-specific outcomes suggested higher extremity pain in patients undergoing cryotherapy. Further randomized studies with standardized protocols are warranted.</p>","PeriodicalId":12610,"journal":{"name":"Georgian medical news","volume":" 375","pages":"111-117"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759927","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}