COMPUTED TOMOGRAPHY IN DETECTING FEATURES OF CORONARY ATHEROSCLEROSIS IN DIFFERENT ETHNIC GROUPS OF KAZAKHSTAN POPULATION.

The aim of the study was to identify the features of coronary lesions and to determine the correlation between the main risk factors for coronary artery disease according to the SCORE quality of life scale and the calcium index in MSCT in different age and ethnic groups in men and women living in Kazakhstan. We retrospectively analyzed 935 case histories of patients undergoing MSCT to assess the condition of the coronary arteries. The patients were divided into three groups: Kazakhs (66.9%), Russians (21.4%) and other (11.7%) nationalities. There were statistically significant differences between ethnic groups in BMI (p=0.03), type of chest pain (p<0.01), statin use (p=0.01), and blood glucose (p<0.01). The study showed that the prevalence of coronary atherosclerosis is higher among Russians compared to Kazakhs, even after adjusting for traditional risk factors. In multivariate analysis, the calcium index values ​​were significantly higher in the group of the Russian population by 48% (OR=1.48; 95% CI 0.91-2.40) than in the Kazakh population. In the course of the cross-sectional study, statistically significant differences in the nature of coronary lesions were revealed between ethnic groups, mainly males, living in the Republic. Until now, such studies have not yet been conducted among the inhabitants of Kazakhstan, and data on the ethnic specificity of risk factors for cardiovascular diseases in this geographical region have not been sufficiently studied. Previous studies have shown that East Asians, including Chinese, Koreans, and Japanese, have a lower incidence of coronary artery disease as measured by CI compared to Europeans. A large MESA study also reported observations that study participants of Chinese nationality had a lower CI compared to Europeans. Despite significant differences in dietary habits and living in different climatic conditions between Asians of different countries, lower CI scores appear to be a racial trait of Asians, which was further confirmed by our study. These results are undoubtedly representative, as patients from different regions of Kazakhstan were treated in two clinics of republican significance. In the future, it is necessary to conduct prospective studies with subsequent follow-up of patients after treatment and in identifying the causes of recurrent coronary events, as was done in the MESA study.

[POSSIBILITIES OF COMPUTER TOMOGRAPHY IN THE DIAGNOSIS OF PULMONARY HYPERTENSION AND INFLUENCE OF VARIOUS FACTORS (GENDER, AGE, BODY WEIGHT, RECEPTION OF MEDICINES) ON THE SEVERITY OF THE PULMONARY HYPERTENSION SYNDROME].

The article is devoted to the study of changes in the lungs occurring under conditions of continuous increased pressure in the pulmonary arteries recorded by measuring densitometric indices according to computed tomography. Also in this publication, analysis data on the multifactorial effect on the severity of pulmonary hypertension syndrome such as gender, age, body weight, and medication are highlighted. Pulmonary hypertension (LH) is a rare multifactorial disease characterized by an increase in mean arterial pressure in the pulmonary vascular system (SLAD) ≥25 mm Hg fixed at rest during catheterization of the right heart. Pulmonary hypertension develops at any age, starting from the neonatal period. According to international data, from the appearance of the first clinical manifestations of the disease to the fact of establishing a diagnosis, even in socio-economically developed countries it is an average of at least 3 years. The delayed diagnosis of pulmonary hypertension negatively affects not only the prognosis of survival, but can also lead to early disability of this category of patients. The results of the study showed, the density of the lung tissue under conditions of a constant increase in pressure in the pulmonary artery was within acceptable values according to multispiral computed tomography. However, a correlation was found between the diameter of the pulmonary trunk and the average pressure of the pulmonary artery according to catheterization of the right heart. According to the effects of factors such as gender, age, body mass index, type of pulmonary hypertension, the use of drugs and the type of surgical intervention for the severity of LH syndrome with a simple analysis showed a significant relationship, but as shown by multidimensional linear modeling, no statistically significant change was found.

[Radiodiagnosis and knee joint replacement in hemophilic arthropathies in Kazakhstan residents].

AIM: To assess complex radiodiagnosis and highly specialized medical care as knee joint replacement (KJR) to patients with hemophilic arthropathies (HA) who live in the Republic of Kazakhstan. SUBJECTS AND METHODS: The results of examination and treatment were analyzed in 40 patients with knee HA who were treated at the specialized Polytrauma Unit, Republican Research Center for Emergency Health Care. All patients with hemophilia A underwent joint X-ray study, computed tomography and magnetic resonance imaging (MRI), X-ray densitometry and ultrasound osteometry on admission and after KJR. RESULTS: Joint X-ray studies and computed tomography revealed that all the patients had Grades II-III arthroses with severe dysfunction of joints, their multiple involvements of different grades, which depended on the rate of recurrent hemarthrosis. Ultrasound study (USS) is the only mini-invasive method to control surgical hemostasis in hemophiliac patients after KJR. Osteodensitometry revealed osteopenia and osteoporosis in all the patients with hemophilia, which was a basis for prescribing calcium preparations in the early postoperative period for the prevention of instability of endoprosthetic components. We elaborated an algorithm for combination treatment in HA patients, which involved knee joint replacement. CONCLUSION: Highly specialized medical care to hemophilic patients and active introduction of the early surgical rehabilitation of the affected joint in their combination treatment contributed to the increased number of positive results, by restoring the quality of life in the patients: excellent, good, and satisfactory anatomic and functional results were obtained in 26.7, 51.1, and 22.2%, respectively. USS and MRI could evaluate joint changes in HA in detail, which plays an important role in the estimation of the course time of the disease, in the planning of endoprosthetic replacement, and in the timely prevention of severe complications of HA. Osteodensitometry makes it possible to monitor bone mineral density around the prosthesis and to postoperatively prevent endoprosthetic instability.