Association of FDG PET/CT-derived parameters with tumor markers and survival rate in Hepatocellular carcinoma

Background. Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths worldwide. The prognosis of patients with HCC is generally poor, and life expectancy is difficult to predict because of various factors. The purpose of the present study was to investigate the relationships between FDG PET parameters and other parameters that may influence the prognosis of patients with HCC.Materials and methods. We conducted a retrospective study on 26 patients who underwent dual-time-point FDG PET imaging before treatment between June 2010 and April 2016 at Nagasaki University Hospital. The SUVmax, SUVpeak, TLG, and MTV of tumors and the SUVmean of the liver were assessed on PET images using Metavol software. All statistical analyses were performed using JMP Pro11 software. P-values of <0.05 were considered to be significant.Results. Log AFP and log PIVKA II showed strong relationships between many FDG parameters. Several types of therapy performed before the introduction of FDG PET showed some relationships but few for FDG parameters. Relationships between AFP, PIVKA II, and therapy were only found between log AFP and the number of transarterial chemoembolizations. The results of the event-free survival analysis showed that patients with larger tumors on PET images had a poorer prognosis.Conclusion. Relationships were observed between FDG PET parameters and AFP and PIVKA II levels, which affect patient prognoses. Based on the present results and previous findings, the combination of FDG parameters with serum AFP and PIVKA II levels may be useful for predicting the outcomes of patients with HCC

Health-care Accessibility Assessment in Kazakhstan

BACKGROUND: Global health initiatives such as health for all and universal health coverage aim to improve access to health care. These goals require constant comprehensive monitoring to eliminate inequalities in the availability of health care. AIM: The purpose of our study was to assess the physical availability of medical care in Kazakhstan. METHODS: A descriptive study based on a Service Availability and Readiness Assessment (SARA) general availability index calculation that used secondary data as a source of information. RESULTS: The general availability index calculated for the regions of Kazakhstan ranged from 95% to 100%. When considering individual indicators of the index, decrease trends of the volume of inpatient care were identified. Outpatient care had fluctuations with values better than benchmark after 2009. Stable upward trend illustrates positive picture of core health personnel. CONCLUSION: According to the SARA availability index, it can be concluded that health care in Kazakhstan exceeds the threshold values and is available in all regions. Trends for individual indicators of the index should be studied in more detail, taking into account the influence of health policy and other factors

Analysis of maternal and infant health indicators in Kazakhstan: 2003–2018

BACKGROUND: The health status of women and children is the first and foremost priority for all countries in the world. In the first decade of Kazakhstan’s independence, the country’s population decreased by over 1 million, or 9.7%. Since 2003, the population of Kazakhstan has been growing steadily and is projected to be 18.9 million people in 2021. The focus on maternal and child health, an increase in the birth rate and a decrease in child and maternal mortality rates are the most important directions for state policy to improve the health and demographic situation in the country. AIM: The main purpose of the article is to analyze the main indicators of maternal and neonatal health in Kazakhstan before and after the implementation of the state health development programs “Densaulyk” and “Salamatty Kazakhstan.” METHODS: A retrospective study was carried out in two main databases of the Ministry of Health of Kazakhstan (Medinfo Database and www.stat gov kz). RESULTS: According to the official statistics in Medinfo database, almost all 12 maternal health and 11 infant health indicators had a positive tendency after implementing state programs (2011–2018). Notable exceptions among maternal and infant indicators included: Rate of C-section increased to 81.3%, provision of care by obstetrician-gynecologists decreased to 16% and the number of hospital beds for pregnant women, women in labor and parturient women dropped to 37.9%, service provision by pediatricians (including neonatologists) decreased to 27.8% with provision of children’s hospital beds dropping to 24.9%. CONCLUSIONS: Health indicators related to mother, pregnancy and children under 1 year old showed favorable results after implementing the state programs “Densaulyk” and “Salamatty Kazakhstan. However, high mortality rates among premature and low birth weight babies point to the need for changes in prevention and education systems in general

Assessment of primary healthcare accessibility and inequality in north-eastern Kazakhstan

Out of the many aspects of health care, the concept of physical accessibility is a priority that not only encompasses availability of health care resources, but also requires that they are easily accessible for all. To assess this factor as expressed in terms of the number of available physicians in the north-eastern part of Kazakhstan, we used the enhanced two-step float catchment area in a geographic information system approach. The Gini index and the Lorentz curve were used to evaluate the economic inequality within this region. Based on the data obtained, we developed models to increase the availability of health care considering allocation of additional primary health care resources. A low to zero index was found to be typical for most rural settlements, which currently make up less than 15% of the total population. We also identified a correlation between the index of accessibility and that of inequality, which indicates that areas with high accessibility show a more equitable distribution of resources. The developed location/ allocation models of additional primary health care resources can be useful in implementing government initiatives to improve the availability of primary health care in rural areas.info:eu-repo/semantics/publishedVersio

Prevalence and Associated Factors of Depression, Anxiety, and Stress Among Academic Medicine Faculty in Kazakhstan: A Cross-sectional Study

Introduction: Psychological distress refers to a set of painful mental and physical symptoms of anxiety and depression, which often coexist and coincide with common somatic complaints and chronic conditions. In Kazakhstan, mental disorders are the second leading cause of years lived with disability. Currently, medical education in Kazakhstan is undergoing comprehensive reform, which creates an additional burden on faculty, fostering mental health concerns. Methods: A quantitative observational cross-sectional study was conducted in 6 large medical universities in Kazakhstan. Data were obtained from 715 faculty academics by using an online self-reported DASS-21. Statistical analysis was performed using the SPSS version 23.0. Bivariate and multivariate logistic regression analyses were applied to evaluate the relationship between predictor and outcome variables. Results: The total prevalence of depression, anxiety, and stress was 40.6%, 41.3%, and 53.0%, respectively. Younger age (p = 0.002), female gender (p = 0.001), being single (p = 0.044) or in a relationship (p = 0.001), having chronic diseases (p &lt; 0.001), holding Master (p = 0.036) or PhD degree (p = 0.040), employment status (p = 0.034), and being involved in additional activities (p = 0.049) were significantly associated with different dimensions of distress. Conclusions: Nearly half of the study population reported symptoms of depression, anxiety, and stress. Due to the higher prevalence of psychological distress amongst academic medicine faculty, determined risk factors must be taken into consideration in developing policies for mental issues prevention

Prevalence of postpartum depression and its associated factors within a year after birth in Semey, Kazakhstan: a cross sectional study

Background: Postpartum depression (PPD) is a depressive disorder that occurs after childbirth and can last until a year after delivery. The global prevalence of PPD among mothers is between 0.5% and 63.3%. The aim of the study is to determine the prevalence of postpartum depression within a year after birth among mothers in Semey (Kazakhstan) and identify the factors associated with it. Methods: A cross-sectional study covering 251 women within one year after delivery was conducted in five Primary Healthcare Centers in Semey. The Edinburgh Postnatal Depression Scale (EPDS) for assessing PPD was used. Data was analysed using the Statistical Package for Social Sciences (SPSS), version 25. The statistical significance and magnitude of the relationships between dependent and independent variables were conducted using chi-square and bivariate and multivariate logistic regression analyses. A p-value of less than 0.05 was considered to be significant. Results: The prevalence of PPD within a year after delivery was estimated as 59.4%. Factors including accommodation type (p = 0.021), satisfaction with living conditions (p = 0.001), relationship with mother-in-law (p = 0.013), the interest of the patronage service about the psychological state of a woman after childbirth (p = 0.001) and husband employment status (p = 0.04) showed significant positive association with PPD. Conclusion: The high prevalence rate of PPD and associated risk factors imply the need for strengthening and improving of postpartum care program in country. Further research on the experiences and the level of antenatal depression among women will be needed to understand and prevent any possible depressions in prenatal and postpartum periods

Usefulness of FDG PET/CT derived parameters in prediction of histopathological finding during the surgery in patients with pancreatic adenocarcinoma

Purpose Pancreatic cancer is the 4th most common cause of cancer death in Japan and exhibits a 5-year overall survival rate of approximately 7%. The accurate diagnosis of pancreatic cancer is important for determining the optimal management strategy. Fludeoxyglucose-positron emission tomography (FDG PET) integrated with computed tomography (18F-FDG PET/ CT) has emerged as a powerful imaging tool for detecting and evaluating various cancers, and it is used for staging, detecting local recurrence and distant metastasis, measuring therapeutic effects,and predicting prognosis in pancreatic cancer patients. Lately, FDG PET/CT-derived parameters, such as standardized uptake values (SUV), the metabolic tumor volume (MTV), and total lesion glycolysis (TLG), have been suggested as prognostic factors for various types of cancer, including pancreatic cancer. However, there is no consensus regarding the best parameters for evaluating patient prognosis, operability, etc. The purpose of this study was to examine the differences between operable and non-operable pancreatic cancer using FDG PET/CT-derived parameters, and to investigate whether volumetric parameters (TLG and the MTV) are superior to SUV-based parameters for predicting infiltration status/determining operability. Materials and methods We conducted a retrospective study of the cases of 48 patients with clinically proven pancreatic adenocarcinoma, who underwent FDG PET/CT imaging before treatment. In the operable group, the surgical specimens were subjected to histopathological examinations, and the cases were separated into those exhibiting less and greater infiltration. SUVmax, SUVpeak, the tumor background ratio (TBR), TLG, and the MTV were compared between these groups as well as between the operable and non-operable groups.Results Venous infiltration showed significant associations with several metabolic parameters (SUVmax, SUVpeak, and the TBR). However, it did not display any significant associations with volumetric parameters, such as TLG or the MTV. None of the FDG PET/CT-derived parameters exhibited significant associations with lymphatic or neural infiltration. Significant differences in volumetric parameters, such as the MTV and TLG,were detected between the operable and non-operable subgroups. Conclusions Metabolic18F-FDG PET/CT-derived parameters,such as SUVmax, SUVpeak, and the TBR, are useful for predicting venous infiltration status in patients with operable pancreatic adenocarcinoma