Effect of Age at Diagnosis on Cervical Cancer Patient Prognoses in Georgia

The current incidence of cervical cancer varies around 17.0/100,000 women per year. The study aims to describe the effect of age at diagnosis on CC patient prognosis in Georgia. Methods. Univariable and Multivariable survival analysis using Cox’s regression model was constructed. All women aged ≤80 years,  diagnosed with invasive CC (ICD10-site code C53) from 2015 to 2019,  were eligible for inclusion in the analysis. During analysis a hazard (mortality) ratio for the patients, who were diagnosed at different ages was estimated. Survival period was determined from the date of diagnosis until the date of death or the date of last follow up visit. High risk of death was defined as a mortality of CC patients whose survival period was less than 5 years.The level of statistical significance of the study findings is estimated by using p-value andthe 95% of confidence interval (95%CI). A p value < 0.05 was considered as statistically significant. In estimation of hazard ratio, the patients under 41 years were selected as a reference group. Data was analyzed using Statistical Package of SPSS version 23. Results.Totally 1646 CC patients were enrolled in the study. The median age at diagnosis was 54years and age range was 25 - 80 years. Univariable statistical analysis has revealed that cancer diagnosed over 60 years of age had a higher death hazard (HR=1.80, p<0.001), compared to cancer detected under 60 years (HR=3.30, p<0.001). Multivariable statistical analysis has detected that stage and age at diagnosis are independent, statistically significant predictors for high mortality in patients diagnosed with cervical cancer, while the role of histological grade has not been revealed. In addition, older age generally is related to a high prevalence of comorbidities. The reasons for the unfavourable cervical cancer prognosis in older patients that was detected  during statistical analysis might be explained by tumor stage at diagnoses and with higher ratesof comorbidity among the elderly. Conclusions: Finally, our study results are in concordance with numerous studies, which confirm that the age of patients at the moment of diagnosis is an independent predictor for cervical cancer early mortality

Slope deformation, reservoir variation and meteorological data at the Khoko landslide, Enguri hydroelectric basin (Georgia), during 2016-2019

The Greater Caucasus mountain belt is characterized by deep valleys, steep slopes and frequent seismic activity, the combination of which results in major landslide hazard. Along the eastern side of the Enguri water reservoir lies the active Khoko landslide, whose head scarp zone affects the important Jvari-Khaishi-Mestia road, one of the few connections with the interior of the Greater Caucasus. Here, we present a database of measurement time series taken over a period of 4 years (2016-2019) that enables us to compare slope deformation with meteorological factors and human-induced perturbations owing to variations in the water level of the reservoir. The monitoring system we used is composed of two digital extensometers, placed within two artificial trenches excavated across the landslide head scarp. The stations are also equipped with internal and near-ground surface thermometers. The dataset is integrated by daily measurements of rainfall and lake level. The monitoring system - the first installed in Georgia - was set up in the framework of a NATO-funded project, aimed at assessing different types of geohazards affecting the Enguri artificial reservoir and the related hydroelectrical plant. Our results indicate that the Khoko landslide displacements appear to be mainly controlled by variations in hydraulic load, in turn induced by lake level oscillations. Rainfall variations might also have contributed, though this is not always evident for all the studied period. The full databases are freely available online at the following DOI: 10.20366/unimib/unidata/SI384-2.0 (Tibaldi et al., 2020)

May measurement month 2019: blood pressure screening results in Georgia, Europe

May Measurement Month is a global campaign aimed at raising public awareness of hypertension and to improve the management of hypertension—the main risk factor for cardiovascular diseases in the population. Screening was carried out at 400 sites on a national scale. More than 500 volunteers, including physicians (80%) and students of medical universities (20%) participated in the screening. To familiarize them with the research tools and standard blood pressure (BP) measurement method, they were trained by the members of the Georgian Society of Hypertension and the National Center for Disease Control and Public Health’s staff. Medical societies, health-care professionals, public health workers, social mass media, and other stakeholders were actively involved in the recruitment process. A total of 13 267 (38.5% males and 61.5% females) individuals were screened. The mean age of participants was 54.7 years (SD 15.9). All participants were Caucasian. After imputation of missing BP readings, 8510 (64.1%) were found to have hypertension, out of whom 7269 (85.4%) were aware of their condition, 7232 (85.0%) were on medication, and 1278 (15.0%) were not taking any medication. Of those taking antihypertensive medication, 34.8% had their BP controlled (<140/90 mmHg). May Measurement Month detected a high proportion of participants with hypertension, with results indicating low rates of control in Georgia

May measurement month 2017: an analysis of blood pressure screening results in Georgia-Europe.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. According to STEPS-Georgia, between 2010 and 2016, arterial hypertension prevalence (BP ≥140/90 mmHg or being treated) increased from 33.4% to 37.7%. According to the Health for All (HFA) (WHO data set) Database in Georgia in 2015 cardiovascular disease (CVD) mortality contributed to 42.6% of overall deaths; among them 23.3% is due to coronary heart disease (CHD), and 30% due to cerebrovascular diseases. An opportunistic screening of volunteers aged ≥18 was carried out in May 2017 (MMM17). BP measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Screening was carried out in 50 sites at a national scale (clinics, public places). Five hundred volunteers, mostly medical personnel took part in the project. A total of 6144 individuals were screened during MMM17. After multiple imputations, 3744 (60.9%) had hypertension. Of those not on anti-hypertensive medication, 958 (28.5%) respondents were found to have hypertension, while 1862 (66.8%) individuals receiving anti-hypertensive medication, had uncontrolled BP. MMM17 was the largest BP screening campaign undertaken in Georgia. Approximately 60% of those screened had hypertension and among those who receive medication, up to 70% are treated inadequately. These results suggest that opportunistic screening can identify a significant number of people with raised BP

May measurement month 2018: an analysis of blood pressure screening results in Georgia.

May Measurement Month (MMM) is aimed at raising public awareness about arterial hypertension-the main risk factor for cardiovascular diseases in the population. Screening was carried out at 200 sites on a national scale. More than 500 volunteers, including doctors (80%) and medical students (20%) participated in the screening. To familiarize them with the research tools and standard blood pressure (BP) measurement method, their training was conducted by the Georgian Society of Hypertension in Tbilisi and other large cities. Social and mass media, medical societies, and other stakeholders were actively involved in the recruitment process. A total of 10 756 people were screened. The mean age of participants was 53.1 years (SD 16.1). Males-67.9%, females-32.1%. One hundred percent were White. After multiple imputation, the number of hypertensive patients was 6.037 (56.1%) and out of them 4950 were aware and 4701 (77.9%) were on medication, 1336 (22.1%) were not taking a medication. Of those taking antihypertensive medication, 38.2% had controlled BP. In spite of non-randomized selection and certain restrictions with respect to extrapolation of the results, MMM comprehensively reflects an urgent problem and major gaps in the health system. Based on the above, its importance is extremely valuable for identifying public health policy priorities

Second hand smoke exposure and the risk of invasive meningococcal disease in children: systematic review and meta-analysis

Background Invasive meningococcal disease remains an important cause of serious morbidity and mortality in children and young people. There is a growing body of literature to suggest that exposure to passive smoke may play a role in the development of the disease, therefore we have performed a systematic review to provide a comprehensive estimate of the magnitude of this effect for smoking by any household member, by individual family members, and of maternal smoking before and after birth. Methods Four databases (Medline, Embase, PsychINFO and CAB Abstracts database) were searched to identify studies (to June 2012) and reference lists scanned for further studies. Titles, abstracts and full texts were checked for eligibility independently by two authors. Quality of included studies was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95% confidence intervals (CI) were estimated using random effect models, with heterogeneity quantified using I2. Results We identified 18 studies which assessed the effects of SHS on the risk of invasive meningococcal disease in children. SHS in the home doubled the risk of invasive meningococcal disease (OR 2.18, 95% CI 1.63 to 2.92, I2 = 72%), with some evidence of an exposure-response gradient. The strongest effect was seen in children under 5 years (OR 2.48, 95% CI 1.51 to 4.09, I2 = 47%). Maternal smoking significantly increased the risk of invasive meningococcal disease by 3 times during pregnancy (OR 2.93, 95% CI 1.52-5.66) and by 2 times after birth (OR 2.26, 95% CI 1.54-3.31). Conclusions SHS exposure, and particularly passive foetal exposure to maternal smoking during pregnancy, significantly increases the risk of childhood invasive meningococcal disease. It is likely that an extra 630 cases of invasive meningococcal disease annually in children under 16 are directly attributable to SHS exposure in UK homes