In this work we reviewed historical and recent data on Leishmania spp. infection combining data collected in Turkmenistan, Uzbekistan, Kazakhstan, Kyrgyzstan, Iran, China and Mongolia. We specifically focused on a complex of co-existing species (Leishmania major, Leishmania turanica and Leishmania gerbilli) sharing the same animal reservoirs and vectors. In addition, we analysed the presence of dsRNA viruses in these species and discussed future research directions to identify species-specific traits, which may determine susceptibility of different Leishmania spp. to viral infection.

• MeSH
• Gerbillinae MeSH
• Leishmania major * MeSH
• leishmanióza kožní * epidemiologie   MeSH
• leishmanióza * epidemiologie   MeSH
• zdroje nemoci MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Turkmenistán MeSH

The Health Impact Assessment (hereinafter referred to as HIA) is an effective method for predicting potential health impacts from decisions. Little is known about the implementation of the HIA in the Republic of Kazakhstan (further, RK). In addition, the Russian language literature has not yet been reviewed in terms of HIA-related knowledge. By conducting a literature review of enabling factors, including Russian language literature, on the implementation of the HIA and studying governance systems in RK, we aim to suggest an implementation process to implement the HIA in RK. After careful analysis of the governance system, we suggest set up of a HIA support unit under the National Scientific Center for Health Development and discuss the possible benefits. The proposed center should guide the implementation of the HIA in RK.

• MeSH
• hodnocení vlivů na zdraví * metody   MeSH
• poskytování zdravotní péče * MeSH
• zdravotní politika MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Kazachstán MeSH

OBJECTIVE: To study the frequency and spectrum of CFTR gene variants in different ethnic groups of Kazakhstan. METHODS: We reviewed the records of 58 patients with cystic fibrosis. All the patients underwent molecular genetic analysis to reveal genotype-phenotype correlations. RESULTS: The median (IQR) age of the patients was 5.4 year (7 months, 18 year); 40% were diagnosed at the age of 5-10 year. The study identified 28 specific variants: p.Phe508del, the variant most common in the European population, was detected in 30 patients (51.7%). Variants other than p.Phe508del were revealed in 31% (21 patients). CONCLUSIONS: We found a number of specific variants characteristic of the Kazakhstani population. A pronounced regression of disease symptoms was detected in patients with mild mutations; whereas in patients with severe mutations, therapy produced very little effect.

• MeSH
• cystická fibróza * epidemiologie   genetika   MeSH
• genotyp MeSH
• lidé MeSH
• mutace MeSH
• protein CFTR * genetika   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Kazachstán MeSH

Acromegaly is a rare condition typically caused by benign pituitary adenomas, resulting in excessive production of growth hormone. Clinical manifestations of acromegaly are diverse, varying from the overgrowth of body tissue to cardiovascular, metabolic, and osteoarticular disorders. Symptoms may emerge slowly, overlapping with other diseases and often involve many different healthcare specialists. In the last decade, efforts to provide an accurate and timely diagnosis of acromegaly have improved disease management and clinical experience. Despite this progress, marked differences in the diagnosis, treatment, and management of acromegaly exist from country-to-country. To address these inconsistencies in the region comprising Central and Eastern Europe, Israel, and Kazakhstan, a panel of acromegaly experts from 13 of these countries was convened. Acromegaly experts from each country provided available information on the approaches from their country, including regional treatment centers and multidisciplinary teams, treatment access, reimbursement and availability, and physician education, disease awareness, and patient advocacy. Across several areas of acromegaly management, divergent approaches were identified and discussed, including the provision of multidisciplinary care, approved and available treatments, and disease awareness programs. These were recognized as areas of potential improvement in the management of acromegaly, in addition to participation in national and regional acromegaly registries. Further experience exchange will facilitate the identification of specific strategies that can be adapted in each country, and widespread participation in acromegaly registries will enable their evaluation. It is anticipated that this approach will support the optimization of acromegaly patient care across this region.

• MeSH
• akromegalie * diagnóza   epidemiologie   terapie   MeSH
• lidé MeSH
• růstový hormon MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Izrael MeSH
• Kazachstán MeSH
• východní Evropa MeSH

PURPOSE: We aimed to map evidence on the development of mental health care in Central Asia after 1991. METHOD: We conducted a scoping review complemented by an expert review. We searched five databases for peer-reviewed journal articles and conducted grey literature searching. The reference lists of included articles were screened for additional relevant publications. RESULTS: We included 53 articles (Kazakhstan: 13, Kyrgyzstan: 14, Tajikistan: 10, Uzbekistan: 9, Turkmenistan: 2, Multinational: 5). Only 9 were published in internationally recognised journals. In the 1990's mental health services collapsed following a sharp decline in funding, and historically popular folk services re-emerged as an alternative. Currently, modernised mental health policies exist but remain largely unimplemented due to lack of investment and low prioritisation by governments. Psychiatric treatment is still concentrated in hospitals, and community-based and psycho-social services are almost entirely unavailable. Stigma is reportedly high throughout the region, psychiatric myths are widespread, and societal awareness of human rights is low. With the exception of Kyrgyzstan, user involvement is virtually absent. After many years of stagnation, however, political interest in mental health is beginning to show, along with some promising service developments. CONCLUSIONS: There is a substantial knowledge gap in the region. Informed decision-making and collaboration with stakeholders is necessary to facilitate future reform implementation.

• MeSH
• lidé MeSH
• zdravotní politika * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Kazachstán MeSH
• Kyrgyzstán MeSH
• Tádžikistán MeSH
• Turkmenistán MeSH
• Uzbekistán MeSH

Autor popisuje své zkušenosti horského záchranáře ve střední Asii a v Rusku. Určeno široké veřejnosti.

• MeSH
• cestování MeSH
• horolezectví MeSH
• vyprávění MeSH
• záchranná práce MeSH
• Publikační typ
• populární práce MeSH
• Geografické názvy
• Rusko MeSH
• střední Asie MeSH

• Konspekt
• Sport. Hry. Tělesná cvičení
• NLK Obory
• urgentní lékařství
• NLK Publikační typ
• vzpomínky

This survey was undertaken in the 18 countries and areas that are members of the WHO Regional Office for Europe Antimicrobial Medicines Consumption Network to assess the current status of regulatory and national/area-level activities in eastern European and central Asian countries and areas to support the appropriate use of antibiotics. All countries and areas reported an existing legislative framework governing the marketing authorization of antimicrobial agents, their distribution, assessment of the quality of products in circulation, their prescription and dispensing. Respondents reported a wide range of activities in support of appropriate use of antimicrobials that targeted the general public, doctors and pharmacists. Priority actions for improving the appropriate use of antibiotics identified by respondents were greater enforcement of existing regulations on prescribing and dispensing of antibiotics to ensure prescription-only access, educating health-care professionals about antimicrobial resistance and appropriate use of antibiotics, improving public awareness on rational use of antibiotics and establishing and implementing standard treatment guidelines for use in clinical practice.

• MeSH
• antibakteriální látky MeSH
• antiinfekční látky MeSH
• lékové předpisy MeSH
• zákonodárství lékařské MeSH
• Geografické názvy
• střední Asie MeSH
• východní Evropa MeSH

• Konspekt
• Veřejné zdraví a hygiena
• NLK Obory
• právo, zákonodárství
• veřejné zdravotnictví
• NLK Publikační typ
• publikace WHO

OBJECTIVES: The aim of this study was to detect the seroprevalence of Crimean-Congo haemorrhagic fever virus (CCHFV) in patients with fever of unknown origin (FUO) in endemic (Kyzylorda) and non-endemic (Almaty) oblasts of Kazakhstan. METHODS: Paired serum samples from 802 patients with FUO were collected. Serum samples were investigated by ELISA to detect IgG and IgM antibodies against CCHFV. Sera with suspected acute infection were further investigated by RT-PCR to detect the viral RNA. RESULTS: IgG antibodies were detected in 12.7% of the sera from both oblasts. Acute infection was shown by IgM ELISA in four patients from Kyzylorda, with only one developing severe CCHF. Viral RNA was found by RT-PCR in the other three patients' sera. Phylogenetic analysis of partial L and S segments revealed CCHFV genotype Asia 2 and a possible reassortment between the genotypes Asia 1/Asia 2. Animal husbandry, such as working with cattle and horses, was significantly associated with CCHFV seropositivity. CONCLUSIONS: The antibodies and viral RNA detected in sera indicate that mild or even asymptomatic CCHFV infections are presented in Kazakhstan. This study describes the circulation of CCHFV in the so far non-endemic Almaty oblast for the first time. In conclusion, physicians treating patients with FUO in Kazakhstan should be aware of mild CCHF.

• MeSH
• dospělí MeSH
• ELISA MeSH
• hemoragická horečka krymská komplikace   epidemiologie   MeSH
• horečka neznámého původu etiologie   MeSH
• koně MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• protilátky virové krev   MeSH
• RNA virová krev   MeSH
• séroepidemiologické studie MeSH
• skot MeSH
• virus krymsko-konžské hemoragické horečky genetika   imunologie   MeSH
• zvířata MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• skot MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Kazachstán MeSH

Here we report sequence and phylogenetic analysis of two new isolates of Leishmania RNA virus 2 (LRV2) found in Leishmania major isolated from human patients with cutaneous leishmaniasis in south Uzbekistan. These new virus-infected flagellates were isolated in the same region of Uzbekistan and the viral sequences differed by only nineteen SNPs, all except one being silent mutations. Therefore, we concluded that they belong to a single LRV2 species. New viruses are closely related to the LRV2-Lmj-ASKH documented in Turkmenistan in 1995, which is congruent with their shared host (L. major) and common geographical origin.

• MeSH
• fylogeneze MeSH
• genom virový * MeSH
• jednonukleotidový polymorfismus MeSH
• Leishmania major virologie   MeSH
• Leishmaniavirus klasifikace   genetika   patogenita   MeSH
• mutace MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Uzbekistán MeSH

AIM: This study aimed to assess safety and outcomes of patients, 2 years after implantation with the HeartMate 3 Left Ventricular Assist System. METHODS AND RESULTS: This study included 50 adults with New York Heart Association (NYHA) class IIIB or IV symptoms or American College of Cardiology/American Heart Association stage D heart failure with an ejection fraction ≤25% and a cardiac index ≤2.2 L/min/m2 without inotropes, or inotrope-dependent with optimal medical management, or listed for heart transplant. The median duration of left ventricular assist device support was 694 days (range: 19-833 days). At baseline, cardiac index was 1.8 ±0.5 L/min/m2 , 58% of patients were receiving inotropes, and 92% were INTERMACS profiles 2-4. At 2 years, Kaplan-Meier survival was 74 ±6%, 5 (10%) patients were transplanted, and 32 patients (64%) remain with support. Adverse event rates include bleeding requiring surgery (16%), gastrointestinal bleeding (20%), driveline infection (24%), ischaemic stroke (16%), haemorrhagic stroke (8%), right heart failure (14%), and outflow graft thrombosis (2%). Notably, no haemolysis, pump thrombosis, or pump malfunction events occurred. At 2 years, 47% of patients remained in NYHA class I and 41% in NYHA class II (P <0.0001). From baseline to 2 years, the mean six-minute walk distance increased from 239 m to 347 m (P <0.0001), and the mean EQ-5D quality of life score improved from 48.2 to 70.6 (P < 0.0001). CONCLUSIONS: Two years post-HeartMate 3 implantation, results show expected and acceptable survival, enhanced haemocompatibility, improved patient functional status and quality of life. This corroborates the success of HeartMate 3 since its first-in-man implantation case in Germany. ClinicalTrials.gov: NCT02170363.

• MeSH
• časové faktory MeSH
• design vybavení MeSH
• lidé středního věku MeSH
• lidé MeSH
• míra přežití trendy   MeSH
• následné studie MeSH
• podpůrné srdeční systémy * MeSH
• prospektivní studie MeSH
• srdeční komory patofyziologie   MeSH
• srdeční selhání mortalita   patofyziologie   terapie   MeSH
• tepový objem fyziologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Austrálie MeSH
• Evropa MeSH
• Kanada MeSH
• Kazachstán MeSH
• Spojené státy americké MeSH