Background: The study conducted a component analysis of the dynamics of the incidence of breast cancer (BC) in Karaganda region. Methods: Primary data were for registered patients with BC (ICD 10–C50) in Kazakhstan, Karaganda region the period of 2009-2018. Evaluation of changes in BC incidence in the population of Karaganda was performed using component analysis according to the methodological recommendations. Results: Overall, 4,391 new cases of BC and 1,202 deaths were recorded. The incidence rate increased from 44.4 (2009) to 72.7 in 2018 and the overall growth was 28.37 per 100,000 population of female, including due to the age structure – ∑ΔA=3.13, due to the risk of acquiring illness – ∑ΔR=22.69 and their combined effect – ∑ΔRA=2.56. The component analysis revealed that the increase in the number of patients with BC was mainly due to the growth of the population (ΔP=+3.7%), changes in its age structure (ΔA=+10.3%) and changes associated with the risk of acquiring illness (ΔR=+75.0%). The mortality rate in the region changed from 18.6 (2009) to 10.9 (2018) and tended to decrease. Conclusion: The role of the influence of demographic factors and the risk of acquiring illness on the formation of the number of patients and the incidence of BC was evaluated. In this region, these indicators were the highest. The implementation of the results of this study is recommended in management of anticancer activities for BC.
Спонтанный остеонекроз коленного сустава (СОНК) все еще остается сложной задачей для диагностики и выбора стратегии лечения, а также обеспечения оптимального функционального результата у пациентов, по причине сложности дифференциальной диагностики и постановки диагноза. Аспекты рентген- и МРТ-диагностики в последнее время широко исследуются, ставя под вопрос этиологию данного заболевания. Целью данной работы является анализ публикации, посвященных вопросам диагностики и консервативного и оперативного лечения СОНК. Поиск проведен в научных базах данных PubMed, The Cochrane Library, eLIBRARY, Clinical Trials, CyberLeninka по ключевым словам: «спонтанный остеонекроз колена», «СОНК», «остеонекроз», «остеонекроз мыщелков большеберцовой и бедренной костей», «МРТ диагностика остеонекроза», «остеопоретические переломы», «субхондральная недостаточность», «тотальная артропластика коленного сустава», «однокомпонентная артропластика коленного сустава». Исследования показывают, что за последние годы были достигнуты значительные успехи в хирургическом лечении и методах диагностики СОНК. Однако препаратами выбора по-прежнему остаются нестероидные противовоспалительные препараты, так как бисфосфонаты не показали достаточной эффективности. На данном этапе, непрерывно ведутся разработки по усовершенствованию существующих консервативных методик лечения и диагностики. С появлением новых МРТ- и рентгенологических признаков и прояснения этиологии заболевания, все больше практикующих врачей осведомлены о возможности развития СОНК как причины вторичного остеоартрита коленного сустава. Кроме того, появление новых методик хирургического вмешательства, немаловажно влияющих на биомеханику сустава, требуют комплексного подхода к каждому клиническому случаю, как с позиции хирурга, так и реабилитолога. Spontaneous osteonecrosis of the knee joint (SONC) is still a difficult task to diagnose and choose a treatment strategy, as well as to ensure optimal functional outcome in patients, due to the complexity of differential diagnosis and diagnosis. Aspects of X-ray and MRI diagnostics have recently been widely studied, calling into question the etiology of this disease. The purpose of this work is to analyze publications devoted to the issues of diagnosis and conservative and surgical treatment of SONC. The search was carried out in the scientific databases PubMed, The Cochrane Library, eLibrary, Clinical Trials, CyberLeninka by keywords: "spontaneous osteonecrosis of the knee", "SONC", "osteonecrosis", "osteonecrosis of the condyles of the tibia and femur", "MRI diagnosis of osteonecrosis", "osteoporetic fractures", "subchondral insufficiency", "total knee arthroplasty", "single-component knee arthroplasty". Studies show that in recent years significant advances have been made in surgical treatment and diagnostic methods of SONC. However, nonsteroidal anti-inflammatory drugs are still the drugs of choice, since bisphosphonates have not shown sufficient effectiveness. At this stage, developments are continuously underway to improve existing conservative methods of treatment and diagnosis. With the advent of new MRI and radiological signs and clarification of the etiology of the disease, more and more practitioners are aware of the possibility of developing SONC as a cause of secondary osteoarthritis of the knee joint. In addition, the emergence of new methods of surgical intervention, which significantly affect the biomechanics of the joint, require a comprehensive approach to each clinical case, both from the perspective of a surgeon and a rehabilitologist. спонтанды тізе остеонекрозы (СТО) дифференциалды диагностика мен диагноздың күрделілігіне байланысты емдеу стратегиясын диагностикалау және таңдау, сондай-ақ пациенттерде оңтайлы функционалдық нәтижені қамтамасыз ету үшін әлі де қиын міндет болып табылады. Рентген және МРТ диагностикасының аспектілері жақында кеңінен зерттеліп, осы аурудың этиологиясына күмән келтірді. Бұл жұмыстың мақсаты СТО диагностикасы мен консервативті және жедел емдеу мәселелеріне арналған басылымды талдау болып табылады. Іздеу PubMed, the Cochrane Library, eLIBRARY, Clinical Trials, Cyberleninka ғылыми дерекқорларында "спонтанды тізе остеонекрозы", "СТО", "остеонекроз", "жіліншік және сан сүйектері остеонекрозы", "остеонекроздың МРТ диагностикасы", "остеопоретикалық сынықтар", "субхондральды жеткіліксіздік", "тізе буынының жалпы артропластикасы", "тізе буынының бір компонентті артропластикасы". Зерттеулер көрсеткендей, соңғы жылдары хирургиялық емдеу мен СТО диагностикасында айтарлықтай жетістіктер болды. Дегенмен, стероидты емес қабынуға қарсы препараттар әлі де таңдаулы препараттар болып табылады, өйткені бисфосфонаттар жеткілікті тиімділікті көрсетпеді. Осы кезеңде емдеудің және диагностиканың қолданыстағы консервативті әдістерін жетілдіру бойынша әзірлемелер үздіксіз жүргізілуде. Жаңа МРТ және рентгенологиялық белгілердің пайда болуымен және аурудың этиологиясының нақтылануымен тәжірибешілер тізе буынының қайталама остеоартритінің себебі ретінде СТО даму мүмкіндігін көбірек біледі. Сонымен қатар, буын биомеханикасына әсер ететін хирургиялық араласудың жаңа әдістерінің пайда болуы хирургтың да, реабилитологтың да позициясынан әр клиникалық жағдайға кешенді көзқарасты қажет етеді.
Objective:The aim is to study the trends in gastric cancer (GC) mortality in Kazakhstan. Methods: Data on those who died from GC and on the annual population were obtained from the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan. A retrospective study was carried out for the period 2009-2018 using descriptive and analytical methods of oncoepidemiology. The extensive, crude and agespecific mortality rates are determined according to the generally accepted methodology used in sanitary statistics. Results: GC mortality in Kazakhstan is considered to be decreasing. It was determined that during the studied period 19,672 died of this cancer. The mean of death was 67.8 with 95% CI of 67.6 to 68.0. The highest mortality rates per 100,000 in the entire population were found in the age groups 75-79 years (145.9±24.1), 80-84 years (161.0±11.0), and 85+ years (116.5±16.4). Trends in age-related mortality rates had a pronounced tendency to increase in 70-74 years (T=+4.3%, R 2 =0.1924) and to decrease in the age of up to 30 (T=−8.7%, R 2 =0.2426). The average annual standardized mortality rate was 13.2 per 100,000, and in trends tended to decrease (T=−5.8%; R 2 =0.9763). In all regions, there is a decrease in mortality, except for the city of Astana. During categorization mortality rates were determined on the basis of standardized indicators: low -up to 12.9, average -from 12.9 to 15.1, high -above 15.1 per 100,000 for the entire population. Conclusion: The mortality rates from GC tend to decrease, while the downward trends and the degree of their approximation are expressed in almost all regions. The study of regional mortality has theoretical and practical significance for monitoring and evaluating the effectiveness of early detection and treatment. Health authorities should take into account the results obtained when organizing antitumor measures.
Objective: The aim is to study the trends in colorectal cancer (CRC) mortality in Kazakhstan. Methods: The retrospective study was done using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific mortality rates are determined according to the generally accepted methodology used in sanitary statistics. Results: CRC mortality in Kazakhstan is considered to be increasing. Therefore, this study (for the period 2009-2018) was undertaken to retrospectively evaluate data across the country available from the central registration bureau. Age standardized data for mortality was generated and compared across age groups. It was determined that during the studied period 15,200 died of this pathology. During the studied years an average age of the dead made 69.8 years (95%CI=69.5-70.0). The average annual standardized mortality rate was 10.2 per 100,000, and in dynamics tended to decrease. Peak of mortality was noted in aged 60-84 years. Trends in age-related mortality rates had a pronounced tendency to increase in 30-34 years (T=+11.7%, R 2 =0.7980) and to decrease in 75-79 years (T=–16.4%, R 2 =0.8881). In many regions, there is a decrease in the number of deaths. During the compilation of cartograms, mortality rates were determined on the basis of standardized indicators: low – up to 8.9, average – from 8.9 to 11.5, high – above 11.5 per 100,000 for the entire population. In addition, all calculations were made taking into account age-sex differences. Conclusion: Trends in mortality from CRC in recent years have decreased from 11.2 to 7.7 per 100,000 of the total population, while the trend is stable (T=−3.6%, R 2 =0.8745). The study of regional mortality has theoretical and practical significance: monitoring and evaluation of the effectiveness of early detection and treatment of detected pathology. Health authorities should take into account the results obtained when organizing anti-cancer measures.
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