THYROID CANCER AS A PUBLIC HEALTH CHALLENGE IN GEORGIA.

Thyroid cancer (TC) is the most common endocrine cancer. The increase in thyroid cancer incidence has been observed in both developed and developing countries in different Geographical and climate areas The share of thyroid cancer drastically increased during the last decades in Georgia and ranked as the second most prevalent cause of cancer among women. Although for addressing the burden of cancer, important steps were taken by the State during the last decades, the burden of this disease is still significant. The presented paper aims to provide an overview of the current burden of thyroid cancer in Georgia, delving into its risk factors. To explore the opinion of key stakeholders about the factors causing the increased trend of thyroid cancer in Georgia in-depth interviews were used. The study was conducted from March to August 2023 in the capital of Georgia - Tbilisi. Women and men who had thyroid cancer and survived, women and men who are suffering from thyroid cancer along with healthcare providers, policymakers, and national professional bodies were the respondents in this study. The guides for the in-depth interviews were prepared based on the literature review. Stakeholders agreed that the number of thyroid cancer cases has increased during the last decades. The concern that the prevalence and incidence of thyroid cancer is the highest in the world in Georgia and it is the second leading cause of cancer among women was also expressed by respondents. According to study findings, new diagnostic methods revealed more cases of thyroid cancer. Other respondents stated that the development of the cancer registry, and the improvement of the reporting system existing cases of this disease. The issue of over-diagnosis was also mentioned by the stakeholders, Almost all study participant patients are challenged by the post-operational period. Some of them had not gotten information on how to deal with this period. Several patients mentioned financial problems due to fee-for-service or co-payments. According to the study participants, the recent sharp increase in the incidence and prevalence of thyroid cancer cases might be associated with overdiagnosis and the lack of monitoring and unified diagnostic and treatment methods.

[THE BIOMARKERS OF MYOCARDIAL DAMAGE AND THEIR ROLE IN THE PROGRESSION OF HEART FAILURE (REVIEW)].

Despite the success achieved in the study and treatment of chronic heart failure, this syndrome still remains one of the most difficult and predictable unreliable pathologies. Moreover, in recent years there has been a tendency of growth of such patients. Based on the above, the attention of scientists focuses on new concepts that involve the study of new biomarkers of cardiac damage and the definition of their role in the progression of heart failure. Based on studies conducted by numerous authors, the paper analyzes the importance of new biomarkers of myocardial damage in the development of heart failure. The manuscript describes biomarkers of damage (troponin T, galectin 3, lipocalin, Cystatin C): nature: the causes and mechanisms of their growth, increase and activity. Biomarkers of myocardial damage are shown to have diagnostic and high predicted values. Their temporary definition provides additional information for stratifying the risks of possible complications. It also gives us the opportunity to allocate patients with high risks in a timely manner and eliminate possible adverse complications.

[Psychoadaptive peculiarities in patients with diabetes mellitus].

At the Department of Endocrinology of the Republican Central Clinical Hospital the fixed set method (FSM) by D. Uznadze was used to examine 203 patients with Diabetes Mellitus (DM)--79 patients (38,92%) with DM type I, 124 patients (61,08%) with DM type II. Among the patients with DM predominated the dynamic type, roughness and weakness of the FS. There were some differences between psychoadaptive features of patients with DM type I and DM type II. In both cases of DM patients predominated dynamic type and weak FS, but the quantitative parameters were higher in DM type 1 patients. Patients with DM type I were characterized by labile FS, while the patients with DM type II had stable FS. In relation to the age, plasticity frequency decreases and roughness of FS increases by age. Dynamic and weak FS was most frequently observed in the patients primary diagnosed for DM in the hospital, those manifested with ketoacydosis, with labile clinic of DM and those with ketoacydosis and hypoglycemic episodes in the anamnesis. Periods of clinical compensation were characterized by plasticity of FS. The group of patients where diabetic late complications were not manifested were not observed was characterized by the dominance of the dynamic type. Use of FSM in DM patients gives us an opportunity for psychodiagnostics and for selection of patients for individual psychocorrection.