Medicine Epidemiology

Healthcare Systems and Public Health

Description

This cluster of papers focuses on the epidemiology, risk factors, prevention, and mortality trends of cardiovascular diseases in Russia. It includes studies on the prevalence of non-communicable disease risk factors, occupational health risks in the Arctic population, economic burden, and healthcare policy related to cardiovascular health.

Keywords

Cardiovascular Diseases; Risk Factors; Prevention; Mortality Trends; Epidemiological Studies; Occupational Health; Arctic Population; Non-communicable Diseases; Healthcare Policy; Public Health

Principles of evaluation diagnostic and management methods major rehabilitation problems rehabilitation of specific disorders. Principles of evaluation diagnostic and management methods major rehabilitation problems rehabilitation of specific disorders.
Background. Self-reported capability in physical functioning has long been considered an important focus of research for older persons. Current measures have been criticized, however, for conceptual confusion, lack of sensitivity … Background. Self-reported capability in physical functioning has long been considered an important focus of research for older persons. Current measures have been criticized, however, for conceptual confusion, lack of sensitivity to change, poor reproducibility, and inability to capture a wide range of upper and lower extremity functioning.
du Coeur et des Vaisseaux, No. 9-10, Sept.-Oct. 1944.Mean pressures were meas- ured with a saline manometer.By personal communica- tion, it has been learned that auricular and ventricular pressures have … du Coeur et des Vaisseaux, No. 9-10, Sept.-Oct. 1944.Mean pressures were meas- ured with a saline manometer.By personal communica- tion, it has been learned that auricular and ventricular pressures have been recorded more recently by a modified piezographic method.METHODS * Y 0. Cd 06 0..CO0
The success of telehealth could be undermined if serious privacy and security risks are not addressed. For example, sensors that are located in a patient's home or that interface with … The success of telehealth could be undermined if serious privacy and security risks are not addressed. For example, sensors that are located in a patient's home or that interface with the patient's body to detect safety issues or medical emergencies may inadvertently transmit sensitive information about household activities. Similarly, routine data transmissions from an app or medical device, such as an insulin pump, may be shared with third-party advertisers. Without adequate security and privacy protections for underlying telehealth data and systems, providers and patients will lack trust in the use of telehealth solutions. Although some federal and state guidelines for telehealth security and privacy have been established, many gaps remain. No federal agency currently has authority to enact privacy and security requirements to cover the telehealth ecosystem. This article examines privacy risks and security threats to telehealth applications and summarizes the extent to which technical controls and federal law adequately address these risks. We argue for a comprehensive federal regulatory framework for telehealth, developed and enforced by a single federal entity, the Federal Trade Commission, to bolster trust and fully realize the benefits of telehealth.
categorical data analysis , categorical data analysis , کتابخانه مرکزی دانشگاه علوم پزشکی تهران categorical data analysis , categorical data analysis , کتابخانه مرکزی دانشگاه علوم پزشکی تهران
The risk for multifactorial diseases is determined by risk factors that frequently apply across disorders (universal risk factors). To investigate unresolved issues on etiology of and individual's susceptibility to multifactorial … The risk for multifactorial diseases is determined by risk factors that frequently apply across disorders (universal risk factors). To investigate unresolved issues on etiology of and individual's susceptibility to multifactorial diseases, research focus should shift from single determinant-outcome relations to effect modification of universal risk factors. We present a model to investigate universal risk factors of multifactorial diseases, based on a single risk factor, a single outcome measure, and several effect modifiers. Outcome measures can be disease overriding, such as clustering of disease, frailty and quality of life. "Life course epidemiology" can be considered as a specific application of the proposed model, since risk factors and effect modifiers of multifactorial diseases typically have a chronic aspect. Risk factors are categorized into genetic, environmental, or complex factors, the latter resulting from interactions between (multiple) genetic and environmental factors (an example of a complex factor is overweight). The proposed research model of multifactorial diseases assumes that determinant-outcome relations differ between individuals because of modifiers, which can be divided into three categories. First, risk-factor modifiers that determine the effect of the determinant (such as factors that modify gene-expression in case of a genetic determinant). Second, outcome modifiers that determine the expression of the studied outcome (such as medication use). Third, generic modifiers that determine the susceptibility for multifactorial diseases (such as age). A study to assess disease risk during life requires phenotype and outcome measurements in multiple generations with a long-term follow up. Multiple generations will also enable to separate genetic and environmental factors. Traditionally, representative individuals (probands) and their first-degree relatives have been included in this type of research. We put forward that a three-generation design is the optimal approach to investigate multifactorial diseases. This design has statistical advantages (precision, multiple-informants, separation of non-genetic and genetic familial transmission, direct haplotype assessment, quantify genetic effects), enables unique possibilities to study social characteristics (socioeconomic mobility, partner preferences, between-generation similarities), and offers practical benefits (efficiency, lower non-response). LifeLines is a study based on these concepts. It will be carried out in a representative sample of 165,000 participants from the northern provinces of the Netherlands. LifeLines will contribute to the understanding of how universal risk factors are modified to influence the individual susceptibility to multifactorial diseases, not only at one stage of life but cumulatively over time: the lifeline.
The aim of the present study was to assess the prognostic value of changes in left ventricular hypertrophy in hypertensive patients with time.Two hundred and fifteen uncomplicated hypertensive patients underwent … The aim of the present study was to assess the prognostic value of changes in left ventricular hypertrophy in hypertensive patients with time.Two hundred and fifteen uncomplicated hypertensive patients underwent a high-quality baseline echocardiogram for left ventricular anatomy evaluation and in 151 of those patients the echocardiographic examination was repeated 10 +/- 1.4 years after the initial study.Left ventricular mass index changes were evaluated, in relation to the incidence of non-fatal cardiovascular events, adjusted for traditional cardiovascular risk factors.According to the presence or absence of left ventricular hypertrophy (left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women) at baseline and at the end of follow-up study, patients were divided into four groups: with normal left ventricular mass at both examinations (n = 78), with regression of left ventricular hypertrophy (n = 32), with persistence of left ventricular hypertrophy (n = 34) and with hypertrophy development (n = 7). After adjustment for traditional cardiovascular risk factors, the cumulative incidence of non-fatal cardiovascular events was significantly higher in the group of patients without regression of left ventricular hypertrophy. Cox survival analysis showed the presence of left ventricular hypertrophy at the end of follow-up study to be the most important factor related to cardiovascular events.The present findings strongly indicate that the lack of decrease or the increase of left ventricular mass after antihypertensive treatment can be associated with a higher risk for cardiovascular events, which is significantly reduced and almost normalized by complete regression of left ventricular hypertrophy.
Progress in improving the credibility of teachers' descriptive evaluations of students and residents has not kept pace with the progress made in improving the credibility of more quantified methods, such … Progress in improving the credibility of teachers' descriptive evaluations of students and residents has not kept pace with the progress made in improving the credibility of more quantified methods, such as multiple-choice examinations and standardized patient examinations of clinical skills. This article addresses innovative approaches to making the ongoing in-training evaluation (ITEv) of trainees during their clinical experiences more reliable and valid. The innovations include the development of a standard vocabulary for describing the progress of trainees from "reporter" to "interpreter" to "manager" and "educator" (RIME), the use of formal evaluation sessions, and closer consideration of the unit of clinical evaluation (the case, the rotation, or the year). The author also discusses initial results of studies assessing the reliability and validity of descriptive methods, as well as the use of quantified methods to complement descriptive methods. Applying basic principles--the use of a taxonomy of professional development and statistical principles of reliability and validity--may foster research into more credible descriptive evaluation of clinical skills.
This report presents period life tables for the United States based on age-specific death rates in 2004. Data used to prepare these life tables are 2004 final mortality statistics; July … This report presents period life tables for the United States based on age-specific death rates in 2004. Data used to prepare these life tables are 2004 final mortality statistics; July 1, 2004, population estimates based on the 2000 decennial census and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 2004, the overall expectation of life at birth was 77.8 years, representing an increase of 0.4 year from life expectancy in 2003. Between 2003 and 2004, life expectancy increased for males and females, and for both the white and black populations. Life expectancy increased by 0.5 years (from 72.6 to 73.1) for the black population and by 0.4 year (from 77.9 to 78.3) for the white population. Both males and females in each race group experienced increases in life expectancy between 2003 and 2004. The greatest increase was experienced by black males with an increase of 0.6 year (from 68.9 to 69.5). Life expectancy increased by 0.4 year for black females (from 75.9 to 76.3), for white females (from 80.4 to 80.8), and for white males (from 75.3 to 75.7).
Quantitative studies on the sinoatrial (SA) node and internodal tracts in IOO heartsfrom patients coming to necropsy with atrialfibrillation have been carried out.In patients with atrialfibrillation developing only in the … Quantitative studies on the sinoatrial (SA) node and internodal tracts in IOO heartsfrom patients coming to necropsy with atrialfibrillation have been carried out.In patients with atrialfibrillation developing only in the last two weeks of life, pulmonary emboli and acute pericarditis were common precipitating factors.Atrial dilatation was common but the SA node and internodal tracts were within normal limits.In contrast patients with long-term atrial fibrillation showed combinations of nodal artery stenosis, muscle loss in the SA node or internodal tracts, and atrial dilatation.The pathological conditions found most commonly were chronic rheumatic valve disease, ischaemic heart disease, hypertension, and cor pulmonale.Atrialfibrillation in some aged patients was associated with loss of muscle fibres in the SA node without any clear pathological cause.
<b>Objective:</b> To analyse trends in mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD) over the period 1965 to 1998 in the European Union, other European countries, the USA, … <b>Objective:</b> To analyse trends in mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD) over the period 1965 to 1998 in the European Union, other European countries, the USA, and Japan. <b>Methods and results:</b> Data were derived from the World Health Organization database. In the European Union, CHD mortality in men rose from 146/100 000 in 1965–9 to 163/100 000 in 1975–9 and declined thereafter to 99/100 000 in 1995–8 (−39%). In women, the fall was from 70 to 45/100 000 (−36%). A &gt; 55% decline in CVD was registered in both sexes. In eastern Europe, mortality from both CHD and CVD rose up to the early 1990s but has declined over the past few years in Poland and the Czech Republic. In the Russian Federation during 1995–8, mortality rates from CHD reached 330/100 000 men and 154/100 000 women and mortality rates from CVD were 203/100 000 men and 150/100 000 women—that is, they were among the highest rates worldwide. In the USA and Japan, long term trends were favourable for both CHD and CVD. <b>Conclusions:</b> Trends in mortality from CHD and CVD were favourable in several developed areas of the world, but there were major geographical differences. In a few eastern European countries, mortality from CHD and CVD remains exceedingly high.
Prevalence rates of mental disorders, hypertensive disease, cerebrovascular disease and other chronic conditions are increasing throughout the world. Two mechanisms are responsible for this situation: the large relative increases that … Prevalence rates of mental disorders, hypertensive disease, cerebrovascular disease and other chronic conditions are increasing throughout the world. Two mechanisms are responsible for this situation: the large relative increases that are occurring in the number of persons in age groups at high risk for developing these conditions; and the increase in average duration of chronic diseases resulting from the successful application of techniques for arresting their fatal complications and prolonging the lives of affected individuals. In the absence of effective techniques for reducing incidence, the prevalence of such diseases will continue to increase. The chronic mental disorders and conditions related to them are used to illustrate the manner in which these mechanisms are operating. Data are presented to demonstrate the increases likely to occur between 1975 and 2000 in the number of persons with these conditions in the more and less developed regions of the world and in selected countries. These findings set new priorities for future epidemiologic research. Emphasis must be placed on discovering the preventable causes of the conditions which are increasing in prevalence.
Despite the popularity of the concept of “anaerobic threshold” (AT), the noninvasive detection criteria remain subjective, and invasive validations of AT have been based on lactate data of arterial, mixed … Despite the popularity of the concept of “anaerobic threshold” (AT), the noninvasive detection criteria remain subjective, and invasive validations of AT have been based on lactate data of arterial, mixed venous, venous, and capillary blood samples without any concern for the possible lactate differences from these sources. Eight normal subjects underwent two exercise tests on a bicycle ergometer. The protocol consisted of 3 min of rest, 3 min of 0 work load, and a 20 W/min ramp (1 W/3 s) until exhaustion. Simultaneous arterial and venous blood samples were drawn during the second test. Noninvasive gas response data were measured using a computerized breath-by-breath stress test system. Threshold phenomenon of the lactate accumulation was not found. The arterial lactate levels increased continuously after the start of the exercise ramp. The rise in venous lactate lagged behind the rise of the arterial lactate by about 1.5 min, and therefore venous lactate was not considered suitable for AT detection. Four independent exercise physiologists determined AT from the gas response data. The reviewer variability (avg range 16%) of AT for a given subject was representative of AT values reported for untrained and trained individuals (40-70% maximum O2 consumption). We concluded that 1) AT is not detectable using invasive methods (arterial and venous lactates); and 2) the noninvasive gas response determination has such a large range of reviewer variability that it is unsuitable for clinical use.
To assess the role of demographic factors and chronic conditions in maintaining mobility in older persons, this study utilized longitudinal data collected as part of the Established Populations for Epidemiologic … To assess the role of demographic factors and chronic conditions in maintaining mobility in older persons, this study utilized longitudinal data collected as part of the Established Populations for Epidemiologic Studies of the Elderly between 1981 and 1987 on 6,981 men and women aged 65 years and older in East Boston, Massachusetts; Iowa and Washington counties, Iowa; and New Haven, Connecticut. Results are presented for those who at baseline reported intact mobility, defined as the ability to climb stairs and walk a half mile without help, and who were followed annually for up to 4 years for changes in mobility status. Age, income, education, and chronic conditions present at baseline and occurring during follow-up were evaluated for their association with loss of mobility. Over the follow-up period, 55.1% of subjects maintained mobility, 36.2% lost mobility, and 8.7% died without evidence of mobility loss prior to death. In both men and women, increasing age and lower income levels were associated with increased risk of losing mobility, even after controlling for the presence of chronic conditions at baseline. After adjustment for age, income, and chronic conditions, lower education levels were a significant risk factor for mobility loss in men, but not in women. Baseline reports of previous heart attack, stroke, high blood pressure, diabetes, dyspnea, and exertional leg pain were associated with small but significant risks for mobility loss. There was a stepwise increase in the risk of mobility loss according to the number of chronic conditions present at baseline that was very consistent between men and women. The occurrence during the study of a new heart attack, stroke, cancer, or hip fracture was associated with a substantially greater risk of mobility loss than was associated with the presence of these conditions at baseline.
Patients with CHDor other atherosclerotic disease.Screen close relatives of patients with premature (men <55 yrs, women <65 yrs) CHD. LifestyleStop smoking, make healthy food choices, be physically active and achieve … Patients with CHDor other atherosclerotic disease.Screen close relatives of patients with premature (men <55 yrs, women <65 yrs) CHD. LifestyleStop smoking, make healthy food choices, be physically active and achieve ideal weight. Other risk factorsBlood pressure <140/90 mmHg, Total cholesterol <5.0 mmol/l (190 mg/dl) LDL-cholesterol <3.0 mmol/l (115 mg/dl) When these risk factor goals are not achieved by lifestyle changes, blood pressure and cholesterol lowering drug therapies should be used.Healthy high risk individuals.Absolute CHD risk ≥20% over 10 years, or will exceed 20% if projected to age 60.Aspirin (at least 75mg) for all coronary patients, those with cerebral atherosclerosis and peripheral atherosclerotic disease.ß-blockers in patients following myocardial infarction.ACE inhibitors in those with symptoms or signs of heart failure at the time of myocardial infarction, or with chronic LV systolic dysfunction (ejection fraction <40%).Anticoagulants in selected coronary patients.Screen close relatives if familial hypercholesterolaemia or other inherited dyslipidaemia is suspected.Aspirin (75 mg) in treated hypertensive patients and in men at particularly high CHD risk. Lifestyle and therapeutic goals for patients with CHD, or other atherosclerotic disease, and for healthy high risk individualsOther prophylactic drug therapies Screen close relatives Table 1 1436 Task Force Report
Major depression is a common and treatable mental disorder characterized by changes in mood, and cognitive and physical symptoms over a 2-week period (1). It is associated with high societal … Major depression is a common and treatable mental disorder characterized by changes in mood, and cognitive and physical symptoms over a 2-week period (1). It is associated with high societal costs (2) and greater functional impairment than many other chronic diseases, including diabetes and arthritis (3). Depression rates differ by age, sex, income, and health behaviors (4). This report provides the most recent national estimates of depression among adults. Prevalence of depression is based on scores from the Patient Health Questionnaire (PHQ-9), a symptom-screening questionnaire that allows for criteria-based diagnoses of depressive disorders (5). Estimates for non-Hispanic Asian persons are presented for the first time.
Hypertension is a major risk factor for cardiovascular disease. Lowering blood pressure has been shown to decrease the incidences of stroke, heart attack, and heart failure (1,2). This report provides … Hypertension is a major risk factor for cardiovascular disease. Lowering blood pressure has been shown to decrease the incidences of stroke, heart attack, and heart failure (1,2). This report provides 2017-2018 U.S. hypertension prevalence estimates using the 2017 American College of Cardiology and American Heart Association definition of hypertension (3) and new guidelines, which redefine hypertension by lowering the previous threshold levels of 140/90 mmHg to 130/80 mmHg (4). This change categorizes a greater percentage of people as having hypertension.
a correction was needed.1. On page e352, in the left column, the text under the heading "Mortality (See Chart 16-7) 2016 ICD-9 427.3;ICD-10 I48" read, "In 2016, AF was the … a correction was needed.1. On page e352, in the left column, the text under the heading "Mortality (See Chart 16-7) 2016 ICD-9 427.3;ICD-10 I48" read, "In 2016, AF was the underlying cause of death in 24 855 people and was listed on 15 816 US death certificates (any-mention mortality)."The text has been updated to read, "In 2016, AF was the underlying cause of death in 24 855 people and was listed on 154 816 US death certificates (any-mention mortality).
In December 2013, the World Health Organization Executive Board generated a report entitled: Strengthening of palliative care as a component of integrated treatment throughout the life course. The contents of … In December 2013, the World Health Organization Executive Board generated a report entitled: Strengthening of palliative care as a component of integrated treatment throughout the life course. The contents of that report are presented.
Abstract Objective To examine the association of atrial fibrillation (AF) prevalence with neighborhood deprivation in a large, national U.S. population across racial and ethnic groups and its association. Methods We … Abstract Objective To examine the association of atrial fibrillation (AF) prevalence with neighborhood deprivation in a large, national U.S. population across racial and ethnic groups and its association. Methods We analyzed data from Epic Cosmos, comprising over 56 million adults with demographic and area deprivation index data in 2024. AF prevalence was defined using ICD-10 codes. Results Overall AF prevalence was 3.7%, higher in men and older adults. Prevalence varied by race/ethnicity, highest in White and American Indian/Alaska Native individuals, and lowest in Asian and Hispanic individuals. AF prevalence increased with higher deprivation across most groups. Conclusion Area-level socioeconomic deprivation was independently associated with higher AF prevalence across all racial and ethnic groups. These findings underscore the importance of addressing structural determinants of health to reduce the burden of AF in diverse communities.
Scientific and technological evaluation serves as a pivotal mechanism for fostering innovation. Objective and scientific evaluation markedly enhances technological innovation capacity and vitality. Presently, research-oriented hospitals in China bear the … Scientific and technological evaluation serves as a pivotal mechanism for fostering innovation. Objective and scientific evaluation markedly enhances technological innovation capacity and vitality. Presently, research-oriented hospitals in China bear the mission of facing four key orientations: the global scientific and technological frontiers, the development of the economy, the major needs of the country, the health and safety of people. These institutions also bear the responsibility for high-quality development. Establishment of a technological evaluation system aligned with contemporary needs is essential. Such a system can scientifically lead an advanced medical innovation, accelerate transformation of research outcomes, and contribute substantially to the "Healthy China" strategy. Collaborative research group on deepening reform of science and technology evaluation in Chinese hospitals and clinical research management group of scientific research management branch of medical scientific research management of Chinese Medical Association, in collaboration with institutions and expert teams, dedicated to research and management of hospital technological evaluation systems, alignment with national demands occurs. Reference to the global research advancements and integrations of hospital practices inform the formulation of this expert consensus. This consensus systematically delineates the framework for constructing and applying a technological evaluation system in Chinese hospitals. Through a scientific and standardized evaluation mechanism, enhancement of hospital innovation capacity and optimization of medical service quality will be promoted. The consensus encompasses evaluation objectives, principles, system constructions, application strategies, and supportive measures. A highly operational indicator system and implementation pathway are provided. Guidance is offered for hospital administrators, policymakers, and researchers.
Objective: To explore the spatial clustering of the mortality rate of cervical cancer in different counties (cities, districts) in Shandong Province from 1970 to 2021 and its 50-year changing trend, … Objective: To explore the spatial clustering of the mortality rate of cervical cancer in different counties (cities, districts) in Shandong Province from 1970 to 2021 and its 50-year changing trend, so as to provide basis for the implementation and evaluation of prevention and control strategies and programs such as cervical cancer screening, early diagnosis and treatment, human papilloma virus (HPV) vaccination, etc. Methods: The mortality data of cervical cancer were obtained from the death registration system of Shandong Province and the data of three retrospective surveys of death causes. The mortality rate and age-standardized mortality rate (using the population composition of China in 1964) are used to describe the changing trend of cervical cancer in different years. The contribution values of population factors and non-population factors in cervical cancer mortality change are calculated by mortality differential decomposition method. ArcGIS 10.8 software is used for spatial distribution and spatial autocorrelation analysis. Results: From 1970 to 2021, the crude mortality rate and age standardized mortality rate of cervical cancer in Shandong Province showed a trend of first rapid decline and then slow increase. The crude mortality rate and standardized mortality rate of female cervical cancer in Shandong Province in 1970-1974 were the highest, reaching 17.22/105 and 13.17/105, respectively. In 2004-2005, it dropped to the lowest levels of 1.50/105 and 0.83/105. Subsequently, it slowly rose to 4.12/105 and 1.56/105 in 2020-2021. The differential analysis of cervical cancer mortality in different years found that the change of cervical cancer mortality was caused by the combined action of population factors and non-population factors. Among them, demographic factors (aging population) led to the increase of cervical cancer mortality, but non-demographic factors (early diagnosis and treatment, HPV infection level, medical technology level, etc) lead to the decrease of cervical cancer mortality. Compared with 1970-1974, with the passage of time, the absolute values of the contribution values of population factors and non-population factors showed an increasing trend, while the contribution of non-population factors was greater than that of population factors, which led to the decline of cervical cancer mortality. From the perspective of spatial distribution, there were great regional differences in the mortality rate of cervical cancer in different counties of Shandong Province. In 2020-2021, the mortality rate of cervical cancer in all counties decreased to a great extent compared with that in 1970-1974, and the high-high and low-low concentration areas of cervical cancer mortality in different years changed obviously. The high-aggregation areas of the cervical cancer mortality rate in Shandong Province from 2020 to 2021 were mainly distributed in some counties and districts of Linyi City, Zaozhuang City, and Heze City in the southwest. Conclusions: There are significant temporal and spatial changes in the mortality rate of cervical cancer in Shandong Province from 1970 to 2021. According to these trends and their geographical and spatial clustering, prevention and control strategies of cervical cancer in different regions should be further formulated and evaluated.
Bevezetés: A szívinfarktusos betegek kezelésének eredményességét, életkilátásait jelentősen befolyásolja a teljes ischaemiás idő, amelyet a panasz kezdetétől az ér megnyitásáig számítunk. Célkitűzés: Vizsgálatunkban a teljes ischaemiás idő összetevőinek hosszát elemeztük, … Bevezetés: A szívinfarktusos betegek kezelésének eredményességét, életkilátásait jelentősen befolyásolja a teljes ischaemiás idő, amelyet a panasz kezdetétől az ér megnyitásáig számítunk. Célkitűzés: Vizsgálatunkban a teljes ischaemiás idő összetevőinek hosszát elemeztük, és összehasonlítottuk az 5 évvel korábbi vizsgálat eredményeivel. Módszer: 2022. 07. 01. és 2023. 06. 30. közötti időszakban 8705 (4334 [49,8%] STEMI, 3428 [39,4%] nő) infarktusos beteget regisztráltunk, akiknél a teljes ischaemiás idő összetevőinek számításához minden adat rendelkezésre állt. Az idők esetén a mediánértéket és a nevezetes kvartiliseket (alsó kavartilis Q1 és felső kvartilis Q3) adtuk meg, előző tanulmányunkhoz hasonlóan. A diagnózist a kórházi kezelés során állapították meg a kezelőorvosok az érvényes kritériumok alapján. Vizsgáltuk a panasz kezdetétől a mentőszolgálat értesítéséig eltelt időt (a beteg késlekedése), a mentő helyszínre érkezésének (M1) és a helyszíni ellátás (M2) idejét, valamint a helyszínről a kórházi felvételéig eltelt időt (M3). A kórházi ellátás értékelésénél a felvétel és az ér megnyitása között eltelt időt („ajtó–tű idő”) adtuk meg. Az adatokat országos és megyei bontásban is megadtuk. Eredmények: STEMI-betegeknél országosan a betegek késésének mediánértéke 140 perc (Q1: 51; Q3: 458) volt. A mentő helyszínre érkezési idejének mediánértéke 13,2 perc (Q1: 8,0; Q3: 21,1), a helyszíni ellátás idejének mediánértéke 25,5 perc (Q1: 17,6; Q3: 34,9), a helyszínről a kórházba érkezés idejének mediánértéke 31,0 perc (Q1: 19,5; Q3: 43,7) volt. A helyszínre érkezés tartománya 8,8–17,9 perc között változott a különböző megyékben. STEMI-betegeknél a medián ajtó–tű idő országosan 51,5 perc (Q1: 28,7; Q3: 121,7) volt. Az NSTEMI-csoportban a betegek késlekedésének mediánértéke 373 perc (Q1: 106; Q3: 1184), a helyszínre érkezési idő 14,2 perc (Q1: 8,5; Q3: 24,8) volt. STEMI esetén a betegek késlekedése – a korábbival összehasonlítva – közel 40 perccel nőtt (101 vs. 140 perc), a mentő helyszínre érkezésének mediánértéke (13,0 vs. 13,2 perc) érdemben nem változott. Az ajtó–tű idő a jelen vizsgálatban közel 15 perccel volt hosszabb, mint korábban (37,0 vs. 51,5 perc). A STEMI-betegcsoportban a kezelések 4,1%-ában 2 órán belül, 38,3%-ában 4 órán belül került sor az ér megnyitására. Következtetés: A teljes ischaemiás idő tekintetében a betegek késlekedése a meghatározó tényező, emiatt a kezelések jelentős részében nem az optimális időben került sor a revascularisatióra. Orv Hetil. 2025; 166(25): 963–969.
Background : the increase in the number of extreme situations threatening the life and health of law enforcement officers leads to the formation of maladaptive reactions and the development of … Background : the increase in the number of extreme situations threatening the life and health of law enforcement officers leads to the formation of maladaptive reactions and the development of clinical symptoms of mental maladaptation, which dictates the need to improve the quality of preventive and curative care, as well as to improve organizational approaches based on scientific analysis of morbidity. The aim was to assess the dynamics of desadaptation disorders prevalence and give a forecast of the need for employees of the internal affairs bodies of the Russian Federation in medical and psychological rehabilitation (MPR) after suffering borderline mental disorders. Materials and Methods : in order to assess the dynamics and predict the need for internal affairs officers in medical and psychological rehabilitation after borderline mental disorders, an analysis of statistical reporting forms for the period 2008-2023, according to the V class of diseases according to the International Classification of Diseases (ICD-10) was carried out. The study included disorders with a good prognosis and stable remission of painful manifestations after complex therapy. These disorders do not prevent the continuation of service as police officers and relate to ICD-10 categories: organic, including symptomatic mental disorders (F00–F09), mood disorders (affective disorders) (F30–F39), neurotic, stress related and somatoform disorders (F40–F48). The need indicators were calculated per 1,000 employees or in ppm (%). At the first stage of analysis, forecasting was calculated without taking into account external factors. At the second stage, the model was built taking into account the main external factor such as a participation in hostilities. To predict the need for MPR for the period 2024 and 2025, the ARIMA model was applied, the quality of the model was evaluated using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), the Ljung-Box test for diagnosing autocorrelation of residues, the confidence interval was denoted as — CI. The Dickey-Fuller test (ADF) was used to check the stationarity of the time series. To determine the trend of acceleration and deceleration of the trend, an assessment of the change in the growth rate of need was carried out using the first and second derivatives. Results : an analysis of the dynamics of the need for ATS employees to conduct MPR after suffering mental disorders shows the variability of indicators for all groups of mental health disorders studied. The forecast model, built taking into account an external factor — the performance of operational and combat tasks in special conditions, demonstrates the expected increase in the MPR need for police officers in 2024 and 2025, which is associated with an increase in the number of extreme situations faced by employees, and, as a result, with an increase in mental maladaptation. Conclusions : further research and monitoring of the factors influencing the need for medical and psychological rehabilitation are critically important for improving the quality of rehabilitation measures and improving the mental health of police officers. The prospects for further research lie in the development of more accurate models for predicting the need for MPR, taking into account not only external stress factors, but also the individual characteristics of employees, which will optimize rehabilitation programs and increase their effectiveness in conditions of increasing professional loads.
The issue of staff shortage in socially important sectors of Russian economy, including health care, is not new. The state adopts various mechanisms and implements projects aimed at its solution, … The issue of staff shortage in socially important sectors of Russian economy, including health care, is not new. The state adopts various mechanisms and implements projects aimed at its solution, but the efforts are insufficient. The statistics of the need for personnel in the health care sector has been analyzed as a justification for the relevance of the study. The experience of the Soviet distribution of graduates, foreign experience, and new draft laws have been studied, and proposals for updating the “old” experience considering the new realities have been formulated. The updated mechanism of the medical graduates state distribution has been proposed. Theoretical conclusions about the necessity of introducing the socially important specialties concept into the law enforcement turnover have been formulated, and the author’s definition has been given. The comparative analysis of the existing mechanisms of providing the labor market with qualified specialists (target training) with the proposed order of distribution has been carried out, and the advantages of the latter and the disadvantages of the existing one have been shown. Proposals for updating the current legislation necessary for state distribution implementation in socially important areas of training, such as health care, have been formulated. The proposed system will allow solving another important problem such as youth employment.
Objective. To implement the lean management principles in the work of the radiotherapy department and evaluate the results. Materials and methods. The study was conducted in the Department of Radiotherapy … Objective. To implement the lean management principles in the work of the radiotherapy department and evaluate the results. Materials and methods. The study was conducted in the Department of Radiotherapy of the N.N. Blokhin National Medical Research Center for Oncology and was divided into three stages: mapping the department’s functioning process (stage 1), implementing several transformations (stage 2), and analyzing the effectiveness of the measures taken and implementation of the lean management principles (stage 3). The effectiveness of these measures was assessed by direct comparison of indicators in absolute and relative values before and after 2020. Results. The work processes in the department were mapped. Modifying stages 2 and 3 allowed for time savings of up to 20 minutes during the preparation for one patient’s hospitalization and 5 to 20 minutes for each patient’s treatment per day. The increase in patient flow in November 2021 compared to November 2020 was 49.5%, and 395% in December 2021 compared to December 2020. The increase in patient flow in January 2021 compared to January 2020 was 140%, and 127% in February 2021 compared to February 2020. Conclusion. The high efficiency of lean management methods was demonstrated through the example of the work of the radiotherapy department. The approach can be extended to radiotherapy departments in oncology clinics in the Russian Federation.
Artificial intelligence has a powerful “generative capacity”, and the rapid development of intelligent technology provides brand-new opportunities for employment and creates a large number of jobs; at the same time, … Artificial intelligence has a powerful “generative capacity”, and the rapid development of intelligent technology provides brand-new opportunities for employment and creates a large number of jobs; at the same time, it also brings certain risks and challenges, leading to the negative effect of employment substitution. The article analyzes the brand-new opportunities for the employment of vocational school students in the context of the artificial intelligence era as well as the realistic challenges they face, and on this basis, puts forward countermeasures from the macro, meso, and micro levels respectively, so as to provide referable opinions for better employment in the future.
In the Republic of Croatia, data on individuals with disabilities are monitored within the Registry of Persons with Disabilities. This paper provides findings from a comparative analysis of the prevalence … In the Republic of Croatia, data on individuals with disabilities are monitored within the Registry of Persons with Disabilities. This paper provides findings from a comparative analysis of the prevalence of disability in Croatia between 2014 and 2024, as well as the demographic distribution of disability by age, gender, and type of impairment in the same period. Aggregated statistical indicators from the annual reports on persons with disabilities and the Croatian Health Statistics Yearbook were used for further analysis. A statistically significant increase was observed in the prevalence of disability (from 12% to 17%). The gender-based distribution of disability has changed: the ratio of men to women remained constant (6 to 4) until 2020, after which, there has been an increasing representation of women. In the first years of observation (until 2019), the highest percentage of persons with disabilities was correlated with the working age (20 to 64 years), but, since 2022, there has been an increase in persons with disabilities in the 65+ years age group. Child disability (0 to 19 years) has also seen an increase. Considering the type of impairment, the most common causes of disability were impairments of the locomotor system, followed by impairments of other organs and organ systems, chromosomopathies, congenital anomalies and rare diseases, and, lastly, mental impairments. We believe that the reason behind the observed increase in the prevalence of disability in Croatia is the digitalisation of the Registry of Persons with Disabilities, thus facilitating the submission of data collected from expert evaluations and allowing forcomplete coverage of data on these individuals. Additionally, the Republic of Croatia has recorded a depopulation rate, as well as population aging, which has increased the number of individuals subject to mandatory expert evaluation for the purpose of claiming disability rights. This increase in prevalence of disability is consistent with global trends. The Convention on the Rights of Persons with Disabilities has not yet been fully ratified across the world, nor has a uniform method for establishing disability been defined: this makes it difficult to develop epidemiological studies and compare prevalence rates at an international scale. In light of the above, it is necessary to develop efficient methods that can be used to record reliable statistics that would enable high-end international comparability studies and, consequently, improve the current level of understanding of disability. This will also enhance the planning of policies related to the care and rights guaranteed for persons with disabilities.
The content and/or weight coefficients of diagnosis-related groups (DRG) for payment for inpatient and day medical care for 2025 have been updated. Following clinical guidelines, changes have been made to … The content and/or weight coefficients of diagnosis-related groups (DRG) for payment for inpatient and day medical care for 2025 have been updated. Following clinical guidelines, changes have been made to the DRG in payment for drug therapy for malignant neoplasms in adults and treatment of transient ischemic attacks, vascular cerebral syndromes, cerebral hemorrhage, and cerebral infarction. For cerebrovascular disorders, the actualization resulted in a significant increase in the payment tariff. Weight coefficients of DRG to pay for the treatment of chronic viral hepatitis B and C using genetically engineered biological agents and selective immunosuppressants, as well as in vitro fertilization, were recalculated. New groups were formed according to the following profiles: “medical rehabilitation,” “neurology” (three DRGs for complex neurological diseases), “ophthalmology” (intravitreal administration of drugs), and a group “daily hospitalization for diagnostic purposes” was added.
Цель. Выполнить сравнительный анализ исходов госпитализации пациентов с COVID-19 в различные периоды пандемии в зависимости от вакцинального статуса. Материалы и методы. В исследование включены 6697 пациентов с диагнозом «COVID-19», госпитализированных … Цель. Выполнить сравнительный анализ исходов госпитализации пациентов с COVID-19 в различные периоды пандемии в зависимости от вакцинального статуса. Материалы и методы. В исследование включены 6697 пациентов с диагнозом «COVID-19», госпитализированных в г. Минске с 1 июня 2021 по 30 июня 2023 года. После применения критериев исключения в анализ был включен 6291 пациент, в том числе с вакцинацией в анамнезе 1063/6291 (16,9%), без вакцинации в анамнезе – 5228/6291 (83,1%). Рассчитывались плотности инцидентности летального исхода на 1000 человеко-дней госпитализации с 95% доверительным интервалом в зависимости от причины исхода и в различные периоды пандемии. Для оценки влияния вакцинации на риск летального исхода от COVID-19 у госпитализированных пациентов с учетом конкурирующих рисков и влияния других факторов использовались модели субраспределенных рисков Файна – Грея. Результаты. Плотность инцидентности летального исхода от COVID-19 в период преобладания варианта Дельта (июнь – декабрь 2021 г.) у вакцинированных пациентов составила 1,88 (95% ДИ 0,69–4,09) на 1000 человеко-дней госпитализации, у невакцинированных пациентов – 4,05 (95% ДИ 3,32–4,89) на 1000 человеко-дней госпитализации, а в период преобладания вариантов Омикрон (январь 2022 г. – июнь 2023 г.) она составила у вакцинированных пациентов 1,01 (95% ДИ 0,37–2,2) на 1000 человеко-дней госпитализации, у невакцинированных пациентов – 2,91 (95% ДИ 2,26–3,68) на 1000 человеко-дней госпитализации. В период преобладания варианта SARS-CoV-2 Дельта вакцинация у госпитализированного пациента была ассоциирована со снижением риска летального исхода от COVID-19 на 65% (sHR 0,35; 95% ДИ 0,15–0,81; p=0,014) с учетом влияния других предикторов и возможности летального исхода от других причин. В период преобладания вариантов Омикрон протективный эффект вакцинации по отношению к летальному исходу от COVID-19 отсутствовал (sHR 0,44; 95% ДИ 0,19–1,04; p=0,063). Заключение. Вакцинация против SARS-CoV-2 в период преобладания варианта Дельта была ассоциирована со снижением риска летального исхода от COVID-19 у госпитализированных пациентов. В период преобладания вариантов Омикрон риск летального исхода от COVID-19 у госпитализированных пациентов в меньшей степени зависел от наличия вакцинации в анамнезе, большое значение в клинических исходах госпитализации имели конкурирующие заболевания и сопутствующая патология. Purpose. To conduct a comparative analysis of hospitalization outcomes in COVID-19 patients across different pandemic periods based on vaccination status. Materials and methods. The study included 6697 patients diagnosed with COVID-19 who were hospitalized in Minsk, Belarus from 1 June 2021 to 30 June 2023. After applying exclusion criteria, 6,291 patients were analyzed, of whom 1,063/6,291 (16.9%) had a history of vaccination, and 5,228/6,291 (83.1%) were unvaccinated. Incidence densities of mortality per 1,000 person-days of hospitalization (with 95% confidence intervals) were calculated according to outcome cause for different SARS-CoV-2 variants. The Fine – Gray subdistribution hazard model was used to assess the effect of vaccination on COVID-19-related mortality risk in hospitalized patients, accounting for competing risks and confounding factors. Results. During the predominance of Delta variant (June – December 2021), the COVID-19-related mortality incidence density was 1.88 (95% CI 0.69–4.09) per 1,000 person-days in vaccinated patients and 4.05 (95% CI 3.32–4.89) per 1,000 person-days in unvaccinated patients. In the Omicron-dominant period (January 2022 – June 2023), the respective values were 1.01 (95% CI 0.37–2.2) and 2.91 (95% CI 2.26–3.68) per 1,000 person-days. During Delta variant predominance, vaccination was associated with a 65% reduction in COVID-19-related mortality risk (sHR 0.35; 95% CI 0.15–0.81; p=0.014) after adjusting for confounders and competing risks. During Omicron waves, no significant protective effect of vaccination against COVID-19-related mortality was observed (sHR 0.44; 95% CI 0.19–1.04; p=0.063). Conclusion. SARS-CoV-2 vaccination was associated with reduced COVID-19-related mortality risk in hospitalized patients during Delta variant predominance. In later Omicron-dominant waves, COVID-19 mortality risk and vaccination status showed less dependence, and the main cause of mortality were competing events in patients with comorbidity.
Background. The digital transformation of healthcare is a strategic direction for the development of the industry [2], while issues related to the provision of medical care in the new conditions … Background. The digital transformation of healthcare is a strategic direction for the development of the industry [2], while issues related to the provision of medical care in the new conditions of the virtual model and the behavior of patients as consumers and doctors as "providers" of digital medical services remain relevant for study [4, 5]. Objective: to evaluate the perception of telemedicine by patients and doctors living in urban and rural areas as a way of their interaction in providing medical care. Materials and methods. The study was conducted in medical organizations of the Nizhny Novgorod region using a questionnaire survey of patients and doctors based on author's questionnaires. The study involved 507 patients and 202 doctors. Results: Most of the surveyed patients of all groups are ready for remote interaction with a doctor in the process of receiving medical care and believe that telemedicine consultations should develop both in the doctor-patient and doctor-physician directions. However, according to 31.1% ± 4.9% of the urban hospital patient and 25.0% ± 3.0% of CRH patients, telemedicine consultations are possible only in the doctor-to-doctor format. Among parents who bring their children to children's clinics, there were significantly fewer such respondents (15.8% ± 2.7%). As in the patient group, more than half of doctors (57.8% ± 3.5%) believe that telemedicine consultations should develop both in the doctor-patient direction and in the direction of the doctor is a doctor. At the same time, only 5.0% ± 1.5% of doctors consider the doctor-patient referral to be a priority, compared to 27.4% ± 2.0% in the patient group. The chi2 test showed the influence of the age factor on the perception of telemedicine in both the patient group (χ2 = 18.452; p-value = 5.196*10-3) and Conclusions: The data obtained confirm the willingness of patients and doctors, regardless of their place of residence, to use telemedicine. However, when implementing telemedicine, the age factor must be taken into account. At the same time, a group of respondents aged 60 and older expressed greater willingness to digital visits than a group of 40-59-year-olds.
This article examines the economic consequences of mental health problems among workers in high-stress professions. The impact of stress on labor productivity, increased illness rates, employee turnover, and the likelihood … This article examines the economic consequences of mental health problems among workers in high-stress professions. The impact of stress on labor productivity, increased illness rates, employee turnover, and the likelihood of mistakes and accidents is analyzed. The importance of considering employees' mental health to maintain efficiency and reduce economic losses is emphasized. The article highlights the need for implementing measures aimed at improving the psycho-emotional well-being of workers in order to minimize negative consequences and enhance overall labor productivity.
May 9, 2025. Doctor of Medical Sciences, Professor Vladimir Pavlovich Novoselov, an outstanding forensic physician, scientist, health care organizer, honored doctor of the RSFSR, founder of the scientific school, celebrated … May 9, 2025. Doctor of Medical Sciences, Professor Vladimir Pavlovich Novoselov, an outstanding forensic physician, scientist, health care organizer, honored doctor of the RSFSR, founder of the scientific school, celebrated his 80th anniversary. All labor and scientific activity of V.P. Novoselov is connected with forensic medicine.
Results of dissertational researches and scientific researches are traditionally referred to the main sources for improving the quality and level of forensic medical examinations. Objective. To analyze the results of … Results of dissertational researches and scientific researches are traditionally referred to the main sources for improving the quality and level of forensic medical examinations. Objective. To analyze the results of dissertational researches, completed by degree candidates in the «Forensic Medicine» specialty over a 15-year period (2009—2023), devoted to the analysis of medical errors in cases of improper healthcare delivery. Material and methods. An analysis of 16 works (4 doctoral and 12 PhD dissertations), published on the official websites of medical universities and the Russian Center of Forensic Medical Expertise, was done. Sampling methods of bibliometric and scientometric analyses were used. Results. Over a 15-year period, all authors published 379 articles, of which 21 (5.5%) were published in the «Forensic Medical Expertise» journal, 27 (7.1%) — in the «Medical Expertise and Law» journal, the overwhelming majority of articles were published in various medical subject collections, materials of research and practice conferences, congresses, including in 49 peer-reviewed medical journals recommended by the State Commission for Academic Degrees and Titles of the Ministry of Education and Science of the Russian Federation. Conclusion. Expert panel evidences on the «medical» cases indicate the need to expand and further develop joint scientific studies in such clinical disciplines as: «obstetrics and gynecology», «anesthesiology and resuscitation», «pediatric surgery», «oncology», «neonatology», «cardiology», «dentistry», «maxillofacial surgery», etc.
April 25, 2025 is the 80th anniversary of the birth of Georgy Pavlovich Juvaliakov, Professor of the Department of Forensic Medicine of Astrakhan State Medical University, candidate of medical sciences, … April 25, 2025 is the 80th anniversary of the birth of Georgy Pavlovich Juvaliakov, Professor of the Department of Forensic Medicine of Astrakhan State Medical University, candidate of medical sciences, associate professor.
| Russian Journal of Archive of Pathology
On April 17, 2025 on the 76th year of life the outstanding scientist, teacher and health care organizer, professor, academician of RAMS and RAS Mikhail Alexandrovich Paltsev passed away. On April 17, 2025 on the 76th year of life the outstanding scientist, teacher and health care organizer, professor, academician of RAMS and RAS Mikhail Alexandrovich Paltsev passed away.
Objective. To compare the structure of causes of death among men and women of different age groups in 2019 and 2023 (using the Moscow Region as an example). Material and … Objective. To compare the structure of causes of death among men and women of different age groups in 2019 and 2023 (using the Moscow Region as an example). Material and methods. Anonymized personalized data from medical death certificates (MDC) of the database of the Main Civil Registry Office in the Moscow Region. A total of 87.555 MDCs in 2019 and 92.182 in 2023 of persons aged 18 years and older. The absolute number of deaths (total and in ten-year age groups), the contribution of disease classes according to ICD-10 were determined, a comparison of unstandardized mortality rates (UR) and the structure of causes of death was carried out. Results. The mortality rate for men (18 years and older) was 1499 per 100.000 men in 2019 and 1434 in 2023; for women — 1367 and 1344, respectively. The UR of men is higher than that of women up to the age of 80, with the greatest differences at the age of 18—39 years. An increase in the number of deaths, UR and contribution to the mortality structure in men and women was noted for 5 ICD classes (E, J, K, N and S-T in men); a decrease was found for class F, for women — for 2 classes (G and R). The most significant differences in the UR and structure of causes of death in men and women are associated with four classes (S-T, J, E and G). The smallest changes were recorded for the class of neoplasms (about 15% of deaths in both men and women in 2019 and in 2023). A high proportion of poorly defined codes was noted (for example, more than 80% in the class of nervous diseases are accounted for by 3 codes G31.1, G93.0 and G93.4). The differences and changes identified in the structure of causes of death in 10-year age groups of men and women are likely largely due to controversial issues regarding the determination of the underlying cause of death. Conclusion. Mortality reduction strategies should take into account age-sex characteristics of causes of death. Significant changes in UR from individual causes and a sharp increase in the proportion of deaths with codes that have no clinical analogues in old age require improvement of approaches to indicating and coding causes of death.
Ultrasound images of the heart are an important source of diagnostic information for the detection of cardiovascular diseases. Today, automated processing and analysis of such images are actively studied in … Ultrasound images of the heart are an important source of diagnostic information for the detection of cardiovascular diseases. Today, automated processing and analysis of such images are actively studied in the fields of telemedicine, digital medical image processing, and artificial intelligence, in particular, to accelerate and accurately diagnose cardiac pathologies. This paper considers a new approach to processing echocardiographic data, which involves converting ultrasound videos or series of images into color phase space projections. This allows you to create informative visual representations suitable for analysis using deep convolutional neural networks. This approach has two key advantages: [1] it provides the ability to use modern deep learning architectures for the recognition of cardiac pathologies, [2] it allows the use of transfer learning techniques, which significantly increases the efficiency of the model even on small data sets.
Сердечно-сосудистые и цереброваскулярные заболевания остаются одной из ведущих причин инвалидизации и смертности во всем мире. При этом спектр и течение этих заболеваний у мужчин и женщин имеют существенные различия, обусловленные … Сердечно-сосудистые и цереброваскулярные заболевания остаются одной из ведущих причин инвалидизации и смертности во всем мире. При этом спектр и течение этих заболеваний у мужчин и женщин имеют существенные различия, обусловленные биологическими, гормональными и социальными факторами. Женщины особенно уязвимы к сосудистым поражениям в определенные периоды жизни, такие как беременность, менопауза, а также менструальный цикл, что связано с колебаниями уровня половых гормонов. Помимо общих факторов риска, таких как артериальная гипертензия, сахарный диабет и ожирение, существуют специфические «женские» факторы, включающие гестационные осложнения (преэклампсия, гестационный диабет) и прием оральных контрацептивов. В данной статье авторы проводят анализ современных литературных данных, посвященных гендерным особенностям патогенеза и прогноза цереброваскулярных заболеваний, вторичных по отношению к кардиальной патологии. Особое внимание уделено механизмам развития инсультов и других сосудистых событий у женщин в разные периоды жизни, включая репродуктивный возраст, беременность и постменопаузу. Рассматривается влияние эстрогенов на сосудистую стенку, роль аутоиммунных процессов и специфических женских факторов риска. Приведены данные о различиях в клинических проявлениях, эффективности терапии и отдаленных исходах цереброваскулярных заболеваний у женщин по сравнению с мужчинами. Исследование подчеркивает необходимость учета гендерных особенностей при разработке профилактических и лечебных стратегий для снижения риска сердечно-сосудистых и цереброваскулярных осложнений у женщин. Cardiovascular and cerebrovascular diseases remain one of the leading causes of disability and mortality worldwide. At the same time, the spectrum and course of these diseases in men and women have significant differences due to biological, hormonal and social factors. Women are especially vulnerable to vascular lesions during certain periods of life, such as pregnancy, menopause, and the menstrual cycle, which is associated with fluctuations in the level of sex hormones. In addition to general risk factors such as hypertension, diabetes mellitus and obesity, there are specific "female" factors, including gestational complications (preeclampsia, gestational diabetes) and the use of oral contraceptives. In this article, the authors analyze modern literary data on gender-specific features of the pathogenesis and prognosis of cerebrovascular diseases secondary to cardiac pathology. Particular attention is paid to the mechanisms of stroke and other vascular events in women at different periods of life, including reproductive age, pregnancy and postmenopause. The effect of estrogens on the vascular wall, the role of autoimmune processes and specific female risk factors are considered. Data on differences in clinical manifestations, therapy effectiveness and long-term outcomes of cerebrovascular diseases in women compared to men are presented. The study emphasizes the need to take into account gender characteristics when elaborating preventive and therapeutic strategies to reduce the risk of cardiovascular and cerebrovascular complications in women.
Increasing the availability and quality of medical care provided to the population of hard-to-reach areas in the territory of the Russian Federation is one of the main directions of state … Increasing the availability and quality of medical care provided to the population of hard-to-reach areas in the territory of the Russian Federation is one of the main directions of state policy. Today, measures are being taken to improve the efficiency of the healthcare system, namely: regulation of pricing for drugs from the list of vital and essential drugs, for residents of hard-to-reach areas, measures are being taken to improve the quality and availability of drug provision. These innovations became possible largely due to the fact that since 2010, the number of persons retailing pharmaceutical products began to include medical specialists of separate divisions of medical organizations (outpatient clinics, feldsher and feldsher-obstetric stations, centers (departments) of general medical (family) practice, since 2024 district hospitals. This also caused a number of difficulties. These include providing medical outpatient clinics and feldsher-midwife stations with equipment, selecting an optimal list of drugs that meet the nature of the disease, demographic situation and financial capabilities of residents of rural settlements. It is also necessary to take into account the requirements for medical organizations to obtain a license. Given the relevance of the topic under consideration, the purpose of the research is to analyze the problem of supplying medicines to the population of remote areas of the Volgograd Region, as well as to develop ways to improve the availability of medicines in such areas. The necessity and possibility of improving the availability of drug care by developing additional measures and opportunities for licensing pharmaceutical activities for both separate divisions of medical organizations and pharmaceutical organizations of other forms of ownership located in sparsely populated, hard-to-reach areas of the region are shown. Taking into account the identified problems and further ways to solve them, a work plan was formed for both health care authorities and individual pharmaceutical and medical organizations of the Volgograd Region.
Analysis of factors influencing the work of the dental service is of crucial importance for any organization, since it affects the organization's desire to improve the provision of services and … Analysis of factors influencing the work of the dental service is of crucial importance for any organization, since it affects the organization's desire to improve the provision of services and job satisfaction by both the doctors themselves and patients. The purpose of the study was aimed at studying the activities of organizations in the Rostov region providing dental services, taking into account the types of dental care, visits, specifics of the services provided, indicators of preventive work for the period from 2018 to 2023. The data for the analysis of the work were taken from statistical form No. 30 "Information about the medical organization" of the Rostov region and a market review of the dental service of the Rostov region for 2018-2023. Results. In the districts of the Rostov region, mixed reception for the provision of dental care is significantly developed, when doctors combine therapeutic interventions with surgical care.
Organization of medical care for women during pregnancy, women in labor, and women who have given birth at 22 weeks or more requires compliance with special sanitary and hygienic standards. … Organization of medical care for women during pregnancy, women in labor, and women who have given birth at 22 weeks or more requires compliance with special sanitary and hygienic standards. Research objectives: to study the conditions in maternity hospitals to optimize the work of the sanitary and epidemiological service for women in labor. Materials and methods: the research work carried out at the Institute of Medicine, the Center for Disease Prevention and State Sanitary and Epidemiological Surveillance. Research results: obtained results helped to develop optimal strategies for organizing the work of the sanitary and epidemiological service, helping to reduce the risk of spreading infections and increase the overall level of safety for patients and medical personnel. It was clarified that conditions in the maternity hospitals and premises does not meet all requirements of sanitary and hygienic standards.
The rapid development of medical science and healthcare practice, the digital transformation of medicine, the need to improve the quality of medical care, and the ongoing modernization of education have … The rapid development of medical science and healthcare practice, the digital transformation of medicine, the need to improve the quality of medical care, and the ongoing modernization of education have been the basis for scientific research and the introduction of the accreditation procedure for healthcare professionals since 2016. The article examines the stages, features of training graduates of medical educational organizations for primary accreditation in order to provide personnel for the healthcare industry, problems and the role of accreditation in the formation of professional competencies of middle-level specialists. The issues of simulation technologies are touched upon — training based on simulation, using modern modeling systems — medical phantoms, simulators and mannequins, the main task of which is to create clinical situations as close as possible to real ones. Simulation training is considered as a kind of modern technology for training highly qualified specialists aimed at developing professional competence among specialists in the medical field. The main advantages of the simulation approach of college education are identified: the development and improvement of practical skills, the formation of communication skills, principles and skills of teamwork. Over the past three years, the preparation of accreditation sites at the Orenburg Medical College, a structural unit of the Orenburg Institute of Railways, a branch of the Volga State University of Railways (hereinafter referred to as OMK OrIPS, a branch of PrivGUPS) has undergone significant changes. The features of the preparation of accreditation sites for accreditation, as well as the results of the primary accreditation of graduates for 3 years at Orenburg Medical College, are presented. The reasons why students of the 4th year actively refuse to undergo accreditation are outlined. The causes of this phenomenon are diverse and require careful analysis.
A szívelégtelenség jelenleg világszerte több mint 23 millió embert érintő népbetegség, amelynek prevalenciája a népesség elöregedése következtében a fejlődő terápiás lehetőségek ellenére évről évre növekszik. Kutatásunk arra keresi a választ, … A szívelégtelenség jelenleg világszerte több mint 23 millió embert érintő népbetegség, amelynek prevalenciája a népesség elöregedése következtében a fejlődő terápiás lehetőségek ellenére évről évre növekszik. Kutatásunk arra keresi a választ, hogy a szívelégtelen betegek körében jellemzően prevalens társbetegségek előfordulása hogyan változik az elemzett betegpopulációban, illetve ezek a betegségek milyen mértékben járulnak hozzá a szívelégtelenség kialakulásához. Elemzéseink alapját a járóbeteg szakellátási és kórházi igénybevételek és a társadalombiztosítási azonosító jellel rendelkező lakosság demográfiai adatállománya (TAJ-törzs) képezte. A különböző adatbázisokat összekapcsolva a demográfiai jellemzők meghatározása mellett főként trendelemzést és többváltozós logisztikus regressziós elemzéseket végeztünk a 40-79 éves korcsoportba tartozó, 2012 és 2020 között szívelégtelenséggel diagnosztizált betegek adatain. A magyarországi szívelégtelen populáció erősen multimorbid, egészségük romlásában több betegség egyszerre játszik szerepet. A szívelégtelenség kialakulásának esélye a megelőző évben akut miokardiális infarktus diagnózissal rendelkező betegek esetében volt a legmagasabb (9,247). A kardiomiopátia 7,377-szeres, hipertónia 4,127-szeres, COPD 3,070-szoros, veseelégtelenség 2,839-szeres, ischaemiás szívbetegség 2,836-szeres, pitvarfibrilláció 2,731-szeres, szívritmuszavar 2,151-szeres és diabétesz 1,507-szeres kockázatot jelent a szívelégtelenség kialakulására. Az ismert kockázati tényezők az adminisztratív adatok elemzése alapján is kockázati tényezőknek minősülnek. Mindezek felhívják a figyelmet a prevenció és a szűrővizsgálatok fontosságára, azért, hogy az érintett betegeknél még a szívelégtelenség kialakulása előtt, vagy annak korai stádiumában el tudják kezdeni a kezelést, ezáltal kedvezőbb egészségnyereséget érjenek el. Tudomásunk szerint közel 10 évet és majdnem 200,000 hazai beteget feldolgozó tanulmány ebben a témában még nem jelent meg. Tanulmányunk megerősítette az eddigi vizsgálatok eredményeit a szívelégtelenség rizikófaktorainak és társbetegségeinek vonatkozásában. Emellett a logisztikus regressziós eredmények alapján súlyoztuk a rizikófaktorokat, melyek kijelölik a prevenciós lépések sorrendjét is.
The demand for specialists with profound knowledge in the subject areas of both the medical profile and information technology has led to a significant increase in the number of universities … The demand for specialists with profound knowledge in the subject areas of both the medical profile and information technology has led to a significant increase in the number of universities implementing the educational program 30.05.03 — "Medical Cybernetics", and became the reason for the need to assess the situation with the training of students in this specialty. The aim of this work is to analyze the structure and subject content of the educational program 30.05.03 — "Medical Cybernetics" in universities of the Russian Federation. Materials and methods. Information presented on the official websites of universities and aggregator websites for applicants; documents regulating the educational process for specialty 30.05.03 "Medical Cybernetics". Results. The analysis of the main aspects of educational programs for specialty 30.05.03 "Medical Cybernetics" in ten universities of the Russian Federation showed their compliance with the general requirements of the Federal State Educational Standard for this specialty, with significant differences in approaches to subject content. Conclusion: Compliance of educational programs only with the formal requirements of the Federal State Educational Standard concerning their overall volume, structure and number of professional competencies does not guarantee that graduates meet the requirements of the professional standard "Cyberneticist". Clear criteria for acceptable differences in the subject content of the educational program are needed.
The integration of Artificial Intelligence (AI) into education and healthcare systems has gained significant momentum in recent years, with the potential to revolutionize both sectors by enhancing efficiency, accessibility, and … The integration of Artificial Intelligence (AI) into education and healthcare systems has gained significant momentum in recent years, with the potential to revolutionize both sectors by enhancing efficiency, accessibility, and outcomes. This chapter explores the multidisciplinary approaches to AI integration, focusing on how collaboration across fields such as data science, psychology, social sciences, and policy-making can ensure the successful deployment of AI technologies.. It examines the transformative role of AI in personalized learning, administrative automation, diagnostic support, and telemedicine, while also addressing the challenges faced in data privacy, system interoperability, and resistance to adoption. Finally, the chapter emphasizes the societal impacts of AI adoption, urging continuous learning, ethical practices, and stakeholder involvement to ensure that AI serves to improve the quality of life globally in both educational and healthcare contexts.
Introduction: Quality health services is a priority in thehealth system. However, after the outbreak of the COVID-19 pandemic, the goals of the health system had tobe adapted to the changed … Introduction: Quality health services is a priority in thehealth system. However, after the outbreak of the COVID-19 pandemic, the goals of the health system had tobe adapted to the changed circumstances, in order tomeet the health needs of patients and the expectationsof health workers related to ensuring safe working conditionsin a crisis.Aim: To examine the attitudes and opinions of patientson the quality of services provided during treatment forthe infection of COVID-19Research material and methods: The study includedpatients aged 18 and over at the Sarajevo Canton HealthCenter who were infected with the COVID-19 virus in thesecond (autumn 2020) and third (spring 2021) waves ofthe pandemic and who used primary health care servicesduring their treatment. To conduct the research, we surveyed a total of 524 patients in the period from15 September 2022 – 30 November 2022.Results: By the recommendations of the Crisis Staff ofthe Ministry of Health and the rules of the profession,the majority of respondents contacted the doctor onthe third day after the onset of symptoms, 193 of them(36.8%). During the second and third wave, the majorityof patients, 287 (54.8%) believed that there were nohealth workers during that period who did not behaveprofessionally during the treatment. During treatmentand visits to healthcare institutions, 72 (13.7%) patientsfelt that they always felt that healthcare professionalstreated them differently. During treatment for COVID-19, 78 (14.89%) patients believed that there werealways enough health workers during their treatment.Conclusion: a large number of respondents think thatthe healthcare professionals treated them professionallyduring the treatment, and that they had enough informationabout the situation, and that they acted in accordancewith the instructions published by the profession.
The article discusses the process of development and approval of the first Code of Ethics of Artificial Intelligence (AI) application in the Russian Federation Healthcare. Against the backdrop of the … The article discusses the process of development and approval of the first Code of Ethics of Artificial Intelligence (AI) application in the Russian Federation Healthcare. Against the backdrop of the active integration of AI technologies into medical practice (39 relevant medical devices have been registered), the emphasis is placed on the importance of establishing ethical standards that ensure the protection of patients' rights, increasing trust in technologies, and standardization processes. International approaches to AI ethics in healthcare (EU, USA, UK, Canada, Australia, China, India) are analyzed and the need to harmonize the domestic code with international initiatives is outlined. The stages of development of the document, in which employees of specialized departments of the Ministry of Health of Russia, chief freelance specialists and experts took part, as well as the structure and main provisions of the approved version of the Code are presented. The key principles emphasized include transparency, confidentiality, fairness, limited autonomy, oversight, and accountability of AI systems. The final version of the document was published in March 2025 on the Unified State Information System in Healthcare (EGISZ) portal after approval by the Interdepartmental Working Group under the Russian Ministry of Health. The Code is intended to serve as a foundation for the sustainable and safe implementation of AI in Russia's healthcare system.
Introduction and Objective: Diabetic eye disease can lead to blindness, yet only 50% of people with diabetes report having an eye exam for diabetes (EED). FDA-cleared autonomous AI solutions are … Introduction and Objective: Diabetic eye disease can lead to blindness, yet only 50% of people with diabetes report having an eye exam for diabetes (EED). FDA-cleared autonomous AI solutions are emerging as a point-of-care option for the EED. We assessed health care professional (HCP) (provider and operator) and, separately, patient perspectives about using autonomous AI for EED (LumineticsCore, Digital Diagnostics Inc, Coralville, IA), at Zufall Health Center (ZHC), a FQHC. Methods: Surveys were anonymously completed by HCPs immediately prior to implementation of autonomous AI for EED (April 2021) and again afterwards (August 2023); patient surveys were anonymously completed between May 2022 and June 2023 immediately following an autonomous AI EED. Pre/Post descriptive statistics were generated. Results: 13/13 HCPs completed surveys prior to implementation and 8/17 completed surveys following implementation; 131/519 patients completed surveys, a 25.2% response rate. Prior to implementation HCPs cited time (46.2%), space (61.5%), and additional workload (30.8%) as expected common challenges in adoption. Following implementation, 87.5% of HCPs “strongly agreed” with recommending autonomous AI EED as a routine part of diabetes care. 46/131 (35.1%) of patients reported having never received an annual EED prior to the autonomous AI. The majority of patients, 115/127 (90.6%), “agreed” or “strongly agreed” with the statement “Overall, I am very satisfied with the autonomous AI EED I received.” Conclusion: Despite EEDs being an evidence-based recommendation (American Diabetes Association and American Academy of Ophthalmology) and a quality measure (National Committee for Quality Assurance), more than a third of ZHC patients reported never having received an EED. Integrating an autonomous AI for EED at point-of-care can ensure increased access, reducing the risk of vision loss in underserved populations. Disclosure M. Castro: None. D. Bishop: None. D. Weitzman: Employee; Digital Diagnostics. R. Ramirez: None.
Introduction and Objective: Comorbid non-insulin dependent diabetes mellitus (NIDDM) and stroke significantly contribute to mortality among older adults. This study examines age-adjusted mortality rates (AAMRs) and disparities by demographics, region, … Introduction and Objective: Comorbid non-insulin dependent diabetes mellitus (NIDDM) and stroke significantly contribute to mortality among older adults. This study examines age-adjusted mortality rates (AAMRs) and disparities by demographics, region, and age groups to identify trends throughout the period. Methods: Mortality data from CDC records for 55-85+ years were analyzed. AAMRs per 100,000 and annual percentage changes (APCs) with 95% confidence intervals (CIs) were calculated using Joinpoint Regression. Results: Between 1999 and 2022, 209,001 deaths among adults aged 55-85+ were attributed to comorbid NIDDM and stroke, with women accounting for 111,481 and men 97,520 deaths. Urban-rural disparities revealed distinct patterns, with a marked increase in metropolitan areas post-2014. Racial disparities were pronounced, particularly among people of Asian/Pacific Island, with a steep increase post-2018. Age-stratified analysis showed a significant increase in mortality rates for ages 55-64 and 85+ from 2015 onwards compared to 1999-2014. Regional trends highlighted the West as having the highest AAMR, while the Northeast exhibited the lowest. Conclusion: Increasing mortality from comorbid NIDDM and stroke underscores increasing disparities across gender, race, age groups, and region. Targeted interventions are needed to mitigate these inequities. Disclosure S.Z. Ali: None. A. Qadeer: None. S. Khan: None. M. Waqas: None. M. Khawar: None. M. Raza: None. H. Asif: None. M. Kakakhel: None. S. Zain: None. M.Z. Haider: None. M. Aamir: None. R. Alcaraz: None. S.B. Dugani: None. R.W. Kirchoff: None.
Introduction and Objective: AI-based retinal imaging is highly sensitive in detecting diabetic retinopathy (DR). However, follow-up adherence, referral efficiency, and ophthalmologist availability remain key challenges for disease monitoring and treatment … Introduction and Objective: AI-based retinal imaging is highly sensitive in detecting diabetic retinopathy (DR). However, follow-up adherence, referral efficiency, and ophthalmologist availability remain key challenges for disease monitoring and treatment access. This project examines the impact that AI-based DR screening has on ophthalmology follow-up rates within a three month time frame for patients with more-than-mild diabetic retinopathy (MTMDR), compared to traditional tele-retinal screening. Methods: Previously (2018-2021), point-of-care DR screening at the Utah Diabetes and Endocrinology Center at the University of Utah utilized a traditional tele-retinal protocol, where clinic-acquired images were transmitted for off-site interpretation by a retina specialist. The lag time from photo acquisition to patient notification of findings was 10 days on average. In May 2021, our clinic began using the AI-based DR screening program EyeArt, which provides immediate interpretation following photo-acquisition. A retrospective review of adults with T1D or T2D and MTMDR on screening compared the follow-up rates of traditional tele-retinal versus AI-based DR screening processes. Results: Among the 357 patients screened traditionally, 12% (n=42) had MTMDR, with 38% (n=16) completing in-person ophthalmology evaluation within three months. Since implementation of AI based screening in 2021, 584 patients have undergone screening, with 25% (n=144) found to have MTMDR, 51% (n=73) of whom completed in-person ophthalmology follow-up within three months. Conclusion: AI-based screening resulted in improved adherence to successful ophthalmology follow-up ophthalmology within three months following a positive screening test as compared to a traditional tele-retinal process. Immediate results and streamlined referrals likely contributed to improved follow-up adherence. However, significant barriers to ophthalmology engagement persist following a positive DR screening. Disclosure C. Watson: None. F.A. Aljabrain: None. M. Wahl: None.
The issue of training specialists in therapy and rehabilitation is especially relevant in today’s realities, as the demand for professional specialists in this cluster of medicine is constantly growing. Higher … The issue of training specialists in therapy and rehabilitation is especially relevant in today’s realities, as the demand for professional specialists in this cluster of medicine is constantly growing. Higher medical education institutions are faced with the need to quickly streamline the teaching and methodological arsenal to meet the standards of the educational and professional program. The purpose of the scientific research is to highlight the specifics of organizational and methodological support of the educational process for students majoring in «Therapy and Rehabilitation». The objectives of the study are to find a balance between traditional and innovative dimensions of teaching and learning support in the modern paradigm of higher medical education. The methodology used in writing the article is focused on the general scientific methodological segment. The analytical dimension has formed the dominant methodological approach, providing generalization of the data obtained and comparison within the educational process in a higher medical education institution. The elaboration of prospects for thedevelopment of educational and scientific activity involves the application of the scientific and philosophical principle of synergy. The results of the study indicate a gradual transformation of the matrix of competencies in theoretical disciplines taught to rehabilitation therapists. The traditional dominance of fundamental skills is losing its relevance due to the dynamism of socio- cultural changes that radically alter the understanding of the principles of treatment and recovery. The biopsychosocial model of therapeutic and rehabilitation activity necessitates new knowledge and skills that are formed when studying the theoretical cluster of the educational program. Soft-skills, live-skills, digital- skills are the usual list of professional competencies of a modern rehabilitation therapist. Disciplines of theoretical profile become an educational space in which a higher education student forms the necessary arsenal of knowledge, skills and abilities. Prospects for the study are the development of interdisciplinary programs that will integrate the potential of several related disciplines, forming universal competencies. The experience of egrotherapy has demonstrated the eъectiveness of using interdisciplinarity in the practical segment of training. The interdisciplinary paradigm in theoretical training is relevant for the therapy and rehabilitation cluster. Thus, the organizational and methodological support of teaching theoretical disciplines to students majoring in «Therapy and Rehabilitation» is constantly changing under the influence of socio- cultural factors. The biopsychosocial model of the medical paradigm of our time provides for the expansion of the competencies of a therapist- rehabilitator, which necessitates the acquisition of flexibility and versatility of professional skills
Aims: Warfarin is approved for the prevention and/or treatment of venous thrombosis, pulmonary embolism, and thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement. international normalized ratio (INR) above … Aims: Warfarin is approved for the prevention and/or treatment of venous thrombosis, pulmonary embolism, and thromboembolic complications associated with atrial fibrillation and/or cardiac valve replacement. international normalized ratio (INR) above the therapeutic range increases the risk of bleeding, its level below the therapeutic range increases the risk of thromboembolic complications. We aimed to evaluate the effect of patients' INR levels on one-month and one-year mortality. Methods: The hospital's electronic information management system retrospectively screened between 01.01.2015, and 31.12.2016. Patients who applied to the emergency department (ED) with a history of warfarin use, were included in the study. The receiver operating characteristics (ROC) analysis and the area under the curve (AUC) for the mortality estimation calculations were used for statistical analysis. Results: Total of 1299 patients with elevated INR due to warfarin use were included in the study. The major ED admission causes were bleeding (n = 338, 26.02%) and INR control with no other complaint (n = 56, 4.31%). Mortality was observed within one month in 118 (9.1%) patients and within one year in 292 (22.5%) patients. The ROC analysis for 1-month and 1-year mortality estimation, AUC values for age, INR, urea, and creatinine were 0.640, 0.549, 0.702, 0.629 and 0.629, 0.532, 0.671, 0.608, respectively. Conclusion: The patients admitted to ED due to high INR values are usually corrected their INR values and then discharged. These patients’ one-year mortality is high so to identify and eliminate the underlying cause of the INR elevation is important.
Objective. To study the dynamics of the level of the diagnostic marker D–dimer to characterize the course of COVID–19 and early diagnosis of thromboembolic complications in patients with long bone … Objective. To study the dynamics of the level of the diagnostic marker D–dimer to characterize the course of COVID–19 and early diagnosis of thromboembolic complications in patients with long bone fractures. Materials and methods. To fulfill the objectives of the study, a retrospective array of 289 patients with skeletal fractures treated at the Kyiv City Clinical Emergency Hospital from March 2020 to February 2021 was formed. The main group included 157 patients with skeletal fractures in the setting of COVID–19, and the control group included 132 patients with skeletal fractures without COVID–19. Results. On the 1st day of treatment, 45.9% of patients in the main group had high levels of D–dimer, while among patients in the control group such results were recorded more than 4 times less often. Extremely high levels of D–dimer were observed in 26.0% of patients in the main group, and no such patients were found in the control group. On the 3rd day of treatment, 53.5% of patients in the main group had high levels of D–dimer, which was 5.5 times more frequent than in the control group. Extremely high levels of D–dimer were observed in 26.7% of patients in the main group and were not observed in the control group. On the 10th day of treatment, normal and subnormal levels of D–dimer were detected in 44.0% of patients in the main group, but this is more than twice as rare as in the control group. High levels of D–dimer were found in 49.0% of patients in the main group and only 3.0% of patients in the control group. Conclusions. Initial levels of D–dimer have a prognostic value for detecting thromboembolic complications at the earliest possible time. Peak D–dimer values are determined on day 3 of treatment and tend to decrease on day 10. High levels of D–dimer in patients with long bone fractures in the setting of COVID–19 have the value of an unfavorable prognostic factor, but this thesis requires additional research.
Background: Artificial intelligence (AI) has made significant advances in nephrology, revolutionizing the diagnosis, prognosis, and treatment of kidney diseases. Summary: This review provides an overview of AI applications in nephrology, … Background: Artificial intelligence (AI) has made significant advances in nephrology, revolutionizing the diagnosis, prognosis, and treatment of kidney diseases. Summary: This review provides an overview of AI applications in nephrology, introducing the basic structures of each model, highlighting both traditional machine learning approaches and neural networks, and providing model application comparisons along with selection recommendations. It discussed key challenges in deciding appropriate AI models for specific tasks and evaluated their advantages, limitations, and optimal use cases. Current applications of AI in nephrology mainly include diagnosis and disease outcome prediction, medical image analysis, treatment recommendations, and personalized health management, supported by massive electronic health records and multimodal data integration. Traditional machine learning models perform well on datasets of varying sizes and structures, while neural networks excel at handling complex and imaging data. Emerging hardware innovations are expected to improve the performance of neural network models, enabling more accurate diagnosis and automated analysis in clinical practice. In the future, AI will have great potential to advance individualized patient care and enable real-time data processing in nephrology. Key messages: An overview of AI applications in nephrology is provided in this review.