Georgian Medical Journal (GMJ)
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Influence of Tskaltubo Low-Radon Nitrogen Mineral Baths on Erythrocyte Biophysical Parameters and Microcirculation in Osteoarthritis: A Prospective Clinical Study
No full textBackground:Osteoarthritis (OA) is a leading cause of disability worldwide and is increasingly recognized as a multifactorial disease involving inflammatory, metabolic, biomechanical, and microvascular mechanisms [1–4]. Emerging evidence suggests that hemorheological disturbances, including impaired erythrocyte membrane stability and increased aggregation, may contribute to tissue hypoxia and disease progression [8–10].
Objective:To evaluate changes in erythrocyte biophysical parameters in patients with osteoarthritis undergoing a standardized course of Tskaltubo low-radon nitrogen mineral baths and to explore their potential role in improving microcirculatory function during rehabilitation.
Methods:This prospective observational clinical study included 165 patients with radiographically confirmed osteoarthritis (Kellgren–Lawrence stages I–IV; mean age 58.4 ± 6.7 years). Participants underwent 22–25 flow-through isothermal mineral baths (34–35 °C; 20 minutes per session). Erythrocyte count, hemoglobin concentration, ultrasonic resistance time (T), electrokinetic potential (EKP), and aggregation activity (AAE) were measured before and after treatment. Ten age-matched healthy individuals served as controls. Statistical analysis included paired t-tests, one-way ANOVA, Pearson correlation analysis, and effect size estimation with 95% confidence intervals.
Results:At baseline, OA patients demonstrated reduced ultrasonic resistance (mean difference −2.4 min; 95% CI −3.6 to −1.2; p = 0.021), decreased electrokinetic potential (mean difference −3.1 mV; 95% CI −4.9 to −1.2; p = 0.008), and increased aggregation activity (mean difference +5.4%; 95% CI 2.1–8.7; p = 0.012) compared with controls. Following treatment, electrokinetic potential increased significantly (mean difference 2.3 mV; 95% CI 0.8–3.8; p = 0.006), corresponding to an 18.4% relative increase. Ultrasonic resistance increased by 14.7% (p = 0.011), and aggregation activity decreased by 16.2% (p = 0.004). Improvements were more pronounced in patients with synovitis. Changes in electrokinetic potential correlated with pain reduction (r = 0.42; p = 0.018).
Conclusion:Tskaltubo low-radon nitrogen mineral baths were associated with improvements in erythrocyte biophysical parameters in osteoarthritis. These findings suggest that modulation of erythrocyte rheology may represent a clinically relevant physiological pathway contributing to improved microcirculatory function and rehabilitation outcomes. Further randomized controlled studies incorporating molecular biomarkers and long-term follow-up are warranted.
Keywords:Osteoarthritis; Balneotherapy; Radon therapy; Erythrocyte rheology; Microcirculation; Hemorheology; Rehabilitatio
Independent Accountability Panel (IAP): Overview and Role in Global Health Governance: Reference Summary (Text)
No full textThis reference summary presents key information from the following source: https://en.wikipedia.org/wiki/Independent_Accountability_Panel. The source describes the Independent Accountability Panel (IAP) as an independent mechanism established by the United Nations Secretary-General in 2015 to review progress on women’s, children’s and adolescents’ health within the Sustainable Development Goals framework. It explains that the IAP conducts independent assessments of the implementation of the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030), focusing on accountability relationships, including who is accountable, for what, and how accountability is ensured. The Panel consists of internationally recognized experts appointed by the United Nations Secretary-General and operates independently while being hosted by the Partnership for Maternal, Newborn & Child Health at the World Health Organization in Geneva. The source further outlines the accountability framework applied by the IAP, based on four core functions: monitor, review, act, and remedy, and highlights its linkage to earlier accountability mechanisms and principles derived from international human rights law
New Hopes for Accountability for Women, Children, and Adolescent Health (The Lancet, 2016): Reference Summary (Article)
No full textThis reference summary presents key information from the following article: https://doi.org/10.1016/S0140-6736(16)31772-X. The source is a commentary titled “New hopes for accountability for women, children, and adolescent health”, authored by Barroso C, on behalf of the United Nations Secretary-General’s Independent Accountability Panel for Every Woman, Every Child, Every Adolescent (IAP: Nicholas Kojo Alipui, Dame Carol Kidu, Brenda Killen, Elizabeth Mason, Giorgi Pkhakadze, Jovana Ríos Cisnero, Gita Sen, Alicia Ely Yamin, Kul Chandra Gautam, and Joy Phumaphi), and published in The Lancet in 2016. The article discusses emerging opportunities to strengthen accountability mechanisms in global health, particularly in the context of the Sustainable Development Goals (SDGs). It highlights the importance of sustaining political commitment, improving monitoring systems, and reinforcing independent review processes to ensure progress in women’s, children’s, and adolescents’ health. The discussion emphasizes that renewed accountability efforts are essential to translate global commitments into measurable outcomes and to support equitable health improvements across countries
A New Voice in Georgian Medicine: Launching the Georgian Medical Journal (GMJ)
No full textScientific journals play a fundamental role in advancing medical knowledge, informing clinical practice, and strengthening evidence-based health policy. The Georgian Medical Journal (GMJ) was established in 2025 as an independent academic platform designed to strengthen medical research and public health dialogue in Georgia and the wider region. The initiative emerged during discussions among academic leaders and representatives of Georgian medical schools held in Tbilisi during the Autumn Council Meeting of the European Union of Medical Specialists (UEMS) in October 2025. Participants emphasized the need for a modern, internationally oriented medical journal capable of amplifying the scientific voice of Georgian medicine while contributing to global health discourse. Following an initial technical preparation phase of the journal platform, this editorial marks the formal launch of GMJ as a scientific publication. The journal aims to provide an accessible and inclusive publishing platform addressing national, regional, and global health challenges. To encourage participation from researchers and early-career scientists, submission and publication fees will be waived during the journal’s initial years of operation. As the founding editorial of the Georgian Medical Journal, this article outlines the journal’s mission, institutional foundations, and strategic priorities for advancing medical scholarship in Georgia and internationally.
Keywords: medical journals; scientific publishing; public health research; health systems; Georgia; global healt
iERG: Lessons and Messages for the Future (2011–2015) — Reflections on Accountability for Women’s and Children’s Health: Reference Summary (Video)
No full textThis reference summary presents key information from the following video: https://youtu.be/rOgazs3g5Jo. The source is a video published by the Partnership for Maternal, Newborn & Child Health (PMNCH), featuring members of the independent Expert Review Group (iERG) on Information and Accountability for Women’s and Children’s Health. The video captures reflections from iERG members on their four-year mandate (2011–2015), focusing on progress, challenges and the future of accountability in global health. The discussion highlights the importance of data, transparency and governance mechanisms in improving health outcomes for women, children and adolescents. It emphasizes lessons learned in strengthening accountability systems at both national and global levels and outlines priorities for sustaining progress within the broader framework of global health governance and the transition toward the Sustainable Development Goals
Accountability for Action — Partners’ Forum 2018, New Delhi, India (11 January 2019, PMNCH) Plenary 3 Part 1: : Reference Summary (Video)
No full textThis reference summary presents key information from the following presentation: https://youtu.be/s_JFi3zoiSE. The source is a plenary session titled “Plenary 3 Part 1: Accountability for Action”, produced by the Partnership for Maternal, Newborn & Child Health (PMNCH) and published on 11 January 2019. The session focuses on advancing accountability for women’s, children’s and adolescents’ health, emphasizing the transition from data collection to action. It highlights the full accountability cycle of monitoring, review, and remedy, and underscores the importance of measurable targets, disaggregated data to identify populations left behind, and the role of political commitment in driving implementation. The discussion also presents practical examples, including national performance systems and communication tools that support accountability processes
Exploring the Vestibular–Cognitive Axis: A Case–Control Study of BACE1 rs638405 and Cognitive Vulnerability in Vestibular Dysfunction
No full textBackground:Alzheimer’s disease (AD) is a leading cause of cognitive decline worldwide and involves complex interactions between genetic, neurodegenerative, and environmental factors [1–3]. Increasing evidence suggests that vestibular dysfunction contributes to cognitive impairment through disruption of hippocampal-dependent processes [17–20]. β-site amyloid precursor protein cleaving enzyme 1 (BACE1) plays a central role in amyloid-β metabolism and synaptic regulation [8,13]; however, the role of BACE1 genetic variation in vestibular-related cognitive vulnerability remains insufficiently explored.
Objective:To investigate the association between the BACE1 rs638405 polymorphism and vestibular dysfunction, and to evaluate patterns of cognitive impairment across study groups.
Methods:This exploratory case–control study included 108 participants aged 25–80 years: vestibular system dysfunction (VSD) (n = 45), Alzheimer’s disease (AD) (n = 21), and healthy controls (n = 42). Cognitive performance was assessed using standardized neuropsychological instruments [29–31]. Genotyping of the rs638405 polymorphism was performed using TaqMan real-time PCR assays. Genotype distributions were compared using Fisher’s exact test, and crude odds ratios (OR) with 95% confidence intervals (CI) were estimated using logistic regression.
Results:The GG genotype of rs638405 was more frequent in the VSD group compared with controls (24.4% vs 7.1%; p = 0.045; OR = 4.51; 95% CI: 1.04–19.66). This marginal statistical significance should be interpreted with caution given the limited sample size and absence of multiple-testing correction. No statistically significant association was observed between rs638405 and AD. Cognitive impairment was identified in 64% of patients with vestibular dysfunction.
Conclusion:These findings suggest a preliminary genetic signal linking BACE1 variation to cognitive vulnerability in vestibular dysfunction, supporting the concept of a vestibular–cognitive axis. However, given the modest sample size, borderline statistical significance, and lack of adjustment for multiple comparisons, the results should be interpreted as exploratory and require confirmation in larger, multi-center studies with comprehensive genetic profiling and adjusted analyses.
Keywords:BACE1; rs638405; vestibular dysfunction; cognitive impairment; Alzheimer’s disease; genetic polymorphis
Cardiovascular Screening in Pediatric Athletes: Prevalence, Risk Stratification, and Public Health Implications from a Georgian Population Cohort
No full textBackground: Sudden cardiac death (SCD) in children and adolescents is a rare but catastrophic event with substantial societal and public health implications. A significant proportion of exercise-related SCD cases are attributable to previously undiagnosed structural or electrical cardiac abnormalities detectable through systematic screening [1–4]. Despite ongoing international debate regarding optimal screening models, region-specific epidemiological data remain limited in Eastern Europe and the Caucasus.
Objective: To determine the prevalence, clinical spectrum, and risk stratification profile of cardiovascular abnormalities identified during structured preparticipation screening of pediatric athletes in Adjara, Georgia, and to evaluate implications for national sports safety policy.
Methods: A population-based cross-sectional study was conducted in 2025 including 442 competitive athletes aged 7–18 years. All participants underwent standardized cardiovascular evaluation comprising structured medical history, physical examination, 12-lead electrocardiography interpreted according to contemporary international criteria, transthoracic echocardiography, and anthropometric assessment. Cardiovascular abnormalities were categorized into low-, intermediate-, and high-risk groups for SCD. Prevalence estimates were calculated with exact 95% confidence intervals (CI).
Results: Cardiovascular abnormalities were identified in 58 athletes (13.1%; 95% CI 10.1–16.6%). High-risk conditions were detected in 2 athletes (0.45%; 95% CI 0.05–1.6%), including one case of hypertrophic cardiomyopathy and one case of Wolff–Parkinson–White syndrome. The majority of abnormalities consisted of low-risk structural valvular findings. The number needed to screen to detect one high-risk condition was 221 athletes.
Conclusion: Systematic preparticipation cardiovascular screening in pediatric athletes reveals a measurable burden of clinically relevant structural and electrical abnormalities, including a small but significant proportion of high-risk conditions associated with exercise-related sudden cardiac events. The observed prevalence and detection yield are consistent with established international screening cohorts, suggesting comparable epidemiological patterns across diverse health system contexts.
While cross-sectional data do not permit inference regarding mortality reduction, these findings provide region-specific parameters necessary for proportional evaluation of screening strategies within organized youth sports. In emerging sports systems, such evidence supports informed and context-sensitive consideration of structured cardiovascular assessment frameworks aligned with available infrastructure and risk calibration.
Keywords: pediatric athletes; sudden cardiac death; cardiovascular screening; electrocardiography; echocardiography; risk stratification; public health polic
Universal Health Coverage: Accountability to Ensure Health for All — UN High-Level Event (2019): Reference Summary (Video)
No full textThis reference summary presents key information from the following presentation: https://webtv.un.org/en/asset/k11/k117zc1h47. The source is a United Nations Web TV recording titled “Universal Health Coverage: Accountability to Ensure Health for All,” held on 23 September 2019 during the High-Level Week of the 74th session of the United Nations General Assembly at United Nations Headquarters in New York. The event focuses on the role of accountability in advancing universal health coverage (UHC), emphasizing the need for governments and stakeholders to deliver on commitments to ensure equitable access to health services. The discussion highlights accountability as a central mechanism for achieving Sustainable Development Goal 3 and strengthening health systems, particularly in ensuring that no population is left behind. The event includes contributions from global leaders, policymakers and international organizations, reinforcing the importance of governance, monitoring and responsibility in achieving UH
Accountability for Adolescents — Advancing Rights-Based Approaches in Global Health (IAP / PMNCH, 2017): Reference Summary (Video)
No full textThis reference summary presents key information from the following video: https://youtu.be/Hbxs_AvYLr8. The source is a discussion presented by the Partnership for Maternal, Newborn & Child Health (PMNCH), featuring Daksitha Wickremarathne and Tikhala Itaye, focusing on accountability for adolescent health and rights. The session highlights the role of the Independent Accountability Panel (IAP) in strengthening accountability mechanisms to ensure that global and national leaders deliver on commitments to adolescents. The discussion emphasizes the transition from service delivery approaches toward a human rights-based framework, where adolescents are recognized as active rights holders. Key themes include meaningful participation of young people in decision-making processes, the importance of adolescent-responsive policies and budgeting, and the need to improve awareness of health rights among adolescents. The session also identifies critical gaps in adolescent-specific data within national reporting systems, underscoring the need for stronger monitoring and evidence-based accountability. The framework is aligned with the Global Strategy for Every Woman, Every Child (EWEC), reinforcing the importance of inclusive, equitable and participatory approaches in global health governance