Translational and Clinical Medicine - Georgian Medical Journal
type: channel
description: Biannual Medical Journal of Ivane Javakhishvili Tbilisi State University and Georgian Medical Association link gacor rokokbet https://pafikopadang.org/ toto 4d slot88 slot 200 slot qris https://rrijm.com/ rokokbet rokokslot link gacor slot dana situs gacor rokokbet rokokbet rokokbet slot88 slot777 slot gacor
publisher: Ivane Javakhishvili Tbilisi State University
language: en-US
publication name: Translational and Clinical Medicine - Georgian Medical Journal
issn: 2346-8491
copyright: Copyright is owned by the journal
items: Exploring EEG Changes in Video Game Players A Study on Behavioral Addiction
items: Artificial Intelligence and Telemedicine in Gerodontology and Improving Oral Health and Quality of Life in Older Adults
items: Hypothyroidism and Left Atrium
items: Beyond Gout: The Cardiovascular Impact of Hyperuricemia and Its Role in Atherogenesis
items: Artificial intelligence in general medicine and dermatology: a comprehensive review
items: Factors associated with HIV status disclosure among people living with HIV in Georgia
items: Impact of conception mothod on the risk of preeclamsia
items: Cardiovascular causes of death in breast cancer patients: analysis of the Georgia Cancer Registry (2020–2021)
items: Diabetic Dyslipidemia in Georgian Children with Type 1 Diabetes
items: Validation of the Georgian version of stress in children questionnaire: translation equivalence and psychometric properties among orphaned children
items: Psychodermatology across the lifespan: Case-based insights into cognitive decline, somatic preoccupations, and factitious dermatitis
items: Actinic Keratosis of the Scalp Initially Diagnosed as Psoriasis: A Case Report
items: Spontaneous puberty in an adolescent girl with a combined structural anomaly of the X chromosome
items: Integrating Alcohol Use Disorder Interventions into HIV and Harm Reduction Programs: A Narrative Review

Exploring EEG Changes in Video Game Players A Study on Behavioral Addiction
type: item
description: Background: Internet Gaming Disorder (IGD) is increasingly seen as a behavioral addiction, partially due to the way its neurological features resemble those that are found in substance-use disorders. To improve our methods in the diagnostics and treatment of IGD, a better understanding of the effects and influences of excessive gaming on the brain is crucial. Aim: This review aims to explore the neurophysiological characteristics of IGD by examining findings from electroencephalography (EEG) studies, focusing on resting-state activity and event-related potentials (ERPs) as potential biomarkers of the disorder. Methods: A range of peer-reviewed EEG studies on individuals diagnosed with IGD were reviewed. The studies included assessments of resting-state brainwave activity and ERP components, particularly those associated with attention and cognitive control. Results: The reviewed studies consistently report altered EEG patterns in individuals with IGD. At rest, there is a notable increase in theta activity and a decrease in beta activity, indicating possible deficits in arousal and cognitive engagement. In ERP studies, IGD participants frequently exhibit reduced P300 amplitudes during cognitive tasks, suggesting impairments in attentional processing and executive function. Conclusions: EEG research reveals distinct neurophysiological patterns in individuals with IGD, reinforcing its classification as a behavioral addiction. The observed changes in brainwave activity and ERP responses may serve as reliable markers for the disorder. These findings highlight the potential of EEG-based measures to enhance diagnostic accuracy and support the development of targeted interventions, including neurofeedback and cognitive-behavioral therapies.
creator: Ketevan Sabauri
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 3
ending page: 7

Artificial Intelligence and Telemedicine in Gerodontology and Improving Oral Health and Quality of Life in Older Adults
type: item
description: The world's population is aging. According to the World Health Organization's forecast, by 2050 the number of people aged 60 and older will double. Along with the increase in life expectancy, it is natural that the risk of chronic diseases and oral health-related problems also increases, which may have a significant impact on a person's overall condition and quality of life.[i] The proportion of individuals aged 65 years and older is rapidly increasing worldwide, caring for the oral health of older adults has become a pressing public health issue. In elderly patients, oral conditions such as edentulism, as well as damage to the hard and soft tissues of the teeth, are common and are often associated with the presence of comorbid general systemic diseases. At the same time, elderly patients may have limited mobility, which further complicates access to dental services.[ii] [iii] In this article, we will discuss ways to assist the elderly population throughქ the help of telemedicine and artificial intelligence models, which have already been created in several countries around the world and are actively undergoing a period of development.[iv] By using artificial intelligence and telemedicine, it is possible to improve the dental status of elderly patients, as these are tools that can replace the consultation provided by a doctor, identify diagnoses, and outline ways for the prevention of various types of diseases. These means can be considered as instruments for improving access to dental services, which will be used in the future to strengthen disease prevention.[v] [vi] With the help of artificial intelligence models, a patient can detect oral diseases at an early stage, regardless of their ability to visit a clinic for professional consultation and early diagnosis based on their socio-economic status. Today, it is already possible to receive a doctor's advice without leaving home and monitor the treatment process; this will especially help rural residents and benefi…
creator: Ketevan Rostiashvili
creator: Manana Kalandadze
creator: Rusudan Ivanisvili
creator: Ketevan Chichua
creator: Teimuraz Ebanoidze
creator: Vladimer Margvelashvili-
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 8
ending page: 11

Hypothyroidism and Left Atrium
type: item
description: Hypothyroidism can be considered a causative factor of heart failure and is associated with left atrial myopathy [1–3]. Introduction In recent years, there has been growing recognition of the intricate relationship between metabolic disorders and cardiovascular health. Among these, hypothyroidism—a condition characterized by insufficient thyroid hormone production—has increasingly been linked to various cardiac abnormalities, including those affecting the left atrium [1,4,5]. This connection not only highlights the physiological complexities underlying both conditions but also underscores the importance of recognizing this interplay in clinical practice. Left atrial function and size serve as critical indicators of cardiovascular health, and alterations in these parameters may predispose individuals with hypothyroidism to adverse outcomes such as arrhythmias, heart failure, and stroke [2,6]. By examining the mechanisms through which thyroid dysfunction impacts left atrial dimensions and functionality, clinicians can better understand the broader implications for patient management and treatment strategies. Ultimately, unraveling this relationship is vital for developing a holistic approach to both hypothyroidism and its cardiovascular consequences. Early detection of cardiac functional or structural changes is crucial for timely intervention [5]. Based on the key roles of thyroid hormones in the cardiovascular system, hypothyroidism is known to be associated with the development or progression of various cardiovascular diseases [1,4,7]. Although several previous studies have reported the association between hypothyroidism and heart diseases, a comprehensive analysis of the relationship between hypothyroidism and the left atrium—one of the most important cardiovascular parameters—has not yet been performed. There are small studies indicating a linear relationship, but most were conducted in populations with other risk factors for left heart disease, such as hypertens…
creator: TEONA ABRAMISHVILI
creator: lali Esebua
creator: Khatuna Papava
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 12
ending page: 15

Beyond Gout: The Cardiovascular Impact of Hyperuricemia and Its Role in Atherogenesis
type: item
description: Background: Atherosclerosis is a chronic inflammatory disease of the arterial wall and remains a leading cause of morbidity and mortality. Hyperuricemia-defined as elevated serum uric acid-has recently been implicated as a potential independent contributor to atherosclerotic cardiovascular disease (ASCVD). Objective: This narrative review aims to explore the interrelationship between hyperuricemia and atherosclerosis by examining shared mechanisms of vascular injury, epidemiological evidence, and implications for management. Methods: A comprehensive computer-based literature search was conducted using PubMed, Scopus, Web of Science and the Cochrane Library from January 2005 to September 2025. Keywords included atherosclerosis, hyperuricemia, gout, peripheral artery disease, and coronary artery disease. No restrictions were placed on language or study design. Reference lists of retrieved articles were manually screened for additional studies. In total, 36 articles met the inclusion criteria for this review. Results: The evidence supports multiple mechanistic links: elevated uric acid promotes endothelial dysfunction, oxidative stress, nitric oxide depletion, activation of urate transporters (e.g., URATv1), and xanthine oxidase–mediated reactive oxygen species generation. Epidemiologic studies demonstrate associations between higher serum uric acid and increased risks of coronary heart disease incidence and mortality, stroke, and peripheral arterial disease; some data suggest stronger associations in women. Therapeutic interventions (e.g., xanthine oxidase inhibitors) may confer vascular benefit beyond urate lowering. Conclusion: Hyperuricemia and atherosclerosis are inter-related through overlapping molecular and inflammatory pathways. Considering serum uric acid as a modifiable cardiovascular risk factor may yield opportunities for earlier detection and prevention of ASCVD. Further prospective trials are needed to determine whether urate-lowering therapy directly re…
creator: Maia Kharebashvili
creator: BACHUKI TSIKLAURI
creator: Kakha Nadaraia
creator: Vakhtang Chumburidze
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 16
ending page: 21

Artificial intelligence in general medicine and dermatology: a comprehensive review
type: item
description: Background: Artificial intelligence (AI) has rapidly transitioned from a conceptual innovation to a practical tool across multiple areas of clinical medicine. Dermatology, in particular, has emerged as a leading specialty for AI integration due to its strong reliance on visual pattern recognition and image-based diagnostics. Aim: This review aims to summarize fundamental concepts of AI, outline its applications across general medicine, and provide an in-depth analysis of current and emerging AI applications in dermatology. Methods: A narrative review of the contemporary literature was performed, focusing on AI applications in clinical medicine and dermatology, including diagnostic support, treatment planning, telemedicine, education, and regulatory considerations. Results: AI systems have demonstrated diagnostic performance comparable to clinicians in selected tasks, particularly in dermatological imaging and skin cancer detection. Applications extend beyond oncology to inflammatory skin diseases, dermatopathology, teledermatology, and clinical decision support. However, challenges remain regarding data bias, interpretability, real-world validation, ethical concerns, and clinical workflow integration. Conclusions: AI represents a transformative technology in general medicine and dermatology, with the potential to enhance diagnostic accuracy, efficiency, and access to care. Responsible implementation, rigorous clinical validation, and attention to ethical and equity considerations are essential for safe and effective clinical adoption.
creator: Nino Tsamalaidze
creator: Tina Kituashvili
creator: Luka Tkhelidze
creator: Elene Gunia
creator: Levan Tsamalaidze
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 22
ending page: 24

Factors associated with HIV status disclosure among people living with HIV in Georgia
type: item
description: Background HIV status disclosure plays a critical role in reducing stigma, improving treatment adherence, and enhancing social support for people living with HIV (PLHIV). Despite its importance, disclosure remains a complex process influenced by individual, relational, and systemic factors. The Eastern Europe and Central Asia region, including Georgia, faces high levels of stigma, making HIV status disclosure particularly challenging. This study explores factors associated with HIV status disclosure among Georgian PLHIV to inform interventions and policies. Aim To examine the sociodemographic and healthcare-related factors associated with HIV status disclosure among PLHIV in Georgia. Methods This secondary data analysis utilized the PLHIV Stigma Index 2.0 survey conducted in Georgia in 2022, which included 765 participants recruited through peer-to-peer interviews in Tbilisi and three additional regions. Data on demographics, stigma, discrimination, and healthcare interactions were collected following standardized methodologies developed by UNAIDS. Statistical analysis included chi-square tests to explore univariate associations and multivariate logistic regression to adjust for potential confounders and identify significant predictors of disclosure. Results Of the 765 participants, 67.4% were male, most of them aged 30–49 years (61.3%). Lower education levels were reported by 64.2%, while 39.6% were unemployed. HIV status disclosure to at least someone from their social and healthcare environment was reported by 86.9% of participants, with 13.1% not disclosing to anyone. Multivariate analysis identified significant predictors of disclosure. Participants aged 30–39 were less likely to disclose than those aged 18–29 (aOR=0.39, 95% CI: 0.16–0.93). Disclosure was more likely among those in intimate relationships (aOR=3.93, 95% CI: 2.42–6.40) and those diagnosed with alcohol or substance use disorder (aOR=4.53, 95% CI: 1.04–19.75) or mental health disorders (aOR=6.86, 9…
creator: Tamar Zurashvili
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 25
ending page: 34

Impact of conception mothod on the risk of preeclamsia
type: item
description: Abstract Background Hypertensive disorders are one of the leading causes of maternal and perinatal morbidity and mortality worldwide. (1) It is responsible for around 16% of maternal deaths globally, in 2023 this was the equivalent to around 42 000 deaths (2, 3). Aim To define the impact of conception method on the risk of preeclampsia. Methods A prospective observational study was conducted at the Zurab Sabakhtarashvili Reproductive Clinic on the pregnant women from 2021 (january)-2025 (november). All of the participants of the study underwent preeclampsia first-semester screening test. 537 pregnant women, who were conceived with artificial reproductive technology (In vitro fertilization and Ovarian stimulation) were selected as group l. In addition to that, 407 woman who had a spontaneous pregnancy were chosen as a control group (group II). Logistic regression was used to exclude confounding factors. Results: In 01.01.2021 – 31.11.2025, 988 preeclampsia screening tests were performed at Zurab Sabakhtarashvili Reproductive Clinic. In 520 cases were confirmed a high risk (52.63%). Group 1 was seperated into three subgroups. Subgroup 1 – method of conception in vitro fertilization and frozen embryo transfer (240 women). Subgroup 2 - method of conception in vitro fertilization and fresh embryo transfer (149 women). Subgroup 3 - method of conception – ovulation drugs (148 women). For control group were selected women with spontaneous pregnancy (407 women). The difference in subgroup 1 and subgroup 2 was not significant (p value = 0.47). The difference between group 1 and group 2 (Assisted reproductive technology vs spontaneous pregnancy) was significant (p value = 0.002). Conclusion: Absence of corpus luteum in frozen embryo transfer regimen is considered to be a key point of increasing risks of Preeclampsia during pregnancy. The mechanism, however is unknown and the results from different studies are controversial. In our study no statistical difference was found betw…
creator: Guranda Okropiridze
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 35
ending page: 37

Cardiovascular causes of death in breast cancer patients: analysis of the Georgia Cancer Registry (2020–2021)
type: item
description: Background: Cardiovascular disease (CVD) has emerged as a major non-cancer cause of mortality among breast cancer (BC) patients, driven by shared risk factors and cardiotoxic effects of anticancer therapies. Objective: To evaluate cardiovascular causes of death among breast cancer patients who underwent anticancer treatment using data from the Georgia Cancer Registry Methods: A retrospective analysis was conducted on 522 deceased BC patients recorded between January 1, 2020, and January 1, 2021. Among them, 344 (65.9%) had received anticancer therapy. Cardiovascular causes of death and contributing conditions were analyzed by age group. Proportions were compared using Pearson’s chi-square test. Results: Cardiovascular causes accounted for 15.1% of deaths among treated patients. Ischemic heart disease was the leading cause (36.5%), followed by cerebrovascular events (19.2%) and pulmonary embolism (11.5%). Heart failure (HF) was identified in 6.7% of patients. including unspecified HF (1.5%). Additional contributing conditions included, hypertension (9 cases,2.6%), valvular disease (3 case, 0.9%), and atrial fibrillation (2 cases, 0.6%). The highest proportion of cardiovascular deaths occurred in patients aged 25–49 years (24.3%), although differences were not statistically significant (p>0.05). Cardiotoxicity-related cardiomyopathy (ICD-10 I42.7)was not reported. Conclusions: CVD constitutes a significant cause of mortality among breast cancer patients in Georgia. The absence of documented cardiotoxic cardiomyopathy suggests underdiagnosis, emphasizing the need for improved cardio-oncology integration
creator: Nino Sharashidze
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 38
ending page: 40

Diabetic Dyslipidemia in Georgian Children with Type 1 Diabetes
type: item
description: Background: Diabetes mellitus in children and adolescents increases the risk of developing dyslipidemia. The aim of our study is to determine the relationship between HbA1c and lipid profile indicators in a Georgian population of children with type 1 diabetes. Methods The study was based on biochemical data obtained from 230 children and adolescents with type 1 diabetes and 383 age-comparable controls from the Megalab clinic population. The participants were 9 to 18 years old; the mean age in the T1D group was 13.22±2.82 years. Biochemical assessment was performed after a 12-hour overnight fast. We studied: Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c). The following lipid indices were assessed: non-HDL-C, TG/HDL-C, log10(TG/HDL-C), HDL-C/LDL-C, TC/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C. Statistical analysis was performed using SPSS - 23. Results: A statistically significant positive correlation was observed between HbA1c and the following indicators: Total cholesterol (TC): r=0.527; LDL-C: r=0.441; triglycerides (TG): r=0.446; non-HDL-C: r=0.522**; HbA1c also showed a low-significant positive correlation with atherogenic indices -TC/HDL-C: r=0.321, LDL-C/HDL-C: r=0.256, non-HDL-C/HDL-C: r=0.321, TG/HDL-C: r=0.369, log(TG/HDL-C): r=0.328, LDL-C–HDL-C: r=0.385**. ( p<0.001)This indicates that an increase in HbA1c in children with type 1 diabetes is associated with a worsening of the atherogenic profile. In the case of HDL-C: r=−0.009; p=0.895 - a statistically significant relationship was not observed. In the T1DM group, significantly increased compared to controls - TC: 153.15 vs 175.92 mg/dL, LDL-C: 89.83 vs106.99 mg/dL; TG: 71.15 mg/dL vs 119.28 mg/dL HDL was reduced in the T1D group by 45.07 mg/dL vs: 49.09 mg/dL. Non–HDL-C -104.06 vs 130.84 mg/dL reflects an increase in atherogenic fractions. In all cases (p<0.001). All indices were signifi…
creator: Davit Rekhviashvili
creator: Giorgi Chakhunashvili
creator: Nino Megrelishvili
creator: Iamze Taboridze
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 41
ending page: 45

Validation of the Georgian version of stress in children questionnaire: translation equivalence and psychometric properties among orphaned children
type: item
description: Background: The Stress in Children is a short, easily administered, self-reported questionnaire, constructed to assess stress in younger children. Aim: The purpose of this study was to validate a Georgian version of The Stress in Children questionnaire and to assess its psychometric qualities in a Georgian sample of Children from orphanages and the surrounding area. Methods: The cross-sectional study was carried out in several orphanages of Georgia. A total of 116 orphaned children aged of 7 to 18 years from 11 orphanages (study group). An equal number of schoolchildren from nearby communities were selected as a comparison group. Translation and adaptation of The Stress in Children was carried out by forward-backward translation method. Pilot test-retest study (time interval between test and retest was 7 days) with 30 bilingual children age of 7 to 18 years. Association of responses considered acceptable if Pearson’s R≥0.7. Based on this pilot study translated version The Stress in Children -Georgia was adapted by correct comprehension, grammar correctness and comprehensibility. Results: Final stage showed acceptable association of test and re-test responses was R=0.769. The association of Test and Re-Test responses on The Stress in Children original and translated versions was significant for all questions, and internal consistencies for both methods were acceptable. Cronbach’s alpha for internal consistency of test responses was 0.883 (95%CI – 0.796-0.970). The comparison of mean total and subscale scores of The Stress in Children -Georgia in the study group (orphaned children) were significantly higher compared to control group – for factor 1 (distress) - 19.8 ± 4.3 vs. 13.9 ± 3.1, respectively, p<0.001; for factor 2 (wellbeing) - 15.2 ± 3.8 vs. 10.0 ± 2.3, respectively, p<0.001; for factor 3 (social support) - 9.3 ± 2.9 vs. 6.1 ± 1.6, respectively, p<0.001; Total - 48.1 ± 8.7 vs. 33.1 ± 6.1, respectively, p<0.001. Conclusions: The Georgian version of The Stress …
creator: Lana Gedenidze
creator: Lela Tsitaishvili
creator: Natalia Manjavidze
creator: Ketevan Devadze
creator: David Tananashvili
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 46
ending page: 50

Psychodermatology across the lifespan: Case-based insights into cognitive decline, somatic preoccupations, and factitious dermatitis
type: item
description: Background: Psychodermatology examines the complex bidirectional relationship between the skin and the mind. This interaction becomes particularly significant in vulnerable populations such as older adults with cognitive decline and younger individuals with psychosocial or developmental vulnerabilities. Aim: To illustrate the heterogeneity of psychodermatological presentations across the lifespan and highlight the role of cognition, insight, and psychosocial context in clinical manifestations. Methods: We present a case-based analysis of three patients with distinct psychodermatological conditions: (1) delusional parasitosis associated with cognitive decline, (2) somatic preoccupation with mild neurocognitive impairment, and (3) factitious dermatitis in a young adult with intellectual disability. Clinical, neuropsychological, and contextual factors were analyzed comparatively. Results: Older patients demonstrated dermatological symptoms linked to cognitive impairment and altered insight, including delusional infestation and psychosomatic skin complaints. In contrast, the younger patient exhibited self-inflicted lesions consistent with factitious disorder, driven by psychosocial stress and limited coping capacity. Insight varied across cases and was closely associated with cognitive status and psychosocial environment. Conclusions: Psychodermatological conditions differ significantly across age groups but share a common biopsychosocial foundation. Early cognitive screening, careful psychiatric assessment, and interdisciplinary collaboration are essential for accurate diagnosis and effective management.
creator: Nino Okribelashvili
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 51
ending page: 54

Actinic Keratosis of the Scalp Initially Diagnosed as Psoriasis: A Case Report
type: item
description: Background: Actinic keratosis (AK) is a common premalignant skin lesion that develops on chronically sun-exposed areas, particularly in elderly individuals. Due to overlapping clinical features, AK may be misdiagnosed as inflammatory dermatoses, including psoriasis. Aim: To highlight the potential for misdiagnosis of scalp actinic keratosis as psoriasis and to emphasize the diagnostic value of dermoscopy and histopathology. Methods: A 79-year-old man with persistent scalp lesions previously diagnosed as psoriasis was clinically evaluated. Dermoscopic examination was performed, followed by histopathological assessment of a skin biopsy. Results: The patient showed no significant improvement after one year of topical corticosteroid therapy. Dermoscopic findings suggested actinic keratosis, which was subsequently confirmed by histopathology. No evidence of psoriasis was identified. Conclusions: Diagnostic reassessment is essential in persistent scalp lesions. Dermoscopy and histopathological examination are valuable tools for accurate diagnosis and timely management of actinic keratosis.
creator: Natia Kakhidze
creator: Tina Kituashvili
creator: Nana Goishvili
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 55
ending page: 56

Spontaneous puberty in an adolescent girl with a combined structural anomaly of the X chromosome
type: item
description: Background Structural anomalies of the X chromosome represent a significant cause of reproductive dysfunction and primary amenorrhea. The coexistence of large-scale deletion and duplication within the same X chromosome is rare and associated with marked clinical variability. In this context, spontaneous pubertal development represents an unusual and rarely reported finding. Advances in cytogenetic and molecular techniques, particularly chromosomal microarray analysis, have improved the detection of combined of chromosomal rearrangements and are essential for accurate diagnosis. Case Presentation We report a 16-year-old adolescent girl presenting with primary amenorrhea and spontaneous but incomplete pubertal development. Physical examination revealed height 152 cm, with minor dysmorphic features, including a low posterior hairline and high-arched palate. Tanner staging corresponded to B4P4Ax3Me0, with normal female external genitalia. Hormonal evaluation demonstrated hypergonadotropic hypogonadism with elevated FSH and LH and low estradiol levels. Pelvic ultrasound revealed a hypoplastic uterus and small ovaries without visible follicles. Cytogenetic analysis identified a structural anomaly of the X chromosome (46,X,del(X)(q21)). Chromosomal microarray analysis confirmed a combined rearrangement consisting of a heterozygous ~70 Mb deletion at Xq21.2–q28 and a heterozygous ~51 Mb duplication at Xp22.33–p11.2. Despite the presence of a terminal Xq deletion, height delay was not observed, as the patient’s stature was consistent with familial height. Conclusion This case highlights the importance of integrated cytogenetic and molecular analysis in patients with DSD. Combined X chromosome copy number variations can result in diverse clinical phenotypes, requiring careful genetic counseling, evaluation of X chromosome inactivation, and multidisciplinary management. Early diagnosis and comprehensive care may improve outcomes, while ongoing advances in genetic research will…
creator: Ana Jibladze
creator: Mariam Chipashvili
creator: Elene Asanidze
creator: Maka Jorbenadze
creator: Levan Kobaladze
creator: Jenaro Kristesashvili
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 57
ending page: 61

Integrating Alcohol Use Disorder Interventions into HIV and Harm Reduction Programs: A Narrative Review
type: item
description: Background: Alcohol use disorder (AUD) is highly prevalent among people who inject drugs (PWID) and it significantly hinders the effectiveness of HIV treatment. Hazardous drinking is mostly associated with viral non-suppression, poor antiretroviral therapy (ART) adherence, and poor retention to care, especially in Eastern Europe and Central Asia (EECA), where structural barriers, fragmented health systems, and stigma limit access to integrated services. Despite the combined burden of HIV and AUD, the utilization of alcohol treatment services among PWID is critically low in Georgia. Aim: To synthesize regional and global evidence on the relationship between alcohol use disorder and HIV-related outcomes, identify determinants and barriers of AUD service utilization among PWID, and evaluate opportunities for integrating AUD interventions into HIV and harm-reduction programs in Georgia and the EECA region. Methods: We conducted a narrative review of regional and global literature published between 2000 and 2025, using Scopus, PubMed and Google Scholar. Study eligibility was based on whether selected studies examined the relationship between alcohol use and HIV-related outcomes and/or determinants of alcohol treatment utilization, with focus on PWID. Andersen’s Behavioral Model of Health Services Use, complemented by the Screening, Brief Intervention, and Referral to Treatment (SBIRT) framework, was used to thematically synthesize the evidence. Findings were triangulated with unpublished Georgian quantitative data (IBBS 2017–2022). Results: Perceived need for treatment emerged as the strongest predictor of AUD service utilization across studies, exceed ing clinical and demographic factors. Dominant barriers were criminalization, stigma, denial, limited behavioral health capacity and poor service integration. Consistent evidence indicates that alcohol use was associated with a double risk of ART non adherence and viral non-suppression. Evidence supports the feasibility an…
creator: Thea Shengelaia
creator: Nino Chikhladze
rights: Copyright (c) 2026 Translational and Clinical Medicine - Georgian Medical Journal
date: 2026-06-30
publication date: 2026-06-30
volume: 11
number: 2
starting page: 62
ending page: 65