Varna Medical University Press: Journals
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The contribution of optics to the screening and prevention of chronic eye diseases
Full text linkThe World Health Organization emphasizes the need for organized blindness prevention programs based on early detection and systematic screening. This article analyzes the possibilities for involving optometrists in coordinated health practices aimed at early detection of chronic eye diseases and optimized referral to specialized ophthalmological care. The premise is that early functional changes in the visual analyzer can be identified at the optician level, which would limit irreversible damage and reduce the health-economic burden on the healthcare system.The methodological approach includes analysis of scientific and regulatory sources, documentary review, and sociological instruments. For research purposes, semi-structured interviews were conducted with experts (n = 14) and patients (n = 14) between October 10 and 23, 2025. The quantitative data were processed using descriptive and inferential statistics, which allowed for the formulation of well-founded conclusions about trends and dependencies in practices, awareness, and readiness for screening. The analysis compares Bulgarian practice with international standards, focusing on staff qualifications, screening methods used, and opportunities for timely referral to ophthalmological care.The data highlight the need for regulatory changes, standardization of screening, and improvement of opticians’ professional skills as a prerequisite for the future inclusion of opticians in preventive activities to promote eye health
Chemical Peeling in the Practice of a Medical Cosmetologist
Full text linkThe aim of the present study is to analyze and systematize the scientific literature devoted to chemical peeling in the context of medical cosmetology practice. The focus is on the types of peels according to depth, the acids used, mechanisms of action, indications, contraindications, and adverse effects. It also addresses the principles of safe application and risk management.Materials and Methods: A literature search was conducted in the electronic databases Google Scholar and ResearchGate, using the keywords: chemical peel, superficial chemical peel, skin rejuvenation, chemical peel complications, post-peel care, patient selection. The search period covered publications from January 2010 to December 2024.Results: The review included 34 articles, presenting studies published between 2010 and 2024 related to chemical peeling in medical cosmetology practice. The analysis demonstrated a predominance of review and expert publications, as well as a sustained interest in superficial and medium-depth peels due to their favorable tolerability profile, and the possibility of protocol personalization according to indications and skin phototype.Conclusion: The results highlight a clear trend toward gentler, serial, and precisely controlled interventions, accompanied by an increasing emphasis on safety, patient selection, and standardized post-procedure care. The findings also indicate a need for more primary clinical studies with comparable outcome measures, particularly across different skin phototypes and in combined therapeutic approaches
Pulp calcifications—diagnostics, clinical significance and therapeutic protocol
No full textIntroduction: Pulp stones are calcified structures that develop within the pulp tissue of both primary and permanent teeth. A number of studies have examined their morphological characteristics and chemical composition. However, their development, structural composition, and morphological configuration are still unclear. They can pose a problem during treatment, making endodontic therapy more difficult to accomplish. Materials and Methods: This study emphasizes on the morphological composition of pulp stones and aims to systematize the means and techniques for dealing with denticles in the pulp chamber.Results: The prevalence of denticles ranges from 8% to 95%. They are more common in maxillary teeth than in mandibular teeth. They may occur in any tooth, though they are most commonly identified in permanent molars and mandibular anterior teeth.Conclusion: Denticles can lead to a partial or complete obliteration of the pulp chamber and/or root canals and therefore can make the endodontic treatment difficult or completely impossible. The use of appropriate instruments and approach in surgical treatment leads to a high success rate
Men in their seventies – how urination changes
No full textIn the present study, we tried to analyze which symptoms predominate in men with advancing age. A single-center, non-interventional study was conducted. The subjects of the study were 263 patients over 60 years of age with lower urinary tract symptoms. In the analysis, we compared patients aged 60–69 years with those over 70 years of age. The results show that irritative complaints (nocturia and urgency) are more pronounced in men over 70 years compared with those aged 60–69 years. Obstructive symptoms do not differ between the two groups. Additionally, patients over 70 years of age have greater prostate volume, higher PSA values, and a larger middle lobe of the prostate
Extraoral criteria for evaluation and analysis of the smile in dental prosthetic treatment – an overview of the concept
No full textDuring smiling, the lips undergo dynamic morphological changes, resulting in the exposure of the dentition and the formation of an individual and characteristic configuration. The smile constitutes a fundamental determinant in attracting and sustaining visual attention toward the form, position and chromatic characteristics of the teeth. The act of smiling involves the coordinated contraction of more than 15 facial muscles, which modulate lip position to varying degrees, influence dental harmony and affect aesthetic perception. Therefore, in aesthetic, prosthetic and orthodontic dental treatment, the position, morphology and color of the teeth must be systematically correlated with the lip configuration during both spontaneous and voluntary (posed) smiling.Smile morphology represents a dynamic parameter influenced by multiple intrinsic and extrinsic factors, including age, the application of dermal fillers, tooth loss, dental, prosthetic, aesthetic and orthodontic interventions, reconstructive and/or plastic surgery, aesthetic procedures, pathological conditions, traumatic events, skin turgor and others. Although post-treatment changes are primarily directed toward the optimization of tooth position, dental arches and occlusal relationships, contemporary dental medicine places parallel emphasis on the aesthetic integration of the smile.The aim of the present review is to define and systematize the principal extraoral criteria and anthropological landmarks involved in the analysis and assessment required for planning, design and execution of dental restorations and comprehensive dental treatment
Basic Elements In The Scope Of Nursing Practice In Patients With Mental Diseases
Full text linkIllustrating the scope of nursing practice requires a clear description of nurses' work and their responsibilities and suggests the need to examine how they actually allocate their time. General care-oriented studies have sought to determine the scope of nursing practice, but still little researches has yet examined the scope of nursing practice in psychiatric wards. The nursing profession has long taken the lead in practicing evidence-based care. Evidence-based nursing practice may be even more important for mental health nurse practitioners. The scope of nursing practice is "the full range of roles, functions, responsibilities, activities, and decision-making abilities that people in the nursing profession are educated, competent, and empowered to perform." It defines the parameters and boundaries within which nurses practice and it is important for the profession that these are clearly articulated to ensure that nursing practice can meet the needs of society. This scope of practice and standards information can serve as a guide for supportive policies and regulations to govern nursing practice for patients with mental illness
Odontogenic keratocyst: A comprehensive review
No full textIntroduction: An odontogenic keratocyst (OKC) is a developmental cyst of the jaws characterized by aggressive growth and a high recurrence rate, leading to ongoing challenges in its classification and management. Aim: This article aims to provide a comprehensive overview of the OKC, examining its etiology, clinical and radiographic features, histopathology, and current treatment strategies. Materials and Methods: This review synthesizes information from relevant literature, including historical accounts of OKC classification, clinical case reports, and studies detailing its pathogenesis, histopathology, and treatment modalities. Results: OKC presents with variable clinical features, often in the mandible, and radiographically appears as a well-defined radiolucent lesion. Histologically, it is characterized by a thin, parakeratinized epithelium. Treatment typically involves surgical removal, but recurrence is a concern.Conclusion: An OKC remains a clinically significant lesion requiring careful diagnostic evaluation and tailored management to minimize recurrence and associated morbidity.
Device and methodology for preparation of samples for microscopic examination of surface morphology and microgap between the implant and the abutment
Full text linkIntroduction: The significance of the microgap and surface characteristics at the implant/abutment interface is critical for the long-term stability and biocompatibility of the implant system, as they can influence bacterial colonization, micromovements, and osseointegration.Aim: The objective of the present study is the development of a device and methodology for the preparation of specimens from various dental implant systems, intended for microscopic examination of the topography of the implant platform and the microgap between the dental implant and the abutment.Methods: A device has been designed, consisting of three components: a cylindrical tube, an upper part, and a lower part. The working surface of the upper part is a convex cone, while that of the lower part is concave, allowing for axial fixation of an implant or an implant/abutment assembly from different systems. The working space of the device is confined by a tube with an opening through which the implants are embedded in resin. After polymerization of the resin, the specimens are sectioned precisely along the longitudinal axis.Results: A methodology has been developed, consisting of the following steps: fixation of the implant or implant/abutment assembly in the lower part; placement of the cylindrical tube; fixation and closure of the device with the upper part; embedding in epoxy resin; resin polymerization; removal of the specimen from the device; longitudinal sectioning of the specimen along the implant axis; grinding of the specimen; polishing of the specimen.Conclusion: The developed device and methodology for the preparation of specimens from different implant systems for microscopic examination have been successfully tested and validated
Collagen Therapy for Knee Osteoarthrosis – A Modern View
No full textIntroduction: Knee osteoarthritis (gonarthrosis) is a leading degenerative disease of the musculoskeletal system, associated with chronic pain, functional limitations, and significant deterioration in the quality of life. The lack of established disease‑modifying therapies necessitates the implementation of effective and safe symptomatic approaches. Along with the widely used intra‑articular injections of hyaluronic acid, over the past decade there has been growing interest in collagen therapies and combined methods for local delivery of bioactive substances.Aim: To evaluate the effectiveness and safety of collagen and collagen‑containing MD‑KNEE injections in patients with knee osteoarthritis, including the potential effect of their combined administration with magnetically‑mediated transdermal delivery, and to compare their therapeutic effect with that of intra‑articular hyaluronic acid in terms of pain, functional capacity, and quality of life.Materials and Methods: A retrospective and prospective clinical analysis with observational and comparative elements was conducted, covering patients with gonarthrosis grade I–III according to Kellgren–Lawrence. The assessment of the therapeutic effect was performed using validated instruments for pain (VAS), functional capacity (Lequesne, WOMAC), and quality of life (SF‑36, EQ‑5D), as well as by analyzing the safety and tolerability of the applied therapies.Results: Clinical trial data show that intra‑articular collagen injections, including MD‑KNEE, result in statistically and clinically significant pain reduction and functional capacity improvement in patients with mild to moderate knee osteoarthritis. Their efficacy is comparable to that of hyaluronic acid, with no significant differences in key clinical outcomes. Both therapeutic approaches demonstrate a favorable safety profile, with rare and mild adverse events. Preclinical and limited clinical data suggest potential additional benefits of combining collagen therapies with magnetophoretic transdermal methods, but direct clinical evidence for this approach is lacking.Conclusion: Collagen injections, including MD‑KNEE, represent a safe and effective alternative or adjunct to intra‑articular hyaluronic acid in the treatment of knee osteoarthritis. Despite promising results, larger, prospective, and long‑term randomized clinical trials are needed to definitively define optimal treatment regimens and to evaluate potential structure‑modifying effects, including when combined with magnetically‑mediated transdermal delivery
The Bulgarian experience: Health technology assessment as a decision science
Full text linkThis review article explores the role of Health Technology Assessment (HTA) as a multidisciplinary decision science that systematically evaluates the medical, economic, social, and ethical aspects of healthcare technologies. Health Technology Assessment supports policymakers, clinicians, and healthcare providers by ensuring that interventions are not only clinically effective but also cost-efficient and aligned with patient needs. In Bulgaria, HTA has become a critical tool for resource allocation, transparency, and the sustainability of the healthcare system.The paper highlights the advantages of HTA, including transparency in decision-making, strategic resource planning, facilitation of risk-sharing agreements, incorporation of patient perspectives, and promotion of innovation. By aligning national policies with international standards, HTA strengthens evidence-based practices and fosters collaboration among diverse stakeholders, such as government agencies, payers, providers, patient groups, and industry.Several case studies from Bulgaria illustrate HTA’s impact. For oncology, biomarker testing demonstrates significant health benefits (+21,000 life years, +16,600 quality-adjusted life years (QALYs)) and economic gains (€76 million GDP contribution). Analyses of disease burdens such as neovascular age-related macular degeneration (nAMD), peripheral artery disease (PAD), lipodystrophy, and atopic dermatitis quantify the direct and indirect costs, emphasizing the need for improved management and policy prioritization. Similarly, projects on sarcoma care expose systemic gaps, underscoring the importance of centralized care and multidisciplinary approaches.Innovative policy models, such as pay-for-performance (P4P) in diabetes care, illustrate how financial incentives linked to treatment outcomes can improve patient health while generating long-term savings. Evaluations of medical devices, including wound care systems, show cost-effectiveness in reducing amputations and relapses. National screening programs for breast, cervical, and colorectal cancers highlight how early detection significantly improves QALYs while reducing long-term costs.The analysis also demonstrates the substantial benefits of high-cost innovative treatments for oncology, autoimmune disorders, diabetes, schizophrenia, asthma, hepatitis C, and rare diseases. Collectively, these therapies contribute over 1.24 million QALYs and €6.55 billion (7.13% of GDP) to the Bulgarian economy, proving their dual health and economic value.In conclusion, the Bulgarian experience with HTA exemplifies its transformative role in shaping evidence-based, sustainable, and patient-centred healthcare policies, reinforcing its importance as a cornerstone of modern health systems