Varna Medical University Press: Journals
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Application of hippotherapy in children
Full text linkIntroduction: Hippotherapy, also referred to as therapeutic horseback riding, is an evidence-based rehabilitation method that employs the multidimensional movement of the horse as a therapeutic modality for addressing physical, cognitive, emotional, and sensory impairments in children with special needs. While the origins of this practice can be traced back to ancient times, it has been formally integrated into interdisciplinary therapeutic approaches over recent decades. The therapeutic effect is grounded in the biomechanical similarities between the horse’s rhythmic, repetitive gait and the human walking pattern; this movement facilitates improvements in postural control, muscle tone regulation, balance, coordination, and sensory integration.Aim: The aim of the present study is to examine the benefits of implementing hippotherapy in children.Materials and Methods: A review of the scientific literature was conducted using the keywords "hippotherapy," "therapeutic potential," and "children" across academic databases such as PubMed, Google Scholar, and Web of Science (WOS). The methodological approach included historical analysis and documentary-content analysis.Results: This article presents a literature review on the effects of hippotherapy in children with special needs, including conditions such as cerebral palsy, autism spectrum disorder, and sensory integration dysfunction. The fundamental principles of sensory-based intervention - involving vestibular, proprioceptive, and tactile stimulation - used during therapeutic sessions are outlined. The role of the physiotherapist in modulating sensory input is also discussed, along with therapeutic strategies tailored to the individual needs of each child. Our analysis indicates that hippotherapy leads to significant improvements in posture and gait, motor coordination, muscle tone, range of motion, attention span and focus, communication, and social interaction skills. Children demonstrate enhanced body awareness, postural stability, reduced sensory sensitivity, and improved emotional well-being.Conclusion: Hippotherapy has been increasingly recognized as an effective and valuable adjunct to conventional kinesiotherapeutic interventions for children with special needs. Through the horse’s multisensory stimulation, comprehensive activation of motor and neurophysiological functions is facilitated, contributing to an overall improvement in the patients’ quality of life. This unique interaction between the child and the horse supports not only physical rehabilitation but also emotional and social development.
Access to targeted therapy for prostate cancer in Bulgaria
Full text linkProstate cancer is one of the leading malignant diseases among men. With the increase in average life expectancy, an ever-growing proportion of the population is at elevated risk of developing prostate cancer. In recent years, the treatment of malignant diseases has made substantial progress, with innovative medicinal products playing a central role in achieving these outcomes.Access to innovative therapy is a priority for the European Commission and the member states of the European Union. The aim is to reduce the incidence and mortality of malignant diseases while improving patient survival.In Bulgaria, patients with oncological diseases experience delayed access to new medicinal therapies. This delay is due in part to the national regulatory framework and the process of including new medicinal products in the positive drug list or expanding the therapeutic indications of already reimbursed medicines. The delay in access to modern therapy for patients with prostate cancer in Bulgaria is substantial compared with many EU countries
New therapeutic approaches in hypertrophic cardiomyopathy
No full textMavacamten is the first cardiac myosin inhibitor to receive worldwide approval for the treatment of adults with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) classified as New York Heart Association (NYHA) functional class II–III. By directly targeting the hypercontractile phenotype underlying the pathophysiology of the disease, mavacamten has demonstrated consistent benefits in phase 2 and 3 studies, including a reduction of left ventricular outflow tract (LVOT) gradient, improvements in exercise capacity, symptoms, and quality of life, as well as evidence of favorable cardiac remodeling on multimodal imaging. An individualized, echocardiography-guided dosing strategy has been developed to optimize efficacy while minimizing the risk of left ventricular ejection fraction reduction. Mavacamten also decreases the proportion of patients meeting guideline criteria for septal reduction therapy. Mavacamten is primarily metabolized by CYP2C19 (cytochrome P450 2C19), with the enzyme phenotype determining the degree of drug exposure. Nevertheless, its use has been shown to have a favorable safety profile regardless of the patient’s metabolic status. Dose titration takes into account the risk of systolic dysfunction in the setting of comorbid conditions, as well as potential drug–drug interactions with inhibitors and substrates of the cytochrome P450 system. This article reviews the available efficacy and safety data from completed and ongoing clinical studies of mavacamten in patients with symptomatic oHCM. Ongoing long-term studies aim to clarify its role within therapeutic algorithms, its interaction with background therapies, and its potential to modify disease progression beyond symptomatic relief
Computational analysis of 3-monosubstituted isatin derivatives for physicochemical properties and drug-likeness
Full text linkIsatin and its derivatives have garnered significant interest in medicinal chemistry due to their diverse pharmacological activities, including anticancer, antiviral, and antimicrobial effects. This study investigates five 3-monosubstituted isatin derivatives—IA, I4AM, I2AP, I3AP, and I4AP—using the SwissADME platform to evaluate their drug-like properties. The derivatives were analyzed for molecular weight, lipophilicity, water solubility, and adherence to drug-likeness criteria, including Lipinski's Rule of Five and other established filters. The derivatives exhibited favorable molecular weights and topological polar surface areas, suggesting good membrane permeability. Lipophilicity assessments indicated moderate values, beneficial for absorption and distribution, while water solubility predictions varied across models, emphasizing the need for experimental validation. All compounds complied with multiple drug-likeness rules, with bioavailability scores suggesting moderate oral potential. This comprehensive in silico analysis highlights the potential of these isatin derivatives as promising drug candidates. Future studies should focus on synthesizing these compounds and validating their pharmacokinetic and therapeutic profiles in biological systems
Hydrotherapy for babies
Full text linkHydrotherapy is a branch of physical therapy that uses water to treat various conditions. There are many methods and forms of performing water procedures. Water affects all systems and organs, and its impact varies depending on the method of application and its physical state. Hydrotherapy in babies is a therapeutic practice in which newborns and infants are immersed in water to support their physical and mental development.Aim: To study the awareness and attitudes of mothers regarding the application of hydrotherapy methods in babies.Materials and Methods: This study included 108 mothers with babies aged 0 to 12 months. A survey method was applied using a Google Form.Results and Discussion: The results indicate that nearly half of the respondents are familiar with hydrotherapy methods for babies (44.9%), and more than a quarter have used the therapeutic properties of water. A positive finding is that 56.4% would consider using a hydrotherapy method after receiving additional information. The highest percentage of respondents believe that the appropriate age for applying hydrotherapy is between 4 and 6 months, once a week. The main factors influencing the non-use of hydrotherapy methods are unfamiliarity with the method and fear of side effects. More than half of the respondents (70.4%) would trust a midwife in applying hydrotherapy methods for babies.Conclusion: Hydrotherapy is an effective and innovative method that stimulates a baby's development by influencing muscle tone, improving range of motion, and enhancing neuropsychological development. Respondents show a willingness to apply hydrotherapy methods after being informed about the benefits and forms of water therapy for babies. A high proportion of mothers identified the midwife as the key specialist in implementing hydrotherapy for babies
Assessment of perceptions and attitudes towards the use of electronic cigarettes and vaping devices among adolescents aged 10-14 in the city of Varna: a pilot study
Full text linkIntroduction: The growing popularity of electronic cigarettes and vaping devices among young people poses a serious challenge to public health. This pilot study aims to assess the awareness, risk perceptions, and behavioral attitudes towards the use of these devices among early adolescents in Varna, Bulgaria.Materials and Methods: A cross-sectional descriptive survey was conducted between April 17-26, 2025, among 195 students (58.5% boys; 41.5% girls) aged 10-14 years from three secondary schools in Varna, selected through convenience sampling. An author-developed anonymous questionnaire with 10 closed questions was administered on paper. Data were analyzed using descriptive statistics (frequency and percentage distribution) and the χ² test for independence.Results: The data analysis revealed extremely high levels of awareness, with 87.2% of respondents knowing what electronic cigarettes are. Significant social exposure was also observed, as 70.3% knew someone who uses such devices. Regarding safety perceptions, slightly over half (50.8%) correctly assessed that electronic cigarettes are not safer than traditional ones, but a substantial proportion (34.9%) expressed uncertainty ("I don't know"). The majority of students (86.1%) stated they would not try an electronic cigarette, but around 14% identified themselves as a risk group with positive or hesitant attitudes.Conclusion: The results show a high degree of awareness and social exposure to these devices, indicating their sustained penetration into the adolescent environment. Despite limited personal experience with electronic cigarette use among the studied population, the presence of information gaps and uncertainty about risks, as well as the existence of a risk group with positive attitudes towards use, highlights the critical need for early and targeted preventive interventions to build robust negative attitudes before potential experimentation.
Rubber dam isolation for deep subgingival defects—practical guidelines
Full text linkThe benefits of using a rubber dam in endodontic treatments and restorative procedures is a widely discussed topic in dental literature. Yet, the question remains: how can we achieve proper isolation in teeth with deep subgingival defects? In this article, we have attempted to synthesize and summarize some practical guidelines to help overcome common clinical challenges associated with managing such cases
Peri-implantitis
Full text linkPeri-implantitis is a biological complication that can occur after a dental implant is placed. It encompasses inflammatory reactions around the implant, such as peri-implant mucositis and peri-implantitis itself. As dental implants become more widely used, complications associated with them are also becoming more common. Several risk factors can contribute to the development of peri-implantitis. These include placing an implant when there is an existing periodontal infection in the remaining teeth, as well as when there is inadequate width of attached gingiva. Poor oral hygiene is another significant risk factor. Additional factors include the presence of an endodontic infection near where the implant is placed, improper implant positioning in terms of prosthetic and/or biological alignment, the implant design itself, incorrect abutment choice, and unremoved cement in cement-retained prosthetic devices. Systemic and genetic factors can also play a role in modifying the risk of peri-implantitis. Peri-implant inflammatory diseases are diagnosed through both clinical and paraclinical testing methods. This involves assessing the risks associated with the implant, such as whether plaque is present, whether there is bleeding on probing, edema, erythema, increased probing depths, exudation, bone loss around the implant, and implant mobility. The treatment for peri-implant inflammation involves CIST therapy
Hospitals of the modern age – synergy between health and design
Full text linkThe need for continuity in the provision of medical care is crucial for hospitals to fully achieve their mission of preserving lives and promoting public health. Future hospitals must urgently allocate financial and human resources to organize workflows and implement new technologies in a way that enhances staff satisfaction and the patient care they provide.Historically, hospitals were viewed as complex facilities, requiring primarily engineering and technical expertise in their construction. Modern perspectives have broadened this understanding; alongside essential security and safety requirements, there's now a focus on creating beautiful, comfortable, and stimulating environments through new advancements in architecture and construction
Where the Sea Heals: 120 Years of the First Children's Sea Sanatorium near Varna
No full textIn 2025, Bulgaria marks the 120th anniversary of the establishment of its first children's seaside sanatorium—a unique medical institution founded near Varna. This sanatorium marked the beginning of the organized fight against osteoarticular tuberculosis in children by utilizing natural healing factors such as sea climate, sun, air, and seawater baths. The article traces its history, founders, therapeutic approaches, and social significance, placing it in the context of European trends in thalassotherapy and social pediatrics