Varna Medical University Press: Journals
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Digital dental file formats (DICOM, STL, PLY, OBJ): specific features and differences
No full textDigitalization has facilitated the work of dentists and dental technicians, but it has provoked an urgent need to increase theoretical and technological competence. By creating specific dental file formats, dental specialists diagnose, plan treatments and create personalized dental constructs. In digital dentistry and dental laboratories, 2D image files, 3D image files and model files are used. Some of the most commonly used file formats are DICOM, STL, PLY and OBJ. Each format has its pros, cons and applications. Practitioners often do not recognize their specificities and differences. Understanding the strengths and limitations of the file formats used in the dental industry is essential in modern digital dentistry. This knowledge is essential for good practice.The purpose of this study is to systematize information about the file formats used in communication and production of constructs in digital dental practice and the dental laboratory. It also aims to consider the main differences between them, their limitations, advantages and most common applications
Opportunities and prospects for the application of inertial navigation systems for military purposes
No full textIn the middle of the third decade of the 21st century, modern military equipment increasingly relies on GPS devices for navigation, collision avoidance, and precise positioning. However, the GPS signal is extremely vulnerable to interference from malicious actors and is highly dependent on the performance of the satellite network. In the event of a powerful solar flare or a malicious attack on satellites, GPS navigation can be disrupted. These facts give grounds for searching for alternative sources of navigation, one of which is inertial navigation system
Regional anesthetic techniques for postoperative pain management in abdominal surgery: A review
Full text linkIntroduction: Pain after surgical intervention continues to be a major challenge for medicine worldwide. Surgical pain is a specific type of acute pain in the modern age of medicine. It arises with the development of new surgical techniques and has one unique characteristic—it is predictable and preventable. Despite better understanding of the physiology, pharmacology, and mechanisms of pain, more than 50% of hospitalized patients report experiencing pain after procedures.In recent years, there has been increasing interest in regional anesthesia techniques and their inclusion in a multimodal analgesia approach. Especially following the introduction of ultrasound navigation, infiltrative techniques as part of regional anesthesia are gaining attention. Some of the most commonly used blocks include local infiltration analgesia (LIA), transversus abdominis plane block (TAP block), quadratus lumborum block (QLB), and erector spinae plane block (ESP).Aim: To study the existing regional analgesia techniques in abdominal surgeries by analyzing the available literature in PubMed, Google Scholar, Cochrane Library, and Medscape.Objectives: To evaluate the existing regional analgesia techniques and their extent and method of application in abdominal surgeries.Conclusions: Fascial blocks, especially after the introduction of ultrasound techniques, have revolutionized the concept of intra- and postoperative analgesia in abdominal surgeries. They are becoming an excellent alternative to epidural analgesia, as they are easier to perform and carry significantly lower risks and complications compared to neuraxial anesthesia. Their inclusion is highly recommended as part of multimodal analgesia and enhanced recovery after surgery (ERAS) protocols
Specifics of pharmaceutical care in joint diseases
Full text linkJoint and rheumatic diseases cause significant, chronic health and societal burden, characterized by progressive impairment and long-term treatment needs. Effective management is multidisciplinary; pharmacists play a key role. This article examines pharmaceutical care’s impact on joint diseases, focusing on core care principles, therapy monitoring, and adherence strategies. Evidence shows pharmacists enhance patient outcomes by individualizing therapy, solving medication issues, educating patients, and ensuring follow-up. The need for structured pharmaceutical care in Bulgaria is highlighted, including clinical pharmacy development and national standards. Pharmacist-led care can improve outcomes and care quality for patients with joint diseases
Total hip replacement after failed operative treatment of trochanteric and subtrochanteric fractures: Our experience in 10 patients with a modular revision stem
Full text linkTrochanteric and subtrochanteric fractures are among the most common types of fractures, and their incidence is expected to rise. As this happens, the rate of complications is also expected to increase. Despite improvements in surgical techniques and implants, complication rates remain significant. The main treatment options for failed operated trochanteric or subtrochanteric fractures are reosteosynthesis or conversion to hip arthroplasty.We present our clinical experience with the use of a cementless modular revision system with a porous titanium stem and a hydroxyapatite-coated metaphyseal component, with the option for distal locking. The inclusion criteria for conversion hip arthroplasty with revision implants were age, osteoporosis, poor bone quality, bone defects, functional level, and life expectancy.Our results demonstrate that modular revision stems provide valuable options for managing such complex cases and help minimize the risk of further reoperations
Laparoscopic surgery for hiatal hernia
Full text linkIntroduction: Hiatal hernia is one of the most common anatomical defects of the gastrointestinal tract and a benign disease of the cardioesophageal junction. It is often accompanied by gastroesophageal reflux disease. Laparoscopic fundoplication is accepted as the gold standard in its treatment and is widely used. An analysis of the results contributes to improving the method and reducing complications.Aim: To conduct a study on the application of laparoscopic fundoplication in hiatal hernia.Materials and Methods: The study included 362 patients who were diagnosed and operated on in the First Clinic of Surgery at St. Marina University Hospital in Varna, during the period 2005–2022. Perioperative results, morbidity, mortality, general and specific complications, as well as pre- and postoperative data according to the follow-up protocol, were analyzed.Results: The distribution of the total group of patients by sex was 30.5% male and 69.5% female. The mean age of the patients was 62.0 years, with 59.1 years for men and 62.9 years for women. The majority of patients had mixed hiatal hernia (type III) (36.8%), followed by type IV (27.9%), type I (15.4%), and paraesophageal hiatal hernia (19.9%). The most commonly performed operative method for fundoplication was Nissen. Collis gastroplasty was also performed in 45 patients with evidence of brachioesophagus. Postoperative complications were considered according to the Dindo-Clavien classification. The recurrence rate was 11.1%. Statistical analysis found that after each intervention there was a significant change in the value of the GIQLI quality of life index. Data on specific complications and management are presented.Conclusion: Laparoscopic fundoplication is a continuously evolving method. Functional outcomes, combined with low mortality and morbidity, ensure a good quality of life for patients
Coronary atherosclerosis and periodontitis
Full text linkCoronary atherosclerosis is а multifactorial disease in which chronic inflammation plays a central role in the initiation and progression of vascular lesions. Emerging evidence indicates that periodontitis, a common chronic oral infection, contributes to systemic inflammation and may exacerbate atherosclerotic processes. Epidemiological studies and clinical investigations consistently show an association between the severity of periodontal disease and the extent of coronary artery involvement. Current evidence focuses on the biological and clinical links between periodontal disease and coronary atherosclerosis, emphasizing the role of pathogenic oral microflora, systemic inflammatory activation, and the potential benefits of integrated periodontal and cardiovascular care. Further multidisciplinary research is essential to clarify microbial and vascular interactions, identify high-risk microbial profiles, and develop preventive strategies targeting the infectious–inflammatory axis of atherosclerosis.Coronary atherosclerosis is а multifactorial disease in which chronic inflammation plays a central role in the initiation and progression of vascular lesions. Emerging evidence indicates that periodontitis, a common chronic oral infection, contributes to systemic inflammation and may exacerbate atherosclerotic processes. Epidemiological studies and clinical investigations consistently show an association between the severity of periodontal disease and the extent of coronary artery involvement. Current evidence focuses on the biological and clinical links between periodontal disease and coronary atherosclerosis, emphasizing the role of pathogenic oral microflora, systemic inflammatory activation, and the potential benefits of integrated periodontal and cardiovascular care. Further multidisciplinary research is essential to clarify microbial–vascular interactions, identify high-risk microbial profiles, and develop preventive strategies targeting the infectious–inflammatory axis of atherosclerosis
Guidelines and policies for infection control in dental laboratories
Full text linkIntroduction: Recommendations for infection control in dental laboratories have evolved as an integral part of guidelines for infection risk management in oral health facilities. With the advancement of science and technology, as well as under the influence of significant events that have had an impact on public health, these recommendations have changed from brief instructions for cleaning prosthetic structures to a comprehensive policy for infection risk control in dental laboratory practice.Aim: The aim of this report is to present a historical overview and analysis of the development of guidelines and policies for infection control in dentistry with a focus on dental laboratories.Materials and Methods: A search was conducted for published policies and evidence-based guidelines for infection control in dentistry and dental laboratories from health and professional organizations in Europe and the United States of America (USA). The search was conducted in July 2025, in English and Bulgarian, in the electronic databases PubMed, Research gate, Google Scholar, and on the official websites of the respective organizations.Results and Discussion: Seventeen documents containing policies or guidelines for infection control in dental facilities were found and assessed. Eight of these contained specific recommendations for infection control in the dental laboratory. They concerned topics such as: disinfection and sterilization of materials, instruments, equipment and environment; personal protective equipment; communication and coordination between the laboratory and the dental office; written infection control policy; vaccination policy; infection control training; waste management. There are no such specific Bulgarian guidelines.Conclusion: Modern guidelines represent comprehensive standards for infection prevention. Their effectiveness depends on systematic updating and integration of new scientific evidence and technological achievements. In Bulgaria, there is a need for specific national guidelines for dental laboratories to support the implementation of established standards and good practices.