Varna Medical University Press: Journals
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Use of assessment scales for early detection of the risk of reduced work ability in mental work
Full text linkThe study shows how combining the Work Ability Index (WAI) with a brief assessment of emotional exhaustion/stress can enable early detection of risk for reduced work ability in cognitive work. The aim is to determine to what extent this simple combination predicts day-to-day and week-to-week performance dynamics and momentary functional state.Methods: Three hundred and fourteen employees were monitored in small and medium-sized enterprises with periodic measurements on Monday, Wednesday, and Friday: overall work ability (WAI). Questionnaires were administered for perceived stress, depressive symptoms/anxiety (HADS and Zung), an attention task (speed and accuracy), fine motor control, and momentary self-assessment (self-confidence, activity, mood; SAN).Results: Half of the participants had a “very good” WAI, but higher stress and emotional exhaustion were associated with lower overall work ability and a less favorable daily/weekly trajectory. Under high stress, people were less likely to “get into the groove” (impaired settling-in) on Monday morning, while on Friday afternoon the most pronounced declines were observed in speed, accuracy, and self-assessed state. The simple combination “WAI below ‘very good’ + moderate/high stress” identified groups at elevated risk for reduced work ability and expected end-of-week declines.In summary, WAI complemented by a brief stress/exhaustion assessment is a practical, noninvasive, and low-resource tool for routine screening in office settings, enabling early risk detection in cognitive work. We recommend easily applicable measures: optimization of time demands (reducing time pressure), structured active breaks, sleep hygiene, and alignment with the natural daily rhythm/chronotype when scheduling complex tasks to facilitate settling in and limit the Friday downturn. Additionally, the analytical approach enables prioritization of resources to vulnerable subgroups (lower WAI and moderate/high stress) and adaptation of schedules by shifting complex cognitive tasks to time windows with a higher likelihood of optimal concentration (midday/Wednesday). The observed links between perceived stress, depressive symptoms, and chronotype suggest that integrating basic psychoeducation and sleep hygiene interventions may improve week-long resilience. The approach is suitable for routine corporate screening and monitoring without complex instruments and can serve as a basis for subsequent interventional studies
Influence of behavioral risk factors on glycemic control in patients with type 1 diabetes
Full text linkIntroduction: Behavioral risk factors, such as nutrition, physical activity (PA), and perceived stress levels in daily life, have a significant impact on glycemic control in patients with type 1 diabetes mellitus (T1DM). Despite advances in insulin therapy and monitoring technologies, unhealthy habits continue to hinder effective treatment.Aim: The aim of the present study was to assess the influence of the main components of lifestyle on glycemic control in patients with T1DM.Material and methods: A prospective cohort study was conducted among 74 adult patients with T1 DM and long-term disease duration (>15 years), in the period August - September 2024. The study is part of project No. 24034, funded by the Science Fund at the Medical University – Varna, Bulgaria. Statistical analysis was performed using IBM SPSS v.26, using the chi-square test (χ2) and Pearson (r) and Spearman (p) correlations.Results: The χ2 test established a statistically significant relationship between balanced nutrition and PA in the prevention of the disease (χ² = 12.683, df = 2, p = 0.002). Spearman correlation analysis demonstrated a statistically significant relationship between PA and BMI (Spearman‘s rho = 0.389, p = 0.01). Regular PA reduced glycated hemoglobin (HbA1c) by an average of 0.48% in athletes and led to a reduction in body mass (χ² = 7.60, df = 1, p = 0.006).Conclusion: Lifestyle changes, through interventions that promote healthy behavior, should be a priority part of diabetes care programs
A method for assessing the psychophysiological state of naval aircrew
No full textThe requirements for professional mental and physical fitness of naval flight crews are numerous. Flight crew members are subjected to a number of extreme stresses, under the influence of meteorological, professional and psychological conditions. This tests the resilience of each participant. The good physical and mental condition of the flight crew is crucial for the successful performance of the mission and is directly related to flight safety. Numerous studies have proven that the causes of serious aviation accidents are human errors, which draws attention to the individual, his mental and physical resilience. The tasks of naval crews are specific and high-risk when performed over the sea, which makes them extremely stressful for the individual. They test the mental and physical strength of the crew members. For this reason, the assessment of the psychophysiological state of the crew members before, during and after the flight is essential. This allows for the assessment of changes occurring in the psychological and physiological functions of each subject under study at an individual and group level. The aim of the article is to present a methodology for assessing the psychophysiological status of naval flight crews. The assessment method involves conducting anthropometric, psychological, laboratory and functional tests in order to provide a comprehensive assessment of the psychological and physiological state of each crew member. The studies are conducted before, during and after the flight task in order to assess the changes (anthropometric, psychological and physiological) occurring in the crew under the influence of the extreme dynamic conditions of the flight environment
Osteoporosis and oral health: a review
Full text linkIntroduction: Osteoporosis is a multifactorial metabolic disease characterized by reduced skeletal mass and impaired bone microarchitecture, leading to increased susceptibility to fractures. It mainly occurs in middle-aged and elderly individuals and usually proceeds unnoticed until the first bone fracture. This review aims to clarify the relationship between osteoporosis and oral health, identify the risks for these patients during dental treatment, and highlight the need for a multidisciplinary approach between dentists and healthcare providers.Materials and Methods: An electronic search was performed in Web of Science, Scopus, PubMed, and Google Scholar using the following keywords: osteoporosis, dentistry, oral health, bisphosphonates, periodontal health, and tooth extraction. After selection and analysis of the obtained data, this review included 46 articles.Results and Discussion: There is a dynamic relationship between osteoporosis and oral health. On the one hand, the pathophysiological processes in osteoporosis have a negative impact on periodontal health and jawbone density and are associated with an increased risk of tooth loss. On the other hand, drug treatment for osteoporosis, including hormone replacement therapy and antiresorptive agents, carries significant risks when performing invasive dental procedures.Conclusion: The multifactorial nature of the relationship between osteoporosis and dental health requires a multidisciplinary approach, including close collaboration between dentists and specialists managing the systemic disease. Professional oral care is a key prerequisite for treatment success and for limiting the risks of future complications
Blepharoplasty and numbers
Full text linkIntroductionBlepharoplasty is one of the most commonly performed aesthetic interventions, which is gaining more and more popularity in Bulgaria. AimThe present study aims to introduce to the oculoplastic community the characteristics of the intervention in the country. Materials and Methods The survey was conducted completely anonymously online, using social networks. ResultsA hundred people took part in the study. Ninety-five percent of those who completed the survey were female with an average age of 52. Forty percent of them were residents of the city of Sofia, 40% inhabited a regional city, and 20%—a smaller city. The average age at which patients were when they underwent the aesthetic intervention was 49 years. Of the possible options, the majority (75%) chose the classic one performed with a scalpel. Eighty percent of the participants underwent correction of the upper eyelids, 5%—of the lower ones, 15% preferred a combined procedure, and only 5% repeated the intervention. The reasons for resorting to the intervention were diverse, with the leading ones being those associated with fatigue and aging. In 60% of the respondents, blepharoplasty was performed by an ophthalmologist, in 36%—by a plastic surgeon, and in 2%—by an otolaryngologist. One of the participants indicated that the manipulation was performed by a dentist and one did not know the specialty of their surgeon. In 45%, the anesthesia of choice was local, in 40%—combined with sedation, and in 15%—complete. Regarding satisfaction, 45% of respondents were absolutely satisfied with the results and 60% reported an improvement in self-esteem and confidence. The complications that have arisen and the resulting negative effects were diverse. Seventy percent would recommend blepharoplasty to relatives and friends. ConclusionBlepharoplasty is an aesthetic intervention that can significantly improve the appearance of patients. However, it is necessary to create standards for its implementation
Basic principles for predictive regenerative therapy
Full text linkIntroductionWe can now talk about predictive regenerative therapy thanks to the fact that there are a series of basic principles that, if taken into account, would guarantee the results we would like to achieve. These principles include primary wound closure, good angiogenesis, barrier function for the required period of time, ensuring and maintaining the space of the bone defect and keeping the blood clot stable.AimThe purpose of this review article is to present a general overview of the above-listed basic principles for achieving predictable results in regenerative therapy. Materials and MethodsKeywords such as "regenerative therapy", "regenerative principles", "guided tissue regeneration", and "guided bone regeneration" were utilized to search Web of Science and Scopus for related scientific articles published in English up until 2024. The literature was thoroughly analyzed. After thoroughly reviewing the reference list, all papers were evaluated and examined for more relevant research. ResultsThe basic principles that are necessary to achieve predictable regenerative outcomes are primary wound closure, good angiogenesis, barrier function for the required period of time, securing and maintaining the bone defect area, and keeping the blood clot stable.ConclusionBoth a high degree of technical proficiency and a comprehensive understanding of the fundamentals of wound healing are necessary for a successful predictive regeneration
Microplastics and CKD: Are we overlooking the role of ecotoxins
Full text linkChronic kidney disease (CKD) represents a major global health burden with complex and multifactorial etiology. In recent years, increasing attention has been directed toward environmental pollutants, including microplastics (MPs), as potential contributors to renal injury. Microplastics, defined as plastic particles less than 5 mm in size, are omnipresent in the environment and have been detected in food, water, and even human biological samples. This review explores the physicochemical characteristics, toxicokinetics, and nephrotoxic potential of MPs, with a particular focus on data from in vivo studies. Evidence suggests that MPs, especially in nanoscale, can penetrate biological barriers, accumulate in renal tissue, and induce glomerular and tubular damage through mechanisms involving oxidative stress, inflammation, and epigenetic dysregulation. MPs should be considered emerging nephrotoxicants with possible relevance in the prevention and management of CKD