Varna Medical University Press: Journals
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Digital literacy and generic competencies among nursing students
Full text linkIntroduction: This article examines the essence and importance of digital literacy and general competencies among nursing students in the context of the increasing demands on healthcare professionals. In an environment of rapidly developing information and communication technologies, the ability to use digital resources effectively, think critically, and adapt to new technological settings becomes a key factor in both professional and personal development.Aim: To investigate the attitudes of nursing students towards digital technologies and to assess their level of digital literacy across key domains.Materials and Methods: An empirical study was conducted among nursing students using a standardised questionnaire. Constructed indices assessed competencies in five areas: information literacy and data management, communication and collaboration through digital tools, content creation, online safety, and problem-solving. The reliability of the indicators was tested using Cronbach’s alpha.Results and Discussion: The findings reveal positive attitudes among students towards the use of digital technologies. Cronbach’s alpha showed high values in all examined areas, confirming the consistency of the constructed indicators. Differences in competence levels were observed – the highest scores were recorded in communication and collaboration, while lower values appeared in the domains of critical evaluation and online safety.Conclusion: The integration of digital literacy into nursing education is essential for the development of adequate professional skills. Strengthening these competencies enhances the competitiveness of future professionals and their ability to meet the demands of the modern healthcare system and society
Types of cervical lymph node dissection in the maxillofacial region. A review article
Full text linkINTRODUCTION: We conventionally divide the lymph nodes of the neck into three major groups—upper, middle and lower. Oral cancer commonly metastasizes to the lymph nodes of the upper and middle groups, and those of thoracic origin—to the lower group.MATERIALS AND METHODS: This review article is based on information from 30 full-text articles published in prestigious medical journals between 2004 and 2024.RESULTS AND DISCUSSION: According to the oncoanatomical distribution of the lymph nodes of neck, there are seven levels of the latter (I to VII). In general, it can be said that involvement of levels I to III is characteristic of oral cancer and levels II to IV—of laryngeal and pharyngeal cancer. There are four varieties of cervical lymph node dissection according to the structures that are removed in them—radical, modified radical, selective radical, and extended radical. Depending on the indications for performing lymph node dissection, the latter is divided into therapeutic and prophylactic. Anatomically, cervical lymph node dissection is divided into supraomohyoid, extended supraomohyoid, lateral, posterolateral, and central.CONCLUSION: The performance of cervical lymph node dissection in cases with metastatic cervical lymph node disease, as well as in those in whom it is performed for prophylactic purposes, is a challenging surgical manipulation that needs a multidisciplinary approach and is critical to the prognosis of these patients
Restoration of critical-size bone defects: A review
Full text linkThere is no standard definition of “critical-size bone defect” in the literature. The term “critical” is often used to describe defects that do not heal spontaneously despite surgical stabilization and require additional bone reconstruction procedures. According to other definitions, these defects measure 2–2.5 cm in size and involve more than 50% loss of the bone’s circumference. Treating bone defects of critical size is a great challenge in bone surgery.This review aims to identify the factors that influence the regeneration of bone defects and provide guidelines for their treatment. A comprehensive electronic search was performed using the following keywords: critical-size bone defect, treatment, management, bone graft, scaffold, and tissue engineering.The analysis of the results demonstrated that the healing process depends not only on the defect’s size but also on various other factors, such as the volume and condition of the surrounding soft tissues, as well as the patient’s age and overall health status. Various treatment modalities have been suggested. Advances in tissue engineering have led to the development of new materials that closely resemble natural bone and facilitate successful anatomical and functional restoration
Vitrectomy and phacoemulsification—to combine or not in patients with a macular hole
Full text linkIntroduction: Macular hole and cataract are pathologies that often occur simultaneously in elderly patients and lead to a progressive decrease in visual acuity and worsen metamorphopsia. The incidence of macular holes varies in different populations, with an average of about 3.3 per 1,000 people. It affects to a greater extent the female sex (F:M = 3:1), usually over sixty years. The causes of a macular hole are many, patients with high myopia are a risk group, trauma is a risk factor at any age, as well as the changes that occur with the vitreous body with age.Aim: The present study aimed to evaluate the visual and anatomical outcomes as well as the quality of life of patients who underwent combined macular hole and cataract surgery.Methods: In the present study, 20 patients diagnosed with macular hole and cataract were included, each patient underwent a complete ophthalmological examination with highly specialized equipment. The Early Treatment Diabetic Retinopathy Study (ETDRS) was used as the gold standard for visual acuity determination, and optical coherence tomography (OCT) was used for diagnosis, macular hole size determination, and postoperative follow-up of anatomical results. Patients underwent cataract phacoemulsification with intraocular lens implantation and pars plana vitrectomy for macular hole. All eyes were injected with expanding gas.Results: Qualitative and quantitative results were followed in 20 patients, of which 14 men and 6 women with a mean age of 63.5 years. Anatomical closure of the macular hole on OCT examination was found in 100% of patients. Complications were not registered during the postoperative period. All patients were followed up at the first and second week, first, second, third, and sixth month after surgery. Visual acuity increased by up to 42% at the time of follow-up.Conclusion: The combined surgical approach for the treatment of macular hole and lens opacity, leads to an earlier visual outcome and less psychoemotional stress for the patient
Evaluating arteriovenous malformation and diffuse glioma: The role of arterial spin labeling MRI in complex neuroimaging—A case report
Full text linkIn this case report, we explore the utility of arterial spin labeling (ASL) MRI in a complex neuroimaging scenario featuring concurrent arteriovenous malformation (AVM) and a non-enhancing glioma in a 38-year old male. The report delves into the integration of ASL MRI with standard neuroimaging techniques, highlighting its role in providing detailed hemodynamic insights, particularly in characterizing the AVM and assessing the glioma's perfusion pattern. The case presents a diagnostic challenge due to the coexistence of these pathologies and discusses the implications of these findings in light of the evolving WHO brain tumor classification, which emphasizes the importance of molecular markers alongside histopathology. The report emphasizes the need for careful interpretation of advanced imaging in the absence of histopathological confirmation and advocates for a multidisciplinary approach in the management of such cases, underscoring the significance of ongoing research in harmonizing imaging techniques with molecular diagnostic
The involvement of necroptosis in the development of cardiovascular diseases
Full text linkRecent data indicate that necroptosis, mediated by the death receptors TNF-α/TNFR1, receptor-interacting protein kinases (RIPK1 and RIPK3), and mixed lineage kinase domain-like protein (MLKL), is implicated in the pathogenesis of ischemia-reperfusion syndrome, acute kidney injury, cardiovascular diseases, neurodegenerative diseases, etc. The plasma concentration of RIPK3 in heart failure patients is markedly elevated compared to healthy individuals, and increased plasma RIPK3 serves as a prognostic indicator in heart failure patients. Recent studies demonstrate that RIPK3 functions as an independent target and mediator of necroptosis in cardiomyocytes, influencing cardiac remodeling and the activation and synthesis of pro-inflammatory mediators and cytokines, as evidenced in disease models and by selective inhibition using necrostatin-1. Moreover, necroptosis is linked to endothelial dysfunction and atherosclerosis, as the expression of RIPK3 and MLKL is markedly elevated in advanced atherosclerotic plaques. Currently, our understanding of necroptosis’s role and effects in the pathogenesis of cardiovascular diseases is still limited, hindering patient monitoring in clinical settings. Furthermore, the investigation of selective inhibitors for therapeutic responses is insufficiently explored.This review aims to elucidate the basic mechanisms of necroptosis and to clarify its role in cardiovascular pathology. The study outlines potential therapeutic models wherein the inhibition of necroptotic mediators may reduce pathological changes and clinical symptoms associated with cardiovascular diseases
Long-term consequences of COVID-19 infection in chronic hemodialysis patients
Full text linkThe long-term effects of COVID-19 infection during the 2020–2022 pandemic remain among the most poorly understood aspects to this day. Numerous secondary symptoms have been reported following acute infection, ranging from cognitive impairments such as “brain fog” to chronic shortness of breath, cough, fatigue, palpitations, and an increased incidence of cardiovascular events [1]. Studies have identified associations between patient multimorbidity and the frequency and severity of long-term consequences [2,3].In this retrospective study, we present data from the Nephrology and Dialysis Clinic of the University Hospital “St. Marina” in Varna, where 88 patients undergoing chronic hemodialysis were followed for six months after COVID-19 infection.The aim of the study was to examine the relationship between the quality of hemodialysis—measured by URR and Kt/V—and clinical outcomes, including the duration of hospitalization due to COVID-19 or its complications, the severity of the disease course, and long-term patient survival. The results indicate that patients with lower URR and Kt/V values tend to experience longer hospital stays, more severe infections, and reduced survival. Although some findings did not reach statistical significance, the data suggest a clinically meaningful association between dialysis quality and post-COVID-19 prognosis
