Varna Medical University Press: Journals
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A rare genetic disorder in ADPKD: Case report
Full text linkAutosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder primarily caused by mutations in the PKD1 gene, which encodes polycystin-1—a protein responsible for cellular signaling and the structure of renal tubules. The defect leads to cyst formation, gradually impairing kidney function and potentially affecting other organs, such as the liver and the cardiovascular system. The disease manifests with hypertension, flank pain, hematuria, and progressive CKD. Diagnosis is based on imaging and genetic testing. Treatment focuses on slowing disease progression through symptom control, while renal replacement therapy is required in advanced kidney failure. Research on PKD1 offers new therapeutic opportunities to slow cystogenesis and improve prognosis. We present a clinical case of a 35-year-old male with polycystic kidney disease. The genetic analysis identified a novel PKD1 mutation: c.11456_11468del p.(Tyr3819Trpfs*3)
Rational probiotic use: specificity of application and approaches to optimize their effect through the prism of pharmaceutical care
Full text linkIntroduction: Probiotics are live microorganisms that, administered in adequate amounts, bring health benefits to the body. In practice, probiotics are indicated for various conditions, from mild diarrhea to conditions such as pseudomembranous colitis, irritable bowel syndrome, and an increase in the immune response. Their application becomes absolutely mandatory when it comes to antibiotic treatment, whose frequent adverse reaction is dysbiosis. As antibiotic use increases, so does the use of probiotics. The probiotics market was valued at USD 68.56 billion in 2022 and is expected to reach around USD 133.92 billion by 2030.Aim: The aim of the current study is to summarize the current information available regarding the appropriate probiotic strains for each condition, to note some of the risks of probiotic treatment, and to make recommendations for the implementation of adequate pharmaceutical care.Materials and Methods: A literature review was performed of available information in the World Gastroenterology Organization (WGO) guideline, Google Scholar, and PubMed, with statistics summarized by the World Health Organization, European Center for Disease Prevention and Control (ECDC).Results and Discussion: According to WGO recommendations, suitable strains in antibiotic-associated diarrhea are Lactobacillus acidophilus, L. casei (≥ 10e10 cfu, once daily), Lactobacillus rhamnosus (10e10 cfu, twice daily), Saccharomyces boulardii (250 mg, twice daily), and in C. difficile infection – Lactobacillus acidophilus, L. casei (≥ 10e10 cfu, once daily), Saccharomyces boulardii (250 mg, twice daily). An important aspect is that the antibiotic and probiotic should be taken separately, in order to avoid antagonizing the two products and the deterioration of antibiotic resistance. They should be taken 2 hours apart. It is advisable to continue using probiotics for at least 2-3 weeks after stopping the antibiotic. The side effects of probiotics are known in 4 main directions: systemic infections, metabolically harmful processes, excessive immune stimulation in susceptible individuals, and gene transfer. However, probiotic microorganisms are believed to be non-pathogenic, and the theoretical risk of infections is very low (mainly in immunocompromised patients). Studies on strain-specific properties, the study of pharmacokinetics, and studies looking for interactions between the strain and the host would prove useful for their more rational application according to scientific sources.Conclusion: Probiotics support the normal functioning of the gastrointestinal tract and prevent possible complications during antibiotic treatment. Each product contains one or more strains of bacteria, with different strains suitable for use in different conditions and antibiotic therapies. The regimen, dose, and duration of probiotic intake are determined by strain-specific properties. Pharmacists have a major role in the use of probiotics, based on patient opinion. Health professionals must obtain information about them from reliable sources and are required to warn patients about the peculiarities and risks of using probiotics
Demographic, social, and genotypic profile of men with HPV genital warts in outpatient practice
Full text linkGenital HPV infection is the most common viral sexually transmitted disease, which is confirmed by all Bulgarian and international publications in recent years. In our country, it has been studied more extensively in women, but there are no sufficiently detailed and representative studies among men. The epidemiological significance of the most common clinical manifestation in men - anogenital warts, is determined by the high contagiousness and increased risk of malignancy and development of anogenital carcinomas.The study covered 166 men with HPV genital warts in outpatient dermatovenereological practice. The profile of the studied group is presented through data on age, social status, educational qualifications, place of residence, sexual partnership, virological examination to determine the genotype of the causative agent
Ethical challenges facing digital health and technology (some contexts and considerations)
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Awareness Of The One Health Approach Among Key Professional Groups In Bulgaria
Full text linkThe sustainable implementation of the One Health concept requires a new way of thinking that embraces holistic knowledge, extending beyond narrowly defined professional competencies of those engaged in public health. The aim of this study is to present findings on the level of awareness of the One Health concept among two key professional groups in Bulgaria: human healthcare and veterinary medicine professionals. Materials and Methods: A prospective cross-sectional sociological study was conducted using direct individual questionnaires administered to the two target groups in paper format. The study was carried out between March 2023 and September 2024 following ethical approval.Results: The study included 228 respondents from the fields of human and veterinary medicine. A total of 168 healthcare professionals from different types of hospitals and 60 veterinary specialists from public and private institutions were surveyed. The sample was predominantly female (80.7%), with a mean age of 47 years, reflecting the actual professional structure of the sectors.The results demonstrate very low awareness of the One Health concept within human healthcare, regardless of the type of healthcare institution. Veterinary professionals showed higher levels of awareness; however, no evidence of substantial practical implementation was identified. Intersectoral communication exists primarily at a formal level, with minimal real participation in coordinated joint actions.Conclusion: The study reveals low overall awareness of One Health in Bulgaria and highlights the need for systematic education to support effective intersectoral practice.Introduction: The sustainable implementation of the One Health concept requires a new way of thinking that embraces holistic knowledge extending beyond narrowly defined professional competencies of those engaged in public health. The aim of this study is to present findings on the level of awareness of the One Health concept among two key professional groups in Bulgaria: human healthcare and veterinary medicine professionals.Materials and methods: A survey of the level of One Health awareness was conducted among the two target groups, admin-istering the questionnaires in paper format. The study was carried out between March 2023 and September 2024 following ethical approval.Results: The study included 228 respondents from the fields of human and veterinary medicine. A total of 168 healthcare pro-fessionals from different types of hospitals and 60 veterinary specialists from public and private institutions were surveyed. The sample was predominantly female (80.7%), with a mean age of 47 years, reflecting the actual professional structure of the sectors. The results demonstrate very low awareness of the One Health concept within human healthcare, regardless of the type of healthcare institution. Veterinary professionals showed higher levels of awareness; however, no evidence of substantial practical implementation was identified. Intersectoral communication exists primarily at a formal level, with minimal real participation in coordinated joint actions.Conclusion: The study reveals low overall awareness of One Health in Bulgaria and highlights the need for systematic education to support effective intersectoral practice
Four international congresses in Germany in two months
Full text linkYear 2025 is full of international congresses hosted by Germany. First of all, this was 17th Congress of the European Society of Pediatric Otorhinolaryngology under the title ”Creating innovations – Implementing innovations”. It was followed by the European Symposium on Pediatric Cochlear Implantation and 6th International Symposium on Otosclerosis and Stapes Surgery. Meanwhile it was also the 97th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery e. V
Papilla preservation flaps – types and indications: A review
Full text linkSurgical interventions for regenerative therapy of deep infraosseous periodontal pockets in the aesthetic zone of the upper jaw are associated with a risk of papilla height loss, the appearance of black triangles between teeth, long clinical crowns, and aesthetic failure post-surgically. This is perceived as an unacceptable result. For this purpose, papilla preservation flaps have been used in practice, with different modifications developed over the years. The aim of the article is to summarize the available literature data on their classification over the years, which would facilitate clinicians in choosing a certain technique in a specific clinical case