Varna Medical University Press: Journals
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The Role and Position of Pharmacists in the Comprehensive Care of Patients with Ankylosing Spondylitis (Bechterew's Disease)
Get PDFAnkylosing Spondylitis (AS), also known as Bechterew's Disease, is a chronic, progressive rheumatologic condition primarily affecting the sacroiliac and axial joints. The disease is characterized by inflammatory back pain, which gradually worsens and can lead to severe functional limitations if not treated in a timely manner. Given its disabling nature and its onset in individuals under 30 years old, AS has significant social implications. Management of AS requires long-term treatment with analgesics and disease-modifying drugs, with the added complexity of managing comorbid conditions. This comprehensive therapeutic approach increases the risk of medication-related problems, such as adverse drug reactions, interactions, and non-adherence.Pharmacists, as key healthcare professionals, play a crucial role in bridging the gap between patients and physicians, ensuring effective therapy adherence, optimizing pharmacotherapy, and providing patient education. They are equipped to identify potential drug-related issues, counsel patients on medication use, and assist in the early screening of undiagnosed patients who may have AS, thereby contributing to timely referrals and appropriate management.This article explores the evolving role of pharmacists from mere dispensers of medication to active participants in the healthcare team, providing personalized pharmaceutical care to improve treatment outcomes in AS patients. By leveraging their expertise in medications, pharmacists can enhance patient outcomes, reduce healthcare costs, and improve the quality of life for those living with AS. The integration of pharmacists into the comprehensive care team is essential for the successful management of this chronic condition
Institutions and Structures Outside the National Health System Related to the Protection of Public Health in Bulgaria
Get PDFThe state's responsibility to protect public health (PH) requires policymakers in all sectors to assess and anticipate the impacts of their policies on people's health. In Bulgaria, the state health policy is guided and implemented by the Council of Ministers, as it encompasses structures from various ministries.The аim of the study is to provide an overview and analysis of the various structures outside the National Health System, which directly or indirectly carry out control activities and provide services for the prevention and protection of public health at the national, regional, and local levels.Materials and Мethods: A documentary method was used to analyze the legal framework in the country regarding the activities of institutions and organizations engaged in the protection, strengthening, and control of public health. For each institution, the study briefly presents the most recent historical developments, organizational structure, and scope of main functions.Results and Discussion: The analysis includes institutions and organizations under the Ministries of: Agriculture and Food, Environment and Water, Labor and Social Policy, Regional Development and Public Works, as well as the Ministry of Interior, Ministry of Economy, and Ministry of Defense. The results show that a wide network of institutions outside the National Health System has been established in Bulgaria, conducting control and preventive activities related to the protection and preservation of public health at the national and regional levels. However, there is still relatively weak participation of non-governmental and municipal structures and organizations directly addressing public health issues at the local level. Furthermore, there is a lack of information and evaluation regarding the quality and effectiveness of inter-sectoral interaction and cooperation among individual structures, as well as their coordination in solving complex cases and issues related to the protection of the population`s health
Monitoring of Patients with Metabolic Diseases: Diabetes and Insulin Resistance
Get PDFIntroduction: Diabetes is one of the most common diseases worldwide, including in Bulgaria. It affects 347 million people globally, of whom 70,000 are children. In Bulgaria, according to statistics, 500,000 people are diagnosed with diabetes. The World Health Organization predicts that by 2030, this number will exceed 500 million worldwide. Diabetes has also seen rapid growth following the COVID-19 pandemic, with an estimated 14% of patients who contracted COVID-19 expected to develop type 2 diabetes.The aim of this article is to establish conditions for monitoring patients with diabetes and pre-diabetes using various blood glucose measurement devices, to develop new programs that include dietary regimens combined with medical gymnastics, and to introduce innovative formulas of nutritional supplements that help reduce blood glucose levels.Materials and Methods: A documentary method was employed, including a review of scientific publications from medical journals related to the monitoring of metabolic diseases.Results: The study identified and analyzed various blood glucose measurement devices, including blood and non-invasive technologies. A feeding regimen tailored to bread unit requirements was developed and compared with existing regimens.Conclusion: Diabetes is a socially significant disease in both Bulgaria and the world. Its early detection can be managed without medication if alternative approaches are followed. By pursuing self-awareness and inner peace, incorporating adequate rest, and appreciating the healing power of nature, individuals can learn to view diabetes as a manageable condition and live harmoniously with it
Risk Factors and Prevention Strategies in Patients with Type 1 Diabetes
Get PDFType 1 diabetes is one of the most rapidly spreading chronic autoimmune diseases, characterized by beta-cell destruction leading to insulin deficiency and hyperglycemia. Early identification of individuals with type 1 diabetes in the presymptomatic phase can predict clinical disease and improve health outcomes.Aim: The aim of this review is to focus on risk factors and prevention strategies in patients with type 1 diabetes.Material and Мethods: A review and systematic search were conducted in the PubMed database using the keywords: type 1 diabetes, risk factors, prevention. The search covered the last 10 years, from 2014 to 2024, and included the full text of available scientific reports from which this review was prepared.Results: The study identified 17 systematic reviews that met the inclusion criteria out of a total of 614 results retrieved using the specified keywords.Discussion: Several risk factors for the development of type 1 diabetes mellitus have been identified, including genetic predisposition, family history, environmental factors, and metabolic biomarkers. Prevention strategies—primary, secondary, and tertiary—are important to stop the natural progression of the disease and identify high-risk individuals.Conclusion: The continuing global prevalence of diabetes represents a significant public health challenge. Accurate identification and characterization of populations at the highest risk are key to developing successful strategies for prevention, prophylaxis, and management of the disease. Predicting risk factors and implementing prevention strategies are important future steps in the treatment and control of the disease
Lumbar Disc Disease - Etiology, Clinical and Diagnostic Features
Get PDFDegenerative disc disease is one of the most common causes of low back pain. Lumbar disc disease has a polyetiological nature. There are multiple risk factors underlying the disease (mechanical, genetic, trophic, environmental, etc.) that, individually or in combination, are responsible for the development of this irreversible process. The most common clinical manifestations associated with degenerative changes in the lumbar spine are local and radicular pain, neurological symptoms (changes in sensation and motor deficit), and functional disorders. For the diagnosis of intervertebral disc degeneration, non-invasive methods, including functional assessment, instrumental methods (MRI, CT), pain questionnaires, and serum biomarkers, are mainly used in practice.Aim: The aim of this review is to reveal the etiological factors leading to the occurrence of degenerative changes in the lumbar spine, as well as to discuss the main clinical manifestations of the disease and diagnostic methods.Materials and Methods: This article summarizes information from various databases such as PubMed, Scopus, and ScienceDirect on the etiological factors, clinical manifestations, and diagnostic methods of lumbar disc disease.Results: The direct action of multiple risk factors for the development of lumbar disc disease has been established. The specific clinical characteristics of the disease are revealed, and the most commonly used diagnostic methods are described.Conclusion: In-depth knowledge of the etiological factors, their mechanisms of action, and the specific symptoms of lumbar disc disease enables more accurate diagnosis, thus ensuring faster recovery for patients
The Role Of Artificial Intelligence In Drug Design
Get PDFArtificial intelligence (AI) aims to simulate human thought and actions. It is an effective tool for various functions, including problem-solving and data classification.In recent years, AI has found numerous applications in the pharmaceutical sector. It is utilized in drug design, optimization of the manufacturing process, adherence to correct drug intake, prediction of treatment outcomes, processing of biomedical and clinical data, analysis of gene expression patterns, and detection of pandemic outbreaks. In modern drug design, AI plays a crucial role in creating molecular libraries, identifying new drug candidates with optimal properties, and predicting the biological functions of drugs with a protein structure.This article aims to present opportunities for optimizing the drug design process through the use of AI.To achieve this goal, a literature review method was used. Articles reviewed were selected from PubMed, Scopus, and Google Scholar databases.AI enables a more systematic search model and allows for the estimation of its parameters. The application of AI in drug design provides opportunities for process optimization, reducing the use of toxic reagents in synthesis. Additionally, AI can address key challenges in traditional drug design methods, such as low success rates, limited target options, poor transition from preclinical to clinical trials, lengthy processes, and high costs
Trust And Sharing - Factors For Better Care In Somnology Nursing Practice
Get PDFWorld sleep organizations state that good somnological care is the result of interdisciplinary interaction. Nurses, as full members of the team providing care for persons with obstructive sleep apnea, actively participate in the entire diagnostic and treatment process. Successful nurse-patient communication is about building an atmosphere of trust and sharing. The purpose of the development is to analyze and outline the importance of trust and sharing as factors for better care in somnological nursing practice. The opinion of 80 patients diagnosed with obstructive sleep apnea was studied through a direct anonymous survey. The results of the analysis show that good professional training, information presented in an understandable language and the ability to devote enough time to communication are qualities that a nurse should possess. The nurse's skills to build an atmosphere of trust, sharing and support are important for effective dialogue with the patient according to 87.50% of respondents and a key moment in the process of providing quality and comprehensive patient-centered health care. Knowledge and application of communication techniques enhance patient satisfaction by creating a favorable basis for strong motivation to conduct treatment
Dynamic characteristics of body posture in patients with orthodontic disorders
Get PDFIntroductionDuring the static and dynamic activities that a person performs, the body takes an automatic and unconscious position, called posture. It is dependent on and influenced by certain factors, such as age, gender, body mass index (BMI), existing diseases of the musculoskeletal, visual, audiovestibular, and stomatognathic systems. Existing disorders in the correct arrangement of teeth in the dental arches have been proven to affect the correct posture of the head and body. Deviations in the center of gravity (CoG) from the norm lead to the manifestation of a pain syndrome.AimThe aim of this article is to analyze the dynamic characteristics of body posture in patients with orthodontic disorders.Materials and MethodsFor the purposes of the following study, 51 patients aged between 18 and 60 years (29 female, 26 male) were included. A specialized otorhinolaryngological and a dental examination, focused on identifying orthodontic disorders, was performed. An analysis of posture and dynamic body stability was also conducted using the diagnostic section PODATA stabilometric platform of the Global Postural System (GPS) Pl0800 Leonardo postural laboratory. The parameters analyzed were the length and shape of the sway curve (stabilogram), area of maximum stability, position of the measured center of gravity (CoG) of the body.ResultsOrthodontic disorders were detected in 24 of the 51 participants included in the study. Deviations from the normal values of the studied parameters (length and shape of the stabilogram, area of maximum stability, position of the CoG) were diagnosed in all patients. The changes were more pronounced in patients with established orthodontic disorders.DiscussionIt was found that changes in the dynamic body posture of individuals were widely diagnosed. An aggravating factor is the presence of additional disorders, in this case—orthodontic.ConclusionProper diagnosis of head and neck disorders is determined by the participation of interdisciplinary teams of specialists. In this way, patients receive a thorough treatment plan and better results from the therapy
Interactions between poorly controlled diabetes mellitus type I and deteriorated oral status—significance of the problem in childhood. A case report
Get PDFIntroduction: Diabetes mellitus type 1 is associated not only with a significant burden upon the physical status, but also with a condition of psychoemotional discomfort, which inevitably deteriorates the quality of life of the individual and the society as a whole.Aim: The aim of this case report is an evaluation of the interactions between poorly controlled diabetes mellitus type 1 and deteriorated oral status in childhood. Materials and Methods: A female child at the age of 8 years with a mixed dentition was examined. The following diagnostic criteria were used: dft, DMFT, PLI, GI, PBI, as well as an enquiry. Conclusion: The efficient long-term management of diabetes mellitus type 1 in childhood is in direct relation to the target diagnostic, therapeutic and prophylactic cares for reconstruction of the oral cavity, respectively improvement of the oral status of the patient