Varna Medical University Press: Journals
Not a member yet
8984 research outputs found
Sort by
Comparative analysis of the quality of life in patients with different stages of diabetic retinopathy
Get PDFIntroduction: Diabetes mellitus is a chronic condition linked to multiple long-term complications, among which is diabetic retinopathy (DR).Aim: The aim of this article is to assess the impact of the different stages of DR on the quality of life of the affected patients by conducting a comparative analysis of the perceptions and level of functionality related to vision and general health.Methods: Fifty-nine patients with the presence of DR, over the age of 18, residents of the city of Varna, who passed through the Department of Endocrinology of St. Marina University Hospital in Varna and the office for laser treatment of retinal diseases of University Specialized Eye Hospital in Varna for the period February–April 2024 were included in the research. The National Eye Institute Visual Function Questionnaire-25 was translated and adapted into Bulgarian to assess the patients’ quality of life. The results obtained were processed using the statistical analysis software Jamovi 2.3.26.Results: Quality of life was assessed based on the conversion of the obtained results into 12 subscales, with higher values in the subscales indicating better visual function and less impact of visual problems on patients' quality of life. The statistical analysis results showed no statistically significant differences between patients with non-proliferative diabetic retinopathy, proliferative diabetic retinopathy, and diabetic macular edema regarding the 12 subscales (p > 0.05 for all indicators).Conclusion: Our results add to existing data in a global context and highlight the need for strategic approaches to the management of diabetic retinopathy, including mental health as a key component
Advances in surgery in children with obstructive sleep apnea
Get PDFSevere pediatric obstructive sleep apnea, usually, requires timely conservative and/or surgical management. Recently, several operative techniques are widely used worldwide. Here belong mainly tonsillectomy, adenoidectomy, and adenotonsillectomy. The surgical interventions are characterized by a different effectiveness and safety. The objective of the present review is to identify the new scientific advances in the field of childhood obstructive sleep apnea surgery
Post-COVID-19 complications – pansinusitis with orbital and cerebral abscess. Case report
Get PDFThe occurrence of superinfections in COVID-19 patients has attracted increasing attention in recent studies. They are associated with the immunocompromised state of the patient. Such a secondary infection is also fungal sinusitis. The most common causative agents are Zygomycetes (Rhizopus, Mucor, Rhizomucor) and Aspergillus, with mucormycosis being more commonly reported. Undetected for a longer period of time give orbital and brain complications, which are distinguished by high mortality. Treatment of this pathology is extremely difficult, but there are also described cases in which it is successful. Such is our clinical case. It concerns a 77-year-old patient who entered the ENT department of "MHAT – Shumen" SA with clinical manifestation of pansinusitis, complicated with brain and orbital abscess after suffering from COVID-19. It comes with severe headache, difficulty breathing, more to the left, pain and loss of vision of the left eye, inability to move the eyeball, ptosis of the left upper eyelid, infiltrate and hyperemia in the area of an inner eye corner spreading to the nose with two fistula openings, from which a thick purulent discharge leaks when pressed over the eyeball. CT showed pansinusitis complicated with a cerebral abscess in the left frontal lobe and an intraorbital abscess in the left medial. Along with antibiotic and antimycotic treatment (Ampicillin, Ceftriaxon, Teicoplanin, Fluconazole, Itraconazole), endonasal surgical treatment with sinus-nasal optics and external incision periorbital medial was carried out. Isolated and identified in NRL by mycoses are Aspergillus niger – en masse and Candida palmioleophila – moderately. A month after surgery, a new external incision periorbital was required. A smooth postoperative period followed. As a way out of the disease, pansinusitis, brain and orbital abscess were controlled, improved in the movements of the eyeball, with persistent ptosis of the left upper eyelid and lack of vision in the left eye
A clinical case of transition from Acute Psychotic Substance Abuse Disorder to Schizophrenia
Get PDFPsychotic disorders due to psychoactive substances (PASs) are increasingly common in clinical practice. Numerous studies have shown that illicit PASs can cause transient psychotic symptoms, acute psychotic states, and subsequently the full-blown clinical picture of paranoid schizophrenia.Common comorbidity indicates common pathogenetic mechanisms of psychosis and addiction. The presented case demonstrates the complex impact of possibly different risk factors – genetic, neurodevelopmental and exogenous, such as systemic combined abuse of PASs since adolescence. Understanding the alleged biological pathways between the effects of PASs, the first episode of psychosis, and the risk of subsequently developing schizophrenia is particularly important for future prevention and early therapeutic interventions in predisposed individuals
Non-Melanoma Skin Cancer of Head and Neck – Case Series
Get PDFNon-melanoma skin cancer (NMSC) of the head and neck is among the most common malignancies globally, primarily comprising basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These cancers predominantly affect fair-skinned individuals exposed to ultraviolet radiation, with high incidence rates in sun-exposed regions of the face, scalp, ears, and neck. The pathogenesis involves DNA damage induced by UV exposure, leading to mutations in key tumor suppressor genes.Clinically, NMSC presents as persistent, non-healing lesions, often with characteristic features such as nodules, ulcers, or plaques. Early detection and management are crucial to prevent local tissue destruction and disfigurement, with treatment options including surgical excision, Mohs micrographic surgery, radiotherapy, and topical therapies. Advances in diagnostic techniques and targeted therapies continue to improve patient outcomes. This review highlights the epidemiology, etiology, clinical features, and current management strategies for NMSC of the head and neck, emphasizing the importance of prevention and early intervention.In this case series, we present five patients with histopathologically confirmed non melanoma skin cancer of the head and neck region, illustrating the variability in clinical outcomes associated with distinct pathological features. These cases highlight the importance of detailed histological assessment in predicting disease progression and tailoring appropriate treatment strategies
Comparative Analysis Of Somatic Complications In Alcohol Dependency And Psychoactive Substance (Pas) Addiction. The Role Of The Psychiatric Nurse
Get PDFAddictions to alcohol and psychoactive substances (PAS) represent a serious medical, social, and economic issue, placing significant strain on the healthcare system. These dependencies lead to increased morbidity, more frequent somatic complications, and a greater demand for healthcare services, resulting in higher financial costs and reduced quality of life for patients. Life expectancy among individuals with addictions is shorter due to complications such as overdose and suicide. This report presents a retrospective analysis of 127 patients treated at University Hospital "St. Marina" – Varna, with the aim of comparing somatic comorbidities in alcohol and PAS dependency. The study evaluates the frequency and severity of somatic complications, revealing that alcohol dependence is primarily associated with chronic liver and neurological diseases, while PAS use leads to a broader range of complications, including cardiovascular and respiratory issues. The conclusion emphasizes the need for a multidisciplinary approach to the treatment of dependent patients, addressing both the physical and mental aspects of the condition, with a key role for the nurse in providing quality care
Challenges in Dental Care Utilization
Get PDFINTRODUCTION: Most oral diseases can be avoided by taking regular preventive measures and having access to well-timed dental care, but various obstacles can prevent consumers from receiving it. The fear of dental manipulations, the lack of sufficient time on the part of the users, the lack of awareness of the need for dental treatment, mobility impairments, and financial restrictions are the most common reasons for postponing examination or treatment at a dental office.AIM: The purpose of the study is to determine the limitations to the usability of dental care by dental service users, depending on the type of dental service needed.MATERIALS AND METHODS: An anonymous survey was conducted among dental service users throughout the country. A survey card was provided for participants to fill out. In the statistical analysis, Pearson’s χ2 test was used, along with the non-parametric Kruskal-Wallis test for comparison of three or more independent cases.RESULTS AND DISCUSSION: The degree of influence of individual barriers is not equal, with the strongest limitation on the use of dental care being the cost of dental services. The sum of barriers when using dental services more strongly restricts consumers who seek medical care for an acute oral problem or a chronic oral disease. Patients with the fewest restrictions on accessing the dental care they need are those who last visited a dentist for prophylactic purposes.CONCLUSION: Reducing the limitations to the utilization of dental care can be achieved by improving patients‘ awareness of the importance of using preventive dental services
Microvascular Alterations Analysis: Optical Coherence Tomography Angiography Evaluation Of Superficial Capillary Plexus In Retinal Vein Occlusion
Get PDFINTRODUCTION: Optical coherence tomography angiography (OCTA) is a method used to detect microvascular changes occurring in the capillary plexuses of the retina in individuals with retinal vein occlusions (RVOs). It enables the quantitative evaluation of parameters related to the vascular network of the macula.AIM: The aim of this article is to evaluate the microvascular changes detected by OCTA in patients with RVO and compare them with their unaffected eyes and a control group.MATERIALS AND METHODS: A total of 75 eyes were included in the study, divided into three groups: Group 1: eyes with RVO (n=25); Group 2: unaffected eyes of patients with RVO (n=25); and Group 3: a control group (n=25). Quantitative data corresponding to the superficial capillary plexus level were collected from the obtained images using OCTA. RESULTS: Foveolar avascular zones (FAZ) showed an increase in perimeter and loss of circularity at the superficial capillary plexus (SCP) level in RVO eyes compared to controls. It was observed that RVO patients’ unaffected eyes also showed the same changes. A decrease in vascular and perfusion density was demonstrated not only in the eyes of RVO patients but also in their unaffected eyes. Nonetheless, not all zones of the macula were affected by this decrease.CONCLUSION: Angio-OCT can be used to evaluate microvascular changes in the macula in patients with RVO. Using the method, both changes to the FAZ have been demonstrated, an increase in the perimeter and disturbances in its circularity, as well as a decrease in vascular density and perfusion density of the macula