Varna Medical University Press: Journals
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Development Of Public Health Protection And Control Activities In Bulgaria
Full text linkОрганизираните обществени дейности в грижата за здравето на населението в България преминават през дълъг и многостепенен процес на развитие. Първите държавни мерки за бързо организиране на управлението в здравеопазването в България се въвеждат веднага след Освобождението през 1878 г. Целта на изследването е да се направи ретроспективен анализ на дейностите за опазване и контрол на общественото здраве (ОЗ) в България и преглед на действащите институции в тази насока от 1878 г. до наши дни. Използвани са исторически и документален метод. Извършен е преглед и подбор на исторически нормативни документи, като е проследено развитието на дейностите в седем последователни периода от историята на България, свързани с етапите на социално-икономически и законодателни промени в държавното устройство и управление. Първите етапи се характеризират с поставяне на основите на санитарно-хигиенното дело за опазване здравето на гражданите, регламентират се основните принципи, създават се първите институции на централно и регионално ниво и се назначават обучени медицински специалисти. Трети и четвърти са етапи на военно и следвоенно възстановяване на здравното дело в страната и предприетите за това законодателни и административни промени. Сериозен напредък се наблюдава през шести етап след 1950 г., когато се изгражда структурата и нормативната рамка на държавния здравен контрол в България. След 1990 г. в последния етап на демократично развитие на здравеопазването се предприемат структурни преобразования, характерни и за други Източно-европейски страни в преход в посока на децентрализация на системата на здравния контрол. Ретроспективният анализ показва надграждане на предприетите мероприятия, структури, указания и нормативни документи, които дават възможност за по-леко преодоляване на последствията от съществуващи войни, кризи и епидемии и най-вече спомагат за по-ефективно опазване здравето и живота на хората. Organized efforts in the field of public healthcare in Bulgaria have undergone a long and multifaceted development process. The first state measures for rapid healthcare organization in Bulgaria were introduced immediately after the Liberation in 1878. The аim of the study is to provide a retrospective analysis of the activities for public health (PH) protection and control in Bulgaria and to review the current institutions from 1878 to the present day. A review and selection of historical normative documents was carried out, following the development of activities in seven consecutive periods of the history of Bulgaria, related to the stages of socioeconomic and legislative changes in the state structure and governance.The initial stages are marked by the establishment of sanitation and hygiene practices, the regulation of foundational principles, the creation of the first central and regional institutions, and the appointment of trained medical specialists. The third and fourth stages encompass the military and postwar recovery of the country`s healthcare sector, reflecting legislative and administrative reforms undertaken for this purpose. Significant progress occurred during the sixth stage, post-1950, when the structural and normative framework of state health control in Bulgaria was solidified. After 1990, the final stage of democratic healthcare development saw structural transformations, characteristic of other Eastern European countries transitioning toward decentralizing their health control systems.The retrospective analysis highlights the evolution of measures, structures, guidelines, and normative documents, enabling more effective responses to wars, crises, and epidemics, while primarily ensuring the protection of public health and lives
COVID-19 AND Cardiovascular Diseases — Interaction, Clinical Course, Outcomes, and Prognosis
Full text linkINTRODUCTION: SARS-CoV-2, the virus responsible for COVID-19, binds to the ACE2 receptor, affecting multiple organs, including the cardiovascular system. Arterial hypertension is one of the most common and significant comorbidities, increasing the risk of severe disease progression and mortality. AIM: The aim of this article is to analyze the interaction between COVID-19 and the cardiovascular system, with a focus on the role of arterial hypertension, the impact of ACE inhibitors (ACEi) and angiotensin receptor blockers (ARBs), and the cardiovascular complications observed in COVID-19 patients. MATERIAL AND METHODS: A review of current literature and clinical observations related to cardiovas-cular involvement in COVID-19 was conducted, with emphasis on comorbid hypertension, pharmacological management, and the nature of cardiac complications reported during the pandemic. RESULTS AND DISCUSSION: Early concerns that ACEi and ARBs might worsen COVID-19 outcomes were not confirmed; instead, these medications are now considered safe and potentially protective. COVID-19 has been frequently associated with cardiovascular complications such as myocardial infarction, myocarditis, arrhyth-mias, and thromboembolism. Notably, some cardiac injuries occur in the absence of typical coronary artery obstruction, suggesting direct viral or immune-mediated damage. Furthermore, many patients delayed seek-ing care for acute cardiac events due to fear of infection, leading to worse clinical outcomes. Elderly patients with preexisting cardiovascular conditions remain at the highest risk. CONCLUSION: COVID-19 and cardiovascular diseases have a mutually deleterious relationship. Arterial hy-pertension is a major and significant risk factor for severe COVID-19 outcomes. Maintaining good blood pres-sure control and continuing prescribed cardiovascular therapies during COVID-19 infection are essential for improving recovery and reducing the risk of fatal outcomes
Diabetes mellitus and arterial hypertension: how do they affect urination?
Full text linkAim: The term lower urinary tract symptoms refers to all changes in urination, regardless of the underlying etiological cause. In the present study, we examine two socially significant diseases (arterial hypertension and diabetes mellitus) and analyze their influence on urination.Materials and Methods: The study subjects were 396 patients examined at the Sveta Anna Medical Center, Varna, during the period from April 2022 to April 2025. Symptoms related to urination were recorded using the International Prostate Symptom Score. Medications taken to treat enlarged prostate, comorbidities, and prostate volume were also recorded.Results: Arterial hypertension and diabetes mellitus lead to more pronounced nocturia and urgency. This results in more frequent administration of prostate medications. In addition, the prostate volume is larger in patients with hypertension.Conclusion: The socially significant diseases arterial hypertension and diabetes mellitus affect the entire organism and also have an impact on the patient’s urination
Virtual reality and eye health: Risks and opportunities for supporting visual function
Full text linkVirtual reality (VR) is among the most rapidly evolving technologies of our time, expanding beyond the field of entertainment into education, professional training, and healthcare. Through its ability to create immersive three-dimensional environments, VR provides new approaches to learning, therapy, and rehabilitation. Despite its considerable potential, concerns have been raised regarding its impact on eye health. Scientific literature identifies visual fatigue, dry eye, blurred vision, and accommodative–convergence conflict as the most frequently reported adverse effects. Although these manifestations are typically transient and reversible, they acquire significance as a public health issue, particularly among children and young people who spend a substantial part of their daily lives in digital environments.Virtual reality is increasingly integrated into education, training, and healthcare, yet it also poses risks to ocular health—most commonly visual fatigue, dryness, blurred vision, and accommodative–convergence conflict. These effects are usually temporary but carry public health relevance, especially for children and adolescents with extensive screen exposure. At the same time, VR demonstrates potential benefits, such as therapeutic applications in amblyopia and strabismus, as well as serving as a valuable tool for ophthalmology training and for enhancing health literacy. This analysis summarizes the available evidence and emphasizes the need for recommendations on safe use and for future interdisciplinary research.
Gastroesophageal reflux disease in patients with long-term type 1 diabetes – diagnostic and therapeutic approaches
Full text linkGastroesophageal reflux disease (GERD) is a common gastrointestinal disorder characterized by reflux of gastric contents and associated mucosal damage. In patients with long-term type 1 diabetes mellitus (T1DM), the incidence of GERD and related complications is higher compared to the general population, which is associated with autonomic neuropathy, impaired esophagealmotility, and delayed gastric emptying.Aim: To systematize and analyze the literature data on GERD in patients with long-standing T1DM, with an emphasis on the pathophysiology, clinical characteristics and barriers to diagnosis. Materials and methods: A systematic review of publications indexed in PubMed, ScienceDirect and Medline was conducted, using the keywords: „type 1 diabetes“, „long-standing“, „GERD“, „autonomic neuropathy“, „esophageal motility“. English-language publications from the last 10–15 years were included, focusing on the pathophysiology, clinical outcomes, diagnostic approaches and their relationship to diabetic autonomic neuropathy and therapy.Results: Literature data indicate that in patients with long-standing T1DM there is an increased frequency of GERD, even in the absence of typical symptoms associated with autonomic neuropathy. Esophageal motor dysfunction and weak lower esophageal sphincter tone have also been documented in such patients. This creates a risk of underestimation of the disease and delay of instrumental diagnostics, including esophageal manometry and 24-hour pH-metry.Conclusion: GERD in patients with long-standing T1DM often remains undiagnosed and undertreated due to underestimation of atypical symptoms and lack of routine instrumental evaluation. An integrated approach, including gastroenterological evaluation, esophageal manometry and 24-hour pH-metry, is needed to improve diagnostic and therapeutic approaches
The professional role of the medical cosmetologist in the context of public health
Full text linkThis study arises from the need to systematize existing knowledge regarding the professional role of the medical cosmetologist in the context of public health.Its aim is to synthesize and analyze the existing scientific evidence concerning the role, tasks, and skills of the medical cosmetologist; the rules and ethics of practice; participation in public health teams; and evidence-based, safe practices that support prevention and improved population health.Materials and Methods: A search of scientific publications was conducted in the electronic databases Google Scholar and ResearchGate using keywords grouped as follows: core terms, public health context, role and scope, quality and safety. The search period covered January 1990 to September 2025.Results: The review includes seven articles presenting studies from 1990–2025 related to the role of (medical) cosmetologists in health promotion and health education in beauty salon settings. The review shows that, following appropriate training, medical cosmetologists can effectively raise awareness and encourage health-promoting behaviors, and that beauty salons are an appropriate context for such interventions.Conclusion: Medical cosmetologists, when purposefully trained and collaborating with the health system, can act as effective health promoters in salon settings, increasing awareness and encouraging health-promoting behaviors
The association between burnout and metabolic disorders
Full text linkIntroduction: Professional burnout is an emotional and physical exhaustion closely related to stress that is not well managed. Initially considered to be specific to medical professionals, today burnout is spoken about in all spheres of social life. The development of the syndrome involves the physical condition, but outgrows or runs parallel to a dysfunctional change in the behavior of those affected.Aim: The aim of this article is to analyze the relationship between burnout and metabolic disorders.Materials and Methods: To achieve the goal, an analysis of the PubMed and Google Scholar databases by keywords has been conducted. Results: Burnout is a result of occupational stress that is not well managed. Subjects with occupational burnout experience emotional exhaustion, which often develops into physical symptoms. Changes in sleep and exhaustion are more often detected in these individuals, which often develop into metabolic disorders. Studies prove a relationship between a high level of occupational stress and a number of markers: increased blood pressure (p = 0.0), visceral obesity (p = 0.03), low HDL (p = 0.02), glycated hemoglobin, etc.High levels of occupational stress are associated with low motivation to build healthy habits. A link between diabetes and burnout has been observed in the literature, both in patients and in their relatives. In this case, occupational burnout is a product of the need to conduct activities to control the condition. The main guidelines related to the development of diabetes burnout are: feelings of mental exhaustion and physical fatigue from self-care related to the condition, neglecting the condition, withdrawal from care and support for the diabetic patient, feeling powerless to deal with diabetic burnout, individual characteristics of the life-like situation, as a result of which the control and aggravation of the condition is reached.Conclusion: Burnout can be a cause of metabolic disorders. On the other hand, diabetic patients and their relatives often suffer from burnout caused by the need to control the condition. It is necessary to carry out measures for the prevention of professional burnout to prevent the development of metabolic disorders, but also to help diabetic patients in the fight against the disease