Varna Medical University Press: Journals
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Integrated food safety control for eggs using the One Health approach
Get PDFIncreasing food safety and ensuring the health and lives of consumers is a strategy related to the behavior of all participants in the food chain, from governmental and non-governmental institutions to food producers and traders to the final target groups of consumers. Eggs as food are consumed by a large target group of consumers and are present in daily nutrition. Issues related to ensuring the safety of eggs used for food production are constantly complicated by the constant dynamics of regulatory requirements and require the implementation of the interdisciplinary One Health approach to prevent the occurrence of food infections and epidemic outbreaks when safety is violated.The purpose of this report is to review and analyze the main issues related to the theory, practice, and applicability of principles and approaches set out in the current regulatory mechanisms and requirements for achieving compliance with food safety policies.In accordance with the set goal, the study used a systematic approach, inextricably linked to systemic analysis and synthesis. In identifying the main elements within the scope of modern food safety requirements, the expert approach was applied.The results derived can be useful in formulating possible solutions for practice, as well as proposals for updating the requirements
Secondary spontaneous cerebrospinal fluid leak rhinorrhea caused by osteoma on ethmoidal roof: A Case Report
Get PDFIntroduction: Osteomas are benign osteogenic lesions. The most prevalent area of occurrence in the craniofacial skeleton is the frontal and ethmoid sinuses. Patients with paranasal sinus osteomas are usually asymptomatic, incidentally discovered and rarely can cause severe complications.Clinical presentation: A 28-year-old man presented with a 6-month history of unilateral watery rhinorrhea with severe headache. He had a history of head trauma from 10 years ago. The CT scan demonstrated an osseous mass within the right roof of the ethmoid sinus with a direct intracranial extension into the anterior cranial fossa and severe pneumocephalus. The patient underwent functional endoscopic sinus surgery.Conclusion: Osteomas are rare, benign tumours. In the area of the paranasal sinuses, they have a slow growth and asymptomatic course. The diagnosis is often made incidentally. In sporadic cases, they can cause orbital and intracranial complications, which should not be clinically underestimated
Case Report: Delayed Onset Cerebrospinal Fluid Rhinorrhea Following Traumatic Head Injury
Get PDFIntroduction: CSF leak rhinorrhea is one of the common early post-traumatic craniofacial complications. Conservative treatment is the first choice in the first few weeks of the trauma. A multidisciplinary team, including a neurosurgeon, an otolaryngologist, a craniofacial surgeon, and a radiologist, treats complicated craniocerebral injuries with persistent pneumocephalus. Late post-traumatic nasal CSF leakage is not common and may present with an intracranial complication such as meningitis or meningoencephalitis. Clinical presentation: It concerns a 34-year old man who was admitted to the Clinic for Infectious Diseases with bacterial meningitis with isolated Streptococcus pneumoniae in the CSF examination. From the patient’s medical history, we understand that he had a watery discharge from the left nose. He was treated on an outpatient basis for allergic rhinitis with a local corticosteroid medication. Eight years ago, he had a motor vehicle accident with severe craniocerebral trauma. After successfully recovering from the intracranial infection, the patient underwent a biochemical analysis of nasal secretion. The beta-2 transferrin analysis was positive. Computed tomography and magnetic resonance imaging were performed. Endonasal endoscopic duraplasty was performed with the application of fluorescein 10% intrathecally. The rhinobase defect was successfully repaired.Conclusion: Delayed CSF rhinorrhea poses significant diagnostic and therapeutic challenges. Clinicians should maintain a high index of suspicion in patients with unilateral clear nasal discharge and a history of cranial trauma, regardless of the time elapsed since the initial injury. Early diagnosis and surgical intervention are crucial to prevent potentially life-threatening complications
Small for gestational age children
Get PDFSmall-for-gestational-age (SGA) children have been the subject of scientific interest over the last century. Since 2013, the 10th percentile for height and/or weight for the corresponding gestational age has been used as a cut-off to define the condition. This specific population group is characterized by multiple early and late complications.The aim of the present paper is to review the data in the literature regarding the prevalence, early and late complications associated with SGA delivery.The most commonly used cut-offs for defining an SGA child are the 2,3rd, 3rd, and 10th percentiles. Using a different definition and curves results in a large difference in prevalence. The presented cohort is characterized by a variety of early and late complications. Early complications include mortality, hypoglycemia, and hypothermia. Mortality in this cohort can be several times higher compared to children born adequate for their gestational age (AGA). Hypoglycemia, especially prolonged and unrecognized, can lead to permanent brain damage. Hypothermia was more common in the group of children born SGA compared to those born AGA.Late complications can develop at any stage of a person’s life. This group includes metabolic disorders, hypertension, precocious puberty, and reduced bone density. To date, an increased cardiovascular risk has been repeatedly demonstrated in adults born SGA. Studies have shown that those born SGA are likely to develop metabolic complications as early as infancy. The most common metabolic disorders are insulin resistance, impaired glucose tolerance and type 2 diabetes mellitus
Analysis of the change in emergency department attendance as a result of COVID infection
Get PDFIntroduction: During the pandemic, a rapid restructuring of the health system was necessary in anticipation of the unpredictable needs of the population. This included shifting people and resources to emergency medicine and intensive care.Aim: In Bulgaria, emergency care is provided directly to patients in emergency departments or by referring patients to their GP for emergency hospitalisation. In this regard, the aim of the present study is to find out how attendance in the emergency department has changed in St. Marina University Hospital in Varna during the COVID pandemic.Materials and Methods: From the hospital database, 94 631 patients were studied in the period 2019–2021. The results were processed statistically with SPSS v. 20.0 using analysis of variance, analysis of covariance and comparative analysis.Results: The mean age of the patients was 44.5 years with male predominance 52.4%. There was a decreasing trend in emergency department attendance. Significant difference was found in age (p < 0.001) and the duration of the examination (p < 0.001) according to patient diagnosis.Conclusion: The overall reduction in the prevalence of patients with non-COVID-19-related illnesses suggests both opportunities to reduce unnecessary emergency department visits for those with low severity of illness in the future and the possibility of delaying diagnosis and complications in patients with severe illness
ПРОБЛЕМНО БАЗИРАНО ОБУЧЕНИЕ В ПОДГОТОВКАТА НА МЕДИЦИНСКИ СЕСТРИ ЗА ФОРМИРАНЕ НА КРИТИЧНО МИСЛЕНЕ
Get PDFВъведение. Уменията за критично мислене са основен компонент в образованието на медицински сестри. Проблемите на всеки пациент са уникални. Те са в резултат на физическото здраве, начин на живот, култура, връзка със семейството и приятелите, жизнена среда и други. Идентифицирането на проблемите на пациентите и вземането на индивидуално ориентирани решения за сестринска намеса са следствие на задълбочен анализ, критично мислене и клинични разсъждения.Проблемно-ориентираните подходи, за преподаване и обучение на медицински сестри, развиват умения за критично мислене като акцентират на прилагането на придобитите клинични знания към реални клинични проблеми.Цел: Тази статия се фокусира върху образователния резултат на проблемно базирано обучение на медицински сестри за формирането на критично мислене и решаването на клинични проблеми.Материал и методи: За събиране на информация са използвани български и чуждестранни литературни източници и публикации, индексирани в следните бази данни: Medline, EBSCO, ScienceDirect, Google Scholar, PubMed, Wiley online, както и сайтовете на Международния съвет на сестрите и други.Заключение: Анализът на достъпната литература доказва, че проблемно базираното обучение в професионалната подготовка на медицински сестри е най-ефективният начин за разширяване на уменията за критично мислене, стратегия за оптимизиране на обучението им за прилагане наефективни, безопасни, компетентни и иновативни сестрински грижи
Factors Affecting Staff Turnover in Dental Technician Laboratories
Get PDFINTRODUCTION: Human resources management is a system of activities that effectively utilizes personnel to achieve the goals of an organization while satisfying the needs of its employees. A company’s success lies in its ability to attract and retain the right employees who are satisfied with their roles and work environment, leading to long-term productivity. As the head of a dental laboratory, a dental technician performs all levels of management simultaneously.AIM: To investigate the opinions of managers of dental technician laboratories, dental technicians, and dentists regarding the factors affecting staff turnover in dental technician laboratories.MATERIALS AND METHODS: Literary sources were reviewed, and an anonymous survey was conducted to achieve the research goal. The study included 250 participants from the cities of Varna, Bourgas, and Dobrich (126 dental technicians - hired workers, 58 managers of dental laboratories, and 66 dentists). Graphical and comparative analyses were used to present and interpret the data.RESULTS: The main factor affecting staff turnover, according to managers (82.76%) and dental technicians (69.84%), is unsatisfactory payment. Dentists, however, indicated workplace conflicts (92.42%) as the primary factor.CONCLUSION: For a dental technician laboratory to be successful, it is important for employers to attract and retain employees. The data from this study can help managers reduce the turnover of dental technicians, improve their practices, and strengthen their positions in the health services market
Supervision – A Prerequisite For Trust In Autonomous Nursing Practice
Get PDFThe nurse is viewed as a central figure in all modern healthcare systems. In accordance with the needs and wants of the population, opportunities are provided for nurses to manage their autonomous practice within the framework of acquired competencies. Nurses in the modern world share a new philosophy of care and offer it to patients through different organizational models, seeking to improve efficiency to make the cost equally affordable. The need to introduce clinical supervision in nursing practice, as well as the factors influencing the development of nursing, are discussed. A Model of Supervision in Bulgaria and a Continuum of a Nursing Supervisor in Bulgaria have been developed and presented
Imaging Features of Thalassemia
Get PDFThalassemia is a group of blood disorders that affect hemoglobin, the protein molecule in red blood cells that carries oxygen. Patients with thalassemia can present with various clinical and imaging findings, including growth disturbances, bone changes, and hepatobiliary and splenic manifestations. Imaging plays a pivotal role in diagnosing thalassemia, monitoring disease progression, and assessing complications. To understand the imaging findings and their correlations, it is important for radiologists to have a solid knowledge of the clinical and laboratory aspects of this condition. The severity of hemolytic anemia varies among different thalassemia syndromes, determined by the underlying molecular defects. Studying the imaging findings will help in understanding chronic hypoxia and the apparent marrow expansion frequently seen in patients with thalassemia. Additionally, the signs of ineffective hematopoiesis can also be appreciated. Given that thalassemia remains prevalent in many countries worldwide, especially in the Mediterranean region, early diagnosis and regular check-ups using imaging become crucial for maintaining the quality of life for affected individuals. This article discusses the radiographic features of thalassemia, including examples from our daily practice of classic imaging findings in patients with thalassemia
Eye health in the context of the COVID-19 pandemic
Get PDFIntroduction: Online learning during the COVID-19 pandemic has led to spending many hours in front of digital devices. Isolation and the fear of contracting the disease have resulted in the postponement of consultations with ophthalmology specialists, which could be associated with a delayed diagnosis of a number of diseases, increasing the risk of permanent vision loss.Aim: The main objective of the study is to establish the ophthalmic status of MU-Varna employees after online training during the COVID-19 pandemic.Materials and Methods: On the territory of the University Specialized Hospital for Eye Diseases for Active Treatment in Varna, prevention examinations of the employees of the Medical University of Varna were carried out, part of a scientific project of the Medical College of Varna in the period from September 2022 until September 2023. Data were collected from a total of 253 patients. A detailed history of each patient regarding their eye health was obtained. Each individual underwent a complete ophthalmological examination.Results: Of all patients, 72.7% needed optical correction for near and/or far distance, 7.1% were not subject to optical correction and 20.2% did not need such; 68.8% had presbyopia, 22%—hypermetropia, 21.3%—myopia, 34%—astigmatism. A total of 5.9% had current optical correction; 3.2% were with amblyopia, 1.6%—with cataract, 0.8%—with lattice dystrophy, 1.2%—with age-related macular degeneration (ARMD), 0.4%—with epiretinal membrane. In 11.9% of patients, elevated intraocular pressure (IOP) values or changes associated with glaucoma were found. A total of 68.8% of patients developed dry eye syndrome or, if they already suffered from it, it deteriorated after starting online training. In 5.2% of the patients over 40 years of age, cornea guttata was established; in 1.2%—pterygium; in 7.9%—allergic conjunctivitis; 0.4% were with bilaterally placed intraocular lenses (IOLs); 0.4% had ectropion.Conclusion: Due to the restrictions introduced during the COVID-19 pandemic, most people did not go to regular checkups. During the preventive examinations, it was found that a large part of the patients had outdated optical correction, dry syndrome, and a number of conditions and diseases