Varna Medical University Press: Journals
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Approaches and techniques of physical therapy and rehabilitation for brain tumours
Get PDFBrain tumors represent a life-threatening illness that often requires a multifaceted approach to treatment. Rehabilitation, in all its facets, is crucial in helping patients adjust to the alterations in their lives following the diagnosis and treatment of a tumour. This article analyses the key components of rehabilitation in this serious medical condition and the contribution of the rehabilitation team in the recuperation of patients with brain tumours
Wound infections caused by Serratia marcescens: a microbiology survey
Get PDF INTRODUCTION: Serratia marcescens wound infections are a concern in healthcare settings, associated with delayed healing, prolonged hospital stays, higher costs, and sepsis in severe cases.AIM: This study aimed to evaluate the antimicrobial susceptibility of S. marcescens wound isolates from patients in St. Marina University Hospital, Varna, Bulgaria (2016–2023) and to explore the genetic mechanisms responsible for the 3rd generation cephalosporin resistance in these isolates.MATERIALS AND METHODS: Over the 8-year period, 131 isolates were collected. Identification and antimicrobial susceptibility testing were performed using Phoenix (BD, USA) and Vitek 2 (BioMerieux, France), with results interpreted by EUCAST guidelines. The genetic mechanisms responsible for beta-lactam resistance were studied by PCR.RESULTS: A total of 98.5% of the patients were diagnosed with nosocomial S. marcescens infections. Diabetes and a cardiovascular disease were found as accompanying risk factors in 42.8% and 71%, respectively. Resistance rates were: ceftriaxone—14.5%; gentamicin—13.7%; cefepime/trimethoprim-sulfamethoxazole—12.9%, and ciprofloxacin/levofloxacin—12.2%. No carbapenem resistance was found. BlaCTX-M was present in 72.7% of cephalosporin-resistant isolates.CONCLUSION: S. marcescens remains a significant nosocomial pathogen, with less than 15% resistance to main antimicrobials. We found the leading role of blaCTX-M for the 3rd generation cephalosporin resistance in S. marcescens, confirming the global trends
Epidemiology of drug-induced dermatoses: Prevalence, risk factors, and clinical outcomes
Get PDFIntroductionDrug-induced dermatoses are adverse skin reactions triggered by medications, ranging from mild rashes to severe conditions like Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Understanding their prevalence, risk factors, and clinical presentations is essential for effective prevention and management. This study investigates the epidemiology, types, and risk factors associated with drug-induced dermatoses, providing insights for healthcare providers.Materials and MethodsA comprehensive review of 125 studies (2000–2024) was conducted using databases such as MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. Data from literature reviews, observational studies, clinical trials, and case reports were analyzed to determine the prevalence, implicated drugs, and demographic or clinical factors influencing these reactions.ResultsDrug-induced dermatoses include a spectrum of reactions from mild to life-threatening. Commonly implicated drugs are antibiotics, NSAIDs, and antiepileptics, with prevalence rates of 0.5% to 5% among high-risk drug users. Severe reactions include SJS/TEN, drug reactions with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). Significant risk factors include genetic predispositions (e.g., HLA-B*1502 for carbamazepine), age extremes, pre-existing conditions such as autoimmune diseases or HIV, and factors related to the type, dose, and duration of drug exposure.ConclusionHealthcare providers should identify high-risk drugs and implement measures such as genetic screening to minimize adverse reactions. Improving diagnostics, clinicians’education, and antibiotic stewardship is vital. Further research into genetic biomarkers and personalized medicine could reduce the clinical and societal impact of these reactions, enhancing patient care and outcomes
Dynamic of Specific Laboratory Indicators in Some Liver Diseases
Get PDFThe liver is the largest organ in the human body after the skin.Clinical and laboratory indicators in liver diseases are diverse in terms of the type of analysis and degree of variation. This diversity arises from the complex functional characteristics of the liver, which occupies a central role in the intermediary metabolism of substances in the human organism.The liver has significant functional reserves; therefore, minor damage often goes unnoticed. Many indicators can remain within reference ranges, which does not necessarily rule out pathology.The main functions of the liver are:Metabolic function – metabolism of carbohydrates, lipids, amino acids, proteins, and hormones;Detoxification function – processing bilirubin, ammonia, alcohol, and medications;Excretory function – gallstones, bilirubin, and cholesterol;Biosynthetic function – production of albumins, acute-phase proteins, pro- and anticoagulant factors, urea, creatinine, glycogen, ketone bodies, and bile acids from cholesterol;Depot function – storage of glycogen, lipids, amino acids, proteins, iron, copper, vitamins, and blood;Phagocytosis – elimination of bacteria from the gastrointestinal tract.Liver diseases represent a large group with varied etiologies, including metabolic, autoimmune, neoplastic, vascular, toxic, parasitic, and biliary tract obstruction-related causes.Tests with high diagnostic and prognostic value for assessing the functional capacity of the liver parenchyma include AFP, CA 19-9, bile pigments (bilirubin), organ-specific liver enzymes (ASAT, ALAT, GGT), total protein, and prothrombin time.The dynamics of these indicators were progressive in the patients described below before their admission for treatment in the Gastroenterology Clinic at St. Ivan Rilski University Hospital - Stara Zagora. These patients had been under long-term observation (2–8 years) with periodic hospitalizations
Mixed Reality Glasses and Their Potential in Vision Care
Get PDFThe eyes are the most highly developed sensory organs, and 80% of our perception of the surroundings takes place through them. This makes them our most important sensory organ, emphasizing the need for proper care and attention through prevention and treatment. Digitalization has become a part of daily life and has impacted people's health. Mixed reality glasses are a technology that can be integrated into various healthcare applications. The purpose of this review is to present the potential of mixed reality glasses in healthcare
Serological Methods in the Diagnosis of Lyme Disease: A Challenge in Laboratory Practice
Get PDFLyme disease is caused by bacteria of the Borrelia burgdorferi sensu lato complex and is the most common tick-borne infection in Europe and North America. Serological methods are approved for laboratory diagnosis, and the CDC continues to recommend a two-step algorithm for their use. However, serological methods have significant limitations that must be considered when interpreting results. We reviewed literature sources with a focus on the standard two-tiered testing (STTT), which is applied in our country, and the modified two-tiered testing (MTTT)
The role of platelet concentrates in oral surgery—a literature review
Get PDFIntroduction: Numerous studies examine the application of biomaterials in regenerative medicine. Platelet concentrates, derived from centrifuged autologous blood, have gained significant attention as biomaterials in the engineering of oral soft and hard tissues. Materials and Methods: This study systematizes the application of platelet concentrates in the field of oral surgery. A literature review was conducted by examining peer-reviewed scientific publications available in the Google Scholar, PubMed, and ResearchGate databases. A total of 36 articles published in the last 5 years were reviewed, of which 13 were selected as primary sources. Results: The application of platelet concentrates in oral surgery is extensive. Their combination with other biomaterials or stem cells represents a modern concept aimed at achieving synergy, expanding their fields of application, and overcoming limitations. The high concentration of growth factors plays a significant role in their broad applicability and highlights one of their main qualities—accelerating tissue regeneration. Discussion: The potential for the application of platelet concentrates in daily surgical practice is significant. They possess three main characteristics: acting as a scaffold for the adhesion of new cells, serving as a source of growth factors, and containing vital cells, all of which contribute to their positive impact on damaged tissue. Conclusion: Many studies highlight the importance of platelet concentrates in tissue healing and regeneration, confirming their benefits. However, their role in complex clinical cases remains debated, and further long-term research is needed to establish them as a predictable biomaterial
Pertussis—the cyclic problem
Get PDFIntroduction: Pertussis is a highly contagious, vaccine-preventable respiratory disease caused by Bordetella pertussis. It is characterized by widespread distribution and cyclicity, with epidemic outbreaks being reported every 3–5 years in the world and in the EU/EEA countries, regardless of the achieved immunization coverage.Aim: The aim of this article is to assess the risk factors for the cyclic rise of pertussis and compare it to the registered incidence in the Varna region and Bulgaria for the period 2006–2024.Materials and Methods: Documentary, statistical, graphic, epidemiological analysis were used.Results and Discussion: There are four misconceptions related to the “resurgence“ of pertussis: uncertainty about the effectiveness of acellular (aP) versus whole-cell (wP) vaccine, the likely mutability of Bordetella pertussis, the uncertainty of the duration of natural post-infectious or artificial post-vaccination immunity, and the depletion of herd immunity and the accumulation of a non-immune population, correlated with the most likely factors, such as increased awareness and improved diagnostics. Similarly to the global experience, we found that pertussis notifications in Bulgaria have multi-year cycles of approximately 3–4 years in length, consistent with the interepidemic periods observed in pertussis incidence in many countries. For the city of Varna, the registered cases are single or none at all, and we did not establish cyclicity.Conclusion: Due to changes in the structure of B. pertussis and the epidemiology and natural course of the disease, a careful evaluation of the current immunization program is needed to develop new solutions, to address the waning immunity from current vaccines, and to expand pertussis vaccine coverage to the whole population