Varna Medical University Press: Journals
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Management of Nursing Care for Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI): Approaches, Practices, and Clinical Guidelines
Get PDFTranscatheter aortic valve implantation (TAVI) is a minimally invasive procedure designed to treat severe aortic stenosis, particularly in patients at high surgical risk. Nurses play a critical role in all phases of care for patients undergoing TAVI—from preoperative preparation and intraoperative monitoring to postoperative care and rehabilitation. In the preoperative period, nurses assess the patient's physical and psychological status, conduct educational sessions to inform the patient and their family, and coordinate preoperative investigations. During the procedure, they assist the interventional team by maintaining a sterile environment and monitoring the patient's vital signs.In the postoperative period, nurses are responsible for continuous patient monitoring, pain management, and the prevention of complications such as bleeding, infections, and thromboembolic events. Additionally, they play a key role in the patient's rehabilitation, aiding recovery through early mobilization and providing guidelines for follow-up care. This article explores clinical guidelines and evidence-based practices for nursing care in TAVI, which help improve patient outcomes and minimize risks. It also discusses the challenges and future directions in enhancing nursing practice for these patients
Imaging Methods And Techniques To Diagnose Scoliosis
Get PDFThe purpose of this study is to provide information on current imaging methods and techniques used in the screening and diagnosis of spinal curvatures, as well as their importance in determining the therapeutic approach.Along with a clinical examination by a specialist physician, imaging studies should be used to confirm the diagnosis. Imaging methods play a key role in establishing the diagnosis, monitoring changes in the deformity, and developing the treatment plan.By outlining and categorizing the imaging methods discussed, we summarize relevant publications that can not only introduce other researchers to the field but also serve as a valuable resource for studying existing methods, developing new ones, or selecting assessment strategies
Modern approaches for restoration of endodontically treated primary teeth
Get PDFIntroduction: Restoring endodontically treated primary teeth poses a significant clinical challenge that requires balancing the aesthetics of a child’s smile with optimal physiological function.Aim: The aim of this article is to investigate contemporary materials for restoring endodontically treated primary molars.Materials and Methods: The study included English-language articles published between 2014 and 2024, identified through a comprehensive search of Google Scholar, PubMed, Scopus, and ScienceDirect.Results: Articles from clinical and experimental studies examined the advantages and disadvantages of the three main contemporary restorative materials. Zirconia crowns are biocompatible, exhibit high flexural strength, and offer excellent aesthetics but are limited by their high cost and invasive reparation. Composite crowns are highly aesthetic and more affordable but have lower durability and are more susceptible to abrasion. Direct composite restorations require minimal removal of tooth tissue but can be challenging for restoring tooth anatomy, have lower strength compared to zirconia crowns, and a higher risk of developing caries in the long term.Conclusion: Accurate replication of the anatomical features of primary teeth is crucial for proper functioning of the masticatory apparatus. Dental materials in pediatric dentistry, such as resin composites, glass-ionomer cements, and preformed metal crowns, do not fully meet the aesthetic demands of today. Aesthetic preformed zirconia and composite crowns, as well as direct composite restorations, are suitable options for restoration due to the favorable properties of the materials, including strength, durability, aesthetics, and the ability to replicate the anatomy of primary teeth.
The fear of the needle—is it necessary in cataract surgery?
No full textAim: The aim of this article is to compare the effectiveness, safety, and smoothness of phacoemulsification surgery using local anesthesia—a peribulbar application of lidocaine and topical alcaine—with local anesthesia using only topical alcaine and an anesthetic viscosubstance.Materials and Methods:The clinical analysis included 40 patients who underwent cataract removal over a six-month period. The evaluations used were best corrected visual acuity (BCVA) before and after surgery and subjective pain perception on a scale from one to ten. Results were assessed before, during, and after surgery.Results: All patients showed vision improvement within a week after surgery. In one case, the surgery was postponed due to significant conjunctival chemosis resulting from peribulbar lidocaine application. Among patients who received only drop anesthesia and an anesthetic viscosubstance, pain did not exceed 4 on the pain scale.Conclusion: Using only topical anesthesia with an anesthetic viscosubstance has a positive impact on phacoemulsification surgery. This approach appears safe and effective and can be considered a good alternative for patients considered at risk in regard to peribulbar application
Odontogenic sinusitis – main etiological factors
Get PDFINTRODUCTION: Odontogenic sinusitis is an inflammatory process that occurs after the Schneiderian membrane is perforated as a result of a natural or iatrogenic cause of dental origin. Odontogenic sinusitis goes by various names in the literature, but the preferred ones are "odontogenic sinusitis" or "maxillary sinusitis of dental origin". This disease has been known to medicine for more than a century. However, recent data indicate that its prevalence is increasing year by year.Nowadays, otolaryngologists identify odontogenic sinusitis as a prevalent, but frequently misdiagnosed illness, and the association between tooth infections and maxillary sinusitis is well documented.Therefore, dentists need to be familiar with the etiologies most commonly associated with odontogenic sinusitis in order to provide the correct diagnosis and treatment for their patients. AIM: The purpose of this article is to summarize the most common etiologic factors associated with the development of odontogenic sinusitis. DISCUSSION: Odontogenic sinusitis is an inflammatory process that occurs after the Schneiderian membrane is perforated as a result of a natural or iatrogenic cause of dental origin (1, 2, 3). Odontogenic sinusitis goes by various names in the literature, but the preferred ones are "odontogenic sinusitis" or "maxillary sinusitis of dental origin", as endodontic and periodontal diseases are considered the most common etiological factors associated with the development of odontogenic sinusitis. These are followed by iatrogenic causes related to dentists' surgical interventions (3, 4).This disease has been known in medicine for more than 100 years and accounts for 10-12% of maxillary sinusitis cases (1, 5, 6, 7). Recent data, however, show that its prevalence rate is increasing every year (8, 9).Nowadays, dentists and otolaryngologists work together with a common goal - the correct diagnosis and treatment of this disease. Specialists need to be well versed in both the differential diagnosis of odontogenic sinusitis and the most common odontogenic etiologic factors associated with it (10, 11, 12). CONCLUSIONOdontogenic sinusitis is a widespread disease. Literature sources often refer to it as an "underestimated disease". Today, it is clear that the main etiologic factors associated with the development of odontogenic sinusitis are endodontic infections and periodontal disease affecting distally positioned maxillary teeth, and iatrogenic causes in the area. Therefore, it is of utmost importance that specialists are familiar with the possible " triggers " of the disease in order to be able to make a prompt and accurate diagnosis, and plan the correct treatment accordingly
Meta-Analysis of the Incidence of Pharygeocutaneous Fistulas In Laryngectomized Patients
Get PDFBackground: Laryngeal cancer is the seventh most common cancer worldwide, with significant morbidity and mortality. Treatment often involves total laryngectomy, leading to complications such as Pharygeocutaneous fistulas (PCF) in 10-20% of cases. PCFs impede recovery and worsen patient outcomes, with risk factors includingnutritional status, surgical techniques and pre-operative radiotherapy.Methods: A retrospective analysis of 19 studies including over 5000 patients was conducted to evaluate the incidence of PCF in laryngectomized patients. The study focused on laryngectomies performed for laryngeal carcinoma. Examining risk factors such as age, nutritional status and deficiencies, radiotherapy and surgical techniques. Studies unrelated to oncological treatment or those published before 2000 were excluded.Results: No significant difference in the rate of PCF was found between oral feeding and feeding via a Nasogastric tube (NGT). Hypoalbuminemia was a notable risk factor in the development of PCF. Advanced tumour stages (T3 and T4) were linked to a higher incidence of PCF, though statical significance varied. Continuous suturing and mechanical sutures showed reduced PCF risk compared to interrupted and manual sutures.Conclusion: PCF are the most common complication post-laryngectomy, with factors like hypoalbuminemia, low haemoglobin and preoperative radiotherapy increasing the risk. Pre-operative optimization of the nutritional and haematological status is recommended to lower PCF incidence and improve patient outcomes and quality of life
Health Care Quality in Patients with Diabetes Mellitus
No full textIn recent years, a serious increase in the number of diabetic patients has been observed worldwide. In order to achieve good diabetes control, patients on insulin treatment need the understanding and support of everyone - medical teams, family, friends, the whole society. One of the tasks faced by the nurse with patients with diabetes mellitus is their education and support to deal with the upcoming problems related to the quality of health care
The effect of Interscalene Plexus Block (ISPB) on intraoperative opioid consumption during an open shoulder surgery
Get PDFShoulder surgery is a growing field in geriatric orthopedics and sports medicine. Surgical methods are applied to diseases where non-invasive treatment techniques have failed. In recent years, the efficacy of peripheral nerve blocks has been repeatedly compared, but studies have focused primarily on their postoperative effects without evaluating intraoperative analgesia and opioid consumption.Aim: The aim of this study was to evaluate the benefits of preoperatively administered ISPB in terms of intraoperative pain control and total intraoperative opioid analgesic consumption.Materials and Methods: A total of 89 patients undergoing open shoulder surgery were included in this study. Of these, 21 underwent shoulder joint replacement surgery, 59 underwent surgery for proximal humeral fracture, and 9 patients underwent open shoulder surgery other than the above-mentioned. Preoperatively, 57 patients underwent ISPB, and 32 patients were without a brachial plexus block. The study was prospective and retrospective because we obtained the data of patients without preoperative ISPB from the hospital records.Results: Administered preoperatively, the ISPB effectively reduced intraoperative opioid analgesic consumption during open shoulder joint and proximal humerus surgery.Conclusion: Interscalene plexus block is an excellent adjunct to multimodal analgesia, not only for postoperative pain control but also as part of intraoperative analgesia
Application of multivariate FIGARCH and FIAPARCH models in the analysis of volatility of exchange rates, gold and oil prices
Get PDFThe study applies multivariate FIGARCH and FIAPARCH volatility models with constant and dynamic conditional correlations to analyze the volatility of exchange rates of the US dollar against the euro and the Japanese yen, as well as the prices of gold and oil. The results reveal the presence of long memory in the volatility of all analyzed series, with dual long memory observed in the case of oil. An asymmetric reaction of oil and gold price volatility to "positive" and "negative" shocks is confirmed based on the applied FIAPARCH models, while such asymmetry is not supported for exchange rates. The applied multivariate volatility models reveal dynamic conditional correlations between exchange rates, gold, and oil prices, aiding optimal portfolio construction. The study identifies volatility spillovers from gold prices and the EUR-USD exchange rate to oil prices, as well as from the USD-JPY exchange rate to the EUR-USD exchange rate. Bidirectional spillovers are observed only between gold prices and the EUR-USD exchange rate