Varna Medical University Press: Journals
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Clinical correlates of congenital blepharoptosis or what have we learned over a five-year period?
Get PDFIntroduction:Blepharoptosis is described as a condition of narrowed eyelid slit caused by a drooping or lower position of the upper eyelid of one or both eyes.Aim:The aim of this article is to analyse the clinical features, associations with eyelid and oculomotor disorders, refractive abnormalities, and histologic characteristics of patients, operated on with a diagnosis of congenital ptosis over a five-year time period, and to present our clinical and surgical approachMaterials and Methods:Retrospective analysis of treatment records of 64 patients with congenital ptosis was conducted. The investigated parameters were forced chin position, asymmetric eyebrow elevation, presence of refractive errors, amblyopia, strabismus, hooded eyelid, syndromic diseases of eyelids and eyelid muscles.Results:Using the one-way ANOVA method to analyse non-parametric data, we found that there was no association between the presence of refractive errors, strabismus, eyebrow elevation, and laterality of disease in both genders. We found a correlation between the presence of bilateral ptosis and forced chin position.Conclusion:Our study on the clinical associations of congenital ptosis demonstrated the multifaceted and diverse pathology associated with this condition. In addition to the higher incidence of refractive errors and strabismus, the cause of reduced vision, in congenital ptosis we find combined accommodative disorders, periocular changes, and oculofacial synkinesis. The presence of all these pathologic changes requires meticulous examination, precise treatment judgement, and long-term follow-up of each individual patient
Morphological and functional effects of using citicoline in primary open angle glaucoma treatment
Get PDFIntroduction: The large multicenter studies (EMGT, CNTGS, CIGTS, AGIS) have revealed that lowering the intraocular pressure (IOP) improves the prognosis of primary open angle glaucoma (POAG) but does not stop its progression. In addition to topical drugs, laser and surgical therapy, in recent years, neuroprotection has increasingly been implemented. It is a promising method and its main task is to prevent the death of retinal ganglion cells (RGC) and slow down the progression of the disease.Aim: The purpose of the study is to observe and compare the effects of using the dietary supplement citicoline as additional therapy for patients with POAG.Materials and Methods: This study includes the results of the examination of 120 eyes of 60 POAG patients aged 50–75 years, who are undergoing topical anti-glaucoma therapy. Patients were randomly divided into two groups of 30 each (A and B) and followed up for a period of 15 months. The IOP values of the monitored patients were in the 14–21 mmHg range. Group A patients did not take any nutritional supplements that could have positive or negative influence on the study results during the observation period. Group B patients took the food supplement Citizin following a prescribed regimen consisting of two 6-month periods with a 3-month break between them. All patients underwent a complete ophthalmological examination, including standard automated perimetry (SAP) and optical coherence tomography (OCT) before enrolling in the study, after 6 months, and after 15 months. The mean deviation (MD) and pattern standard deviation (PSD) parameters measured by SAP, as well as retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) measured by OCT, were considered.Results: During the observation period, there was a deterioration of the monitored parameters and progression of the disease in group A. Both MD and PSD deteriorated by 0.22 dB and 0.37 dB, respectively, and mean RNFL and GCC values decreased by 3.37 μm and 2.75 μm, respectively, for Group A over the period of monitoring. An improvement of the parameters in Group B was noted, which was more evident after the second 6-month intake of citicoline. In Group B, MD improved by 0.31 dB and PSD improved by 0.4 dB over the entire observation period. Mean RNFL and GCC values for Group B increased by 1.28 μm and 1.9 μm, respectively, during the same period.Conclusion: In conclusion, although these results need to be confirmed by further studies with a longer follow-up period and performed on a larger population, and it would be useful to add other tests on optic nerve function and visual pathways, the data from our study show that the dietary supplement citicoline has a positive effect on slowing the progression of POAG at different stages of the disease
Comparison of soft tissue grafts harvested from the maxillary tuberosity and the hard palate: A review
Get PDFINTRODUCTIONAutologous soft tissue grafts were first used for keratinized tissue (KT) augmentation around teeth. They have been considered an excellent alternative to tissue regeneration materials for their stable, long-term results.AIMThis review aims to compare soft tissue grafts harvested from two different donor sites—the maxillary tuberosity and the hard palate, evaluate their advantages and disadvantages, and summarize the indications and limitations for their use.MATERIALS AND METHODSAn electronic search using PubMed, Web of Science, Scopus, and Google Scholar databases was conducted until June 2024. This review includes 32 articles. It summarizes the knowledge on soft tissue grafts harvested from the hard palate and maxillary tuberosity.RESULTS AND DISCUSSIONThe palate and the maxillary tuberosity are the most common donor sites for soft tissue grafting in the oral cavity. They have various applications, such as soft tissue augmentation around teeth and implants, treatment of gingival recessions, and peri-implant dehiscence, and recently they have been suggested as a method for alveolar ridge preservation. The main differences between these grafts are their availability and structural and histological features.CONCLUSIONThe present review summarizes the advantages, disadvantages, applications, and limitations of soft tissue grafts harvested from the palate and the maxillary tuberosity. Various clinical assessments and histological and molecular analyses have highlighted their differences in structure and behavior
Contemporary approaches to the prevention of risks associated with preeclampsia
Get PDFIntroduction: Preeclampsia is a condition unique to humans, developing during pregnancy and affecting multiple organs and systems in the body. Modern medicine estimates that preeclampsia occurs in 2-8% of pregnancies, leading to significant maternal and fetal morbidity and mortality.Aim: To explore and analyze current understanding of preeclampsia and options for preventing potential maternal and neonatal complications within obstetric care.Materials and Methods: National and international publications related to preeclampsia were reviewed with a focus on prenatal screening for risk assessment and prevention of complications. A sociological survey was conducted among 126 students from the Midwifery program at MU – Varna in April 2024, followed by a graphical analysis of the results.Results and Discussion: Preeclampsia is commonly indicated by high blood pressure, proteinuria, and edema, although a diagnosis does not require all three symptoms to be present. It is most frequently diagnosed after the 34th week of gestation. Midwives play a critical role in identifying risk factors for hypertensive complications, implementing preventive measures, and providing active care when the condition manifests.Conclusions: Midwives have a pivotal role in assessing risk factors, conducting screening, and monitoring pregnant women at risk of developing hypertensive complications during pregnancy
Good Nursing Practices In Chemotherapy Transfusion For The Rational Application Of Blood Products
Get PDFIn modern healthcare, hemotransfusion of various blood products is used as a therapeutic method due to their multiple effects, both in emergency cases and in the treatment of a number of acute and chronic diseases. The uniqueness of blood and blood products in medical practice stems from the fact that the only source of blood is a healthy individual. While attempts have been made for many years to create artificial blood, no synthetic liquid has yet been developed that can fully replace donated blood.OBJECTIVE: To analyze the activities related to the provision and administration of blood products, and to clarify the need and importance of implementing good nursing practices in hemotransfusion.MATERIALS AND METHODS: Documentary method: Research of medical literature, documentation, and regulatory documents on the subject.Sociological method: Self-developed questionnaires used for two public opinion surveys.Statistical methods: Data analysis and interpretation.RESULTS AND DISCUSSION: More than half of the surveyed nurses (64.2%) shared the need to introduce new forms to recruit a sufficient number of donors to ensure the necessary amounts of blood products. The experts expressed approval and agreed that this is the correct approach to securing donors. Adherence to established healthcare algorithms for both donors and recipients would help avoid errors and prevent complications during hemotransfusion.
Diagnosis and Treatment of Acute Pancreatitis in Adult Patients
Get PDFINTRODUCTION: Population aging is a significant medico-social problem that remains relevant today and still lacks a sufficiently adequate solution. This is due to the complex influence of numerous factors on people's health, as well as increased morbidity and mortality from both common and relatively rare diseases.AIM: The aim of this article is to define the features of subjective complaints, physical findings, diagnostic possibilities, and the course and outcome of acute pancreatitis in elderly patients.MATERIAL AND METHODS: The subject of the present study includes 29 patients with acute pancreatitis, hospitalized on an emergency basis and operated on in the Second Department of Surgery at the Clinic of Surgical Diseases, at St. Marina University Hospital - Varna. All hospitalized patients underwent routine clinical, laboratory, and imaging tests. The following statistical methods were used for analysis and interpretation of the obtained data: alternative analysis, variation analysis, correlation analysis, and univariate logistic regression analysis.RESULTS: A constellation of indicators characterizes some of the key peculiarities in the diagnosis and treatment of these patients, with an emphasis on the role of General Practitioners, aiming to increase efficiency and improve the quality of medical care for this specific population.CONCLUSION: The clinical presentation of acute pancreatitis in the elderly differs from the typical form. A sudden onset with low-intensity epigastric pain and vomiting is crucial in diagnosing the disease
The nutcracker syndrome – case report
Get PDFThe Nutcracker syndrome represents a congenital vascular defect in which the left renal vein is compressed between the abdominal aorta and the superior mesenteric artery. The most common symptom of the disease is hematuria, with or without left flank pain. The condition is often underdiagnosed due to the absence of specific symptoms. We present a clinical case of a 56-year-old woman with complaints of general fatigue, intermittent flank pain, and microscopic hematuria. A contrast-enhanced CT scan of the abdomen and pelvis revealed compression of the left renal vein between the superior mesenteric artery and the aorta, along with a bulging left ovarian vein, confirming the diagnosis of Nutcracker syndrome. In this specific case, observation is recommended, but in the event of more pronounced clinical symptoms, such as unbearable pain, severe hematuria, renal failure, or lack of response to conservative treatment, various endovascular interventions may be performed