Varna Medical University Press: Journals
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Awareness as a Means of Improving Sexual Health Among Adolescents
Get PDFIntroduction: Sex education is a starting point for creating models of family coexistence and parenting. It supports the acquisition of knowledge, the formation of attitudes towards sex, the development of gender identity, and promotes responsible behavior in intimate relationships. For maximum effectiveness, sex education should begin early, before young people reach puberty and before they establish behavioral patterns.The aim of the present study is to investigate and analyze the opinions of adolescents from two age groups regarding where they get information related to sexual health and which sources have the strongest impact on improving their awareness of sexual health.Materials and Methods: A survey was conducted among 244 students from schools in the Sliven region. The survey was administered during the class teacher’s lesson.Results: Adolescents in the 13–15 age group identified social media and the Internet as their primary source of information (54.60%), followed by friends (51.30%) and books (21.80%). In the 16–18 age group, students indicated that their primary source of information was friends (50.40%), followed by social media and the Internet (36.10%), and conversations with a parent, mainly the mother (30.30%).Conclusion: It is crucial that access to information is not delayed but provided as early as possible, in a manner appropriate to adolescents' physical and psycho-emotional maturity. Awareness and knowledge form the foundation of attitudes and help shape behavior
Coenzyme Q10: an innovative solution for treating chronic kidney disease and protecting heart health
Get PDFCoenzyme Q10: an innovative solution for treating chronic kidney disease and protecting heart health Coenzyme Q10 (CoQ10) is a fat-soluble, vitamin-like quinone found in cell membranes and mitochondria in both reduced (ubiquinol) and oxidized (ubiquinone) forms. Its concentration is high in organs with accelerated metabolism, such as the heart, kidneys, and liver, where it acts as an energy-carrying molecule. Factors that lead to reduced CoQ10 levels include age, genetic factors, medications, and cardiovascular and kidney diseases. Dysfunction in the mitochondrial respiratory chain, oxidative stress, and inflammation are involved in the pathogenesis of chronic kidney disease (CKD) and contribute to decreased plasma CoQ10 concentrations. CoQ10 reduces lipid peroxidation and inflammatory markers that cause kidney cell damage. Additionally, it positively affects cardiovascular parameters by lowering blood pressure and improving endothelial function, thereby reducingthe risk of cardiovascular incidents. Its therapeutic use in CKD patients offers a dual mechanism of action: reducing oxidative stress and inflammation and improving cardiovascular health. This makes CoQ10 a promising addition to therapeutic strategies for treating chronic kidney disease and preventing cardiovascular complications
Current approaches to the treatment of teeth with furcation defects
Get PDFINTRODUCTION: When the bifurcations and trifurcations of multirooted teeth are invaded by a periodontal disease process, it is referred to as furcation involvement. The treatment of these defects is extremely complex but determines the prognosis and survival of the teeth with affected furcation.AIM: The aim of this study is to specify current treatment approaches for different types of furcation defects.DISCUSSION: Today, we are familiar with the fact that teeth with furcation defects are considered teeth with a doubtful prognosis or non-rational for treatment in periodontal therapy. Because of their morphological features, accessibility, and the complexity of the healing, furcation defects pose a challenge to doctors. Over the years, a variety of studies have been conducted regarding the treatment of teeth with affected furcation. Non-surgical periodontal therapy has repeatedly been shown to lead to unsatisfactory results in these teeth (the exception being isolated cases of teeth with class 1 furcation defects). The reason for this lies in the inability to perform adequate debridement in relation to the anatomy of the furcation. Based on numerous studies and their results, nowadays it is clear that for teeth with a furcation defect (mostly class 2 and less often class 1) the most used methods are those of regenerative therapy. Class 3 furcation defects are the ones where the teeth are indicated for resective surgery or extraction with subsequent implant placement in the area.CONCLUSION: The presented study shows that presently in class 1 furcation defects, emphasis is placed on non-surgical periodontal therapy. In class 2 furcation defects, particular attention is paid to regenerative treatment methods, and in class 3 furcation defects, if radical actions are chosen, such as tooth extraction and implant placement afterwards, or if there are contraindications for such—there is a compromise option involving specific resective methods
Osteoradionecrosis of the jaw: a review article
Get PDFIntroduction: Radionecrosis of the jaw is a rare but serious complication in patients who undergo head and neck radiation therapy. The condition was first described by Regaud in 1922 with the term "osteoradionecrosis" (ORN). It is defined as "exposed non-vital irradiated bone that does not heal for more than three months and there is no evidence of a primary tumor, tumor recurrence, or metastases."Aim: This review article aims to summarize the epidemiological data, etiopathogenesis, classification, staging systems, clinical findings, and diagnosis of ORN, as well as provide a critical analysis of the treatment and prevention methods.Materials and Methods: An extensive search was performed in PubMed, Scopus, and Web of Science databases using the following keywords: ((osteoradionecrosis) OR (radionecrosis) OR (post-radiation necrosis) OR (post-radiation osteomyelitis)) AND (jaw). After analyzing the obtained data, 33 articles were included in this review.Results and Discussion: The exact pathogenetic mechanisms for the development of ORN are not fully understood, but the etiology is assumed to be multifactorial. Treatment depends on the stage of ORN, typically involving a combination of conservative and surgical methods. Dentists play a key role in prevention through timely dental treatment and tooth extraction when indicated.Conclusion: Osteoradionecrosis is a serious complication that can occur after head and neck radiotherapy. Its treatment requires a multidisciplinary approach. Efforts should aim for effective prevention and prophylaxis of the condition, optimization of conventional treatment protocols, and the adoption of new ones.Introduction: Radionecrosis of the jaw is a rare but serious complication in patients who undergo head and neck radiation therapy. The condition was first described by Regaud in 1922 with the term "osteoradionecrosis" (ORN). It is defined as "exposed non-vital irradiated bone that does not heal for more than three months and there is no evidence of a primary tumor, tumor recurrence, or metastases."Aim: This review article aims to summarize the epidemiological data, etiopathogenesis, classification, staging systems, clinical findings, and diagnosis of ORN, as well as provide a critical analysis of the treatment and prevention methods.Materials and Methods: An extensive search was performed in PubMed, Scopus, and Web of Science databases using the following keywords: ((osteoradionecrosis) OR (radionecrosis) OR (post-radiation necrosis) OR (post-radiation osteomyelitis)) AND (jaw). After analyzing the obtained data, 33 articles were included in this review.Results and Discussion: The exact pathogenetic mechanisms for the development of ORN are not fully understood, but the etiology is assumed to be multifactorial. Treatment depends on the stage of ORN, typically involving a combination of conservative and surgical methods. Dentists play a key role in prevention through timely dental treatment and tooth extraction when indicated.Conclusion: Osteoradionecrosis is a serious complication that can occur after head and neck radiotherapy. Its treatment requires a multidisciplinary approach. Efforts should aim for effective prevention and prophylaxis of the condition, optimization of conventional treatment protocols, and the adoption of new ones
The Pediatric And School Health Care Nurse In Child Abuse Prevention
Get PDFChild abuse is a complex and multifaceted social phenomenon, common to modern society. It is an integral part of history and dates back to ancient times. "Violence prevention" is just a term, but the real way to protect children is to care for them, respect their personality, educate them and love them.This study aims to explore and analyse the nurse’s role in the multidisciplinary team in introducing a risk assessment tool to all children and pupils, which can identify those who have been victimised as well as children at high risk of abuse.Material and methods: 162 health professionals working in child and school health care in Veliko Tarnovo province were polled. The following methods were used: documentary, questionnaire, and statistical methods for data processing and analysis. An author’s questionnaire was developed, containing 19 (13 closed and 6 open) questions to survey the opinion of child and school health care professionals on the attributes studied.Results and Discussion: The poll data indicate that more than half of the respondents from both professional groups gave a positive but inconclusive "Rather Yes" response (53% and 65%) regarding the recognisability of signs of child abuse. Physical (40%) and psychological abuse (40%) were most frequently recognised by school health professionals, with child neglect (62%) most frequently recognised by nursery professionals.Conclusion: The introduction of indicators for different types of violence can help healthcare professionals identify children who have been victims of violence to prevent its recurrence, and also enable timely assistance to reduce the harmful effects of the trauma experienced
Lid Margin Tumors
Get PDFIntroduction: A stable lid margin with a correct configuration is an important element ensuring the normal structure and function of the eyelids. Any change in its contour or position can lead to incomplete closure of the eyelids and problems with the anterior ocular surface. Tumor formations of the eyelids are the most common neoplasms in ophthalmological practice, and often they are located on or partially involve the lid margin.Aim: The aim of the study is to present various tumors of the lid margin, their surgical treatment, and the postoperative results.Materials and Methods: The clinical appearance of the tumor formations was evaluated in order to estimate the volume of the primary excision. The removed neoplasms were placed in 10% formalin solution and histological examination was performed. The post-excision defects healed spontaneously or were repaired by direct closure or flap formation.Results: Benign lid margin tumors were more common than malignant ones. Of the benign, the most common were squamous papilloma and seborrheic keratosis, of the malignant—basal cell carcinoma. Postoperatively, the lid margin was in a normal position, and a very good aesthetic result has been achieved.Conclusion: Lesions of the lid margin often go untreated for a long time due to patients' fear of the postoperative outcome. Although benign lesions are more common than malignant lesions, their timely surgical removal with subsequent histological examination is the gold standard of behavior in such cases.Introduction: A stable lid margin with a correct configuration is an important element ensuring the normal structure and function of the eyelids. Any change in its contour or position can lead to incomplete closure of the eyelids and problems with the anterior ocular surface. Tumor formations of the eyelids are the most common neoplasms in ophthalmological practice, and often they are located on or partially involve the lid margin.Aim: The aim of the study is to present various tumors of the lid margin, their surgical treatment, and the postoperative results.Materials and Methods: The clinical appearance of the tumor formations was evaluated in order to estimate the volume of the primary excision. The removed neoplasms were placed in 10% formalin solution and histological examination was performed. The post-excision defects healed spontaneously or were repaired by direct closure or flap formation.Results: Benign lid margin tumors were more common than malignant ones. Of the benign, the most common were squamous papilloma and seborrheic keratosis, of the malignant—basal cell carcinoma. Postoperatively, the lid margin was in a normal position, and a very good aesthetic result has been achieved.Conclusion: Lesions of the lid margin often go untreated for a long time due to patients' fear of the postoperative outcome. Although benign lesions are more common than malignant lesions, their timely surgical removal with subsequent histological examination is the gold standard of behavior in such cases
Swept-Source OCTA features of choroidal nevi and assessment of malignancy risks
Get PDFIntroduction: The choroidal nevus is the most common benign intraocular lesion.Aim: The aim of this article is to determine the information given by swept-source optical coherence tomography angiography (SS-OCTA) in the follow-up of patients with choroidal nevus and to evaluate the risk factors for malignant transformation of the nevus.Materials and Methods: A retrospective study of patients examined at Zora Medical Centre, Sofia, during the period November 2021–August 2023 was conducted. The study included 21 eyes with choroidal nevus. All patients underwent indirect ophthalmoscopy after mydriasis, fundus photography, SS-OCTA, and for elevated lesions—A- and B-mode ultrasound. SS-OCTA scanning was performed on ZEISS PLEX Elite 9000 (Carl Zeiss Meditec, Inc., Dublin, CA).Results: Based on the classification created by Gowtham et al., the patients were divided into 5 groups. Evaluation of the visualization of the choroidal vasculature was performed in 13 eyes. In 9 of the nevi visualization of vessels in the area of the nevus was absent, and in 3, vessels similar to the rest of the choroidal vessels were found in the area of the nevus. Of the examined eyes, only in 1 eye there was a different pattern of the vascular network—vessels with the formation of loops (looping pattern). When assessing the risk of nevus malignancy in the study group, only 1 eye with 3 risk factors was found.Conclusion: Swept-source OCTA is a non-invasive, reproducible, and reliable method for follow-up of the small choroidal nevi and assessing their risk for malignization
The advantages of interlocking intramedullary fixation of fibula fractures over conventional plating
Get PDFIntroduction: Ankle fractures are among the most common injuries encountered in the emergency department. They affect young and elderly people equally and up to a quarter of them require surgical intervention to restore the ankle joint. For the last 50 years, plate osteosynthesis has been the gold standard for open reduction and internal fixation of fibula fractures. A new alternative to this method is the locked intramedullary fixation with fibula nails. Aim: The purpose of the current paper is to introduce the main advantages of fibula nail fixation over plate fixation in fibula fractures. Methodology: A total of 28 papers relevant to fibular nailing complications were identified using the PubMed search engine. After excluding irrelevant articles, the information was compared to the abundance of information about complications after plate fixation in the literature. Results: Locked intramedullary fixation of fibula fractures appears to be a viable alternative to plate fixation, especially in patients with diabetes mellitus, osteoporosis, and peripheral vascular disease due to significant reduction in the wound complication and reoperation rates. Conclusion: The new generation of fibula nail implants are a valuable tool in the armamentarium of trauma surgeons. Although data is still limited in the literature and further studies are required, this technique provides promising results in the treatment of ankle fractures in the presence of multiple comorbidities or advanced age