Varna Medical University Press: Journals
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Surgical Treatment of Chronic Pilonidal Disease
Get PDFIntroduction: Pilonidal disease is a relatively common surgical disease affecting mainly young men aged 15–35 years (almost 4 times more than women) and with a tendency to increase its prevalence in the last two decades, including also among women. Although many surgical treatment methods have been described, the rate of recurrence and complications related to wound healing remain relatively high (17.5% and 11.6%, respectively, according to literature data) and worsen the quality of life of the patients for a long period of time.Material and Methods: For a 10-year period, from 2012 to 2022, 235 patients with an average age of 42.1 years were operated on for a pilonidal cyst in the Clinic for Hepatobiliary, Pancreatic and General Surgery of Acibadem City Clinic Hospital Tokuda. In 37.4% of them, surgical treatment was due to recurrence.Results: In all patients, after verification of the fistula course(s) with methylene blue and/or a ball probe, a sheet-like excision of the formation was performed. In 24 of the cases (10.2%), transposition with a Limberg flap followed; 118 patients (50.2%) were treated according to the so-called open method, and in 93 patients the resulting defect was closed primarily with imposed drainage.Conclusion: The ideal therapeutic approach should provide a short recovery period with the possibility of a quick return to normal daily life. Currently there is no consensus on the best operative technique
Physiotherapy for Postural Disorders in the Lumbar Region
Get PDFHypodynamia and incorrect posture determine the increasing frequency and lower age limit of spinal distortions and, in particular, of postural disorders in the lumbo-sacral region. They are one of the most common causes of musculoskeletal dysfunctions in the back area, disability, and reduced quality of life. Active kinesitherapy serves as the foundation for the treatment and prevention of postural disorders in the lumbar region and dealing with the accompanying pain and discomfort.The aim of this article is to assess postural disorders in the lumbar region among second-year students specializing in "Kinesitherapy" and propose a kinesitherapeutic methodology for their treatment and prevention.Materials and methods: The study involves a literature review on the nature and development of dorso-ventral curvatures in the lumbar spine. Second-year students specializing in "Kinesitherapy" are the subjects of the research. To evaluate postural dysfunctions, various tests were conducted, including somatoscopy, the Schober lumbar mobility test, functional muscle shortening tests in the lumbar spine and hip joint, and manual muscle testing to assess trunk muscle strength.Results: The results indicated an increased lumbar lordosis and a positive Schober test in 60% of the examined. The results of manual muscle testing showed weakness of the abdominal and gluteal muscles in 80% of the participants. Shortening tests demonstrated reduced mobility in the m. iliopsoas
Eating Habits of Preschool-Age Children with Overweight and Obesity
Get PDFHypercaloric nutrition is identified as a major factor in childhood overweight and obesity. Substantial attention is paid to children's eating behavior from preschool age, defined as a key period for the development of both proper motor and eating skills and habits.The purpose of the present study is to analyze the frequency of consumption of certain foods, both risky and non-risky, for increasing the body mass of preschool children.Materials and methods. The objects of research are 104 children aged 5 and 6, who were attending 25 kindergartens within the Stara Zagora municipality as part of a research project conducted by the Faculty of Medicine. A survey method was used to study the frequency of consumption of certain foods.Results and discussion.The results indicate that 16.5% of children consume fresh milk on a daily basis, while 36.7% have yogurt regularly and 22% consume cheese. Regarding meat, 34.9% of children consume it 2-4 days per week. Fish is consumed once a week by 45.9% of children. A significant proportion of children consume fresh fruit daily (61.5%), along with vegetables (37.6%), white bread (44%), and low-fat whole grain bread (10.1%). Notably, a majority of children (89.9%) consume soft drinks less than once a month. However, bottled, packaged, and freshly-squeezed juices are consumed relatively often (2-4 days per week) by 21.1% of the children, while chocolate desserts are consumed by 39.4% and dairy desserts such as ice cream and pudding by 15.6%. French fries are consumed once per week by 27.5% of the children.Conclusion.The findings indicate a positive trend in the regular consumption of essential food groups, including milk and milk products, meat and fish, fruits, and vegetables. However, it is concerning to note that there is still a significant frequency of consumption of "junk food" among preschool-aged children
Caloric restriction mimetics as a therapeutic approach to metabolic syndrome
Get PDFCaloric restriction is a reduction in caloric intake without reaching a state of malnutrition, and it affects multiple cellular signaling pathways. Experimental data shows that this leads to an increase in longevity or in maintaining a healthy state for an extended period in both invertebrates and vertebrates, including mammals. Certain food compounds or drugs possess the ability to replicate these effects through shared mechanisms; they are known as caloric restriction mimetics (CRM). What they have in common is the ability to induce autophagy by stimulating deacetylation of cellular proteins. In addition, they modulate energy metabolism and reduce oxidative stress.The current review aims to explore mechanisms and potential outcomes of CRM utilization in addressing metabolic syndrome, with an emphasis on polyphenols and metformin. Their influence on carbohydrate and lipid metabolism, their antioxidant and anti-inflammatory actions, as well as their modulation of gut microbiota emphasize their suitability for managing metabolic syndrome. These effects are at least partially mediated by the same cellular signaling pathways that are activated by caloric restriction, such as adenosine monophosphate-activated protein kinase, mammalian target of rapamycin (mTOR), sirtuins, peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1ɑ), and many others, participating in complex interactions.The data suggests that CRM is an innovative approach in the prevention and therapy of age-related and non-communicable diseases, showcasing significant potential for targeting metabolic syndrome
Establishment and development of the first hospital pharmacy in the city of Burgas
Get PDFThe main purpose of the study is to summarize and synthesize available information on the establishment and early operations of the first hospital in Burgas, founded immediately after the Liberation of Bulgaria. The secondary goal is to trace and analyze its development up to the present day. An important and integral part of any hospital's structure is the hospital pharmacy. Therefore, another equally important part of the study is to highlight the role, main activities, and evolving responsibilities of the staff in this pharmacy over time, as well as the changes in the requirements for the qualification of the master pharmacists who manage the hospital pharmacy. To accomplish these objectives, comparative-historical and comparative methods are employed, along with an analysis and synthesis of the investigated problems. The guidelines for the development of modern hospital pharmacy are briefly outlined at the end of the publication
Imaging of proximal lacrimal system with spectral-domain anterior segment optical coherence tomography
Get PDFIntroduction: Lacrimal punctum is the entry point for tears to the nasolacrimal duct. In the literature there are few studies on the punctum, due to the lack of consensus regarding the imaging modalities for the proximal lacrimal system. There are currently no routinely used imaging modalities for the proximal lacrimal system.Aim: The aim of this article is to assess the proximal lacrimal system using a novel non-contact method with the use of anterior segment optical coherence tomography.Materials and Methods: This study included 25 right eyes of 25 healthy volunteers. Optical coherence tomography images of the right lower lacrimal puncta were obtained by two operators using SD OCT 3D OCT-2000 FA Plus (Topcon Corporation, Japan) and software version 8.11. The measurements were repeated after 7 days. The inner diameters of the canaliculus and tear meniscus height were measured. IBM SPSS v23 was used for statistical analysis.Results: The mean age of subjects was 24 ± 2.4 years. The study included 10 males and 15 females. The mean punctal diameters at Visit 1 and Visit 2 were 179.08 ± 76.97 µ and 179.64 ± 76.37 µ for investigator 1 (experienced), and 204.72 ± 106.98 µ and 192.32 ± 91.52 µ for the second investigator (inexperienced), respectively. In 20 patients the tear meniscus height in the punctum was measured. The Wilcoxon signed-rank test showed no statistically significant difference between the values of the two investigators (p = 0.106). Linear regression analysis demonstrated excellent correlation between the investigators (p = .000, r = 0.834). Levene’s test of homogeneity showed similar measurement variance between observers (p = 0.424, F = 0.643).Conclusion: Anterior segment optical coherence tomography can be successfully used to visualize the structures of the proximal lacrimal system and provide accurate measurement of the inner diameter of the canaliculus and tear meniscus height in healthy subjects. The method demonstrates excellent repeatability, which does not depend on investigator experience. It could be implemented successfully in future diagnostics of different lacrimal pathologies for objective assessment by imaging technology.
Non-Alcoholic Fatty Liver Disease and Non-Invasive Methods of Diagnosis
Get PDFNon-alcoholic fatty liver disease (NAFLD) is widely recognized as the hepatic manifestation of the metabolic syndrome, characterized by the accumulation of triglycerides in the hepatocyte cytoplasm. With a global prevalence estimated at 25%, NAFLD stands as the most common chronic liver disease. While the majority of NAFLD patients may never experience liver-related complications, a notable 5–10% face the risk of progression to cirrhosis, end-stage liver disease, or hepatocellular carcinoma. NAFLD patients with advanced fibrosis are at the highest risk of developing cardiovascular, renal, and cirrhosis-related complications. Liver biopsy is currently considered the reference method for evaluating liver steatosis and fibrosis stages. However, due to their limitations in large-scale screening, non-invasive tests (NIT) have gained prominence in evaluating steatosis and fibrosis stages in NAFLD patients. These NIT methods encompass serum-based algorithms as well as ultrasound- and magnetic resonance-based techniques. This review explores the advantages and limitations of NIT for identifying steatosis and advanced fibrosis in NAFLD
Factors Influencing Osteogenesis
Get PDFThe process of osteogenesis includes the well-coordinated proliferation and differentiation of osteogenic cells. It is known that mesenchymal stem cells are the progenitor cells in this process. They differentiate into osteoblasts and give rise to new bone formation. Osteogenesis happens not only as a normal process during embryonal development but also as result of some dis-eases, traumatic injury, and fractures. The mechanisms of physiological and pathological processes of ossification are similar. However, the factors participating have not yet been studied in detail. The involvement of genetic mechanisms, cell growth fac-tors, pharmacological substances, biochemical pathways and nutrients are reported committing to osteogenic differentiation at multiple levels. In conclusion, osteogenesis is a complex process and a modern approach to the influencing factors is needed
