Varna Medical University Press: Journals
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Customs risk management
Get PDFRisk analysis remains a key element for the efficiency of customs control, allowing customs authorities to focus their controls in an environment where the increasing volume and pace of trade more than ever requires a selective and targeted approach. The trends and challenges related to the modernization of customs administrations prove the role of customs organization in the effective implementation of the process and the importance of the competence of the authorities (within the object of control). The aim of this research is to present the trends in customs risk management. In the study have been used the descriptive - analytical approach, the methods of comparison, analysis and synthesis
Latent Mastoiditis And Facial Paralysis In A Child As Complications After A Coxsackie Virus Infection. Clinical Case
Get PDFCoxsackie virus infection usually presents with mild to moderate clinical manifestations. Within 10 - 14 days a complete cure is achieved. The development of complications occurs rarely.We present a clinical case of “mouth-hand-foot“ disease in a 3-year-old child who developed complications of the lung, heart, middle ear, and facial nerve. The disease develops on undamaged terrain. Complications occur after a 30-day light period from the viral infection, which is treated on an outpatient basis. The appearance of complications and the child’s sharply deteriorated general condition become a reason for hospitalization. After the medical and surgical treatment, the child was discharged healthy, without medical risk.Acute suppurative otitis media after a coxsackie virus infection is not common. Complaints may be atypical and therefore missed. The diagnosis is made late, after complications have occurred
Cornerstones in the surgical treatment of chronic pancreatitis
Get PDFIntroduction: Chronic pancreatitis is a disease with various frequency depending on social and geographic factors. Nowadays genetic predisposition is well studied in cases of familial disease. The most common etiology is related to alcohol consumption. In the progression of the disease, the exocrine and endocrine function are impaired, which leads to disability. Moreover, chronic pancreatitis is linked to increased risk of pancreatic cancer.Surgical treatment is required in cases of complications, increased ductal pressure, and pain syndrome, associated pancreatic cancer. Different types of surgical interventions are introduced in practice for improvement of the patient’s condition—surgical drainage and different types of pancreatic resections. Drainage procedures are related to successful management of the pain syndrome, combined with pancreatic function preservation. Resection may decrease the risk of pancreatic cancer, but is often linked to insulin-dependent diabetes type 3C.Aim: The aim of this article is to assess different types of surgical interventions for treatment of chronic pancreatitis and its complicationsMaterials and Methods: This article presents a review of the literature data and comparison between the methods for surgical drainage and resection of the pancreas depending on specific pathologic changes of the pancreatic gland and complications of the disease.Discussion: In the middle of the nineteenth century, for the first time, methods for pancreatic decompression of the duct system were described in the literature. This is related to pain reduction. Subsequently, numerous other methods were introduced in the practice. Combinations of pancreatic resection and drainage have been reported to provide the best results in the management of pain. Other publications suggest pancreatic resections as the best option in the surgical treatment of the chronic pancreatitis.Conclusion: Internal surgical drainage is the best alternative in cases of elevated intraductal pressure and complications of the disease related to this. Small duct disease is a condition requiring a combined resection/drainage procedure. A resection of the pancreas is required in cases of groove pancreatitis, cases of jaundice due to a pancreatic tumor or associated cancer.
Mental Health In The Focus Of Preventive And Promotional Nursing Care In Outpatient Care
Get PDFMental health is an important component of an individual's health. Challenges to the ability to maintain mental equilibrium, balance and sense of well-being are increasing. The most vulnerable is the health of children and learners, but also that of young people and their parents. In recent years, measures and important documents regarding mental health have been taken in the European Commission of the EU and Bulgaria. An essential part of policies to strengthen mental health are nurses, who carry out a wide range of activities for prevention and health promotion of children and students. In the present study, the attitudes, capabilities and competence of nurses to provide psychological support, promotion of mental health and care for children and young people in outpatient settings are established. A survey was conducted with 124 persons in the month of June, 2023 and sociological and documentary methods were used. The obtained results allow the following conclusions to be formulated: The interviewed people are mostly aware of the national health legislation, which regulates their promotional activity in relation to mental health, and they have the competence to carry it out. Both groups of respondents believe that proper upbringing at home has an important role for the neuro-psychological development and sustainable psyche of the children and learners. Out of six groups of risk factors, nurses and students believe that the first three groups have the most significant importance for disturbances in the psycho-emotional state and health: problems in the family, problems with one's own health and violence. All the people who were interviewed are convinced that multidisciplinary teams consisting of the general practitioner, the nurse, the psychologist and the parents, could have a positive impact on raising and educating citizens with mental resilience and good mental health
Prevention Of Perineal Trauma By Antenatal Preparation Of The Pelvic Floor
Get PDFVaginal deliveries are associated with some degree of trauma to the genital tract with significant short- and long-term morbidity. Risk factors associated with perineal trauma include: first birth, increased fetal weight, operative vaginal delivery, prolonged second period, maternal lithotomy position, maternal age, induction of labor, use of episiotomy, and strong medicalization of the labor process. Basic strategies to reduce perineal trauma begin as early as the third trimester of pregnancy. Midwifery practice plays a leading role through prenatal education. In the antenatal period, a combined training program based on perineal massage after the 32nd gestational week and pelvic floor exercises are recommended.The aim of this study was to investigate to what extent antenatal training with a combined training program resulted in less perineal trauma and restrictively reduced the incidence of routine episiotomy
Preventive Health Care For Young Children In Bulgaria
Get PDFIntroduction: The 2000 reform created new conditions for the development of child health care. Children's consultation is now mainly the activity of GPs, providing also the opportunity for a specialist paediatrician. Children's development is monitored under the Child Health Programme Vaccinations are carried out by the child's GP without the involvement of a paediatrician.Aim: To evaluate preventive care for young children through the eyes of mothersMaterial and methods: A survey was conducted between November 2019 and June 2021 among mothers of young children to assess their relationship with the health service regarding their children's health. Mothers were selected on a nested basis from three districts in southern Bulgaria - Stara Zagora, Burgas and Kardzhali. 250 mothers were invited, of which 202 responded (80.8% response rate). A 35-question questionnaire was used to conduct the survey in the same nests in 2014 (242 mothers). The two surveys are conventionally designated I-14, conducted in 2014, and I-21, conducted in 2019-2021. A comparison was made between I-14 and I-21 as two independent samples.SPSS v. 25.0 software was used for statistical processing and data analysis.Results and Discussion: According to the mothers, 88.12% of the children were followed up in child consultation and 11.88% were not covered.Regarding the distribution of responses by "education", "ethnicity" and "residence", the results were as follows: by "education" p<0.012; by "ethnicity" p<0.008 and by "residence" p<0.014. The comparative analysis reveals that the number of children not covered by the children's consultation increased 3.6 times during the study period. GPs had the highest proportion of 61.69% in child monitoring compared to paediatricians 31.84%.Conclusion: There is inequity in access to pediatricians in preventive care in early childhood. There is a trend towards a decrease in the relative proportion of specialist care. Nurse involvement, both alone and in a team with a doctor, is minimised
Severe mycotic pansinusitis in a patient with hairy cell leukemia, ending lethally
Get PDFHairy cell leukemia, HCL is the result of a mutation of B-memory lymphocytes from the germinal center with a low degree of malignancy, with an indolent course, slow progression and a very good therapeutic effect. Clinically, HCL is characterized by a tendency toward peripheral pancytopenia, discrete lymphoadenomegaly, and significant splenomegaly. The main reason for shortened survival, even in contemporary, is various infectious complications, especially opportunistic infections, mycotic, etc. They not only limit or compromise the therapeutic response, but also often lead to a fatal outcome.We present a 42-year-old patient diagnosed with HCL in 2014 who underwent a significant number of specific courses of treatment, including splenectomy. In a subsequent recurrence, marked enlargement and thickening of the mucosa of the left maxillary, sphenoidal, frontal and ethmoidal sinuses, polypoidal mucosal hypertrophy with partial obstruction of the nasal passages, massive necrotic involvement of the soft tissues and bilateral thrombosis of the facial arteries were found. Histological examination confirmed mycotic hyphae. Aspergillus Flavus was verified microbiologically. Despite comprehensive conservative and surgical treatment, the disease ended fatally. Infectious complications (especially mycotic ones) are the result of severe quantitative and qualitative disorders in the main effector cell lines with pronounced granulocytopenia, monocytopenia, reduced activity of natural killers, T-helpers, poor antibody response even with normal immunoglobulins and reduced antibody-dependent cellular cytotoxicity. When such complications occur, patients require immediate action by an interdisciplinary team
Diverticular Disease (DD) of the Digestive Tract. Classification, Types of Complications, and Treatment
Get PDFIntroductionDiverticular disease (DD) of the digestive system is a common disease with an increasing incidence recorded. The most frequently affected anatomical areas are the distal sections of the large intestine, namely the distal colon and sigmoid colon.AimThe aim of this article is to investigate the frequency of DD, the position of the diverticula, the types of complications and treatment.Material and MethodsThe study was single-center, retro- and prospective, covering 1,879 patients hospitalized at the General Hospital in Pleven for the period 01.01.2022–01.06.2023. A total of 66 patients (3.5%) were diagnosed with DD. Both sexes were affected equally.ResultsThe complications were as follows: bleeding in 39 (59%) patients, and 12 (18%) had the presence of an inflammatory process. Eleven of the patients (16.6%) were operated on. In 27% Hartmann’s resection was performed, in 72%—partial resection or hemicolectomy with primary anastomosis. We have no lethal outcomes in the studied patient group. The operated patients were evaluated according to CDD, Modified Hinchey and Hansen-Stock classifications.ConclusionThe most frequent factors affecting the incidence of DD are the increased survival rate of the population, inadequate prevention of gastrointestinal tract (GIT) diseases, constipation, disturbances in the dietary regimen. The GIT parts affected by DD in the group of patients was of the Western type, i.e., mainly on the left. The most common complication is bleeding, which in most cases is controlled with medication. Operative treatment was applied in cases of diagnosed peritonitis and/or unsatisfactory result of antibiotic treatment
Physiotherapy for IT Specialists with Pain in the Cervical and Thoracic Spine
Get PDFThe aim of the present study is to propose a kinesitherapeutic program designed to alleviate cervicothoracic pain and enhance the quality of life among IT professionals.Methods and materials: Due to the nature of their profession, IT specialists spend prolonged periods sitting in front of a computer, which leads to frequent complaints of pain in the cervical and thoracic parts of the spine. This negatively affects their health, work productivity, and quality of life, with the most common cause of the pain being the upper crossed syndrome, which is a muscle imbalance affecting the upper part of the spine. The primary objective of the current study is to assess the effectiveness of physiotherapy in reducing pain and improving the quality of life for IT specialists experiencing discomfort in the cervical-thoracic region. The study enrolled 9 IT specialists who reported pain and restricted range of motion in the neck and upper back. These participants underwent an eight-week physiotherapy treatment program, which included specialized exercises tailored to their needs.Results: Functional assessments of the affected area and the quality of life of all participants were assessed before and after the physiotherapy treatment. The results showed a significant improvement in pain intensity and functional status. Participants reported reduced pain levels and an enhanced ability to engage in daily activities without discomfort.Conclusion: The results demonstrate that physiotherapy is an effective method for maintaining good muscle tone, eliminating pain symptoms, and improving work performance and the overall quality of life among IT specialists
A Complex Approach in a Child with Obesity: A Clinical Case
Get PDFChildhood obesity is a problem that requires a complex approach to treatment.The aim of the research is to propose a complex rehabilitation program designed to reduce body weight and mitigate the effects of obesity.Materials and methods: The article presents a clinical case of a 10-year-old boy with obesity. His parents reported several concerns, including a significantly increased appetite, impaired physical activity, frequent illnesses, insomnia, and a lack of concentration. The child underwent a thorough examination by specialists at the Medical Center of the University of Varna, including a doctor of physical and rehabilitation medicine and a physiotherapist. Subsequently, a comprehensive rehabilitation program was developed for the patient, consisting of phytotherapy, climate treatment, and an individualized physiotherapy program. The patient diligently followed the program for 45 days, performing the prescribed physiotherapy exercises daily. Additionally, with the child's consent, he participated in sports activities twice a week with an intense workload. Regular physical assessments were conducted every 15 days to monitor progress and adapt the program, while changes in the child's psycho-emotional state after the physiotherapeutic activities were also closely observed.Results: The research proved that after the complex therapy, a reduction in body weight, fat percentage, and body measurements was achieved. The duration and efficiency of his sleep also improved, as did his concentration in the performance of every-day activities.Conclusion: This study highlights the positive impact of selecting appropriate physiotherapeutic methods and incorporating sports, climate therapy, and phytotherapy in the treatment of childhood obesity. The findings indicate the beneficial effects in terms of addressing functional deficits and enhancing overall quality of life