Varna Medical University Press: Journals
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Main emergencies in maxillofacial surgery and their relationships with other medical specialties
Full text linkBackground: Emergencies in maxillofacial surgery are numerous, and many require urgent medical intervention. Their diagnosis necessitates collaboration between the maxillofacial surgeon and other medical specialties, while effective treatment and monitoring are impossible without an interdisciplinary team.Materials and Methods: This review article analyzes information from 77 scientific publications to provide current data on major emergencies in maxillofacial surgery and the relationship between maxillofacial surgeons and other medical specialists in their diagnosis and treatment.Discussion: Emergencies and diseases in the maxillofacial area are primarily categorized as inflammatory or traumatic. The most common inflammatory ones are acute lymphadenitis, acute sialadenitis, abscesses, and phlegmons. Their management involves antibacterial therapy, with surgical intervention for evacuation if a purulent focus forms. Traumatic emergencies typically involve soft tissue wounds and fractures of the facial bones (e.g., mandible, maxilla, zygomatic, and nasal bones). Effective management of all these conditions necessitates a collaborative approach with specialists from other disciplines; without such interdisciplinary involvement, diagnostic and therapeutic efforts would be compromised, potentially leading to patient disability or even mortality.Conclusion: Daily interaction between maxillofacial surgeons and specialists from various medical fields is fundamental for accurate diagnosis and appropriate treatment of emergency conditions in maxillofacial surgery
Resuscitation of a drowned casualty and the impact of extracorporeal life support (ECLS)
Full text linkAccording to a study of the British Red Cross in 2018, only 5% of the population consider themselves knowledgeable and confident enough to provide first aid in the event of an emergency. First aid is one of the most important medical skills for people in their everyday life, although most do not consider themselves capable of acting.The aim of this research is to analyze the impact of post-drowning treatment on the outcome with special focus on extracorporeal life support (ECLS).A comprehensive literature review was conducted using documentary and analytical methods.The importance of first aid stems from the fact that most emergencies occur when no professional medical equipment is available and often the scenario takes place far from the familiar environment of the first aiders.The quicker the patient receives help and the better the quality of the received help, the better the chances of the patient for good outcome. In drowning, hypothermia and infection play a large role, which complicates a smooth recovery.After successful first aid, the patient’s admission to a hospital with possible treatments such as ECLS may save lives
Potential factors for vertical post-extraction alveolar crest resorption—a CBCT study
Full text linkIntroduction: The changes in the alveolar crest after dental extraction lead to its reduction in height and width and are referred to as post-extraction resorption. The buccal socket wall is more prone to bone loss due to its width and structure, composed mainly of bundle bone. The extent of bone loss is individual and depends on various local and systemic factors.Aim: This research aims to evaluate the influence of different factors (jaw—upper or lower, tooth type—premolars or molars, tooth diagnosis, smoking habit, and socket wall thickness) on vertical post-extraction resorption for 3 months using cone-beam computed tomography (CBCT).Materials and Methods: The sample size consisted of 20 participants who needed an extraction of a posterior tooth (molar or premolar).Results and Discussion: Two CBCT (Planmeca) examinations were performed—one after the procedure and the second was done after a 3-month healing period. There was no convincing evidence that the considered local and systemic factors (type of jaw—upper/lower, section of the dentition—premolar/molar, diagnosis—periodontitis/periapical lesion, and smoking) had an impact on the quantitative change in the height of the alveolar ridge for 3 months after extraction.Conclusion: Further research is necessary to validate or contradict these findings
Fractures and thickness of the lateral wall in trochanteric fractures. A literature review
Full text linkTrochanteric fractures are among the most common types of hip fractures, mainly affecting the elderly. These fractures can be divided into stable and unstable types, with lateral wall fractures being included as a diagnostic criterion over the past 20 years. The lateral wall plays a key role in stability, serving as a support for the proximal fragment. Its thickness, in turn, determines overall stability and, in some cases, helps predict possible complications such as secondary fracture when the thickness is less than 20.5 mm. Accurate assessment of the fracture and appropriate selection of the implant and treatment method lead to good outcomes and rapid patient recovery
Attitudes towards human papillomavirus vaccination
Full text linkIntroduction: Despite the proven effectiveness of the human papillomavirus (HPV) vaccine, a number of negative perceptions and opinions continue to persist in society. These attitudes are influenced by multiple factors such as low levels of public awareness, socio-economic status, cultural differences, and the growing impact of social media.Aim: To examine the factors influencing attitudes towards HPV vaccination among different population groups at European and international level.Materials and Methods: An analysis was conducted of scientific studies and publications presenting the various attitudes and beliefs of people from different socio-economic groups, ethnicities, and religions.Results and Discussion: Studies conducted in Bulgaria, Europe, and the Middle East reveal varying levels of awareness and acceptance of the HPV vaccine. In Bulgaria, there is a tendency towards lower awareness and higher levels of distrust, whereas in Western European countries attitudes are generally more positive. In the Middle East, vaccination faces obstacles due to a number of cultural and religious factors. Healthcare professionals play a key role in increasing vaccination rates by providing accessible information about the benefits of immunisation. The COVID-19 pandemic has had both positive and negative effects on attitudes towards HPV vaccination: it has raised awareness of the advantages of vaccines, while at the same time generating distrust among certain groups. Social media simultaneously serves as a tool for acquiring knowledge and as a channel for spreading misleading information and harmful influences.Conclusion: Increasing public awareness and health education play a crucial role in shaping attitudes towards HPV vaccination. Joint efforts are needed to provide accessible and comprehensible information, as well as to use social media effectively to raise awareness about the benefits of vaccination
Clinical manifestations and natural history of ventricular extrasystoles in children without underlying structural cardiac pathology: A review
Full text linkIntroduction: Ventricular extrasystoles (VES) are a type of dysrhythmia that may originate from any point of the ventricular myocardial tissue below the atrioventricular node. They occur both in patients with congenital heart malformations (CHD) and in those without underlying structural cardiac pathology.Aim: To determine the prognostic significance and the need for therapy in children with VES without underlying structural cardiac pathology by analysing the available literature in PubMed, Google Scholar, the Cochrane Library, and Medscape.Results: Ventricular extrasystoles (VES) are among the most common rhythm disorders in childhood. They are often detected incidentally, as a large proportion of cases are asymptomatic, but they may also present with various symptoms—from palpitations to syncope. Long-term studies report that most VES have a benign course and show spontaneous regression. Some authors indicate that a higher frequency of VES, the presence of couplets, triplets, ventricular tachycardia (VT), or multifocality are risk factors for the development of left ventricular dysfunction, while others do not find such an association. A small proportion of patients (around 1%) develop cardiomyopathy (CMP) as a result of dyssynchrony. The left ventricular changes leading to reduced ejection fraction (EF) are reversible with timely initiation of medical therapy and/or ablation.Conclusion: Since there are no clear criteria to predict which patient may develop left ventricular dysfunction, all patients should be periodically monitored for cardiac function
Neoadjuvant chemoradiotherapy and total neoadjuvant therapy in locally advanced rectal cancer: Current evidence and guidance
Full text linkNeoadjuvant chemoradiotherapy (nCRT) has become the backbone of treatment for locally advanced rectal cancer (LARC). In recent years, total neoadjuvant therapy (TNT)—delivering all planned systemic chemotherapy preoperatively—has aimed to improve systemic control and organ preservation.Aim: To synthesize contemporary evidence on nCRT and TNT in LARC, emphasizing comparative efficacy, organ-preserving strategies, toxicity profiles, quality-of-life outcomes, and practical recommendations.Materials and Methods: Narrative, critical review of randomized trials, large cohorts, and guideline-relevant studies on short-course radiotherapy (SCRT), long-course chemoradiotherapy (LCRT), TNT sequencing, watch-and-wait protocols, and emerging biomarker-driven approaches. Emphasis is placed on imaging-based response assessment, surgical timing, functional outcomes, and survivorship.Result: LCRT yields higher pathological complete response (pCR) rates compared with immediate-surgery SCRT; delayed surgery after SCRT narrows this gap. Fluoropyrimidines (5-FU or capecitabine) remain the standard concurrent agents, while adding oxaliplatin increases acute toxicity without proven survival benefit. TNT improves distant control and increases organ preservation in selected patients (e.g., mFOLFIRINOX-based regimens) at the expense of higher grade 3–4 toxicities. Clinical complete response permits organ-sparing strategies with intensive surveillance and high salvageability. MSI-H/dMMR disease demonstrates exceptional responses to PD-1 blockade.Conclusion: nCRT remains standard for most cases of LARC. TNT is a strong option for high-risk disease and for organ preservation, provided there is careful patient selection and toxicity management. Multidisciplinary, biomarker-informed decision-making is essential
Milk—useful or harmful? Online survey of the attitudes of Bulgarian citizens
Full text linkIntroduction: The purpose of this epidemiological study is to analyze the attitudes and knowledge about the health effects of the consumption of milk and dairy products among Bulgarian citizens.Materials and Methods: An online survey was conducted among Bulgarian adult citizens. A questionnaire including questions on the preference and frequency of consumption of milk and dairy products and those exploring respondents' knowledge of the health effects of this food group was attached. The frequency of consumption was compared with the National Dietary Guidelines. The data were processed with Jamovi statistical software package.Results: The survey was conducted among 489 Bulgarian citizens with a mean age of 41.5 (± 11.8) years. A consumption of animal milk was found among 69.1% of the respondents. Those who did not consume milk of animal origin were 6.1%. The analysis of the results shows that according to 13.7% of the study participants, milk is a harmful food.Conclusion: Skepticism regarding the consumption of milk and dairy products is found among the study participants. The scientific literature shows that appropriate consumption of milk and dairy products can be beneficial for all ages, except for specific medical conditions such as lactose intolerance or milk protein allergy