Acta Medica Bulgarica最新文献

{"title":"Chronic Necrotizing Pulmonary Aspergillosis After SARS-CoV-2 Infection – A Case Report","authors":"M. Alexieva, I. Serkedzhiev, R. Cherneva, S. Ivanova, G. Yankov","doi":"10.2478/amb-2023-0031","DOIUrl":"https://doi.org/10.2478/amb-2023-0031","url":null,"abstract":"Abstract Aspergillosis is a fungal infection, caused by the mould Aspergillus, most commonly Aspergillus fumigatus species. Chronic pulmonary aspergillosis after SARS Cov-2 infection is a rare presentation that is commonly misdiagnosed. The prolonged corticosteroid and antibiotic application and the pro-inflammatory state in COVID-19 patients predisposes to Aspergillus infection and its chronification. Surgery plays a pivotal role in cases with unclear diagnosis, ineffective medical therapy or when complications develop. We present a case of a 73-year-old woman with chronic pulmonary aspergillosis, developed after COVID-19 pneumonia. A right lateral muscle-sparing thoracotomy, right upper lobectomy and atypical resection of the 9th and 10th segments were performed.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Sensitive and Specific are Rapid Antigen Tests for SARS-CoV-2 – The Experience of One of the Biggest Bulgarian Hospitals","authors":"D. Niyazi, T. Todorova, Zh. Stoykova, Ts. Kostadinova, M. Bozhkova, T. Stoeva","doi":"10.2478/amb-2023-0035","DOIUrl":"https://doi.org/10.2478/amb-2023-0035","url":null,"abstract":"Abstract Rapid point-of-care tests that detect antigens specific for SARS-CoV-2 are less expensive and faster than the standard molecular methods. However, their accuracy varies widely between tests, populations and settings. We decided to assess the diagnostic precision of antigen tests for SARS-CoV-2 in a real-life hospital environment. In a cohort of 2677 hospitalized patients, we found a sensitivity of 60.2% (95% CI 57.1%-63.4%) and a specificity of 98.1% (95% CI 97.4%-98.7%) for the antigen tests when compared to RT-PCR. The accuracy of antigen testing could be acceptable in a hospital setting, especially when the result is consistent with the clinical and epidemiological context. When there is discordance between the antigen test result and the patient’s symptoms, a confirmation with molecular methods is needed.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Registered Cases of Acute Flaccid Paralysis in Stara Zagora District as a Part of Polio Eradication Strategy","authors":"I. Simeonova, I. Mladenova, D. Petrov","doi":"10.2478/amb-2023-0026","DOIUrl":"https://doi.org/10.2478/amb-2023-0026","url":null,"abstract":"Abstract Poliomyelitis is the infection that, after smallpox, is a “serious candidate” for eradication worldwide. In accordance with the WHO strategy for 2022-2026, epidemiological surveillance of acute flaccid paralysis (AFP) is carried out with the aim of poliomyelitis eradication. The aim of the study is to determine the risk factors for the occurrence of AFP in children up to 15 years of age and to analyze the effectiveness of the established system for epidemiological surveillance of AFP, in Bulgaria. Materials and methods. All cases of AFP for the monitoring period 2012-2021, in Stara Zagora district, were studied. A questionnaire (34 questions) for sociodemographic and lifestyle possible risk factors for developing of AFP was also completed. Retrospective, descriptive and analytic cross-sectional epidemiological methods were applied. The data were analyzed using SPSS Statistics, Version 25.0 (IBM Corp. Armonk, NY, USA) (with Fisher’s exact test). Results. There were 81 cases of Facial paralysis only, registered in the Web based system for surveillance of AFP, for Stara Zagora region, and 11 – AFP (without facial paralysis), for the period 2012-2021, in Stara Zagora district (92 in total). The protective factors for developing of AFP from our study were significantly associated to: having no history of paresis or paralysis in the past; absence of trauma; presence of central sewage near the home; absence of contact with animals; absence of consumption of unwashed fruits and vegetables. Conclusion. It is very important to carry out systematic surveillance of AFP, in children up to 15 years, with the aim of investigating all cases as part of the Global strategy for the eradication of poliomyelitis; monitoring of the immunization coverage with polio vaccine to maintain a high level; surveillance of the waste and sewage waters, twice during the year in 6 months.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Invasive Diagnostics of Reproductive Failure with Infectious Etiology on Menstrual Tissue","authors":"K. Mesechkova, A. Kavrakova, B. Georgieva, I. Sigridov, V. Mitev, A. Todorova","doi":"10.2478/amb-2023-0023","DOIUrl":"https://doi.org/10.2478/amb-2023-0023","url":null,"abstract":"Abstract Aim: We investigated the role of bacterial (Chlamydia trachomatis, Ureaplasma urealyticum/ parvum, Mycoplasma hominis/genitalium, Gardnerella vaginalis) and viral (HSV1/2, EBV, CMV, VZV, HHV6/HHV7, HHV8) pathogens, as a potential cause of reproductive failure in women by testing menstrual tissue samples. Materials and methods: We examined DNA extracted from 180 probands selected on the basis of their infertility background. DNA extraction, real-time qPCR, agarose gel-electrophoresis were applied. Results: In 61,1% of all tested menstrual tissue samples of infertile women bacterial and/ or viral pathogens were detected. In 48,8% of all tested samples we found bacterial, while in 22,2% viral pathogens. Ureaplasma parvum and Gardnerella vaginalis were detected in 61,36% and 69,31%, respectively, while Mycoplasma hominis and Ureaplasma urealyticum in equivalent rate 2,27% of the positive for bacterial pathogens samples. HHV7, EBV, HHV6, CMV, HSV2 were detected in 42,5%, 40%, 10%, 7,5%, 2,5% of the positive for viral factors samples. Variable combinations of bacterial and/or viral co-infection were found in 39,9% of all infected patients. Infections with the rest of target pathogens were not detected in the menstrual tissue samples. Conclusions: Our research offers new approach for noninvasive diagnostics of infections in the upper female genital tract by analyzing menstrual tissue as a target biological sample. The detection of asymptomatic bacterial and viral infections or co-infections in female endometrium contributes to the clarification of the infectious etiology of reproductive failure. It is of a great importance for applying of an adequate and individualized therapy.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aronia Melanocarpa Fruit Juice Ameliorates the Histopathological Changes in the Myocardium and Coronary Arteries in a Rat Metabolic Syndrome Model","authors":"M. Reyzov, M. Tzaneva, M. Eftimov, S. Gancheva, M. Todorova, S. Valcheva-Kuzmanova","doi":"10.2478/amb-2023-0028","DOIUrl":"https://doi.org/10.2478/amb-2023-0028","url":null,"abstract":"Abstract Aim: The purpose of this study was to examine the effect of Aronia melanocarpa fruit juice (AMFJ) on the histology of the myocardium and coronary arteries in metabolic syndrome (MS) rats. Materials and methods: The animals were divided into five groups: control, MS, MS+AMFJ2.5, MS+AMFJ5, and MS+AMFJ10. For 10 weeks, the control group received regular rat chaw and tap water, the other groups – high-fat, high-fructose diet and 10% fructose in their drinking water to induce MS. Throughout the experiment, rats received a daily oral treatment: the control and MS groups – 10 ml/kg distilled water, the other groups – AMFJ at doses of 2.5, 5.0, and 10.0 ml/kg, respectively. At the end of the experimental period, the animals were sacrificed and tissue samples from the myocardium and coronary arteries were evaluated histologically. Results: In the MS group, degeneration of the cardiomyocytes and endothelial cell necrosis were detected. In the MS+AMFJ2.5 group, cardiomyocyte damage was decreased, the endothelium was damaged and the preserved cells were activated. In MS+AMFJ5 and MS+AMFJ10 groups, the myocardium and the endothelial layer of the coronary arteries were preserved. Conclusion: These results indicate cardio- and vasoprotective effects of the juice.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135640219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Comorbidity in Patients with Bacterial Meningitis","authors":"P. Argirova, Y. Kalchev, M. Murdjeva, M. Stoycheva","doi":"10.2478/amb-2023-0015","DOIUrl":"https://doi.org/10.2478/amb-2023-0015","url":null,"abstract":"Abstract Introduction. Bacterial meningitis is a severe disease with high mortality and frequent residual neurological sequelae. It is associated with multiple risk factors. The aim of the study was to establish the main risk factors associated with bacterial meningitis and to outline the incidence of chronic diseases in patients with bacterial meningitis and their relationship to the patients’ age and etiology of meningitis, if any. Materials and methods. The study included 90 patients with bacterial meningitis admitted to the Clinic of Infectious Diseases, University Hospital “Sv. Georgi” – Plovdiv during the period January 1, 2016 – September 30, 2019. Epidemiological analyses, clinical examinations, laboratory and microbiological tests, and statistical methods were used. Results. A total of 76.8% of patients had concomitant conditions: cardiovascular diseases (38.9%), diabetes mellitus (16.7%), immunosuppression (16.7%), liver diseases (11.1%), pulmonary diseases (10%), neoplasms (7.8%), chronic kidney diseases (7.8%). The incidence of immunosuppression (p = 0.009), cardiovascular disease (p = 0.0001), and diabetes (p = 0.009) were significantly higher in adults compared to children. Risk factors were present in 37.8% of patients (44% in children and 35.4% in adults, p > 0.05), especially in patients with pneumococcal meningitis (47.1%). The main risk factor was otitis or sinusitis in the last 3 months before meningitis (17.8%), followed by head trauma (6.7%), alcoholism (6.2%), recurrent episode of meningitis (4.4%), nasal leakage of cerebrospinal fluid (3.3%), general surgery (3.3%), and splenectomy (2.2%). Conclusion. Elderly patients with meningitis had more frequent comorbidities than children, mostly cardiovascular diseases, diabetes, and immunosuppression. The highest incidence of chronic diseases was found in patients with listerial meningitis. Risk factors were found in both age groups.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"20 - 25"},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48224983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public Attitudes, Awareness and Fears Related to the Spread of COVID-19 in Bulgaria","authors":"D. Penchev, D. Petkova, R. Zlatanova-Velikova","doi":"10.2478/amb-2023-0020","DOIUrl":"https://doi.org/10.2478/amb-2023-0020","url":null,"abstract":"Abstract The pandemic caused by COVID-19 has led to radical lifestyle changes worldwide, particularly in the Republic of Bulgaria, and was a factor for global changes in economics, politics, healthcare and daily life. Aim The aim of the study was to analyze the public attitudes, awareness and fears related to the COVID-19 disease in the Republic of Bulgaria. Materials and Methods The survey was conducted between August 1st, 2022 and September 1st, 2022 via an anonymous questionnaire consisting of 24 closed questions. A total of 1861 people, aged 18-69 years and older, took part in the survey after being selected randomly. The data were statistically processed via MS Excel. Results The main source of information to the respondents on issues related to COVID-19 was the Internet (29,8%), followed by TV (26%) and the specialized website (Single information portal) – 15,9%. More than one-third (35,1%) of the respondents was afraid of getting infected and an equal share of participants reported that they have been infected with COVID-19. More than half of the respondents (52,5%) adhered to all the provisions of the governmental bodies related to limiting the COVID-19 pandemic. The most frequent symptom of post- COVID-19 syndrome was being easily fatigued (26,7%), followed by shortness of breath (13,4%) and persistent cough (11,6%). Conclusion The survey could be useful in understanding what were the public attitudes, awareness and fears related to the COVID-19 disease in the Republic of Bulgaria during the pandemic.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"60 - 65"},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46581678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Better Approach of Assessing Lalerality by Using Combined Foot and Eye Dominance Scale in Mentally Healthy Subjects","authors":"K. Akabalieva, V. Kotetarov, A. Beshkov","doi":"10.2478/amb-2023-0017","DOIUrl":"https://doi.org/10.2478/amb-2023-0017","url":null,"abstract":"Abstract Objective To investigate the reliability (internal consistency) of a Combined Foot and Eye Dominance Scale in healthy subjects. Materials and methods A total of 82 mentally healthy subjects were assessed with a Combined Foot and Eye Dominance Scale. The Foot Dominance Subscale included a modified Chapman & Chapman Foot Dominance scale and a new Complex Tasks scale with four foot tests reflecting more complex tasks. The Eye Dominance Subscale included three eye tests. Scale reliability statistics (item-scale statistics, summary statistics for the items, Cronbach’s alpha), nonparametric Mann-Whitney test and Spearman’s rank correlation coefficient were used. Results Considerable differences were found in the contribution of the single items to the Combined Scale. The means of some items were 37.83 times greater than those of other items (from 0.15 to 5.61), which suggested greater phenogenetic component and consequently greater contribution of these items to the total scale mean. The mean correlation between the items of the Combined Foot and Eye Dominance Scale was strongly positive (0.39), indicating good internal consistency of the scale. Conclusions Eye and foot dominance appear to be a much subtler indicator of altered hemispheric lateralization than hand dominance. The Combined Dominance Scale provides a more adequate tool for objective measuring of leftedness, as a way to assess laterality, since this scale is to a great degree unaffected by socio-cultural impact. The scale would provide comparability of leftedness as an indirect clue of abnormal lateralization in studies of mentally healthy subjects and subjects with neurodevelopmental disorders with presumed abnormal cerebral asymmetry across cultures.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"33 - 41"},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47734141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Hamartomas: Report of Two Rare Primary Cardiac Tumors (Rhabdomyoma and Hamartoma of Mature Cardiomyocytes) with Review of the Literature","authors":"D. Metodiev, A. Gegova, M. Ruseva, R. Ganeva, D. Parvanov, R. Marinov, D. Georgiev, D. Staneva-Mitkova, G. Stamenov","doi":"10.2478/amb-2023-0021","DOIUrl":"https://doi.org/10.2478/amb-2023-0021","url":null,"abstract":"Abstract The most common primary cardiac tumors are myxomas, while cardiac hamartomas are rare. Cardiac hamartomas may constitute manifestation of a genetic disorder such as tuberous sclerosis, or could be diagnosed independently as a solitary lesion. We present two rare cases of primary cardiac tumors detected via diagnostic imaging and subsequent histopathology examination. The first described case is that of a male preterm foetus with multiple rhabdomyomas in the heart, discovered during foetal echocardiography. The finding was later confirmed by autopsy, which also revealed presence of cortical tubers with typical balloon cells constituting well known epileptogenic lesions in the foetal brain. The second case describes an even rarer benign cardiac lesion – a hamartoma of mature cardiomyocytes – which was discovered by chance in a 49-year old female patient during echocardiography. The performed CT scan revealed a 37 x 16 x 12 mm tumor in the right atrium obstructing the superior vena cava inlet. The malformation was surgically removed and examined histologically revealing disorganized hypertrophic mature cardiomyocytes, partly separated by fibrous strands and admixed with mature adipocytes. Differential diagnosis was performed to rule out other benign tumors with myocyte differentiation – cardiac rhabdomyoma, histiocytoid cardiomyopathy and adult cellular rhabdomyoma. Conclusion The diagnosis of cardiac hamartomas was possible only after pathomorphological examination of material from the tumors. Reporting of rare neoplasms is crucial in order to determine their prevalence and to inform clinical practice.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"66 - 72"},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47381940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Citizen Control in Primary Outpatient Care – Opportunities and Realities in Bulgaria","authors":"T. Zlatanova, M. Djuglarska, N. A. Popov, D. Shtereva-Tzоuni, T. Petrova-Gotova, R. Yaneva, E. Naseva, M. Lazarova, T. Stoyanova, N. N. Popov","doi":"10.2478/amb-2023-0019","DOIUrl":"https://doi.org/10.2478/amb-2023-0019","url":null,"abstract":"Abstract The significance of control increases with the push towards improving the overall effectiveness of the health insurance system. In order for public resources to be spent lawfully and effectively, there needs to be increased control not only from the National Health Insurance Fund (NHIF), but citizen control also needs to be incorporated in the process. Materials and Methods The goal of this survey is to analyze the opportunities for implementing citizen control over the spending of public health funds and compare them to the real conditions as far as the outpatient medical care level. Legislation and news from NHIF’s webpage related to citizen control opportunities were studied. A direct, anonymous survey was carried out on the Google forms platform amongst Bulgarian citizens past the age of majority. Results The results of the questionnaire survey carried out between 24.06.2022 and 16.10.2022 among 1045 adults with compulsory health insurance from all over the country, showed that they were poorly informed on the opportunities for citizen control which have been regulated and created in practice and don’t take advantage of them. Only 45,6% of the participants were aware of the digital services “Record review for health-insured persons”, which is found on NHIF’s webpage, and less than half of them (42,8%) used this service. The NHIF’s mobile application for feedback was used by as little as 11,8% of the respondents, and only seven patients have used it to share an opinion, while nine have used it to get notifications for data changes in their patient record. The portion of participants who have taken part in NHIF inquiries was also very small – 2,5%. Merely 2,8% have posted a complaint to the NHIF after being denied medical services. Conclusions All of this makes it evident that a change is necessary in order for citizen control to be strengthened as a mechanism. This will lead to the correction of proven deviations in reported medical activities and will make it easier to get the patients’ opinions on the medical care they have been provided with.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"49 - 59"},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44190581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}