Acta Medica Bulgarica最新文献

{"title":"The Effect of Smoking and Opioid Consumption on the Severity of the Disease and Duration of Hospitalization in COVID-19 Patients","authors":"H. S. Fayazi, A. Naeimi, M. Yaseri, S. S. M. Khatibani","doi":"10.2478/amb-2023-0005","DOIUrl":"https://doi.org/10.2478/amb-2023-0005","url":null,"abstract":"Abstract Objective In the Coronavirus 2019 (COVID-19) global pandemic, various studies on the target communities of this virus were widely started and rapidly progressed. Smokers and opioid consumers are one of the virus targets since they have a vulnerable respiratory system. Due to the contradictory results in previous studies and the lack of similar investigations in this area, we aimed to perform this study to investigate the effect of smoking and opioid consumption on the consequences of the COVID-19 disease. Materials and Methods In this retrospective study, the required information was collected and analyzed from the archives of Razi Hospital, Rasht, Iran. Study variables included age, sex, the need for intubation, hospital length of stay, history of current smoking or opioid consumption, and intensive care unit (ICU) admission, ICU length of stay, admission oxygen saturation, disease severity, and the outcome of death or recovery. Data were collected and divided into the case (including current cigarette smokers, opioid consumers, and cigarette-opioid consumers) and control (non-smokers and non-opioid-consumers) groups. Out of 986 patients, 489 patients met the criteria for inclusion and subsequent analysis. The average age was 69.79 ± 16.06, and 294 (60.1%) patients were male. The median age of the case group (65.15 ± 42.41) was older than the control group (57.45 ± 15.71, P = 0.001). The case group consisted of more male patients than the control group (P = 0.001). Results The adjusted regression models demonstrated that current cigarette smoking, opioid, and cigarette-opioid consumption did not significantly predict hospital and ICU length of stay, ICU admission, disease severity, and mortality outcomes (P > 0.05). Current cigarette smoking and opioid consumption could not be an independent predictor for the consequences of ICU admission, hospital and ICU length of stay, the need for intubation, disease severity, and mortality in COVID-19 patients.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"34 - 40"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44548849","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":"Polymorphic Variant rs11206510 in PCSK9 and Risk of Coronary Artery Disease in Bulgarians","authors":"R. Tzveova, T. Yaneva-Sirakova, G. Naydenova, S. Vandeva, D. Pendicheva-Duhlenska, P. Atanasov, V. Mitev, R. Kaneva","doi":"10.2478/amb-2023-0003","DOIUrl":"https://doi.org/10.2478/amb-2023-0003","url":null,"abstract":"Abstract Objective The aim of this study was to investigate the potential association of rs11206510 in PCSK9 gene with coronary artery disease (CAD) and myocardial infarction (MI) in Bulgarians. Materials and Methods The current analysis included 261 patients with angiographically documented CAD (153 with MI and 108 without MI) and 496 population – based controls. Genomic DNA was extracted from venous blood samples. The selected polymorphism was genotyped by TaqMan SNP Genotyping Assay. The genotype and allele frequencies were compared between cases and controls using χ2 test. Results In this study, the presence of the T allele of rs11206510 in the PCSK9 gene was found to be associated with elevated risk for MI in patients with already existing myocardial ischemia (allele T, OR1.78,CI95:1.16-2.73, p = 0.007). The result was enhanced in the male subgroup (allele T, OR1.74, CI95:1.02-2.96, p = 0.038). Also, we found reduced risk of CAD (without MI) for T allele (OR0.70, CI95:0.49-0.99, p = 0.04). This trend was stronger in the male subgroup (OR0.56, CI95:0.35-0.90, p = 0.02). There was not any relationship of the studied genetic variant with the levels of total cholesterol, triglycerides, low density lipoproteins and high-density lipoproteins, or with systolic and diastolic blood pressure values. Conclusion Our study found a difference in the frequencies of rs11206510 genotypes and alleles in the PCSK9 gene between cases and controls, and the relationship of the investigated polymorphism to the risk of cardiac injury in the Bulgarian population was demonstrated. Further investigations with a larger number of cases and controls will be needed in order to evaluate a possible association between this variant and CAD/MI in Bulgarians.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"19 - 26"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47565122","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":"Dietary Intake of Vitamin D and Dental Caries Incidence in People with Overweight and Obesity","authors":"Biser Stoichkov, L. Doichinova, P. Bakurdjiev, E. Radeva, D. Kirov, M. Nikolova","doi":"10.2478/amb-2023-0002","DOIUrl":"https://doi.org/10.2478/amb-2023-0002","url":null,"abstract":"Abstract Aims The aims of the present study are to investigate the relationship between the anthropometric indicators and peculiarities of the nutritional intake in people with overweight and obesity and the risk factors for the development of dental caries in adults. Materials and Methods The study involved 264 individuals aged between 18 and 60 years. The following risk factors for the development of dental caries were traced: diet (carbohydrate intake), oral hygiene habits and social status in overweight and obese people. The dental caries incidence was determined through the DMFT index, by assessing the total number of teeth which are decayed (D), missing (M) due to caries, or filled (treated, F). Results The age-related distribution was as follows: from 18 to 25 years – 14.4%; from 25 to 35 years – 16.7%; from 35 to 50 years – 42.4%; and over 50 years – 26.5%. The established average BMI was 25.60 ± 4.359, with the lowest and highest measured values – 18.5 and 37.55, respectively. The value of DMFT was 12.55 ± 5.545. A direct correlation between the elevated incidence of dental caries in patients with overweight and obesity was revealed. No significant relationship was found between the decreased nutritional intake of vitamin D and the incidence of dental caries in individuals with Class I and Class II obesity. Conclusion Dental caries and obesity have a similar etiology – improper dietary habits, excessive consumption of foods containing low molecular weight carbohydrates and carbonated beverages. The reported higher levels of dental caries in these groups could be explained by an improper diet and more frequent snacking.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"13 - 18"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46096211","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":"Intrascrotal Incision: An Alternative Technique for the Management of Inguinoscrotal Pathologies, Experience from 76 Cases","authors":"I. Gkalonaki, M. Anastasakis, V. Moutsanas, T. Feidantsis, M. Mitroudi, I. Patoulias","doi":"10.2478/amb-2023-0007","DOIUrl":"https://doi.org/10.2478/amb-2023-0007","url":null,"abstract":"Abstract Introduction The aim of this clinical study was to present our experience gained by using the intrascrotal incision through the mid raphe for the management of a variety of inguinoscrotal pathologies. Materials and Methods A total of 76 male patients, between 2 and 16 years, underwent surgical treatment through a mid raphe intrascrotal incision, for a wide range of inguinoscrotal diseases, including torsion of the spermatic cord, torsion of the testicular appendages, non-communicating hydrocele, communicating hydrocele, ectopic testis, retractile testicles, palpable undescended testis, testicular trauma and testicular prosthesis placement. Results All the patients had an uneventful postoperative recovery, with none mentioned complication, and none of them required convention to the traditional inguinal method. The follow-up examination ranged from 6 months to 3 years, with no surgical complication highlighted. Conclusions We recommend that the intrascrotal incision through the mid raphe may be considered as an alternative technique to inguinoscrotal pathologies, instead of other approaches. The ability to treat a variety of pathologies regarding both two hemi-scrotums and the inguinal region at the same time, the provision of adequate surgical site, while succeeding much less dissection and disruption of tissue, the excellent cosmetic result, the greater comfort for the ‘day-case’ child, the ability to use the scrotal septum in order to fix the testis in the scrotum and the avoidance of an extra incision are the main advantages of the intrascrotal incision.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"48 - 53"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47938020","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":"The Importance of Manual Detorsion in Intravaginal Testicular Torsion","authors":"M. Anastasakis, I. Gkalonaki, C. Doitsidis, P. Michou, I. Patoulias","doi":"10.2478/amb-2023-0006","DOIUrl":"https://doi.org/10.2478/amb-2023-0006","url":null,"abstract":"Abstract Objective The aim of the present prospective clinical study was to highlight the importance of the proper application of the manual detorsion (MD) in cases of intravaginal testicular torsion. Major complications such as ischemia, reperfusion injury and testicular compartment syndrome could be avoided. Materials and Methods From January 2017 to February 2018, 26 boys aged between 8 and 16 years underwent surgical treatment for intravaginal testicular torsion (ITT) (14 left- and 12 right-sided). Diagnosis was made upon clinical criteria (both symptoms and signs); sudden onset of scrotal pain (n = 26, 100%), nausea and vomiting (n = 25, 96,15%), abdominal pain (n = 3, 11,53%), high testicular position (n = 21, 80,77%), absence of the cremasteric reflex (n = 26, 100%), harshness of the twisted testicle (TT) (n = 24, 87.5%), alteration on axis or orientation of the TT (n = 24, 94,31%), and pain during palpation (n = 26, 100%). Two cases presented with neglected scrotum leading to inability to evaluate the intrascrotal structures. Major ultrasonographic findings were the following: absence of perfusion, heterogeneity of the parenchyma and identification of the Whirlpool sign. Therefore, our study group consisted of 15 out of the 26 cases, in which the initial assessment at the Emergency Department occurred within the first 3-7 hours after the onset of ITT. Results Based on high clinical suspicion and ultrasonographic documentation of the ITT, MD was performed in all those cases. Pain alleviation followed immediately, while significant improvement of the clinical picture of the suffering scrotum was also observed. Successful detorsion was documented via ultrasonography. After completion of the preoperative assessment, bilateral orchidopexy was performed. All patients had an uneventful postoperative course and were discharged home on the second postoperative day. Conclusion In conclusion, we hereby document that MD is a safe, non-invasive method, easy to learn for every clinician. It can be applied immediately after the diagnosis of the ITT, converting a highly urgent surgery into an elective one. Of course, surgical exploration of intrascrotal structures constitutes a crucial final step.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"41 - 47"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46978256","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 Clinical Case of Tonsillar Lymphangiomatous Polyp","authors":"A. Vlaykov, A. Atanasov, M. Hadzhi, M. Gulubova","doi":"10.2478/amb-2023-0010","DOIUrl":"https://doi.org/10.2478/amb-2023-0010","url":null,"abstract":"Abstract Introduction Tonsil lymphangiomas are extremely rare benign tonsil tumors. They could be asymptomatic, especially when they are small, and in these cases, they are most often found by chance on physical examination. Clinical case The authors present a 67-year-old man with complaints of discomfort, a sore throat, and an unspecific formation on his right tonsil. Upon microscopic examination, we found a polypoid mass covered by squamous epithelium with a stroma composed of lymphoid tissue. Discussion Benign tonsillar tumors are significantly more common than malignant ones. Lymphangiomatous polyps located in the tonsillar region, on the other hand, have been described as very rare, and their etiology and pathogenesis remain unclear. They tend to occur in areas where lymph vessels are abundant, with more than 90% of all lymphangiomas occurring in the head and neck region. Conclusion Lymphangiomatous polyps should be considered in the differential diagnosis of all benign tumors, and it is extremely important to differentiate them from malignant tonsil lesions.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"63 - 66"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44507749","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":"Telemedicine in Ophthalmology: Lessons from the COVID-19 Era and Beyond","authors":"S. Uzunova, K. Kilova","doi":"10.2478/amb-2023-0012","DOIUrl":"https://doi.org/10.2478/amb-2023-0012","url":null,"abstract":"Abstract The progress of information and communication technologies in the era of COVID-19 created an unprecedented opportunity for medicine to adapt to new models of care. Telemedicine and telehealth have enabled medical care at a distance in various fields, including ophthalmology. The aim of this article is to review the current state and the opportunities for telemedicine in ophthalmology. Materials and methods PubMed, ScienceDirect Database, Google Scholar databases, as well as official sites of various governmental and non-governmental institutions were explored. The search was conducted between May 1, 2022 and July 31, 2022 using as key words “teleophthalmology”; “telemedicine/telehealth and ophthalmology”; “ophthalmology and COVID-19”. Results 87 primary sources were reviewed. An exploratory analysis of the current state and application of telemedicine in ophthalmology was made. Conclusion A great number of innovations have created an environment allowing for teleophthalmology to flourish, whereas the COVID-19 epidemic has accelerated the development and adoption of these digital technologies. Telemedicine has become an extremely valuable tool during a pandemic, and even if it would never fully replace in the person-to-person patient visits, it certainly has an important role in our dynamic and high-tech world.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"50 1","pages":"72 - 76"},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43699911","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":"The Role of Certain Polymorphic Variants in Genes, Previously Associated with Blood Pressure Values, with Reference to the Risk of Development of Coronary Artery Disease","authors":"T. Yaneva-Sirakova, R. Kaneva, R. Tzveova, R. Bozhilova, I. Popov, M. Shumkova, I. Hristova, D. Vassilev","doi":"10.2478/amb-2022-0034","DOIUrl":"https://doi.org/10.2478/amb-2022-0034","url":null,"abstract":"Abstract The aim of the study was to analyze the effect of polymorphic variants previously associated with arterial hypertension (AH) in Genome Wide Association Studies (GWASs) in/next to genes and locuses CYP7A1 and PLEKHA7 on the development of coronary artery disease (CAD) in Bulgarian patients. A hundred and nine consecutive patients with angiographically documented CAD were studied. The genotyping was done with 7900 HT Fast Real-Time PCR (Applied Biosystems) with TaqMan® method. The control group consisted of 192 healthy population controls, selected from the bio- bank of the Molecular Medicine Center. SPSS and PLINK were used for the statistical analysis with level of significance < 0.05 and confidence interval 95%. The mean age of the studied patients was 63.71 ± 9.35 years; 35 (35%) females. Previous myocardial infarction (MI) had 38(38%); one-vessel – 39 (39%); two-vessel – 28 (28%); three-vessel disease – 34 (34%); 43 (43%) were with diabetes mellitus; 92 (92%) – with arterial hypertension (AH); 77 (77%) – with dyslipidemia; 42 (42%) were smokers; 25 (25%) were obese. We did not find any significant association between CAD and poly- morphism rs11191548 near CYP17A1 and only a tendency for genotype of rs381815 in PLEKHA7 (p = 0.06; OR 0.64; CI 0.40-1.02 for CAD) under dominant model. This is of practical importance both for studying the genetic aspects of CAD in the future and for enlargement of the current database.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"5 - 11"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45740131","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":"Pathophysiology and Management Possibilities of Thyroid-Associated Depression","authors":"S. Ivanov, D. Bakalov, G. Bocheva","doi":"10.2478/amb-2022-0033","DOIUrl":"https://doi.org/10.2478/amb-2022-0033","url":null,"abstract":"Abstract Thyroid hormones and the hypothalamic-pituitary-thyroid (HPA) axis are responsible for multiple metabolic processes and psychological well-being. Hypothyroidism can induce mood changes, depressive symptoms and even major depressive disorder. This review is focused on the pathophysiology and mechanisms through which the low level of thyroid hormones may affect the brain function, causing the characteristic symptoms of depression. Key pathways of hypothyroid-associated depressive states include: morphological changes in some brain areas (mainly in the hippocampus – a reduction in its volume); a significant reduction of the cerebral blood flow (incl. hippocampus), and lowered levels of neurotrophic factors (e. g. BDNF – brain-derived neurotrophic factor), which are regulated by the thyroid hormones. An adequate and timely thyroid hormone replacement and treatment with conventional antidepressants often can reverse the psychological symptoms.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"68 - 72"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43850152","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":"Anatomical Variations of the Maxillary Sinus – A Cone Beam Computed Tomography Study","authors":"M. Asan, R. Castelino, S. Babu, D. Darwin","doi":"10.2478/amb-2022-0027","DOIUrl":"https://doi.org/10.2478/amb-2022-0027","url":null,"abstract":"Abstract Objectives: The knowledge of the normal morphology of the maxillary sinuses and their variations is important for maxillofacial radiologists to achieve a better evaluation and delineation of pathologies and for pre-implant evaluation of the maxilla. The aim of our study was to evaluate anatomical variations of maxillary sinuses using Cone Beam Computed Tomography (CBCT). Materials and methods: 150 CBCT images where bilateral maxillary sinuses were scanned were included in the study following the inclusion and exclusion criteria. 75 CBCT scans each of males and females were studied using the Planmeca Romexis software (Version 4.6.2). Multiplanar images were searched for the presence of anatomical variations such as septae, haller cells and ethmomaxillary sinus. The data were subjected to Chi square test using SPSS software to compare and relate gender and site based differences in the occurrence of the anatomical variations. Results: Sinus septa was the predominant variation in both males and females with significantly higher prevalence in females and on the right side. An ethmomaxillary sinus was seen significantly more often in males, while Haller cells did not show any gender based differences in their occurrence. Ethmomaxillary sinus and Haller cells showed no difference in occurrence on the right and left side. Conclusions: Anatomic variations of the maxillary sinuses are a common finding. It necessary for the clinicians to be familiar with these variations to avoid clinical complications especially in cases of implant placements.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"33 - 37"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49262236","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}