Acta Medica Bulgarica最新文献

{"title":"Expansion of Psychosocial Distress in Nurses Working in Hemodialysis During Exposure to COVID-19 Pandemic in Bulgaria","authors":"N. Madjarov, R. Nikolova, T. Kundurzhiev, L. Hristova, K. Lyubomirova, I. Tonev","doi":"10.2478/amb-2024-0007","DOIUrl":"https://doi.org/10.2478/amb-2024-0007","url":null,"abstract":"\u0000 A new type of virus, SARS-CoV-2, has spread globally throughout the world. The COVID-19 epidemic rapidly spread worldwide. The health care system, society and medical professionals have prepared to adapt, train and resist the increased psychosocial pressure. In this situation, the role and place of medical professionals has become noticeably more prominent, and the psychosocial stress of the work environment has increased its impact – progressing to high levels of harmful intensity towards the medical professionals. Focusing within the borders of Bulgaria, it can be argued that the initial two waves of high levels of COVID-19 prevalence were difficult and critical to overcome. The aim of our study is to investigate the impact of psychosocial stress on the functional status examined with the response of arterial blood pressure of nurses, practicing long-term care in hemodialysis clinics and centers during exposure to COVID-19 pandemic. A study was conducted on the subjective assessment of psychological and social risk factors, and arterial systolic and diastolic blood pressure in 2018-2019 (pre-COVID-19 period) and 2020 (COVID-19 period), respectively. The methods used were the NIOSH questionnaire – to assess psychosocial stress at work and to measure blood pressure with a sphygmomanometer. The results showed that the expansion of psychosocial risks from the work environment impacted on the functional status of nurses, with an increase in the level of social support and systolic blood pressure during the COVID-19 compared to the pre-COVID-19 period, and a decrease in the level of control when comparing the same periods. We will monitor and observe these effects with concern in order to respond in a timely manner with effective and practical strategies, policies and programs to counter and prevent psychosocial stress in the workplace. One of the outlined guiding goals and trends for this will be to both preserve and prolong the work life of nurses and to reposition them as a key and significant group for the healthcare system.","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"156 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270795","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":"Bilayer Technique for Alveolar Ridge Augmentation in Pre-Prosthetic Implant Surgery: Indications and Problems","authors":"E. Deliverska, B. Yordanov, J. Kirilova","doi":"10.2478/amb-2024-0008","DOIUrl":"https://doi.org/10.2478/amb-2024-0008","url":null,"abstract":"\u0000 \u0000 \u0000 Prosthetic rehabilitation of missing teeth with dental implant-supported restorations has recently become a predictable treatment option in contemporary dentistry with a highly successful rate. Due to different factors, vertical and horizontal bone loss could present, and the available alveolar bone may not be sufficient for optimum implant position. Ridge augmentation procedures could be applied to increase the volume of the deficient sites for accurate prosthetic implant placement, which assures functional and esthetic stability of tissues around the implants, essential for long-term success.\u0000 \u0000 \u0000 \u0000 study aims to evaluate the efficiency of the bilayer technique of guided bone regeneration for alveolar ridge augmentation procedure in cases of bone deficiency for optimum implant placement and long-term success.\u0000 \u0000 \u0000 \u0000 We present several cases of alveolar bone deficiency treated with the bilayer technique – the combination of allo- and xenograft, covered by collagen membrane, with long-term follow-up. The defects were filled with allograft, and a layer of xenograft and barrier membrane was placed above it. This technique combines the benefits of all xenografts and barrier membranes.\u0000 \u0000 \u0000 \u0000 The bilayer technique with allo- and xenograft and collagen membranes is predictable, with a high success rate and lower morbidity. We have a 100% survival rate of the implants placed in a grafted area with long-term follow-up with excellent aesthetic and functional results.\u0000 \u0000 \u0000 \u0000 The bilayer technique uses the benefits of two bone graft materials, is associated with less morbidity for the patients, and has excellent long-term results if performed accurately according to indications and technique.\u0000","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"1 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270380","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":"Genetic Polymorphisms in CYP2 Gene Family in Bulgarian Individuals and their Clinical Implications","authors":"S. Yovinska, D. Bakalov, K. Mihova, K. Kamenarova, R. Kaneva, R. Nikolov, I. Dimova","doi":"10.2478/amb-2024-0001","DOIUrl":"https://doi.org/10.2478/amb-2024-0001","url":null,"abstract":"\u0000 The cytochrome P450 superfamily consists of hemeproteins involved in the detoxication of different xenobiotics, including drugs. The CYP2 gene family is responsible for the metabolism of 80% of the drugs in clinical use. There are considerable interindividual and interethnic variabilities in the rate of drug metabolism as a result of genetic polymorphisms. The goal of our study was to determine the frequency of 10 genetic polymorphisms in CYP2 family genes to give light on the pharmacogenetic defects of the main CYPs, involved in drug metabolism, in Bulgarian individuals. We detected high allele frequency for CYP2D6*10 (0.27), CYP2D6*4 (0.22), and CYP2B6*9 (0.24), followed by CYP2C19*2 (0.14), CYP2C9*3 (0.11) and CYP2C9*2 (0.09). The genotype frequencies were also determined for all investigated variants. In total 47.2% of the analyzed individuals carried CYP2D6 genetic polymorphisms – 5.6% carried a single variant and 41.6% were found to have two or more such variants. Homozygotes for CYP2D6 variants were established among 14% of Bulgarian individuals. Determination of the prevailing pharmacogenetic polymorphisms of the CYPs, most responsible for drug metabolism, will lead to a lower risk of drug toxicity, increased drug efficacy, and drug dose optimization.","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"268 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279596","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":"Canalis Basilaris Medianus as an Anatomical Variation in the Basilar Part of the Occipital Bone: A Descriptive Cone Beam Computed Tomographic Study","authors":"D. Darwin, G. Babu, V. Ajila, S. Hegde, M. Asan","doi":"10.2478/amb-2024-0006","DOIUrl":"https://doi.org/10.2478/amb-2024-0006","url":null,"abstract":"\u0000 \u0000 \u0000 Canalis basilaris medianus (CBM) is a unique anatomical variation located in the basal occipital region of the skull, rarely encountered in head and neck radiographic imaging. The aim of the present study was to evaluate the prevalence and types of CBM using Cone Beam Computed Tomography (CBCT) scans.\u0000 \u0000 \u0000 \u0000 CBCT (Full FOV) images of 200 patients aged between 10 to 70 years were selected for the current retrospective study following the inclusion and exclusion criteria. The image sections from the scan data were scrutinized for the presence of CBM, in addition to its classification based on the type of morphology. The presence and types of CBM were recorded based on the age and gender. The chi-square test was used to analyze the presence and types of CBM with regard to gender and age group.\u0000 \u0000 \u0000 \u0000 The overall prevalence of CBM was estimated as 9.5%. CBM was present in 13% of males and 3% of females (p = 0.021). Considering the types of CBM, the superior recess type was predominantly observed followed by the inferior recess, superior and inferior type. However, there was no significant gender-based differences noted among the types of CBM (p > 0.05). Also, there was no statistically significant difference noted in the prevalence of CBM in different age groups (p > 0.05).\u0000 \u0000 \u0000 \u0000 It is necessary for maxillofacial radiologists to have a solid understanding of both normal and variant skull-base anatomy to facilitate recognition of variants such as CBM in order to recognize the associated anomalies. To our knowledge, this was the first study done which assesses the gender-based differences among the various types of CBM.\u0000","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"546 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140282995","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":"Operative Treatment of Idiopathic Isolated Clitoromegaly – A Clinical Case","authors":"S. Stoyanov, K. Ivanova, I. Koleva","doi":"10.2478/amb-2024-0009","DOIUrl":"https://doi.org/10.2478/amb-2024-0009","url":null,"abstract":"\u0000 Idiopathic clitoromegaly is a relatively rare disease. A case of isolated idiopathic clitoromegaly is presented. It concerns a 31-year-old woman, in whom the clitoris has showed a tendency for progressive enlargement in the last 3-4 years. The patient had no gynecological and systemic diseases and disorders. Karyotype and hormone levels were normal. No cystic changes in the ovaries and other changes in the abdominal organs were detected during ultrasound. Computerized axial tomographic (CAT) scan of the adrenal glands was performed and showed normal appearance. Method of selection in such cases is operative treatment – clitoroplasty with storage of neurovascular bundle of the clitoris.","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"45 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271515","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":"Seroprevalence of IgG Antibodies Against SARS-CoV-2 N Protein Among Vaccinated and Unvaccinated Subjects in Lahore, Pakistan","authors":"A. Donia, M. Nawaz, M. F. Shahid, R. Shahid, A. Javed, T. Yaqub, H. Bokhari","doi":"10.2478/amb-2024-0005","DOIUrl":"https://doi.org/10.2478/amb-2024-0005","url":null,"abstract":"\u0000 The spread of SARS-CoV-2 represented a global health crisis. On May 5, 2023, the chief of the World Health Organization (WHO) officially announced the end of COVID-19 as a global health emergency. Serological assays can identify previously infected SARS-CoV-2 individuals, even if they did not go for testing while acutely ill. The current study sought to detect antibodies directed against the nucleocapsid of SARS-CoV-2 (IgG against the SARS-CoV-2 N protein) in both vaccinated and unvaccinated COVID-19 individuals. Of the 100 participants, 53 and 47 were vaccinated and unvaccinated, respectively. The vaccination status of the cohort based on gender data indicates that 41 (41%) of all participants were vaccinated males, whereas 12 (12%) were vaccinated females. We found that 42 (42%) were unvaccinated males and 5 (5%) were unvaccinated females. Of 53 vaccinated subjects, 42 and 11 participants were positive and negative for IgG against the SARS-CoV-2 N protein, respectively. Of 47 unvaccinated participants, 28 and 19 were positive and negative for IgG against the SARS-CoV-2 N protein, respectively. The average of S/P “Sample/Positive control” percentages, which correlate to levels of IgG against SARS-CoV-2 N protein, were significantly higher among the vaccinated patients (73.8%) as compared to non-vaccinated patients (57.1%), with p = 0.02. There was a downward trend in levels of IgG against the SARS-CoV-2 N protein with increasing age, except for the 60–69 age group.","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"139 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279478","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":"Prevalence of Incidental Findings in Oral and Maxillofacial Cone-Beam Computed Tomography: A Systematic Review and Meta-Analysis","authors":"F. Abesi, M. A. Omran, M. Zamani","doi":"10.2478/amb-2024-0011","DOIUrl":"https://doi.org/10.2478/amb-2024-0011","url":null,"abstract":"\u0000 \u0000 \u0000 As the use of cone-beam computed tomography (CBCT) is increasing and the quality of images is enhanced, the likelihood of incidental findings detection in CBCT radiographs is raised. Variable frequency of incidental findings on oral and maxillofacial CBCT scans has been reported.\u0000 \u0000 \u0000 \u0000 To perform a systematic review and meta-analysis to resolve the conflicting results about the overall prevalence of incidental findings in oral and maxillofacial CBCT scans.\u0000 \u0000 \u0000 \u0000 We searched the literature in PubMed, Embase, and Scopus databases from inception to 31 October 2022 to identify studies that reported the frequency of incidental findings in the subjects undergoing CBCT imaging. We pooled the extracted data and reported the estimates as a percent with a 95% confidence interval (CI).\u0000 \u0000 \u0000 \u0000 A total of 21 eligible studies were included, comprising 9,788 patients (54.2% women) and 10,625 CBCT scans. Analysis showed that the incidental findings were present in 69.1% (95% CI: 55.6-80.0) of the CBCT scans. There were 1.48 incidental findings per CBCT scan. Pooled prevalence of incidental findings in men was 50.2% (95% CI: 23.1-77.3), which was higher than in women (41.8% [95% CI: 16.5-72.2]).\u0000 \u0000 \u0000 \u0000 A considerable prevalence of incidental findings was observed in oral and maxillofacial CBCT scans.\u0000","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"16 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270426","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":"Prevalence of Metabolic Syndrome and its Components in Patients with Controlled Graves’ Disease","authors":"M. Stoynova, L. Lilova, D. Petrova, I. Yankova, I. Dimitrova, A. Shinkov, R. Kovatcheva","doi":"10.2478/amb-2024-0003","DOIUrl":"https://doi.org/10.2478/amb-2024-0003","url":null,"abstract":"\u0000 \u0000 \u0000 Our aim was to assess the prevalence of the metabolic syndrome (MetS) and its components in patients with controlled Graves’ disease (GD).\u0000 \u0000 \u0000 \u0000 This was a cross-sectional study involving 95 consecutive patients with GD referred to our tertiary care inpatient clinical center meeting the following inclusion criteria: controlled hyperthyroidism, treatment with antithyroid drugs, untreated Graves’ orbitopathy (GO), if present. Patients’ anthropometric parameters were evaluated and laboratory tests were performed with measurement of fasting blood glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, thyroid hormone and antibody levels. The presence of the MetS and its components as defined by the International Diabetes Federation from 2009 were evaluated.\u0000 \u0000 \u0000 \u0000 In our patient cohort 82.1% were females, 17.9% were males, mean age 50.2 ± 13 years, with median duration of GD 16.5 months. The MetS was observed in 32.6% of our patients, obesity – in 34.7%, hyperglycemia in 38.9%, arterial hypertension – in 36.8%, low HDL-cholesterol – in 23.2% and hypertriglyceridemia – in 13.7%. There was not statistical difference neither between the prevalence of the MetS, nor between the prevalence of its individual components in female and male GD patients. The MetS was significantly more frequent in older patients, as well as abdominal obesity, hyperglycemia and arterial hypertension. There was not statistical difference in the frequency of the MetS and its components between GD patients with and without GO, except for waist circumference, which was significantly higher in patients with GO.\u0000 \u0000 \u0000 \u0000 The presence of the MetS and its components among GD patients are to great extent similar to those reported in the general population, which underlines the need for their screening and proper treatment in this subpopulation.\u0000","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"146 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270997","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":"Permanent Pacemaker Implantation: Early Post-Implantation Data","authors":"I. Yoncheva, D. Biserov, M. Negreva","doi":"10.2478/amb-2024-0002","DOIUrl":"https://doi.org/10.2478/amb-2024-0002","url":null,"abstract":"\u0000 \u0000 \u0000 Data on the development of left ventricular dysfunction after permanent pacemaker implantation are available. Myocardial collagen deposition is a well-known mechanism that occurs in left ventricular remodelling. This gave us reason to dynamically monitor the levels of the main molecules involved in collagen synthesis, PIPC (carboxy-terminal propeptide of type I procollagen) and PIIINP (amino-terminal propeptide of type III procollagen).\u0000 \u0000 \u0000 \u0000 PIPC and PIIINP levels were studied using enzyme-linked immunoassays in plasma from 45 patients (25 men, 20 women, 72.1 ± 9 years) and 46 controls (24 men, 22 women, 71.9 ± 8.7 years) without known cardiovascular diseases (except arterial hypertension, conduction disorder, indication for the procedure) at baseline (immediately before PPM implantation for patients), at 12 and 24 weeks.\u0000 \u0000 \u0000 \u0000 There was no difference in baseline levels of PICP and PIIINP between patients and controls (p > 0.05, Table abstract). At week 12, PICP levels increased significantly in patients compared to baseline in controls (p < 0.05, Table abstract). At week 24, values continued to increase and were again significantly higher than baseline in the controls (p < 0.001, Table abstract). At the 12-week follow-up visit, PIIINP values in patients were significantly higher than those at baseline in controls (p < 0.001, Table abstract). At week 24, the values of the patients were still higher than those of the controls, but the difference was not significant (p > 0.05, Table abstract).\u0000 \u0000 \u0000 \u0000 This study showed early activation of collagen synthesis < 6 months after PPM (permanent pacemaker) implantation. Due to the selection of patients without concomitant cardiovascular pathology, we have reason to assume that it is a result of the procedure itself and a serious prerequisite for increased collagen deposition in the myocardium.\u0000","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"198 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274529","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":"Epidemiological Surveillance of Acute Flaccid Paralysis for Eradication of Poliomyelitis (A Brief Review)","authors":"I. Simeonova, I. Mladenova, A. Patel","doi":"10.2478/amb-2024-0010","DOIUrl":"https://doi.org/10.2478/amb-2024-0010","url":null,"abstract":"\u0000 In May 1988 the World Health Assembly set to World Health Organization (WHO) the goal to achieve a global eradication of poliomyelitis by the year 2000. Surveillance of the acute flaccid paralysis (AFP) remains the ‘gold standard’ for the detection of polio. The criterion of sensitivity of the surveillance system is the incidence from non-polio related AFP, in children under 15 years of age. The aim is to detect more than 1 case of AFP, per 100,000 children. In 2019, WHO announced the eradication of wild poliovirus 3, and poliovirus 2 was eradicated in 2015. Wild poliovirus 1 continues to circulate. The main goals of the WHO Polio Eradication Strategy for the period 2022-2026 are: permanently interrupt all poliovirus transmission in endemic countries (Afghanistan and Pakistan), stop cVDPV (circulating vaccine-derived poliovirus) transmission and prevent outbreaks in non-endemic countries.","PeriodicalId":503338,"journal":{"name":"Acta Medica Bulgarica","volume":"675 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140281109","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}