Journal of IMAB - Annual Proceeding (Scientific Papers)

767-769

Authors: Vanya Slavcheva, Kalina Ignatova, Stanislava Panayotova, Nikolai Tzvetkov, Vasil Todorov.

Acute lymphoblastic leukemia is a disease, which is more common in children. We report a clinical case of a patient aged 25. Thirty-two months before his last admission in Hematology clinic, acute pre- B lymphoblastic leukemia had been diagnosed and treated till March 2012. In September 2013 after bone marrow aspiration, flow cytometric analysis, trepan biopsy and biopsy of the kidney had been carried out, the patient was diagnosed with first late relapse, involving bone marrow and kidney. A second remission was achieved using Berlin- Frankfurt– Munster chemotherapy [BFM] and allogenic stem cell transplantation was performed.

779-783

Authors: Minka Hristova, Ganka Bekyarova, Maria Tzaneva

Melatonin is indoleamine hormone derived from L-tryptophan. Due to its lipophilic nature, it is accessible to every cell. Melatonin has immunomodulatory and antioxidant activities thus protecting tissue injury. Heat shock proteins such as HSP32 known as heme oxygenase-1 (HO-1) possesses antioxidant, anti-inflammatory, and vasodilatory properties and plays an important role in the protecting of tissues from several stresses. The aim of study is to investigate the expression of HO-1 in gastric mucosa and its connection with oxidative stress and melatonin mediated protection after thermal injury. On rats back, under anesthesia, third degree burn was applied involving 30% of total body surface area (TBSA). Melatonin (10 mg per kg body mass) was injected i.p. immediately and 12 hours after thermal skin injury. We used tissue malondialdehyde (MDA), lipid peroxidation product, as a marker of oxidative stress. Gastric mucosa histopathology were observed on light microscopy and light immunohistochemistry investigating the HO-1 too. Results: The levels of MDA in gastric mucosa were elevated (p< 0.05). The HO-1 expression was significantly increased in rats with trauma. Melatonin inhibited elevation in lipid peroxidation product and augmented the increase in expression of HO-1 in the gastric mucosa. In conclusion, our data suggest that HO-1 induction following burn injury is an adaptive response protecting gastric mucosal against further oxidative damage. Melatonin increased the antioxidant capacity and restricted burn-induced oxidative damage in gastric mucosa and thus could be used therapeutically in organ protection.

677-681

Authors: Todor T. Uzunov, Dimitar Kosturkov, Tsonko Uzunov, Dimitar Filchev, Boiko Bonev, Andon Filchev.

Purpose: Dental photography plays important role in the transfer of information between dentists as well as in communication between them and the dental technicians. It is very important to take precise photos of external and internal morphological characteristics of the teeth. There are different methods for that. The aim is to establish a protocol for registration of internal morphological characteristics of teeth by digital dental photography. Material and methods: For the accomplishment of the aim60intact frontal teeth of 30 patients aged between 18 and 20 years were photographed. The following basic and additional devices for dental photography were used: 1. Digital SLR (DSLR): • Body - Nikon D90 • Lens - Nikon AF-S Micro Nikkor 105 f / 2.8G VR • Flash - Nikon SB-R-200 Speedlight remote kit R1 2. Lingual contraster 3. Reflective disk with silver surface Lingual contraster was placed behind the respective tooth when taking photos. Light reflector was placed sideways near patient’s head. The head of the flash that is near to the reflector was oriented towards it. The other flash on the opposite side, activated at a minimum power, was directed to the tooth row. Results: Internal characteristics of the tooth - enamel cracks, translucency, transparency, opacity and opalescence were easily and predictably recorded by the described methodology. Conclusions: The method suggested by us can be successfully used for recording the internal morphological characteristics of the tooth.

687-689

Authors: Kamen Kotsilkov, Radoi Dimitrov

INTRODUCTION: Periodontitis is characterized by progressive destruction of periodontium, caused by relatively small group of microorganisms. The treatment aims to create proper environment which hampers the colonization of pathogens. The mechanical cleaning of the root surfaces combined with meticulous oral hygiene is the consensus treatment. In advanced cases the progression of the disease could lead to different problems - gingival recessions, insufficiency of attached gingiva, mobility and tooth loss which require complex treatment. OBJECTIVE: This presentation demonstrates the multidisciplinary treatment approach in a patient with a severe chronic periodontitis. METHODS: S.S. (42) with severe chronic periodontitis, insufficient mandibular vestibule depth, lack of keratinized gingiva, class III recessions and central incisors with grade III mobility. The #12 is missing and a crossbite is present on #32. The anti-infective therapy led to stable periodontal status. The corrective phase included the creation of vestibule depth with an autogenous gingival graft, dental implant placement with immediate provisional loading for #12, extraction of #31 and #41 due to attachment loss to the apex and immediate placement of provisionals with crossbite correction. RESULT: The reevaluation demonstrated good control of the gingival inflammation and stable periodontal status. The subsequent implant and prosthetic treatment led to the restoration of a functional dentition. CONCLUSION: The long term success of the treatment of the complex cases with severe chronic periodontitis depends significantly upon the proper control of the periodontal infection and the achievement of a stable periodontal status. These are the major prerequisites for successful further implant and prosthetic rehabilitation.

694-698

Authors: Adriana Ruseva, Radka Lazarova, Ilko Kosturkov, Vesselina Ianachkova, Stella Yordanova, Zhivka Boneva, Diana Nikolovska.

Colorectal cancer is one of the most common cancers worldwide. The role of the female sex hormones in the etiology of the disease is very intriguing. Reproductive factors are surrogate measure of lifetime exposition to the sex hormones. Purpose: Our aim is to investigate the association between the reproductive factors and colorectal carcinoma risk. Materials and methods: We include 234 Bulgarian women in our study – 117 cases with colorectal cancer and the same number of healthy controls. Cases are divided into three groups according to the localization of the tumor. We conduct case-control study, using questionnaires about reproductive factors. We use the following statistical methods – descriptive, variational analysis, binary logistic regression. Results: We observed that only the age at menopause is associated with colorectal cancer risk, and this factor has strongest protective effect in the proximal colon (95% CI - 0,051-0,781, OR – 0,200, p – 0,021). Conclusion: Analyzing our data we observed that among Bulgarian women the only reproductive factor that show association with the risk of colorectal cancer is the age at menopause.

705-708

Authors: Mariela Yaneva-Deliverska, Jordan Deliversky, Maya Lyapina.

A multiplicity of laws, standards, and recommendations regulate the marketing of medical devices. Therefore, legal regulations do not release the specialists in the fields of medicine and dentistry from the responsibility to gather as much information as possible about the products used or to request this information from the manufacturer. Safety data sheets for medical devices can be downloaded from the Internet. They are an important source of information about the biocompatibility of dental materials as they were investigated by the manufacturers. Appropriate safety labels on the wrappings should be considered. The manufacturer/importer is responsible for its products and is potentially liable for damages. The medical doctors and dentists should use only those medical devices for which appropriate information is available.

713-717

Authors: Jordan Deliversky, Mariela Yaneva-Deliverska, Maya Lyapina, Angelina Kisselova.

Standards are produced for many different products and services, and may be created for company, national, regional or global application. In Europe there are three different categories of standard: International standard – a standard adopted by an international standardization organization; European standard – a standard adopted by a European standardization body; National standard – a standard adopted by a national standardization body and made available to the public. Harmonized standards play a special role in the EU. A harmonised standard is a European standard elaborated on the basis of a request from the European Commission to a recognised European Standards Organisation to develop a European standard that provides solutions for compliance with a legal provision. Most standards for dental materials have been harmonized through a so-called cumulative standard (EN 1641:2009 - Dentistry - Medical devices for dentistry - Materials). This European Standard specifies general requirements for materials used in the practice of dentistry for the restoration of the form and function of the dentition and which are medical devices. A multiplicity of laws, standards, and recommendations regulate the marketing of medical devices. The medical doctor and the dentist should be informed about the European and international standards concerning medical devices and use only those for which appropriate information is available. The manufacturer/importer is responsible for its products and is potentially liable for damages.

722-727

Authors: Tatjana Jakovska, Stojka Fustik, Tatjana Zorcec.

Introduction: failure to maintain bone mass density is a major problem in patients with cystic fibrosis (CF). CF is due to mutations in the CFTR gene and other genes may contribute to modifying the disease. Genetic and environmental factors may play a role in determining the variability of bone mass. Aim of the study: to analyse the association between polymorphic variants of genes considered to be risk factors of bone metabolism disturbances and decreased bone mineral density (BMD) in children and adults with CF in R. Macedonia. Materials and methods: the study included 80 clinically stable CF patients (age range 5-36y), who regularly attended the CF center at the Pediatric Clinic in Skopje, Macedonia. Three candidate genes likely associated with BMD variability were studied: the vitamin D receptor (VDR) gene, the estrogen receptor alpha (ESR1) and the type I alpha I collagen (COLIA1) gene. A complete bone and CF evaluation was obtained for all patients: 55 had normal BMD (group 1), 17 were osteopenic (group 2) and 8 were osteoporotic (group 3). Results: Low bone mineral density (Z score < -1SD) was found in 31.25% patients and in 10% of them BMD was below -2SD. Patients with low BMD had worse BMI, FEV1 and more severe symptoms of CF. No significant correlation was found between COLIA1 and VDR polymorphisms and BMD. Conclusion: There was no evidence that the genes under study may modulate bone phenotype in CF.