Варненски медицински форум (Varna Medical Forum)

Number 1, 2

7-12
Contemporary management of Burning Mouth Syndrome

Authors: Mario Milkov, Plamen Nedev, Tsvetan Tonchev, Hristina Madzhova

Abstract

View in PDF

Number of views: 684

Burning mouth syndrome is characterized by a bilateral burning sensation in the oral mucosa and perioral areas, taste disorders, oral dryness and absent objective findings. It is difficult to diagnose and manage as well. Three main therapeutic approaches are nowadays used: behavioural interventions, topical medications and systemic medications. The first one includes cognitive behavioural therapy, group psychotherapy and electroconvulsive therapy. Topical drugs belong to several groups such as benzodiazepines, anesthetics, atypical analgesics, tricyclic antidepressants, nonsteroidal anti-inflammatory drugs, antimicrobials and mucosal protectors. System drugs additionally include anticonvulsants, selective inhibitors the reuptake of serotonin and norepinepherine, antioxidants, dopamine agonists, histamine-2 receptor antagonists, herbal medicines and salivary stimulants as well. Lowenergy laser therapy can be successfully applied, too.

13-17
Prognostic significance of Epidermal Growth factor receptor in colon cancer patients on surgical treatment

Authors: Emil Kanchev,Georgi Kobakov,Kiril Kirov,Daniel Yankov,Petya Koleva, Snezhana Vicheva,Daniel Kostov,Nikolay Georgiev,Zdravko Dimitrov, Yordan Borisov

Abstract

View in PDF

Number of views: 692

Recently, pathological expression of epidermal growth factor receptor (EGFR) is increasingly used in the diagnosis of various epidermal tumours. The aim of this study is to analyze the role of EGFR in comparison to p53 as a prognostic marker in patients with colon cancer who undergo surgical treatment. Two types of immunohistochemical examinations (for EGFR and p53) have been performed in 120 patients with colon cancer histologically verified by using of hematoxylin-eosin staining. Our results clearly demonstrate that EGFR expression is present in 18 patients (in 15% of the cases). It occurs much more often in the patient with TNM stage II and especially in those with TNM stage III and relatively more frequently in the patients aged between 51 and 70 years and presenting with a moderately differentiated tumour. Besides, this expression immediately relates to a recurrence of the disease and worsened clinical course. There exists a correlation between the enhanced expression of EGFR and that of p53. Because of the small sample, our results are not statistically significant. EGFR can serve as an independent prognostic factor and indicator of more common recurrences of the disease, worse quality of life and poorer prognosis in colon cancer patients. Further intensive collaboration between coloproctologists and pathologists is needed to improve the individualized surgical behaviour in such patients.

19-23
Clinico>statistical study of patients with Diseases related with an increased risk for Ischemic stroke lbased on the material of first Clinic of neurology, st. Marina university Hospital of varnar

Authors: Daniela Arabadzhieva

Abstract

View in PDF

Number of views: 571

In the present paper, the results from the clinical analysis of the patients with ischemic stroke and diagnosed risk diseases were analysed. During the period from 2007 to 2012, a total of 960 patients who had survived ischemic stroke, 456 males (47,50%) and 504 females (52,50%), aged between 32 and 94 years and hospitalized in the First Clinic of Neurology, St. Marina University Hospital of Varna, were examined. Some cerebrovascular, cardiovascular and metabolic diseases belonged to the most common pathology related with enhanced risk for ischemic stroke. The patients within the age groups between 40 and 59 years represented a considerable part among this contingent. There were statistically significant differences between males and females concerning the incidence rate of heart rhythm disturbances (p<0,001). A further more detailed analysis of the mutual relationships between ischemic stroke and the diseases related with higher risk for it will be carried out.

25-29
Opportunities for creation of Telemedicine Centres of diagnostic imaging - a new approach in Contemporary Public Health in Bulgaria. a regional project in Dobrich Region

Authors: Biserka Pacholova,Strashimir Genev

Abstract

View in PDF

Number of views: 638

The article presents the opportunities of e-h ealth telematics and telemedicine in the context of European eHealth initiatives. The practical application of digitalization in the field of diagnostic imaging in the creation of a regional telemedicineimaging centre in Dobrich Region is considered. The reasons for establishing the centre facing the negative health and demographic indicators, poor infrastructure, remoteness to hospitals and insufficient number of specialists in diagnostic imaging and radiologic technologists are presented. The information is systematized according to the already implemented and currently functioning systems worldwide and could meet the medical standards of communication. Several benefits for the region are highlighted such as improving the access of population to medical imaging aid that is characterized by the required timeliness, continuity and quality, ensuring equi table patients’ medical service as well as positive health and socio-economic impact.

31-34
Assessment of Operative Risk in Colorectal Oncologic Surgery

Authors: Georgi Kobakov,Kiril Kirov, Daniel Yankov,Daniel Kostov

Abstract

View in PDF

Number of views: 575

The objective of the present study is to elaborate a prognostic index for qualitative assessment of the operative risk in the surgical treatment of colorectal cancer (CRC). The documentation of 150 CRC patients, 91 males and 59 females, operated on in the Clinic of Surgery, Marko A. Markov Specialized Hospital of Oncological Diseases of Varna during the period from June 2008 till April 2009 was analyzed. Mean patients’ age was 64,2 years (range, 34-84 years). Seventy patients presented with colon cancer, 76 - with rectum cancer while 4 patients presented with multiple tumour localizations. The risk factors included the following: patient’s age and gender; ASA stage; CRC localization according to ICD of WHO; surgical procedure according to OPCS4 system; emergency; CRC stage according to TNM classification; resection type, and hematocrit level. There were 55 patients with TNM stage I, 80 patients with TNM stages II-III, and 15 patients with TNM stage IV. The most common interventions were anterior resection (in 48 patients), right hemicolectomy (in 41 patients), and sigmoidectomy (in 23 patients). Thirty-day operative lethality rate was zero. The created data-base can successfully be used for the purposes of CRC prognostication with the patients forwarded to operative treatment.

35-39
Study of Hemodialysis Patients’ Compliance for the Performed Treatment. Do the Patients Adhere to Physician’s Guidelines?

Authors: Alexandar Stoyanov,Krasimira Nenova,Kiril Nenov

Abstract

View in PDF

Number of views: 687

The patients with chronic renal failure (CRF) on chronic haemodialysis (CHD) should strictly adhere to the prescribed therapeutic regimens and physician’s guidelines. Otherwise the results from this long-lasting treatment are often unfavourable. The aim of the present study was to reveal the opinion of CRF patients on CHD about their attitude towards their continuous treatment. Forty patients, 21 males and 19 females, at the mean age of 50,48±14,90 years and a mean duration of CHD of 5,82±4,11 years were examined. They filled-in anonymous questionnaire containing 26 items devoted to their observation of the necessary therapeutic and dietary regimens. The longer CHD duration influenced negatively on patient’s compliance. However, such patients tended to observe more strictly the time for haemodialysis prescribed by the physician. Patient’s compliance depended on the educational level, too. Therefore, an extraordinarily important physician’s task was the provision to the patients of adequate information about their disease and its treatment.

41-45
Experience of Parents and Specialized Daily Centers in Satisfying the Specific Needs of Children with Autism Spectrum Disorders

Authors: Svetlana Georgieva,Gergana Angelova-Popova,Radoslava Dimitrova

Abstract

View in PDF

Number of views: 563

Autism and autistic disorders are a heterogeneous group of disorders of the neuropsychological development which are of complex genetic etiology. They are characterized to a different extent by difficulties in social interaction, verbal and non-verbal communication and behaviour problems. Recently, the incidence of autism as well as the interest in it increases and the establishment of more centres to work with these children testifies to that. An inquiry investigation among the relatives and parents of children with autistic disorders concerning their awareness about autism status, opportunities to meet the specific needs of their children and support of their development and social interaction as well as concerning the effectiveness of the applied treatments, programs, and interventions in ‘Faith, Hope and Love’ Daily Care Centre of Bourgas for working with the children with autism was carried out.

47-52
Prevention of Hypotrophy in Children with Disabilities in “Faith, Hope And Love” Home for Medical and Social Care for Children of the Town of Bourgas

Authors: Svetlana Geogrieva, Radoslava Dimitrova, Gergana Angelova-Popova

Abstract

View in PDF

Number of views: 663

A child with disability is a severe problem for both parents and physicians. There are different degrees of disability leading to delay of physical and mental development. There is no perspective for a considerable improvement of the health status in a small group of children. Thus they need a specialized social support system because of their predisposition to hypotrophy. In this study, an inquiry investigation of medical staff engaged with specialized care for disabled children with hypotrophy was carried out. Some opportunities for hypotrophy prevention in the children with disabilities in ‘Faith, Hope and Love’ Home for Medical and Social Care for Children of the town of Bourgas, one of the few institutions in this field in Bulgaria, were revealed and discussed.

53-57
Rare Anatomic Variations of the Female Reproductive System Published in Bulgarian Medical Literature in Late XIX. Century

Authors: Dimitar Stavrev, Georgi Marinov

Abstract

View in PDF

Number of views: 612

Periodic medical press in Bulgaria dates back to 80s of the XIX century, when the first scientific medical journals have been published. A sample of publications devoted to a specific medical problem, i. e. of the rare variations of the female reproductive system was studied by means of a detailed analysis of the literature from this period. In this paper the articles concerning the description of variations, journals containing them and their authors along with a short biographic data were presented. The results showed a high professionalism and desire for research of these authors.