Варненски медицински форум (Varna Medical Forum)

5-8

Authors: Svetlana Popova

The meaning of life and the pursuit of development excite every healthy person. In antiquity, Aristotle states that the ultimate goal of human development is to achieve eudaimonia (happiness). One of the aspects of eudaimonia is health and storing it for a long time has been associated with the theory of homeostasis. Researchers in the new time challenge the idea of homeostasis with another theory, i.e. of noodynamics. The aim of this study is to explore at theoretical and empirical level the importance of the meaning of life and the pursuit of self-actualization in the context of a healthy personality. We studied classical and modern scientific theories of healthy personality. Respondents were 100 people in Varna region in the stage of youth. Alternative, graphic and comparative analyses were accomplished. Our study shows that the availability of purpose that gives meaning and direction in life is extremely important for 80% of the participants. Some 60% believe that they are aware of their personal and professional development over the next 5 years. Some 80% do not accept their life-style and strongly desire certain change. Between 24% and 80% of the participants experienced emptiness in their life as a manifestation of an existential vacuum. For a healthy personality it is not so important to maintain homeostasis, as much as noodynamics related to the realization of personal purposes and goals. The existential vacuum is the result of frustrated development needs and a negative health indicator.

15-22

Authors: Lyudmila Angelova

Genetic factors for development of insulin-dependent diabetes mellitus (IDDM), non-insulin dependent diabetes mellitus (NIDDM) and maturity onset diabetes of the young (MODY) according to the classification of hyperglycemia in children and adolescents are reviewed. Original studies showing an association between HLA from MHC with IDDM have revealed protective and susceptibility alleles in HLADQB1 locus. About 20 genes other than class II MHC loci can also predispose to the development of the disease. Genome-wide screen and data analyses have shown that an allele for a transcription factor TCF7L2 is significantly associated with NIDDM. Another predisposition variant, i. e. a mutation in PPARG that is a member of the nuclear hormone receptor family, plays an important role in the regulation of adipocyte function and differentiation. Antigens involved in β-cell autoimmune reaction, genetic risks for occurrence (recurrence) of affected family members, gestational diabetes mellitus and protection approach towards congenital anomalies among mothers with diabetes mellitus are considered.

27-30

Authors: Gergana Ingilizova, Ivan Kostov, Ivan Lazarov, Daniela Velkova

The first baby conceived and born as a result of intracytoplasmic sperm injection (ICSI) was reported by Palermo et al. in 1992 in Belgium (12). Since then onwards, ICSI has become a popular fertilization technique proved to be a very efficient way in treating the male infertility. As a result of this procedure, many healthy children with normal physical and mental development have been born worldwide. However, because of the complexity of the technology and the poor characteristics of the spermatozoa used, concerns about the safety of ICSI still exist. According to some researchers, congenital malformations in infants born after ICSI occur more often than in naturally conceived children or even in conventional in vitro fertilization (IVF) conceived children. However, the literature reviewing the subject is far more contradictory and medical opinions differ significantly amongst the medical research centers. A conclusive report from the Practice Committee of the American Society of Reproductive Medicine states that ICSI is an effective and safe procedure for treatment of male infertility; however, it increases the risk of transmitting certain DNA mutations to the offspring. The reason is not only due to the procedure itself but also to the likelihood of carrying such gene mutations in parents. The aim of the present survey is to review and discuss the advantages and disadvantages of such a procedure and to focus clinicians’ attention on refining its application in order to minimize possible complications during and after pregnancy.

35-39

Authors: Silviya Filkova, Vanya Todorova, Violeta Kovacheva

Physical activity (PA) is one of the basic factors for primary health prevention. It counteracts hypodynamia that is a risk factor for the occurrence of numerous socially significant diseases. According to 2010 Eurobarometer data, 82% of the population in Bulgaria does not go for sports or does it one time per month as this relative share is the highest one in the European Union. The objective of this survey is to enhance the awareness about the influence on the human organism of PA, its benefits for health and its dosage in the single age groups of healthy individuals. Modern literature sources were analysed. As a result from systematic physical loadings some positive structural and functional changes in the organism can be achieved. The risks of many non-infectious diseases are reduced. This is of benefit for the society as social interaction and involvement enhances. PA is a main means for improvement of the physical and psychic health of people. It is not only an issue of public health but also it stimulates well-being of people and environmental protection. PA is an investment in the health of future generations and that is why it should turn into a model of health behaviour.

47-50

Authors: Rositsa Stancheva, Boryana Kavaldzhieva, Staniela Porozhanova, Ruzha Pancheva

Honey bees produce unique products that provide health and promote human longevity. Honey is the best known and most widely consumed substance produced by bees. The purpose of this study is to assess the role of bee honey for the nutrition of Varna citizens and the level of their awareness about the benefits of honey and bee products. A total of 438 individuals from the town of Varna at an average age of 42,90±10,90 years (range, 27 to 83 years) were recruited. They filled-in a questionnaire about their nutritive habits in regard to honey. Respondents were divided into two age groups - aged up to 40 and above 40 years old. The study shows that people aged over 40 years consume more often honey every day compared to those aged up to 40 years (p<0,05). Besides 20,55% of all the respondents consume honey every day, 13,47 % do only in winter and 14,84% - only when they are ill. Only 5,94% of the respondents do not consume honey at all. Over half of the respondents (60,50%) share that they would consume honey more often. In 46,35% of the respondents honey has been used as a sweetener. A total of 32,65% respondents replace sugar with honey always when possible, 50,68% of them do it occasionally only, and 15,30% never do it. People under the age of 40 years hardly replace sugar with honey when possible. Only 33,79% of the respondents consume honey as food. This is more common among subjects aged up to 40 years (p<0,05). In 24,20% of the cases honey is a means for treatment of diseases. The majority of respondents (92,69%) believe that bee products are useful because they are natural, contain essential ingredients for the human body and strengthen the immune system.

55-59

Authors: Mihaela Varneva, Petya Yakimova, Daniel Kostadinov

Mentoring in the education of the students in the speciality of dental technician at the Medical College of Varna manifests itself as a voluntary partnership between the student and the mentor taking place in an independent medico-technical laboratory for dentistry certiWed to be a basis for student’s education. Yis method of education can be assessed through gathering the information about the manner of performance and proposals for its optimization. Ye result can be used as a mean of assessing the quality of the education. It is recommended that such an assessment should periodically be done. Ye purpose of the present study is to Wnd out by using feedback from the mentors their opinion about the quality and usefulness of mentoring. An inquiry examination was used. Subjects of the examination were the workers in 13 out of 31 dental laboratories used (41,93%). While processing these data it was established that all the respondents gave a very positive evaluation of the mentoring as a method of education and of the quality of their work with the students (100%). Yis shows that mentoring is an extraordinarily accessible and e^ective method for delivering work experience, knowledge and professionalism during the practical training and probation prior to graduation.

65-73

Authors: Elena Tubinis, Ilko Bakardzhiev, Margarita Stancheva, Desislava Gesheva

Dry skin (хerosis cutis) is a common problem a`ecting people art di`erent age and of di`erent skin types. he reasons for dry skin can be natural (physiological), pathological, or related to the inquence of unfavourable environmental factors. he purpose of the paper is to elaborate an algorithm for diagnosis and management of patients with dry skin of various etiology. A retrospective search in the following data-bases was carried out: MEDLINE (PubMed) of the National Library of Medicine (USA), Consilium-Medicum (Russia) and Russkij meditsinskij zhurnal (Russia). When the diagnosis of dry skin is made, usually, one takes into consideration the disturbance of the hydratation of the corneal layer (10%) only. his parameter can be considered as a screening tool only and should not be the only criterion for choice of therapy. he pathophysiological changes are assocaited with disturbace of the epidermal barrier, incerase of the transepidermal water loss and pH alterations of stratum corneum. he basic diagnostic criteria are the following: transepidermal water loss and fatty secretion level (i.e., normal, low or high). hese parameters should be born in mind in the selection of treatment and can be assessed through the application of rapid real-time invivo methods such as TEWL-metry and sebumetry. he recent research achievements demonstrate that natural moisturizing factor, ceramides and aquaporins are the key factors for skin hydratation. he chouice of therapy in patienst with dry skin is a great challenge. It is strictly individualized. Treatment errors could lead to patient’s status worsening.

7-12

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

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.

19-23

Authors: Daniela Arabadzhieva

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.

31-34

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

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.

41-45

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

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.

53-57

Authors: Dimitar Stavrev, Georgi Marinov

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.