Варненски медицински форум (Varna Medical Forum)

5-9

Authors: Meglena Angelova, Vanya Goranova, Dessislava Marinova, Stoyan Pavlov, Vesselina Mihaleva, Tetsumori Yamashima, Anton Tonchev

Cerebral cortex оf mammals is mainly generated during the embryonic period by stem cells and their derivative progenitors in the palium of the developing telencephalon. Various genes in complex interactions are involved in the processes of differentiation of the cerebral neurons. Transcriotional factor Sox2 plays a key role for self renewing and sustaining multipotency of embryonic neural stem/progenitor cells. Data about the expression and function of Sox2 in human fetal brain are insufficient and controversial. In the present sudy tissue samples of spontaneously aborted human fetuses aged between 12th to 28th gestational weeks (g. w.) were examined by a standard histological and immunohistochemical technique for paraffin sections. Sox2 expression was followed in the zones of cellular proliferation and migration in the occipital lobe of human fetal telencephalon mainly during 17th g. w. Within ventricular and outer subventricular zones we detected similar amount approximately 45% Sox2+ cells, whereas in the intermediate zone, cortical plate and marginal zone expression of Sox2 was not found. The data obtained on the location and expression dynamics of Sox2 contribute to a more complete understanding of neural stem/progenitor cell biology during embryonic neurogenesis in the human cerebral cortex.

15-20

Authors: Kader Dervisheva, Stefka Valcheva-Kuzmanova

On the Bulgarian market, the products containing Ginkgo biloba extract are three categories – medicinal products (MP) and food supplements (FS), which are mono-products and combined products. The purpose of this study was to analyze the use of products containing Ginkgo biloba extract in Bulgaria for the period 2011-2013 and by a questionnaire method to study the practice of doctors to prescribe such products. The market research is done according to data from IMS Health and by interviews with doctors from the regions of Varna and Dobrich. The results from the study showed that in the years 2011-2013 there was an increase in the sale of products containing Ginkgo biloba extract, both in number of packs sold and in terms of value at a relatively unchanging average package price. In the study period, the greatest was the increase in the use of MP. The greatest was the market share of the combined FS. The predominant share of combined FS cuold be explained by the greater variety and number of these products. The four products with the greatest market share were combined FS. The survey showed that almost all physicians prescribe products containing Ginkgo biloba extract. The most prescribed and recommended are the combined FS. Most often Ginkgo biloba containing products are prescribed for disturbances in blood flow and memory in patients above the age of 60. Decisive in the choice of a product is the combination of efficacy, quality and price.

25-28

Authors: Anna Todorova, Antoaneta Tsvetkova, Ana-Maria Velcheva, Maia Radeva, Kristina Decheva, Teodora Georgieva, Nadia Agova

In recent decades, both worldwide and in our country, there is a noticeable increase in allergic diseases, including those of respiratory system – bronchial asthma and allergic rhinitis. Epidemiological studies show that these conditions often coexist in the same patient. Allergen – specific sensitization is one of the major risk factors for the development of asthma in children. Allergic rhinitis usually precedes asthma. The premise “one respiratory system, one disease” marks a change in diagnostics and therapeutic treatment of respiratory allergies. Currently allergen-specific immunotherapy, administered in the early stage of the disease, is the only treatment that could have disease-modifying effect. The aim of this study is to analyze what proportion of children with asthma suffer from allergic rhinitis and what are the most common therapeutic schemes and practices used in the prophylaxis and treatment of the condition. For this purpose we conducted a survey among parents of children suffering from bronchial asthma on the territory of the city of Varna. Data were processes statistically based on respondent’s answers and were presented graphically. Results confirm that allergic rhinitis is a widespread disease among children with asthma and that is often neglected and not diagnosed and managed in time. Early diagnostics and adequate control of allergic rhinitis is crucial to stop the disease progression to asthma.

33-35

Authors: Ilia Todorov, Mariana Mihaylova, Todor Todorov

Introduction: The authors reveal the opportunities for a diagnosis and treatment with the methods of manual medicine of a muscle very often responsible for the cases of muscle dysbalance in the thoracolumbar passage, lumbar region and the lower extremities. In addition, the anatomic position and function of the muscle very often lead to the association of the clinical symptoms with other deceases. Objectives and tasks: Accomplishment of an effective treatment algorithm for dealing with the problem. Materials and methods: We have executed on a group of patients the most common techniques of manual diagnostics and have discovered the chain links between the observed pathology and other regions of the vertebral column – the thoracolumbar and lumbosacral passages. We also have shown the results of the manual therapy techniques applied – postisometric relaxation (PIR) as well as manual manipulation for the chain-linked blockages. The authors reveal the possible combinations of manual medicine and physical factors. Results: Of the 44 patients included in the study by 37 (84,09%) a pathology of the iliopsoas muscle has been found. By 36 of the mentioned 37 patients a complete relief of the pain symptoms has been achieved and by all of the patients with a change of the posture normalization occurred. Conclusion: The final results of the investigation prove the effectiveness of the exercised clinical approach in dealing with the pathology of m.iliopsoas. The manual diagnostics has proven itself as a leading method of tracking of the somatic dysfunction of a muscle, the effects of the applied PIR techniques decisively excelling the medication with non-steroid drugs.

39-40

Authors: Evgenia Vladeva

The article reveals the physicochemical characteristics of the sea lye, lixivium and particularly sea lixivium “Longoza”, the main healing agents during it’s usage and the indications for the treatment of different diseases.

5-9

Authors: Dessislava Marinova, Vesselina Mihaleva, Meglena Angelova, Stoyan Pavlov, Tetsumori Yamashima, Vanya Goranova, Anton Tonchev

Ìultipotent progenitors exist in the adult mam- malian central nervous system, capable of producing both neurons and glia. Their proliferation in the spi- nal cord is limited. Generation of putative stem/pro- genitor cells has been reported in intact and injured spinal cord of rodents and in a limited number in monkeys with a spinal injury, but not in intact spi- nal cord in vivo. We recently reported de novo gener- ated cells in the intact spinal cord of macaque mon- keys. Here we extend these findings by showing data of intact juvenile and neonatal monkey spinal cord. We used bromodeoxyuridine (BrdU) to label the de novo generated cells in the experimental animals and stud- ied their quantity and distribution at different time- points after the BrdU infusion. As expected, we found a significant elevation of the BrdU-labeled cells at neo- natal stage. However, there was no difference between juvenile and adult stages. These results suggest that the survival of newly born cells in the intact primate spinal cord does not change after juvenile stage and this could be used to further study repair mechanisms in adult primate spinal cord.

15-20

Authors: Stefka Valcheva-Kuzmanova, Petko Denev, Maria Krachanova, Adriana Surleva, Anna Belcheva

Aronia melanocarpa is a woody shrub of the Rosaceae family. Its fruits are used for consumption either fresh, or as juice, jam and wine. The aim of the present study was to measure the concentration of some biologically active substances and the antioxidant activity of two samples of Aronia melanocarpa fruit juice (AMFJ). The juice was prepared from fresh fruits. One of the samples was produced using a juice centrifuge and was preserved with potassium sorbate (1.0 g/l). The other sample was produced by crushing and squeezing of fruits after which the juice was filtered and sterilized at 100 °C for 10 min. The contents of biologically active substances in the juice samples were measured by spectrophotometric and high-performance liquid chromatography methods. The antioxidant activity of the two juice samples was measured by the ORAC (oxygen radical absorbance capacity) and HORAC (hydroxyl radical аverting capacity) methods. The results showed that both samples were extremely rich in polyphenolic substances, amongst which the highest was the concentration of procyanidins followed by phenolic acids (chlorogenic and neochlorogenic) and anthocyanins. Sample 1 had higher concentration of total phenolics and contained higher quantities of most polyphenolic substances with the exception of anthocyanins. It also contained micro-quantities of cyanogens. The variations in the composition of the two samples could be attributed to the different methods of juice production and conservation. Both juice samples showed very high ORAC and HORAC values which were higher for sample 1 (the sample with the higher concentration of polyphenolic substances). The high antioxidant activity of the two AMFJ samples could be attributed to their polyphenolic ingredients.

29-35

Authors: Vasil Bozhkov, Plamen Chernopolsky, Rosen Madjov

As a renal replacement therapy, peritoneal dialy- sis has been applied in the clinic since the 1970s. Com- pared with hemodialysis, it has a unique superior- ity since it requires only simple equipment and sur- gery and it is more effective at protecting residual re- nal function. In recent years, with significant improve- ment of the peritoneal dialysis connecting system and peritoneal dialysis solution biocompatibility, as well as increasing standartization of patients’ training has be- come the best method of early renal replacement ther- apy for patients with end-stage renal disease. We present you a review of different techniques, the cost effectiveness and comparison of the most frequent complications and we share our ten years’ experience in peritoneal catheter placement in our clinic.

44-47

Authors: Tosho Ganev, Lidiya Petkova, Tony Statelov, Nikolay Evtimov

Serum PSA gives information about the future increase of prostate volume, deterioration of symptoms and patient’s anxiety, sexual dysfunction, deterioration of urinary flow and risk of urinary retention and prostate surgery. Higher PSA strongly indicates higher risk of future BPH progression. Strong correlation is proven between prostate volume ,,age and PSA-data are from study including 4627 patients with BPH(Roehrborn et al.1999). The results of the studies show that with the increase of PSA-value, increases its sensitivity and specifity. The Curve of PSA for detecting prostate cancer is higher in men receiving dutasteride compared with placebo-group. After 6-months of treatment with 5-alpha reductase inhibitors the value of serum PSA decreases with about 50%.

52-56

Authors: Anna Todorova, Antoaneta Tsvetkova, Ana-Maria Velcheva, Maia Radeva, Kristina Decheva, Teodora Georgieva, Nadia Agova

Bronchial asthma is a major cause of morbidity in children in developed countries. In recent years, a large number of epidemiological studies have found an in- creased incidence of childhood asthma which makes this respiratory disorder the most frequent chronic dis- ease in childhood. Many factors are responsible for the huge incidence of asthma: triggering factors from the external environment, the use of inappropriate an- ti-inflammatory medication, lack of assistance with regard to therapeutic regimen, inadequate training of patient (family). The quality of life adolescents suffer- ing of bronchial asthma and their families often is ex- tremely deteriorated. Asthma may limit the ability of children to play, learn and sleep, to lead normal active life. Achieving disease control is the main goal of the treatment conducted. The Global initiative for asthma (GINA) defines control on asthma as minimal chron- ic symptoms, no emergency medical visits, no need of saving medication, normal daily activity, social adap- tation and school attendance. The aim of this study is to analyze the quality of life of children with asthma based on the achieved disease control. To achieve this goal a survey was conducted among parents and children of various ages in the city of Varna. Data from the surveys were processed using mathematical and statistical methods, and the results are presented by graphic images. Results show that in early childhood, when the treatment is performed under the supervision of par- ents, a well-controlled treatment is achieved compared to teenage years. Bronchial asthma is a chronic disease that is best affected in “therapeutic cooperation” between clini- cians, patients and their families. Implementation of training programs for children and parents will im- prove their compliance and execution of their indi- vidual treatment plan, and hence disease control and quality of life of patients.

62-65

Authors: Todor Todorov, Ilia Todorov, Mariana Mihajlova, Evgenia Vladeva

The article reveals modern aspects of physical threatment of low back pain – electro- and light ther- apy, thermotherapy, passive kinesitherapy – massage, manual therapy, tractions, exercises, lasertherapy, acupuncture.

69-74

Authors: Paraskeva Mancheva

The realization of the rights of disabled people in Bulgaria is directly related to the activity of Medical Committee. The Expert decision published by Medical Committee is a necessary requirement for the usage of these rights. The insufficiency of a current informa- tion from available source slows down the process of social integration. Also these legal assumptions, which underline these rights are changing dynamically too. The general practice is the point of beginning, from which the procedure for certification starts. This is the place where disabled people come back and look for the answers of their questions, which are created from the Expert decision. The continuing education of general practitioners is an opportunity for improving their competence in this area.

82-86

Authors: Ivan Kostov, Ivan of Lazarov

Electronic Health Portal is a web-based platform that collects and distributes health information between individuals, medical professionals, pharmacies and others. The portal is a unique elec- tronic solution that unites participants in the health sector through the network and thus enables to effec- tively exchange information in real time. Thus may be used various options to facilitate the citizens, doctors and businesses. A flow of increasing the number of us- ers, using this type of electronic platforms for differ- ent purposes is being watched. The main among them are: e-shopping, online consultations, public access of information about different types of medicines, choice in real time of an adequate specialist, etc. The elec- tronic health portal has as a main purpose to make the health services better and it is a complementary di- vision to the traditional forms of interaction between doctors and patients.