The main risk factors for Human papillomavirus (HPV) infection, and the development of associated diseases are related to sexual behavior and health literacy of the population. The study aimed to investigate the impact of risk and protective factors for HPV infection and the development of associated diseases in adult women. A case-control study was conducted from January 2020 to May 2022A. Respondents had sought outpatient and/or inpatient obstetric-gynecological care in the city of Pleven. The significance of results, findings, and conclusions was determined at p< 0.05, and the odds ratio (OR) was calculated. Data analysis identified three out of the 15 factors as significant: lower education (primary and secondary) OR=2.36 95% CI (0.97-5.74), lack of vaccination against HPV OR=2.05, 95% CI (0.86-4.92), and urban residence OR of 1.29 95% CI (1.11-1.52). Two factors with a protective effect on HPV infection were statistically significant: education (secondary and higher) (p=0.05) and rural residence (p=0.001). Improving health literacy among the population and enhancing preventive measures related to HPV and its associated diseases would reduce the impact of risk factors.
{"title":"Impact of risk and protective factors for Human papillomavirus infection and the associated diseases among adult women","authors":"Elitsa Y. Stoyanova, Mariela Kamburova","doi":"10.3897/jbcr.e126698","DOIUrl":"https://doi.org/10.3897/jbcr.e126698","url":null,"abstract":"The main risk factors for Human papillomavirus (HPV) infection, and the development of associated diseases are related to sexual behavior and health literacy of the population. The study aimed to investigate the impact of risk and protective factors for HPV infection and the development of associated diseases in adult women. A case-control study was conducted from January 2020 to May 2022A. Respondents had sought outpatient and/or inpatient obstetric-gynecological care in the city of Pleven. The significance of results, findings, and conclusions was determined at p< 0.05, and the odds ratio (OR) was calculated. Data analysis identified three out of the 15 factors as significant: lower education (primary and secondary) OR=2.36 95% CI (0.97-5.74), lack of vaccination against HPV OR=2.05, 95% CI (0.86-4.92), and urban residence OR of 1.29 95% CI (1.11-1.52). Two factors with a protective effect on HPV infection were statistically significant: education (secondary and higher) (p=0.05) and rural residence (p=0.001). Improving health literacy among the population and enhancing preventive measures related to HPV and its associated diseases would reduce the impact of risk factors.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141363875","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}
E. Borisova, S. Ivankovska, P. Pavlov, Asparuh Nikolov, P. Glogovska
At the end of 2019, several cases of pneumonia provoked by an unknown causative agent were identified in China. In March 2020, the World Health Organization announced a pandemic of a new strain of Coronavirus - SARS-CoV-2. The neutrophil/lymphocyte ratio (NLR) is a biomarker that has recently become an important diagnostic and prognostic indicator in many diseases. The study‘s objective was to look for a relationship between NLR and the outcome of Covid-19 infection. Retrospectively, we studied 288 patients (mean age 69.1 ± 12.5) treated in an intensive pulmonology unit over ten months since 01.08.2021. All patients had severe pneumonia caused by SARS-CoV-2 infection, proven by a polymerase chain reaction (PCR) test. Leukocytes, lymphocytes, neutrophils, and NLR were traced. Hundred and seventy-four (60.4%) of the patients died, and the rest were discharged with improvement. Concerning NLR, we found values of 9.52 in the group of the deceased and 7.87 in those discharged, respectively, at the beginning. In the end, this indicator increased in the group of deceased to 15.04, while we found a drop to 7.3 in those discharged. A statistically significant difference was found regarding the outcome of the disease and the change in the NLR values in dynamics (p = 0.005). NLR is a cheap and reliable biomarker that can predict the outcome of Covid-19 infection.
{"title":"The role of the neutrophil/lymphocyte ratio as a biomarker predicting the severity of COVID-19 infection","authors":"E. Borisova, S. Ivankovska, P. Pavlov, Asparuh Nikolov, P. Glogovska","doi":"10.3897/jbcr.e126686","DOIUrl":"https://doi.org/10.3897/jbcr.e126686","url":null,"abstract":"At the end of 2019, several cases of pneumonia provoked by an unknown causative agent were identified in China. In March 2020, the World Health Organization announced a pandemic of a new strain of Coronavirus - SARS-CoV-2. The neutrophil/lymphocyte ratio (NLR) is a biomarker that has recently become an important diagnostic and prognostic indicator in many diseases. The study‘s objective was to look for a relationship between NLR and the outcome of Covid-19 infection. Retrospectively, we studied 288 patients (mean age 69.1 ± 12.5) treated in an intensive pulmonology unit over ten months since 01.08.2021. All patients had severe pneumonia caused by SARS-CoV-2 infection, proven by a polymerase chain reaction (PCR) test. Leukocytes, lymphocytes, neutrophils, and NLR were traced. Hundred and seventy-four (60.4%) of the patients died, and the rest were discharged with improvement. Concerning NLR, we found values of 9.52 in the group of the deceased and 7.87 in those discharged, respectively, at the beginning. In the end, this indicator increased in the group of deceased to 15.04, while we found a drop to 7.3 in those discharged. A statistically significant difference was found regarding the outcome of the disease and the change in the NLR values in dynamics (p = 0.005). NLR is a cheap and reliable biomarker that can predict the outcome of Covid-19 infection.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":" August","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364436","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}
Hristo S. Milev, V. Nanev, Desislava Dimitrova, S. Strashilov, A. Yordanov, Miroslava Mihailova-Strashilova, Silvia V. Naneva, Simoneta Ivanova, Milena Karcheva, Ivan Ivanov
There are no specific recommendations for evaluating the Ki-67 index in heterogeneous breast carcinomas. This study aimed to evaluate the applicability of currently accepted recommendations for Ki-67 evaluation in breast cancer in the context of intratumor heterogeneity. Twelve cases of heterogeneous breast carcinomas obtained from 110 patients were retrospectively studied. Ki-67 staining was performed according to protocols provided by the reagent manufacturer. Results for Ki-67 of the separate components in each tumor were obtained, described, and analyzed statistically using a paired t-test. Values of p < 0.05 were considered as statistically significant. SPSS software was used for statistical analysis. Results from the comparison of the Ki-67 index evaluation in each heterogeneous component of the studied tumors demonstrated no statistically significant difference of mean values t = 0.4802, p = 0.6405. The anticipation of an average Ki-67 score in the evaluated cases would have changed the molecular subtype from Luminal B to Luminal A (due to the Ki-67 index below 14%) in two of the cases. Heterogeneous tumors had a different Ki-67 index in their separate components. Our observations suggest that Ki-67 in heterogeneous breast carcinoma is evaluated and reported separately for the distinguishable tumor components.
{"title":"Evaluation of Ki-67 index in breast cancer cases with intratumor heterogeneity","authors":"Hristo S. Milev, V. Nanev, Desislava Dimitrova, S. Strashilov, A. Yordanov, Miroslava Mihailova-Strashilova, Silvia V. Naneva, Simoneta Ivanova, Milena Karcheva, Ivan Ivanov","doi":"10.3897/jbcr.e126709","DOIUrl":"https://doi.org/10.3897/jbcr.e126709","url":null,"abstract":"There are no specific recommendations for evaluating the Ki-67 index in heterogeneous breast carcinomas. This study aimed to evaluate the applicability of currently accepted recommendations for Ki-67 evaluation in breast cancer in the context of intratumor heterogeneity. Twelve cases of heterogeneous breast carcinomas obtained from 110 patients were retrospectively studied. Ki-67 staining was performed according to protocols provided by the reagent manufacturer. Results for Ki-67 of the separate components in each tumor were obtained, described, and analyzed statistically using a paired t-test. Values of p < 0.05 were considered as statistically significant. SPSS software was used for statistical analysis. Results from the comparison of the Ki-67 index evaluation in each heterogeneous component of the studied tumors demonstrated no statistically significant difference of mean values t = 0.4802, p = 0.6405. The anticipation of an average Ki-67 score in the evaluated cases would have changed the molecular subtype from Luminal B to Luminal A (due to the Ki-67 index below 14%) in two of the cases. Heterogeneous tumors had a different Ki-67 index in their separate components. Our observations suggest that Ki-67 in heterogeneous breast carcinoma is evaluated and reported separately for the distinguishable tumor components.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"119 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141360656","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}
The study aimed to evaluate and analyze the impact of the COVID-19 pandemic on the emotional state of patients in General Medical Practice in Bulgaria. In July-December 2022, a survey was organized among 306 GPs working in primary health care (PHC) in Bulgaria. They represent about 8% of the country’s general practitioners and work in eight regions. An individual self-completion questionnaire was offered. After obtaining permission from the Ethics Committee, respondents were randomly selected. The data was processed with a specialized statistical software package, SPSS 22. The COVID-19 pandemic has increased the number of patients with anxiety and depressive symptoms in the period 2020–2022, according to 95.3% (286) of the GPs surveyed. According to the GPs, the reasons for this were social isolation – 79.4%, negative information from the media – 73.1%, uncertainty – 65%, financial worries – 51.7%, uncertainty about the future – 38.8%, and other – 2.1%. The population of Bulgaria has been greatly affected by the COVID-19 pandemic. The pandemic has increased the number of patients with anxiety and depression in the General Medical Practice for the period 2020–2022. Bulgarians often resort to self-medication despite the easy access to general practitioners and the possibility of consultation with a psychiatrist.
{"title":"Impact of the COVID-19 pandemic on the patients’ emotional state in general practice in Bulgaria","authors":"Elka Tumbeva, Tsvetelina Valentinova","doi":"10.3897/jbcr.e126717","DOIUrl":"https://doi.org/10.3897/jbcr.e126717","url":null,"abstract":"The study aimed to evaluate and analyze the impact of the COVID-19 pandemic on the emotional state of patients in General Medical Practice in Bulgaria. In July-December 2022, a survey was organized among 306 GPs working in primary health care (PHC) in Bulgaria. They represent about 8% of the country’s general practitioners and work in eight regions. An individual self-completion questionnaire was offered. After obtaining permission from the Ethics Committee, respondents were randomly selected. The data was processed with a specialized statistical software package, SPSS 22. The COVID-19 pandemic has increased the number of patients with anxiety and depressive symptoms in the period 2020–2022, according to 95.3% (286) of the GPs surveyed. According to the GPs, the reasons for this were social isolation – 79.4%, negative information from the media – 73.1%, uncertainty – 65%, financial worries – 51.7%, uncertainty about the future – 38.8%, and other – 2.1%. The population of Bulgaria has been greatly affected by the COVID-19 pandemic. The pandemic has increased the number of patients with anxiety and depression in the General Medical Practice for the period 2020–2022. Bulgarians often resort to self-medication despite the easy access to general practitioners and the possibility of consultation with a psychiatrist.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"124 52","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141361471","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}
Ivelina J. Pitakova, Todor Kozhuharov, Dimana Mitsova
Vision is a complex act that allows the visual analyzer to perceive and analyse objects in the environment. The teams of two eye clinics conducted a “good vision-good driver” awareness campaign in combination with a survey. In most countries in the world, drivers over the age of 65 are required to renew their licences every 2 or 3 years. The European Commission wants car drivers over 70 to prove their ability every 5 years. The aim was to analyze the relationship between patients’ visual performance concerning their self-reported driving and their subjective general health. The survey was conducted through a direct survey at St. Nikolay Chudotvorets Eye Clinic Eye Clinics from 1.06.2021 to 31.06.2022. For the period, 103 patients were surveyed, 84 male and 19 – female. The group of 50–70-year-olds was the most numerous. Uncorrected vision equal to or less than 0.3 was present in 45.6% of all 206 eyes. Almost all respondents drove a car, only 3 were not drivers, and most (50.9%) had no difficulty driving. More than 42% of the respondents found driving difficult only at night, and 6.8% had difficulty always. There is an overlap in the results of the questions of whether the patient had had a traffic accident – positive in 13.7% and whether they had ever had a stroke. The ability to drive is a multifactorial process in which vision plays an undeniable role. Visual acuity reflects the need for correction in the driving licence. The present research proves the need because it shows patients with poor vision driving and not at a young age who overestimate their general and visual objective condition.
{"title":"Good vision – good driver","authors":"Ivelina J. Pitakova, Todor Kozhuharov, Dimana Mitsova","doi":"10.3897/jbcr.e126649","DOIUrl":"https://doi.org/10.3897/jbcr.e126649","url":null,"abstract":"Vision is a complex act that allows the visual analyzer to perceive and analyse objects in the environment. The teams of two eye clinics conducted a “good vision-good driver” awareness campaign in combination with a survey. In most countries in the world, drivers over the age of 65 are required to renew their licences every 2 or 3 years. The European Commission wants car drivers over 70 to prove their ability every 5 years. The aim was to analyze the relationship between patients’ visual performance concerning their self-reported driving and their subjective general health. The survey was conducted through a direct survey at St. Nikolay Chudotvorets Eye Clinic Eye Clinics from 1.06.2021 to 31.06.2022. For the period, 103 patients were surveyed, 84 male and 19 – female. The group of 50–70-year-olds was the most numerous. Uncorrected vision equal to or less than 0.3 was present in 45.6% of all 206 eyes. Almost all respondents drove a car, only 3 were not drivers, and most (50.9%) had no difficulty driving. More than 42% of the respondents found driving difficult only at night, and 6.8% had difficulty always. There is an overlap in the results of the questions of whether the patient had had a traffic accident – positive in 13.7% and whether they had ever had a stroke. The ability to drive is a multifactorial process in which vision plays an undeniable role. Visual acuity reflects the need for correction in the driving licence. The present research proves the need because it shows patients with poor vision driving and not at a young age who overestimate their general and visual objective condition.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141366132","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}
Hiatal hernia (HH) is often seen in surgery practice. The main feature of HH is the migration of abdominal viscera in the mediastinum via the esophageal hiatus. We performed - on 53 patients from November 2009 to June 2018 in the Department of General and Digestive Surgery of General Hospital of Villarobledo. Forty-one patients were diagnosed with hiatal hernia, 9 - with gastroesophageal reflux disease (GERD), and 3 - with Barrett’s esophagus. The average operative time was 89 ± 33 minutes, and the average follow-up was four years. The following complications were recorded: perforation of the distal esophagus in 1 patient (1.9%), postoperative spleen hemorrhage requiring emergency laparotomy in 1 patient (1.9%), dysphagia in 6 patients (11.3%) in the early postoperative period (treated conservatively), one patient had small bowel obstruction in the fourth postoperative year, three patients (5.6%) had radiological signs of HH recurrence and GERD despite the fundoplication. One patient (1.9%) was reoperated for stenosis of the distal esophagus and recurrent paraesophageal hiatal hernia one year after the first intervention. Postoperative ventral hernia (POVH) was seen in 2 patients (3.8%). All recurrence rate was 7.5%, recorded in 4 patients.
{"title":"Nissen fundoplication in a series of 53 consecutive patients","authors":"Тoni Ivanov Stoyanov","doi":"10.3897/jbcr.e122210","DOIUrl":"https://doi.org/10.3897/jbcr.e122210","url":null,"abstract":"Hiatal hernia (HH) is often seen in surgery practice. The main feature of HH is the migration of abdominal viscera in the mediastinum via the esophageal hiatus. We performed - on 53 patients from November 2009 to June 2018 in the Department of General and Digestive Surgery of General Hospital of Villarobledo. Forty-one patients were diagnosed with hiatal hernia, 9 - with gastroesophageal reflux disease (GERD), and 3 - with Barrett’s esophagus. The average operative time was 89 ± 33 minutes, and the average follow-up was four years. The following complications were recorded: perforation of the distal esophagus in 1 patient (1.9%), postoperative spleen hemorrhage requiring emergency laparotomy in 1 patient (1.9%), dysphagia in 6 patients (11.3%) in the early postoperative period (treated conservatively), one patient had small bowel obstruction in the fourth postoperative year, three patients (5.6%) had radiological signs of HH recurrence and GERD despite the fundoplication. One patient (1.9%) was reoperated for stenosis of the distal esophagus and recurrent paraesophageal hiatal hernia one year after the first intervention. Postoperative ventral hernia (POVH) was seen in 2 patients (3.8%). All recurrence rate was 7.5%, recorded in 4 patients.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":" 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141366336","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}
Radina Kirkova, S. Murgova, V. Kirkov, Tzvetomir Dimitrov, Georgi Balchev, Ivan Tanev
Age-related macular degeneration (AMD) is a degenerative, progressive disease, which destroys the central retina. AMD has two main forms - „dry“ and „wet“ (exudative). In order to make the diagnosis of AMD with CNV, apart from ophthalmoscopy, specialized tests are needed - fluorescein angiography (FA), indocyanine angiography, OCT, OCT-angiography (OCT-A). OCTA is a new and non-invasive technology. Compared to the old, well-known techniques for retinal evaluation, it is very precious because of its high resolution and detailed images – which allow early diagnosis and objective monitoring of the lesions in the future. The aim of this review is to describe the principles of function, features of the device and its application in everyday clinical practice in diagnosing patients with macular pathology. A systematic search of the literature, published in the past decade was identified from PubMed and Ovid databases with reference to the Preferred Reporting items for Systematic Review. AMD is a disease that is increasingly socially important because of the aging population in developed countries. The increasing use of OCT-A nowadays suggests new classification systems. The non-invasiveness, the short examination time and the high informativeness that OCT-A brings in relation to AMD requires a deeper study of the methodology and the development of new classifications to facilitate clinical practice.
{"title":"Optic coherence tomography-angiography – a new technique in the diagnosis and follow-up of the patients with age-related macular degeneration – an overview","authors":"Radina Kirkova, S. Murgova, V. Kirkov, Tzvetomir Dimitrov, Georgi Balchev, Ivan Tanev","doi":"10.3897/jbcr.e126554","DOIUrl":"https://doi.org/10.3897/jbcr.e126554","url":null,"abstract":"Age-related macular degeneration (AMD) is a degenerative, progressive disease, which destroys the central retina. AMD has two main forms - „dry“ and „wet“ (exudative). In order to make the diagnosis of AMD with CNV, apart from ophthalmoscopy, specialized tests are needed - fluorescein angiography (FA), indocyanine angiography, OCT, OCT-angiography (OCT-A). OCTA is a new and non-invasive technology. Compared to the old, well-known techniques for retinal evaluation, it is very precious because of its high resolution and detailed images – which allow early diagnosis and objective monitoring of the lesions in the future. The aim of this review is to describe the principles of function, features of the device and its application in everyday clinical practice in diagnosing patients with macular pathology. A systematic search of the literature, published in the past decade was identified from PubMed and Ovid databases with reference to the Preferred Reporting items for Systematic Review. AMD is a disease that is increasingly socially important because of the aging population in developed countries. The increasing use of OCT-A nowadays suggests new classification systems. The non-invasiveness, the short examination time and the high informativeness that OCT-A brings in relation to AMD requires a deeper study of the methodology and the development of new classifications to facilitate clinical practice.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141365246","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}
Rectal stump leak following Hartmann’s procedure resulting in an abscess formation is quite a rare complication. The size of the cavity, the healing process, neoadjuvant radiotherapy, and the patient’s overall condition may play a huge role in the stoma reversal rates, functional outcomes, and the patient’s quality of life. Moreover, it can lead to septic complications if not treated properly. We present a case of a 75-year-old male patient who underwent Hartmann’s procedure due to low rectal carcinoma. He presented one month after the procedure in our office with a fever and anal secretion. He was treated with three different types of antibiotics, drainage of the abscess cavity, and dressing twice a day of the wound with a povidone-iodine solution without success. Amputation of the rectal stump, debridement of the necrotic tissue, and VAC therapy resolved the symptoms and closed the perineal defect. VAC therapy may be used successfully for chronic pelvic inflammatory complications after Hartmann’s procedure.
{"title":"Vacuum-assisted closure for treating chronic pelvic abscess following rectal stump leak after Hartmann’s procedure for low rectal cancer","authors":"Meri Shoshkova, M. Karamanliev","doi":"10.3897/jbcr.e119983","DOIUrl":"https://doi.org/10.3897/jbcr.e119983","url":null,"abstract":"Rectal stump leak following Hartmann’s procedure resulting in an abscess formation is quite a rare complication. The size of the cavity, the healing process, neoadjuvant radiotherapy, and the patient’s overall condition may play a huge role in the stoma reversal rates, functional outcomes, and the patient’s quality of life. Moreover, it can lead to septic complications if not treated properly. We present a case of a 75-year-old male patient who underwent Hartmann’s procedure due to low rectal carcinoma. He presented one month after the procedure in our office with a fever and anal secretion. He was treated with three different types of antibiotics, drainage of the abscess cavity, and dressing twice a day of the wound with a povidone-iodine solution without success. Amputation of the rectal stump, debridement of the necrotic tissue, and VAC therapy resolved the symptoms and closed the perineal defect. VAC therapy may be used successfully for chronic pelvic inflammatory complications after Hartmann’s procedure.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364775","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}
Anabela Glavanova, Branimir Raduilov, Tsvetelina V. Miteva, Mariela Kamburova, Ivan Polyakov, E. Mekov
Thyroid diseases are common and, in most cases, can be safely and effectively detected and treated in primary medical care. This article aimed to analyze and evaluate the rate of thyroid ultrasonographic abnormalities in a primary medical care practice in Bulgaria. The research was conducted from 2016 to 2021. A random cohort of patients undergone annual preventive screening was included. Demographic information (age and sex) was collected. The descriptions of the ultrasonographic findings were standardized based on the following parameters: deviations in shape, size, position of the thyroid gland, deviations from normal parenchymal echogenicity (hyper-, hypo-, and heteroechogenic parenchyma), presence and size of detectable formations, and presence of calcifications. The total number of participants in this study was 3 178. Of these, 60% (1 907/3 178) were women and 40% (1 271/3 178) were men. The average age of participants was 40.1 ± 11.3 years, and there was no significant difference between the males and females. Deviations from normal ultrasonographic findings were observed in 36.2% (1 151/3 178), with a frequency increasing with age. Detectable formations were seen in 19.7% (625/3 178) of the patients, and those larger than 1 cm accounted for 4.4% (139/3 178) of all cases and 22.2% of all formations (139/625). Calcifications were found in 0.5% (15/3 163). Over 1/3 of the performed thyroid ultrasounds revealed abnormalities. Thyroid ultrasonographic abnormalities were significantly more common in women compared to men, and their frequency increased with age.
{"title":"Ultrasound screening of thyroid pathology in primary medical care in Bulgaria","authors":"Anabela Glavanova, Branimir Raduilov, Tsvetelina V. Miteva, Mariela Kamburova, Ivan Polyakov, E. Mekov","doi":"10.3897/jbcr.e127525","DOIUrl":"https://doi.org/10.3897/jbcr.e127525","url":null,"abstract":"Thyroid diseases are common and, in most cases, can be safely and effectively detected and treated in primary medical care. This article aimed to analyze and evaluate the rate of thyroid ultrasonographic abnormalities in a primary medical care practice in Bulgaria. The research was conducted from 2016 to 2021. A random cohort of patients undergone annual preventive screening was included. Demographic information (age and sex) was collected. The descriptions of the ultrasonographic findings were standardized based on the following parameters: deviations in shape, size, position of the thyroid gland, deviations from normal parenchymal echogenicity (hyper-, hypo-, and heteroechogenic parenchyma), presence and size of detectable formations, and presence of calcifications. The total number of participants in this study was 3 178. Of these, 60% (1 907/3 178) were women and 40% (1 271/3 178) were men. The average age of participants was 40.1 ± 11.3 years, and there was no significant difference between the males and females. Deviations from normal ultrasonographic findings were observed in 36.2% (1 151/3 178), with a frequency increasing with age. Detectable formations were seen in 19.7% (625/3 178) of the patients, and those larger than 1 cm accounted for 4.4% (139/3 178) of all cases and 22.2% of all formations (139/625). Calcifications were found in 0.5% (15/3 163). Over 1/3 of the performed thyroid ultrasounds revealed abnormalities. Thyroid ultrasonographic abnormalities were significantly more common in women compared to men, and their frequency increased with age.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":" 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141365615","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}
Nephrolithiasis is a disease that occurs with the formation of stones in the urinary tract. The occurrence of such stones depends on geographical, climatic, ethnic, dietary, and genetic factors. Most often, they are seen in countries with warm and dry climates. The Balkans are an endemic area, and 2% of the population is estimated to have the condition annually. The frequency is the same in both sexes. It is relatively rarer in childhood. This study aimed to show the modern possibilities for surgical treatment of kidney stone disease and combinations of different surgical approaches to achieve mini-invasiveness, short-term hospital stay, and reduction of postoperative complications. We present a clinical case of a patient with kidney stone disease with multiple lithiasis with multiple localization found in the left kidney. A combined (hybrid) operative approach was used – combining the laparoscopic technique and flexible renoscopy. We combined the possibilities of the two operative procedures and achieved a one-act cure for the patient. The method was minimally invasive. The hospital stay was shorter, and no postoperative complications occurred.
{"title":"A hybrid approach in surgical treatment of kidney stone disease","authors":"Stanimir Stanimirov, Petar P. Vatov","doi":"10.3897/jbcr.e126573","DOIUrl":"https://doi.org/10.3897/jbcr.e126573","url":null,"abstract":"Nephrolithiasis is a disease that occurs with the formation of stones in the urinary tract. The occurrence of such stones depends on geographical, climatic, ethnic, dietary, and genetic factors. Most often, they are seen in countries with warm and dry climates. The Balkans are an endemic area, and 2% of the population is estimated to have the condition annually. The frequency is the same in both sexes. It is relatively rarer in childhood. This study aimed to show the modern possibilities for surgical treatment of kidney stone disease and combinations of different surgical approaches to achieve mini-invasiveness, short-term hospital stay, and reduction of postoperative complications. We present a clinical case of a patient with kidney stone disease with multiple lithiasis with multiple localization found in the left kidney. A combined (hybrid) operative approach was used – combining the laparoscopic technique and flexible renoscopy. We combined the possibilities of the two operative procedures and achieved a one-act cure for the patient. The method was minimally invasive. The hospital stay was shorter, and no postoperative complications occurred.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364997","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}
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