Yoana G. Ivanova, M. Gohar, E. Gyokova, A. Yordanov, D. Dimitrov
Summary Uterine fibroids are the most common benign uterine tumours in women of reproductive age. They can present with different symptoms, including menorrhagia, cramping lower abdominal pain, bloating, urinary/bowel symptoms, spotting, and infertility. Management could be medical and surgical. Other options include uterine artery embolization and non-invasive treatment with high-intensity focused ultrasound (HIFU). We present a case of a 32-year-old woman with menorrhagia and severe pelvic pain. Ultrasound examination revealed an intramural myoma measuring 93x98x87 mm. The patient signed informed consent for HIFU ablation of the fibroid. Three months after the procedure, an MRI scan showed the fibroid had shrunk to 75% of its original size with dimensions 32x35x29. After six months, she became pregnant and gave birth to a healthy infant at 38-weeks gestation with caesarean section, at which point the fibroid measured 2 cm. HIFU is an alternative to surgical therapies and is highly beneficial in women wishing for future pregnancies. Preserving the option for future pregnancies in patients with uterine fibroids is only one of its benefits and might be the key solution for these women. HIFU treatment of uterine fibroids is an innovative approach. It should be encouraged: it is widely adopted in similar cases where it has positively impacted the treatment of uterine fibroids.
{"title":"Use of High-Intensity Focused Ultrasound (HIFU) in Treating Uterine Fibroids: A Case Report","authors":"Yoana G. Ivanova, M. Gohar, E. Gyokova, A. Yordanov, D. Dimitrov","doi":"10.2478/jbcr-2022-0025","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0025","url":null,"abstract":"Summary Uterine fibroids are the most common benign uterine tumours in women of reproductive age. They can present with different symptoms, including menorrhagia, cramping lower abdominal pain, bloating, urinary/bowel symptoms, spotting, and infertility. Management could be medical and surgical. Other options include uterine artery embolization and non-invasive treatment with high-intensity focused ultrasound (HIFU). We present a case of a 32-year-old woman with menorrhagia and severe pelvic pain. Ultrasound examination revealed an intramural myoma measuring 93x98x87 mm. The patient signed informed consent for HIFU ablation of the fibroid. Three months after the procedure, an MRI scan showed the fibroid had shrunk to 75% of its original size with dimensions 32x35x29. After six months, she became pregnant and gave birth to a healthy infant at 38-weeks gestation with caesarean section, at which point the fibroid measured 2 cm. HIFU is an alternative to surgical therapies and is highly beneficial in women wishing for future pregnancies. Preserving the option for future pregnancies in patients with uterine fibroids is only one of its benefits and might be the key solution for these women. HIFU treatment of uterine fibroids is an innovative approach. It should be encouraged: it is widely adopted in similar cases where it has positively impacted the treatment of uterine fibroids.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"3 1","pages":"178 - 181"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89765585","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}
Summary Gastric cancer is the fifth most common and third leading cause of cancer death worldwide. Patients with chronic atrophic gastritis (CAG) and intestinal metaplasia (IM) are at increased risk of developing gastric cancer (GC). It is common for CAG to precede IM, but the etiology of the two conditions is not always the same. Different scoring systems are used to assess HAG, MI, and GC risk, making it difficult to interpret results from investigations and management of these conditions.
{"title":"Current Understanding of Atrophic Gastritis and Intestinal Metaplasia as a Premalignant Lesion of Gastric Cancer","authors":"Zornica Gorcheva","doi":"10.2478/jbcr-2022-0016","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0016","url":null,"abstract":"Summary Gastric cancer is the fifth most common and third leading cause of cancer death worldwide. Patients with chronic atrophic gastritis (CAG) and intestinal metaplasia (IM) are at increased risk of developing gastric cancer (GC). It is common for CAG to precede IM, but the etiology of the two conditions is not always the same. Different scoring systems are used to assess HAG, MI, and GC risk, making it difficult to interpret results from investigations and management of these conditions.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"21 1","pages":"118 - 122"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84932521","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}
Summary The study compared early post-surgical complications between two groups of patients with pancreatoduodenal resection for pancreatic head carcinoma: patients with pancreatic-gastric anastomosis with mixed drainage and controls with pancreatic jejunal anastomosis with external drainage. The present study was a cohort study. The patient group was selected prospectively, and the control group – retrospectively. Patients were randomized by sex, age, primary tumor location, pancreatic parenchyma density, clinical symptoms, tumor–node–metastasis (TNM), and grade (G). We used the IBM SPSS Statistics software with the following tests: Fisher’s exact test, Pearson’s chi-squared test, Mann–Whitney U test. The optimized reconstruction approach with mixed drainage reduced early complications: early mortality - by 2.5%, overall morbidity - by 7.5%; pancreatic-digestive anastomosis insufficiency - by 2.5%; intra-abdominal bleeding - by 2.5%; intra-abdominal infection - by 2.5%; gastroparesis - by 5.0%; wound infection - by 2.5%; biliary leakage -by 2.5%. There were no cases of clinically significant pancreatic fistula. The control group was associated with an average of 9-fold higher relative risk of early complications. The passage was restored between the 4th and 7th day. Patients had a shorter average hospital stay (11 days) compared to controls (22 days). Digestive anastomoses reconstruction on a single loop and mixed intraluminal drainage through a modified nasogastric tube led to a 7-fold reduction in early post-surgical complications and a 2-fold shorter hospital stay.
{"title":"Optimized Drainage of Pancreatic-Digestive Anastomosis in Patients with Pancreatoduodenal Resection","authors":"N. Mena, Polina Marinova-Kichikova, K. Kirov","doi":"10.2478/jbcr-2022-0019","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0019","url":null,"abstract":"Summary The study compared early post-surgical complications between two groups of patients with pancreatoduodenal resection for pancreatic head carcinoma: patients with pancreatic-gastric anastomosis with mixed drainage and controls with pancreatic jejunal anastomosis with external drainage. The present study was a cohort study. The patient group was selected prospectively, and the control group – retrospectively. Patients were randomized by sex, age, primary tumor location, pancreatic parenchyma density, clinical symptoms, tumor–node–metastasis (TNM), and grade (G). We used the IBM SPSS Statistics software with the following tests: Fisher’s exact test, Pearson’s chi-squared test, Mann–Whitney U test. The optimized reconstruction approach with mixed drainage reduced early complications: early mortality - by 2.5%, overall morbidity - by 7.5%; pancreatic-digestive anastomosis insufficiency - by 2.5%; intra-abdominal bleeding - by 2.5%; intra-abdominal infection - by 2.5%; gastroparesis - by 5.0%; wound infection - by 2.5%; biliary leakage -by 2.5%. There were no cases of clinically significant pancreatic fistula. The control group was associated with an average of 9-fold higher relative risk of early complications. The passage was restored between the 4th and 7th day. Patients had a shorter average hospital stay (11 days) compared to controls (22 days). Digestive anastomoses reconstruction on a single loop and mixed intraluminal drainage through a modified nasogastric tube led to a 7-fold reduction in early post-surgical complications and a 2-fold shorter hospital stay.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"43 1","pages":"135 - 141"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82207782","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}
Summary Abnormalities in mineral and bone metabolism are a risk factor for increased cardiovascular and all-cause mortality and bone fractures in patients with chronic kidney disease stage 5D (CKD 5D). This single-center study aimed to investigate the age-related features of mineral and bone disorders in patients with CKD 5D on haemodialysis treatment and analyse the therapy provided. The biochemical parameters of mineral and bone metabolism and the ongoing therapy were studied in 90 patients undergoing hemodialysis treatment, of whom 44 (48.9%) were aged <65 years and 46 (51.1%) were aged ≥65 years. Serum phosphate, 25(OH) vit.D, parathyroid hormone, and serum albumin were significantly lower in patients aged ≥65 years compared with patients aged <65 years. There was a significant negative correlation between these parameters and age. We found no significant differences in therapy between the two age groups. A significant proportion of the patients aged ≥65 years had serum calcium and parathyroid hormone values below the lower desirable limit, while most of those aged <65 years had hyperphosphatemia and parathyroid hormone ≥600 pg/ml. Mineral and bone metabolism in CKD stage 5D patients on hemodialysis showed age-dependent patterns. Knowing them is crucial for optimal treatment.
{"title":"Age-Related Characteristics of Mineral and Bone Metabolism in Patients with Chronic Kidney Disease Stage 5D on Hemodialysis","authors":"M. Yankova, Gergana V. Todorova, V. Todorov","doi":"10.2478/jbcr-2022-0023","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0023","url":null,"abstract":"Summary Abnormalities in mineral and bone metabolism are a risk factor for increased cardiovascular and all-cause mortality and bone fractures in patients with chronic kidney disease stage 5D (CKD 5D). This single-center study aimed to investigate the age-related features of mineral and bone disorders in patients with CKD 5D on haemodialysis treatment and analyse the therapy provided. The biochemical parameters of mineral and bone metabolism and the ongoing therapy were studied in 90 patients undergoing hemodialysis treatment, of whom 44 (48.9%) were aged <65 years and 46 (51.1%) were aged ≥65 years. Serum phosphate, 25(OH) vit.D, parathyroid hormone, and serum albumin were significantly lower in patients aged ≥65 years compared with patients aged <65 years. There was a significant negative correlation between these parameters and age. We found no significant differences in therapy between the two age groups. A significant proportion of the patients aged ≥65 years had serum calcium and parathyroid hormone values below the lower desirable limit, while most of those aged <65 years had hyperphosphatemia and parathyroid hormone ≥600 pg/ml. Mineral and bone metabolism in CKD stage 5D patients on hemodialysis showed age-dependent patterns. Knowing them is crucial for optimal treatment.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"33 1","pages":"165 - 170"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87959293","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}
Summary Using CT in patients with stable angina can help diagnose obstructive and non-obstructive coronary heart disease and improve the prognosis of patients. Purpose of this study was to compare the diagnostic accuracy of CT in patients with stable angina to conventional invasive angiography. A retrospective study of 142 consecutive patients with stable angina from 2005 to 2014 was conducted. All patients underwent CT coronary angiography and subsequent conventional angiography. Patients without significant stenosis but with typical anginal symptoms and over three risk factors for coronary heart disease, such as after PCI and ACB, and patients with CT evidence of significant coronary atherosclerosis were also included in this study. A contingency table was used to calculate sensitivity and specificity. The value of the cap was 0.610. The sensitivity of the methodology was 93% (CI 89% - 98%), the specificity 57% (CI 89% - 98%), the positive predictive value was 88%, and the negative predictive value was 73%. The high sensitivity, negative and positive predictive hundredth of CTA compared to conventional angiography suggest that this methodology is of great diagnostic value and opportunities to influence the clinical behavior and improve the prognosis.
{"title":"Coronary Computed Tomography Angiogram in Patients with Stable Chest Pain","authors":"Z. Stoykova","doi":"10.2478/jbcr-2022-0020","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0020","url":null,"abstract":"Summary Using CT in patients with stable angina can help diagnose obstructive and non-obstructive coronary heart disease and improve the prognosis of patients. Purpose of this study was to compare the diagnostic accuracy of CT in patients with stable angina to conventional invasive angiography. A retrospective study of 142 consecutive patients with stable angina from 2005 to 2014 was conducted. All patients underwent CT coronary angiography and subsequent conventional angiography. Patients without significant stenosis but with typical anginal symptoms and over three risk factors for coronary heart disease, such as after PCI and ACB, and patients with CT evidence of significant coronary atherosclerosis were also included in this study. A contingency table was used to calculate sensitivity and specificity. The value of the cap was 0.610. The sensitivity of the methodology was 93% (CI 89% - 98%), the specificity 57% (CI 89% - 98%), the positive predictive value was 88%, and the negative predictive value was 73%. The high sensitivity, negative and positive predictive hundredth of CTA compared to conventional angiography suggest that this methodology is of great diagnostic value and opportunities to influence the clinical behavior and improve the prognosis.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"15 1","pages":"142 - 150"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73946505","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}
Summary Gastroenteropancreatic neuroendocrine tumors are a heterogeneous group of tumors. There are several classification systems, and all of them have been validated.The article aims to summarize the existing classification systems of gastroenteropancreatic neuroendocrine tumors.A critical evaluation was based on the data available from existing studies.The classification of the European neuroendocrine tumor society is the one with the clinical benefits.The lack of unified classification systems creates incomplete epidemiologic data, leading to confusion among pathologists and clinicians.
{"title":"Classification of Gastroenteropancreatic Neuroendocrine Tumors","authors":"P. Vladova","doi":"10.2478/jbcr-2022-0017","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0017","url":null,"abstract":"Summary Gastroenteropancreatic neuroendocrine tumors are a heterogeneous group of tumors. There are several classification systems, and all of them have been validated.The article aims to summarize the existing classification systems of gastroenteropancreatic neuroendocrine tumors.A critical evaluation was based on the data available from existing studies.The classification of the European neuroendocrine tumor society is the one with the clinical benefits.The lack of unified classification systems creates incomplete epidemiologic data, leading to confusion among pathologists and clinicians.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"6 1","pages":"123 - 129"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90112146","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}
Summary With over one million newly diagnosed cases in 2018, gastric cancer remains the fifth most common malignancy worldwide. Early detection of the disease is challenging as most patients are asymptomatic. The lack of screening programs leads to detection at an advanced stage and worsens the prognosis. Using biomarkers or endoscopic methods for early diagnosis would reduce the mortality from gastric cancer. We present a case of total extended (TEG) in advanced gastric cancer and a literature review of indications and complications of this treatment.
{"title":"Total Extended Gastrectomy in Advanced Gastric Cancer – Clinical Case","authors":"Zornitsa V. Gorcheva, Mirela V. Vasileva","doi":"10.2478/jbcr-2022-0026","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0026","url":null,"abstract":"Summary With over one million newly diagnosed cases in 2018, gastric cancer remains the fifth most common malignancy worldwide. Early detection of the disease is challenging as most patients are asymptomatic. The lack of screening programs leads to detection at an advanced stage and worsens the prognosis. Using biomarkers or endoscopic methods for early diagnosis would reduce the mortality from gastric cancer. We present a case of total extended (TEG) in advanced gastric cancer and a literature review of indications and complications of this treatment.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"80 1","pages":"182 - 186"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84182874","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}
Summary Food safety is an essential and integral part of public health policies in developed countries. Canned foods play a significant role in modern human nutrition. Improving the safety of internal control in production is additional prevention of the potential risks of consuming contaminated food. The present study aims to perform a health assessment and medical analysis of the Internal Control System and a canning company’s Hazard Analysis and Critical Control Points (HACCP) plan. Our study also aimed to find potential mechanisms to increase the safety in producing this type of ready-to-eat foods and possible new approaches in avoiding and managing risks. An audit algorithm was developed to analyze the existing food safety systems in the enterprise to achieve the study’s goal. The algorithm was based on the Codex Alimentarius methodology, presented in the document “Food Quality and Safety Systems - A Training Manual on Food Hygiene and the Hazard Analysis and Critical Control Point (HACCP) System. A medical analysis of the Internal Control System was performed, based on the prerequisite programs, technical documentation, and the company’s HACCP-plan. The analysis of the documentation and the critical remarks made can provide more reliable conditions for producing products safe for consumers’ health. The proposed corrections in the Good Hygiene Practices (GHP), the Good Manufacturing Practices (GMP), and the HACCP plan, mainly through adequately naming authentic hazards of a biological nature, are the basis for more professional verification of the processes and ensuring food safety.
{"title":"Medical Review and Analysis of Canned Food Production Safety","authors":"Tsv. Vitkova","doi":"10.2478/jbcr-2022-0001","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0001","url":null,"abstract":"Summary Food safety is an essential and integral part of public health policies in developed countries. Canned foods play a significant role in modern human nutrition. Improving the safety of internal control in production is additional prevention of the potential risks of consuming contaminated food. The present study aims to perform a health assessment and medical analysis of the Internal Control System and a canning company’s Hazard Analysis and Critical Control Points (HACCP) plan. Our study also aimed to find potential mechanisms to increase the safety in producing this type of ready-to-eat foods and possible new approaches in avoiding and managing risks. An audit algorithm was developed to analyze the existing food safety systems in the enterprise to achieve the study’s goal. The algorithm was based on the Codex Alimentarius methodology, presented in the document “Food Quality and Safety Systems - A Training Manual on Food Hygiene and the Hazard Analysis and Critical Control Point (HACCP) System. A medical analysis of the Internal Control System was performed, based on the prerequisite programs, technical documentation, and the company’s HACCP-plan. The analysis of the documentation and the critical remarks made can provide more reliable conditions for producing products safe for consumers’ health. The proposed corrections in the Good Hygiene Practices (GHP), the Good Manufacturing Practices (GMP), and the HACCP plan, mainly through adequately naming authentic hazards of a biological nature, are the basis for more professional verification of the processes and ensuring food safety.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"125 1","pages":"5 - 12"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86050523","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}
Summary We present the applicability and cost-effectiveness of the large loop excision of the transformation zone (LLETZ) procedure in outpatient settings – anesthesia, postoperative pain, postoperative stay, and complications such as intraoperative bleeding, early postoperative bleeding, infection, late cervical canal stenosis, spotting, incomplete epithelialization, inadequate colposcopy). From Jan 1, 2017, to Jul 31, 2021, 189 patients underwent LLETZ at Medical Center “Prof. Kornovski”. The methodology includes the indications for performing the LLETZ procedure, the preparation of the patients, a description of the procedure, tools, technical parameters, the operation technique, and the postoperative period. We present the duration of the procedure; analgesics in terms of intraoperative bleeding; postoperative pain; postoperative stay; early postoperative complications (bleeding, infection); late postoperative complications (stenosis of the cervical canal, incomplete epithelialization, spotting before menstruation, and inadequate colposcopy). The LLETZ procedure is applicable in outpatient practice with low intra- and postoperative complications and minimum stay. Two main factors determine its cost efficiency in outpatient practice: the use of local anesthesia instead of general anesthesia requiring an anesthesiologist, anesthesiology nurse, anesthetic for short-term venous anesthesia, and the daily cost for an occupied bed – a financial factor in-hospital care versus the lack of daily cost per occupied bed in outpatient care.
{"title":"LLETZ Procedure in an Outpatient Setting: Applicability and Cost-Effectiveness","authors":"Yonka. I. Kornovska, S. Tomov, A. Yordanov","doi":"10.2478/jbcr-2022-0007","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0007","url":null,"abstract":"Summary We present the applicability and cost-effectiveness of the large loop excision of the transformation zone (LLETZ) procedure in outpatient settings – anesthesia, postoperative pain, postoperative stay, and complications such as intraoperative bleeding, early postoperative bleeding, infection, late cervical canal stenosis, spotting, incomplete epithelialization, inadequate colposcopy). From Jan 1, 2017, to Jul 31, 2021, 189 patients underwent LLETZ at Medical Center “Prof. Kornovski”. The methodology includes the indications for performing the LLETZ procedure, the preparation of the patients, a description of the procedure, tools, technical parameters, the operation technique, and the postoperative period. We present the duration of the procedure; analgesics in terms of intraoperative bleeding; postoperative pain; postoperative stay; early postoperative complications (bleeding, infection); late postoperative complications (stenosis of the cervical canal, incomplete epithelialization, spotting before menstruation, and inadequate colposcopy). The LLETZ procedure is applicable in outpatient practice with low intra- and postoperative complications and minimum stay. Two main factors determine its cost efficiency in outpatient practice: the use of local anesthesia instead of general anesthesia requiring an anesthesiologist, anesthesiology nurse, anesthetic for short-term venous anesthesia, and the daily cost for an occupied bed – a financial factor in-hospital care versus the lack of daily cost per occupied bed in outpatient care.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"599 1","pages":"58 - 64"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85346827","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}
Summary Nursing research is a relatively new area of professional development that began firstly in the USA and made significant progress during the second half of the 19th century. Nursing research has made significant progress in European countries, mainly developed countries. This article aimed to review publications describing the evolution of nursing research, the directions of development, and best practices in the USA and Europe. Different databases were searched according to selected criteria, and a narrative literature review was conducted. Forty-two articles from the USA and Europe were identified and included as the most appropriate in the analysis, published in 22 journals. During the analysis, five basic directions of developing nursing research were identified - nursing research education, organizational structures for nursing research and collaboration with clinical professionals, research dissemination and journals, trends and priorities, and funding nursing research. To increase research capacity and respond to the growing research culture and the requirements of the scientific community, nursing research education is needed at every educational level. Establishing organizational structures has proved the importance of supporting and encouraging nurses to participate in and conduct studies. Funding research in teams is more likely to occur at any organization or centеr than looking for funding sources from individuals. Encouraging nurses and midwives to conduct research in clinical practice and publish results from scientific studies will help achieve sustainable implementation of evidence-based practice.
{"title":"Development of Nursing Research–Directions and Best Practices in the USA and Europe: A Narrative Review","authors":"Milena Saleva, S. Aleksandrova-Yankulovska","doi":"10.2478/jbcr-2022-0002","DOIUrl":"https://doi.org/10.2478/jbcr-2022-0002","url":null,"abstract":"Summary Nursing research is a relatively new area of professional development that began firstly in the USA and made significant progress during the second half of the 19th century. Nursing research has made significant progress in European countries, mainly developed countries. This article aimed to review publications describing the evolution of nursing research, the directions of development, and best practices in the USA and Europe. Different databases were searched according to selected criteria, and a narrative literature review was conducted. Forty-two articles from the USA and Europe were identified and included as the most appropriate in the analysis, published in 22 journals. During the analysis, five basic directions of developing nursing research were identified - nursing research education, organizational structures for nursing research and collaboration with clinical professionals, research dissemination and journals, trends and priorities, and funding nursing research. To increase research capacity and respond to the growing research culture and the requirements of the scientific community, nursing research education is needed at every educational level. Establishing organizational structures has proved the importance of supporting and encouraging nurses to participate in and conduct studies. Funding research in teams is more likely to occur at any organization or centеr than looking for funding sources from individuals. Encouraging nurses and midwives to conduct research in clinical practice and publish results from scientific studies will help achieve sustainable implementation of evidence-based practice.","PeriodicalId":15099,"journal":{"name":"Journal of Biomedical and Clinical Research","volume":"1 1","pages":"13 - 21"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89860901","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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