Introduction Melanoma is a malignant tumor with an unfavorable prognosis and an increasing incidence worldwide, with the most significant and the most common type being cutaneous melanoma. The epidemiological characteristics of cutaneous melanoma in Bulgaria are presented with low morbidity, moderate growth rate, and relatively low mortality, but with a rapid rate of increase in both sexes. Aim The aim of this study was to establish the clinical and morphological features of cutaneous melanoma in the Dobrich district and compare them to the European trends. Materials and Methods A retrospective non-clinical approach was used in the selection of patients. The study included patients with histologically proven skin melanoma in the period 2016–2019. Data on patient sex, age at diagnosis, tumor location, and clinical stage of the disease were collected according to Clark and Breslow criteria. Results The collected data show that the cutaneous melanoma in Dobrich district has a profile different from the average European one—all age groups are affected, except for 11- to 20-year-olds, and most cases occur in the age group of 61- to 70-year-olds, with an average age of diagnosis 59.82 years. In regard to sex distribution, men are more common, and the most common localization is the lower limbs. Morphological features show an advanced nature of the disease with a diagnosis in the late clinical stages. Conclusion Our data show that the gender distribution of cases corresponds to the European average, but the age and clinical stage of the disease are significantly more advanced, indicating a delayed diagnosis and emphasizing the need to develop a campaign for the prevention and early diagnosis.
{"title":"Demographic, clinical and morphological profile of malignant cutaneous melanoma in a Northeastern region of Bulgaria","authors":"Lilyana Petkova, G. Stoyanov","doi":"10.14748/SSM.V0I0.7204","DOIUrl":"https://doi.org/10.14748/SSM.V0I0.7204","url":null,"abstract":"Introduction Melanoma is a malignant tumor with an unfavorable prognosis and an increasing incidence worldwide, with the most significant and the most common type being cutaneous melanoma. The epidemiological characteristics of cutaneous melanoma in Bulgaria are presented with low morbidity, moderate growth rate, and relatively low mortality, but with a rapid rate of increase in both sexes. Aim The aim of this study was to establish the clinical and morphological features of cutaneous melanoma in the Dobrich district and compare them to the European trends. Materials and Methods A retrospective non-clinical approach was used in the selection of patients. The study included patients with histologically proven skin melanoma in the period 2016–2019. Data on patient sex, age at diagnosis, tumor location, and clinical stage of the disease were collected according to Clark and Breslow criteria. Results The collected data show that the cutaneous melanoma in Dobrich district has a profile different from the average European one—all age groups are affected, except for 11- to 20-year-olds, and most cases occur in the age group of 61- to 70-year-olds, with an average age of diagnosis 59.82 years. In regard to sex distribution, men are more common, and the most common localization is the lower limbs. Morphological features show an advanced nature of the disease with a diagnosis in the late clinical stages. Conclusion Our data show that the gender distribution of cases corresponds to the European average, but the age and clinical stage of the disease are significantly more advanced, indicating a delayed diagnosis and emphasizing the need to develop a campaign for the prevention and early diagnosis.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78046569","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}
Introduction: Urinary stones affect approximately 5 to 15% of the population in developed countries and depend on geographical location, age and gender. Laser lithotripsy has already become established worldwide as a preferred method for their treatment in urological practice. At present, retrograde intrarenal surgery (RIRS) has shown a high success rate and an acceptable number of complications. Recent studies show a complication rate of 9 to 25% of ureteroscopic procedures in different parts of the world. Urinary tract infections, ureteral lesions, hematuria, and postoperative renal colic are the most common complications in this type of surgery. Aim: The main goal of our study is to analyze the characteristics and risk factors of complicated urinary tract infections during retrograde intrarenal surgery and to look for the most effective options for their prevention and treatment. Materials and Methods: The study was conducted in two university hospitals in Varna and Sofia under relatively similar conditions and equipment. Between January 2019 and June 2020, this study retrospectively included 324 patients who underwent RIRS for the treatment of kidney stones with 212 patients undergoing laser treatment at the Clinic of Urology at St. Marina University Hospital, Varna, and 112 patients—in the Urology Department at Sofiamed University Hospital, Sofia. Results: The overall incidence of postoperative urinary tract infections was 14.5% (47/324 patients). The mean age of the patients was 52.8 ± 13.1 years, out of 324 patients, 217 patients (67%) were men and 107 patients (33%) were women. Major diseases included diabetes mellitus—52 (16%), and chronic kidney disease 16 (4.9%). Conclusion: Despite adequate prophylactic measures, postoperative urinary tract infections after ureteroscopy (URS) were found in 14.5% of the cases of this study and the most commonly found microorganism, which was isolated in more than half of patients with febrile urinary tract infection, was E. coli . In addition, it is necessary to reduce the operative working time, because this is the most important factor that prevents postoperative urinary tract infection.
{"title":"Concomitant urinary tract infections in retrograde intrarenal surgery (RIRS)","authors":"I. Velev, D. Anakievski","doi":"10.14748/SSM.V0I0.7456","DOIUrl":"https://doi.org/10.14748/SSM.V0I0.7456","url":null,"abstract":"Introduction: Urinary stones affect approximately 5 to 15% of the population in developed countries and depend on geographical location, age and gender. Laser lithotripsy has already become established worldwide as a preferred method for their treatment in urological practice. At present, retrograde intrarenal surgery (RIRS) has shown a high success rate and an acceptable number of complications. Recent studies show a complication rate of 9 to 25% of ureteroscopic procedures in different parts of the world. Urinary tract infections, ureteral lesions, hematuria, and postoperative renal colic are the most common complications in this type of surgery. Aim: The main goal of our study is to analyze the characteristics and risk factors of complicated urinary tract infections during retrograde intrarenal surgery and to look for the most effective options for their prevention and treatment. Materials and Methods: The study was conducted in two university hospitals in Varna and Sofia under relatively similar conditions and equipment. Between January 2019 and June 2020, this study retrospectively included 324 patients who underwent RIRS for the treatment of kidney stones with 212 patients undergoing laser treatment at the Clinic of Urology at St. Marina University Hospital, Varna, and 112 patients—in the Urology Department at Sofiamed University Hospital, Sofia. Results: The overall incidence of postoperative urinary tract infections was 14.5% (47/324 patients). The mean age of the patients was 52.8 ± 13.1 years, out of 324 patients, 217 patients (67%) were men and 107 patients (33%) were women. Major diseases included diabetes mellitus—52 (16%), and chronic kidney disease 16 (4.9%). Conclusion: Despite adequate prophylactic measures, postoperative urinary tract infections after ureteroscopy (URS) were found in 14.5% of the cases of this study and the most commonly found microorganism, which was isolated in more than half of patients with febrile urinary tract infection, was E. coli . In addition, it is necessary to reduce the operative working time, because this is the most important factor that prevents postoperative urinary tract infection.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80887160","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}
T. Georgiev, I. Kolev, Nikolay T. Dukov, S. Mavrodinova, M. Yordanova, K. Bliznakova
Introduction : 3D anthropomorphic models of human tissues have become a requirement for conducting realistic virtual studies. One of the current directions in the research of X-ray imaging is the development of physical models with 3D printing techniques using specific materials aiming to obtain replica of the human body tissues with similar radiological characteristics. Aim : The aim of this study is to create a calibration phantom for establishing the X-ray properties of different cartridge infills and their suitability to represent the X-ray properties of different breast types. Materials and Methods : A physical calibration model consisting of 22 objects was designed and printed by using an inkjet printer. A mixture was obtained from 5 mL printer ink and 3 g of potassium iodide (KI), which was used to fill the printer’s cartridge and to print the model on a set of plain office paper. Experimental X-ray images of the physical model were acquired on radiographic system SEDECAL X PLUS LP+. The obtained attenuation coefficient of the printing mixture was evaluated and compared to the breast tissue coefficients corresponding to the used X-ray energy. Results and Discussion : The physical model was printed on ten office sheets and stacked above one another. The obtained attenuation coefficient of the printing mixture was found very similar to that of the glandular tissue of the breast for the used X-ray energy. Conclusion: The obtained printer ink-KI mixture is suitable for representing the glandular part of breast tissue. The method has the potential to be used for creation of a realistic physical breast model.
人体组织的三维拟人化模型已经成为进行逼真虚拟研究的必要条件。目前x射线成像的研究方向之一是利用特定材料的3D打印技术开发物理模型，旨在获得具有相似放射学特征的人体组织的复制品。目的:本研究的目的是创建一个校准模体，以建立不同药筒填充物的x射线特性及其代表不同乳房类型x射线特性的适用性。材料与方法:设计了一个由22个物体组成的物理标定模型，并利用喷墨打印机进行了打印。从5ml打印机墨水和3g碘化钾(KI)中获得混合物，用于填充打印机墨盒，并在一套普通办公纸上打印模型。物理模型的实验X射线图像在X射线照相系统SEDECAL X PLUS LP+上获得。对得到的打印混合物的衰减系数进行了评估，并与使用的x射线能量对应的乳腺组织系数进行了比较。结果与讨论:物理模型被打印在十张办公纸上，并堆叠在一起。所得到的打印混合物的衰减系数与乳腺腺体组织的衰减系数非常相似。结论:所制备的打印机油墨- ki混合液适合于乳腺组织腺状部分的表征。该方法有潜力用于创建一个真实的物理乳房模型。
{"title":"Development of an inkjet calibration phantom for x-ray imaging studies","authors":"T. Georgiev, I. Kolev, Nikolay T. Dukov, S. Mavrodinova, M. Yordanova, K. Bliznakova","doi":"10.14748/SSM.V0I0.7410","DOIUrl":"https://doi.org/10.14748/SSM.V0I0.7410","url":null,"abstract":"Introduction : 3D anthropomorphic models of human tissues have become a requirement for conducting realistic virtual studies. One of the current directions in the research of X-ray imaging is the development of physical models with 3D printing techniques using specific materials aiming to obtain replica of the human body tissues with similar radiological characteristics. Aim : The aim of this study is to create a calibration phantom for establishing the X-ray properties of different cartridge infills and their suitability to represent the X-ray properties of different breast types. Materials and Methods : A physical calibration model consisting of 22 objects was designed and printed by using an inkjet printer. A mixture was obtained from 5 mL printer ink and 3 g of potassium iodide (KI), which was used to fill the printer’s cartridge and to print the model on a set of plain office paper. Experimental X-ray images of the physical model were acquired on radiographic system SEDECAL X PLUS LP+. The obtained attenuation coefficient of the printing mixture was evaluated and compared to the breast tissue coefficients corresponding to the used X-ray energy. Results and Discussion : The physical model was printed on ten office sheets and stacked above one another. The obtained attenuation coefficient of the printing mixture was found very similar to that of the glandular tissue of the breast for the used X-ray energy. Conclusion: The obtained printer ink-KI mixture is suitable for representing the glandular part of breast tissue. The method has the potential to be used for creation of a realistic physical breast model.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80612257","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}
D. Vankova, M. Pasheva, A. Angelov, Y. Yotov, B. Galunska
Introduction: Nowadays Gla-rich protein (GRP) is recognized as a novel biomarker playing a pivotal role in the crosstalk between chronic inflammation and vascular calcification. Aim: The aim of this article is to study the link between circulating GRP, cardiovascular pathology, and the degree of arterial calcification evaluated by the coronary arterial calcium score (CACS) in a Bulgarian population sample. Materials and Methods: Adult participants (n = 81) of both genders were divided into: controls (n = 41)—subjects with estimated moderate-to-high risk without known cardiovascular diseases (CVDs) and a combined CVD group (n = 40)—patients with paroxysmal or persistent atrial fibrillation in sinus rhythm, and heart failure subjects with preserved ejection fraction. A structured interview was carried out for evaluation of the classical CVD risk factors. CACS was determined by multislice computed tomography. Routine laboratory parameters were extracted from medical records. Serum levels of total GRP, matrix Gla protein, and osteocalcin were estimated by commercial ELISA kits. Standard statistical methods (descriptive statistics, Student’s t-test and Spearman’s correlation) were applied. Statistical significance was considered at p<0.05. Results: Significantly lower GRP levels were established in patients with coronary calcium compared to those without calcium deposits. Clear tendency for decreased levels of GRP was observed in the combined CVD group vs controls. Circulating GRP significantly correlates with uncarboxylated matrix Gla protein. An association between serum GRP, CRP, and low-density lipoproteins (LDLs) was demonstrated. Conclusion: This study adds new information regarding the role of circulating GRP as a new player in calcification inhibition. Our findings illuminate the link between total circulating GRP, CVD pathology, and the degree of coronary calcification.
{"title":"Is circulating Gla-rich protein linked with coronary calcium and cardiovascular pathology in patients with atrial fibrillation or heart failure? A pilot study","authors":"D. Vankova, M. Pasheva, A. Angelov, Y. Yotov, B. Galunska","doi":"10.14748/SSM.V0I0.7374","DOIUrl":"https://doi.org/10.14748/SSM.V0I0.7374","url":null,"abstract":"Introduction: Nowadays Gla-rich protein (GRP) is recognized as a novel biomarker playing a pivotal role in the crosstalk between chronic inflammation and vascular calcification. Aim: The aim of this article is to study the link between circulating GRP, cardiovascular pathology, and the degree of arterial calcification evaluated by the coronary arterial calcium score (CACS) in a Bulgarian population sample. Materials and Methods: Adult participants (n = 81) of both genders were divided into: controls (n = 41)—subjects with estimated moderate-to-high risk without known cardiovascular diseases (CVDs) and a combined CVD group (n = 40)—patients with paroxysmal or persistent atrial fibrillation in sinus rhythm, and heart failure subjects with preserved ejection fraction. A structured interview was carried out for evaluation of the classical CVD risk factors. CACS was determined by multislice computed tomography. Routine laboratory parameters were extracted from medical records. Serum levels of total GRP, matrix Gla protein, and osteocalcin were estimated by commercial ELISA kits. Standard statistical methods (descriptive statistics, Student’s t-test and Spearman’s correlation) were applied. Statistical significance was considered at p<0.05. Results: Significantly lower GRP levels were established in patients with coronary calcium compared to those without calcium deposits. Clear tendency for decreased levels of GRP was observed in the combined CVD group vs controls. Circulating GRP significantly correlates with uncarboxylated matrix Gla protein. An association between serum GRP, CRP, and low-density lipoproteins (LDLs) was demonstrated. Conclusion: This study adds new information regarding the role of circulating GRP as a new player in calcification inhibition. Our findings illuminate the link between total circulating GRP, CVD pathology, and the degree of coronary calcification.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78859690","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}
Todor Yordanov, I. Temelkova, B. Ivanova, E. Popchristova, Neli Koleva, J. Dimitrova, T. Kalinova, S. Márina
Carcinoma erysipeloides (CE) is an uncommon cutaneous metastasis of advanced breast carcinoma, showing distinctive features and presenting as a well-demarcated erythematous macule or plaque varying in size. It also may show a raised border and oedema. The differential diagnoses include erysipelas or cellulitis of the breast, or rarely—radiodermatitis. Most of the time CE is associated with advanced breast cancer and rarely with neoplastic tumours of the colon, pancreas, oesophagus, uterus, etc. We report a 58-year-old woman who presented at the Medical Institute of the Ministry of Internal Affairs with a 1-month history of not well-demarcated, erythematous, oedematous patches and plaques on the left and right breast, abdomen and both shins, associated with advanced invasive lobular carcinoma of the breast.
{"title":"Carcinoma erysipeloides of the breast in a patient with advanced invasive lobular breast cancer","authors":"Todor Yordanov, I. Temelkova, B. Ivanova, E. Popchristova, Neli Koleva, J. Dimitrova, T. Kalinova, S. Márina","doi":"10.14748/SSM.V0I0.7296","DOIUrl":"https://doi.org/10.14748/SSM.V0I0.7296","url":null,"abstract":"Carcinoma erysipeloides (CE) is an uncommon cutaneous metastasis of advanced breast carcinoma, showing distinctive features and presenting as a well-demarcated erythematous macule or plaque varying in size. It also may show a raised border and oedema. The differential diagnoses include erysipelas or cellulitis of the breast, or rarely—radiodermatitis. Most of the time CE is associated with advanced breast cancer and rarely with neoplastic tumours of the colon, pancreas, oesophagus, uterus, etc. We report a 58-year-old woman who presented at the Medical Institute of the Ministry of Internal Affairs with a 1-month history of not well-demarcated, erythematous, oedematous patches and plaques on the left and right breast, abdomen and both shins, associated with advanced invasive lobular carcinoma of the breast.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87417979","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}
Kamelia Rankova, V. Iotova, V. Mladenov, Teodora Karamfilova, Yuliya Bazdarska, N. Yordanova, I. Halvadjian, M. Hachmeriyan, Y. Bocheva, V. Boyadzhiev, S. Galcheva
Introduction : Turner syndrome (TS) is a rare disease with typical phenotype manifestations and short stature. Part of the therapy in TS patients is the recombinant human growth hormone (rhGH) that leads to improved height velocity and final height. Aim : The aim of the current study is to summarize the results of the diagnosis and treatment with rhGH of the TS patients followed up at a tertiary university center from 2011 to 2020. Patients and Methods : The study design is a retrospective cohort evaluation. All study participants had at least one full year of observation at the center. A total of 28 children with genetically confirmed TS or TS variation karyotype, aged between 2 and 18 years, 92.9 % of whom were girls, participated in the study. Results : The mean age at diagnosis was 9.6±3.7 years. Therapy with rhGH was started at 9.27±3.4 years in 22 (78.5%) of them with a mean rhGH dose of 0.035±0.006 mg/kg/d, which led to height gain of 8.0±1.3 cm for the first year. With a similar rhGH dose for the 2 nd year of treatment (0.033±0.007 mg/kg/d), height velocity of 6.8±1.1 cm was achieved (p<0.005). A positive change in SDS height was observed for the first year of therapy (-2.75±1.2 vs. -2.27±1.2, p=0.005). SDS IGF -1 before and after one treatment year increased significantly (-0.74±1.1 vs.1.57±1.4, p=0.001), without exceeding 2.0 SD. Conclusion : The achieved growth in the presented TS cohort is suboptimal though consistent with the international guidelines for treatment of TS, and could help optimize future treatment approach to TS patients in our center.
简介:特纳综合征(TS)是一种罕见的疾病，具有典型的表型表现和矮小的身材。TS患者的部分治疗是重组人类生长激素(rhGH)，可以提高身高速度和最终身高。目的:总结2011 - 2020年在某高校中心随访的TS患者rhGH的诊断和治疗结果。患者和方法:本研究设计为回顾性队列评价。所有的研究参与者在中心至少观察了整整一年。共有28名年龄在2岁至18岁之间的遗传证实TS或TS变异核型的儿童参加了这项研究，其中92.9%为女孩。结果:平均诊断年龄为9.6±3.7岁。22例(78.5%)患者在9.27±3.4岁时开始rhGH治疗，平均rhGH剂量为0.035±0.006 mg/kg/d，第一年身高增加8.0±1.3 cm。在治疗第2年rhGH剂量相近(0.033±0.007 mg/kg/d)的情况下，身高速度达到6.8±1.1 cm (p<0.005)。治疗第一年SDS高度出现正变化(-2.75±1.2 vs -2.27±1.2,p=0.005)。SDS - IGF -1治疗1年前后显著升高(-0.74±1.1 vs.1.57±1.4,p=0.001)， SD均未超过2.0。结论:虽然与国际TS治疗指南一致，但该TS队列的实现增长并不理想，可以帮助优化我们中心未来对TS患者的治疗方法。
{"title":"Treatment with recombinant growth hormone in children with Turner syndrome: a study from a tertiary university center","authors":"Kamelia Rankova, V. Iotova, V. Mladenov, Teodora Karamfilova, Yuliya Bazdarska, N. Yordanova, I. Halvadjian, M. Hachmeriyan, Y. Bocheva, V. Boyadzhiev, S. Galcheva","doi":"10.14748/SSM.V0I0.7348","DOIUrl":"https://doi.org/10.14748/SSM.V0I0.7348","url":null,"abstract":"Introduction : Turner syndrome (TS) is a rare disease with typical phenotype manifestations and short stature. Part of the therapy in TS patients is the recombinant human growth hormone (rhGH) that leads to improved height velocity and final height. Aim : The aim of the current study is to summarize the results of the diagnosis and treatment with rhGH of the TS patients followed up at a tertiary university center from 2011 to 2020. Patients and Methods : The study design is a retrospective cohort evaluation. All study participants had at least one full year of observation at the center. A total of 28 children with genetically confirmed TS or TS variation karyotype, aged between 2 and 18 years, 92.9 % of whom were girls, participated in the study. Results : The mean age at diagnosis was 9.6±3.7 years. Therapy with rhGH was started at 9.27±3.4 years in 22 (78.5%) of them with a mean rhGH dose of 0.035±0.006 mg/kg/d, which led to height gain of 8.0±1.3 cm for the first year. With a similar rhGH dose for the 2 nd year of treatment (0.033±0.007 mg/kg/d), height velocity of 6.8±1.1 cm was achieved (p<0.005). A positive change in SDS height was observed for the first year of therapy (-2.75±1.2 vs. -2.27±1.2, p=0.005). SDS IGF -1 before and after one treatment year increased significantly (-0.74±1.1 vs.1.57±1.4, p=0.001), without exceeding 2.0 SD. Conclusion : The achieved growth in the presented TS cohort is suboptimal though consistent with the international guidelines for treatment of TS, and could help optimize future treatment approach to TS patients in our center.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83408864","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}
Introduction: Health-related quality of life (HR-QoL) is an essential index of outcome after acute ischemic stroke (AIS). The minimal clinically important differences (MCIDs) represent the smallest change detected by a specific HR-QoL measuring tool beyond the standard measurement error. Aim: We aimed to establish the MCID in the HR-QoL after AIS during the first three months post-stroke. Materials and Methods: A total of 143 participants were assessed using the Stroke Impact Scale 3.0 (SIS 3.0) to measure HR-QoL at discharge, the first and the third month after AIS. Aggregated scores between 0-100 for all domains were used. MCID was defined as positive changes (PCs)(+15 points), negative changes (NCs)(–15 points), and no significant difference (NSDs)(–14 to +14). General linear modeling was used to determine time changes, and the differences were considered significant at a p-value < 0.05. Results: The most affected SIS 3.0 domains on the third month were Mobility - 56.74, Hand function - 58.92, and Strength - 59.62. The majority of the patients had NSDs. The proportion of those with NCs was significantly lower than those of PCs. The domains with most PCs were Stroke recovery - 34.97%, Strength - 33.57%, and Mobility - 31.47%, while Memory and thinking had the least - 13.29%. The most NCs were found in the domains Participation - 4.90%, Emotion - 4.20%, and Hand function -3.50%. The emotion domain manifested with the greatest variety ranging from 25.87% PCs and 4.20% NCs. Conclusion: The most affected HR-QoL aspects were from the physical dimension, with an additionally high level of engagement of the emotional sphere. Stroke survivors require a holistic approach during the recovery period, including physical and speech rehabilitation and timely social and mental support.
{"title":"Minimal clinically important differences in health-related quality of life after ischemic stroke","authors":"M. Tsalta-Mladenov","doi":"10.14748/SSM.V52I3.7295","DOIUrl":"https://doi.org/10.14748/SSM.V52I3.7295","url":null,"abstract":"Introduction: Health-related quality of life (HR-QoL) is an essential index of outcome after acute ischemic stroke (AIS). The minimal clinically important differences (MCIDs) represent the smallest change detected by a specific HR-QoL measuring tool beyond the standard measurement error. Aim: We aimed to establish the MCID in the HR-QoL after AIS during the first three months post-stroke. Materials and Methods: A total of 143 participants were assessed using the Stroke Impact Scale 3.0 (SIS 3.0) to measure HR-QoL at discharge, the first and the third month after AIS. Aggregated scores between 0-100 for all domains were used. MCID was defined as positive changes (PCs)(+15 points), negative changes (NCs)(–15 points), and no significant difference (NSDs)(–14 to +14). General linear modeling was used to determine time changes, and the differences were considered significant at a p-value < 0.05. Results: The most affected SIS 3.0 domains on the third month were Mobility - 56.74, Hand function - 58.92, and Strength - 59.62. The majority of the patients had NSDs. The proportion of those with NCs was significantly lower than those of PCs. The domains with most PCs were Stroke recovery - 34.97%, Strength - 33.57%, and Mobility - 31.47%, while Memory and thinking had the least - 13.29%. The most NCs were found in the domains Participation - 4.90%, Emotion - 4.20%, and Hand function -3.50%. The emotion domain manifested with the greatest variety ranging from 25.87% PCs and 4.20% NCs. Conclusion: The most affected HR-QoL aspects were from the physical dimension, with an additionally high level of engagement of the emotional sphere. Stroke survivors require a holistic approach during the recovery period, including physical and speech rehabilitation and timely social and mental support.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89767840","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}
N. Ivanova, Javor Ivanov, Miroslav Petrov, M. Marinov
Introduction: During working with sources of ionizing radiation, it is of special importance to take into account the dose load of the personnel working with such equipment. Aim: The aim of this article is to discuss the dose load of people working with mobile X-ray systems with a C-arm, who perform orthopedic procedures in the Clinic of Orthopedics and Traumatology of the St. Marina University Hospital, Varna. This research tries to convincingly show orthopedic surgeons and traumatologists that using a fluoroscopy mode (in all its variations) of the C-arm X-ray system when the tube is positioned under the patient table is best for their work when it comes to the working conditions, the image quality, the information value and the dose exposure of the staff. Materials and Methods: In the article a comparison of the dose load (effective dose) was made based on dosimetric measurements with respect to the personnel in different modes of operation of the X-ray equipment—roentgenoscopy (single shot) and fluoroscopy. The doses received by the surgeon-operator and his assistant were measured at three points of the body—head, gonads and feet, in radiography mode (single shot) and in three sub-modes of the fluoroscopy mode—continuous fluoroscopy, ½ dose fluoroscopy, and pulse fluoroscopy. For a more accurate comparison of the dose load in the respective operating modes, the time for reaching the dose limit for the personnel, determined by the Bulgarian legislation, was calculated—namely 20mSv per year. Results: The results of all measurements and calculations showed that the dose load in the radiography mode (single shot) was several times larger than the dose that was received in the three variations of the fluoroscopy mode at the same operating time. Conclusion: The results suggest that when using the fluoroscopy mode, even in the sub-mode with the highest dose load, it gives a lower dose than using the mode roentgenography, at the same time of operation of the X-ray tube.
{"title":"Comparison of dose rate when working with a C-arm X-ray system","authors":"N. Ivanova, Javor Ivanov, Miroslav Petrov, M. Marinov","doi":"10.14748/SSM.V52I4.7154","DOIUrl":"https://doi.org/10.14748/SSM.V52I4.7154","url":null,"abstract":"Introduction: During working with sources of ionizing radiation, it is of special importance to take into account the dose load of the personnel working with such equipment. Aim: The aim of this article is to discuss the dose load of people working with mobile X-ray systems with a C-arm, who perform orthopedic procedures in the Clinic of Orthopedics and Traumatology of the St. Marina University Hospital, Varna. This research tries to convincingly show orthopedic surgeons and traumatologists that using a fluoroscopy mode (in all its variations) of the C-arm X-ray system when the tube is positioned under the patient table is best for their work when it comes to the working conditions, the image quality, the information value and the dose exposure of the staff. Materials and Methods: In the article a comparison of the dose load (effective dose) was made based on dosimetric measurements with respect to the personnel in different modes of operation of the X-ray equipment—roentgenoscopy (single shot) and fluoroscopy. The doses received by the surgeon-operator and his assistant were measured at three points of the body—head, gonads and feet, in radiography mode (single shot) and in three sub-modes of the fluoroscopy mode—continuous fluoroscopy, ½ dose fluoroscopy, and pulse fluoroscopy. For a more accurate comparison of the dose load in the respective operating modes, the time for reaching the dose limit for the personnel, determined by the Bulgarian legislation, was calculated—namely 20mSv per year. Results: The results of all measurements and calculations showed that the dose load in the radiography mode (single shot) was several times larger than the dose that was received in the three variations of the fluoroscopy mode at the same operating time. Conclusion: The results suggest that when using the fluoroscopy mode, even in the sub-mode with the highest dose load, it gives a lower dose than using the mode roentgenography, at the same time of operation of the X-ray tube.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79425366","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}
INTRODUCTION: Heart failure (HF) is a chronic progressive syndrome, which is a result of preceding heart diseases and manifests with serious symptoms. Depression and anxiety are frequent comorbidities in chronic HF, which deteriorate the general status of the patients and are related to unfavorable health results—increased number of hospitalizations, deteriorated quality of life, and elevated mortality. AIM: The aim of this article is to assess the tendency to fall into depression of patients with HF in NYHA class III-IV, hospitalized in the non-invasive cardiology clinic of St. Marina University Hospital, Varna and the link to socioeconomic factors—social isolation, family status, educational level, region of residence and so on. MATERIALS AND METHODS: Overall, 39 patients with HF (17 women and 22 men) were investigated. They were in III-IV NYHA functional class during hospitalization. After preliminarily informed consent, they were asked to fill out a validated screening questionnaire for depression in adults—the 15-item Geriatric Depression Scale (GDS). The link to the patients’ socioeconomic, demographic, biological, and clinical characteristics was sought with the help of a multi-factor linear and logistic regression analysis. RESULTS: The results for the level of depression among HF patients were related to socioeconomic factors— region of residence, level of education, social isolation as well as to other variables—gender, age, and systolic left ventricular function assessed through the ejection fraction (EF). Higher levels of depression were observed in patients who resided in larger populated areas, with higher level of education and patients living alone. As far as gender was concerned, females were more susceptible to depressive episodes than males. At an average EF of 49.54 ±15.29%, the decreased left ventricular systolic function was also a factor of the degree of development of anxiety and depression. In a multi-factor analysis, however, only living alone was related to enhanced depressive attitude. CONCLUSION: Depression/anxiety in HF patients requires increased need of health care, shows poor health results, has high costs for treatment related to the serious symptoms, disability and high mortality. Regardless of that, no programs for timely detection, diagnosis, and treatment have been developed yet.
{"title":"Depression in patients with heart failure","authors":"M. Georgieva, L. Mircheva, Y. Yotov","doi":"10.14748/SSM.V0I0.7173","DOIUrl":"https://doi.org/10.14748/SSM.V0I0.7173","url":null,"abstract":"INTRODUCTION: Heart failure (HF) is a chronic progressive syndrome, which is a result of preceding heart diseases and manifests with serious symptoms. Depression and anxiety are frequent comorbidities in chronic HF, which deteriorate the general status of the patients and are related to unfavorable health results—increased number of hospitalizations, deteriorated quality of life, and elevated mortality. AIM: The aim of this article is to assess the tendency to fall into depression of patients with HF in NYHA class III-IV, hospitalized in the non-invasive cardiology clinic of St. Marina University Hospital, Varna and the link to socioeconomic factors—social isolation, family status, educational level, region of residence and so on. MATERIALS AND METHODS: Overall, 39 patients with HF (17 women and 22 men) were investigated. They were in III-IV NYHA functional class during hospitalization. After preliminarily informed consent, they were asked to fill out a validated screening questionnaire for depression in adults—the 15-item Geriatric Depression Scale (GDS). The link to the patients’ socioeconomic, demographic, biological, and clinical characteristics was sought with the help of a multi-factor linear and logistic regression analysis. RESULTS: The results for the level of depression among HF patients were related to socioeconomic factors— region of residence, level of education, social isolation as well as to other variables—gender, age, and systolic left ventricular function assessed through the ejection fraction (EF). Higher levels of depression were observed in patients who resided in larger populated areas, with higher level of education and patients living alone. As far as gender was concerned, females were more susceptible to depressive episodes than males. At an average EF of 49.54 ±15.29%, the decreased left ventricular systolic function was also a factor of the degree of development of anxiety and depression. In a multi-factor analysis, however, only living alone was related to enhanced depressive attitude. CONCLUSION: Depression/anxiety in HF patients requires increased need of health care, shows poor health results, has high costs for treatment related to the serious symptoms, disability and high mortality. Regardless of that, no programs for timely detection, diagnosis, and treatment have been developed yet.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85139872","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}
Introduction: Eyelid reconstruction is not implemented very often in ophthalmic surgical practice. Numerous surgical procedures exist, and the surgeon’s experience is one of the leading factors for the choice of a technique. Aim : The aim of this article is to study the causes and frequency of eyelid surgeries at the Specialized Eye Hospital for а five-year period and to evaluate the chosen surgical approach in relation to patients’ disease. Materials and Methods: A retrospective study was conducted on all patients who underwent eyelid surgery in the hospital for the study period (2011-2015). Detailed information was collected on demographic data, clinical details for the diagnosis, histological results, and type of surgery. Results: A total of 692 reconstructive eyelid surgeries were performed, which represents 5.63% of all surgeries in the hospital for the study period. The most common cause of planed eyelid surgery was tumor excision (50.8%) and the used reconstructive procedures were: direct closure in 78.3% of cases, skin flap transposition – 15.5%, Hughes procedure – 3.1%, full-thickness skin graft – 2.7%, and Cutler-Beard procedure – 0.4%. Entropion was diagnosed in 18.5%, ectropion – 13.0%, dermatochalasis – 9.1%, and ptosis – 8.5% of the planned surgeries. The most frequently used technique for entropion repair was the Quickert procedure – 44.7% and for ectropion repair this was the Bick procedure – 59.1%. Ptosis was acquired in 62.8% of cases, and the most frequently used technique was aponeurosis surgery – 57.2%. Conclusion: Eyelid reconstruction is an important branch of oculoplastic surgery. We found that tumor excision was the most common reason for planned eyelid surgeries. In recent years, the number of blepharoplasties has increased markedly.
{"title":"Eyelid reconstruction in ophthalmic surgical practice","authors":"Z. Zlatarova, B. Nenkova","doi":"10.14748/SSM.V52I4.7359","DOIUrl":"https://doi.org/10.14748/SSM.V52I4.7359","url":null,"abstract":"Introduction: Eyelid reconstruction is not implemented very often in ophthalmic surgical practice. Numerous surgical procedures exist, and the surgeon’s experience is one of the leading factors for the choice of a technique. Aim : The aim of this article is to study the causes and frequency of eyelid surgeries at the Specialized Eye Hospital for а five-year period and to evaluate the chosen surgical approach in relation to patients’ disease. Materials and Methods: A retrospective study was conducted on all patients who underwent eyelid surgery in the hospital for the study period (2011-2015). Detailed information was collected on demographic data, clinical details for the diagnosis, histological results, and type of surgery. Results: A total of 692 reconstructive eyelid surgeries were performed, which represents 5.63% of all surgeries in the hospital for the study period. The most common cause of planed eyelid surgery was tumor excision (50.8%) and the used reconstructive procedures were: direct closure in 78.3% of cases, skin flap transposition – 15.5%, Hughes procedure – 3.1%, full-thickness skin graft – 2.7%, and Cutler-Beard procedure – 0.4%. Entropion was diagnosed in 18.5%, ectropion – 13.0%, dermatochalasis – 9.1%, and ptosis – 8.5% of the planned surgeries. The most frequently used technique for entropion repair was the Quickert procedure – 44.7% and for ectropion repair this was the Bick procedure – 59.1%. Ptosis was acquired in 62.8% of cases, and the most frequently used technique was aponeurosis surgery – 57.2%. Conclusion: Eyelid reconstruction is an important branch of oculoplastic surgery. We found that tumor excision was the most common reason for planned eyelid surgeries. In recent years, the number of blepharoplasties has increased markedly.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87743045","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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