S. Gancheva, E. Marinova, B. Kanazirev, M. Boyadzhieva, M. Zhelyazkova-Savova
Introduction: Osteocalcin (OC) is a bone-derived protein that undergoes vitamin K-dependent carboxylation. The undercarboxylated form of the protein (ucOC) is released in the circulation during the process of bone resorption. Experimental studies on mice and rats have revealed that ucOC is involved in the regulation of energy homeostasis, linking in this way the bone, pancreas, and adipose tissue metabolism. Experimental studies suggest no hormonal role for the carboxylated form (cOC) of the protein. Aim: In the current study we aimed to examine the levels of OC in its carboxylated and undercarboxylated form in patients with type 2 diabetes and control subjects, and to compare the vitamin K status between the two groups. Materials and Methods: The present cross-sectional study involved a sample of 46 adults type 2 diabetes patients and a control group of 19 individuals. The carboxylated and undercarboxylated forms of OC were measured in serum by using highly sensitive sandwich-type enzyme immunoassay kits. Vitamin K status was evaluated by the ratio ucOC/cOC. Student’s two-tailed unpaired t-test was used to compare the groups. Results: UcOC and cOC serum levels were significantly lower in patients with type 2 diabetes compared to controls. We found no difference in the vitamin K status between the groups. Conclusion: Our results show that OC might be involved in the regulation of carbohydrate metabolism. In humans, it appears that the carboxylation state might not be essential for the hormonal role of the protein as in mice and rats.
{"title":"Levels of carboxylated and undercarboxylated osteocalcin in patients with type 2 diabetes","authors":"S. Gancheva, E. Marinova, B. Kanazirev, M. Boyadzhieva, M. Zhelyazkova-Savova","doi":"10.14748/SSM.V52I4.7172","DOIUrl":"https://doi.org/10.14748/SSM.V52I4.7172","url":null,"abstract":"Introduction: Osteocalcin (OC) is a bone-derived protein that undergoes vitamin K-dependent carboxylation. The undercarboxylated form of the protein (ucOC) is released in the circulation during the process of bone resorption. Experimental studies on mice and rats have revealed that ucOC is involved in the regulation of energy homeostasis, linking in this way the bone, pancreas, and adipose tissue metabolism. Experimental studies suggest no hormonal role for the carboxylated form (cOC) of the protein. Aim: In the current study we aimed to examine the levels of OC in its carboxylated and undercarboxylated form in patients with type 2 diabetes and control subjects, and to compare the vitamin K status between the two groups. Materials and Methods: The present cross-sectional study involved a sample of 46 adults type 2 diabetes patients and a control group of 19 individuals. The carboxylated and undercarboxylated forms of OC were measured in serum by using highly sensitive sandwich-type enzyme immunoassay kits. Vitamin K status was evaluated by the ratio ucOC/cOC. Student’s two-tailed unpaired t-test was used to compare the groups. Results: UcOC and cOC serum levels were significantly lower in patients with type 2 diabetes compared to controls. We found no difference in the vitamin K status between the groups. Conclusion: Our results show that OC might be involved in the regulation of carbohydrate metabolism. In humans, it appears that the carboxylation state might not be essential for the hormonal role of the protein as in mice and rats.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87372595","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}
Miller Fisher syndrome is a rare neurological disease that is considered to be a variant of Guillain-Barre syndrome. It is characterized by abnormal muscle coordination (ataxia), paralysis of the eye muscles (ophthalmoplegia), and absence of the tendon reflexes (areflexia). Additional symptoms include generalized muscle weakness and respiratory failure. Symptoms are usually preceded by a viral illness. This paper describes a clinical case of the syndrome in a patient who presented primarily with blurred and double vision, and gait disturbance.
{"title":"Miller Fisher syndrome: A case report","authors":"S. Atanasova, Ivan Dimitrov, A. Kaprelyan","doi":"10.14748/SSM.V0I0.7148","DOIUrl":"https://doi.org/10.14748/SSM.V0I0.7148","url":null,"abstract":"Miller Fisher syndrome is a rare neurological disease that is considered to be a variant of Guillain-Barre syndrome. It is characterized by abnormal muscle coordination (ataxia), paralysis of the eye muscles (ophthalmoplegia), and absence of the tendon reflexes (areflexia). Additional symptoms include generalized muscle weakness and respiratory failure. Symptoms are usually preceded by a viral illness. This paper describes a clinical case of the syndrome in a patient who presented primarily with blurred and double vision, and gait disturbance.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84171332","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}
P. Manoilov, P. Panayotov, V. Petrov, G. Todorov, M. Slavov
Introduction: Patients on permanent hemodialysis need constant and secure vascular access with optimal flow to perform the procedure. Failure to provide such access can lead to life-threatening deterioration of the patient's condition. Case Presentation: We report a case of implantation of a hemodialysis catheter directly in the right atrium (RA) in an emergency in a 46 year-old woman, placed on permanent hemodialysis (HD) for nine years due to end-stage renal disease with exhausted opportunities for vascular access over the years and unsuitable for peritoneal dialysis. After a consultation between a cardiac surgeon, a vascular surgeon and an interventional radiologist, a decision was made to directly implant a permanent catheter for HD in the superior vena cava (SVC). The operation was performed as a matter of urgency, operative access was through ministerotomy and the catheter was implanted directly in the right atrium (RA) due to thrombosis and fibrosis of the SVC. No cardiac complications associated with the procedure were observed in the postoperative period. On the first postoperative day, HD was performed, followed by others according to the therapeutic plan. The patient was discharged from the Cardiac Surgery Department on the 7th postoperative day. Conclusion: The use of open surgical access and the implantation of a permanent HD catheter directly into the RA can be considered a life-saving procedure in HD patients with acute uremic syndrome and exhausted vascular access.
{"title":"Implantation of a hemodialysis catheter directly in the right atrium due to exhaustion of vascular access","authors":"P. Manoilov, P. Panayotov, V. Petrov, G. Todorov, M. Slavov","doi":"10.14748/SSM.V52I3.6642","DOIUrl":"https://doi.org/10.14748/SSM.V52I3.6642","url":null,"abstract":"Introduction: Patients on permanent hemodialysis need constant and secure vascular access with optimal flow to perform the procedure. Failure to provide such access can lead to life-threatening deterioration of the patient's condition. Case Presentation: We report a case of implantation of a hemodialysis catheter directly in the right atrium (RA) in an emergency in a 46 year-old woman, placed on permanent hemodialysis (HD) for nine years due to end-stage renal disease with exhausted opportunities for vascular access over the years and unsuitable for peritoneal dialysis. After a consultation between a cardiac surgeon, a vascular surgeon and an interventional radiologist, a decision was made to directly implant a permanent catheter for HD in the superior vena cava (SVC). The operation was performed as a matter of urgency, operative access was through ministerotomy and the catheter was implanted directly in the right atrium (RA) due to thrombosis and fibrosis of the SVC. No cardiac complications associated with the procedure were observed in the postoperative period. On the first postoperative day, HD was performed, followed by others according to the therapeutic plan. The patient was discharged from the Cardiac Surgery Department on the 7th postoperative day. Conclusion: The use of open surgical access and the implantation of a permanent HD catheter directly into the RA can be considered a life-saving procedure in HD patients with acute uremic syndrome and exhausted vascular access.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87284689","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. Tsaneva-Damyanova, Z. Stoykova, I. Ivanova, T. Kostadinova, L. Ivanova
Inroduction: Hepatitis D (HDV) is the most interesting and unique among animal viruses. It causes viral hepatitis D only in individuals already infected with HBV (hepatitis B). This dual infection leads to the most aggressive hepatic dysfunction of all human viral hepatitis. Aim: This study was made to outline the hepatitis D virus among patients with chronic liver disorders in northeastern Bulgaria, in the sight of virus epidemiology, pathogenicity and viral genotype. Materials and methods: This is a retrospective study conducted between 2013-2019 at St. Marina University Hospital,Varna, Bulgaria. We have analyzed 418 serum samples from 391 patients with chronic liver disease using ELISA, PCR and HDV sequencing and genotyping. Results and Discussion: From 391 patients with chronic liver abnormalities, 16.6% (95% CI: 15.9% - 23.8%, n = 65) had an etiological association with HDV in ELISA. We found HDV RNA positive results in 63 out of all 65 anti-HDV Ab (antibody) positive patients (96.9%). Twenty-four of them, or 38.1% (95% CI: 26.1% - 51.2%, n = 24), were on antiviral HBV/HDV therapy. For five of them, or 20.8% (95% CI: 7.1% - 42.2%, n = 5), HDV genotype I was found. Conclusion: HDV infection has still many mysteries to discover - in terms of pathogenesis, clinical outcome in chronic HBV/HDV-infected individuals, as well as genotype variations and their role in avoiding immune elimination of the virus. All these unanswered questions pose a great challenge to the scientific thought and efforts of humankind to reduce and gradually eliminate viral hepatitis D.
丁型肝炎(HDV)是动物病毒中最有趣和独特的一种。它仅在已经感染HBV(乙型肝炎)的个体中引起病毒性丁型肝炎。这种双重感染导致所有人类病毒性肝炎中最严重的肝功能障碍。目的:从病毒流行病学、致病性和病毒基因型的角度概述保加利亚东北部慢性肝病患者的丁型肝炎病毒。材料和方法:这是一项2013-2019年在保加利亚瓦尔纳圣玛丽娜大学医院进行的回顾性研究。我们使用ELISA、PCR和HDV测序和基因分型分析了391例慢性肝病患者的418份血清样本。结果和讨论:在391例慢性肝脏异常患者中，16.6% (95% CI: 15.9% - 23.8%， n = 65)的ELISA检测结果与HDV有病因学关联。我们发现65例抗HDV Ab(抗体)阳性患者中有63例HDV RNA阳性(96.9%)。其中24人(38.1%，95% CI: 26.1% - 51.2%， n = 24)正在接受抗病毒HBV/HDV治疗。其中5例(20.8%)(95% CI: 7.1% - 42.2%， n = 5)发现HDV基因I型。结论:在慢性HBV/HDV感染者的发病机制、临床转归、基因型变异及其在避免免疫消除病毒中的作用等方面，HDV感染仍有许多未解之谜。所有这些尚未解决的问题对人类减少和逐步消除病毒性丁型肝炎的科学思想和努力提出了巨大的挑战。
{"title":"Hepatitis D virus in Bulgaria: virology, epidemiology and pathogenesis in chronic HBV carriers with liver dysfunction","authors":"D. Tsaneva-Damyanova, Z. Stoykova, I. Ivanova, T. Kostadinova, L. Ivanova","doi":"10.14748/SSM.V52I3.6610","DOIUrl":"https://doi.org/10.14748/SSM.V52I3.6610","url":null,"abstract":"Inroduction: Hepatitis D (HDV) is the most interesting and unique among animal viruses. It causes viral hepatitis D only in individuals already infected with HBV (hepatitis B). This dual infection leads to the most aggressive hepatic dysfunction of all human viral hepatitis. Aim: This study was made to outline the hepatitis D virus among patients with chronic liver disorders in northeastern Bulgaria, in the sight of virus epidemiology, pathogenicity and viral genotype. Materials and methods: This is a retrospective study conducted between 2013-2019 at St. Marina University Hospital,Varna, Bulgaria. We have analyzed 418 serum samples from 391 patients with chronic liver disease using ELISA, PCR and HDV sequencing and genotyping. Results and Discussion: From 391 patients with chronic liver abnormalities, 16.6% (95% CI: 15.9% - 23.8%, n = 65) had an etiological association with HDV in ELISA. We found HDV RNA positive results in 63 out of all 65 anti-HDV Ab (antibody) positive patients (96.9%). Twenty-four of them, or 38.1% (95% CI: 26.1% - 51.2%, n = 24), were on antiviral HBV/HDV therapy. For five of them, or 20.8% (95% CI: 7.1% - 42.2%, n = 5), HDV genotype I was found. Conclusion: HDV infection has still many mysteries to discover - in terms of pathogenesis, clinical outcome in chronic HBV/HDV-infected individuals, as well as genotype variations and their role in avoiding immune elimination of the virus. All these unanswered questions pose a great challenge to the scientific thought and efforts of humankind to reduce and gradually eliminate viral hepatitis D.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"170 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76031423","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, J. Dimitrova, I. Temelkova, T. Kalinova, Neli Koleva, S. Márina
Pyoderma gangrenosum (PG) is an auto inflammatory non-infectious neutrophilic dermatosis often presenting with pustules or nodules that progress to ulcers. PG has specific clinical features and non-characteristic histology findings. Some systemic diseases such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, hematologic malignancy or autoimmune disease are commonly associated with PG. One of the most characteristic features of pyoderma gangrenosum is pathergy, which is the appearance of new lesions at sites of trauma, including surgical wounds. We present a 62-year-old male with a large ulceration on the left lower leg after a bee sting.
{"title":"Idiopathic pyoderma gangrenosum or a systemic disease predictor?","authors":"Todor Yordanov, J. Dimitrova, I. Temelkova, T. Kalinova, Neli Koleva, S. Márina","doi":"10.14748/SSM.V52I2.6568","DOIUrl":"https://doi.org/10.14748/SSM.V52I2.6568","url":null,"abstract":"Pyoderma gangrenosum (PG) is an auto inflammatory non-infectious neutrophilic dermatosis often presenting with pustules or nodules that progress to ulcers. PG has specific clinical features and non-characteristic histology findings. Some systemic diseases such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, hematologic malignancy or autoimmune disease are commonly associated with PG. One of the most characteristic features of pyoderma gangrenosum is pathergy, which is the appearance of new lesions at sites of trauma, including surgical wounds. We present a 62-year-old male with a large ulceration on the left lower leg after a bee sting.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91026225","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. Marinova, M. Boyadzhieva, Nadezhda Hvarchanova, B. Kanazirev
INTRODUCTION: Data for arterial stiffness (АS) in type 2 diabetes mellitus (Т2DM) patients is important for better management of cardiovascular complications and early therapeutic approach. AIM: The aim of this article is to obtain data for pulse wave velocity (PWVβ) and other AS parameters in patients with T2DM without cardiovascular atherosclerotic disease and compare them with controls. MATERIALS AND METHODS: This cross-sectional clinical investigation involves a sample of 100 patients with T2DM without cardiovascular complications and a control group of 30 healthy subjects. In all patients one-point echo-tracking measurement of carotid artery (CA) stiffness with Aloka Prosound α7 machine were conducted and pulse wave velocity (PWVβ), β-stiffness index, arterial compliance (АС), augmentation index (AI), Peterson’s modulus (Ep) were measured. RESULTS AND CONCLUSION: Our results showed the mean value of PWVβ on the left CA (L) in the group of patients with T2DM is 7.37 ± 1.32 m/sec and on the right CA (R) is 7.42 ± 1.33 m/sec. The performed t-test showed statistical significance of the differences of PWVβ (L) and PWVβ (R) in the studied group, compared to the control group (t = 3.764; p = 0.001 and t = 3.561; p = 0.001). The data showed significantly higher values of β-stiffness index (p = 0.001) and Ep (p = 0.001) in patients with T2DM compared to controls. AC was significantly lower in T2DM, when it is measured on the left CA (p = 0.001). AI was significantly higher in T2DM when it is measured on the right CA (p = 0.009). Patients with T2DM are associated with significantly increased AS parameters compared to controls.
{"title":"Type 2 diabetes mellitus is associated with increased arterial stiffness measured by the echo-tracking method","authors":"E. Marinova, M. Boyadzhieva, Nadezhda Hvarchanova, B. Kanazirev","doi":"10.14748/SSM.V52I2.6619","DOIUrl":"https://doi.org/10.14748/SSM.V52I2.6619","url":null,"abstract":"INTRODUCTION: Data for arterial stiffness (АS) in type 2 diabetes mellitus (Т2DM) patients is important for better management of cardiovascular complications and early therapeutic approach. AIM: The aim of this article is to obtain data for pulse wave velocity (PWVβ) and other AS parameters in patients with T2DM without cardiovascular atherosclerotic disease and compare them with controls. MATERIALS AND METHODS: This cross-sectional clinical investigation involves a sample of 100 patients with T2DM without cardiovascular complications and a control group of 30 healthy subjects. In all patients one-point echo-tracking measurement of carotid artery (CA) stiffness with Aloka Prosound α7 machine were conducted and pulse wave velocity (PWVβ), β-stiffness index, arterial compliance (АС), augmentation index (AI), Peterson’s modulus (Ep) were measured. RESULTS AND CONCLUSION: Our results showed the mean value of PWVβ on the left CA (L) in the group of patients with T2DM is 7.37 ± 1.32 m/sec and on the right CA (R) is 7.42 ± 1.33 m/sec. The performed t-test showed statistical significance of the differences of PWVβ (L) and PWVβ (R) in the studied group, compared to the control group (t = 3.764; p = 0.001 and t = 3.561; p = 0.001). The data showed significantly higher values of β-stiffness index (p = 0.001) and Ep (p = 0.001) in patients with T2DM compared to controls. AC was significantly lower in T2DM, when it is measured on the left CA (p = 0.001). AI was significantly higher in T2DM when it is measured on the right CA (p = 0.009). Patients with T2DM are associated with significantly increased AS parameters compared to controls.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88999985","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, Neli Koleva, J. Dimitrova, E. Popchristova, I. Yungareva, T. Kalinova, S. Márina
Burning mouth syndrome (BMS) is described as a burning feeling or sensation in the mouth in the absence of specific oral mucosa lesions. Patients with BМS often complain of paraesthesia (tingling sensation in the mouth), xerostomia (dry mouth sensation), changes in sense of taste and smell. In the past two decades, significant research of this condition has been conducted. Psychological, systemic and local factors probably play a role in the pathogenesis of BMS. We present a case of an 82-year-old female with burning sensation in the mouth and a coexisting growing lesion on her lower lip.
{"title":"Burning mouth syndrome and squamous cell carcinoma: Coincidence or a new disease association","authors":"Todor Yordanov, Neli Koleva, J. Dimitrova, E. Popchristova, I. Yungareva, T. Kalinova, S. Márina","doi":"10.14748/SSM.V52I2.6651","DOIUrl":"https://doi.org/10.14748/SSM.V52I2.6651","url":null,"abstract":"Burning mouth syndrome (BMS) is described as a burning feeling or sensation in the mouth in the absence of specific oral mucosa lesions. Patients with BМS often complain of paraesthesia (tingling sensation in the mouth), xerostomia (dry mouth sensation), changes in sense of taste and smell. In the past two decades, significant research of this condition has been conducted. Psychological, systemic and local factors probably play a role in the pathogenesis of BMS. We present a case of an 82-year-old female with burning sensation in the mouth and a coexisting growing lesion on her lower lip.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85179004","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: After the initially chaotic and sporadic worldwide response to the COVID-19 pandemic, measures and strategies against the spread of this modern-time plague are getting shape and are relatively well adopted. In this environment, we witness the process of hard re-prioritization of needs, re-allocation of resources and some strict means to limit certain freedoms and actions. On the ethical ground, issues of social justice and individual rights are colliding in the shape of a conflict between infringement of rights and violation of rights. In this humanitarian crisis, we observe yet another confrontation of public against individual interest. AIM: The aim of this article is to bring up for discussion from an ethical standpoint freedoms and ultimately rights - in light of the current precautionary measures and the way they affect our social interactions. MATERIALS AND METHODS: Ethical analysis and documental research was conducted, including approved World Health Organization (WHO) statistics and data, experts’ reports, action recommendations, guidelines for measures, and standards of care in a pandemic situation. RESULTS AND CONCLUSION There are different approaches among people towards the pandemic, hence leading to attitudes spanning from indifference and ignorance, to conspiracy suspicions. Others believe that their rights are being unjustly violated. Even though some government strategies suggest debatable - on ethical grounds measures - we need to reconsider our typical expectations of social justice, priorities, and autonomy. Rights and freedoms need to be flexible in contexts of mass disasters, just like our attitude needs to be. To ensure their application in times of peace and prosperity, we need to be ready to give away some of them in times of crisis/pandemic.
{"title":"Necessities versus ethical considerations – the realities of COVID-19 and the moral strain they enforce on society","authors":"M. Mirchev, A. Kerekovska","doi":"10.14748/SSM.V52I2.6566","DOIUrl":"https://doi.org/10.14748/SSM.V52I2.6566","url":null,"abstract":"INTRODUCTION: After the initially chaotic and sporadic worldwide response to the COVID-19 pandemic, measures and strategies against the spread of this modern-time plague are getting shape and are relatively well adopted. In this environment, we witness the process of hard re-prioritization of needs, re-allocation of resources and some strict means to limit certain freedoms and actions. On the ethical ground, issues of social justice and individual rights are colliding in the shape of a conflict between infringement of rights and violation of rights. In this humanitarian crisis, we observe yet another confrontation of public against individual interest. AIM: The aim of this article is to bring up for discussion from an ethical standpoint freedoms and ultimately rights - in light of the current precautionary measures and the way they affect our social interactions. MATERIALS AND METHODS: Ethical analysis and documental research was conducted, including approved World Health Organization (WHO) statistics and data, experts’ reports, action recommendations, guidelines for measures, and standards of care in a pandemic situation. RESULTS AND CONCLUSION There are different approaches among people towards the pandemic, hence leading to attitudes spanning from indifference and ignorance, to conspiracy suspicions. Others believe that their rights are being unjustly violated. Even though some government strategies suggest debatable - on ethical grounds measures - we need to reconsider our typical expectations of social justice, priorities, and autonomy. Rights and freedoms need to be flexible in contexts of mass disasters, just like our attitude needs to be. To ensure their application in times of peace and prosperity, we need to be ready to give away some of them in times of crisis/pandemic.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80663000","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, E. Popchristova, J. Dimitrova, Neli Koleva, I. Yungareva, S. Márina
Pilomatrix carcinoma is a very rarely diagnosed malignancy. There are around 150 cases reported in the literature. In the very past this type of carcinoma was considered as a low-grade, non-metastasizing tumor. Nowadays with its high potential of recurrence and metastasizing the approach to this type of neoplasm should always be careful and multidisciplinary. The first line of therapy is wide surgical excision, followed by adjuvant radiotherapy. If there is observation of lymph node metastases they should be surgically or radiotherapeutically treated. In the present case report, we present a 46-year-old patient with pilomatrix carcinoma in the presternal region.
{"title":"Pilomatrix carcinoma in the presternal region. Very rare or very often misdiagnosed malignancy?","authors":"Todor Yordanov, E. Popchristova, J. Dimitrova, Neli Koleva, I. Yungareva, S. Márina","doi":"10.14748/SSM.V52I2.6495","DOIUrl":"https://doi.org/10.14748/SSM.V52I2.6495","url":null,"abstract":"Pilomatrix carcinoma is a very rarely diagnosed malignancy. There are around 150 cases reported in the literature. In the very past this type of carcinoma was considered as a low-grade, non-metastasizing tumor. Nowadays with its high potential of recurrence and metastasizing the approach to this type of neoplasm should always be careful and multidisciplinary. The first line of therapy is wide surgical excision, followed by adjuvant radiotherapy. If there is observation of lymph node metastases they should be surgically or radiotherapeutically treated. In the present case report, we present a 46-year-old patient with pilomatrix carcinoma in the presternal region.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87803305","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, E. Popchristova, Neli Koleva, I. Yungareva, J. Dimitrova, S. Márina
Disseminated superficial actinic porokeratosis (DSAP) is a skin condition that consist of multiple annular, hyperkeratotic lesions. They are usually distributed bilaterally and mostly affect the extremities. DSAPs have a wider distribution than the porokeratosis of Mibelli and usually appears between the age of 40 and 50. Squamous cell carcinoma, Bowen’s disease, and basal cell carcinoma that arises in the classical type of porokeratosis of Mibelli is well-documented, but there are not many reported cases of Bowen’s disease and basal cell carcinoma arising in DSAP. We present a 77-year-old woman in whom the two– Bowen’s disease and Basal cell carcinoma develop in a histologically proven DSAP.
{"title":"Disseminated superficial actinic porokeratosis, Bowen's disease and basal cell carcinoma. Coincidence or rare double malignant transformation?","authors":"Todor Yordanov, E. Popchristova, Neli Koleva, I. Yungareva, J. Dimitrova, S. Márina","doi":"10.14748/ssm.v51i3.6445","DOIUrl":"https://doi.org/10.14748/ssm.v51i3.6445","url":null,"abstract":"Disseminated superficial actinic porokeratosis (DSAP) is a skin condition that consist of multiple annular, hyperkeratotic lesions. They are usually distributed bilaterally and mostly affect the extremities. DSAPs have a wider distribution than the porokeratosis of Mibelli and usually appears between the age of 40 and 50. Squamous cell carcinoma, Bowen’s disease, and basal cell carcinoma that arises in the classical type of porokeratosis of Mibelli is well-documented, but there are not many reported cases of Bowen’s disease and basal cell carcinoma arising in DSAP. We present a 77-year-old woman in whom the two– Bowen’s disease and Basal cell carcinoma develop in a histologically proven DSAP.","PeriodicalId":21710,"journal":{"name":"Scripta Scientifica Medica","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81854928","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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