M. Nikolova, I. Angelova, V. Kotseva, A. Kostadinova, D. Genov, C. Vutova, N. Koleva, J. Todorov, K. Chupetlovska, M. Penkov, J. Ananiev, V. Milenova, A. Kundurdzhiev
Abstract In December 2019 a newly described single-stranded coronavirus, later named SARS-CoV-2, started its expansion around the world and subsequently caused a global pandemic, affecting the lives of millions of people worldwide. SARS-CoV-2 can bind multiple receptors on different cells and thus invade many target organs, including the respiratory and gastrointestinal mucous membranes, lungs, central nervous system, heart, etc. This virus can affect the kidney tissue both directly and as a consequence of other organ involvement or of the treatment administered, causing acute kidney injury and leaving long term squeals that worsen the prognosis. We describe three patients with acute kidney injury and subsequent acute renal failure at the background of coronaviral infection.
{"title":"Acute Kidney Injury and Acute Renal Failure in Coronaviral Infection","authors":"M. Nikolova, I. Angelova, V. Kotseva, A. Kostadinova, D. Genov, C. Vutova, N. Koleva, J. Todorov, K. Chupetlovska, M. Penkov, J. Ananiev, V. Milenova, A. Kundurdzhiev","doi":"10.2478/amb-2022-0028","DOIUrl":"https://doi.org/10.2478/amb-2022-0028","url":null,"abstract":"Abstract In December 2019 a newly described single-stranded coronavirus, later named SARS-CoV-2, started its expansion around the world and subsequently caused a global pandemic, affecting the lives of millions of people worldwide. SARS-CoV-2 can bind multiple receptors on different cells and thus invade many target organs, including the respiratory and gastrointestinal mucous membranes, lungs, central nervous system, heart, etc. This virus can affect the kidney tissue both directly and as a consequence of other organ involvement or of the treatment administered, causing acute kidney injury and leaving long term squeals that worsen the prognosis. We describe three patients with acute kidney injury and subsequent acute renal failure at the background of coronaviral infection.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"38 - 42"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43879870","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}
Abstract Objectives: The knowledge of the normal morphology of the maxillary sinuses and their variations is important for maxillofacial radiologists to achieve a better evaluation and delineation of pathologies and for pre-implant evaluation of the maxilla. The aim of our study was to evaluate anatomical variations of maxillary sinuses using Cone Beam Computed Tomography (CBCT). Materials and methods: 150 CBCT images where bilateral maxillary sinuses were scanned were included in the study following the inclusion and exclusion criteria. 75 CBCT scans each of males and females were studied using the Planmeca Romexis software (Version 4.6.2). Multiplanar images were searched for the presence of anatomical variations such as septae, haller cells and ethmomaxillary sinus. The data were subjected to Chi square test using SPSS software to compare and relate gender and site based differences in the occurrence of the anatomical variations. Results: Sinus septa was the predominant variation in both males and females with significantly higher prevalence in females and on the right side. An ethmomaxillary sinus was seen significantly more often in males, while Haller cells did not show any gender based differences in their occurrence. Ethmomaxillary sinus and Haller cells showed no difference in occurrence on the right and left side. Conclusions: Anatomic variations of the maxillary sinuses are a common finding. It necessary for the clinicians to be familiar with these variations to avoid clinical complications especially in cases of implant placements.
{"title":"Anatomical Variations of the Maxillary Sinus – A Cone Beam Computed Tomography Study","authors":"M. Asan, R. Castelino, S. Babu, D. Darwin","doi":"10.2478/amb-2022-0027","DOIUrl":"https://doi.org/10.2478/amb-2022-0027","url":null,"abstract":"Abstract Objectives: The knowledge of the normal morphology of the maxillary sinuses and their variations is important for maxillofacial radiologists to achieve a better evaluation and delineation of pathologies and for pre-implant evaluation of the maxilla. The aim of our study was to evaluate anatomical variations of maxillary sinuses using Cone Beam Computed Tomography (CBCT). Materials and methods: 150 CBCT images where bilateral maxillary sinuses were scanned were included in the study following the inclusion and exclusion criteria. 75 CBCT scans each of males and females were studied using the Planmeca Romexis software (Version 4.6.2). Multiplanar images were searched for the presence of anatomical variations such as septae, haller cells and ethmomaxillary sinus. The data were subjected to Chi square test using SPSS software to compare and relate gender and site based differences in the occurrence of the anatomical variations. Results: Sinus septa was the predominant variation in both males and females with significantly higher prevalence in females and on the right side. An ethmomaxillary sinus was seen significantly more often in males, while Haller cells did not show any gender based differences in their occurrence. Ethmomaxillary sinus and Haller cells showed no difference in occurrence on the right and left side. Conclusions: Anatomic variations of the maxillary sinuses are a common finding. It necessary for the clinicians to be familiar with these variations to avoid clinical complications especially in cases of implant placements.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"33 - 37"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49262236","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}
Abstract Objective: to describe the results from intravenous calcium loads in patients with suspected PHPT. Methods: This was a retrospective cross-sectional study with inpatients’ data review. Baseline serum calcium, phosphates, magnesium, creatinine, alkaline phosphatase, beta-crosslinks were recorded. The calcium loading had been performed after an overnight fasting. Calcium gluconate 0.25 mmol/kg body weight (10 mg/kg) dissolved in 0.9% Sodium Chloride was infused intravenously for 3 hours. Blood samples for total serum calcium, phosphates and iPTH were drawn before and up to 60 minutes after the calcium load. The intact parathyroid hormone (iPTH) and 25(OH)-vitamin D were determined by electro-hemi-luminescence (Elecsys, Roche Diagnostics). The PTH inhibition rate in % (PTH-IR), the calcium increment, the ratio R (ΔPTH/ΔCalcium) and the product P (calcium X PTH at test end) were calculated. Results: 23 patients with PHPT had complete data from calcium loading tests. The PTH suppression was < 30% in 17.4% of the participants, 30% to 50% – in 21.7% and > 50% in the remaining 60.9%. One patient displayed PTH suppression > 75%. The Ratio R was < 4.0 in all but one patient. Product P was above 1100 mg/dl x pg/ml in 9 participants (39.1%). Sixteen patients (69.6%) had positive localization results from US or SPECT-CT. The level of PTH suppression was not related to any parameter except the volume of the suspected lesion. Conclusion: The calcium loading test was unable to differentiate the forms of PHPT. It did not add great value in the diagnostic work-up of PHPT.
摘要目的：描述疑似PHPT患者静脉内钙负荷的结果。方法：这是一项回顾性横断面研究，对住院患者的数据进行回顾。记录基线血清钙、磷酸盐、镁、肌酸酐、碱性磷酸酶、β交联。钙负荷是在禁食过夜后进行的。将溶解在0.9%氯化钠中的葡萄糖酸钙0.25mmol/kg体重（10mg/kg）静脉内输注3小时。在钙负荷之前和之后直到60分钟抽取血清总钙、磷酸盐和iPTH的血样。完整的甲状旁腺激素（iPTH）和25（OH）-维生素D通过电化学发光（Elecsys，Roche Diagnostics）测定。计算PTH抑制率（%）（PTH-IR）、钙增量、比率R（ΔPTH/Δ钙）和产物P（试验结束时钙X PTH）。结果：23例PHPT患者的钙负荷试验数据完整。17.4%的参与者PTH抑制<30%，21.7%的参与者为30%-50%-，其余60.9%的参与者为>50%。一名患者显示PTH抑制>75%。除一名患者外，所有患者的比值R均<4.0。9名受试者（39.1%）的产物P高于1100 mg/dl x pg/ml。16名患者（69.6%）的US或SPECT-CT定位结果呈阳性。PTH抑制水平与任何参数无关，除了可疑病变的体积。结论：钙负荷试验不能区分PHPT的形态。它在PHPT的诊断检查中没有增加很大的价值。
{"title":"The Calcium Loading Test in Primary Hyperparathyroidism – Does it Provide Useful Information?","authors":"D. Bakalov, M. Boyanov, Prof. Mihail Boyanov","doi":"10.2478/amb-2022-0023","DOIUrl":"https://doi.org/10.2478/amb-2022-0023","url":null,"abstract":"Abstract Objective: to describe the results from intravenous calcium loads in patients with suspected PHPT. Methods: This was a retrospective cross-sectional study with inpatients’ data review. Baseline serum calcium, phosphates, magnesium, creatinine, alkaline phosphatase, beta-crosslinks were recorded. The calcium loading had been performed after an overnight fasting. Calcium gluconate 0.25 mmol/kg body weight (10 mg/kg) dissolved in 0.9% Sodium Chloride was infused intravenously for 3 hours. Blood samples for total serum calcium, phosphates and iPTH were drawn before and up to 60 minutes after the calcium load. The intact parathyroid hormone (iPTH) and 25(OH)-vitamin D were determined by electro-hemi-luminescence (Elecsys, Roche Diagnostics). The PTH inhibition rate in % (PTH-IR), the calcium increment, the ratio R (ΔPTH/ΔCalcium) and the product P (calcium X PTH at test end) were calculated. Results: 23 patients with PHPT had complete data from calcium loading tests. The PTH suppression was < 30% in 17.4% of the participants, 30% to 50% – in 21.7% and > 50% in the remaining 60.9%. One patient displayed PTH suppression > 75%. The Ratio R was < 4.0 in all but one patient. Product P was above 1100 mg/dl x pg/ml in 9 participants (39.1%). Sixteen patients (69.6%) had positive localization results from US or SPECT-CT. The level of PTH suppression was not related to any parameter except the volume of the suspected lesion. Conclusion: The calcium loading test was unable to differentiate the forms of PHPT. It did not add great value in the diagnostic work-up of PHPT.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":" ","pages":"5 - 11"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49380198","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}
R. Gancheva, T. Kundurzhiev, I. Sheitanov, T. Petranova, Z. Kolarov, P. Yankova, M. Nikolova, A. Kundurdzhiev
Abstract Aim: To investigate the association between cardiovascular burden and monosodium urate (MSU) deposits in the joints of patients with asymptomatic hyperuricemia and no evidence of arthritis and subjects with psoriatic arthritis and hyperuricemia. Patients and methods: A single-center, cross-sectional study including 52 individuals: 39 with asymptomatic hyperuricemia and 13 with psoriatic arthritis and hyperuricemia. All patients underwent ultrasound of the joints by which the presence or absence of MSU crystal deposits was assessed. Subjects underwent transthoracic echocardiography by which left ventricular mass index (LVMI) was estimated. Intima-media thickness (IMT) of the common carotid arteries was measured and the presence of atherosclerotic plaques was registered. Results: We found no difference in the distribution of cardiovascular risk factors between the two groups. Further, no difference in their distribution was found between those who were not treated and those who were treated with urate-lowering medications. The frequency of articular MSU deposits was similar between non-allopurinol-treated and allopurinol-treated individuals (p = 0.554). There was no difference in the frequency of articular deposits between benzbromarone recipients and non-recipients (p = 0.396). We observed no connection between articular MSU deposits and LVMI (p = 0.625), IMT (p = 0.117) and atherosclerotic plaques (p = 0.102). Among untreated and treated with urate-lowering drugs there was no difference in LVMI (p = 0.063), IMT (p = 0.975) and plaque distribution (p = 1.000). Conclusion: We can assume that in patients with asymptomatic hyperuricemia and no evidence of arthritis and in subjects with psoriatic arthritis and asymptomatic hyperuricemia, only the prescription of urate-lowering medications for reduction of urate load and cardiovascular risk is not sufficient.
{"title":"The Prevalence of Asymptomatic Hyperuricemia in Patients with or Without Psoriatic Arthritis is Associated with a Similar Cardiovascular Risk","authors":"R. Gancheva, T. Kundurzhiev, I. Sheitanov, T. Petranova, Z. Kolarov, P. Yankova, M. Nikolova, A. Kundurdzhiev","doi":"10.2478/amb-2022-0024","DOIUrl":"https://doi.org/10.2478/amb-2022-0024","url":null,"abstract":"Abstract Aim: To investigate the association between cardiovascular burden and monosodium urate (MSU) deposits in the joints of patients with asymptomatic hyperuricemia and no evidence of arthritis and subjects with psoriatic arthritis and hyperuricemia. Patients and methods: A single-center, cross-sectional study including 52 individuals: 39 with asymptomatic hyperuricemia and 13 with psoriatic arthritis and hyperuricemia. All patients underwent ultrasound of the joints by which the presence or absence of MSU crystal deposits was assessed. Subjects underwent transthoracic echocardiography by which left ventricular mass index (LVMI) was estimated. Intima-media thickness (IMT) of the common carotid arteries was measured and the presence of atherosclerotic plaques was registered. Results: We found no difference in the distribution of cardiovascular risk factors between the two groups. Further, no difference in their distribution was found between those who were not treated and those who were treated with urate-lowering medications. The frequency of articular MSU deposits was similar between non-allopurinol-treated and allopurinol-treated individuals (p = 0.554). There was no difference in the frequency of articular deposits between benzbromarone recipients and non-recipients (p = 0.396). We observed no connection between articular MSU deposits and LVMI (p = 0.625), IMT (p = 0.117) and atherosclerotic plaques (p = 0.102). Among untreated and treated with urate-lowering drugs there was no difference in LVMI (p = 0.063), IMT (p = 0.975) and plaque distribution (p = 1.000). Conclusion: We can assume that in patients with asymptomatic hyperuricemia and no evidence of arthritis and in subjects with psoriatic arthritis and asymptomatic hyperuricemia, only the prescription of urate-lowering medications for reduction of urate load and cardiovascular risk is not sufficient.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"12 - 18"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44075193","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}
A. Keltchev, S. Kazakov, M. Alexieva, E. Mekov, G. Yankov, Assoc. Prof. Evgeni Mekov
Abstract Infectious endocarditis (IE) represents an inflammation of the heart endothelium usually as a result of bacterial colonization after trauma. Splenic abscess is a rare and dangerous extracardiac manifestation of IE. An expert multidisciplinary collaboration is necessary for the diagnosis and treatment strategy of this high-risk and challenging disease. Valvuloplasty and splenectomy are the mainstay of radical treatment and offer excellent long-term results. We present two cases with infectious endocarditis, complicated with splenic abscesses, which were successfully operated in the Department of Cardiac Surgery.
{"title":"Surgical Treatment of Infective Endocarditis, Complicated with Splenic Abscesses","authors":"A. Keltchev, S. Kazakov, M. Alexieva, E. Mekov, G. Yankov, Assoc. Prof. Evgeni Mekov","doi":"10.2478/amb-2022-0029","DOIUrl":"https://doi.org/10.2478/amb-2022-0029","url":null,"abstract":"Abstract Infectious endocarditis (IE) represents an inflammation of the heart endothelium usually as a result of bacterial colonization after trauma. Splenic abscess is a rare and dangerous extracardiac manifestation of IE. An expert multidisciplinary collaboration is necessary for the diagnosis and treatment strategy of this high-risk and challenging disease. Valvuloplasty and splenectomy are the mainstay of radical treatment and offer excellent long-term results. We present two cases with infectious endocarditis, complicated with splenic abscesses, which were successfully operated in the Department of Cardiac Surgery.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"43 - 49"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41786081","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}
A. Nikolov¹, N. Popovski², I. Hristova³, Assoc. Prof. Asparuh Nikolov
Abstract Background: Мatrix metalloproteinase-2 (MMP-2) is an enzye from the gelatinases family involved mainly in collagen degradation. It is also known as a key regulator of normal vascular remodelling during a healthy pregnancy. Failure of regulation of MMP-2 has been associated with abnormal vasodilation, placentation, uterine expansion and development of preeclampsia (PE). Aims: (1) determine serum MMP-2 levels in women with PE and healthy pregnancy, (2) evaluate mean uterine arteries Doppler pulsatility index (UtA PI) and (3) investigate the a possible association between these parameters. Materials and methods: This was a case-control study. Fifty-five women with PE (mean age 24.9 ± 6 years) and a control group of 35 women with normal pregnancies (mean age 24.7 ± 5.4 years) were examined. An enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of MMP-2. Mean UtA PI were evaluated by Doppler velocimetry. Results: Serum ММР-2 levels in preeclampsia were significantly higher than in women with normal pregnancy 11.7 (9.1÷15.5) vs. 7.7 ng/ml (6.5÷13.4) (p = 0.016). Mean UtA PI was significantly higher in preeclampsia than in healthy pregnant women: 1.12 (0.82÷1.5) vs. 0.75 (0.69÷0.85); (p = 0.024). ММР-2 correlated with UtA PI (r = 0.214; p = 0.043). Cutoff value at 14 ng/ml for MMP-2 was found to discriminate between PE and healthy pregnancy. Conclusion: Our data showed an association between serum MMP-2 and Mean UtA PI. We suggest that MMP-2 could have a potential imply on maternal uterine arteries’ structure, favoring their constriction, increased resistance and abnormal uterine vascular remodeling. Further studies are warranted to clarify whether determination of MMP-2 cutoff value might contribute in the diagnosic work-out strategy for PE.
{"title":"Association Between Serum Matrix Metalloproteinase-2 Levels and Mean Doppler Pulsatility Index of Uterine Arteries in Patients with Preeclampsia","authors":"A. Nikolov¹, N. Popovski², I. Hristova³, Assoc. Prof. Asparuh Nikolov","doi":"10.2478/amb-2022-0025","DOIUrl":"https://doi.org/10.2478/amb-2022-0025","url":null,"abstract":"Abstract Background: Мatrix metalloproteinase-2 (MMP-2) is an enzye from the gelatinases family involved mainly in collagen degradation. It is also known as a key regulator of normal vascular remodelling during a healthy pregnancy. Failure of regulation of MMP-2 has been associated with abnormal vasodilation, placentation, uterine expansion and development of preeclampsia (PE). Aims: (1) determine serum MMP-2 levels in women with PE and healthy pregnancy, (2) evaluate mean uterine arteries Doppler pulsatility index (UtA PI) and (3) investigate the a possible association between these parameters. Materials and methods: This was a case-control study. Fifty-five women with PE (mean age 24.9 ± 6 years) and a control group of 35 women with normal pregnancies (mean age 24.7 ± 5.4 years) were examined. An enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of MMP-2. Mean UtA PI were evaluated by Doppler velocimetry. Results: Serum ММР-2 levels in preeclampsia were significantly higher than in women with normal pregnancy 11.7 (9.1÷15.5) vs. 7.7 ng/ml (6.5÷13.4) (p = 0.016). Mean UtA PI was significantly higher in preeclampsia than in healthy pregnant women: 1.12 (0.82÷1.5) vs. 0.75 (0.69÷0.85); (p = 0.024). ММР-2 correlated with UtA PI (r = 0.214; p = 0.043). Cutoff value at 14 ng/ml for MMP-2 was found to discriminate between PE and healthy pregnancy. Conclusion: Our data showed an association between serum MMP-2 and Mean UtA PI. We suggest that MMP-2 could have a potential imply on maternal uterine arteries’ structure, favoring their constriction, increased resistance and abnormal uterine vascular remodeling. Further studies are warranted to clarify whether determination of MMP-2 cutoff value might contribute in the diagnosic work-out strategy for PE.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"19 - 24"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43343568","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}
Y. Vlahov, E. Mollova, K. Vidinov, G. Mateva, M. Mladenov, P. Bochev, A. Borissova
Abstract Primary hyperparathyroidism (PHPT) is the third most common endocrine disease after diabetes and osteoporosis. It is more common in women and its prevalence increases with age. PHPT is associated with parathyroid adenoma or cancer or paraneoplastic parathyroid hormone (PTH) production. PHPT can be asymptomatic or present with nephrolithiasis, peptic ulcers, pancreatitis, bone lesions and rarely – as a palpable formation in the cervical area. We present a 73-year-old female patient with cystic cervical lesion with high levels of PTH in the evacuated fluid contents. We discuss the differential diagnosis and the diagnostic algorhythm in cystic cervical lesions.
{"title":"Cervical Cyst – A Tale of the Unexpected","authors":"Y. Vlahov, E. Mollova, K. Vidinov, G. Mateva, M. Mladenov, P. Bochev, A. Borissova","doi":"10.2478/amb-2022-0031","DOIUrl":"https://doi.org/10.2478/amb-2022-0031","url":null,"abstract":"Abstract Primary hyperparathyroidism (PHPT) is the third most common endocrine disease after diabetes and osteoporosis. It is more common in women and its prevalence increases with age. PHPT is associated with parathyroid adenoma or cancer or paraneoplastic parathyroid hormone (PTH) production. PHPT can be asymptomatic or present with nephrolithiasis, peptic ulcers, pancreatitis, bone lesions and rarely – as a palpable formation in the cervical area. We present a 73-year-old female patient with cystic cervical lesion with high levels of PTH in the evacuated fluid contents. We discuss the differential diagnosis and the diagnostic algorhythm in cystic cervical lesions.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"54 - 57"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48808939","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}
Y. Yordanov, Sen. Assistant Prof, MPharm Yordan Yordanov
Abstract Background: Necrotizing enterocolitis (NEC) is a major health burden in peterm neonates with mortality rates between 21% and 50%. Prophylaxis is of primary importance as early diagnosis is hindered by the lack of specific signs and laboratory markers. Although probiotics have been routinely used for NEC prophylaxis in neonatal intensive care units around the world, clinical trials provide contradictory data, which fuels an ongoing debate about their efficacy and safety. Aims: To perform a review and bibliometric analysis on available clinical trials and case reports data on the safety and efficacy of probiotics in preterm neonates and identify relevant publication trends and patterns. Methods: A bibliometric search for publications on the topic was performed in the Web of Science Core Collection database and the resulting records analyzed in bibliometrix package in R. Results: Trends in publication activity, historical direct citation network relationships and keyword co-ocurrences were discussed in the context of the most recent therapeutic recommendations. Conclusion: We took a round view of the potential drawbacks to probiotic use in preterm infants and their possible solutions.
摘要背景：坏死性小肠结肠炎（NEC）是彼得姆新生儿的主要健康负担，死亡率在21%至50%之间。预防是最重要的，因为缺乏特定的体征和实验室标志物阻碍了早期诊断。尽管益生菌已在世界各地的新生儿重症监护室常规用于NEC预防，但临床试验提供了相互矛盾的数据，这引发了关于其疗效和安全性的持续争论。目的：对早产儿益生菌安全性和有效性的现有临床试验和病例报告数据进行综述和文献计量分析，并确定相关的出版趋势和模式。方法：在Web of Science核心收藏数据库中对该主题的出版物进行文献计量学搜索，并在R中的文献计量学包中分析结果记录。结论：我们全面了解了早产儿使用益生菌的潜在缺点及其可能的解决方案。
{"title":"Probiotic Use in Preterm Neonates: A Review and Bibliometric Analysis","authors":"Y. Yordanov, Sen. Assistant Prof, MPharm Yordan Yordanov","doi":"10.2478/amb-2022-0032","DOIUrl":"https://doi.org/10.2478/amb-2022-0032","url":null,"abstract":"Abstract Background: Necrotizing enterocolitis (NEC) is a major health burden in peterm neonates with mortality rates between 21% and 50%. Prophylaxis is of primary importance as early diagnosis is hindered by the lack of specific signs and laboratory markers. Although probiotics have been routinely used for NEC prophylaxis in neonatal intensive care units around the world, clinical trials provide contradictory data, which fuels an ongoing debate about their efficacy and safety. Aims: To perform a review and bibliometric analysis on available clinical trials and case reports data on the safety and efficacy of probiotics in preterm neonates and identify relevant publication trends and patterns. Methods: A bibliometric search for publications on the topic was performed in the Web of Science Core Collection database and the resulting records analyzed in bibliometrix package in R. Results: Trends in publication activity, historical direct citation network relationships and keyword co-ocurrences were discussed in the context of the most recent therapeutic recommendations. Conclusion: We took a round view of the potential drawbacks to probiotic use in preterm infants and their possible solutions.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"58 - 67"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43208083","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}
Abstract The femoro-acetabular impingement (FAI) syndrome is a motion-related disorder of the hip joint with premature contact between the acetabulum and the proximal femur. It is a relatively new clinical entity and no strict treatment protocols and guidelines have been established yet. Furthermore, patients are often misdiagnosed and not properly treated. We report a clinical case of a young adult female patient presenting with a bilateral FAI-CAM type deformity during the last 2 years. An individual progressive global elastic resistant training program was established which involved stimulation to all affected muscle groups using Pilates concept. Hip-specific and functional lower limb strengthening targeted the deep hip external rotators, abductors and flexors in the transverse, frontal, and sagittal planes. Improving the dynamic stability and Core stability was the main aim of the challenging physiotherapy treatment in this case. A good functional result was registered at 6 months follow up. All therapeutic activities were performed in a pain free range of motion which was of paramount importance for achieving excellent patient compliance and successful outcome respectively. The applied treatment strategy demonstrated to be reliable and could be a helpful tool in the armamentarium of contemporary physiotherapy when dealing with the FAI group of patients.
{"title":"Conservative Physiotherapy Treatment of Femoroacetabular Impingement","authors":"A. Nikolova, Y. Yordanov","doi":"10.2478/amb-2022-0030","DOIUrl":"https://doi.org/10.2478/amb-2022-0030","url":null,"abstract":"Abstract The femoro-acetabular impingement (FAI) syndrome is a motion-related disorder of the hip joint with premature contact between the acetabulum and the proximal femur. It is a relatively new clinical entity and no strict treatment protocols and guidelines have been established yet. Furthermore, patients are often misdiagnosed and not properly treated. We report a clinical case of a young adult female patient presenting with a bilateral FAI-CAM type deformity during the last 2 years. An individual progressive global elastic resistant training program was established which involved stimulation to all affected muscle groups using Pilates concept. Hip-specific and functional lower limb strengthening targeted the deep hip external rotators, abductors and flexors in the transverse, frontal, and sagittal planes. Improving the dynamic stability and Core stability was the main aim of the challenging physiotherapy treatment in this case. A good functional result was registered at 6 months follow up. All therapeutic activities were performed in a pain free range of motion which was of paramount importance for achieving excellent patient compliance and successful outcome respectively. The applied treatment strategy demonstrated to be reliable and could be a helpful tool in the armamentarium of contemporary physiotherapy when dealing with the FAI group of patients.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"50 - 53"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46202558","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}
Abstract Aim: to investigate the slime production in isolates of Staphylococcus spp., associated with bacteremia in patients after hematopoietic stem-cell transplantation (HSCT) and to determine the relationship between the slime production and ica genes carriage, as well as the correlation of ica and methicillin resistance. Materials and methods: Between 2019 and 2020, twenty-one clinically significant Staphylococcus spp. isolates were obtained from blood cultures of 17 patients after HSCT. The species identification and the susceptibility to cefoxitin were determined by BD Phoenix M50. Two phenotypic tests (Congo red agar, CRA; Christensen’s method, TT) and PCR for icaA and icaD were used to detect slime production. A PCR method was also used to detect the mecA, mecC genes. Results: In the studied group of 21 isolates (S. epidermidis, n = 12; S. haemolyticus, n = 4; S. hominis, n = 2; S. aureus, n = 3), the phenotypic tests were positive in 13 isolates. Ten isolates (47.6%) were identified as carriers of ica genes (S. epidermidis, n = 9, and S. haemolyticus, n = 1). Five isolates (23.8%) were detected as slime producers by all three methods. The mecA gene was identified in 18 isolates (85.7%). All ica positive isolates were also mecA carriers. Conclusion: A relatively high proportion of the blood isolates of Staphylococcus spp. were slime producers, associ-ated with ica genes. A combination of both phenotypic and genetic methods should be used to detect alternative routes of slime production. The co-expression of ica and mecA is associ-ated with the occurrence of difficult-to-eradicate isolates.
{"title":"Phenotypic and Molecular Detection of Slime Producing Staphylococcus Spp. Obtained from Blood Samples of Patients Undergoing Hematopoietic Stem-Cell Transplantation","authors":"D. Niyazi, I. Micheva, R. Markovska, T. Stoeva","doi":"10.2478/amb-2022-0013","DOIUrl":"https://doi.org/10.2478/amb-2022-0013","url":null,"abstract":"Abstract Aim: to investigate the slime production in isolates of Staphylococcus spp., associated with bacteremia in patients after hematopoietic stem-cell transplantation (HSCT) and to determine the relationship between the slime production and ica genes carriage, as well as the correlation of ica and methicillin resistance. Materials and methods: Between 2019 and 2020, twenty-one clinically significant Staphylococcus spp. isolates were obtained from blood cultures of 17 patients after HSCT. The species identification and the susceptibility to cefoxitin were determined by BD Phoenix M50. Two phenotypic tests (Congo red agar, CRA; Christensen’s method, TT) and PCR for icaA and icaD were used to detect slime production. A PCR method was also used to detect the mecA, mecC genes. Results: In the studied group of 21 isolates (S. epidermidis, n = 12; S. haemolyticus, n = 4; S. hominis, n = 2; S. aureus, n = 3), the phenotypic tests were positive in 13 isolates. Ten isolates (47.6%) were identified as carriers of ica genes (S. epidermidis, n = 9, and S. haemolyticus, n = 1). Five isolates (23.8%) were detected as slime producers by all three methods. The mecA gene was identified in 18 isolates (85.7%). All ica positive isolates were also mecA carriers. Conclusion: A relatively high proportion of the blood isolates of Staphylococcus spp. were slime producers, associ-ated with ica genes. A combination of both phenotypic and genetic methods should be used to detect alternative routes of slime production. The co-expression of ica and mecA is associ-ated with the occurrence of difficult-to-eradicate isolates.","PeriodicalId":35746,"journal":{"name":"Acta Medica Bulgarica","volume":"49 1","pages":"11 - 15"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46298904","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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