This paper aims to demonstrate that improving automated systems used to spread regulated information has a positive social effect. The provision of capability to replace manual insertion, and particularly direct import of data in XML-format into the systems of information agencies will save time (“economization of time”) spent for spreading financial statements by 90%. The saved working time can be utilized to fulfill other office tasks within current employees’ obligations, carrying out office assignments not listed as present obligations. Employees could improve their qualification through familiarization with novelties in normative bases or with good practices of other companies, substitute colleagues absent from work (leave or sick leave), and analyze work environment and suggest improvements.
Miroslav Ts. Eftimov and StefkaV. Valcheva-Kuzmanova
Aronia melanocarpa fruit juice (AMFJ) has been intensively studied for effects on the central nervous system. The study aimed to investigate AMFJ for possible sedative-hypnotic effects in rats after acute and subchronic administration. Male Wistar rats were treated orally with three doses of AMFJ (2.5, 5.0 and 10.0 ml/kg) either once (acute treatment) or in 30 days (subchronic treatment). Control rats were similarly treated with distilled water. The tests were performed 1 hour after the last AMFJ administration. The possible sedative-hypnotic effects of the juice were investigated in the open field test (OFT) and thiopental-induced sleeping time test. Substances with sedative-hypnotic effects decrease locomotor activity in the OFT and prolong the time of thiopental-induced sleep. The results from the OFT showed that neither the acute, nor the subchronic treatment of rats with all AMFJ doses affected the horizontal and vertical locomotor activity significantly. The two patterns of administration of AMFJ (acute and subchronic) had no significant effect on the duration of thiopental-induced sleep. The lack of effect of AMFJ on locomotor activity and the lack of prolongation of thiopental-induced sleep showed that AMFJ did not display sedative-hypnotic effects in rats.
Our purpose was to present a technique of pneumodissection applied with total mesorectal excision that ensured effective pelvic nerve preservation. Its detailed description emphasized the role of the proper definition of optimal dissection plane around the rectal cancer, the so-called ‘holy plane’ for total mesorectal excision. The study covered 28 rectal cancer patients at a mean age of 58±7.6 years (range 53 to 69 years). Rectal cancers were of TNM stages I-III and differentiation grades of G1-G3. Total mesorectal excision with pneumodissection between 2011 and 2016 was performed. Inflation of the pararectal space with CO2 improved visualization of the operative field between visceral and parietal fascia thus preserving plexus (pl.) vesicalis, pl. deferentialis, pl. prostaticus and pl. cavernosus penis. A fast and clean mesorectum mobilization was made without any damage to the visceral fascia, and total mesorectal excision was performed in the embryonal plane. Pl. hypogastricus superior in the region of the aortic bifurcation nervi (nn.) hypogastrici dextri et sinistri laterally to the rectum and pl. hypogastricus inferior were preserved, too. Encouraging postoperative results included pelvic nerve preservation and absence of complications. A broader application of the safe method of pneumodissection in open and laparoscopic rectal cancer surgery should be recommended.
Petko H. Stefanovski, Vladimir R. Radev, Nela T. Stefanovska, Nachko I. Tocev, Slavejko H. Bogdanov, Hristo S. Gigov, Pencho T. Tonchev and Radko N. Radev
We performed a retrospective evaluation of the criteria for suspected pulmonary embolism (PE) and requests for computed tomography angiography (CTA) by the emergency room (ER) teams. Simultaneously, we tried to find irregularities in their work. Then we designed new behavioral protocols, and yearly we evaluated the effect on the workload of the computed tomography (CT) unit of the Roentgenology and Radiology at the University Hospital – Pleven and the total impact on the behavior of the teams in cases of suspected for PE. The data from before and after the intervention was evaluated. After the implementation of the protocols, matching the criteria of PE rule-out criteria (PERC), the number of D-dimer testing, echocardiography, and computed tomography pulmonary angiographies (CTPA) was significantly higher. We found that the number of patients urgently transported for primary thrombectomy had increased, and the reduction of PE mortality in the Emergency Unit proves the safety of our intervention. Overall, the intervention in the attitude of the ER teams has a significant positive effect on the management of patients with suspected PE.
Sergey D. Iliev, Anislav V. Gabarski, Paulina T. Vladova, Pencho T. Tonchev, Ivailo M. Presolski, Kiril L. Nedyalkov, Ivanche T. Ristovski, Pavlin M. Mirochnik, Emil T. Filipov and Dobromir D. Nguen
Over the last decade, there has been a steady trend in increasing the incidence of colorectal cancer on a global scale. The relative share of patients under the age of 40 increases with each year. There is also a tendency for the incidence to be almost the same in males and females. Despite the efforts of the National Cancer Institute (NCI) to establish and implement adequate screening for disease prevention, 45.8% of patients were diagnosed in the advanced (third and fourth) stages of the disease. In 44.7% of patients, it was in the first and second stages, and the stage was unspecified in the remainder .
The prognosis in patients with colorectal cancer has been significantly improved. Precise staging of the tumor, adequate interpretation of predictive and prognostic factors is essential in the choice of therapeutic behavior. On the other hand, an inappropriate therapy administered to a patient with a diagnosed cancer can lead to disease progression, metastasis, and death, which can be avoided by adequate, patient-specified treatment.
Stillbirth rate is an essential indicator of population health and is much more common than presumed. In 2014, it was 7.34‰ in Bulgaria. These trends are seen against the background of a continuous process of increasing proportion of births to unmarried women. This report aims to investigateand conduct a comparative analysis of indicators of stillbirth and extramarital births in Bulgaria for a 15-year period. The data was derived from the National Statistical Institute (NSI) and Eurostat and statistically processed with Statistical Package for Social Science version 24.0 (SPSS v.24.0). The correlation coefficient of Pearson was used to establish the relationship between stillbirth rates and extramarital births.
Despite the technological progress of contemporary medicine, the stillbirth rate in Bulgaria during the last 15 years remained almost the same – from 7.48‰ in 2000 to 7.34‰ in 2014. One of the factors that may increase the risk for stillbirth is the marital status of the mother. The proportion of extramarital stillbirths for the country was 74.70% of all stillbirths for 2014, but in several districts, this proportion was 100%. Extramarital births and stillbirth rate in Bulgaria seem to be related. There are persisting regional differences in Bulgaria. A potential explanation includes health inequalities and welfare differences.
Aleksandar A. Todorov, Petranka G. Chumpalova-Tumbeva, Maya Y. Stoimenova-Popova, Vanya S. Popova, Doroteya K. Todorieva-Todorova, Nikolai T. Tzvetkov, Ivailo G. Hristov, Georgi K. Georgiev, Valentin I. Valtchev, Niya A. Krasteva, Ralitza G. Ilieva, Emiliya M. Dimitrova, Ljudmil Z. Tumbev and Adelaida L. Ruseva
Affective disorders, including depression, are of great social importance and lead to serious everyday life infringement and disability. Affective disorders are one of the main causes of suicide causes. Anxiety disorders represent a variety of psychic disorders that often lead to disability. Anxiety and depression syndromes together are often seen in patients. Vitamin B12 (cobalamin) is the only vitamin containing cobalt. Our aim was to investigate, evaluate and compare depression and increased anxiety and serum Vitamin B12 level in patients with depression, in patients with Vitamin B12 deficiency anemia and healthy controls. We investigated 74 subjects – 38 patients and 36 healthy controls. Serum Vitamin B12 level was measured in all participants. It is assumed that normal ranges of Vitamin B12 level vary. The most recently accepted ones are 200 to 900 pg/ml. In cases of levels below 200 pg/ml, a therapy with vitamin B12 should be applied. On the other hand, the level necessary for normal biochemical processes is higher – 250 pg/ml. In our study, serum Vitamin B12 level in more than 50% of patients with depression/anxiety was below 200 pg/ml, and in more than 60% of these patients it was below 250 pg/ml.
Ljubomir S. Kovachev, Pencho T. Tonchev and Kiril L. Nedialkov
Advanced information technologies have entered all spheres of human activities. In healthcare, this happens much too fast and encompasses all its branches. How does the Internet form the relationship between patients and medical staff? What information do patients seek and how do they get it? What problems arise during the communication process via new means? How can we describe an e-patient? How does the Internet model the doctor-patient relationship in case of cancer, one of the most dramatic diseases? Are students prepared to face an e-patient and how are they trained to do it? What is to be done to optimize internet communication between patients and health providers? This review analyzes information on these issues and outlines some opportunities for solving problems arising against the background of IT use in health care.
Regina S. Komsa-Penkova, Georgi M. Golemanov, Zdravka V. Radionova, Pencho T. Tonchev, Sergej D. Iliev and Veselin V. Penkov
Fetuin-A is a major plasma glycoprotein released mainly by the liver. Its functions include inhibition of the activity of insulin receptor, regulation of response to inflammation, inhibition of calcified matrix metabolism and ectopic mineralization, etc. Three major functional domains of fetuin-A have been identified: one similar to the Ca-binding domains, one inhibiting cysteine protease, and a domain with high affinity to insulin receptor. The fetuin-A molecule may be considered as a highly pleomorphic protein with an important impact in a variety of clinically expressed metabolic and pathological processes. It could be used as a marker in clinical practice in the future.