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Non-Invasive and Minimum Invasive Concepts in Prevention, Cariology and Endodontics – from Research and Science to Practice

Abstract

The minimum invasive dental concept is based on practical experience of more than 30 years negative trends from the use of resin materials in distal teeth and early metal-ceramic “aesthetic” crowns and bridges. The scientific dental research includes all aspects of the conservative dentistry treatment which are scientifically and clinically proved with most up to date methods and tests: anthropometric, epidemiological, biochemical, immunohistochemical, electron microscopy, polarized light microscopy, light induced fluorescence, microradiography, microbiology, genetic tests, etc. Experiments in vitro, animal tests, clinical research in the last 34 years are focused in the field of prevention of dental caries, treatment of precavitated precarious lesions with nanotechnologies, preparation of hard dental tissues with most conservative techniques, adhesive restoration methods with amalgam and resins, backup in endodontics in root canals preparation methods and in pins and posts fixations. The conclusions can be focused on basic principles and refocused in the 21st century like: Dental caries is not only predictable and controlled disease but is also a polyetiological disease on a community and population levels and uni- or bi-etiological on an individual level. The minimum invasive dental concept in cariology and endodontics leads to prevention of early extractions, early prosthetic medical procedures and to lifetime dental health. This plays a key role in prevention of metabolic disorders and gastrointestinal diseases.

Open access
Sialolipoma of the Parotid Gland: An Uncommon Lipoma Variant of Salivary Gland

Abstract

Sialolipoma affecting the salivary glands is an uncommon lipoma variant composed of mature adipose tissue mixed with acinar, ductal, basal and myoepithelial cells of normal salivary gland. It has a wide age range at presentation. Generally, the major gland has male predilection while the minor gland has a female preponderance. A diagnostic workup requires CT or MRI to define the exact location and texture of the lesion. Surgical excision is recommended when the tumor progressively increases in size. Prognosis is good whereby no malignant transformation or recurrences has been reported.

Open access
Superluminous Devices Versus Low-Level Laser for Temporomandibular Disorders

Abstract

The aim of this study is to compare the pain intensity reduction between the mean radiation doses per session of gallium-aluminum-arsenide (GaAIAs) laser with superluminous diodes (SLD) in four of the most common pain-related chronic temporomandibular disorders (TMD) - local myalgia, myofascial pain, myofascial pain with a referral, and arthralgia. This study was implemented on 124 patients with pain-related temporomandibular disorders according to the DC/TMD criteria. We applied trigger point oriented near-infrared laser (785 nm, 100 s, 8 J/cm2) and SLD cluster sessions (the cluster is composed of 49 SLDs with a combination of visible red (633 nm) and infrared (880 nm) diodes, 200 mW, 300 s, 8 J/cm2) for the temporomandibular joints and the affected muscles. Patients were evaluated at the start of the treatment, and after the 6th session of combined phototherapy. The pain intensity scores were measured according to the Visual Analogue Scale (VAS). Our results show that the most statistically manifested pain reduction is found for the SLD dose, р = 0,000118, followed by the overall dose (laser plus SLD); р = 0,001031, and the laser dose; р = 0,030942 (ANOVA dispersion analyses). Consequently, it can be concluded that myalgia is better treated through lower doses of red light compared to infrared laser doses because SLDs combine the prooxidative effect of photons with 633 nm wavelength, a large area of exposure, sufficient tissue penetration, and some positive warming thermal impact of the SLD clusters.

Open access
Trace Elements and Vitamin D in Gestational Diabetes

Abstract

Gestational diabetes mellitus (GDM), one of the most common pregnancy complications, is defined as glucose intolerance with onset or first recognition during pregnancy. Its prevalence varies worldwide in dependence on characteristics of the underlying population and applied diagnostic criteria. The etiology is multifactorial and not sufficiently elucidated. Available evidence suggests that the base of pathogenesis is relatively diminished insulin secretion coupled with pregnancy-induced insulin resistance. Modifiable and non-modifiable risk factors for development have been identified. Trace elements and vitamin D could be contributed to modifiable factors for prediction the risk in a large population. Essential trace elements in pregnancy are necessary to overcome systemic oxidative, metabolic and inflammatory stress. Evidence, still inconclusive, has been accumulated about the relation between higher incidence of vitamin D failure/deficiency during pregnancy and GDM. The lower level of 25-OH vitamin D could be associated with increased risk for anemia development, also including pregnant women. This review intends to provide an overview of the possible link between both vitamin D and trace elements as risk factors for GDM development.

Open access
Altruistic Surrogacy – Ethical Issues and Demographic Differences in Public Opinion

Abstract

This is the first study of the attitude of Bulgarian people towards the allowing of altruistic surrogacy which is prohibited in Bulgaria. This study used an online survey which was active during one year (July 2010-June 2011) and which was answered by 951 respondents between 18-65 years of age. The majority of them (87%) are young people between 18-43 years. The respondents are men and women with secondary, university and medical university education from the capital and the countryside. They have different marital status. The data were treated with statistical package SPSS 16. The link between the demographic characteristics (gender, age, education, marital status and place of residence) and the answers of the respondents was identified. The majority of the respondents (73%) think that the altruistic surrogacy must be allowed in Bulgaria and the main supporters are the women and the residents in the countryside – married or living with partner. Only 38% of the respondents mostly divorced middle aged persons accept the access of same sex couples to surrogacy. The majority of the respondents (53%) fear that the surrogacy may transform poor women into incubators for babies. This opinion is shared by the men, by the youngest and the oldest respondents and by the unmarried persons.

Open access
Antiproliferative Properties Against Human Breast, Cervical and Ovarian Cancer Cell Lines, and Antioxidant Capacity of Leaf Aqueous Ethanolic Extract from Cotinus coggygria Scop.

Abstract

Cotinus coggygria Scop. leaf aqueous ethanolic extract was examined for its in vitro antiproliferative and antioxidant activity. Antiproliferative effect was assessed on four human gynecological cancer cell lines: breast (MCF7, T47D), cervical (HeLa) and ovarian (A2780) and compared to the cell growth inhibitory effect on non-cancerous breast epithelial cell line MCF10A using MTT cell proliferation assay. Radical scavenging assay with DPPH was applied to evaluate antioxidant potential of the extract. The obtained results showed that the herb inhibited cell growth of all of the tested cancer cell lines and the highest was the cytostatic effect on A2780 cells with a half maximal inhibitory concentration (IC50) value of 30.8 μg/ml. For the other cell lines the IC50 values were in the range of 55-122.7 μg/ml. Additionally, the extract exerted considerably weaker reduction in cell proliferation of the non-cancerous cell line MCF10A compared to cancer cells, which indicates for antiproliferative selectivity. C. coggygria extract showed high free radical scavenging activity with an IC50 value of 11.2 μg/ml. The obtained data provide evidence for pharmacological potential of the tested extract and future more detailed studies concerning the molecular mechanisms of the anticancer effect of the herb are needed.

Open access
Basic Mechanisms of Action of the Antiepileptic Drugs

Abstract

Available antiepileptic drugs interact with a variety of different molecular targets. The mechanism of action of most anticonvulsants is most often complex with a number of affected regions. The combination of mechanisms of action of drugs in particular proportions can possibly determine the showcase of its antiepileptic activity. The common factor between the different supposed mechanisms for a number of drugs includes the possibility for modulating the excitatory and inhibitory neurotransmission through effects upon the voltage-gated ion channels, synaptic plasticity, heterogeneous receptors, and metabolism of neurotransmitters. There are controversial data on the extent to which a specific action can be the reason for the wholesome anticonvulsive characteristics of various medications, as well as the relation with the presence of undesired drug effects. The complexity of the action of some antiepileptic drugs creates conditions for optimal choice during therapy. In many cases, the insufficient familiarity with individual genetic differences and the disease related receptor damages can hinder defining a particular drug action. Characterizing the mechanisms of action of the present antiepileptic medications would increase the understanding for the pathophysiological mechanisms of epileptic seizures, as well as the development of new therapeutic strategies. The development of novel antiepileptic drugs and the ongoing research regarding the mechanism of action of established antiepileptic drugs, are continuously increasing the level of complexity in the spectrum of molecular targets relevant for epilepsy therapy. The current state of knowledge as well as the limitations in our understanding should guide future research aiming for a more detailed elucidation of the impact of genetics and pathophysiological mechanisms on interindividual differences in expression and function of antiepileptic drug targets.

Open access
Cardiovascular Risk Factors in White Collar Workers Under Shift Work

Abstract

Shift work is associated with circadian disruption, disturbs sleep and social life, and modifies disease risk factors, and thus can potentially contribute to various chronic diseases including cardiovascular diseases. The aim of the study was to follow cardiovascular risk in white collar workers under shift work. Cardiovascular risk was studied in sound-engineering staff in sound-recording production. The study encompassed 168 employees (46% males and 54% females) working under shift work of age 48.04 ± 8.8 years and length of service 21.6 ± 4.6 years. Our data show that 31.1% of the investigated employees were hypertensive, of which 22.6% had preliminary physician’s diagnosis of arterial hypertension, showing comparatively high rates of undiagnosed hypertension, higher in males in comparison to females. The TC and HDL-C were slightly higher with the females, while the triglycerides and TC/HDL-C ratio with the males. High rates of smoking, physical inactivity, overweight and obesity were found with both genders, slightly higher with the females. The preventive approach incorporating regular medical surveillance of shift workers and health promotion covering both life style factors and shift work organization is needed for tackling CVD in shift workers for better cardiovascular health.

Open access
Clinical and Etiological Structure of Nosocomial Infections in Bulgaria for the Period 2011-2016

Abstract

Despite their partial diagnosis and registration, nosocomial infections are widespread in Bulgaria and they are of great healthcare, social and economic importance for the society. Statistical processing of official information for the period 2011-2016 shows that the incidence of registered NI among hospitalized patients in Bulgaria is below 1%. In the clinical structure of NI in the above mentioned period, the infections of the surgical site are leading with a prevailing share of 20.67%. S. aureus (19.74%) and E. coli (19.33%) have the highest incidence in the etiological deciphering of infections of the surgical site. Leading etiological agents of lower respiratory tract infections (including pneumonia) in Bulgaria are Acinetobacter spp. (24.12%) and Pseudomonas spp. (20.18%). Urinary tract infections have a relative share of 15.08% in the clinical structure of NI. They are primarily caused by E. coli (28.95%). In bloodstream infection, coagulase-negative staphylococci (S. epidermidis prevailing) are isolated in 30.58% of the cases.

Open access
The Effects of Recreation Therapy on the Habit of Smoking and Positive–Negative Symptoms Among Patients with Chronic Schizophrenia

Abstract

Schizophrenia is a psychiatric condition that has detrimental outcomes on an individual’s thinking, understanding and feelings. However, it not only affects one’s actions and emotions, but also, and quite specifically, creates an avenue for such antisocial behavior as seclusion. Hence, it is important to highlight the necessary requirements for the recovery of schizophrenic patients and subsequently delve deeper into the signs and symptoms of schizophrenia itself, especially among patients who have been confined to psychiatric care for too long. The aim of this study was to determine the effects of recreation therapy on smoking as well as the positive-negative symptoms of schizophrenia among patients who have reached the chronic stage of this condition. Essentially, this was a semi-experimental study with one pretest and one posttest. 50 patients under psychiatric care, aged between 30 to 50 years, were selected and then equally divided into the control and experimental groups. The instruments for this research were the Anderson questionnaire and the smoking cigarette questionnaire, the latter being created by the researcher. Data were analyzed using descriptive and inferential statistics. To evaluate the hypothesis of research, this study relied on a covariance analysis. Based on the results, it can be said that there were significant (p ≤ 0.05) differences between the control and experimental groups related to smoking as well as the positive-negative symptoms of schizophrenia. It shows that 4 months of recreation therapy was able to decrease the prevalence of smoking (19.9%), in addition to the positive symptoms (18.3%) and negative symptoms (14.7%) of schizophrenia within the experimental group. It is hoped that the results of this study will encourage the use of recreation therapy as a practical and non-pharmacological form of treatment for patients with chronic schizophrenia.

Open access