Dancho P. Dekov, Ivan N. Ivanov, Sergey D. Kostadinov, Savelina L. Popovska, Petko I. Lisaev and Plamen D. Dorovski
The study is a statistical analysis of the dynamics and structure of forensic autopsies performed on dead bodies and body remains at University Hospital “Dr. Georgi Stranski” in Pleven. The study was based on forensic autopsy records database and forensic autopsy reports for the period 2009-2013. A total of 976 cases, including forensic autopsies, exhumations, examination of bone remains and inspection of dead bodies at the site of death (without following forensic autopsy), were analyzed. The studied data was coded and processed with Microsoft Excel software. A detailed data analysis of the number of autopsies, frequency of death by cause, distribution of death by gender, age, residence, place of death and its forensic category is presented. According to our results, the deaths due to diseases comprised 35% of all forensic autopsies. The most common cause of violent death was damage by mechanical factors (53%), followed by asphyxia (24.7%). The most common mechanical factor was vehicle crash trauma, followed by falling (22.5%). Accidents were the most common cause of death 62%, followed by suicides (31 %) and homicides 7%. Fifty-nine percent of the suicides were by hanging. The preliminary analyses of the studied data lead to several conclusions. The number of forensic autopsies was found to be progressively decreasing, but the road traffic death rate remained unchanged. Most of the forensic autopsies were performed in July. The highest death rates by age was observed in the age group between 51 and 60 years, with predominance of males over females (3.3 males: 1 females).
Georgi D. Bonchev, Snezha Z. Zlateva and Marieta I. Yovcheva
The aim of the study was to carry out a toxicological chemical analysis of methanol in detectable quantities in the blood of patients with acute alcohol intoxication. Blood samples from 85 patients with acute alcohol intoxication were analysed for the presence of methanol. All patients with acute methanol intoxication were excluded from the study. The methods of gas chromatography with vapor-phase analysis (head-space) and flame ionization detection (FID) were used. The limit of detection (LOD=0.015 g/L) and the limit of quantification (LOQ=0.025 g/L) of methanol in whole blood were evaluated. In 30% of the cases, methanol was found in the blood in detectable quantities. The levels of methanol were on the average 5 to 6 times lower than the toxic methanol level (0200 g/L) and they were not due to natural metabolic processes (ingestion of fruit, fruit juices or vegetables). No reliable statistically linear correlation between the concentration of ethanol and methanol was found. Methanol subintoxications are major factors in alcohol intoxications, in which the quantity of the alcohol ingested is not as important as its quality. Chronic methanol subintoxication of people who often consume alcohol of poor quality is discussed.
Svetlana A. Mateva, Margarita R. Nikolova, Alexandar V. Valkov and Margarita R. Nikolova
Liposarcoma is one of the most common soft tissue sarcomas in adults with a relative incidence amongst other sarcomas ranging from 9.8% to 16%. It usually locates in the limbs and retroperitoneum. Primary liposarcomas of the larynx and hypopharynx are rare, comprising less than 20% of all head and neck liposarcomas. According to World Health Organization, these tumors are divided into four histologic types, and well-differentiated liposarcoma is the most common one. It is a tumor of low-grade malignancy that may recur locally, but does not metastasize. We present a case of laryngopharyngeal well- differentiated liposarcoma in an old patient with two previous removals. We also discuss recently published cases with this unusual location of liposarcoma.
Desislava P. Petrova, Sotir T. Marchev and Boyko D. Kuzmanov
Since 1994, alcohol septal ablation (ASA) has been used as a minimally invasive treatment of patients with hypertrophic obstructive cardiomyopathy, resistant to conservative medical therapy. This catheter-based intervention consists of injecting absolute alcohol in a septal perforator to induce infarction of the hypertrophied septum and thus diminish the left ventricle outflow tract obstruction. This reduction of the gradient is associated with reduction of symptoms and left ventricle remodeling. The procedure was improved after the introduction of myocardial contrast echocardiography for visualization of the area at risk of infarction and reduction of the alcohol amount. Major complications of ASA are rare but centers with experience have reported conduction disorders - about 10% of patients needed permanent pacing because of complete AV block. Large randomized prospective studies have not yet compared alcohol septal ablation to the gold standard for treatment of hypertrophic obstructive cardiomyopathy - surgical myomectomy.
Katerina D. Simeonova, Krassimir D. Dimitrov and Nikolay D. Danchev
The present study demonstrates the antihypertensive effect of magnesium sulfate (Cormagnesin®) and its combination with Furosemide on conscious spontaneously hypertensive rats (SHR) after intravenous infusion. Experiments were carried out on six groups of conscious male SHR (n=6). Under short anesthesia the rats were chronically instrumented for intravenous (i.v.) drug administration. The arterial blood pressure (AP) was measured by indirect tale method. Cormagnesin® was applied by i.v. infusion in doses of 5, 20 and 40 mg/kg; and furosemide (10 mg/kg) was applied intraperitoneally. Experimental results showed significant decrease of AP after i.v. infusion of 20 mg/kg Cormagnesin® as well as after application of the Cormagnesin® and furosemide combination. The hypotensive effects of 40 mg/kg Cormagnesin® and of furosemide were not significant. There was no significant difference between the antihypertensive effects of Cormagnesin® and its combination with furosemide but the combination showed much better hypotensive effect than Furosemide (p<0.05). Our study demonstrated the antihypertensive effect of magnesium sulfate on conscious SHR after i.v. application. Our results suggest that the antihypertensive effect of magnesium sulfate in the doses applied is not dose-dependent. Magnesium sulfate potentiates the antihypertensive effect of furosemide in SHR.
Tsvetelina Valentinova, Magdalena I. Balashkova, Vania M. Nedkova-Milanova and Lyubomira D. Gadjelova
This study aimed to investigate the opinion of students of medicine, nursing and midwifery on their training in communication skills as an optional course. The participants included in the study were 126 students altogether. Information was gathered using a self-administered questionnaire. The results showed the level of motivation to participate in the training process, the results desired and achieved by the students and their evaluation of the quality of the training. The respondents were convinced that such training would be an asset for their future work as medical professionals and they were satisfied with the quality of training.
Jacob Moreno defined sociometry as “the inquiry into the evolution and organization of groups and the position of individuals within them”. Every person composes their own group of significant others and the social relations in this dominated by the person group of the most important people in their life is called sociometric profile. The sociometric profile provides an opportunity to reveal social bonds, dependences and influences that impact one's behavior. The aim of the study was to describe the sociometric profile of regularly drinking adolescents as a result from comparison with the sociometric profile of non-drinking adolescents. We conducted a survey among 903 students (aged 15-19), by means of a self-administered questionnaire about relations with father, mother, friends and lovers. Of these, 169 identified themselves as regular drinkers (RDAs) and 279 ‒ as abstainers (NDAs). We compared these groups to reveal the comparative sociometric profile of drinking adolescents. It was found that RDAs were significantly more likely to be: 1) highly dependent on their lovers (OR=1.6); 2) detached from their mothers (OR=4.55); 3) in ambivalent relations with their friends; 4) without significant differences in relations with their fathers. It seems that the Stars of RDAs are their lovers, the Isolates are their mothers and friends are their ambivalent Mutual Choice. This comparative sociogram suggests that lovers are likely to be the most influencing person among RDAs' significant others and intimate relations might be the main target in alcohol prevention programs.
Aronia melanocarpa fruit juice (AMFJ) is very rich in polyphenolic compounds. Quercetin is a naturally occurring flavonoid, one of AMFJ polyphenols. The aim of the present study was to investigate the effect of AMFJ in comparison with quercetin in a model of paracetamol-induced hepatotoxicity in rats. AMFJ at doses of 2.5 and 5.0 ml/kg and quercetin at doses of 50 and 100 mg/kg were administered daily orally from day 1 to day 7 to different animal groups. Paracetamol was applied intraperitoneally (1.0 g/kg) on day 5. Blood and liver ware taken for biochemical investigations on day 7. Liver toxicity was estimated by the serum activities of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Oxidative stress was estimated by the levels of thiobarbituric acid reactive substances (TBARS) in liver homogenate and serum. Paracetamol caused a significant elevation of serum AST and ALT, and induced lipid peroxidation as measured by the significant increase of TBARS in serum and liver. In animals pretreated either with AMFJ or quercetin, liver enzyme activities did not differ significantly from the control levels. Both AMFJ and quercetin prevented the elevation of TBARS in the liver at the two applied doses and in the serum only at the higher of the tested doses. In the present model of paracetamol-induced hepatotoxicity, the protective effect of AMFJ was comparable to that of quercetin.
Doroteya V. Malinova, Penka L. Kolova and Radoslav S. Radev
Congenital cystic adenomatoid malformation (CCAM) is a rare abnormality of lung development. It was classified into 5 types by Stocker in 2002 and is also known under the name of congenital pulmonary airway malformation (CPAM). Cases are typically identified prenatally by routine ultrasonography screening. CCAM may present in the older child and adult as an incidental finding. The case presented is of a 21-year-old male patient who suffered from pulmonary infections with a recurrent productive cough 3-4 times the last 4 years. CT scanning of the thorax showed multiple cystic lesions in the right middle and lower lobes. The areas with the lesions were resected. The macroscopic and histological findings were typical for congenital cystic adenomatoid malformation type 2, which was the final diagnosis. Clinical presentations and prognosis depend on the type of lesion and its sequelae. The diagnosis is confirmed histologically.
Doroteya V. Malinova, Penka L. Kolova and Radoslav I. Georgiev
Epidermoid cysts are benign lesions composed of ectodermal structures. They account for less than 2% of primary intracerebral tumors. They can be present at birth (congenital cysts), or can be acquired cysts (after surgery or trauma). Some cysts are asymptomatic but depending on their location, they may cause symptoms such as headache, vertigo, seizures, focal deficits, increased intracranial pressure. The major differential diagnosis of epidermoid cysts are dermoid cyst, any cystic neoplasm, craniopharyngioma, arachnoid cyst. A 39-year-old female patient with complaints of headache, vertigo, nausea and vomiting was admitted to the hospital. Radiological data suggested intracranial tumor in fossa posterior. Craniotomy was performed and the biopsy specimen demonstrated the mass lesion to be an epidermoid cyst of the intracranial dermal sinus tract. Intracranial cystic-appearing masses can be problematic for both radiologists and physicians. Important characteristics demonstrated by computed tomography scans and classical magnetic resonance imaging sequences are significant for the accurate diagnosis, but the imaging appearances of intracranial cystic lesions are sometimes nonspecific, and the diagnosis is usually established by histological examination.