Scientific reviews: Vol. 9, 2015

BMJ

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arrow Vol. 9, 3/2015

Epidemiology

Hystorical development and contemporary aspects of the concept for community immunity - Bulgarian medical journal (Български медицински журнал), 9, 2015, №3, 7-13. (Abstract)
V. Doycheva 1, I. Popivanov 2, Tz. Doychinova 3 and D. Shalamanov 3

1 - Department of Epidemiology, Medical University – Sofia
2 - Military Medical Academy – Sofia
3 - Section “Infectious Diseases, Epidemiology, Parasitology and Tropical Medicine", Faculty of Public Health, Medical University – Pleven
Summary. The origin and meaning of the term “community immunity”, the main stages through which the concept of collective protection from infections passed and contemporary importance of mass immunization are discussed. The basic theoretical arguments explaining the concept of resetting the immune population after disease or immunization are presented. Indicative epidemic situations occurring after breaking the community immunity in some states and communities are described. The reasons hindering the achievement of a reliable level of immunization coverage of the population are analyzed. The ideas to optimize the epidemiological control in the field of immunoprophylaxis are rationalized.
Kеy words: community immunity, infections, epidemics
Address for correspondence: Assoc. Prof. V. Doycheva, MD, PhD, Department of Epidemiology, Medical University – Sofia, SBALAG “Maychin dom”, floor 6, room 667, 2 Zdrave St., Bg − 1431 Sofia, tel. 00359 2 9523844, e-mail: v.doycheva@abv.bg


Stenotrophomonas maltophilia: mechanisms of antimicrobial resistance - Bulgarian medical journal (Български медицински журнал), 9, 2015, №3, 14-20.
M. Bozhkova, T. Stoeva and K. Bozhkova

Department of Мicrobiology, Medical University – Varna
Summary. Stenotrophomonas maltophilia is increasingly recognized as one of the most important and problematic hospital pathogens. This bacterial species can cause a variety of infections predominantly in immunocompromised patients. The inherent resistance to multiple antimicrobial agents is an important specifi city of S. maltophilia. During the last years, the microbiological and clinical interest in this microorganism tends to increase together with the increased levels of acquired resistance in S. maltophilia to some of the most widely used antimicrobial agents in the clinical practice. The infections, caused by this multidrug resistant pathogen, are one of the most diffi cult to treat. In this review, the specifi c mechanisms of resistance in S. maltophilia to different antimicrobial agents are presented. The problematic testing of antimicrobial susceptibility of this bacterial pathogen as well as the recommendations for antimicrobial treatment of S. maltophilia associated infections are also discussed.
Key words: Stenotrophomonas maltophilia, antibiotics, mechanisms of resistance
Address for correspondence: Milena Krasimirova MD, Bozhkova, Department of Microbiology, Medical University, 55 Marin Drinov St., Bg – 9001 Varna, tel.: 00359 52/978566, e-mail: drbojkovam@abv.bg


History of medicine

Historical evolution of the concept for poor circulation of the heart as a reason for IHD (part 1) - Bulgarian medical journal (Български медицински журнал), 9, 2015, №3, 21-26.
V. Belcheva 1, K. Kafedjiiski 2 and E. Grigorov 3

1 - Faculty of Public Health, MU – Sofia
2 - Medical College, MU – Pleven
3 - Faculty of Pharmacy, MU – Varna
Summary. The article traces some of the most important moments in the history of ischemic heart disease. It elicits the role and fi ndings of many prominent physicians and distinguished scientists who have contributed to the clarifi cation of the anatomy and pathophysiology of this disease.
Key words: history, concept, ischemic heart disease
Address for correspondence: E. Grigorov, DM, Faculty of Pharmacy, Medical University, 84 Tsar Osvoboditel Blvd., Bg 9000 Varna, е-mail: evgeni.grigorov@mu-varna.bg

 

arrow Vol. 9, 2/2015

Epidemiology

Current status and perspectives for control of leishmaniasis - Bulgarian medical journal (Български медицински журнал), 9, 2015, №2, 7-11.
V. Doycheva1, I. Angelov2, I. Popivanov3, Ts. Doychinova2 and D. Shalamanov2
1Medical University – Sofia, 2Medical University – Pleven, 3Military Medical Academy – Sofia
Summary. Leishmaniasis is a parasitic disease, where the risks of morbidity activation increase. Without discounting the importance of some engaging the public and medical attention infections (fl u, haemorrhagic fever Ebola) it can be argued that Leishmaniasis is a neglected disorder. In this review it is analized the outbreak of the disease in a natural areas in the country, the Mediterranean and the Middle East. Discussed are the current clinical diagnostic and therapeutic opportunities and the perspectives for improving the effi ciency of chemical control of vectors. A short review of recently implemented and developed vaccines and prophylactics practices is presented.
Key words: leishmaniasis, epidemiology, diagnosis, therapy, insect control, immunoprophylactics
Address for correspondence: Assoc. Prof. Viktoriya Doycheva, MD, PhD, Department of Epidemiology, Medical University, USBALAG “Maychin dom” fl oor 6, room 667, 2 Zdrave St., Bg – 1431 Sofi a, tel.: 02 9523844, e-mail: v.doycheva@abv.bg

Epidemiological characteristics of viral hepatitis A in Europe and in Bulgaria 2008-2013 - Bulgarian medical journal (Български медицински журнал), 9, 2015, №2, 12-15.
V. Doycheva, Y. Mitova, S. Angelova and J. Donkov.

Department of Epidemiology, Medical University – Sofia
Summary. Viral hepatitis A (VHA) is an anthroponosis infection disease distributed to all countries of EU/EEA. The causative agent is hepatotropic picornavirus. In 2012 the countries of EC/EEA registered 13 038 cases of VHA. The overall rate of confirmed cases was 2, 60 per 100 000 population. Most affected regions are Eastern Europe and Balkan region. The largest number of cases and highest rate in 2012 are registered in Bulgaria – 4896 (66,82 per 100 000). The highest case rate in 2012 was observed in the age group 5-14 years – 5,45 per 100 000 population. During 2013 three major hepatitis A outbreaks were reported in the EU/EEA. Frozen and fresh berries have been implicated as vehicle of the infection.
Kеy words: viral hepatitis A, epidemiological situation, epidemic outbreaks, epidemiological investigations
Address for correspondence: Assoc. Prof. Viktoriya Doycheva, MD, PhD, Department of Epidemiology, Medical University, USBALAG “Maychin dom”, floor 6, room 667, 2 Zdrave St., Bg – 1431 Sofi a, tel.: 02 9523844, e-mail: v.doycheva@abv.bg


Infectology

Main etiological causes of fever of unknown origin - Bulgarian medical journal (Български медицински журнал), 9, 2015, №2, 16-26.
M. Baymakova.
Department of Infectious Diseases, Military Medical Academy – Sofia
Summary.
Fever of unknown origin (FUO) is a challenge of the thorough medical society. It’s known than over 200 diseases are the etiological causes of the persistent febrile syndrome. Five categories are accepted for the systematizing the causes: infection, neoplasm, noninfectious infl ammatory disease, miscellaneous and undiagnosed causes. Tuberculosis, endocarditis and abscesses are the leading infectious causes. Lymphomas, hepatic cancer and hypernephroma are reported as neoplasms presented with FUO. Still’s disease and polymyalgia rheumatica are among the main causes in the group of noninfectious infl ammatory diseases. In the category of miscellaneous
diseases are included various reasons as endocrinological conditions, rare and exotic diseases, genetic and autoimmune disorders. Every other case of FUO, which cause is not established, is classifi ed as an undiagnosed case.
Key words: causes, prolonged fever, etiological units
Address for correspondence: Magdalena Baymakova, MD, Department of Infectious Diseases, Military Medical Academy, 3 Georgi Sofiyski St., Bg – 1606 Sofi a, e-mail: dr.baymakova@gmail.com

Epidemiology

Bioterrorism and biological weapon - Bulgarian medical journal (Български медицински журнал), 9, 2015, №2, 27 -39.
D. Dimitrov.

Blagoevgrad
Summary. Concerns about the possible use of microbes by bioterrorists have increased signifi cantly over the past decade. The havoc that could be generated by such an attack was illustrated in 2001 when a small number of letters laced with Bacillus anthracis spores were disseminated via the U.S. postal system. Although only 22 persons became ill and fi ve geographic areas were actually affected, fear and apprehension extended across the country and around the world. There is general consensus (among those who are most knowledgeable about bioterrorism and the potential use of biotechnology for subversive goals) that the release of one or more biological agents is inevitable. The release and subsequent spread of a contagious agent, such as smallpox virus, could prove catastrophic if measures for control were not promptly and effectively applied. Equally serious would be a large-scale release of a highly lethal but non-transmissible agent, such as anthrax or botulinum toxin. The possible use of genetically modifi ed agents offers yet another dimension to the threat. It is clear that the world, including the United States, is ill prepared to deal with serious microbial challenges, whatever their source. Complacency about present capabilities to deal with these problems, such as has characterized the public health and the medical communities, is no longer an acceptable policy.
Key words: bioterrorism, biological weapon, history
Address for correspondence: Dimitar At. Dimitrov, m.u. 26 400 – Blagoevgrad, GSM: 0898 773559, e-mail: dimitrov2610@abv.bg

Dental medicine

Possibilities for assessment of injury of alveolar inferior nerve during surgical removal of impacted and semiimpacted mandibular third molars - Bulgarian medical journal (Български медицински журнал), 9, 2015, №2, 40-42.
N. Pavlov.

Dental ambulatory - Plovdiv
Summary. The injuries of the alveolar inferior nerve during the surgical removal of impacted and semiimpacted mandibular third molars are serious complications. The author analyzes the tests for subjective and objective evaluation of altered sensation of the nerve when associated with iatrogenic trauma.
Key words: alveolar inferior nerve, injury, third molar
Address for correspondence: Nikolay V. Pavlov, Oral Surgeon, 15A Lozarska St., Bg – 4000 Plovdiv, tel.: 0888254906

 

 

 

arrow Vol. 9, 1/2015

Epidemiology

Vaccines against Human Immunodefi ciency Virus – present and perspectives - Bulgarian medical journal (Български медицински журнал), 9, 2015, №1, 7-16.
V. Doycheva and Y. Mitova-Mineva.
Summary. The development of an HIV-1 vaccine is a formidable challenge. An effective HIV vaccine should be able to induce durable immunity and prevent the acquisition of infection and/or reduce virus replication in infected persons so as to slow disease evolution and reduce viral transmission.
Kеy words: Human Immunodefi ciency Virus, AIDS, preexposure immunoprophylaxis, therapeutic vaccines
Address for correspondence: Assoc. Prof. Viktoriya Doycheva, PhD, Department of Epidemiology, Medical University, SBALAG
”Maychin dom”, room 667, 2 Zdrave St., Bg – 1431 Sofi a, tel: 359 2 952 38 44, e-mail: v.doycheva@abv.bg

 

Clinical laboratory

Anemia in rheumatoid arthritis - Bulgarian medical journal (Български медицински журнал), 9, 2015, №1, 17-21.
V. Manolov1, S. Hadjidekova2, M. Velizarova1, V. Paskaleva-Peycheva3, V. Vasilev4 and K. Tzatchev4

1- Deptment of Medical Genetics, Central Clinical Laboratory, University Hospital for Active Treatment “Aleksandrovska”, Medical University – Sofia
2 - Deptment of Medical Genetics, Medical University – Sofia
3 - Rheumatology Clinic, Deptment of Internal Diseases, University Hospital for Active Treatment “Ivan Rilski”, Medical University – Sofia
4 - Deptment of Clinical Laboratory and Clinical Immunology, Central Clinical Laboratory, University Hospital for Active Treatment “Aleksandrovska”, Medical University – Sofia

Summary. Determination of serum hepcidin is still a novelty in clinical laboratory practice in Bulgaria. Its determination routine would facilitate the correct selection of a therapeutic approach for the treatment of abnormal iron metabolism in patients with rheumatoid arthritis. The level of hepcidin may differentiate patients with a functional iron defi ciency and a reticuloendothelial blockade. In these cases the quantitative determination of hepcidin can serve to monitor the degree of iron overload in the body, to provide information to physicians about the effi cacy of therapy and to alert in case of toxic over-accumulation. Low levels of the hormone can identify the patients most likely suitable for oral administration of iron.
Key words: anemia, rheumatoid arthritis, hepcidin, infl ammation
Address for correspondence: Victor Manolov, MD, Department of Medical Genetics, Medical University, 1 “Sv. Georgi Sofi yski” St.,
Bg – 1431 Sofi a, phone: +359 2 9230 928; GSM +359 887 222 069, e-mail: victhedoc2@yahoo.com

 


Endocrinology

 

Metabolic changes during menopause - Bulgarian medical journal (Български медицински журнал), 9, 2015, №1, 22 -27.
D. Gavrailova, A. Dimitrova and D. Hadgideleva.

Faculty of Public Health, Medical University – Sofia
Summary. Menopause represents a period of accelerated physical, physiological, and neuroendocrine aging in women. The constellation of adverse changes that occurs in response to the altered hormonal environment characterizing menopause, especially the sharp decline in estrogens that marks this transition, results in a dramatic rise in the risk of cardiovascular disease (CVD).
Key words: menopause, metabolic syndrome, cardiovascular disease
Address for correspondence:
Daniela Gavrailova, MD, Medical University  Sofi a, Faculty of Public Health, 8 Byalo more St.,
Bg – 1527 Sofi a, tel.: + 359 2 9432-219, e-mal: ditcheli@abv.bg

 


Neurology


Role of immunity and neuroinfl ammation in the pathogenesis of epilepsy - Bulgarian medical journal (Български медицински журнал), 9, 2015, №1, 28-33.
E. Haritov, E. Angeleska and N. Boyadjieva.
Department of Pharmacology and Toxicology, Medical Faculty, MU – Sofia
Summary. Epilepsy is one of the most common chronic brain disorders, that affects 1% of the human population. Experimental and clinical studies suggest that there is a positive feedback cycle between neuroinfl ammation and epileptogenesis. Epileptic activity lead to increase of key infl ammatory mediators and activates immune responses in the brain. This in turn promotes the neuronal excitability and the likelihood of recurrent spontaneous seizures. In this review we describe data of preclinical and clinical studies, wich showed the role of neuroinfl ammation in the pathogenesis of epilepsy. We discussed several proinfl ammatory pathways, like IL-1R/TLR signaling cascade, wich are involved in the immune response of the brain after seizures. Finally we highlighted the immune mechanisms of epiletogenesis. Infl ammatory mediators, such cytokines and prostaglandins could be therapeutic targets for the development of new antiepileptic drugs, wich infl uence on pathogenetic course of epilepsy.
Key words: epilepsy, epileptogenesis, immune response, neuroinfl ammation, proinfl ammatory cytokines
Address for correspondence:
E. Haritov, MD, Department of Pharmacology and Toxicology, Medical Faculty, Medical University, 2 Zdrave St., Bg - 1431 Sofi a, e-mail: evgeniharitov@gmail.com

 


Dental medicine


The effects of the ER:YAG lasers (λ = 2940 nm) on the vital tissues.- Bulgarian medical journal (Български медицински журнал), 9, 2015, №1, 34-37.
B. Blagova.
Department of Oral Surgery, Faculty of Dental Medicine, Medical University – Plovdiv

Summary. The Er:YAG lasers are fi nding wider application in the medicine. Many in vitro and in vivo studies have been performed in recent years. Their main aim was to specify exactly and understand the direct laser effects on the vital tissues, on their morphology and functions. Based on the publications in many scientifi c journals and the questions arised, it was taken the decision a review of these effects to be done. Articles up to the present moment were used as a main information source. A retrospective analysis of the authors’ results was performed.
Key words: Er:YAG lasers, oral surgery
Address for correspondence: Dr Bistra Blagova, assistant professor, Department of Oral Surgery, Faculty of Dental Medicine, 3 Hristo Botev Blvd., Bg - 4000 Plovdiv, tel.: + 359 87 88 43 408, e-mail: bistra_blagova@abv.bg

Coronectomy – a method for treatment of impacted and semi-impacted mandibular third molars - Bulgarian medical journal (Български медицински журнал), 9, 2015, №1, 38-40.
N. Pavlov.

Summary. Coronectomy is a technique that reduces morbidity of n. alveolaris inferior after operation on high-risk impacted and semiimpacted mandibular third molars. The author describes the basic tehnique of coronectomy and critically discusses the benefi ts and the danger of the method.
Key words: coronectomy, third molar, mandible
Address for correspondence: Dr N. Pavlov, оral surgeon, 15A Lozarska St., Bg – 4000 Plovdiv, tel.: +359 888254906

 

 

 

 

 

 

Last update: 12.02.2016

 

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