Scientific reviews: Vol. 10, 2016

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Vol 10, 1/2016

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Vol 10, 3/2016



arrow Vol. 10, 3/2016

Dermatology

Fotoprotective agents - Bulgarian medical journal (Български медицински журнал), 10, 2016, №3, 7-12.
D. Brambarova1 and R. Yankova2

1Department of Dermatology and Venereology, Faculty of Medicine, Medical University – Plovdiv,
2Head of Dermovenereology and Allergology Center, UMBAL „Pulmed“ – Plovdiv
Summary. Topical drugs and cosmetic products frequent cause cutaneous reactions due to changed sensitivity and photosensitivity. Bulgarian Dermatology Society organizes every year campaign ‘Euromelanoma’. The aim of the campaign is to inform the society for hazardous effects of UV radiation, the risk of skin cancers and prevention through photoprotection. There is a data for safety profi le and side effects in the literature for active ingredients of topical photoprotective agents. Our experience in last three years about safety profile of most frequent used topical photoprotective agents, including tinted agents, shows that skin sensitivity and photosensitivity reactions are very rare.
Key words: photoprotection, topical photoprotective agents, UV rays, skin sensitivity and photosensitivity, cosmetic products
Address for correspondence: D. Brambarova, MD, Department of Dermatology and Venereology, Faculty of Medicine, Medical University, 15A, V. Aprilov Bvld., Bg – 4002 Plovdiv, tel.: +359 876781555, e-mail: d.brambarova@abv.bg


Epigenetics

Epigenetics of aging - Bulgarian medical journal (Български медицински журнал), 10, 2016, №3, 13-17.
G. Bogdanov, R. Metodieva and N. Boyadjieva

Department of Pharmacology and Toxicology, Medical Faculty, Medical University – Sofia
Summary. Aging is a physiological process which is associated with different acute or chronic diseases. It is well documented that the frequency of cardiovascular, neurodegenerative, metabolic and malignant diseases increases in people over 60 years of age. All of these diseases have different pathophysiological mechanisms but also there is a common element – genes responsible for aging. In the recent years there is increased research on the epigenetic mechanisms involved in the pathogenesis of many diseases, including the ones connected with aging. Epigenetics studies the changes in the genome which do not alter the DNA sequence. Target for epigenetic changes are the histones which determine the stability of the DNA and the expression of different genes. The aim of the current review is to present the published data for the epigenetic mechanisms of aging and the related chronic diseases.
Кey words: epigenetics, aging, neurodegenerative, cardiovascular, metabolic, malignant diseases
Address for correspondence: Georgy Asenov Bogdanov, MD, epartment of Pharmacology and Toxicology, Medical Faculty, Medical University, 2 Zdrave St., Bg - 1431 Sofia, е-mail: dr.georgi.bogdanov@mail.bg, GSM: +359 889501994


Labour medicine

COPD as socially signifi cant disease in which important etiological cofactor are unfavorable working conditions and lack of adequate prevention - Bulgarian medical journal (Български медицински журнал), 10, 2016, №3, 18-25.
A. Vatkova.

Medical Faculty, Sofia University – Sofia
Summary. COPD is a widespread chronic disease with exceptional social signifi cance. Many factors are leading to the development of this disease as one of the causes of deterioration is the exposure to harmful factors of the working environment. In this work, we will consider COPD as a result of harmful respiratory occupational exposure on workers from different professional groups. Diffi culties in determining of this disease as occupational stem mostly from its multifactorial etiology, although the presence of such occupational exposure in occupational biography of the patient points to its professional genesis. Work-related COPD, however, is almost never isolated etiologically and is accompanied by many other causal factors such as genetic predisposition, residence, and smoking. For the emergence and development of COPD, the adverse occupational exposure plays a huge role. In this article we looked at a number of scientifi c studies in different parts of the world, dedicated to tracing of the occupational noxa in the emergence and development of COPD.
Key words: COPD, FEV, FVC, emphysema, bronchitis, vapor, gases, steam, silica dust, occupational respiratory exposure, socially significant disease
Address for correspondence: Albena Vatkova, Medical Faculty, Sofi a University ‘’Sv. Kliment Ohridski’’, 1 Bogatitsa St., Bg – 1407 Sofia, e-mail: hariomabby@abv.bg


Lead exposure and lead intoxication are still health problem at the work place - Bulgarian medical journal (Български медицински журнал), 10, 2016, №3, 26-35.
A. Vatkova.
Medical Faculty, Sofia University – Sofia
Summary. Lead is known from the past, and is used for production of various materials widely used in households and industry. The toxic effects of lead have been known since antiquity. Hippocrates and Pliny provide mentions of the poisonous effect of lead in manufacturing conditions, most commonly in ore mining. In today’s world, toxicological characterization of lead is well known and observations on its impact, both in the environment and as occupational exposure are carried out by more than 100 years. Even Prof. Robert Lane, one of the veterans in occupational medicine, made observations and wrote papers on occupational exposure to lead in the second half of 19th century. However, today we continue to register cases of acute and chronic intoxication with lead, which leads us to continue the discussion on this topic. This article discussed a number of scientifi c studies related to damages to multiple organs and systems in the body due to chronic occupational lead poisoning. Results of studies remind us that this problem should not be underestimated, and to develop targeted prevention programs focusing on education of those working in risky industries, focusing on the use of respirators, without being in breach of hierarchical control. Some researchers propose to secure additionally and if possible, to limit proceedings related to lead exposure that are not essential to the production profi le of the countries, and when possible, lead and its compounds, to be replaced by suitable alternatives.
Key words: inorganic lead, organic lead, lead poisoning, lead exposure
Address for correspondence: Albena Vatkova, Medical Faculty, Sofia University ‘’Sv. Kliment Ohridski’’, 1 Bogatitsa St., Bg – 1407 Sofi a, e-mail: hariomabby@abv.bg

 

arrow Vol. 10, 2/2016

Mycotoxins as a biological weapon - Bulgarian medical journal (Български медицински журнал), 10, 2016, №2, 7-12.
T. Vrabcheva
National Center of Public Health and Analyses

Summary. The potential for biological weapons to be used in terrorism is a real possibility. Biological weapons include infectious agents and toxins. Toxins are poisons produced by living organisms. Toxins have properties of biological and chemical weapons. Unlike pathogens, toxins do not produce an infection. Biological warfare agents may be more potent than conventional and chemical weapons. During the past century, the progress made in biotechnology and biochemistry has simplifi ed the development and production of such weapons. In addition, genetic engineering holds perhaps the most dangerous potential. A biowarfare attack would not only cause sickness
and death in a large number of victims but would also aim to create fear, panic, and paralyzing uncertainty. Mycotoxins are defi ned as naturally occurring toxic compounds obtained from fungi. They are the biggest chronic health risk when incorporated into the diet. The current list of fungal toxins as biochemical weapons is small, although awareness is growing of the threats they may pose. Aflatoxin B1, fumonisin B1, ochratoxin A, and the trichothecenes T-2 toxin and deoxynivalenol could be weaponized for bioterrorism. All of these mycotoxins except deoxynivalenol are carcinogens. T-2 toxin is perhaps the biggest concern. Mycotoxins are impractical as tactical weapons, but they can be used by small poor terrorist organizations to poison food and water sources or can be released in crowded, confi ned areas. Knowledge of the symptoms of intoxication and the biochemical mechanisms of action of mycotoxins is necessary for the rapid identifi cation of the toxins, the development of prophylactic antidotes, and the design of effective treatments of affected persons.
Key words: microscopic fungi, mycotoxins, bioweapons
Address for correspondence: Assoc. Prof. Terry Vrabcheva, MD, PhD, National Center of Public Health and Analyses, 15 „Akad. Ivan Geshov” Blvd., Bg – 1431 Sofia, tel.: 02/8056391, e-mail: t.vrabcheva@ncpha.government.bg



Lung transplantation. Part I. History, problems. - Bulgarian medical journal (Български медицински журнал), 10, 2016, №2, 13-16.
A. Semkov, D. Yankov and D. Petrov

Clinic for Thoracic Surgery, SHATPD “Sv. Sophia”, Medical University – Sofia
Summary. The possibility of transplantation of tissues and organs is one of the greatest achievements in medicine. Transplantology overcomes many technical limitations as this evolution involves almost all medical specialities. The results of transplantation are constantly improving in contribution with the criteria for selecting candidates, preparation and opportunities for intensive care. The fi rst reports of transplantation of tissues and organs are dated from the 19th and early 20th century. By the mid-50’s the technical features of lung transplantation are been studied on dogs. The fi rst successful lung transplantation on a dog was described by Metras in France in 1950. The fi rst lung transplantation on human has been made in the US by James Hardy in 1963. In the 80’s lung transplantation has serious development. In the 90’s technical details of lung transplantation standardize. In the following decades, the number of lung transplantations increases, while that of heart-lung transplantations decreases, and the results are improved in both types. The report of ISHLT from 2015 reported 51,440 lung transplantations and 3,820 heart-lung transplantations in adults.
Key words: Lung transplantation- history, methods, results
Address for correspondence: Dr Anatoli Valentinov Semkov, Clinic for Thoracic Surgery, SHATPD “Sv. Sophia”, Medical University, 19 Iv. Geshov blvd., Bg – 1431 Sofia




Lung transplantation. Part II. Indications, selection, surgical technique postsurgery conduct and results. - Bulgarian medical journal (Български медицински журнал), 10, 2016, №2, 17-25.
A. Semkov, D. Yankov and D. Petrov

Clinic for Thoracic Surgery, SHATPD “Sv. Sophia”, Medical University – Sofia

Summary. Over the past 25 years lung transplantation is the main therapeutic method for patients with lung diseases in fi nal stage. In this paper the indications and methods for lung transplantation, criterias for selection of recipients and their eligible donors, postoperative therapy, possible complications and outcomes in short and long term are discussed. The specifi c indications in various diseases and contraindications are described. The post-transplant complications are also included with their symptoms and options for treatment.
Key words: Lung transplantation – indications, contraindications, results.
Address for correspondence: Dr Anatoli Valentinov Semkov, Clinic for Thoracic Surgery, SHATPD “Sv. Sophia”, Medical University, 19 Iv. Geshov blvd., Bg 1431 Sofia

 



Opportunistic pnemonias in HIV infection - Bulgarian medical journal (Български медицински журнал), 10, 2016, №2, 26-37.
N. Yancheva

Department for Infectious Diseases, Parasitology And Tropical Medicine,
Department for AIDS, SHATIPD „Prof. Ivan Kirov“, MU – Sofia

Summary. The patients with HIV infection are at higher risk to develop majority of opportunistic pneumonia, neoplasm and other chronic pulmonary diseases. The etiology of HIV-associated pneumonia is broad and includes bacterial, fungal, viral and parasitic causative agents. The aim of this review is to present the etiology, major clinical symptoms, diagnostic methods, treatment and prevention of the HIV associated pneumonia. The correct diagnosis, suitable treatment and prophylaxis of the HIV associated pneumonia are important stages in the strategy for lowering the morbidity and mortality connected with HIV/AIDS.
Key words: HIV infection, AIDS, opportunistic pneumonia
Address for correspondence: Dr Nina Yancheva, Department for AIDS, SHATIPD „Prof. Ivan Kirov“, 17 “Academician Ivan Geshov” Blvd., Bg – 1606 Sofi a, е-mail: dr.yancheva@abv.bg

 



Antibiotic therapy in the therapeutic algorithm allergic rhinitis in childhood - Bulgarian medical journal (Български медицински журнал), 10, 2016, №2, 38-41.

A. Spassova and Sv. Velizarova
University Children’s Clinic for Lung Diseases, SHATPD „Sv. Sofia“

Summary. Allergic rhinitis is a widely spread disease. This is the most common allergy suffering, affecting 10-40% of the population in the world with a progressive increase in its frequency. In evaluative disease progression upper respiratory tract is infected with bacterial pathogens. Under these circumstances the disease already has infectious-allergic character. Conducting of an etiologically determined antibiotic therapy as a fi rst stage of the therapeutic algorithm is extremely important requirement for achieving good therapeutic effect.
Key words: allergic rhinitis in children, allergic symptoms, antibiotic therapy
Address for correspondence: A. Spassova, MD, University Children’s Clinic for Lung Diseases, SHATPD „Sv. Sofi a“, 19 Iv. Geshov blvd., Bg – 1431 Sofia

 



Allergic rhinosinusitis – diagnostic algorithm in childhood - Bulgarian medical journal (Български медицински журнал), 10, 2016, №2, 42-43.
A. Spassova and Sv. Velizarova

University Children‘s Clinic for Pulmonary Diseases, SHATPD „Sv. Sofi a“ – Sofia

Summary. Allergic rhinosinusitis is one of the most common allergic diseases. Non-treated allergic rhinosinusitis has a signifi cant negative impact on quality of life in previously untreated patients. In clinical practice, diffi culties arise in the identifi cation of various types of rhinitis. An exact diagnosis depends on knowledge of the anatomy and physiology of paranasal sinuses. Based on this background a diagnostic algorithm is created, which is consistent with the European Consensus on allergic rhinosinusitis.
Key words: Allergyc rhinitis in children, eosinophils, eosinophil cationic protein, IgE
Address for correspondence: A. Spassova, MD, University Children’s Clinic for Lung Diseases, SHATPD „Sv. Sofi a“, 19 Iv. Geshov blvd., Bg – 1431 Sofia

 



Behavior in haemothorax - Bulgarian medical journal (Български медицински журнал), 10, 2016, №2, 47-51.
G. Yankov, A. Semkov and D. Petrov

Clinic for Thoracic Surgery, SHATPD „Sv. Sofi a”, Medical University – Sofia
Summary. A brief survey of different treatment methods of haemothorax is discussed and a management algorithm is presented. The last is with a practical signifi cance and is directed to a broad spectrum of medical specialists. The haemothorax etiology and pathogenesis are considered as well. The management of this occasionally urgent and life threatening conditions are divided into two stages: (a) initial therapeutic procedures in early stage, indications for surgery (open or VATS), the rationale for prophylactic antibiotic treatment and intrapleural fi brinolytic therapy in patients with tube thoracostomy, and (b) indications for thoracotomy or VATS in the late stage.
Key words: haemothorax, management, indications for surgery
Address for correspondence: Prof. Danail Petrov, MD, Clinic for Thoracic Surgery, SHATPD „Sv. Sofi a”,19 “Ivan Geshov Blvd., Bg – 1431 Sofi a, , e-mail: danail_petrov@hotmail.com, tel.: +359887234759



arrow Vol. 10, 1/2016

Epidemiology

The Anthrax − as a means of biological warfare and bioterrorism - Bulgarian medical journal (Български медицински журнал), 10, 2016, №1, 9-13.
Ts. Mincheva(1), V. Doycheva(1), D. Shalamanov(2) and Ts. Doychinova(2)
(1)Department of Epidemiology, Medical University – Sofia; (2)Section „Infectious Diseases, Epidemiology, Parasitology and Tropical Medicine“, Faculty of Public Health, Medical University – Pleven

Summary. Presented is a modern characteristic of a biological weapon. Performed is an historical overview of biological programs developed by individual countries in part related to Anthrax infection. Discussed are in detail various aspects of bioterrorism and it is mentioned the Anthrax mail in the USA in 2001. Indicated is the laboratory accident with Anthrax in 1979 and the new possibility of infection by heroin contaminated with Anthrax spores.
Key words: Anthrax, biological weapon, bioterrorism
Address for correspondence: Dr. Tsvetanka Mincheva, Department of Epidemiology, Medical University, SBALAG, “Maychindom”, floor 6, room 665, Bg – 1431 Sofia, tel.: 00359 9523844

 

Pharmacology

Bleomycin-induced pulmonary fi brosis, mechanisms - Bulgarian medical journal (Български медицински журнал), 10, 2016, №1, 14-20.
V. Dancheva, G. Stavreva and L. Terziev.

Medical University – Pleven
Summary. Мore than 10% of patients treated with bleomycin may be affected by specifi c side effects in the lungs. The mechanisms underlying the drug-induced pulmonary fi brosis are not fully understood. A defi ciency of the enzyme responsible for the metabolism of bleomycin to nontoxic molecules, oxidative damage, pro- and anti-infl ammatory cytokines are involved in the development of interstitial pulmonary disease. This review is focused on the main pathogenetic mechanisms leading to imbalance in the processes of formation of collagen and collagenolysis accumulation of connective tissue dysfunction and embarrassed gas exchange in the lungs. Оwn results for pneumоtoxic changes after intratracheal administration of bleomycin at a dose of 2.5 mg/kg in rats were compared and analyzed.
Key words: bleomycin, fi brosis, interstitial pulmonary disease, cytokines
Address for correspondence: Assoc. Prof. V. Dancheva, MD, Medical University, 1 Kliment Ohridski St., Bg  5800 Pleven, tel.: 00359 887 468717, sl. tel.: 00359 64/884288, e-mail: vilidana@abv.bg

 

 

Dental medicine

Oral lichen planus - Bulgarian medical journal (Български медицински журнал), 10, 2016, №1, 21-25.

Ts. Tsvetanov.
Department of Oral Surgery, Faculty of Dental Medicine, Medical University – Plovdiv

Summary. Oral lichen planus (OLP) is one of the most common diseases of the oral mucosa, which affects 1-3% people worldwide. Experimental and clinical trials show the connection between antigen-specifi c and non-specifi c mechanisms and OLP. Abnormal expression of various infl ammation-related cytokines may lead to the onset of immune defi ciency and these are the central agents in the immunopathogenesis. In this review are described some datas about the frequency, oral lichen forms, etiology and pathogenesis of OLP disease. Clinical symptoms and treatment methods are described. The basic information sources are up to date articles. The author‘s results are retrospectively analysed.
Key words: treatment, oral lichen planus (OLP), pathogenesis
Address for correspondence: Tsvetan Tsvetanov, Ph.D, D.D.S., Chief Assistant, Department of Oral Surgery, Faculty of Dental Medicine, Medical University, 3 Hristo Botev Bvd, Bg – 4000 Plovdiv, tel.: 00359 898-32-53-32


Ultrasound – application in oral surgery - Bulgarian medical journal (Български медицински журнал), 10, 2016, №1, 26-29.
B. Blagova and P. Pechalova
.

Department of Oral Surgery, Faculty of Dental Medicine, Medical University – Plovdiv, Bulgaria
Summary. The aim of our research of literature was to fi nd out and summarize the latest data about ultrasound and evidence-based conclusions for its practical application in oral surgery. The on-line publications were limited so far as to the last ten years and were analyzed. Following the syntheses of the results and the conclusions in the published research works about the ultrasound in oral surgery, it can be deduced that there is a wide fi eld for application of this physical phenomenon making it a real alternative to the conventional methods and devices.
Key words: oral surgery, piezosurgery, ultrasound
Address for correspondence: Dr Bistra Blagova, Assist. Prof., 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
Funding: A research project Grant from Medical University – Plovdiv, Bulgaria: СДП 06МлУ/2015 г.

 

 

Surgery

Hernia meshes – problems and solutions - Bulgarian medical journal (Български медицински журнал), 10, 2016, №1, 30-34.
S. Sopotensky (1), M. Kirilova-Doneva (2, 3), D. Pashkuleva (3), N. Gerassimov (2) and G. Petrova (2)
(1)UMBAL „Pirogov", (2)Faculty of Pharmacy, MU – Sofia, (3)Institute of Mechanics, Bulgarian Academy of Science

Summary. Hernia is a socially important disease leading to huge economic cost. There are 750 000 surgical operations in the USA. In Germany are registered yearly 150 000 (0,4%) new cases of inguinal hernia, and 10-15% of all operations are herniatomies. In Russia 3-4% of the population suffers from hernia. The current study described the analysis of the problems and possible solutions
for choice of hernia meshes that should be taken in consideration from surgeons. It was reviewed the importance of the meshes characteristics, main problems during hernia surgery, complications, reoperations and lethality. Hernia meshes are selected only on the basis of their shape and heaviness, and there is a lack of consistency regarding their elasticity and deformation, that could lead to pressure over surgery. In conclusion it could be said that due to the lack of clarity for technical characteristics of hernia meshes over their packages is necessary to be created patients registry, describing the characteristics for every particular patient and each device.
Key words: hernia meshes, factors for meshes choice, characteristics of hernia meshes
Address for correspondence: Miglena Kirilova-Doneva, Faculty of Pharmacy, Medical University, 2 Dunav, St., Bg – 1000 Sofia, e-mail: miglena_doneva@abv.bg

 

 

Gastroenterology

 

Esophageal infections - Bulgarian medical journal (Български медицински журнал), 10, 2016, №1, 35-41.
A. Kotzev (1) and M. Mirchev (2).
(1)Gastroenterology Unit, University Hospital „Alexandrovska”, Medical University – Sofia, (2)Clinic of Gastroenterology, University Hospital „Sv. Marina”, Medical University – Varna
Summary. Infections of the esophagus usually occur in immunocompromised patients, but esophageal infections can be developed as well in immunocompetent hosts. The esophageal infections are caused by fungi, viruses, bacteria and parasites. The major symptoms in esophageal infections include dysphagia and odynophagia. The diagnosis is confi rmed by endoscopy and histological assessment of biopsy material. Тhe therapy of esophageal infections is performed by specifi c antifungal, antiviral, antibacterial, and antiparasitic drugs, and if necessary, with endoscopic and surgical methods.
Key words: esophagus, infection, immunity, risk factors, diagnosis, endoscopy, histology, therapy
Address for correspondence: Andrey Kotzev, M. D., Gastroenterology Unit, University Hospital „Alexandrovska”, 1 Sv. G. Sofiyski St., Bg − 1431 Sofi a, е-mail: dr_andrey_kotzev@abv.bg

 

 

 

 

 


Last update: 23.01.2017

 

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