Medical University of Varna

About: Medical University of Varna is a education organization based out in Varna, Varna, Bulgaria. It is known for research contribution in the topics: Population & Medicine. The organization has 1199 authors who have published 1273 publications receiving 32940 citations. The organization is also known as: MU-Varna & Higher Medical Institute of Varna.

Diagnostic value of fine needle aspiration biopsy of space-occupying soft tissue lesions in the head and neck region

Abstract: Заболяванията на меките тъкани на главата и шията са разнообразни по своя характер патология - бенигнени и малигнени тумори, кистозни образувания, възпалителни процеси. Морфологичното им диагностициране определя терапевтичния подход. Лесно приложим и с най-малко странични ефекти диагностичeн метод е тънкоиглената аспирационна биопсия (ТАБ), съчетана с, или предшествана от образни изследвания. В настоящото проучване са представени 69 случая на ТАБ от обемзаемащи процеси на меките тъкани в областта на главата и шията. Съпоставката на цитологичен и хистологичен материал, показва висок процент на съвпадение. ТАБ демонстрира висока чувствителност - 100%, специфичност - 88.52% и диагностична точност - 89.96% във всички случаи.

Retrobulbar optic neuritis and cystoid macular edema as a first manifestation of lyme disease

Abstract: Lyme disease is a multi-system disorder caused by the spirochete Borrelia burgdoferi. Eye manifestations are a rare involvement. We report two cases of patients who developed a retrobulbar optic neuritis and a cystoid macular edema as a sole clinical presenting in Lyme disease. A 42-year-old female presented with left eye decreased visual acuity and painful ocular movement. Dilated funduscopy and neurological examination were normal. A diagnosis of left eye retrobulbar optic neuritis was made. The brain and spinal cord MRI showed typical lesions characteristic of MS. Serological tests for Lyme disease revealed positive results for IgM ELISA and Western blot. The possible serologically proven Lyme disease was diagnosed. Visual acuity returned to normal following a course of high-dose steroids and intravenous antibiotic, after by oral antibiotic. A 28-year-old male presented with left eye blurred vision and intermittent blurring vision in his right eye. Dilated funduscopy revealed bilateral cystoid macular edema (left more than right). He was positive for Lyme serology, IgM ELISA and Western blot, and intravenous antibiotic therapy was commenced, followed by oral antibiotic. Visual acuity was restored and fuduscopy was normal. In summary, although Lyme disease is an uncommon cause of these neuro-ophthalmic complications, our two patients highlight the importance of considering this disorder as a differential diagnosis and to initiate an early adequate therapy.

A critical review of primary health care reform in Bulgaria: impact on consumers

Abstract: The Health Care System in Bulgaria is in a period of transition and is undergoing profound changes in financing, organization and ownership. A priority of this reform is to shift the focus of healthcare to the primary sector and to emphasize general practice. New legislation in support of this health care reform has been passed over the last few years. However, this legislation, although consistent with the global aims to be achieved, has proven to be contradictory in terms of its practical implementation. This has had a negative impact on health care consumers’ interests and rights. This paper evaluates the effects of primary health care reform in Bulgaria from the perspective of patient satisfaction. For this purpose, a major task to be fulfilled is to identify the contradictions emerging between the legislation outlining the reforms and the realities of practical implementation with respect to its impact on consumers. The methods applied include: a review of the legislation, a review of the practical progression of the reform process, and an assessment of the new developments in health care consumers’ interests and rights. Considerable contradictions have been found between the legal framework of health care reform in primary care and existing experiences, traditions and expectations. The legislation is inconsistent with the existing realities of healthcare provision. This is leading to turmoil in the health care system during its present transformation and is infringing upon consumers’ rights. Problems emerging in the process of reform need to be identified, and solutions need to be found and worked out as the reforms progress. An assessment system has to be developed to monitor the overall reform process and to evaluate the effectiveness and efficiency of the changes introduced. The impact on consumer and patient satisfaction should be an area of prime concern during these assessments.

Prevention and treatment of ischemic stroke in patients with atrial fibrillation

Abstract: Atrial fibrillation (AF) is the most common sustained arrhythmia. It affects a considerable number of patients in the world and is responsible for ischemic stroke (IS) in many of them. Age greater than 75 years, congestive heart failure, arterial hypertension, diabetes mellitus, tobacco smoking and other structural lesions of the heart represent the main risk factors for IS in AF patients. Long-term anticoagulation therapy with warfarin is considered the most effective therapy for IS prevention in selected patients with AF and other risk factors. However, management of the drug presents with some challenges such as need for frequent monitoring, interactions with food and other medications, variability in metabolism and delayed onset of action. Antiplatelet therapy may provide some benefit for patients who can't tolerate warfarin. Recently, direct oral thrombin inhibitor dabigatran and oral factor Xa inhibitors rivaroxaban and apixaban are approved by the Food and Drug Administration (FDA). Non-pharmacologic approaches to IS prevention in AF focus on occlusion or ligation of the left atrial appendage, which is often the location of thrombus formation and on percutaneous techniques that may not require anticoagulation afterwards as well. New diagnostic modalities detect paroxysmal AF and expand the potential impact of preventive strategies on the population. Scripta Scientifica Medica 2013; 45(3): 7-15. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";}

Significant inhibition of the triggering mechanism of the extrinsic system of blood coagulation in rats by thymus peptides thymulin, thymosin alpha 1 and thymosin beta 4

Abstract: INTRODUCTION : The role of the thymus gland and the effects of thymic peptides on the coagulation status are relatively insufficiently studied. Recent data indicate controversial and not persuasive results due to in­vestigation of single hemostasis parameters and application of various pathological models. AIM : The present study aimed to elucidate the influence of thymus peptides thymulin, thymosin alpha 1 and thymosin beta 4 applied s.c. on intact rats, on key triggering factors of blood coagulation via the extrin­sic pathway: plasma concentration of tissue factor (TF); concentration and activity of free TFPI; and the ac­tivity of plasma clotting factor VII, as well as on prothrombin time (PT) - an integral clinical parameter of the intrinsic pathway. MATERIALS AND METHODS : The study was performed on 52 male Wistar strain rats, weighing 200-220 g and bred under standard conditions at dark/light cycle 12/12 h. The rats were divided into four equal groups (n=13) and injected s.c. once daily in the time interval 08.00-09.00 h in the course of three consecutive days as follows: 1st group (controls) - with saline (the solvent of the peptides); 2nd group - with thymulin (Sigma Aldrich, 0.4 mg/kg b.m.); 3rd group - with thymosin alpha 1 (Sigma Aldrich, 0.3 mg/kg b.m.); and the 4th group - with thymosin beta 4 (Sigma Aldrich, 0.3 mg/kg b.m.). RESULTS : Results indicate that thymulin and thymosin alpha 1 expressively decrease TF and increase TFPI concentrations. All three thymic peptides reduce FVIIa activity, increase TFPI activity, and significantly elongate PT. CONCLUSIONS : Thymus peptides thymulin, thymosin alpha 1 and thymosin beta 4 significantly suppress blood coagulation through the extrinsic pathway and generate a distinct tendency for hypocoagulability.