Vaccination Prophylaxis for Bacterial Infections

Introduction: Bacterial infections affect an increasing portion of the population and pose a significant threat to global health. Treatment has become more challenging due to bacterial resistance to various antibiotics, leading to the need for alternative methods to combat these infections. One such method is vaccination prophylaxis.Aim: The aim of this study is to analyze data from scientific publications and assess the effectiveness of vaccines against some of the most common bacterial pathogens.Materials and Methods: This study was conducted using a literature review approach, focusing on articles published in PubMed and Google Scholar from 2019 to 2024.Results: Our study found that vaccination prophylaxis is a widely used method for combating various bacterial pathogens. A strict vaccination program and adherence to it significantly reduce the spread of life-threatening infectious diseases. In Bulgaria, immunization begins in maternity wards, while in some European countries, it starts after the second month of life.Conclusion: The increasing spread of bacterial infections can be mitigated by developing new vaccines and optimizing the prophylaxis of existing ones. Adherence to immunization schedules significantly reduces the spread of serious infections and improves public health

Clinical Application Of Endoanal And Endorectal Ultrasound For Benign And Malignant Conditions Of The Anus, Perianal Space, And Rectum

INTRODUCTION: Benign and malignant conditions of the anus, perianal space, and rectum encompass various disorders: perianal abscesses and fistulas, anal fissures, hemorrhoids, incontinence, defecation disorder, rectovaginal and rectovesical fistulas, rectal prolapse, neoplasms of the anal canal and rectum. Very often patients have more than one condition. The high prevalence of benign anal disorders makes them socially significant. In the last two decades, a lot of new diagnostic methods were introduced. This has improved the understanding of the pathogenesis of these conditions. Endoanal and endorectal endoscopic ultrasound has become an important part of the evaluation of anal and rectal disease. This method is widely preferred because of its low price, accessibility, lack of complications, and good tolerance to the examination without sedation.MATERIALS AND METHODS: Thirty patients have undergone endorectal ultrasound (ERUS) examination, from April 2023 to June 2023. All ERUS examinations were performed using 3D 20R3 and 3D X14L4 endorectal transducers connected to BK 3000 Ultrasound System (BK Medical Aps, Denmark).RESULTS: The mean age was 48.4. Eighteen patients were male (60%). The main clinical indication was an evaluation of perianal abscesses and fistulas or neoplasms. Nine of the examinations, or 30%, were performed for anal and rectal tumors. Perianal abscesses were identified in 7 cases (23%); 5 patients had anal fissures; 4 had perianal fistulas (13%); 1 had a rectovaginal fistula. The rest of the patients had hemorrhoidal disease.CONCLUSION: Endorectal and endoanal ultrasound is a sensitive and reliable method for the assessment of the anatomical structures and diagnosis of benign and malignant diseases of the anus, perianal space, and rectum

Surgical Methods for Minimizing the Incidence of Paracolostomy Hernias

INTRODUCTION: Regardless of the advances in surgical techniques, parastomal hernia continues to be a frequent and serious complication after colostomy construction. The outcomes after surgical treatment are often not satisfactory, and the recurrence rate is high.AIM: The study aims to present modern surgical methods for the prevention of paracolostomy hernias.MATERIALS AND METHODS: The study included 77 patients with formed colostomies in the Clinic of Surgery of Alexandrovska University Hospital during the period from 2017 to 2022, analyzed with a follow-up period of at least six months. Group A includes 35 patients whose stoma was constructed by the extraperitoneal route. Group B consists of 42 patients with the traditional transperitoneal technique. In addition, 2 patients in whom synthetic mesh was used to treat and prevent paracolostomy hernia are reported.RESULTS: In group A only one patient was diagnosed with parastomal hernia, while in group B there were 9. The difference between the two groups was found to be statistically significant (p < 0.05). In the cases where a prophylactic synthetic mesh was utilized, no complications we observed.CONCLUSION: Improving surgical techniques for preventing paracolostomy hernias is crucial, as they represent an inevitable complication, in most cases, after colostomy formation. The results of the conducted study as well as the available literature data highlight the benefits of methods such as the extraperitoneal route for stoma construction and the prophylactic use of synthetic meshes

Advantages and Limiting Factors in Laparoscopic Colorectal Surgery

INTRODUCTION: Laparoscopic surgery has become the gold standard for surgical treatment of diseases of the gastrointestinal tract. In terms of results, it is comparable and has established itself as a reliable alternative to conventional surgery, both in benign and malignant diseases. The minimally invasive approach enjoys all the short-term advantages, such as less postoperative pain, better cardiopulmonary function, faster recovery of the gastrointestinal passage, faster mobilization and recovery, shorter intensive care, and hospital stay. Long-term oncological outcomes still remain debatable.AIM: Our study aims to demonstrate the advantages of the laparoscopic approach and highlight some of its limiting factors in terms of operative time and postoperative stay in the conditions of the Clinic of Anesthesiology and Intensive Care (CAIL).MATERIALS AND METHODS: A total of 42 patients with histologically proven colorectal cancer (CRC) and resection with primary anastomosis were retrospectively included. We divided the patients into two groups according to the surgical technique: Group A: 21 patients operated by laparoscopic surgery (LS), and Group B: 21 patients operated by conventional open surgery (OS). Some of the basic characteristics: sex, age, body mass index (BMI), preoperative staging, mean operative time, postoperative period in CAIL, and analgesia, were examined.RESULTS: The mean operative time (MOT) in the LS group was 201 min and 189 min in the OS group. With respect to the gender factor, the MOT in LS was 211 min in men and 185 min in women, while in OS, there was no difference in MOT in relation to the gender factor. The mean operative time in patients compared to BMI was examined. In patients with normal weight, it was 160 min in LS and 351 min in OS, 220 min and 164 min in overweight patients, and 218 min and 197 min in obese patients, respectively. In the OS group, all patients had a stay in CAIL of more than 72 hours, while in LS only 57% of patients stayed for 72 hours. Regarding intraoperative and postoperative analgesia, natural opioid analgesics, including morphine, were administered to 10% of the LS group and 100% of the OS patients. Semi-synthetic opioid analgesics were administered in 60% of LS patients and 100% of OS patients.CONCLUSION: Laparoscopic colorectal surgery does not show an advantage in terms of mean operative time, but patients have a shorter stay in the CAIL setting, less postoperative pain, and enjoy all the advantages of a minimally invasive approach with equivalent oncological outcome