Risk factors associated with the development of dental caries in Bulgarian children

The purpose of this study was to examine the risk factors associated with the development of dental caries in children in Bulgaria. The research has been carried out at the Faculty of Dental Medicine, in the period 2015-2016, with the permission of the University Scientific Research Committee and informed consent signed by each parent. The subject of observation was parents of children from Varna region in Bulgaria. The results were statistically processed with SPSS v.20.0, using variation and comparison (chi-square) analyzes. For significance level we assume p<0.05. The volume of observation encompasses 100 persons. Units of observation are patients aged three to six years with the need for prevention and treatment of dental caries of the primary dentition. The registration was done in a specially developed questionnaire, including 22 questions, each with the possibility of more than one answer. In processing the obtained data, Student's criterion was used to compare the mean values of two independent samples. In a comparative analysis of the results, we found that 71.01% of children aged three to six years visit a dentist, and patients use fluoride only in the form of toothpaste containing fluoride. When studying the knowledge and behavior of parents in the direction of risk factors for the development of dental caries and oral prophylaxis, need for a new approach of pediatric dentists has been found, focused on programming preventive and non-invasive treatment of children according to their individual needs

The knowledge of dentists for preventive influence of the caries process

The line of knowledge runs from the general social, legal, financial and managerial framework. It is necessary to present the object of professional activity, the peculiarities of professional work and the methods for its optimization. Subjects of the survey were 100 dentists who perform treatment of deciduous teeth from the city of Varna, Bulgaria. The individual addressed anonymous survey was fulfilled during educational, clinical and organization meetings at the Faculty of Dental Medicine-Varna and on the territory of the city of Varna. The interviewed dentists encounter difficulties with the diagnosis of the initial dental caries in primary dentition. The dentists included in the survey rely mainly on their theoretical and practical experience and routine clinical methods for non-invasive treatment of the initial dental caries. Work experience and the specialty do not have a significant impact on the awareness of dentists about the new criteria related to the diagnosis and prevention of dental caries in the primary dentition. The age, work experience and specialty of dentists are factors for their awareness of the new approaches to treatment of children, as doctors up to 30 years of age, with a recognized specialty and work experience up to five years are more informed

Investigation of the dental technicians’ readiness to manufacture dental prostheses using digital technologies

Introduction: Modern digital technologies allow us to generate a virtual model of the patient and to design his/her smile.  The future definitely belongs to the digital technologies because they offer a reliable, predictable and highly esthetic manner of treatment.Aim: The aim of the present study is to investigate the dental technicians' readiness to manufacture dental prostheses using digital technologies.Materials and Methods: A total of 159 respondents - practicing dental technicians and   students - were surveyed using an online survey. The survey was conducted via a social network platform.Results were processed with SPSS v. 20 using variational, comparative and correlation analyses. Results: Over 50% of the respondents have indicated that they use different types of digital technologies in their practice, the main reason being that the construction time is shortened and that the accuracy is improved (85.20%). There is a correlation between the length work experience and the use of new technologies (p<0.05), with younger specialists being the ones who primarily use modern technology. Young specialists are willing to invest in the purchase of modern equipment and to attend additional courses on working with it.Conclusion: Despite the variety of methods for recreating the prosthetic field when manufacturing prosthetic constructions, a trend towards full digitalization of the process is observed.The results from the conducted analyses show that digitalization is being increasingly used by young specialists (CAD planning and software application – 78.40%), who prefer it because it increases accuracy and shortens production time (85.40%)

Investigation of voice characteristics and their modification in dental prosthetics

Each person's voice is unique. Voice quality is characterized by intelligibility of speech (correlation between voice pitch, volume, timbre and speech speed). Changes in the oral cavity due to tooth loss and resorption of processus alveolaris maxillae or processus alveolaris mandibulae can cause defects in the patient's voice and speech. When using incorrect or functionally low-quality dentures, other changes can be observed, such as skipping, replacing, distorting, adding sounds, as well as nasal speaking. Restrictions or changes in the normal movement of the jaws may interfere with the transmission of acoustic energy through the oral cavity, thereby affecting both the voice characteristics and capabilities, and the balance of the oral resonance. Phonetic adaptation of prosthetic patients depends on the choice and placement of artificial teeth, on the thickness, size and placement of the prosthetic base, optimal tongue space, individual adaptive ability, and the patient's ability to recognize the sound. This report presents the possibilities for maximum restoration of voice characteristics in effective collaboration between the dental team and specialists in otolaryngology and speech therapy

THE VALIDITY OF THE HAMILTON DEPRESSION RATING SCALE AS A SCREENING AND DIAGNOSTIC INSTRUMENT FOR DEPRESSION IN PATIENTS WITH EPILEPSY

Aim: To evaluate the concurrent validity of the Hamilton Depression Rating Scale (HAMD-17) against ICD-10 criteria for depressive disorder and its performance as a screening and diagnostic tool for depression in patients with epilepsy (PWE).Subjects and Methods: One hundred and six PWE underwent clinical psychiatric examination followed by evaluation on HAMD-17. ICD-10 criteria for comorbid depressive disorder were applied. Internal consistency was assessed using Cronbach’s α. A “receiver operating characteristics” (ROC) curve was obtained and the sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated for different cut-off points of the HAMD-17.Results: Internal consistency measured by Cronbach’s α was 0.74. Maximal discrimination between depressed and non depressed was obtained at a cut-off score of 8/9 (sensitivity 0.93, specificity 0.98). High sensitivity and NPV at the same cut-off score (sensitivity 0.93, NPV 1.0) show the screening properties, and high specificity and PPV at cut-offs 9/10, the diagnostic properties of the instrument. The area under the ROC curve (AUC=0.746) indicates the concurrent validity of the HAMD-17 score with the ICD-10 criteria for depressive disorder.Conclusion: The validity of the HAMD-17 against ICD-10 criteria for depressive disorder in PWE in our study is fair. The concurrent administration of diagnostic criteria can ascertain the presence of core symptoms of depression

SEIZURE SEVERITY AS AN ALTERNATIVE MEASURE OF OUTCOME IN EPILEPSY

Seizure severity emerges as an important aspect of epilepsy. This is most relevant in refractory patients in whom complete remission of seizures is unlikely and reduced seizure severity may be a significant determinant of psychosocial well-being with a consequent improvement in quality of life (QOL). Thus a valid measure of seizure severity can serve both as an indicator of clinical outcome and as an evaluation tool of the interaction between seizures and the psychosocial complications of epilepsy.After a brief review of the most frequently used scales measuring seizure severity in adults with epilepsy we have explored the relationship between seizure severity and QOL in a set of 103 patients. Two self-evaluation questionnaires were applied: the Seizure Severity Questionnaire (SSQ) and the Quality of Life in Epilepsy Inventory (QOLIE-31). The severity of the coexisting depression, an important confounder in the relationship between seizure severity and QOL, was assessed by the Hamilton Depression Rating Scale (HAMD-17).All domains of the Quality-of-Life in Epilepsy Inventory (QOLIE-31) correlated highly significantly with seizure severity (p≤0.01). The correlation was strong for the Overall score (r=-0.70; p≤0.001) and the Seizure worry domain (r=-0.71; p≤0.001). When the potentially confounding effect of depression was controlled for, the regression of seizure severity with the QOLIE-31 Overall score (P=0.001; R²=0.56) and the Seizure worry domain (P=0.001; R²=0.50) remained significant. These findings indicate that seizure severity is strongly associated with QOL in epilepsy and could be used as an alternative indicator of outcome in clinical research

Dose escalation and pharmacokinetic study of AEZS-108 (AN-152), an LHRH agonist linked to doxorubicin, in women with LHRH receptor-positive tumors

Receptors for luteinizing hormone-releasing hormone (LHRH) can be utilized for targeted chemotherapy of cytotoxic LHRH analogs. The compound AEZS-108 (previously AN-152) consists of [D-Lys?]LHRH linked to doxorubicin. The objectives of this first study in humans with AESZ-108 were to determine the maximum tolerated dose and to characterize the dose-limiting toxicity, pharmacokinetics, preliminary efficacy, and hormonal effects

Listening to patients, for the patients: The COVAD Study-Vision, organizational structure, and challenges

Background: The pandemic presented unique challenges for individuals with autoimmune and rheumatic diseases (AIRDs) due to their underlying condition, the effects of immunosuppressive treatments, and increased vaccine hesitancy. Objectives: The COVID-19 vaccination in autoimmune diseases (COVAD) study, a series of ongoing, patient self-reported surveys were conceived with the vision of being a unique tool to gather patient perspectives on AIRDs. It involved a multinational, multicenter collaborative effort amidst a global lockdown. Methods: Leveraging social media as a research tool, COVAD collected data using validated patient-reported outcomes (PROs). The study, comprising a core team, steering committee, and global collaborators, facilitated data collection and analysis. A pilot-tested, validated survey, featuring questions regarding COVID-19 infection, vaccination and outcomes, patient demographics, and PROs was circulated to patients with AIRDs and healthy controls (HCs). Discussion: We present the challenges encountered during this international collaborative project, including coordination, data management, funding constraints, language barriers, and authorship concerns, while highlighting the measures taken to address them. Conclusion: Collaborative virtual models offer a dynamic new frontier in medical research and are vital to studying rare diseases. The COVAD study demonstrates the potential of online platforms for conducting large-scale, patient-focused research and underscores the importance of integrating patient perspective into clinical care. Care of patients is our central motivation, and it is essential to recognize their voices as equal stakeholders and valued partners in the study of the conditions that affect them