Eye care – 3 O perspective: obstacles and opportunities

Aim The aim of the present study is to determine the realization of different eye care practitioners as part of the 3 O perspective in eye health care and to analyze the methodologies for their development.Methods Retrospective documentary analysis of the trends for the specialty of medical opticians. Comparative analysis of the profession with other elements of the 3 O perspective, including optometrists and ophthalmologists.Results The number of medical opticians graduated from the Medical University of Varna since 2016 is 69, the largest in 2016 – 16, and the lowest in 2018 – 10. On average 20% of medical opticians are realized in practice without further qualification, while all others continue with a master‘s degree in optometry. Medical opticians most often work in an optical store, with 60% developing their own business. The number of opticians realized in medical establishments is small. The number of masters in optometry, realized in medical institutions is significantly higher and reaches 30%. Ophthalmologists are realized in medical institutions at 100% up to 3 years after graduation. Over 80% of ophthalmologists work in optical centers during their training.Conclusions As a result of an in-depth analysis of the market and the demand for qualified eye care practitioners, Medical University of Varna closes the cycle of the 3 O perspective with the following specialties: ophthalmologists, optometrists and opticians. The three categories of eye health professionals work in symbiosis to develop a comprehensive concept for prevention, prophylaxis, optical correction and treatment. Optical centers and medical institutions providing specialized care for eye diseases exchange staff, which is beneficial for the overall concept of the eye care

Orthostatic Reactivity in Patients with Ischemic Stroke in the Chronic Period

[This article has been corrected.  See http://dx.doi.org/10.3889/oamjms.2015.094 and http://dx.doi.org/10.3889/oamjms.2015.095] AIM: This study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on orthostatic reactivity in patients with ischemic stroke in the chronic period (ISChP).MATERIAL AND METHODS: An active orthostatic test is used for the evaluation of the orthostatic reactions. The arterial blood pressure and heart rate were defined in the 10 minutes of supine position, before and after 1, 5 and 10 minutes of active upright position. The orthostatic autoregulation is evaluated four times - at the beginning of the study, on the 10th day, on the 1st month and three months after the start of the KT. The classification by Thulesius was used to separate the patients into two groups depending on the type of their orthostatic reactivity.RESULTS: At the beginning of the study of infringements symptomatic type orthostatic reactivity (SOR) was observed in 24 patients and hypertensive type orthostatic reactivity (HOR) was observed in the remaining 32 patients. Once applied SKTM establish improvement of orthostatic autoregulation for the groups SOR and HOR at the 10th day and the 1st month with a level of significance p <0.05.CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as an adapted exercise program at home, has significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to the ISChP

Errata Corrige. Orthostatic Reactivity in Patients with Ischemic Stroke in the Chronic Period. http://dx.doi.org/10.3889/oamjms.2015.090

[See http://dx.doi.org/10.3889/oamjms.2015.090 and http://dx.doi.org/10.3889/oamjms.2015.094]AIM: This study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on orthostatic reactivity in patients with ischemic stroke in the chronic period (ISChP).MATERIAL AND METHODS: An active orthostatic test is used for the evaluation of the orthostatic reactions. The arterial blood pressure and heart rate were defined in the 10 minutes of supine position, before and after 1, 5 and 10 minutes of active upright position. The orthostatic autoregulation is evaluated four times - at the beginning of the study, on the 10th day, on the 1st month and three months after the start of the KT. The classification by Thulesius was used to separate the patients into two groups depending on the type of their orthostatic reactivity.RESULTS: At the beginning of the study of infringements symptomatic type orthostatic reactivity (SOR) was observed in 24 patients and hypertensive type orthostatic reactivity (HOR) was observed in the remaining 32 patients. Once applied SKTM establish improvement of orthostatic autoregulation for the groups SOR and HOR at the 10th day and the 1st month with a level of significance p <0.05.CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as an adapted exercise program at home, has significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to the ISChP

Influence of Kinesitherapy on Balance Reactions in Patients with Ischemic Stroke in the Chronic Period

AIM: The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on balance reactions in patients with ischemic stroke in the chronic period (ISChP).MATERIAL AND METHODS: A prospective, multicenter study with 56 patients with ISChP. Evaluation of balance reactions using Berg Balance Scale - BBS, includes implementation of 14 tasks with increasing difficulty reflecting the usual activities of everyday life. The first 5 assignments are used to assess the main balance potential and the remaining 9 (6th to 14th task) include more sophisticated balance tasks.RESULTS: The patients were found with a significant improvement in balance opportunities, according to the scale of Berg. Compared to initial data there is a significant increase in the number of points in the measured indicators for functional and static balance. In absolute terms, positive change is most pronounced during the 1st month with a level of significance of p <0.001. CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as adapted exercise program at home, and significantly improved equilibrium reactions in patients with postural disorders because of ischemic stroke and is with a supportive prolonged exposure

Influence of kinesitherapy on motor recovery and functional independence in patients with ischemic stroke in the chronic period

The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on motor recovery and functional independence in patients with ischemic stroke in the chronic period (ISChP). Material and Methods The study was conducted with 56 patients with ISChP (32 men and 24 women, mean age 63.2 ± 8.8 years old, weight 77.9 ± 10.1 kg, height 169.2 ± 6.4 centimeters and duration of illness up to 1 year). Assessment of motor recovery and the level of functional independence test is used to test Brunnstrom and functional independence - FIM. The stage of functional recovery and the level of functional independence were assessed at the beginning, at the 10th day, at the 1st month and at the 3rd month after the start of the kinesitherapy. All patients were treated with a specialized 10-day SKTM, which later continued to be performed by patients as adapted exercise program at home for a period of three months. Results After the application of SKTM the highest tendency towards improvement in the motor recovery and functional independence was established at the 1st month with a level of significance p<0.000. Conclusion The applied kinesitherapeutic specialized methodology continued later as adapted exercise program at home, significantly improved motor recovery and functional independence in patients with functional impairment due to ISChP. Keywords: Kinesitherapy, Motor recovery, Functional independence, Ischemic Strok

Orthostatic reactivity in patients with ischemic stroke in the chronic period

Summary This study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on orthostatic reactivity in patients with ischemic stroke in the chronic period (ISChP). An active orthostatic test is used for the evaluation of the orthostatic reactions. The arterial blood pressure and heart rate were defined in the 10 minutes of supine position, before and after 1, 5 and 10 minutes of active upright position. The orthostatic autoregulation is evaluated four times - at the beginning of the study, on the 10th day, on the 1st month and three months after the start of the KT. Results At the beginning of the study of infringements symptomatic type orthostatic reactivity (SOR) was observed in 24 patients and hypertensive type orthostatic reactivity (HOR) was observed in the remaining 32 patients. Once applied SKTM establish improvement of orthostatic autoregulation for the groups SOR and HOR at the 10th day and the 1st month with a level of significance p <0.05. Conclusion The applied specialized kinesitherapeutic methodology continued later as an adapted exercise program at home, has significantly improved the orthostatic reactivity in patients with orthostatic dysregulation due to the ISChP. Keywords: Orthostatic reactivity, Kinesitherapy, Neurorehabilitation, Neurodevelopment treatment, Ischemic stroke, Chronic period

Influence of kinesitherapy on gait in patients with ischemic stroke in the chronic period

AIM: The study aims to trace the influence of specialized kinesitherapeutic methodology (SKTM) on gait in patients with ischemic stroke in the chronic period (ISChP). MATERIAL AND METHODS: The study was conducted with 56 patients with ISChP (duration of the disease up to 1 year). For determining changes in gait before and after the treatment a cadence of gait and maximum movement speed were taken into consideration. To determine the cadence, steps are counted for covering 6 meters and 10 meters respectively. The maximum speed of the gait is determined in m / min by dividing undergone distance (m) and time (min). RESULTS: Patients were found to significantly normalize the parameters of gait. Compared to the initial data, there is a significant reduction in the number of steps on 6 and 10 meters and a tendency to increase the speed of gait, with the significant change during the 1st month with a level of significance of p<0.001. CONCLUSION: The applied specialized kinesitherapeutic methodology continued later as exercise program at home, which significantly improved gait cadence and speed of movement in patients with ischemic stroke in the chronic period and is with a supportive prolonged exposure

Specific Immunoglobulin E and G to Common Food Antigens and Increased Serum Zonulin in IBS Patients: A Single-Center Bulgarian Study

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder whose pathogenesis is considered multifactorial, including abnormal gut motility, visceral hyperreactivity, psychological factors, disturbances in the brain-gut axis, leaky gut, oxidative stress, etc. We aimed to investigate serum levels of specific immunoglobulin E and G to common food antigens and zonulin and to assess their use in clinical practice for patients with IBS. Material and methods. We included 23 participants, 15 with IBS (diagnosed according to the Rome IV criteria) and 8 healthy controls. We investigated serum levels of specific IgG antibodies to 24 food antigens, specific IgE antibodies to 20 food antigens, anti-celiac antibodies, fecal calprotectin and serum zonulin by ELISA. Results. Food-specific positive IgG antibodies were significantly higher in patients with IBS than in controls (p = 0.007). IgE-mediated allergic reactions were found in five patients with IBS; no one had anti-TG antibodies. One-third of IBS patients demonstrated a low degree of chronic inflammation (positive fecal calprotectin test > 50 ng/mL) without specific bacterial infection. Serum levels of zonulin in IBS patients were higher than in healthy controls (0.378 ± 0.13 vs. 0.250 ± 0.14 ng/mL, p = 0.0315). However, no correlations between clinical symptoms and zonulin levels were found. Conclusion. The mechanisms of IgG hypersensitivity and low degree inflammation in IBS and elevated zonulin may contribute to multifactor pathogenesis in IBS

Specific Immunoglobulin E and G to Common Food Antigens and Increased Serum Zonulin in IBS Patients: A Single-Center Bulgarian Study

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder whose pathogenesis is considered multifactorial, including abnormal gut motility, visceral hyperreactivity, psychological factors, disturbances in the brain-gut axis, leaky gut, oxidative stress, etc. We aimed to investigate serum levels of specific immunoglobulin E and G to common food antigens and zonulin and to assess their use in clinical practice for patients with IBS. Material and methods. We included 23 participants, 15 with IBS (diagnosed according to the Rome IV criteria) and 8 healthy controls. We investigated serum levels of specific IgG antibodies to 24 food antigens, specific IgE antibodies to 20 food antigens, anti-celiac antibodies, fecal calprotectin and serum zonulin by ELISA. Results. Food-specific positive IgG antibodies were significantly higher in patients with IBS than in controls (p = 0.007). IgE-mediated allergic reactions were found in five patients with IBS; no one had anti-TG antibodies. One-third of IBS patients demonstrated a low degree of chronic inflammation (positive fecal calprotectin test &gt; 50 ng/mL) without specific bacterial infection. Serum levels of zonulin in IBS patients were higher than in healthy controls (0.378 &plusmn; 0.13 vs. 0.250 &plusmn; 0.14 ng/mL, p = 0.0315). However, no correlations between clinical symptoms and zonulin levels were found. Conclusion. The mechanisms of IgG hypersensitivity and low degree inflammation in IBS and elevated zonulin may contribute to multifactor pathogenesis in IBS