Serum homocysteine and high-sensitive C-reactive protein levels and cardiovascular disease in patients with diabetes mellitus type 2

PURPOSE: Hyperhomocysteinemia and hs-CRP are non-classical risk factors independently associated to the development of cardiovascular disease. The increased coronary heart disease (CHD) risk in subjects with type 2 diabetes mellitus (DMT2) can be in part explained by the classical risk factors like hypertension, hyperlipidemia and obesity. There is no sufficient data about the importance of homocysteine (Hcy) and hs-CRP levels in DMT2 patients without CHD in predicting the macroangiopathic complications. The aim of this study was to determine the association between plasma homocysteine and hs-CRP concentrations in DMT2 patients with and without CHD.MATERIAL AND METHODS: Fifty patients hospitalized in the Clinic of Endocrinology at St. Marina University Hospital of Varna were divided into three groups: group one, 20 DMT2 patients without any evidence of CHD; group two, 20 DMT2 patients with history of CHD and group three, 10 healthy controls matched to these groups in terms of age and classical risk factors for CHD.RESULTS: Serum hs-CRP concentrations were significantly higher in DMT2 patients than in healthy controls as well as in DMT2 patients with CHD than in CHD-free DMT2 ones. Serum Hcy concentrations were significantly higher in DMT2 patient with CHD than in controls. Both markers were elevated in group two presenting with the highest risk for CHD.Scripta Scientifica Medica 2013; 45(1): 58-61

Midwives coping with stress

Professional stress can be defined as an emotional, cognitive, behavioural and psychological reaction to nega­tive and unfavourable aspects related to the nature of the work. This reaction affects the whole organism and its environment, can become a permanent condition and is characterised by a high degree of suffering, and often with a sense of impasse. According to NIOSH (National Institute for Occupational Safety and Health), occupational stress is a combination of negative physical and emotional responses that occur when there is a mismatch between job requirements and capabilities, resources or needs of the worker.AIM: The aim of this study is to determine the ability of midwives working in the St. Anna University Hospital and SHOGAT `Prof. Dr. D. Stamatov`, Varna, to cope with stress arising from the job environment.MATERIALS AND METHODS: We have studied the opinion of working midwives from St. Anna University Hospital and SHOGAT „Prof. Dr. D. Stamatov` - Varna. The survey was conducted in June 2016. The methods we used were: documentary, statistical - questionnaire, graphic analysis.RESULTS AND DISCUSSION: The answer of the respondents indicates an increased workload, which can be a source of stress. Increased physical overload and emotional exhaustion in the workplace are a prerequisite for the emergence of stress. The accumulated fatigue and inadequate rest decrease the ability to work and are a prerequisite for the occurrence of stress among working midwives. Many midwives work a second job or have family (other) obligations that prevent them from getting adequate rest. It is noteworthy to mention that more than half of the midwives choose their relatives and friends to share the emotions experienced during the day.CONCLUSIONS:1. Increased physical overload and emotional exhaustion in the workplace are a prerequisite for the emergence of stress.2. The accumulated fatigue and inadequate rest decrease the ability to work and are a prerequisite for the occurrence of stress among working midwives.3. Stress is the cause of discomfort among midwives.4. Respondents choose to share with family and friends to overcome stress

Women‘s readiness to take care of their babies after their maternity ward discharge

Готовността за отглеждане на новородено у дома след изписването от Родилното отделение започва дълго преди настъпването на дългоочаквания момент. Полагането на грижи за новороденото бебе включва много нови преживявания. Необходимо е формиране на умения и знания в Родилното отделение, които правят ежедневието по-спокойно и по-малко стресиращо. Храненето, къпането и сменянето на памперси не са втора природа на никого.Целта на настоящото изследване е да разкрием степента на готовност на младите майки да разполагат с умения, необходими да задоволяват нуждите на детето си.Материали и методи: Приложени методи - документален, статистически и социологически. Резултати и обсъждане: От получените данни на базата на качествен и количествен анализ се установи, че готовността на жените след изписване от Родилния дом да отглеждат децата си е сравнително голяма.Изводи: Готовността на младата майка да обслужва бебето си и да успява да разграничава нормалните реакции от отклоненията е доказателство за добре свършена работа на персонала в Родилния дом.Readiness to take care of newborn babies at home after a discharge from the maternity ward develops long before the long-awaited moment happens. Looking after a newborn baby includes a variety of new experiences. It is necessary for new abilities and knowledge to be formed in the maternity ward, which could lead to easier and less stressful daily life. Feeding, bathing and changing nappies are no one`s second nature. The aim of present investigation is to reveal the degree of readiness of young mothers to have abilities, necessary to satisfy their child`s needs.Materials and Methods: The methods we have applied were: documental, statistical and sociological. Results and Discussion: Data obtained on basis of quality and quantity analysis determined that women ‘s readiness after maternity hospital discharge to take care their children is significant.Conclusions: The young mother`s readiness to care for the baby and to succeed in differentiating its normal reaction from the deviations is a proof for a job well done by the maternity hospital staff

Gynecological Health - Conscious Care For The Interns From The Midwife Program Of The Medical University Of Varna

УВОД: В периода на обучение бъдещите акушерки изучават задълбочено широк кръг от дисциплини, свързани с гинекологичното здраве на момичето и жената (1). В този процес се преплита и информацията, която достига до всички нас от медии и други места. Като бъдещи специалисти те се научават да интерпретират този информационен поток и да са грамотни по отношение на медицински проблеми (2). Нашето проучване е насочено към практическата грижа, която студентите оказват в края на обучението си за своето гинекологично здраве.МАТЕРИАЛ И МЕТОДИ: Използван е социологически метод, като са анкетирани индивидуално и анонимно всички завършващи 28 стажант-акушерки през 2017 г. на МУ-Варна.Документален метод, като са анализирани литературни източници, разглеждащи предмета на настоящото изследване.Статистически метод, използван при анализ на резултатите от собственото проучване.РЕЗУЛТАТИ И ОБСЪЖДАНЕ: Голям процент от студентите (72%) са запознати с методите за откриване на отклонения в гинекологичното здраве. От анкетираните 75% посещават активно гинеколог и си правят профилактична цитонамазка. Училището е мястото, където 64% от бъдещите акушерки са получили необходимата информация за това.ИЗВОДИ: Към момента на проучването завършващите акушерки са готови да се грижат за собственото си гинекологично здраве, както и да бъдат полезни за своите близки и пациентки. Почти единодушни са в отговорите си за необходима промяна на отговорностите относно гинекологичните изследвания.INTRODUCTION: During the training period, prospective midwives study a wide range of disciplines related to the gynecological health of the girl and the woman. This process intertwines the information that reaches all of us from the media and other places. As future specialists they learn to interpret this information flow and to be knowledgeable about medical problems. Our study focuses on the practical care that students provide at the end of their training for their gynecological health.MATERIALS AND METHODS: A sociological method was used, with an individual and anonymous interview of all 28 students graduating  from the Midwife program in 2017 at the Medical University of Varna.A documentary method, analyzing literary sources dealing with the subject of this study was applied as well as a statistical method used to analyze the results of the own study. RESULTS AND DISCUSSION: A large percentage of students (72%) are familiar with the methods of detecting disorders in gynecological health. Of those surveyed, 75% visit a gynecologist regularly and have a prophylactic pap smear. The school is the place where 64% of future midwives have received the necessary information about it.CONCLUSION: At the time of the study, midwives are ready to take care of their own gynecological health and be useful for their relatives and patients. They are almost unanimous in their responses on the necessary change in responsibilities for gynecological examinations

The Opinion Of Third-Year Students The Midwife Program Of The Medical University Of Varna On The Practical Preparation During Their Training

Увод:Акушерството е трудна професия, изискваща интелигентност, бърза мисъл, практически умения и учене през целия живот (1).Студентите от специалност „Акушерка” получават теоретична и клинична подготовка в своя четиригодишен курс на обучение, която отговаря на ЕДИ. Теоретичната подготовка се осъществява чрез задължителни, избираеми и факултативни учебни дисциплини. Клиничната подготовка се осъществява чрез клинична практика и преддипломен стаж. По време на клиничната подготовка студентите извършват дейности под ръководството и наблюдението на преподавател по практика и/или правоспособна акушерка. (2)Материал и методи: Използвани са:Социологически метод, като са анкетирани индивидуално и анонимно всички 28 студентки от 3 курс специалност „Акушерка” на МУ-Варна през юни 2018 г.Документален метод, като са анализирани литературни източници, разглеждащи предмета на настоящото изследване.Статистически метод, използван при анализ на резултатите от собственото проучване.Резултати и обсъждане: От отговорите на студентите установихме, че голям процент (78,57%) са доволни от базите за клинична практика на МУ-Варна. Също толкова мислят, че на клинична практика получават достатъчно знания и умения. Според 89,28% от студентите за практическото им обучение голямо значение има преподавателят, който води клинична практиката.Изводи: Воденето на клиничната практика и клиничните бази на МУ-Варна за специалност „Акушерка” покриват голяма част от очакванията на студентите. Според анкетираните е необходимо подобряване на отношението на персонала в отделенията към тях.INTRODUCTION: Being a midwife is a difficult profession requiring intelligence, quick thinking, practical skills and lifelong learning.Students from the Midwife program receive a theoretical and clinical training in their four-year training course that meets the Unified State Requirements. Theoretical training is done through compulsory, elective and facultative subjects. Clinical training is conducted through clinical practice and pre-graduate practice. During clinical preparation, students undertake activities under the guidance and supervision of a practicing lecturer and/or a qualified midwife. MATERIALS AND METHODS: A sociological method was used, and 28 third-year students from the Midwife program at the Medical University of Varna were interviewed individually and anonymously in June 2018.A documentary method analyzing literary sources dealing with the subject of this study was applied.A statistical method was used to analyze the results of the own study.RESULTS AND DISCUSSION: From the answers of the students, we found that a large percentage (78.57%) were satisfied with the clinical practice bases of the Medical University of Varna. They also thought that they had enough knowledge and skills in terms of clinical practice. According to 89.28% of the students for their practical training, the lecturer who led the clinical practice was of great importance.CONCLUSION: The clinical practice and clinical bases at the Medical University of Varna for the Midwife program fulfil the majority of the expectations of the students. According to respondents, it is necessary for the attitude of the staff in the wards toward them to be improved

Economic costs due to workers’ sick leave at wastewater treatment plants in Bulgaria

Background The compensatory mechanisms of social security include expenses for sick leave. The aim of the study is to determine the economic cost due to sick leave among workers in wastewater treatment plants (WWTPs), comparing with the same economic indicators of the National Social Security Institute (NSSI) in Bulgaria. Material and Methods The sick leave of 111 workers at 3 WWTPs was studied in the period 2012–2014 on the grounds of registered absences from work due to temporary incapacity for work. The economic indicators of the NSSI, the gross salary at WWTPs, payable social security contributions and compensatory payments for sick leave have been used for economic cost calculation for temporary incapacity of the workers. Results The frequency of cases and the frequency of lost days due to temporary incapacity were increased in the observed period at WWTPs and in Bulgaria, and it is significantly higher for the employed at WWTPs. The percentage share of workers equivalent to 1.66% at WWTPs have not worked for an entire year as a result of temporary incapacity in 2012, 2.76% – in 2013, and 4.61% – in 2014. The economic burden due to sick leave at WWTPs was raised from EUR 4913.02 in 2012 to EUR 16 895.80 for 2014 for employers and the NSSI. Conclusions The frequency of cases and the frequency of lost days due to temporary incapacity were increased in the observed period at WWTPs and in Bulgaria, and it is significantly higher for the employed at WWTPs. The economic burden was equally distributed between employers and the NSSI. Med Pr 2018;69(2):129–14

Maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer: Outcomes by somatic and germline BRCA and other homologous recombination repair gene mutation status in the ORZORA trial

Background. The open-label, single-arm, multicenter ORZORA trial (NCT02476968) evaluated the efficacy and safety of maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer (PSR OC) who had tumor BRCA mutations (BRCAm) of germline (g) or somatic (s) origin or non-BRCA homologous recombination repair mutations (HRRm) and were in response to their most recent platinum-based chemotherapy after >= 2 lines of treatment. Methods. Patients received maintenance olaparib capsules (400 mg twice daily) until disease progression. Prospective central testing at screening determined tumor BRCAm status and subsequent testing determined gBRCAm or sBRCAm status. Patients with predefined non-BRCA HRRm were assigned to an exploratory cohort

Economic costs due to workers’ sick leave at wastewater treatment plants in Bulgaria

Background The compensatory mechanisms of social security include expenses for sick leave. The aim of the study is to determine the economic cost due to sick leave among workers in wastewater treatment plants (WWTPs), comparing with the same economic indicators of the National Social Security Institute (NSSI) in Bulgaria. Material and Methods The sick leave of 111 workers at 3 WWTPs was studied in the period 2012–2014 on the grounds of registered absences from work due to temporary incapacity for work. The economic indicators of the NSSI, the gross salary at WWTPs, payable social security contributions and compensatory payments for sick leave have been used for economic cost calculation for temporary incapacity of the workers. Results The frequency of cases and the frequency of lost days due to temporary incapacity were increased in the observed period at WWTPs and in Bulgaria, and it is significantly higher for the employed at WWTPs. The percentage share of workers equivalent to 1.66% at WWTPs have not worked for an entire year as a result of temporary incapacity in 2012, 2.76% – in 2013, and 4.61% – in 2014. The economic burden due to sick leave at WWTPs was raised from EUR 4913.02 in 2012 to EUR 16 895.80 for 2014 for employers and the NSSI. Conclusions The frequency of cases and the frequency of lost days due to temporary incapacity were increased in the observed period at WWTPs and in Bulgaria, and it is significantly higher for the employed at WWTPs. The economic burden was equally distributed between employers and the NSSI. Med Pr 2018;69(2):129–14

Distribution model and habitat characteristics of Morimus asper funereus Mulsant, 1863 (Coleoptera: Cerambycidae) in Bulgaria

Morimus asper funereus is a protected longhorn beetle species of community interest and conservation importance. It is included in Annex II of the Habitats Directive (as M. funereus) and protected under the Bulgarian Biodiversity Act. Although this saproxylic beetle is widespread in old-growth forests or well-structured woodlands in Central and Southeast Europe, its populations are currently threatened by forest practices, such as the removal of wood (branches and logs) (Hardersen et al. 2017). The species is with limited dispersal ability (due to lack of wings) and is very likely to possess very isolated and localized populations.   In addition, M. asper funereus is of considerable interest from a taxonomic point of view with unclear taxonomic status for as much as Morimus asper is a morphologically highly variable species. At present, at least three species/subspecies of the genus Morimus are known from the territory of Bulgaria - Morimus asper, M. orientalis and M. vercundus bulgaricus (Danilevsky et al. 2016). Although, it is considered M. asper to be met almost everywhere in Bulgaria, its distribution is still not sufficiently known. We started a systematic and more intensive study on the species distribution in 2012 with the mapping of NATURA 2000 sites. Until the present study 54 localities from the literature had been known, after 562 new records have been added. The available information is organised in a database incorporated into the platform “SmartBirds Pro” - https://smartbirds.org (Popgeorgiev et al. 2015), part of which gives the possibility for registration of protected beetle species. In addition, the platform provides free access to all data (type, location, coordinates, date, observer).  Here we present all available data for the species records, and its potential distribution and habitat preference for the territory of Bulgaria via deductive model, using the possibilities of GIS and MAXENT (Fourcade et al. 2014)