SUBJECT: QUALITY OF THE STRUMA RIVER

Struma is one of the main rivers in the Republic of Bulgaria with certain hydrologic characteristics. The size of its catchment area is 10,797 km. It flows through southwestern Bulgaria and northern Greece and flows into the Aegean Strymonian Gulf of the Aegean Sea. Its length is 415 km, of which 290 kilometers are within the Republic of Bulgaria.For the survey, the section between the points of Razhdavitsa village and the village of Krupnik has been selected. The selected area has the best informative value, which makes the survey representative. There are active hydrometric stations supporting hydrometric network of the National Institute of Meteorology and Hydrology at the Bulgarian Academy of Sciences and points for surface water monitoring by the National System for Environmental Monitoring of the Ministry of Environment and Water. The area is representative for conducting research on the quality and quantity of water.An analysis and evaluation of water quality of the Struma River in the selected area between Razhdavitsa and Krupnik for the period 1981 -2005 have been made.The research presented is part of my PhD dissertation: "Use of information on water quality in making management decisions".Struma is one of the main rivers in the Republic of Bulgaria with certain hydrologic characteristics. The size of its catchment area is 10,797 km. It flows through southwestern Bulgaria and northern Greece and flows into the Aegean Strymonian Gulf of the Aegean Sea. Its length is 415 km, of which 290 kilometers are within the Republic of Bulgaria.For the survey, the section between the points of Razhdavitsa village and the village of Krupnik has been selected. The selected area has the best informative value, which makes the survey representative. There are active hydrometric stations supporting hydrometric network of the National Institute of Meteorology and Hydrology at the Bulgarian Academy of Sciences and points for surface water monitoring by the National System for Environmental Monitoring of the Ministry of Environment and Water. The area is representative for conducting research on the quality and quantity of water.An analysis and evaluation of water quality of the Struma River in the selected area between Razhdavitsa and Krupnik for the period 1981 -2005 have been made.The research presented is part of my PhD dissertation: "Use of information on water quality in making management decisions"

Replacement Treatment with Peritoneal Dialysis in CKD—Significance of Diabetes Mellitus

Introduction: Diabetes mellitus (DM), as a condition with an increasing incidence, is responsible for approximately 1/2 of patients with chronic kidney disease (CKD) worldwide, and its complications often determine the prognosis and outcome for patients.Aim: The aim of this article is to analyze the etiological and clinical significance of diabetes in the treatment of PD.Patients and Methods: A retrospective analysis covered a total of 84 patients (39 men and 45 women, mean age 45 years +/- 15 years), observed in the Clinic of Nephrology of St. Marina University Hospital, Varna in the period 2010–2021. Method survival, survival and mortality of patients, and comorbidity were compared in 26 diabetics and 58 patients without diabetes.Results and Discussion: In the observed group of patients with PD, 30.95% were diabetics. The results for survival of PD as a method for renal replacement therapy (RRT) did not differ significantly for diabetics and non-diabetics, respectively 57.59% and 58.93% at the end of the 5-year period after the start of PD. In the studied group of patients with diabetes, no higher mortality was found compared to patients without diabetes. In a comparative analysis, the groups of patients with and without diabetes did not differ significantly in terms of their survival at the end of the 1st and 3rd year, but the 5-year survival of diabetics was significantly lower—61.54% against 78.57% (p < 0.01). In the group of patients with diabetes, we found higher comorbidity compared to non-diabetics, which is probably the main reason for the lower survival of diabetics at 5 years. The comparative analysis showed that the clinical outcomes in the observed diabetics with PD were identical to those in non-diabetics, except for the lower 5-year survival. The establishment of equal survival of the PD method, as well as the lack of a significant difference in mortality in diabetics and non-diabetics, means that PD is a good choice for the treatment of diabetics with CKD.Conclusion: In conclusion, the close clinical outcomes in patients with and without diabetes mellitus identify PD as an applicable and appropriate RRT for diabetics

Achieving a Longer Duration of Peritoneal Dialysis Replacement Treatment in Patients with CKD

INTRODUCTION: The International Society for Peritoneal Dialysis (ISPD) and the European Peritoneal Dialysis Association (EuroPD) recommend peritoneal dialysis (PD) as an initial replacement therapy for renal function due to a number of benefits of the method for both patients and the treatment team, health funds and society as a whole. It would be in everyone's interest to achieve a longer duration of PD treatment. For each dialysis center, the first step in this direction should be to identify the most common reasons for termination of PD. The next step is to develop a strategy to eliminate them or reduce their frequency based on the recommendations of the EuroPD and ISPD for best clinical practice in the field of PD. AIM: The aim of this article is to analyze the reasons for discontinuation of treatment with PD and to outline opportunities for their elimination in order to achieve a longer duration of treatment with PD leading to longer overall life expectancy of patients. PATIENTS AND METHODS: During the period 01.01.2010–31.12.2019 patients were observed in the Clinic of Nephrology and Dialysis of the St. Marina University Hospital, Varna. The group consisted of 82 patients with CKD on replacement therapy with PD, aged 20 to 79 years—42 women and 40 men, with a duration of treatment of 3 to 108 months. The reasons for discontinuation of the PD treatment were analyzed. The EuroPD and ISPD recommendations for best clinical practice in the field of PD related to the targets are summarized. RESULTS AND DISCUSSION: Of the 82 patients included in the study, as of December 31, 2019, 18 patients continue treatment with PD, 35 have switched to hemodialysis (HD), 8 have been transplanted, and 21 have died. The most common reason for transfer to HD is impaired peritoneal membrane function with reduced removal of waste products of protein metabolism and ultrafiltration (UF) deficiency. It is followed by peritonitis, catheter-associated infections and other reasons, incl. non-medical. The most common causes of death are cardiovascular complications—cerebrovascular disease (stroke), ischemic heart disease (heart attack), heart failure. Recurrent peritonitis and catheter-related infections are next in frequency. In some patients the cause of death remains unknown. Some of the reasons for stopping treatment could be eliminated, and for others it is probably possible to reduce their frequency. CONCLUSION: In conclusion, in order to achieve a longer duration of treatment with PD, the efforts of the treatment team should be focused on 3 main areas: (1) preservation of peritoneal membrane function and its periodic examination for timely diagnosis of changes in it; (2) development and implementation of a strategy for prevention of peritonitis and catheter-related infections, and (3) monitoring and timely treatment of hypertension, hyperlipidemia, and hyperhydration as major risk factors for cardiovascular pathology

Manage epidemiological risk for HIV infection in the maritime transport and shipments

AIDS is a disease which is caused by the human immunodeficiency virus - HIV. Today HIV / AIDS is a global health, social and economic problem and a cause of high mortality. There are three main ways of HIV transmission: sexual transmission; blood and vertical. Lead is sexually transmitted - 87 percent in various forms of sexual intercourse without a condom. In particular, the use of services of prostitutes and nonuse of condom. Traveling abroad (mobile population) as economic migrants, on the occasion of trips, work, business trip, vacation is a vulnerable group for HIV / AIDS. Analyzing the spread of HIV / AIDS in the world and the country - 45% of new HIV infections occur in African Americans, 35% of whites and 17% for Hispanics. (10) our geographical location, the development of tourism, our status as a port city and describing the epidemiological risk for HIV among sailors and travelers have the need to study the epidemiology of HIV / AIDS in terms of shipping and transportation

Border health control in ports of the republic of Bulgaria and programmes for the management of infectious risk

According to the International Health Regulations as a risk for the public health are determined infectious diseases, radiation and chemical pollution. Urbanization and technological progress are a prerequisite for increasing the importance of these risks. The border crossing is facilitated, the area of spread of some infectious diseases expanded, they emerged new ones. We are witnesses of intensive migration of large groups of people without information about their health status. The system of medical control has as a basic order not to hinder the transport of goods and cargo, not to hinder people in their professional and personal trips. There remains the need to control the medical and health risk. Underway are several international projects and programs in this area. Inspectors carrying out border health control at the port of Varna actively participate in these activities. The trainings have aim to exchange experience, best practices and research for objectification of control. It must be optimization of administrative procedures, unification of issued international documents, a providing of ongoing training for border medical services, manning companies and ships` crews.Materials and methods: We used official documents of the WHO and the Republic of Bulgaria, working materials of international programs, official statistics RHI Varna for 2013 and 2014.Results and discussion: The border health control is essential for communicable disease surveillance - the preventing of import and spread of quarantine and especially dangerous infections, timely assessment and response to health risks for public health. It is done in accordance with the International Health Regulations (2005), Regulations on border crossings and border health control. Electronic systems are introduced for exchanging information, which requires good professional training of border medical services. The responsibility of seafarers increases because completing and bringing specific information into the electronic system. The importance of experience and communication between crews and medical services in order preparedness for rapid reaction grows. Realized are various education and training projects, optimized are health documents and protocols. It is necessary a development of target programs on particular problems of border health control to maintain the preparedness of seafarers and institutions for timely identification of health risks and adequate response

Sea epidemiology in teaching maritime medicine - prevention of infectious diseases, being subject to international health regulation and controlled by WHO

Naval Medicine is a scientific and practical direction with a complex interdisciplinary character and is a state policy in countries like Spain, Britain, Poland and the USA. Naval Medicine is defined as a system of scientific knowledge and practical activities, whose purpose is to protect and to gain in health of seafarers, life extension, prevent and treat diseases in humans. Sea epidemiology is a very important part of the medical disciplines. It is formed as a separate direction of epidemiology and as a section of maritime medicine in the 70s-90s of the twentieth century. During a trip the parasitic system, which interacts with the crew of the ships, operates completely differently than in conditions of residence on land, which requires specific approaches for the organization of prevention of infectious diseases during the journey and on land. The control of diseases, which are subject to the international health regulation, is an essential aspect of the marine epidemiology. In the directions for work on the implementation of the International Health Regulations (2005) in 2007 is said, that we should be ready for response in infectious diseases, which may arise as a result of sudden and rapid environmental and climatic changes as a result of industrial pollution and accidents that can put at risk millions of people in many countries and that is why they require measures of worldwide importance to be taken. The measures to protect public health are a significant section in the travel and the transport. Тhe management of infections by means of vaccine agents takes an important place in the system of actions. It finds systemic application in terms of maritime epidemiology as a tool for managing the infectious risk according to the number of vaccination avertible infections. Maritime training epidemiology should include the main sections of the general and private epidemiology in a constantly changing ecological and social environment of sea travel and transport

Importans of the epidemiological control of insects and rodents for the navigation and limitation of infectious risk

The study of the characteristics of monitoring and control of epidemiologically significant insects and rodents in terms of navigation is a key to achieving effective ship‘s disinsection and deratisation (deratting). The success is a result of systematic and timely performed pest control. In international perspective ever closer the institutions work for the unification of these measures and the criteria for certification. In the contemporary conditions of globalization and intensive exchange of goods and passenger the vessels and vehicles can play an important role in the spread of infected rodents and insects in the world.Objective: To present to the medical and non-medical professionals related with navigation, the importance of bloodsucking insects and rodents for the spread of infectious diseases and to emphasize the importance of control measures against them to prevent „ship-associated infections`. Tasks: To present the targeted persons the specifics of control of insects and rodents in the vessels.Materials and Methods: The included teaching is consistent with the International Health Regulations (IHR 2005). They were studied historical materials, articles, epidemiological studies and analyzes of the WHO for the spread of communicable diseases. Manuals for anti-epidemic control and certification of vessels were used.Results and Discussion: Epidemiological significant rodents and insects can penetrate active or passive on vessels. They appear a risk factor for human health and the technical condition of the ship. It is essential the management, monitoring and actions related to pest control

MOLECULAR DIFFERENTIATION OF PAULOWNIA SPECIES AND HYBRIDS

Paulownia is the only genus in Paulowniaceae family and encompasses several species with similar characteristics. In the last years the interest for industrial use of the genus is rising in Bulgaria in relation to the possibilities for using it as bioenergy source and a raw material for wood industry. Knowledge of the genus however is very limited and poses difficulties even when species and hybrids that are marketed in the country are to be differentiated. Therefore a system for adequate identification of different genotypes is not just of scientific, but of practical interest as well. Due to the lack of adequately described methods for molecular differentiation of the species of Paulownia sp. the present study aims at assessing the efficiency of using ISSR markers within this genus and to make an attempt to differentiate the genotypes within the group of species and hybrids, that are available in vitro at the Laboratory of Plant biotechnology of the Agricultural University of Plovdiv