15 research outputs found

    CALCULATION OF LOSSES OF ACTIVE POWER AND ENERGY IN TRANSMISSION LINES AND TRANSFORMERS, AS A PART OF THE ELECTRICAL DISTRIBUTION POWER NETWORK

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    The paper inhere discusses the impact of renewable distributed generation sources upon the power and energy losses in electrical distribution power networks where these sources are attached. In addition a set of mathematical expressions to calculate these active power and energy losses are presented with the respective examples and implementation

    Π•ΠΌΠΏΠΈΡ€ΠΈΡ‡Π½ΠΎ изслСдванС Π½Π° ΡƒΠΏΡ€Π°Π²Π»Π΅Π½ΠΈΠ΅Ρ‚ΠΎ Π½Π° услугитС Π½Π° агроСкосистСмитС Π² Π‘ΡŠΠ»Π³Π°Ρ€ΠΈΡ

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    The study is a report from the second stage of the research project "Management of agro-ecosystem services", funded by the Agricultural Academy - https://maessbg.alle.bg The approach developed during the first stage for analysis, evaluation and improvement of the management system of the agro-ecosystem services in the country has been tested. A survey with agricultural producers identified the size and type of "produced" services of agro-ecosystems of different types, and the dominant forms, factors and efficiency of management of agro-ecosystem services. Primary micro-information was collected from managers of 162 "typical" farms of different legal type, size, production specialization, ecological and geographical location. The main agro-regions and basic agroecosystems (plain, mountainous, protected areas, non-favored areas, etc.) are covered, as well as 12 main specific agroecosystems and their agro-ecosystems - Western Stara Planina, Central Balkans, Danube Plain, Stara Planina, Northeast Fore-Balkans, Struma River Valley, Rhodopes, Pernik Basin, Radomir Field, Sredna Gora, Sub-Balkans, Thracian Lowland and Southeastern Bulgaria. By grouping and summarizing the collected primary information, the structure and volume of agro-ecosystem services in the country and in the main types of agro-ecosystems are identified - geographical, basic and specific ecosystems, subsectors of agricultural production, size and legal type of farming organization. Share of participating producers and degree of participation in storage and supply were used as proxy indicators for production volume of the respective types of holdings. The connection between the main characteristics of farm managers (gender, age, education, farming experience, etc.) and their knowledge and application of the concept of agro-ecosystem services has been established. The main domestic, market, contractual, collective, tripartite, etc. are identified. forms of management of agro-ecosystem services of different types in general and depending on the type of agro-ecosystem and the agricultural producer. An in-depth study of the predominant forms of management of basic agro-ecosystem services such as providing external access to the farm, biodiversity conservation, plant pollination, bioproduction, etc. has been established, and a link with specialization, location, etc. has been established. characteristics of holdings. The effectiveness of the various forms of management of agro-ecosystem services has been established by assessing the direct and additional costs associated with the supply and management of agro-ecosystem services, as well as the direct, additional and indirect effects of their supply. The main behavioral, economic, institutional, natural, etc. are identified. factors that stimulate or limit the "production" of agro-ecosystem services by farmers. The intentions of the agricultural producers related to the protection of ecosystems and ecosystem services in the near future have also been determined. An in-depth analysis of the development and efficiency of organic production as one of the main forms of supply of agro-ecosystem services by Bulgarian farms. A multifaceted analysis of soils has been made as part of Bulgaria's agri-environmental resource, on the example of rural areas in the South Central region. The possibilities for using the sludge from the wastewater treatment plants as a form of agro-eco-service in support of agriculture have been assessed. The use of the customer value category in the management of agro-ecosystem services is analyzed. Summarized conclusions and proposals for improving the approach to scientific analysis and guidelines for improving public policies and forms of public intervention, and individual, business and collective strategies and actions for effective management of agro-ecosystems and services of agro-ecosystems of different types have been prepared

    WALOWA (wave loads on walls) : large-scale experiments in the delta flume

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    Overtopping wave loads on vertical structures on top of a dike have been investigated in several small scale experiments in the past. A large-scale validation for a mild foreshore situation is still missing. Hence the WALOWA experimental campaign was carried out to address this topic. In the present paper the objectives of the WALOWA project are outlined in detail, the model and measurement set-up described and the test program presented. Furthermore, preliminary results featuring a single 1000 irregular waves test of the test program are highlighted. This includes the study of the mild and sandy foreshore evolution by comparing profiles before and after the test execution. The profile measurements are obtained with a mechanical profiler. The wave parameters offshore and at the dike toe are numerically simulated using a SWASH model. The numerical results are validated against the measurements. Finally, the force and pressure time series of the waves impacting against the wall are processed and filtered. The load cell measurements and the time series of integrated pressures are compared to each other and for each impact event the maximum force is derived.Hydraulic Structures and Flood RiskEnvironmental Fluid Mechanic

    Π₯олистичСн ΠΏΠΎΠ΄Ρ…ΠΎΠ΄ Π·Π° Π΄Π΅Ρ„ΠΈΠ½ΠΈΡ€Π°Π½Π΅, оцСняванС ΠΈ подобряванС Π½Π° конкурСнтоспособността Π½Π° зСмСдСлскитС стопанства Π² Π‘ΡŠΠ»Π³Π°Ρ€ΠΈΡ

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    The report presents the results of the first stage of the research project "Competitiveness of agricultural farms in Bulgaria" funded by the Agricultural Academy and implemented by a team from the Institute of Agrarian Economics, UNWE, NBU and IPAZR "N. Pushkarov ”in Sofia. A holistic framework for understanding, evaluating, and improving the competitiveness of agricultural holdings in Bulgaria has been elaborated. The achievements of the interdisciplinary New Institutional Economics, Theory of Economic Organizations, Theory of Competitiveness and other scientific methods such as: study of literature and experience, summary, synthesis, design, comparative and institutional analysis, multicriteria analysis, groupings, discrete structural analysis, value -measuring, qualitative analysis, expert evaluation, survey, Shift-share Analysis, VTOPSIS and statistical analysis, localization analysis, etc. Numerous publications and experience in the country and the world for understanding and assessing the competitiveness of agricultural holdings have been studied. On this basis, a (more) adequate definition of the competitiveness of the farm is given, it is justified that it has four equally important pillars (economic efficiency, financial capability, adaptability and sustainability), and a hierarchical system is developed to assess its level consisting of adequate criteria, indicators and reference values, and an approach to integration and interpretation. The new evaluation system is being experimented with, using survey information from managers of "typical" farms of different types, production specializations and geographical locations. The theoretical bases of business models are summarized and an innovative model of competitiveness of agricultural holdings is developed. An approach to assessing market and factor competitiveness has been adapted and tested in the dairy sector. The regional differences in the competitiveness of agriculture in the EU countries have been identified. The competitive positions and forms of management of alternative farms in the conditions of the Kovid pandemic are assessed. The peculiarities in determining the competitiveness of organic farms are highlighted. The advantages of strategic partnerships and network structures as a tool for increasing the competitiveness of small and medium farms were assessed. The possibilities of the "new" forms of marketing (green, niche, sustainable, etc.) and digitalization to increase the competitiveness of farms are assessed. A regional analysis of agricultural holdings and employees in the South Central region was made. Alternative forms of financing agriculture from banks and leasing companies to improve the competitiveness of farms have been assessed. Conclusions and recommendations for improving public policies and farming strategies have been prepared. The performed activity and the achieved results in terms of volume and quality fully correspond (and exceed) the planned for all tasks. More information can be obtained from the project website https://cfb.alle.bg

    Wave impacts on storm walls, a study on scale effects

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    Low-lying countries such as Belgium and the Netherlands are naturally susceptible to overtopping wave attacks. Coastal regions are therefore facing the threat of such events causing damage to dike-positioned structures and buildings. Research in this filed is often conducted using scaled-down 2D hydraulic physical models, which introduces so called scale effects that can bias the results with regard to measured wave-structure impact forces. This thesis therefore attempts to determine the effects of scaling for post-overtopping wave impacts. To achieve this, large scale physical modelling tests were conducted at Deltares’ Delta flume and compared with a small scale model of similar configuration. A second thesis aim stems from the application of measurement devices in an innovative manner while conducting the large scale tests, and their applicability is assessed here. The model comparison shows that in general the small scale test performs very similarly to its large scale counterpart, and scaling effects did not appear to bias the impact events considerably. This was also observed for the pre-impact flow evolution, where the wave interference mechanisms and resulting bore characteristics were also largely similar. The force-time signal for the largest impacts also is related to the pre-impact mechanisms observed. Classification of the extreme bore impacts according to their impact peak ratio did outline a discrepancy between the two models, which was also linked to the difference in entrapped air pocket impacts.The four measurement instruments assessed are a Terrestrial Laser Scanner (TLS), waterproof action camera(s), optical phase detection probe (OPDP) and a high speed camera mounted behind an opening in the impacted wall. Data from the former two was also used in this analysis and their performance was determined to be good.Coastal and Marine Engineering and Management (CoMEM

    Cardiac implantable electronic devices in Bulgaria: results from the electronic registry BG-Pace for 2022

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    Настоящото ΠΏΡ€ΠΎΡƒΡ‡Π²Π°Π½Π΅ прСдставя Π°Π½Π°Π»ΠΈΠ· Π½Π° дСйността ΠΏΠΎ СлСктрокардиостимулация Π² Π‘ΡŠΠ»Π³Π°Ρ€ΠΈΡ ΠΏΡ€Π΅Π· 2022 Π³ΠΎΠ΄ΠΈΠ½Π° Π½Π° Π±Π°Π·Π°Ρ‚Π° Π½Π° Π΄Π°Π½Π½ΠΈ ΠΎΡ‚ Π½Π°Ρ†ΠΈΠΎΠ½Π°Π»Π΅Π½ Ρ€Π΅Π³ΠΈΡΡ‚ΡŠΡ€ Π½Π° ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€Π°Π½ΠΈΡ‚Π΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ.Β ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»ΠΈ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ:Β Β Β Β Β Β Β Β Β Β Β Β Β  Π”Π°Π½Π½ΠΈΡ‚Π΅, въвСдСни Π² Ρ€Π΅Π³ΠΈΡΡ‚ΡŠΡ€Π° BG-Pace Π·Π° 2022 Π³ΠΎΠ΄ΠΈΠ½Π° са изслСдвани рСтроспСктивно. Анализирани са дСмографски Π΄Π°Π½Π½ΠΈ Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅, Ρ‚ΠΈΠΏΠ° ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€Π°, Ρ‚ΠΈΠΏΠ° устройство, Ρ€Π΅ΠΆΠΈΠΌΠ° Π½Π° стимулация, Стиологията, симптомитС ΠΈ Π•ΠšΠ“ ΠΎΠ±Ρ€Π°Π·Π° ΠΏΡ€Π΅Π΄ΠΈ имплантацията. Анализиран Π΅ броят ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ ΠΏΡ€ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½ΠΈΡ‚Π΅ Ρ‚ΠΈΠΏΠΎΠ²Π΅ устройства ΠΈ ΠΎΠ±Π΅ΠΌΠ° дСйност Π½Π° Ρ†Π΅Π½Ρ‚Ρ€ΠΎΠ²Π΅ ΠΈ ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΎΡ€ΠΈ.Β Β Β Β Β Β Β Β Β Β Β Β Β Β  Π Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈ: Π—Π° изслСдвания ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ са ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€Π°Π½ΠΈ 4770 устройства ΠΎΡ‚ 45 ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΎΡ€ΠΈ Π² 30 Ρ†Π΅Π½Ρ‚ΡŠΡ€Π°. Π’ΡŠΠ·Ρ€Π°ΡΡ‚Ρ‚Π° Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅ ΠΏΡ€ΠΈ имплантацията Π΅ Π±ΠΈΠ»Π° 76 (IQR 69-82, 14-98) Π³ΠΎΠ΄ΠΈΠ½ΠΈ ΠΊΠ°Ρ‚ΠΎ ΠΏΡ€Π΅ΠΎΠ±Π»Π°Π΄Π°Π²Π°Ρ‚ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅ ΠΎΡ‚ мъТки ΠΏΠΎΠ» – 2843 (59,6%). Най-голям Π±Ρ€ΠΎΠΉ ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ са ΠΎΡΡŠΡ‰Π΅ΡΡ‚Π²Π΅Π½ΠΈ във Π²ΡŠΠ·Ρ€Π°ΡΡ‚ΠΎΠ²Π°Ρ‚Π° Π³Ρ€ΡƒΠΏΠ° 70-79 Π³ΠΎΠ΄ΠΈΠ½ΠΈ. ОсновСн дял Π·Π°Π΅ΠΌΠ°Ρ‚ Π°Π½Ρ‚ΠΈΠ±Ρ€Π°Π΄ΠΈΠΊΠ°Ρ€Π΄Π½ΠΈΡ‚Π΅ стимулатори - 578,8/ΠΌΠΈΠ»ΠΈΠΎΠ½. ΠžΡ‚ тях систСми Π·Π° Ρ„ΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡ‡Π½Π° стимулация са Π±ΠΈΠ»ΠΈ 111 (2,3%). Броят Π½Π° ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€Π°Π½ΠΈΡ‚Π΅ ΠΊΠ°Ρ€Π΄ΠΈΠΎΠ²Π΅Ρ€Ρ‚Π΅Ρ€-Π΄Π΅Ρ„ΠΈΠ±Ρ€ΠΈΠ»Π°Ρ‚ΠΎΡ€ΠΈ Π΅ ΠΏΠΎ-висок спрямо ΠΏΡ€Π΅Π΄Ρ…ΠΎΠ΄Π½ΠΈ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ΠΈ ΠΈ достига 31,9/ΠΌΠΈΠ»ΠΈΠΎΠ½. Π˜ΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈΡ‚Π΅ Π½Π° систСми Π·Π° рСсинхронизираща тСрапия с функция Π½Π° Π΄Π΅Ρ„ΠΈΠ±Ρ€ΠΈΠ»Π°Ρ‚ΠΎΡ€ ΡΡŠΡ‰ΠΎ Π±Π΅Π»Π΅ΠΆΠ°Ρ‚ Ρ€ΡŠΡΡ‚ Π΄ΠΎ 15,9/ΠΌΠΈΠ»ΠΈΠΎΠ½. Π—Π½Π°Ρ‡ΠΈΡ‚Π΅Π»Π΅Π½ Ρ€ΡŠΡΡ‚ сС наблюдава ΠΈ ΠΏΡ€ΠΈ ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€ΡƒΠ΅ΠΌΠΈΡ‚Π΅ Π»ΡƒΡƒΠΏ-Ρ€Π΅ΠΊΠΎΡ€Π΄Π΅Ρ€ΠΈ, ΠΊΠΎΠΈΡ‚ΠΎ достигат Π΄ΠΎ 8,8/ΠΌΠΈΠ»ΠΈΠΎΠ½. Броят ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ Π·Π° Ρ†Π΅Π½Ρ‚ΡŠΡ€ Π΅Β  Π±ΠΈΠ» 115,5 (IQR 53-261,3, 3-546), Π° Π·Π° ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΎΡ€ – 76,5 (IQR 36,8-154,8, 3-364) устройства. ΠŸΡ€Π΅ΠΎΠ±Π»Π°Π΄Π°Π²Π°Ρ‚ ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈΡ‚Π΅ Π½Π° Π΄Π²ΡƒΠΊΡƒΡ…ΠΈΠ½Π½ΠΈ устройства, Ρ‡ΠΈΠΉΡ‚ΠΎ дял Π΅ 83,1% ΠΏΡ€ΠΈ АV Π±Π»ΠΎΠΊ Π† ΠΈ Π†Π† стСпСн, 72,5% ΠΏΡ€ΠΈ пълСн АV Π±Π»ΠΎΠΊ, 82,6% ΠΏΡ€ΠΈ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡ Π½Π° Π²ΡŠΡ‚Ρ€Π΅ΠΊΠ°ΠΌΠ΅Ρ€Π½Π°Ρ‚Π° проводимост ΠΈ 66,8% ΠΏΡ€ΠΈ синдрома Π½Π° болния синусов възСл. Π Π΅ΠΆΠΈΠΌΠΈΡ‚Π΅, позволяващи ΠΏΡ€Π΅Π΄ΡΡŠΡ€Π΄Π΅Π½ сСнзинг дСмонстрират ΠΏΡ€Π΅Π²ΡŠΠ·Ρ…ΠΎΠ΄ΡΡ‚Π²ΠΎΒ  – 62,4% ΠΏΡ€ΠΈ всички ΠΏΡ€ΠΎΠ²ΠΎΠ΄Π½ΠΈ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡ. НалицС Π΅ Π·Π½Π°Ρ‡ΠΈΠΌΠΎ (Π <0,001) нарастванС Π½Π° дяла Π½Π° VVΠ† Ρ€Π΅ΠΆΠΈΠΌΠ° с нарастванС Π½Π° Π²ΡŠΠ·Ρ€Π°ΡΡ‚Ρ‚Π°. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅: Националният Ρ€Π΅Π³ΠΈΡΡ‚ΡŠΡ€ BG-Pace Π²ΠΊΠ»ΡŽΡ‡Π²Π° систСмно въвСдСни ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π½ΠΈ, дСмографски ΠΈ ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€Π½ΠΈ Π΄Π°Π½Π½ΠΈ Π½Π° ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€Π°Π½ΠΈΡ‚Π΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ. ДСмонстрира сС повишаванС Π½Π° броя Π½Π°Β  ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ Π² сравнСниС с ΠΏΡ€Π΅Π΄Ρ…ΠΎΠ΄Π½ΠΈ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ΠΈ ΠΊΠ°Ρ‚ΠΎ ΡΡŠΡ‰ΠΈΡΡ‚ остава нисък спрямо срСдното СвропСйско Π½ΠΈΠ²ΠΎ. The current study analyses the activity on cardiac pacing in Bulgaria in 2022 based on data derived from a national registry of patients with cardiac implantable electronic devices (CIEDs).Β Materials and methods.Β Data from the national registry BG-Pace for 2022 was studied retrospectively. Demographic data, procedure and device type, pacing mode, etiology, symptoms, preimplantation ECG, number of implantations, and centre and operator volumes were analyzed.Β Results:Β Four thousand seven hundred seventy devices were implanted by 45 operators in 30 centers. Median age was 76 (IQR 69-82, 14-98) years, and male patients were 2843 (59,6%). The most significant number of implantations were carried out in the age group 70-79 years. The most commonly implanted CIEDs were antibradycardia devices - 578,8/million. Of them, conduction system pacing was used in 111 (2.3%). Implanted cardioverter-defibrillators demonstrated a growth compared to previous periods and reached 31.9/million. Cardiac resynchronization defibrillators implantations also shown a growth to 15.9/million. A considerable increase was found with implantable loop-recorders, which reached 8.8/million. Number of implantations per center was 115.5 (IQR 53-261.,3, 3-546), and 76,5 (IQR 36,8-154,8, 3-364) devices per operator. Dual chamber devices were most commonly implanted with a share of 83.1% in AVB I and II degrees, 72.5% in complete AVB, 82.6% in intraventricular conduction disturbances, and in 66.8% in patients with sick sinus syndrome. Pacing modes allowing for atrial sensing were most frequently implanted – 62.4% of all implantations for conduction disturbances. There was a significant increase in the use of VVI mode with increasing age (P<0.001).Β Conclusion:Β The national registry BG-Pace includes systematic clinical, demographical, and proceduralΒ data for CIED implantations in Bulgaria. There is a growth in the implantation rates compared to previous periods, but they remain lower than the average number for Europe

    Cardiac implantable electronic devices in Bulgaria: results from the electronic registry BG-Pace for 2022

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    Настоящото ΠΏΡ€ΠΎΡƒΡ‡Π²Π°Π½Π΅ прСдставя Π°Π½Π°Π»ΠΈΠ· Π½Π° дСйността ΠΏΠΎ СлСктрокардиостимулация Π² Π‘ΡŠΠ»Π³Π°Ρ€ΠΈΡ ΠΏΡ€Π΅Π· 2022 Π³ΠΎΠ΄ΠΈΠ½Π° Π½Π° Π±Π°Π·Π°Ρ‚Π° Π½Π° Π΄Π°Π½Π½ΠΈ ΠΎΡ‚ Π½Π°Ρ†ΠΈΠΎΠ½Π°Π»Π΅Π½ Ρ€Π΅Π³ΠΈΡΡ‚ΡŠΡ€ Π½Π° ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€Π°Π½ΠΈΡ‚Π΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ.Β ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»ΠΈ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΈ:Β Β Β Β Β Β Β Β Β Β Β Β Β  Π”Π°Π½Π½ΠΈΡ‚Π΅, въвСдСни Π² Ρ€Π΅Π³ΠΈΡΡ‚ΡŠΡ€Π° BG-Pace Π·Π° 2022 Π³ΠΎΠ΄ΠΈΠ½Π° са изслСдвани рСтроспСктивно. Анализирани са дСмографски Π΄Π°Π½Π½ΠΈ Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅, Ρ‚ΠΈΠΏΠ° ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€Π°, Ρ‚ΠΈΠΏΠ° устройство, Ρ€Π΅ΠΆΠΈΠΌΠ° Π½Π° стимулация, Стиологията, симптомитС ΠΈ Π•ΠšΠ“ ΠΎΠ±Ρ€Π°Π·Π° ΠΏΡ€Π΅Π΄ΠΈ имплантацията. Анализиран Π΅ броят ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ ΠΏΡ€ΠΈ Ρ€Π°Π·Π»ΠΈΡ‡Π½ΠΈΡ‚Π΅ Ρ‚ΠΈΠΏΠΎΠ²Π΅ устройства ΠΈ ΠΎΠ±Π΅ΠΌΠ° дСйност Π½Π° Ρ†Π΅Π½Ρ‚Ρ€ΠΎΠ²Π΅ ΠΈ ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΎΡ€ΠΈ.Β Β Β Β Β Β Β Β Β Β Β Β Β Β  Π Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈ: Π—Π° изслСдвания ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ са ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€Π°Π½ΠΈ 4770 устройства ΠΎΡ‚ 45 ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΎΡ€ΠΈ Π² 30 Ρ†Π΅Π½Ρ‚ΡŠΡ€Π°. Π’ΡŠΠ·Ρ€Π°ΡΡ‚Ρ‚Π° Π½Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅ ΠΏΡ€ΠΈ имплантацията Π΅ Π±ΠΈΠ»Π° 76 (IQR 69-82, 14-98) Π³ΠΎΠ΄ΠΈΠ½ΠΈ ΠΊΠ°Ρ‚ΠΎ ΠΏΡ€Π΅ΠΎΠ±Π»Π°Π΄Π°Π²Π°Ρ‚ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈΡ‚Π΅ ΠΎΡ‚ мъТки ΠΏΠΎΠ» – 2843 (59,6%). Най-голям Π±Ρ€ΠΎΠΉ ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ са ΠΎΡΡŠΡ‰Π΅ΡΡ‚Π²Π΅Π½ΠΈ във Π²ΡŠΠ·Ρ€Π°ΡΡ‚ΠΎΠ²Π°Ρ‚Π° Π³Ρ€ΡƒΠΏΠ° 70-79 Π³ΠΎΠ΄ΠΈΠ½ΠΈ. ОсновСн дял Π·Π°Π΅ΠΌΠ°Ρ‚ Π°Π½Ρ‚ΠΈΠ±Ρ€Π°Π΄ΠΈΠΊΠ°Ρ€Π΄Π½ΠΈΡ‚Π΅ стимулатори - 578,8/ΠΌΠΈΠ»ΠΈΠΎΠ½. ΠžΡ‚ тях систСми Π·Π° Ρ„ΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡ‡Π½Π° стимулация са Π±ΠΈΠ»ΠΈ 111 (2,3%). Броят Π½Π° ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€Π°Π½ΠΈΡ‚Π΅ ΠΊΠ°Ρ€Π΄ΠΈΠΎΠ²Π΅Ρ€Ρ‚Π΅Ρ€-Π΄Π΅Ρ„ΠΈΠ±Ρ€ΠΈΠ»Π°Ρ‚ΠΎΡ€ΠΈ Π΅ ΠΏΠΎ-висок спрямо ΠΏΡ€Π΅Π΄Ρ…ΠΎΠ΄Π½ΠΈ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ΠΈ ΠΈ достига 31,9/ΠΌΠΈΠ»ΠΈΠΎΠ½. Π˜ΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈΡ‚Π΅ Π½Π° систСми Π·Π° рСсинхронизираща тСрапия с функция Π½Π° Π΄Π΅Ρ„ΠΈΠ±Ρ€ΠΈΠ»Π°Ρ‚ΠΎΡ€ ΡΡŠΡ‰ΠΎ Π±Π΅Π»Π΅ΠΆΠ°Ρ‚ Ρ€ΡŠΡΡ‚ Π΄ΠΎ 15,9/ΠΌΠΈΠ»ΠΈΠΎΠ½. Π—Π½Π°Ρ‡ΠΈΡ‚Π΅Π»Π΅Π½ Ρ€ΡŠΡΡ‚ сС наблюдава ΠΈ ΠΏΡ€ΠΈ ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€ΡƒΠ΅ΠΌΠΈΡ‚Π΅ Π»ΡƒΡƒΠΏ-Ρ€Π΅ΠΊΠΎΡ€Π΄Π΅Ρ€ΠΈ, ΠΊΠΎΠΈΡ‚ΠΎ достигат Π΄ΠΎ 8,8/ΠΌΠΈΠ»ΠΈΠΎΠ½. Броят ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ Π·Π° Ρ†Π΅Π½Ρ‚ΡŠΡ€ Π΅Β  Π±ΠΈΠ» 115,5 (IQR 53-261,3, 3-546), Π° Π·Π° ΠΎΠΏΠ΅Ρ€Π°Ρ‚ΠΎΡ€ – 76,5 (IQR 36,8-154,8, 3-364) устройства. ΠŸΡ€Π΅ΠΎΠ±Π»Π°Π΄Π°Π²Π°Ρ‚ ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈΡ‚Π΅ Π½Π° Π΄Π²ΡƒΠΊΡƒΡ…ΠΈΠ½Π½ΠΈ устройства, Ρ‡ΠΈΠΉΡ‚ΠΎ дял Π΅ 83,1% ΠΏΡ€ΠΈ АV Π±Π»ΠΎΠΊ Π† ΠΈ Π†Π† стСпСн, 72,5% ΠΏΡ€ΠΈ пълСн АV Π±Π»ΠΎΠΊ, 82,6% ΠΏΡ€ΠΈ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡ Π½Π° Π²ΡŠΡ‚Ρ€Π΅ΠΊΠ°ΠΌΠ΅Ρ€Π½Π°Ρ‚Π° проводимост ΠΈ 66,8% ΠΏΡ€ΠΈ синдрома Π½Π° болния синусов възСл. Π Π΅ΠΆΠΈΠΌΠΈΡ‚Π΅, позволяващи ΠΏΡ€Π΅Π΄ΡΡŠΡ€Π΄Π΅Π½ сСнзинг дСмонстрират ΠΏΡ€Π΅Π²ΡŠΠ·Ρ…ΠΎΠ΄ΡΡ‚Π²ΠΎΒ  – 62,4% ΠΏΡ€ΠΈ всички ΠΏΡ€ΠΎΠ²ΠΎΠ΄Π½ΠΈ Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡ. НалицС Π΅ Π·Π½Π°Ρ‡ΠΈΠΌΠΎ (Π <0,001) нарастванС Π½Π° дяла Π½Π° VVΠ† Ρ€Π΅ΠΆΠΈΠΌΠ° с нарастванС Π½Π° Π²ΡŠΠ·Ρ€Π°ΡΡ‚Ρ‚Π°. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅: Националният Ρ€Π΅Π³ΠΈΡΡ‚ΡŠΡ€ BG-Pace Π²ΠΊΠ»ΡŽΡ‡Π²Π° систСмно въвСдСни ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π½ΠΈ, дСмографски ΠΈ ΠΏΡ€ΠΎΡ†Π΅Π΄ΡƒΡ€Π½ΠΈ Π΄Π°Π½Π½ΠΈ Π½Π° ΠΈΠΌΠΏΠ»Π°Π½Ρ‚ΠΈΡ€Π°Π½ΠΈΡ‚Π΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΈ. ДСмонстрира сС повишаванС Π½Π° броя Π½Π°Β  ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ†ΠΈΠΈ Π² сравнСниС с ΠΏΡ€Π΅Π΄Ρ…ΠΎΠ΄Π½ΠΈ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ΠΈ ΠΊΠ°Ρ‚ΠΎ ΡΡŠΡ‰ΠΈΡΡ‚ остава нисък спрямо срСдното СвропСйско Π½ΠΈΠ²ΠΎ. The current study analyses the activity on cardiac pacing in Bulgaria in 2022 based on data derived from a national registry of patients with cardiac implantable electronic devices (CIEDs).Β Materials and methods.Β Data from the national registry BG-Pace for 2022 was studied retrospectively. Demographic data, procedure and device type, pacing mode, etiology, symptoms, preimplantation ECG, number of implantations, and centre and operator volumes were analyzed.Β Results:Β Four thousand seven hundred seventy devices were implanted by 45 operators in 30 centers. Median age was 76 (IQR 69-82, 14-98) years, and male patients were 2843 (59,6%). The most significant number of implantations were carried out in the age group 70-79 years. The most commonly implanted CIEDs were antibradycardia devices - 578,8/million. Of them, conduction system pacing was used in 111 (2.3%). Implanted cardioverter-defibrillators demonstrated a growth compared to previous periods and reached 31.9/million. Cardiac resynchronization defibrillators implantations also shown a growth to 15.9/million. A considerable increase was found with implantable loop-recorders, which reached 8.8/million. Number of implantations per center was 115.5 (IQR 53-261.,3, 3-546), and 76,5 (IQR 36,8-154,8, 3-364) devices per operator. Dual chamber devices were most commonly implanted with a share of 83.1% in AVB I and II degrees, 72.5% in complete AVB, 82.6% in intraventricular conduction disturbances, and in 66.8% in patients with sick sinus syndrome. Pacing modes allowing for atrial sensing were most frequently implanted – 62.4% of all implantations for conduction disturbances. There was a significant increase in the use of VVI mode with increasing age (P<0.001).Β Conclusion:Β The national registry BG-Pace includes systematic clinical, demographical, and proceduralΒ data for CIED implantations in Bulgaria. There is a growth in the implantation rates compared to previous periods, but they remain lower than the average number for Europe

    Minimally Invasive Management of Giant Esophageal Polyp - a Case Report

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    Introduction:Β The benign tumors of the esophagus are rare disease. Their size has a great variation - from a few centimeters to taking up the whole length of the esophagus. Usually, they present with dysphagia, anemia and in some cases - aspiration or protrusion through the mouth. The polyps are mainly of fibroepithelial origin. Most of them are treated surgically with cervicotomy or esophagotomy.Materials and Methods:Β We present a case of a 65-year-old male patient with a large 18x5 cm esophageal polyp with an origin from the upper esophagus after the hypopharynx. The preoperative computed tomography angiography excluded the presence of large vessels in the polyp stalk and that helped to establish the surgical strategy - injection of aethoxysklerol at the polyp base and resection with the help of laparoscopic vessel sealer and divider (LigaSureΓ’β€žΒ’). The transoral endoscopic approach was achieved using Weerda diverticuloscope.Results:Β The polyp was resected successfully. The vessel sealer provided excellent hemostasis and no damage to the surrounding tissues. The only limitation of the transoral approach was due to the large size of the polyp, which had to be extracted via gastrotomy through a 5cm midline laparotomy incision. The postprocedural period was uneventful, liquid food intake was restored on the 2nd postprocedural day and solid food on the 3rd day. The patient was discharged on the fifth day. After one-year follow-up no recurrence was detected. Discussion: Various approaches have been described for the removal of large esophageal polyps, varying from transoral hybrid approach, cervical approach, thoracoscopic approach and even esophagectomy according to the experience of the institution. Due to the benign characteristics of the disease more minimally invasive approach is preferred and it should be offered to the patient.Conclusion:Β Preoperative staging of the disease is essential to determine the operational approach that will be applied. The LigaSure device can provide safe hemostasis and facilitate the resection of the polyp stalk. The minimally invasive approach even in cases of large esophageal polyp is safe and feasible and the tumor can be easily extracted via small laparotomy and gastrotomy
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