Positive reframing in somatoform and functional disorder - supporting the patients in understanding the sickness

Modern psychiatry with its current classification of diseases and symptom-oriented modern pharmacotherapy ousted the concept of classical German psychiatry genesis of diseases and replaces it with the diagnosis of physiological models of disease. Active participation of the patient in the treatment needs a full understanding of the disease. There are two psychotherapeutic techniques to achieve a new perspective and to develop a new attitude: positive reframing (4) and paradoxical intention (1, 3)

The need for psychological crisis counseling immediately after announcement of death

Предмет на настоящата разработка е да се докаже необходимостта от своевременна психологична помощ, непосредствено след съобщаване на новината за смърт и да се представи ефективността й за адекватното разрешаване на скърбенето. Разгледани са 170 контакта с близки на починали, разделени в две групи: гр. А (близки на починали след продължително боледуване) и гр. Б (близки на инцидентно починали). Регистрирани са преживяванията им в началото и в края на психологичната работа. Получените резултати представят необходимостта от психологично консултиране и в двете групи, с подчертан превес при близки на починали от гр. Б.The article targets at giving a proof for the necessity of redundant psychological assistance after announcement of death and its effectiveness in coping with grief. 170 cases of relatives of deceased people were studied separated into two groups: Group A (relatives of people who died after prolonged illness) and Group B (relatives of people who died after an accident). Their reactions and emotions were registered at the beginning and the end of a session with a therapist. The results show necessity for psychological therapy in both groups, especially for the people in Group B

Acute poisonings with neuroleptics in clinic of toxicology of military Medical academy Varna/Bulgaria registered for 20 year period

Objective: This retrospective study was conducted to follow out acute intoxications with neuroleptics in Varna region, to assess the frequency and proportion depending on other drug and non-pharmacological poisoning.Methods: The objects of the study are 193 patients with acute neuroleptic intoxication treated in the Clinic of toxicology - VMA-MBAL-Varna. The study is retrospective and covers a period of 20 years (1991-2010).Results: Incidence of acute poisoning with neuroleptics is 7.5% of all drug poisoning and 2.5% of general poisoning. Poisoning occurs commonly in women and the majority of poisonings are in people of working age.Conclusion: In recent years, there is a trend for an increase in the absolute number and the proportion of poisonings with neuroleptics. Lethality in these poisonings is not high and is 0.4 percent

Malaria - contemporary problem in shipping and maritime tourism

Among the diseases associated with maritime traveling and tourism, malaria continues to pose a major health treat due to its wide distribution in tropical regions and severe and life-threatening clinical course. For the European countries and Bulgaria the major obstructions in the control of malaria and other imported parasitic diseases are the rising number of travels and increased immigration from countries with endemic distribution. Occupational risk of contracting malaria for Bulgarian and foreign ship crews continues to be the most important problem for the Varna region. In a globally connected world, the control of imported malaria and the prevention of its local distribution require both active control and continuous training of general practitioners, ground and naval administration in the constantly changing aspects of the disease and effective collaboration between all of them

Manageable droplet infections in the Dobrich region - past, present and future

Въведение: В края на ХІХ и началото на ХХ век главната причина за смъртността в света са инфекциозните болести. Научните постижения в борбата с инфекциозните заболявания доведоха до ликвидиране на вариолата през 1980 година и изпълнение на международни програми за ликвидиране на други - морбили, епидемичен паротит, вродена рубеола и други. Това са ваксино-предотвратими инфекции, наречени управляеми, за които са въвеждани обективни критерии за епидемиологичен надзор, които дават възможност за своевременни корекции в имунизационните програми и повлияване на заболеваемостта от тях.Цел и задачи: Проучване на регистрираната обща инфекциозна и управляемата въздушно капкова заболяемост в Добричка област за периода 1995- 2012 год.Материали и методи: Отчети, анализи на РЗИ, МЗ, НЦЗПБ, епидемиологично проучване, епидемиологичен анализ, статистически методи.Резултати: Основните показатели на епидемиологичния анализ, които включват заболяемост, смъртност, леталитет, заболяемост по възрастови групи, разглеждаме за продължителен период (1995-2012 г.), тъй като влиянието на имунопрофилактиката при въздушно-капковите инфекции е бавен процес, свързан както с възрастта, така и с държавната политика в областта на имунизационното дело.Изводи: Общата заразна заболяемост в област Добрич за проучвания 18-годишен период (1995- 2012 г.) е около или под средните стойности за страната с изключение на няколко години (1996 г., 2001 г., 2002 г., 2003 г., 2004 г.). Управляемите въздушно-капкови инфекции - морбили, епидемичен паротит, и рубеола са с ниска заболяемост до липсваща такава.Introduction: In the late nineteenth and early twentieth century the main cause of mortality in the world was infectious diseases. Scientific advances in the fight against infectious diseases led to the eradication of smallpox in 1980 and implementation of international programs for the eradication of others - measles, mumps, congenital rubella and others. These are vaccine-preventable infections (the socalled manageable infections), for which objective criteria for epidemiological surveillance have been introduced, that allow for timely adjustments in immunization programs and to influence their morbidity.Purpose and tasks: To investigate the registered total infectious and manageable droplet morbidity in the Dobrich region for the 1995-2012 period.Materials and Methods: Reports, analysis of RHI (Regional Health Inspectorate), MH (Ministry of Health), NCIPD (National Center of Infectious and Parasitic Diseases), epidemiological study, epidemiological analysis, statistical methods.Results: We observed the main indicators of epidemiological analysis, which include morbidity, mortality, lethality and incidence by age groups, for a long period (years 1995-2012), since the impact of immunotherapy in droplet infections is a slow process, related to age as well as to government immunization policies.Conclusions: The total infectious morbidity in Dobrich for the studied 18 years period (1995- 2012) was around or below the national average with exception of a few years (1996, 2001, 2002, 2003 and 2004). The manageable droplet infections - measles, mumps, and rubella have low or no morbidit

Dissemination of anthrax in humans in stationary anthrax outbreaks in Dobrudzha region

Болестта антракс е зооноза, която се разпространява главно от трупове на заразени и умрели домашни и диви животни. По хората се разпространява чрез контакт със заразени животни, заразена почва, месо и предмети, имали досег с трупа.Цел: Да проучим зависимостта между природо-географските условия на почвите и разпространението на антракса при хората за периода 1991-2013 година в област Добрич.Материали: Данните от официалната регистрация на заразните заболявания в Добрич и страната.Методи: Частичен епидемиологичен анализ, картографски методи, статистически методи.Резултати: Специфичното разпростране ние на антракса зависи от степента на развито животновъдство в даден район и от характера на почвите, в които попадат спорите. За съществуването и оцеляването на бацила в почвата влияние оказват не толкова температурата и влажността, a по-скоро наличието на органични съединения, които да служат за микроба като благоприятен субстрат.Изводи: Черноземните почви в Добруджанския край, с натрупването на хумус в значителни количества, слабо алкални или неутрални и с много други органични вещества са подходящи за дългогодишното съхранение на инвазиоспособни спори, включително и антраксни. Заболяванията от антракс при хората в област Добрич са регистрирани в 9 години, от проучвания 23-годишен период, в 5 общини, със засегнати 11 населени места.Anthrax is a zoonotic disease, which is spread mainly by carcasses of infected and dead domestic and wild animals. In people it is spread by contact with infected animals, contaminated soil, meat and objects which were in contact with the body.Aim: To investigate the relationship between geographic conditions of the soil and the spread of anthrax in humans for the period 1991-2013 year in the Dobrich region.Materials: We have used data from the official registration of communicable diseases in the Dobrich region and in the country.Methods: We have used partial epidemiological analysis, cartographic methods, statistical methods. Results: The specific distribution of anthrax depends on the extent of livestock farming in a given area and the nature of the soils, where spores fall. The existence and survival of the bacillus in the soil is influenced not so much by the temperature and humidity, but rather by the presence of organic compounds that serve as favorable microbial substrate.Conclusions: Black soil in the Dobrudzha region, with the accumulation of humus in significant quantities, being slightly alkaline or neutral and containing many other organic substances are suitable for longterm storage of invasive spores, including anthrax. Anthrax in humans in Dobrich were registered in nine years, from the studied 23-year period in 5 municipalities, with 11 affected settlements

Quality of drinking water in the Black Sea coast Dobrich - Part 2

Introduction: Water is essential to life, but it can also be a carriers of diseases in the countries of all continents - from the poorest to the richest. The most common and widespread health risks associated with drinking water are dependent upon geological conditions, natural and anthropogenic chemicals above certain levels, as well as upon pathogenic bacteria , viruses and parasites caught in it.Aim and tasks: To investigate the quality of drinking water in the coast municipalities in Dobrich area: Balchik, Kavarna and Shabla for a 6 -year monitoring period 2008-2013Materials and methods: Data from monitoring joint programs in areas which supply water for the Black Sea coast municipalities: Shabla, Kavarna, Balchik with total beam sampling and testing for chemical and microbiological parameters of drinking water at the tap of the consumer, according to Ordinance №9 regarding the quality of drinking water and such for household purposes (Prom. SG SG 30/2001. )Results: The water-supply network in the municipalities on the Black Sea coast Shabla, Kavarna and Balchik is more than 40 years old, great at length. Non-standard samples by municipalities are in a wide range from 6% in 2008 for Balchik to 70% for Kavarna in 2011. Non-standard samples in Kavarna Municipality are permanently deviated by indicator nitrates in 6 settlements, in the municipality of Shabla in two settlements, which affects the overall indicator of substandard for microbiological and chemical parameters.Conclusions: Deviations from the norm in Balchik municipality are 6% from 2009 to 13% in 2012 and 2013, in Shabla municipality deviations are in the range from 31% for 2009 to 12% in 2013. Kavarna municipality - from 25.4% in 2009 to 70% in 2011 and 38% and 22% for 2012 and 2013