Dental Trauma. Decoronation Technique as a Successful Method in the Treatment of Ankylosis

Introduction: Dental trauma is a common condition among children which occurs more often at the age of 8-12 years. Posttraumatic dental ankylosis is a major problem that can be solved with decoronation.  This is a technique developed in 1984 to remove ankylosed teeth and increase marginal bone levels in young growing individuals.Materials and Methods: After studying different articles and researches we have tried to describe the main advantages of the decoronation technique.Results: The decoronation technique is suggested as an alternative treatment to the extraction of ankylosed teeth which attempts to preserve its surrounding alveolar bone and prevent tooth infra-positioning. This procedure involves gingival mucoperiosteal flap elevation, subcrestal removal of the tooth crown leaving the root in its alveolus to be replaced by bone. Following complete crown removal, the existing root canal filling is removed to prevent foreign body reaction. The preservation of decoronated roots in the alveolar process helps maintain existing bone volume and enables vertical bone growth which can be observed coronally to the decoronated root. Studies show that in early mixed dentition (age 7-10 years) cases - decoronation should be performed within 2 years, whereas in late mixed dentition (age 10-12 years) cases - a decision based on the individual case  should be made.Conclusion: In conclusion, we can summarize that dental trauma often results in tooth ankyloses, which can lead to serious complications such as root resorption, tooth infra-position, or can affect the development of the alveolar ridge. The adequate treatment in such cases requires performing the decoronation technique, which not only helps in preserving the bone volume but also complements the future prosthetic treatment

Phytotherapy in the Management of Menopause-Associated Vasomotor Symptoms

Introduction: Menopause is the permanent cessation of menstruation for at least 12 consecutive months which results from the loss of ovarian follicular activity. Although it is a normal and natural part of aging occurring on average at age of 51 years, most menopausal women develop symptoms, which may deteriorate their quality of life for around one third of their life span (given the mean female life expectancy in Bulgaria of 78 years). The most common complaints are the vasomotor symptoms (VMS: hot flashes and night sweats). Hormone therapy was the gold standard of care for menopausal symptoms before the release of the Women`s Health Initiative. Afterwards, women became reluctant or anxious to use hormone therapy and sought natural non-hormonal alternatives.Materials and Methods: An analysis of accessible articles in scientific web databases (PubMed, ScienceDirect and Google Scholar) on the problem was conducted. Collected data considering evidence in alleviating vasomotor symptoms by popular herbal remedies was further reviewed and summarized.Results: Botanical supplements are considered to act through a number of different mechanisms of action including estrogenic, progestogenic, and/or serotonergic pathways that might mimic the actions of endogenous substances. But clinical studies of the main herbal drugs used to alleviate vasomotor symptoms either did not suggest significant efficacy (as not being superior to placebo) or were limited, and inconsistent, or show different improvements: in well-being, depression, health scores. Thus, patients should be informed to be cautious of possible side effects notwithstanding the general perception of that something is safe if it is of natural origin. In case of adverse reactions, women should be referred to specialists for reconsideration of their therapy.Conclusion: To conclude, as the evidence for phytotherapeutic menopausal VMS relief is both scarce and unconvincing, there is definitely a continued need for further work on the effectiveness and long-term safety of herbal medicinal products

Pregnancy with Tetralogy of Fallot

Introduction: Tetralogy of Fallot is a congenital heart defect that is present at birth. It features four problems: a ventricular septal defect, pulmonary stenosis, a right ventricular hypertrophy  and an overriding aorta. The cause of the tetralogy of Fallot is not known and it is most often diagnosed in the first few weeks of life due to either a loud heart murmur or cyanosis. Children having a tetralogy spell will initially become extremely irritable in response to the critically low oxygen levels and may become sleepy or unresponsive if the severe cyanosis persists.The aim of our research was to evaluate the pregnancy outcome in women with tetralogy of Fallot. The study was a retrospective analysis of maternal and perinatal outcome in 3 women with TOF treated in a cardio-obstetric unit. One of the women with this uncorrected congenital heart defect had one child. Obstetric and cardiac complications were more frequent in the uncorrected tetralogy.Materials and Methods: A retrospective analysis of maternal and perinatal outcome of pregnancies in women with TOF who were seen in the obstetrics unit in Varna`s hospital - Maichin Dom. All women were supervised in the cardio-obstetric clinic under joint supervision of obstetrician and cardiologists. These women were kept under observation post partum.Results: The outcome of our research was that in the women with a corrected condition - there were 100% live births to term. In the uncorrected woman there was one preterm birth. There was 1 neonatal death in the uncorrected woman, too. No baby was determined to have a congenital anomaly, including congenital cardiac malformations.Conclusion: Tetralogy of Fallot carries substantial risk to mother and fetus. Surgical correction is associated with improved maternal and perinatal outcome. These patients need detailed pre-pregnancy evaluation and should be under joint supervision of an obstetrician, a cardiologist, a congenital cardiac surgeon, and an anesthetist

Impact of the postpartum depression on the mother-infant bound

Introduction: Postpartum Depression is a depressive disorder that happens to mothers in the pu­erperium period, between four and twelve weeks after the baby has been born and is characterized by manifestations of extreme sadness, anxiety, fatigue, depressed humour, difficulty to concentrate, feelings of guilt, lack of energy and pleasure performing everyday activities. The main aim of this re­search is to reveal how such maternal characteristics affect the interaction between a mother and her children and what are the consequences in the development of the child.Methods and materials: We had connected two women with children of approximately 3 years that were registered for struggling with postpartum depression at the Psychiatric Hospital ‘`Saint Mari­na`` in Varna. They were treated in an outpatients` department so foremost the treating doctor was contacted an appointment was set for a short interview with both of them. Question sheets with 7 questions were used in order to receive direct information from both the interrogation as well as through the paper questionnaire.Results: According to the answers both of the mothers did not breastfeed their babies which lead to the inability to form a deep attachment between them and the baby. The answers in relation to the in­fant`s interpersonal functioning when in direct communicative engagement with the mother showed a lower rate of overall interactive behaviour, less concentration and more negative responses. On the question of how they estimate their parenting style while one describes it as intrusive the other wom­an considered it as neglectful. Furthermore the mothers reported for sleeping and eating disturbanc­es of the baby and excessive infant crying.Conclusion: It is evident that postnatal depression is associated with detached and neglectful mother-child relationships that inhibit maternal bonding and the provision of warm and attentive care and poses a risk for the cognitive, emotional and behavioural development of the child

New Biomarkers for Systemic Necrotizing Vasculitides

Systemic necrotising vasculitides (SNVs) pose significant challenges due to their diverse clinical manifestations and variable outcomes. Therefore, identifying reliable biomarkers holds promise for improving precision medicine in SNVs. This review explores emerging biomarkers aiming to enhance diagnostic accuracy, prognostic assessment, and disease monitoring. We discuss recent advances in immunological biomarkers, inflammatory indicators, and other parameters that exhibit potential diagnostic and prognostic utility. A comprehensive understanding of these biomarkers may facilitate earlier and more accurate SNV detection, aiding in timely intervention and personalized treatment strategies. Furthermore, we highlight the evolving landscape of disease monitoring through innovative biomarkers, shedding light on their dynamic roles in reflecting disease activity and treatment response. Integrating these novel biomarkers into clinical practice can revolutionize the management of SNVs, ultimately improving patient outcomes and quality of life

Mapping the path to excellence: Evaluation of the diagnostic and treatment tools for invasive fungal infections in the balkans

Background: In the Balkans, rising concerns about invasive fungal infections over the past decade stem from various factors. Primarily, there has been a notable uptick in immunocompromised individuals, including those with chronic illnesses like immunological and hematological diseases. Thus, it is essential to assess the region's laboratory capabilities and the availability of antifungals. This evaluation is vital for gauging the preparedness to diagnose and treat fungal infections effectively, thus minimizing their public health impact. Methods: Data were collected via an online questionnaire targeting healthcare professionals specializing in relevant fields across diverse healthcare settings in Balkan countries. The survey covered various aspects, including diagnostic methods, imaging techniques, and available antifungal armamentarium. Results: Responses were obtained from 50 institutions across the Balkans. While conventional diagnostic methods like microscopy (96 %) and culture (100 %) diagnostics were widely available, access to newer diagnostic tools such as molecular assays (61 %) were limited, often relying on outsourced services. Imaging modalities like ultrasound (100 %) and CT scans (93 %) were universally accessible. A variety of antifungal drugs were available, including amphotericin B formulations (80 %), echinocandins (79 %), and triazoles (100 %). However, access to newer agents like posaconazole (62 %) and isavuconazole (45 %) was inconsistent. Therapeutic drug monitoring (53 %) services were also limited. Conclusion: The study underscores the need for equitable access to diagnostic facilities and antifungal treatments across healthcare settings in the Balkan geographic region. Improving access to molecular diagnostic tools and essential antifungal drugs, as well as implementing therapeutic drug monitoring, would optimize the management of fungal infections in the region