Exploitation results of MIS Imunolog

The software solution “Imunolog”, presented in this paper, is developed after winning international project between University Hospital Alexandrovska, New Bulgarian University and Barcelona Medical University. The fundamental initiative is to localize the main predispositions for this disease based on the statistic data from Bulgarian patients, the relationship between treatment and following manifestations of the disease, sequence of results from a concrete therapy and human body systems reactions and adaptation. In our country there are no investigations and results, regardless of the enormous database of paper epicrysis, visits and anamnesis. Systemic lupus erythematosus (SLE) is a widespread disease with unknown cause, which attacks person's immune system and injures the body's own organs and tissues. We have addressed this problem and devised a software system for assessing both current lupus disease activity and changes in that activity since the patient`s last visit. Imunolog©® is retrospective database with strictly defined purpose objectives – to explore causes, treatment schemes, manifestations and reactions of all available patients in Bulgaria since 1960. It is a result of won international project between University Hospital Alexandrovska, New Bulgarian University and Barcelona Medical University

mHealth Solution in Bulgaria

mHealth by definition is health care, realized through mobile devices for specialized procedures, information exchange, expertize and effects on patients and healthy way of life. As a technologically assisted action, it ensures dynamic unique interactions and contacts - temporary and permanent, on topics and problems of healthcare, as well as providing medical services to individuals and large contingents in unforeseeable circumstances and conditions. The paper presents project of a network for provision of continuity of care with telemedical and telehealth services between Greece and Bulgaria which will: be based on the Internet and 3rd/4th generation GSM services; handle the medical records of citizens of both countries, allow the patients themselves or those responsible for their care to enter data or to utilize for this purpose electronic devices that can do the task automatically (e.g., glucose measuring devices, portable ECG machines, spirometry devices etc); permit the treating physician to continuously monitor his patient's progress from a distance; permit the diffusion and dissemination (to specific target groups) of health related information; use smart card technology to fortify the security of data contained in the patients' records and provide tele-education for the medical and paramedical personnel involved in the project. mHealth applications ensure collection of health and clinical data, delivering health information and real-time monioring of vital signs, and direct provision of information in different stages of its acquisition and processing. Small and convenient size, low power consumption, they can be integrated almost everywhere: furniture, automobiles and even clothes. Mobile phones or personal digital assistants (PDA) with wireless networking capabilities, can serve as inputs to the processes of storage and transfer of recorded and measured parameters to clinicians, selected by their subsequent applications. Patients, involved in the current project, using their mobile phones will be able to send and receive short text messages. They can initiate telephone calls related to health information and education, study therapeutic schemes for meetings and consultations, transport to health experts, even just for support and courage

Hospital Information Systems in Bulgaria – 20 Years of Experience

This paper is devoted to one very exotic, strange at first sight and unusual approach for historical investigation of information systems (IS) in medicine and healthcare in Bulgaria. Our purpose is to explore and make a research, based on 20 years old evaluation scheme for health and medical information systems, and to evaluate the newest and most famous in Bulgarian medical practice developed hospital software systems

Teleconsult – One Telemedical Solution in Bulgaria

The mission of Telemedicine is to provide medical services independent of geographical distances between the involved sites. Through Telemedicine patients can get access to medical expertise that may not be available at the patients’ site. Experience over the last decade has shown that the goals of Telemedicine are not automatically reached by the introduction and use of particular new technologies per se, but rather require the implementation of integral services and specialized information systems. Software Teleconsult aims to provide logistic and telemedical services between two distant hospitals on the territory of Bulgaria. By definition TIS is an information system necessary for the implementation of telemedicine services. Our development is a product with three layer architecture – expert’s, operator’s and administrator’s modules. Each of the profiles has specific functions and characteristics, discussed and experimentally introduced to the users. This paper is focused on presenting the system itself, as well the implementation experience and different module parameters

Model of Electronic Health Record for Gynecology Practice in Bulgaria

The Health Information Management Systems Society’s (HIMSS) definition of EHRs is: “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, and radiology reports. The EHR automates and streamlines the clinician's work flow. The EHR has the ability to generate a complete record of a clinical patient encounter, as well as supporting other care-related activities directly or indirectly via interface—including evidence-based decision support, quality management, and outcomes reporting.” It is important to note that an EHR is generated and maintained within an institution, such as a hospital, integrated delivery network, clinic, or physician office. An EHR is not a longitudinal record of all care provided to the patient in all venues over time. This paper presents a functional software development, specialized for obstetrics and gynecology practice in Bulgarian medical environment. The record design is subordinated to the Bulgarian and international medical laws for tracing the pregnancy period. It consists of three separated modules – medical history of the patient, administrative data, tracing the pregnancy in 3 trimesters with various tests and medical analyzes, different for each trimester. It allows multimedia history archive, heart rate records, 3D/4D video records, fetal morphology history, biochemical screening record, weekly echograph records and full laboratory history at simple screen. It performs telemedical functions through the possibility to connect from every point with Internet and to be accessible both – for patient and doctor. The EHR is unique for Bulgarian gynecology medical practice. It combines the validate paper version of pregnant patient record with separate medical exams that are performed from different specialists and genetic laboratories

Milestone Before/After Analysis of Telemedicine Implementation

This article is focused on description and evaluation of telemedical benefits for the users and participants in medical services, that work in conditions of telepracticing. It is dedicated to a newly introduced software solution for the purposes of distant medical consultation and diagnostic processes in Bulgaria that has been exploited for 6 months period and evaluated by 20 users in 2 hospitals

How to Choose a Suitable Technology for Teleconsultations

In this paper are discussed different versions of solutions for consultations from distance. It will be presented review of consultations through web-site, portal, bridge and cell phone - examples of the different technical and virtual schemes, used in telemedicine. Based on our experience we would discuss positive and negative factors, which can influence the choice of a concrete working model for telemedical practice. As a successful example would be presented one solution, which is based on several interoperating systems: Desktop software that is composed of: a patient database access module, an administrator module and an operator module; a teleconference software solution, a forum and a mail module

ВОЗМОЖНО ЛИ ВЛИЯНИЕ МИКОПЛАЗМЕННОЙ ИНФЕКЦИИ НА ПАТОГЕНЕЗ РАКА ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ?

Objective: to define a possible correlation between Mycoplasma infection persistence and prostate cancer (PC). Subjects and methods. Two hundred and fifty males aged 45 to 83 years (mean age 65.50.71 years) with suspected PC were examined. In all the patients, polyfocal prostate biopsy from 12 points was carried out, by additionally taking 2 tissue columns from the peripheral area of both lobes. The basic material was referred for morphological study; the two additional columns were tested for Mycoplasma DNA by a polymerase chain reaction (PCR) and real-time PCR. The study was blind. According to the morphological findings, the patients were divided into 2 groups: 1) those with chronic prostatitis, prostate adenoma, low-grade prostatic interstitial neoplasia (PIN); 2) those with high-grade PIN (HG-PIN), PC. There were no age differences between the groups (p = 0.05). Results. The standard procedure for PCR was applied to 127 subjects. Twenty-six (20.5%) of the 127 subjects with suspected PC were found to have Mycoplasma infection, Mycoplasma being detected in 21 (26.2%) of the 81 patients with verified HG-PIN and PC. Mycoplasma hominis was encountered in 19 (15%) patients of the 127 subjects with suspected PC and this infection was present in 16 (20%) of the 81 patients with verified HG-PIN and PC. Comparison of the frequency of HG-PIN and PC in the patients of general group (60%) and in those with Mycoplasma infection (80.8%) revealed significant differences (p = 0.031). HG-PIN and PC were also significantly more frequently seen in the patients with Mycoplasma hominis (84.2%) that in the general patient group (60%) (p = 0.033). There were no significant differences in the frequency of HG-PIN and PC between the patients from the general group (60%) and those with Mycoplasma genitalium (71.4%) (p = 0.05). The patients with verified PC and HG-PIN were more frequently found to have Mycoplasma hominis (20%) than Mycoplasma genitalium (6.2%), which further drew our closer attention to just this pathogen. The real-time PCR was used in 123 subjects to detect Mycoplasma. HG-PIN and prostate adenocarcinoma were revealed in 63 of the 123 patients with suspected PC, Mycoplasma hominis was seen in 46 (37%). The frequency (n=46) was 73.9%. The frequency of HG-PIN and PC was significantly higher in the patients with isolated Mycoplasma hominis DNA that in those without this pathogen (p < 0.001). Conclusion. Thus, the investigation showed a significantly higher correlation in the frequency of HG-PIN and PC in the patients with Mycoplasma infection that in the general study patients with suspected PC. This was supported by the use of both the standard procedure for Mycoplasma DNA determination and real-time PCR diagnosis.Objective: to define a possible correlation between Mycoplasma infection persistence and prostate cancer (PC). Subjects and methods. Two hundred and fifty males aged 45 to 83 years (mean age 65.50.71 years) with suspected PC were examined. In all the patients, polyfocal prostate biopsy from 12 points was carried out, by additionally taking 2 tissue columns from the peripheral area of both lobes. The basic material was referred for morphological study; the two additional columns were tested for Mycoplasma DNA by a polymerase chain reaction (PCR) and real-time PCR. The study was blind. According to the morphological findings, the patients were divided into 2 groups: 1) those with chronic prostatitis, prostate adenoma, low-grade prostatic interstitial neoplasia (PIN); 2) those with high-grade PIN (HG-PIN), PC. There were no age differences between the groups (p = 0.05). Results. The standard procedure for PCR was applied to 127 subjects. Twenty-six (20.5%) of the 127 subjects with suspected PC were found to have Mycoplasma infection, Mycoplasma being detected in 21 (26.2%) of the 81 patients with verified HG-PIN and PC. Mycoplasma hominis was encountered in 19 (15%) patients of the 127 subjects with suspected PC and this infection was present in 16 (20%) of the 81 patients with verified HG-PIN and PC. Comparison of the frequency of HG-PIN and PC in the patients of general group (60%) and in those with Mycoplasma infection (80.8%) revealed significant differences (p = 0.031). HG-PIN and PC were also significantly more frequently seen in the patients with Mycoplasma hominis (84.2%) that in the general patient group (60%) (p = 0.033). There were no significant differences in the frequency of HG-PIN and PC between the patients from the general group (60%) and those with Mycoplasma genitalium (71.4%) (p = 0.05). The patients with verified PC and HG-PIN were more frequently found to have Mycoplasma hominis (20%) than Mycoplasma genitalium (6.2%), which further drew our closer attention to just this pathogen. The real-time PCR was used in 123 subjects to detect Mycoplasma. HG-PIN and prostate adenocarcinoma were revealed in 63 of the 123 patients with suspected PC, Mycoplasma hominis was seen in 46 (37%). The frequency (n=46) was 73.9%. The frequency of HG-PIN and PC was significantly higher in the patients with isolated Mycoplasma hominis DNA that in those without this pathogen (p < 0.001). Conclusion. Thus, the investigation showed a significantly higher correlation in the frequency of HG-PIN and PC in the patients with Mycoplasma infection that in the general study patients with suspected PC. This was supported by the use of both the standard procedure for Mycoplasma DNA determination and real-time PCR diagnosis

[In vitro research on the interaction of natural zeolites with diploid cells from the human embryonic lung].

A study of the biological effect of the natural zeolites, clinoptilolite, mordenite and erionite on monostratum cellular culture of human embryonic lung is performed. The number of pyknotic cells, morphological changes in the cells, and monostratum, mitotic activity and changes in the cellular culture are reported during a continuous experiment. As positive control is used standard quartz dust DQ-12 and for negative dust of TiO2. It is already established that the dust particles of natural zeolites with dimensions under 5 micron display biological aggressiveness. With most strongly expressed effect is the clinoptilolite dust, which related to identical active surface, is comparable to that of quartz DQ-12. The mordenite is with moderate cytotoxic effect, proportional to the time and concentration, while erionite is with slight and very delayed effect. There are differences concerning the effect on the miotic activity of the cells. The biologic aggressiveness of the zeolites is discussed in relation to their strong active surface, their ionometabolic properties and their capacity to generate hydrogen at moistering