Pediatric Ulcerative Colitis

Inflammatory bowel disease (IBD) is a collective term that includes a group of disorders with unknown etiology characterized by chronic inflammation of the gastrointestinal tract and relapsing and remitting course. Ulcerative colitis (UC) is a type of IBD that affects the large intestine, causing irritation, inflammation, and ulcers in its lining. Approximately 25% of patients with IBD are diagnosed before the age of 18 years. Children and adolescents with UC are more likely to have more severe disease course with more extended intestinal involvement at diagnosis and faster disease progression than adults. Atypical presentation is also common in pediatric age. Treatment recommendations for children and adolescents are different than those for adults and offer many unique challenges for the healthcare professionals

Posttraumatic Parinaud’s syndrome as a contrecoup injury in a case of closed head trauma

The purpose of the study was to present a rare case of post-traumatic Parinaud’s syndrome with a history of closed head injury. The clinical characteristics, examination, and management are presented in a 12-year-old boy who was a victim of physical violence at the hands of a young boy who punched him in his chin with his fists, with associated paralysis of the upward gaze of the left eyeball, and convergence nystagmus with pupillary involvement. CT examination indicated posttraumatic lesions in the dorsal midbrain and in the cavity of third ventricle, suggestive of acute hemorrhages. Posttraumatic Parinaud’s syndrome is a rare phenomenon that can occur in a case of closed head trauma as contrecoup injury

To the Problem of Poetical World picture and Formation of Author's Ego (Based on the Poetical Metaphors of Ivan Bunin)

У статті досліджено метафори в поетичній творчості Івана Буніна. Лексичний рівень поетики дає змогу простежити, передусім, зміни словоформ і значень, а вже потім – семантичні та когнітивні зсуви. Функціонуючи на рівні поетичної картини світу, метафора слугує засобом відображення авторського «Я». Проаналізовано також основні позиції поетичної метафори в дискурсі Івана Буніна. До того ж, мовна особистість, відповідно до теорій зарубіжних і вітчизняних науковців, постає складним соціокультурним та лінгвістичним явищем із неоднозначною структурою й властивими їй засобами вираження. The paper is dedicated to the studying of metaphor in Ivan Bunin’s poetical creativity. Functioning on the level of poetical world picture, metaphor exists as a mean of expressing of poet’s Ego. Moreover, the metaphor not only reunites several conceptual domains bases, but is used for explication and expression of a completely new type of semantical and lexical unit. During the investigation it was managed to identify the basic metaphorical fields which more clearly convey the meaning of the poetics of Ivan Bunin. The authors analyze the basic positions of poetical metaphor in Ivan Bunin’s discourse. The language personality exists as complex sociocultural, linguistic phenomenon with complicated structure and its peculiar means of expression. Besides, to investigate the formation of a triad of author’s Ego (Ego-creator, and literary Ego and the image of the author), the authors of this paper turn to the characteristics of the nature of real personality –Ivan Bunin-poet

Primary immunodeficiency screening in an infant with cytomegalovirus disease reveals HIV infection

Cytomegalovirus is widely spread worldwide, and it is not uncommon for it to complicate the congenital human immunodeficiency virus (HIV) disease as an acquired or congenital coinfection. However, the association of the two infections is not common amongst infants with primary immune deficiencies. We describe a case of a 6-month-old infant with acquired cytomegalovirus and HIV infections, diagnosed in the course of the patient’s clinical and laboratory workup for a presumed primary immunodeficiency. To date, this is the first reported case of such a combination in a child from Bulgaria

Clinical Laboratory Tests in Some Acute Exogenous Poisonings

Background: There is no specific toxicological screening of clinical laboratory parameters in clinical toxicology when it comes to acute exogenous poisoning

Gastric trichobezoar in the absence of psychosocial stressors: a report of two cases

Abstract Bezoars are accumulations in the gastrointestinal tract caused by intentional or unintentional consumption of indigestible materials. After food and mucus impaction they become solid masses with different sizes, presenting with various non-specific symptoms. Current treatment options for bezoars include enzymatic dissolution, endoscopic fragmentation and removal, and surgical removal. Herein, we report two cases with an abdominal trichobezoar due to trichophagia presenting with mild atypical symptoms and requiring surgical removal. The patients had no underlying psychological and behavioral deviations, psychiatric disorders, stressful or traumatic live events that may trigger the condition. We present our approach to making the diagnosis, the challenges we met, and our treatment strategy. Trichobezoar should not be forgotten as part of the differential diagnosis of abdominal pain and abdominal mass in children and adolescent

Initial experience in target peroral endoscopic submucosal myotomy combined with septotomy for epiphrenic diverticulum

The epiphrenic esophageal diverticulum is a rare non-malignant condition that is commonly associated with motility disorders. It would normally be treated surgically, but with the advancement of endoscopy techniques, peroral endoscopic myotomy with septotomy (D-POEM) has shown its benefits in coping with the symptoms. We present a case of a 71-year-old woman with increasing symptoms of dysphagia, weight loss and imaging data showing a large epiphrenic diverticulum. We treated her using peroral endoscopic myotomy combined with septotomy of the diverticular septum. The procedure showed excellent results with reducing the amount of contrast materials retained in it, improving the quality of life of the patient, and increasing her weight. There were minimal adverse events and no perforations or severe adverse effects occurred. D-POEM is a new and rapidly evolving procedure that is proving to be a safe and effective method of treating epiphrenic esophageal diverticulum

Justification of the need to implement intelligent warehouse systems in fish processing

The paper reviews the existing state of fishing worldwide and in Bulgaria. Then the scheme is determined, according to which the live fish moves from the water basins in which it is raised and lives until it is sent to the store network and the end customers. As a result of the studies conducted, two-week points in the transitional warehouses have been identified. They are characterized by four main indexes: oxygen, temperature, Ph acidity and water level in the container. It these four are not within the determined allowances, it is possible the quality of the environment for storing the live fish to be deteriorated, which can lead to premature death of the fish. In this respect, a regression model with the four main indexes that are to be monitored and maintained within the allowance values has been created for achieving high quality of the storage environment. For the regression model has been determined a coefficient of determination R = 0.9131, and a Fisher’s criterion, which is 5.0143 compared to the one in the Table - 2.5802, which shows that the model is adequate and can be used for further calculations. For the practical solution of the problem, it has been proposed to introduce an intelligent information system in the transitional warehouses for storing live fish before the end processing. The system proposed will be used to monitor and control the four main indexes and to improve the conditions for storing live fish when it is moved along the chain of fish farms to the warehouses for end processing

Endoscopic Diagnosis of Intramural Hematoma in The Colon sigmoideum In a Child With High Titer Inhibitory Hemophilia A

Lower gastrointestinal bleeding is a rare condition in childhood pathology. The incidence of this disorder in the general population of Bulgarian children is unknown