Inter-incisive index in Bulgarians and its application in dentistry / Indice interincisivo en búlgaros y su aplicación en odontología

SUMMARY: In recent years, aesthetic dentistry has become a major focus for the public. Facial attractiveness plays a key role on modern society and the creation of harmonious smile is an aim for every dentist. The objective of this study was to define certain values of the inter-incisive index in Bulgarians, the sexual dimorphism and bilateral asymmetry and to verify differences of this index between Bulgarians and other Balkan populations. The present study included 121 males and 111 females of Bulgarian origin aged 20- 40 years. Mesiodistal dimensions of maxillary central and lateral incisors were measured by Dentistry Sliding Vernier Caliper. We used the technique of direct anthropometry, modified by Prof. Y. Yordanov. We calculated the inter-incisive index as ratio of the mesiodistal dimension of maxillary lateral incisor to the mesiodistal dimension of the maxillary central incisor. The measurements were analyzed with SPSS 23. The level of statistical significance was set at P< 0.05. The inter-incisive index showed no statistically significant differences between left and right side of the dental arch in both sexes. We did not find statistically significant differences between males and females as well. On the other hand, we found statistically significant differences in MD values of incisors between Bulgarians and other Balkan nations. Inter-incisive index shows no sexual dimorphism and bilateral asymmetry in Bulgarians. This can be helpful in aesthetic dentistry, in prosthodontics and in orthodontic treatment planning.

RESUMEN: En los últimos años, la odontología estética se ha convertido en un foco importante para el público. El atractivo facial juega un papel clave en la sociedad moderna y la creación de una sonrisa armoniosa es importante para todos los dentistas. El objetivo de este estudio fue definir ciertos valores del índice interincisivo en búlgaros, el dimorfismo sexual y la asimetría bilateral y verificar diferencias de este índice entre búlgaros y otras poblaciones balcánicas. El presente estudio incluyó a 121 hombres y 111 mujeres de origen búlgaro entre 20 y 40 años de edad. Las dimensiones mesiodistales de los incisivos superiores centrales y laterales se midieron con un calibrador Vernier deslizante de odontología. Utilizamos la técnica de antropometría directa, modificada por el Prof. Y. Yordanov y se calculó el índice interincisivo como la relación entre la dimensión mesiodistal del incisivo lateral superior y la dimensión mesiodistal del incisivo central superior. Las medidas se analizaron con SPSS 23. El nivel de significancia estadística se fijó en P<0,05. El índice interincisivo no mostró diferencias estadísticamente significativas entre los lados izquierdo y derecho de la arcada dentaria en ambos sexos. Tampoco encontramos diferencias estadísticamente significativas entre hombres y mujeres. Por otro lado, encontramos diferencias estadísticamente significativas en los valores de DM de los incisivos entre búlgaros y otras naciones balcánicas. El índice interincisivo no muestra dimorfismo sexual ni asimetría bilateral en los búlgaros. Esto puede ser útil en odontología estética, en prostodoncia y en la planificación de tratamientos de ortodoncia.

Injection Shrinkage аnd Water Sorption of Some Thermoplastic Dental Materials

Objective: To evaluate the change of diameter of different injection-molded thermoplastic materials. Material and Methods: Four thermoplastic injection-molded materials were analyzed (Bre.flex 2nd edition, Vertex ThermoSens, Perflex Biosens and Polyan IC). A total of 432 test samples were made in the form of an "hourglass". All samples were divided into three groups: Group I (Control) - consisting of 36 test samples for each type of material, that was not exposed to artificial aging or a wet environment; Group II - consisting of 36 test samples for each type of material, that were artificially aged through dehydration; Group III - specimen were subjected to artificial aging without dehydration. The diameter of each specimen was measured with a digital caliper. Data were analysed using the Student's t-test. Results: Regarding to shrinkage, the samples from the Bf Control group have a mean value of 1.56 mm and was observed a shrinkage of the injection-molded polyamide material within 0.25%. The comparison between the samples from Group II and Group III showed statistically significant differences (p<0.001). There were no significant differences between groups for Thermosens and Biosens (p>0.05). The comparison between Group II and Group III for Polyan IC samples shows that Group III has a higher arithmetic mean value (p<0.01). Conclusion: Shrinkage of the polymers during the injection process is present in all materials. The thermocycling and the storage in a dry or in a wet environment of the samples results in a change of the diameter in almost every single type of material.

Morphometric studies of Sideritis scardica Grsb. and S. syriaca L. in their natural populations in Bulgaria / Estudios morfométricos de Sideritis scardica Grsb. y S. syriaca L. en sus poblaciones naturales en Bulgaria

The paper aimed at studying the morphometric variation in eight natural populations of two rare Sideritis species occurring in Bulgaria. Thirteen measured traits and four ratios were used to reveal the degree and distribution of variation. Most traits exhibited moderate to high variation and the most differentiating one was the length of the acumen. Cluster analysis and Principal component analysis revealed that the two taxa, S. scardica and S. syriaca are well distinguished but the population Chervenata stena, classified as S. scardica differed significantly from the remaining ones of the same species. Results of the morphometric study indicate the necessity of further studies for revealing the taxonomic relationships among the taxa.

El manuscrito tenía como objetivo estudiar la variación morfométrica en ocho poblaciones naturales de dos especies raras de Sideritis que crecen en Bulgaria. Se utilizaron trece rasgos medidos y cuatro relaciones para revelar el grado y la distribución de la variación. La mayoría de los rasgos mostraron una variación de moderada a alta y la más diferenciadora fue la longitud del acumen. El análisis de conglomerados y el análisis de componentes principales revelaron que los dos taxas, S. scardica y S. syriaca están bien diferenciados, pero la población de Chervenata stena, clasificada como S. scardica, difería significativamente de las restantes de la misma especie. Los resultados del estudio morfométrico indican la necesidad de estudios adicionales para revelar las relaciones taxonómicas entre los taxones.

Does Nationality Matter for the Gunshot Brain Injury? Ten-Year Retrospective Observational Cadaveric Comparative Study for Gunshot TBI between Greece and Bulgaria / 대한신경손상학회지

OBJECTIVE: Penetrating brain trauma (PBT) caused by gunshot is one of the most lethal traumatic brain injuries (TBIs) and its management and confrontation is of great importance. METHODS: The authors searched retrospectively the archives from 2 similar autonomous laboratories of forensic science and toxicology in the Balkan peninsula for a 10-year period of time and included only fatal penetrating brain injuries. RESULTS: The study is conducted in 61 cadavers with gunshot PBT. All of the cadavers were victims of suicide attempt. The most common anatomical localization on the skull were the facial bones, followed by skull base, temporal and parietal bone, conducting a trajectory of the gunshot. Additional findings were atherosclerosis of the blood vessels and chronic diseases such as chronic obstructive pulmonary disease, cancer and fatty liver. CONCLUSION: PBI has a high mortality rate. There are factors and findings from the collected data differing between the 2 aforementioned nations. Either way, better preventative measures, gun control and healthcare system are highly necessary.

The Socialist Camp's North Korean Medical Support and Exchange (1945–1958): Between Learning from the Soviet Union and Independent Course / 의사학

This study focused on the socialist camp's North Korean medical support and its effects on North Korean medical field from liberation to 1958. Except for the Soviet assistance from liberation to the Korean War, existing studies mainly have paid attention to the ‘autonomous’ growth of the North Korean medical field. The studies on the medical support of the Eastern European countries during the Korean War have only focused on one-sided support and neglected the interactions with the North Korean medical field. Failing in utilizing the materials produced in North Korea has led to the omission of detailed circumstances of providing support. Since the review of China's support and the North Korea-China medical exchanges has been concentrated in the period after the mid-1950s, the impacts of China's medical support on North Korea during the Korean War period and the post-war recovery period have not been taken into account. In terms of these limitations, this study examined the medical activities by the Socialist camp of the Eastern European countries in North Korea after the Korean War. The medical aid teams from Hungary, Romania, Bulgaria, Czechoslovakia, Poland, and East Germany that came to North Korea in the wake of the Korean War continued to stay in North Korea after the war to build hospitals and train medical personnel. In the hospitals operated by these countries, cooperative medical care with North Korean medical personnel and medical technology education were conducted. Moreover, medical teams from each country in North Korea held seminars and conferences and exchanged knowledge with the North Korean medical field staffs. These activities by the Socialist countries in North Korea provided the North Korean medical personnel with the opportunity to directly experience the medical technology of each country. China's support was crucial to North Korea's ‘rediscovery’ of Korean medicine in the mid-1950s. After the Korean War, North Korea began to apply the Chinese-Western medicine integration policy, which was performed in China at that time, to the North Korean health care field through China's medical support and exchanges. In other words, China's emphasis on Chinese medicine and the integration of the Chinese-Western medicine were presented as one of the directions for medical development of North Korea in the 1950s, and the experiences of China in this process convinced North Korea that Korean medicine policy was appropriate. The decision-makers of the North Korean medical policies, who returned to North Korea after studying abroad in China at that time, actively introduced the experiences from China and constantly sought to learn about them. This study identified that a variety of external stimuli had complex impacts on the North Korean medical field in the gap between ‘Soviet learning’ in the late 1940s and the ‘autonomous’ medical development since the 1960s. The North Korean medical field was formed not by the unilateral or dominant influences of a single nation but by the stimulation from many nations and the various interactions in the process.

Molecular methods for diversity assessment among xanthomonads of Bulgarian and Macedonian pepper

ABSTRACT Bacterial spot is an important disease of pepper in Bulgaria and Macedonia. For characterization of Xanthomonas species associated with bacterial spot, 161 strains were collected from various field pepper-growing regions. Among them, 131 strains were identified as Xanthomonas euvesicatoria and 30 as Xanthomonas vesicatoria using species-specific primers and polymerase chain reaction followed by restriction fragment length polymorphism analysis. To assess the genetic diversity of the strains, two methods (Random Amplified Polymorphic DNA and Repetitive Element Palindromic-Polymerase Chain Reaction) were applied. Discriminatory index was calculated and analysis of molecular variance was carried out.Combined random amplified polymorphic DNA analysis of the X. euvesicatoria strains with primers CUGEA-4 and CUGEA-6 had greater discriminative power (0.60) than repetitive element palindromic-polymerase chain reaction with ERIC and BOX A1R primers, which makes this method applicable for strain diversity evaluation. Discrimination among the X. vesicatoria strains was achieved by the use of ERIC primers and only for the Bulgarian strains. The results demonstrated that X. euvesicatoria was more diverse than X. vesicatoria and heterogeneity was observed mainly in the Bulgarian populations. According to the analysis of molecular variance, genetic variations in X. euvesicatoria were observed among and within populations from different regions, while the differences between the two countries were minor. Following the principal coordinates analysis, a relation between the climatic conditions of the regions and a genetic distance of the populations may be suggested.

A clinical training model for students: intensive treatment of stuttering using prolonged speech

ABSTRACT Purpose This study describes a practical model for improving the quality of Speech-Language Pathology (SLP) education on a clinical setting in a Bulgarian University. During this study, adults who stutter (AWS) received intensive treatment (IT) to increase fluent speech. The intensive treatment was delivered by students trained in the SLP Master's degree program "Logopedics Management in Fluency and Voice Disorders". Methods The La Trobe University intensive program of prolonged speech was implemented. SLP students were trained and delivered the IT for AWS, under supervision in all stages. The treatment followed a clinical modeling pattern. Results The primary outcomes were measured according to (i) percent of syllables stuttered (%SS) within and outside the stuttering research center of the university; (ii) self-reported inventory scores; and (iii) speech naturalness score evaluations from pre-treatment, immediately following treatment, 11 months post-treatment, and 18 months after the intensive treatment using stutter-free speech samples. The outcomes were reported for the overall IT program delivered by the SLP Master students. Conclusion The treatment delivered by students can ensure objective speech outcomes. The evidence-based practice model allowed students to develop and master specific clinical skills in establishing fluent speech by applying a prolonged speech technique. During the IT experience, students began to incorporate elements of evidence-based practice (EBP), clinical expertise, and consider values held by AWS. After four outcome-sessions, the AWS developed self-consciousness about the quality of their prolonged speech during controlled fluent patterns. The participants produced objective speech fluency data and statistically significant differences before and immediately after the IT regarding %SS and overall speech naturalness.

Serotype changes and antimicrobial nonsusceptibility rates of invasive and non-invasive Streptococcus pneumoniae isolates after implementation of 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in Bulgaria

Abstract The 10-valent pneumococcal conjugate vaccine (PCV10) has been included in Bulgarian Childhood Immunization Program since 2010. This study aimed to assess serotype distribution and antimicrobial resistance of 198 invasive and non-invasive Streptococcus pneumoniae strains that had been isolated in Bulgaria during 2011-2016 from patients with invasive (IPD) and non-invasive (NIPD) pneumococcal diseases. The most common invasive serotypes were 3 (10.1%), 19F (4.0%), and 7F (3.0%). A significant decrease in the proportion of invasive vaccine types (VTs) from 64.2% to 35.2% was found in comparison with pre-vaccine era. The most common serotypes among middle ear fluids were 3, 19A and 19F (5.6% each), and VTs fell down from 66.4% to 40.0% in post-PCV10 period. Among respiratory isolates, the most prevalent serotypes were some emergent serotypes such as 15A/B/C (5.0%), 19A, and 6C (4.0% each). VTs decreased significantly (16.3%) among vaccinated children compared to unvaccinated children and adults (44.0%). Two non-VTs (19A and 6C) have increased significantly more (p < 0.05) in vaccinated children than in unvaccinated patients. The rates of antibiotic nonsusceptible S. pneumoniae in Bulgaria remained high in post-PCV10 era. Among all source of isolates, antimicrobial nonsusceptibility rates were: oral penicillin - 46.5%, trimethoprim-sulfamethoxazole - 45.4%, erythromycin - 43.9%, tetracycline - 37.4%, and multidrug-resistance (MDR) was 44%. The most common MDR serotypes were 19F, 19A, 6A/C, 15A/B/C and 23A. Our results proved that PCV10 vaccination substantially reduced VTs pneumococcal IPD and NIPD. There has been a shift in the distribution of S. pneumoniae serotypes mostly in vaccinated children but also in the whole population and strong serotype-specific antibiotic resistance was observed after vaccine implementation. Therefore, it is important to continue monitoring serotype changes and pneumococcal resistance among all patient ages in addition to aid in determining the long-term effectiveness of PCV10 interventions.

Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly

ABSTRACT Objective To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. Materials and methods Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. Results In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). Conclusion The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.

Incidence of virulence determinants in clinical Enterococcus faecalis and Enterococcus faecium isolates collected in Bulgaria

Abstract Objectives To evaluate the prevalence of some virulence genes among 510 clinical Enterococcus spp. isolates and to assess the association of those genes with the species, infection site, and patient group (inpatients/outpatients). Methods Adhesins genes (aggregation substances agg and asa1 of Enterococcus faecalis and Enterococcus faecium, respectively), enterococcal surface protein (esp), endocarditis-specific antigen A (efaA), collagen-binding proteins (ace/acm)); invasins (hyaluronidase (hyl) and gelatinase (gelE)); cytotoxines (activation of cytolysin (cylA) in E. faecalis); and modulators of the host immunity and inflammation (enhanced expression pheromone (eep) in E. faecalis) were detected by polymerase chain reaction. Results The overall prevalence was: esp – 44.3%, agg/asa1 – 38.4%, ace/acm – 64.3%, efaA – 85.9%, eep – 69.4%, gelE – 64.3%, hyl – 25.1%, and cylA – 47.1%. E. faecalis isolates had significantly higher frequency of adhesin genes (esp and agg/asa1) and gelatinase in comparison to E. faecium. Multiple virulence genes in E. faecalis were significantly more prevalent than in E. faecium isolates. Domination of E. faecium with or without only one gene compared to the isolates of E. faecalis were found. Enterococcus spp. isolates obtained from outpatients compared to inpatients isolates had significantly higher frequency of agg/asa1, eep, gelE and cylA. Some adhesins genes (esp, agg/asa1 and efaA) had higher prevalence among the non-invasive Enterococcus spp. isolates compared to those causing invasive bacteremia, while ace/acm revealed higher dissemination in isolates causing invasive infections compared to non-invasive isolates. Conclusion Most E. faecalis attaches to abiotic surfaces in hospital environment, which correlates with higher prevalence of gene encoding for virulence factors involved in biofilm formation, such as enterococcal surface protein, aggregation substance, and gelatinase. The intestinal tract is an important reservoir for opportunistic enterococcal pathogens and allows them to access infectious sites through different virulence factors, demonstrated in outpatient isolates in this study.

Microorganisms in Vacuum Stored Flower Bee Pollen

Contamination with sanitary microorganisms from Enterobacteriaceae, Pseudomonadaceae, Staphylococcaceae, Micrococcaceae and Bacillaceae families in flower bee pollen from Bulgaria after one-year vacuum-packed cold storage has been found. Dried flower bee pollens intended for human consumption were with high incidence rate of contamination with Pantoea sp. (P. agglomerans and P. agglomerans bgp6) (100%), Citrobacter freundii (47%), Proteus mirabilis (31.6%), Serratia odorifera (15.8%) and Proteus vulgaris (5.3%). Bee pollens were also positive for the culture of microorganisms from Staphylococcaceae, Micrococcaceae and Bacillaceae families: Staphylococcus hominis subsp hominis, Staphylococcus epidermidis, Arthrobacter globiformis, Bacillus pumilis, Bacillus subtilis and Bacillus amyloliquefaciens. It was concluded that, if consumed directly, the vacuum-packed cold stored dried bee pollen, harvested according hygienic requirements from bee hives in industrial pollution-free areas without intensive crop production, is not problem for healthy human.

Clinical Evaluation of Rapid Diagnostic Test Kit Using the Polysaccharide as a Genus-Specific Diagnostic Antigen for Leptospirosis in Korea, Bulgaria, and Argentina

Leptospirosis, a zoonotic disease that is caused by many serovars which are more than 200 in the world, is an emerging worldwide disease. Accurate and rapid diagnostic tests for leptospirosis are a critical step to diagnose the disease. There are some commercial kits available for diagnosis of leptospirosis, but the obscurity of a species- or genus-specific antigen of pathogenic Leptospira interrogans causes the reduced sensitivity and specificity. In this study, the polysaccharide derived from lipopolysaccharide (LPS) of nonpathogenic Leptospira biflexa serovar patoc was prepared, and the antigenicity was confirmed by immunoblot and enzyme linked immunosorbent assay (ELISA). The performance of the rapid diagnostic test (RDT) kit using the polysaccharide as a diagnostic antigen was evaluated in Korea, Bulgaria and Argentina. The sensitivity was 93.9%, 100%, and 81.0% and the specificity was 97.9%, 100%, and 95.4% in Korea (which is a rare region occurring with 2 serovars mostly), Bulgaria (epidemic region with 3 serovars chiefly) and Argentina (endemic region with 19 serovars mainly) respectively. These results indicate that this RDT is applicable for global diagnosis of leptospirosis. This rapid and effective diagnosis will be helpful for diagnosis and manage of leptospirosis to use and the polysaccharide of Leptospira may be called as genus specific antigen for diagnosis.

Clinical Evaluation of Rapid Diagnostic Test Kit Using the Polysaccharide as a Genus-Specific Diagnostic Antigen for Leptospirosis in Korea, Bulgaria, and Argentina

Leptospirosis, a zoonotic disease that is caused by many serovars which are more than 200 in the world, is an emerging worldwide disease. Accurate and rapid diagnostic tests for leptospirosis are a critical step to diagnose the disease. There are some commercial kits available for diagnosis of leptospirosis, but the obscurity of a species- or genus-specific antigen of pathogenic Leptospira interrogans causes the reduced sensitivity and specificity. In this study, the polysaccharide derived from lipopolysaccharide (LPS) of nonpathogenic Leptospira biflexa serovar patoc was prepared, and the antigenicity was confirmed by immunoblot and enzyme linked immunosorbent assay (ELISA). The performance of the rapid diagnostic test (RDT) kit using the polysaccharide as a diagnostic antigen was evaluated in Korea, Bulgaria and Argentina. The sensitivity was 93.9%, 100%, and 81.0% and the specificity was 97.9%, 100%, and 95.4% in Korea (which is a rare region occurring with 2 serovars mostly), Bulgaria (epidemic region with 3 serovars chiefly) and Argentina (endemic region with 19 serovars mainly) respectively. These results indicate that this RDT is applicable for global diagnosis of leptospirosis. This rapid and effective diagnosis will be helpful for diagnosis and manage of leptospirosis to use and the polysaccharide of Leptospira may be called as genus specific antigen for diagnosis.

The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects / Prevalência de síndrome metabólica aumenta em quartis de hormônio tireoestimulante em uma amostra de sujeitos eutiroides baseada na população

Objective The aim of the study was to assess the prevalence and characteristics of metabolic syndrome (MetS) and its elements in relation to TSH in euthyroid subjects. Materials and methods In the cross-sectional study, 2,153 euthyroid adults, 47.2 ± 14.5 years (20-94) with no current antithyroid or thyroid replacement therapy were enrolled. All participants filled a questionnaire on past and current morbidities, medication and smoking. Body weight, height, waist circumference, serum TSH, glucose and lipids were measured. The subjects were stratified by quartiles of TSH (QTSH) and the prevalence of the MetS elements was calculated. MetS was determined by the IDF 2005 criteria. Results Overweight prevalence was 37.2% (35.2-39.2), obesity in 25.1% (23.3-26.9), abdominal obesity – 61.4% (59.3-63.5), hypertension – 42.1% (38.9-43.1), diabetes/increased fasting glucose – 13.6% (12.1-15), low HDL-cholesterol – 27.6% (25.7-29.5), hypertriglyceridemia – 24.1% (22.3-25.9), MetS – 32.2% (30.2-34.2). MetS was more prevalent in the highest QTSH (34.9%, 30.9-38.9) than the lowest (27%, 23.3-30.9), p < 0.001, as were low HDL-C (32%, 28-35.9 vs. 25%, 21.3-28.7, p < 0.001) and hypertriglyceridemia (26.8%, 23-30.5 vs. 20.4%, 17-23.8, p = 0.015). Each QTSH increased the risk of MetS by 14%, p < 0.001, of hypertriglyceridemia by 20%, p = 0.001 and of low LDL-C by 9%, p = 0.042. Other significant factors for MetS were age, male gender and obesity. Conclusion The prevalence of MetS increased with higher QTSH within the euthyroid range, mostly by an increase in the dyslipidemia. Arq ...

Objetivo O objetivo deste estudo foi avaliar a prevalência e características da síndrome metabólica (MetS) e seus elementos em relação ao TSH em sujeitos eutireoides. Materiais e métodos Foram analisados, em um estudo transversal, 2.153 adultos eutiroides, de 47,2 ± 14,5 anos (20-94) sem terapia antitiroidiana ou de reposição. Todos os participantes preencheram um questionário sobre doenças atuais e passadas, medicações e tabagismo. O peso corporal, altura, circunferência da cintura, TSH, glicose e lipídios séricos foram medidos. Os sujeitos foram estratificados em quartis de TSH (QTSH) e a prevalência dos elementos da MetS foram calculados. Os critérios da MetS foram determinados pela IDF 2005. Resultados A prevalência de sobrepeso foi de 37,2% (35,2-39,2), de obesidade – 25,1% (23,3-26,9), obesidade abdominal – 61,4% (59,3-63,5), hipertensão – 42,1% (38,9-43,1), diabetes/aumento da glicose de jejum – 13,6% (12,1-15), baixo colesterol HDL – 27,6% (25,7-29,5), hipertrigliceridemia – 24,1% (22,3-25,9), MetS – 32,2% (30,2-34,2). A MetS foi mais prevalente no QTSH mais alto (34,9%; 30,9-38,9) do que no mais baixo (27%; 23,3-30,9), p < 0,001, assim como o baixo HDL-C (32%, 28-35,9 contra 25%, 21,3-28,7; p < 0,001) e hipertrigliceridemia (26,8%; 23-30,5 contra 20,4%, 17-23,8; p = 0,015). Cada QTSH aumentou o risco MetS em 14%, p < 0,001, de hipertrigliceridemia em 20%, p = 0,001 e de baixo LDL-C em 9%, p = 0,042. Outros fatores significativos para a MetS foram idade, sexo masculino e obesidade. ...

Intensive non-avoidance group therapy with stutterer adults: preliminary results / Terapia intensiva de enfrentamento em grupo com adultos gagos: resultados preliminares

PURPOSE: The purpose of the present study was to evaluate and document the use and efficacy of intensive non-avoidance group treatment for Bulgarian adults who stutter (AWS), to specify that changes are adopted in different speech situations (in the stabilization phase), and to demonstrate that changes are maintained after intensive therapy. METHODS: Participants were AWS (n=15, 12 males) with an average age of 25.2 years) Bulgarian native-speakers. Twelve participants were University students and three were clients with tertiary education in different areas. All participants were enrolled in First (overall effect) and Second (interim effect) Stages of Intensive Non-Avoidance Treatment for Stuttering. Van Riper's stuttering modification therapy approach was employed; the latter considers a non-avoidance treatment for stuttering. The treatment was conducted in participants' native Bulgarian language. RESULTS: AWS, as a group (n=15), significantly decreased the number of stuttered utterances after intensive treatment; findings were consistent for participants with moderate as well as severe stuttering. Likewise, there was a significant decrease in duration (in seconds) of disfluencies after treatment; findings were consistent for participants with moderate as well as severe stuttering. Eighty percent of AWS used cancellation immediately and six months after treatment, 65% mastered preparatory sets immediately and six months after treatment, 35% exhibited pull-outs immediately after treatment and 55%, six months post-treatment. CONCLUSION: These preliminary findings were taken to suggest that intensive non-avoidance treatment for stuttering can be successfully employed with Bulgarian adults who stutter. Special focus was on the positive fluency changes that occurred during the course of therapy regarding the duration of disfluencies in seconds, and index of disfluencies. .

OBJETIVO: O objetivo deste estudo foi avaliar e documentar o uso e a eficácia do tratamento intensivo de enfrentamento em grupo em adultos com gagueira (ACG) búlgaros, especificar quais mudanças são adotadas em diferentes situações de fala (em fase de estabilização), e demonstrar que as mudanças são mantidas após a terapia intensiva. MÉTODOS: Os participantes eram ACG (n = 15, 12 do sexo masculino, com idade média de 25,2 anos), falantes nativos de búlgaro. Doze participantes eram estudantes universitários e três tinham ensino superior em diferentes áreas. Todos os participantes foram inscritos no Primeiro (efeito total) e Segundo (efeito provisório) Estágios do Tratamento Intensivo de Enfrentamento para Gagueira. A abordagem empregada foi a terapia de modificação da gagueira de Van Riper, considerado um tratamento de enfrentamento para a gagueira. O tratamento foi realizado em búlgaro, língua nativa dos participantes. RESULTADOS: Como um grupo, os ACG (n = 15) apresentaram uma diminuição significativa no número de elocuções gaguejadas após tratamento intensivo. Estes resultados foram consistentes para os participantes com gagueira moderada e grave. Da mesma forma, houve uma diminuição significativa na duração (em segundos) das rupturas após o tratamento, sendo estes resultados também consistentes para os participantes com gagueira moderada e grave. Oitenta por cento dos ACG utilizaram o cancelamento imediatamente e seis meses após o tratamento, 65% dominaram os movimentos preparatórios imediatamente e seis meses após o tratamento, 35% apresentaram uso da técnica do pull-out imediatamente após o tratamento, e 55% o apresentaram seis meses após o tratamento. CONCLUSÃO: Estes resultados preliminares sugerem que o tratamento ...

Gardnerella vaginalis-associated bacterial vaginosis in Bulgarian women

ABSTRACT BACKGROUND: Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of reproductive age. The purpose of this study was to determine the frequency of BV in Bulgarian pregnant and nonpregnant women from several age ranges and to compare three different laboratory methods for Gardnerella vaginalis detection in patents suffering from BV. METHODS: Between September 2011 and June 2012, 809 women of 16-40 years of age separated in two major groups: nonpregnant - 469 (355 with and 114 without symptoms) and pregnant - 340 (213 and 127 respectively) were enrolled for the study. The women underwent three different laboratory tests simultaneously: scoring of Gram staining of vaginal smear, culture, and polymerase chain reaction (PCR) assay for G. vaginalis. RESULTS: The microscopic method detected high frequency of BV in symptomatic (57%) whereas only a minority of asymptomatic subjects (14%) were detected. G. vaginalisassociated BV was diagnosed in approximately equal proportions when evaluated with PCR and microscopic method for both pregnant and nonpregnant women. The comparative analysis of microscopic evaluation, culture and PCR assays demonstrated greater concurrence (about 90%) between Gram staining and PCR detection for BV, than both methods compared to culture. The combination of microscopy and PCR turned out to be very reliable and repeatable for detecting G. vaginalis-associated BV. CONCLUSIONS: This is the first comparative investigation on the epidemiology of G. vaginalisassociated BV in Bulgaria. The established highest frequency in the young Bulgarian women (21-30 years) is alarming and should be considered in prophylaxis and reproductive programmes.

Validation of a scale assessing the impact of periodontal diseases on patients' quality of life in Bulgaria (pilot research)

The aim of the paper is to present the validation of a scale for assessing the impact of periodontal diseases on individuals' quality of life in Bulgaria. A pilot research was made among 30 diagnosed patients with periodontitis visiting the Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria. The minimum sample size of 30 people was established based on a power analysis for sample size calculation. The mean age of participants was 48.95 ± 11.85 years, being 56.67 ± 9.05 years for males and 43.33 ± 9.05 years for females. Standard interviews were conducted using a specific instrument: self-designed questionnaire and a 5-degree ranked scale, containing initially 11 questions. The interviews were repeated after 3 months with the same patients for retest analysis. The data was statistically processed using SPSS v.13 software. Results received after the initial interviews: Cronbach's coefficient (α=0.882), Spearman-Brown coefficient (r sb=0.998), average inter-item correlation coefficient (R=0.426), difficulty of the questions from 0.173 to 0.757 and discrimination power from 0.405 to 0.809. Results after the second interviews: α=0.883, r sb=0.998, R=0.507, difficulty from 0.287 to 0.757 and discrimination power from 0.524 to 0.809. In two of the questions, a low level of inter-item correlation with the rest of the items was found and they were excluded. The final version of the questionnaire contained 9 questions. The validation proved that the developed scale is sufficiently reliable and will be used in the final research, the first one to use such an instrument for measuring oral health-related quality of life in Bulgaria.

O objetivo deste artigo é apresentar a validação de uma escala que mede o impacto das doenças periodontais sobre a qualidade de vida das pessoas na Bulgária. Foi feito um estudo piloto com 30 indivíduos diagnosticados com doença periodontal, entre os pacientes do Departamento de Periodontologia da Faculdade de Medicina Odontológica da Universidade de Medicina de Plovdiv, Bulgária. A amostra mínima de 30 pessoas foi estabelecida baseada em análise de potência para cálculo do tamanho de amostra. A idade média dos participantes foi de 48,95 ± 11,85 anos, sendo de 56,67 ± 9,05 para homens e de 43,33 ± 9,05 para mulheres. Foram feitas entrevistas padronizadas usando um instrumento específico: um questionário com uma escala de 5 graus, contendo 11 perguntas iniciais. As entrevistas foram repetidas 3 meses depois, com os mesmos pacientes, para reanalisar o teste. Os dados foram processados estatisticamente pelo programa SPSS v.13. Os resultados das entrevistas iniciais foram: coeficiente de Cronbach (α=0,882), coeficiente de Spearman-Brown (rsb=0,998), coeficiente de correlação média inter-item (R=0,426), dificuldade das questões de 0,173 a 0,757 e potência de discriminação de 0,405 a 0,809. Os resultados da segunda série de entrevistas foram: α=0,883, rsb=0,998, R=0,507, dificuldade de 0,287 a 0,757 e potência de discriminação de 0,524 a 0,809. Duas das questões apresentaram baixo nível de correlação inter-item e foram excluídas. A versão final do questionário continha 9 perguntas. A validação comprovou que a escala desenvolvida é suficientemente confiável e será usada na pesquisa final, a primeira a utilizar tal instrumento para mensurar a qualidade de vida relacionada à saúde oral na Bulgária.