Analysis of the results from an early low-level predischarge and late symptom-limited exercise tests and coronary angiographic examination in patients with uncomplicated myocardial infarction.

The aim of our study was to evaluate the prognostic value of an early predischarge and late symptom-limited exercise tests as opposed to the evidence from the coronary angiographic examination. Twenty patients with an uncomplicated myocardial infarction were studied with an early predischarge exercise test (14-21 days) and a following postdischarge late symptom-limited veloergometric test. All the patients underwent an exercise test designed according to the protocol of the International Health Organization. A coronary angiographic examination was carried out in all the studied patients. Thirteen of the patients were with two positive veloergometric tests and significant stenosis from the selective coronary angiography. Seven of the patients had two negative tests. Two of them did not have significant coronary stenosis from the angiografic assessment. Generally 40% of the patients undergoing late exercise test reached a higher workload. There was no significant difference between the results from an early predischarge and late symptom-limited veloergometric test. A higher physical work load reached during the late exercise test did not show an improved coronary blood flow. Positive early and late exercise tolerance tests proved significant coronary stenosis. A negative exercise test did not exclude significant coronary stenosis.

LDL-receptor gene polymorphism in patients with early-onset coronary artery disease.

Simultaneous amplification of the promoter and 17 (out of 18) exons of the LDL-R gene (along with flanking intron sequences) was performed in 36 patients with hypercholesterolemia and early-onset coronary artery disease. The identification of the PCR-products on denaturing gradient gel electrophoresis (DGGE) revealed 34 cases of heteroduplexes in 24 patients. The heteroduplexes in exons 12, 10, and 2 (31%, 28% and 22%, respectively) probably reflect common polymorphism of LDL-R gene, while heteroduplexes in exons 6, 4 and 13 are less frequent (5.6%, 5.6%, and 2.8%, respectively). Significant association between the genetic variants, or polymorphism with clinical manifestations, could not be established.

A case of Friedreich's ataxia confirmed by DNA-analysis.

The first case of DNA-confirmed Friedreich's ataxia in Bulgaria is presented. The results from the DNA studies of the index patient revealed two alleles with an expansion between 500 and 1500 repeats of the GAA trinucleotide in the first intron of the X25 gene. The parents had one normal allele with 7-22 repeats and one allele with a similar expansion to that of the patient in the first intron of the X25 gene. These results confirm the homozygous mode of transmission of the abnormal alleles (with an expansion of the GAA trinucleotide in the first intron of the X25 gene) from the two normal heterozygous parents to their affected offspring.

Effect of an amine fluoride dentifrice on dental caries used in a community-based oral health education program.

OBJECTIVES: The purpose of this study was to investigate the caries-reducing effect of an amine fluoride toothpaste when used under real-life conditions in a community preventive program. METHODS: Approximately 12,500 children 3-12 years of age were provided with toothpaste (four tubes or 360 grams annually during three years) to be used in kindergartens or schools and once a day at home. The teachers supervised daily toothbrushing sessions. Random samples of children in each of the ages 3, 6, 9, and 12 years were selected from the intervention and the reference communities at both the start of the study and after three years, and examined for dental caries experience. RESULTS: Amine fluoride dentifrice seemed to provide a reduction in dental caries prevalence compatible to the most commonly used fluoride dentifrice compounds. CONCLUSIONS: The implemented fluoride toothpaste program is a feasible and practical method of improving the oral health status of children.

Analytic performance of digoxin laboratory monitoring.

Since therapeutic drug monitoring is rapidly becoming a widely-used tool in clinical medicine we prospectively assessed 547 control samples over a period of 18 months using fluorescence polarization immunoassay, calibrators and control samples to determine the analytical performance of Abbott TDx in measuring serum digoxin levels. Recovery of the controls (within-run and between-run coefficient of variation) evaluated at the low, target therapeutic and intoxication ranges was 14%, 8% and 7% and precision was -3.57, -7.02, -3.38, respectively. Our clinical utility analysis showed that the prescribed dose provided serum digoxin levels within, above and below the targeted therapeutic range for 50.2%, 38.4% and 11.4% of the patients, respectively. The discrepancy between the calibrators and the controls, the tendency towards lower prescription dosage and patient noncompliance with the prescribed dose all account for these findings. The direct costs for digoxin serum concentration monitoring amount to 10 US $. A closer collaboration between the laboratory and the prescribing physician will undoubtedly form the basis of a more effective cost-efficacy strategy of digoxin serum monitoring as an indispensable tool and cornerstone of clinical decision-making.

[On the problem of diagnostics and treatment of herpetic infection in the oral cavity]. / Kum vuprosa za diagnosgikata i lecheniego na kherpetichnite infektsii v ustnata kukhina.

A clinical case of herpetic manifestation in the mouth is described as a grave gingivostomatitis in a child aged 12. Chronology and symptomatics of the disease are analyzed in details as well as the difficulties both in diagnostics and treatment. Some important moments are discussed that usually aggravate the clinical picture and the treatment of similar conditions--including an antibiotic from penivillin group in the treatment, the presence of cutting teeth with inflammatory alterations around them, extraction. All possible diseases in the oral cavity are analyzed that could give a similar symptomatics as well as the tactics of the stomatologist until making the final diagnosis. The diagnosis was ex juvantibus elucidated Symptomatic treatment was carried out and paraclinical examinations performed enabling the authors to make the diagnosis recurrent herpetic infection with not typical course upon the oral mucosa induced by the virus of herpes simplex, type I.

[Level of information and motivation for complex stomatological prophylaxis of polyvalent stomatologists]. / Nivo na informiranost i motivatsiia za kompleksna stomatologichna profilaktika na polivalentnite stomatolozi.

The level of scientific knowledge in the field of the complex stomatological prophylaxis of the polyvalent stomatologists is studied in the present paper, who are the direct executors of the complex prophylactic programmes. Their motivation for an actual realization of the prophylaxis was studied. A sociological study was carried out based on the inquiry method with 110 polyvalent stomatologists. The testing carried out revealed that the level of information of those stomatologists as regards the complex prophylaxis of the stomatological diseases was low, that their motivation was rather impoper necessitating a reconsideration of the training and pre-training of those important executive personnel in that field of the stomatological science and practice.

[Information level of mothers children from 0 to 3 years about the problems of stomatological prophylaxis]. / Prouchvane nivoto na informiranostta na maikite na actsa ot 0 do 3 godini po problemite na stomatologichnata profilaktika.

The information of the mothers as regards the possibilities of realization of complex prophylaxis of dental caries and periodontopathis is of great importance for such prophylaxis. The objective of this work is a sociological study, by the inquiry method, at the information level about those problems of 500 mothers of children, aged from 0 to 3 years in the town of Pernik. The results from the study reveal that the information level of the mothers is unsatisfactorily due to the insufficient work of the stomatologist in prenatal and well baby clinic. That raises the problem for exact regulation of prophylactic time of work with the pregnant and the mothers of little children.

[Epidemiological study on dental caries and periodontium state of students from HChTI "A. Zlatarov"]. / Epidemiologichno prouchvane na zubniia karies i sustoianieto na parodonta na studenti ot vkhti "A. Zlatarov"--Burgas.

The authors carried out an epidemiological study on dental caries and periodontium state of 247 students from HChTI "A. Zlatarov--Burgas in an age standardized group of 20-24 years. WHO index CPITN was used for the determination of periodontium state. The data from the study reveal that the epidemicity of the dental caries in the group examined reaches to 97.98% with an intensity of 7.89. A total of 26.03% of the carious teeth have not been treated and 40.90% from the students have extracted teeth. Only 19.71% of the females and 4.54% of the males have 3 or more sound sextants according to CPITN. Those data raise the problem of the necessity of complex prophylactic measures among the students.