ABSTRACT
Background: UMHATEM N.I. Pirogov" Sofia, is one of the largest and busiest hospitals for emergency medical care in Bulgaria. It is the legal successor of the former Institute of Emergency Medicine N.I. Pirogov", and it can be said that at the moment it is the only diagnostic-therapeutic, prophylactic and scientific-educational structure of this type within the Bulgarian healthcare system. The concept of adequate functioning and development of this type of hospital does not consider structuring an Infectious Diseases diagnostic-treatment unit. This reality makes necessary the formation of a radically different organization for the admission and treatment of patients in the hospital, both for those with symptoms of Covid 19 and for all other emergency patients. The organization created in this way must absolutely guarantee safety for both streams of patients. In the conditions of a pandemic, in case of a real threat to public health, the main task of triage in the Emergency Department is to establish indications for urgent hospitalization, or to refuse it in the absence of indications. The characteristic course of the disease, the prolonged treatment, the manifestations within the so-called post-Covid syndrome", require serious planning not only of the diagnostic-treatment and rehabilitation period, but also adequate monitoring in the first months after the patient's discharge. Within the national reorganization measures, during the determined periods, the main changes concerning the MED (Multi-profile emergency department) of Pirogov are implemented, with an emphasis on the formation of a specialized triage for the diagnosis and clinical evaluation of patients with a coronavirus infection. The main goal is the adequate diagnosis, treatment and follow-up of patients with coronavirus infection who have passed through the organized Covid-triage in a period of extreme pressure on the emergency structures and on the hospital system in the country as a whole. Objective(s): For a MED, which at the time of declaring an epidemic situation does not have a concept for the diagnosis and treatment of infectious diseases, to systematize the main urgently implemented organizational and structural changes, which turned out to be absolutely necessary to meet a newly emerging epidemiologically significant infectious disease. Aim(s): To systematize the organizational changes imposed by the situation and urgently implemented in the MED (multi-profile emergency department). To systematize the structural changes imposed by the situation and urgently implemented in the work of the MED. To analyze the organizational and structural changes carried out in this way and to differentiate the main difficulties caused by the regulations existing at the time of the announcement of the epidemic situationCopyright © Pantileeva D et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
ABSTRACT
The aim of current study was to determine, retrospectively, possible correlations between smoking and the incidence, course severity, intubation rate, and mortality (by gender and age) in patients treated for complicated coronavirus infection in the internal medicine clinic at UMHATEM ”N. I. Pirogov” Sofia for the period 01.03.2020–31.12.2020. In a prospective study, the recovery period and immunogenesis in smokers and non-smokers within a one-year period after hospital discharge was investigated. The applied methods were: 1) computed tomography and blood gas analysis 2) chemiluminescent immunoassay for the qualitative determination of total IgM, IgA and IgG anti-SARS-CoV2 AB. Results showed that the part of non-smokers with a positive PCR test is significantly higher compared to the group of former and current smokers. The data obtained from the study confirmed that Covid infection is much more severe among smokers and former smokers with a higher levels of inflammatory markers noticed among the smoking group.
ABSTRACT
The results of a one-year prospective study, during which the process of immunogenesis in patients over 18 years of age with moderate and severe coronavirus infection was monitored and analyzed in clinical and paraclinical (clinical laboratory) aspects, are summarized and presented. The study included 2683 patients, all treated in the Clinic of Internal Diseases at the University Multiprofile Hospital for Active Treatment and Emergency Medicine “N. I. Pirogov” EAD, Sofia for the period from April 2020 to December 2020. Patients were followed for one year after recovering from moderate to severe coronavirus infection. Patients are grouped into four age categories as follows: 18–45 years;46–65 years;66–80 years and over 80 years. The results of our study show that during the study period in 97% of patients the level of anti-SARS-CoV2, rose and in the remaining three percent it was flat or followed by subsequent waning (in less than 1% of patients), but does not reach critically low levels (i. e. below the positivity conditional threshold). The level of IgG reached a peak and then waned, but on the other hand, as mentioned above, the amount of Ig-Total tested shows a significant increase. This trend is observed in all age groups, with a difference in the level of IgG and Ig-Total depending on age. The results of the additional screening in the target period in terms of virulence and virus segregation, categorically rule out the suspicion of the presence of “silent spreader”. During the follow-up period, no patients were re-hospitalized due to recurrence of Coronavirus infection (re-infection and illness). © 2022
ABSTRACT
The interest in the practical use of herbal substances for medical purposes is growing worldwide. The herbal medicines can be applied as a supplement not only to restore the physiological functions but also to treat specific conditions such as -dyspepsia;hepatic and biliary diseases;prevent and modify cardiovascular diseases;treat infectious diseases. They are among the pharmaceutical products preferred by parents and pediatricians. In January 2020, the World Health Organization (WHO) declared the spread of the new coronavirus -a situation with a global impact. During the last year, there have been some publications describing the use of Chinese herbal preparations for the prevention and prophylaxis of COVID-19. There is information about the use of pharmaceuticals to treat infectious diseases and fever but real evidence for their impact on the SARS-CoV-2 virus is still insufficient. Therefore, the purpose of this study is to establish how many of the medicines sold without a prescription containing a plant component are used among very young children in Bulgaria and if these phytoproducts can be used to treat pediatric patients with COVID-19.
ABSTRACT
The study of the effectiveness of distance learning in yoga courses is conditioned by the ability of students to learn the exercises through various forms – videos, specialised literature and video conferencing. The results of this study are the basis for choosing the right methodological approach for this form of learning. For effective distance learning in activities related to physical activity, a method is needed in which successful feedback is possible. This significantly increases the rate of absorption of exercises by students. The results are also indicative of the application of relevant training methods in other fields that rely on physical activity and field activities in the learning process – Earth sciences, ecology, oceanography, field science, zoology and a number of others. The similarity of problems in Covid-19 conditions between training, requiring physical activity and requiring practical experiments and field activities implies similar solutions. Methodology is based on the comparative analysis of the effectiveness of distance yoga training of students at different stages of education and with different forms of teaching. © 2021, Scibulcom Ltd.. All rights reserved.
ABSTRACT
The development of computer technologies has created preconditions, and the Covid-19 pandemic – the need to create an opportunity to conduct a training process in chess entirely online. For the effectiveness of the process, it is necessary to develop a comprehensive program through which to conduct group training. The accepted hypothesis was: it is possible to conduct group chess training online with a sufficient degree of efficiency. The methodology used was: Comparative analysis of success in test form in over-the-board and online training;Comparative analysis of the cognitive anxiety of the competitors in the present and online form in connection with their results from the competition. A high degree of similarity was found in the results of the tests (14 out of 15), as well as in the degree of cognitive anxiety – 0.274 in over the board trainees and 0.316 in online trainees. © 2021, Scibulcom Ltd.. All rights reserved.
ABSTRACT
The etiological cause of Coronavirus infection, which has captured the attention of almost the whole world at the moment, is SARS-CoV2. The clinical picture of coronavirus infection varies from asymptomatic to severe respiratory infection with manifestations of respiratory failure, the development of respiratory distress syndrome and even death. Already in the first months of the coronavirus pandemic in the United States there was a serious decline in the number of patients seeking medical care in the Emergency Department (49.3%) compared to 2019. There is evidence of increased mortality during the pandemic, which causality cannot be directly or associated with coronavirus infection. Even in the context of a global pandemic, we must not forget all other diagnoses and conditions that exist as comorbidity, and emergency care must be provided without delay and delay.