Zlatina Ivanova - Academia.edu (original) (raw)

Papers by Zlatina Ivanova

Research paper thumbnail of Frequent COPD exacerbators are not a stabile phenotype

Monitoring airway disease, 2019

je po končanem pravnem študiju, promociji in sodniškem izpitu ter vzporednem študiju glasbe v Gra... more je po končanem pravnem študiju, promociji in sodniškem izpitu ter vzporednem študiju glasbe v Gradcu vstopil v sodniško službo. Kot obetaven kader za prihodnjo slovensko univerzo je dobil državno štipendijo za izpopolnjevanje na univerzi v Leipzigu. Po vrnitvi se je znova zaposlil na okrajnem sodišču v Ljubljani, od koder so ga prestavili v tajništvo Vrhovnega in kasacijskega sodišča na Dunaju, kjer je ostal do razpada monarhije in dosegel naslov dvornega sekretarja oziroma svetnika višjega deželnega sodišča. Po razpadu monarhije je bil imenovan za svetnika Višjega deželnega sodišča v Ljubljani. Tu mu je bilo poverjeno vodenje knjižnice. Napisal je knjižnični red in uredil njeno poslovanje. Ko je bil ustanovljen Oddelek B Stola sedmorice v Zagrebu, se je prijavil za svetnika tega sodišča. Preden je bila njegova prošnja rešena, ga je kralj imenoval za rednega profesorja za državljansko in rimsko pravo na novoustanovljeni juridični fakulteti v Ljubljani. * Akad. zasl. prof. dr. dr. h. c., univ. dipl. pravnik, Pravna fakulteta Univerze v Ljubljani,

Research paper thumbnail of Biochemical Characterization for Lipid Synthesis in Aspergillus niger

Baghdad Science Journal, 2016

A niger, a fungus which doesn't have high ability to production lipid, this fungus has been selec... more A niger, a fungus which doesn't have high ability to production lipid, this fungus has been select to investigate the non oleaginicity. In this search, there are explorations about: i) growth profile ii) enzymes profile iii) isoforms. Growth profile shows that this fungus doesn't have ability to accumulate lipid more than 6% while bio mass are around 10g/l in spite of the presence of glucose in the media till the end of cultivation time and excision of nitrogen within 24 hrs. In enzyme study, we investigate all lipogenic enzymes Malic enzyme (ME), Fatty acid synthase (FAS), ATP: Citrate lays (ACL), NAD + isocitrate dehydrogenase (NAD + ICDH), Glucose-6phosphate (G6PD), and 6-phosphogluconate dehydrogenase (6PGD), all these enzymes show, activities till the end of cultivation time including ACL which is regarded the key enzyme to differentiate between the two species oleaginous and non oleaginous. So, there is no main reason to non oleaginicity for this fungus. A further experiment has been done using Polyacrylamide gel electrophoresis to identify ME isoforms. The result of Polyacrylamide gel electrophoresis shows multi isoforms (A, B, C, D & E), with low intensity of isoform E, the isoforms that may involve in lipid synthesis. We have now studied the biochemistry of A.niger grown under conditions designed to promote lipid accumulation and can now advance a coherent hypothesis to explain why A niger could not accumulate lipid more than 6%. So the absence of isoforme E is the main reason for non oleaginicity in A niger.

Research paper thumbnail of Original Article. Improving the Inhalation Technique in Patients with Obstructive Pulmonary Diseases

Journal of Biomedical and Clinical Research, 2016

SummaryThe study aimed to assess the inhalation technique of patients with bronchial asthma/chron... more SummaryThe study aimed to assess the inhalation technique of patients with bronchial asthma/chronic obstructive pulmonary disease (COPD) via an objective method and to evaluate the effect of training in patients with incorrect technique. Тhe inhalation technique of 120 patients with obstructive pulmonary disease was tested. The patients were divided into two groups: using metered dose inhalers (MDI) - 34 patients (28%) and dry powered inhalers (DPI) - 86 patients (72%). The most frequent mistakes in the MDIgroup were short duration of the inhalation (55.88%) and bad synchronization between activating the canister and the inhalation (29.41%). For the DPIgroup, the inhalation was not forceful enough (48.84%) and the short duration of the inhalation (12.79%). Patients claiming to have good inhalation technique accounted for 97%of those in the MDIgroup, and 96.5%of those in the DPIgroup. There were two patients (5.88%) with correct inhalation technique in the MDIgroup at their first att...

Research paper thumbnail of Do air pollution and outdoor temperature influence the frequency of acute COPD exacerbations?

European Respiratory Journal, 2016

Topic: There is not enough data in Bulgaria about the influence of air pollution and outdoor temp... more Topic: There is not enough data in Bulgaria about the influence of air pollution and outdoor temperature on the frequency of acute exacerbations of COPD (AECOPD). Aim: To study the relationship between the levels of air pollutants and outdoor temperature and frequency of AECOPD. Methods: To observe the frequency of AECOPD we followed 477 hospitalized and ambulatory COPD patients for 3 years. The levels of PM 10 , NO, NO2, SO2 and outdoor temperature were obtained from local environmental office measured by automatic station. Statgraphics, SPSS and Excel were used for statistical analysis. Results and discussion: A total of 708 AECOPD of patients living in the town were found. The mean weekly levels of PM10 were found to correlate with the mean weekly levels of: NO(r=0,68; p= 0,0001), NO2(r= 0,46; p= 0,0001) SO2(r=0,63; p=0,0001) and the mean weekly outdoor temperature (T weekly ) (r=-0,70; p=0,0001). T weekly had a negative correlation also with: NO(r=-0,53; p= 0,0001), NO2( r=-0,19; p= 0,03) and SO2(r=-0,68; p=0,0001). The frequency of AECOPD was found to correlate with: NO(r=0,34; p=0,02), SO2(r=0,31; p=0,0002), PM10 (r=0,26; p=0,001), season (r=0,38 p= 0,0001). It also had a negative correlation with the outdoor temperature (r=-0,38; p= 0,0001). Conclusions: The air pollution and the outdoor temperature are important predictors of AECOPD. The results from our study could be used for applying preventive measures.

Research paper thumbnail of Outcomes in patients with COPD during a 3 year follow-up

European Respiratory Journal, 2015

Introduction: The GOLD 2014 assessment predicts future exacerbations and mortality risk, separati... more Introduction: The GOLD 2014 assessment predicts future exacerbations and mortality risk, separating patients into high symptom groups (B, D) and high risk groups (C, D). Aim: Our aim was to investigate hospitalisations, exacerbations and mortality in a 3 year prospective study in outpatients with COPD. Material and Methods: A total of 262 (210 male and 52 female, mean age 66±9) COPD outpatients were recruited. From all patients 20,2 % were no smokers, 25,2% were active smokers (39,1±20,1 pack/years) and 54,6% were ex-smokers (40,0±31,6). During 2012, 2013 and 2014 all COPD related exacerbations and hospitalisations were tracked down. Data for the mortality and the cause of death is gathered from medical records. Results: According to GOLD 2014 patients were divided as follows: A 69 (26%), B 73 (28%), C 36 (14%) and D 84 (32%). The mean number of hospitalisations for the 3 year period rose from group A to group D (A 0,55±0,9; B 1,41±1,7; C 1,92±2,4; D 2,96±2,9) and in every consecutive year (p Conclusion: The new GOLD 2014 assessment proposal is feasible and valid for assessing future hospitalisations (severe exacerbations) which increase from groups A to B to C to D and predict the mortality risk. In the group of smokers (active and ex-smokers) we found that number of exacerbations and hospitalisations are related with age (p

Research paper thumbnail of An Examination of Ar Information Display with Eye Gaze Input

Research paper thumbnail of Pembangunan Inokulum Untuk Penghasilan Lipid Dan Asid Gamma Linolenik Gla Oleh Cunninghamella Bainieri 2A1

Penerbit Universiti Kebangsaan Malaysia, Apr 1, 2012

... dalam penggunaan substrat serta dapat memendekkan masa pengkulturan dan seterusnya akan menin... more ... dalam penggunaan substrat serta dapat memendekkan masa pengkulturan dan seterusnya akan meningkatkan produktiviti keseluruhan proses kerana masa bagi proses pengkulturan dapat dikurangkan dua hari. ... RUJUKAN Bajpai, PK, Bajpai, P. & Ward, OP 1991. ...

Research paper thumbnail of The risk factors in asthma patients for COVID19 infection

Monitoring airway disease, 2021

Research paper thumbnail of Younger COPD patients – the need for long-term follow-up

Monitoring airway disease, 2020

Research paper thumbnail of Evaluating peanut (Arachis hypogaea L.) seed vigor

Production of seed peanuts requires careful management of several factors that may affect quality... more Production of seed peanuts requires careful management of several factors that may affect quality, for example, adequate water and calcium availability during pod-fill, maturity at harvest, curing and storage at the recommended temperature and seed moisture levels, and shelling and conditioning with min imal mechanical damage. Seed vigor tests may be used to assess storability and suitability for planting. Tests may be categorized as quick tests, which can be performed within 24 hours, and standard germination and stress-type germi nation tests, which require 7 to 12 days. Calcium assay is included as a quick method to assess quality since it is a critical nutrient for seed peanuts. The tetrazolium and electrical conductivity tests both evaluate aspects of tissue integrity. The standard germination test is indicative of seed vigor with > 85% germination considered strong vigor. The accelerated aging and cold germina tion tests are two stress-type methods that are good indicators ...

Research paper thumbnail of Selection of potential petroleum hydrocarbon-degrading bacteria

Research paper thumbnail of Risk contribution of comorbidities in hospitalized patients with Covid 19 pneumonia

Respiratory infections and bronchiectasis, 2021

Research paper thumbnail of Application of a novel finger temperature device in the assessment of subjects with Raynaud's phenomenon

Skin Research and Technology, 2021

INTRODUCTION Finger skin thermometry is one of the most commonly used methods for evaluating the ... more INTRODUCTION Finger skin thermometry is one of the most commonly used methods for evaluating the response of the digital vessels to cold stimulation. The aim of this study was to evaluate the applicability of a novel finger skin temperature device for performing cold-stimulation test (CST) in subjects with primary and secondary Raynaud's phenomenon (RP). METHODOLOGY A total of 155 consecutive subjects were studied. They were divided into three groups: 73 patients with primary RP (8 males, 65 females, mean age 38.5 ± 16.2), 42 patients with secondary RP (4 males, 38 females, mean age 49.6 ± 13.1, connected with lupus erythematosus and systemic scleroderma), and 40 healthy controls (5 males, 35 females, mean age 38.8 ± 16.6). Standardized CST consisting of exposure of both hands to water with a temperature of 10℃ for 5 minutes was performed. Changes in skin temperature of both wrists and 2-5 fingers were measured using a novel finger temperature device (Courage & Khazaka). Measurements were made before and 5, 10, 15, 20, 25, and 30 minutes after cold stimulation. The time of recovery for baseline temperature of all fingers below 15 minutes was considered normal. RESULTS The CST was normal in 6 (8.2%) of the patients with primary RP, in 7 (16.6%) of the patients with secondary RP, and in 28 (70%) of the healthy control subjects. The time of complete recovery of baseline temperature with respect to the first finger and for all 2-5 fingers in the three groups was as follows: 24.8 and 28.5 minutes (primary RP), 21.7 and 26.8 minutes (secondary RP), and 11.1 and 15.2 minutes (healthy subjects). Furthermore, the microcirculation was seriously disturbed (rewarming time >31 minutes of all 2-5 digits of both hands) in 54.1% (n = 79), 34.5% (n = 29) and 5% (n = 4) in the same study groups. DISCUSSION Our results suggested that skin microcirculation is more disturbed in patients with primary RP than in patients with secondary RP. In support of this unexpected finding were the results reported by Ruaro B. et al (2019). They investigated the blood perfusion (BP) by laser speckle contrast analysis (LASCA) at different skin areas of hands and found that it was significantly lower in primary RP than in secondary RP related to systemic sclerosis. CONCLUSION The new finger temperature device used could be considered useful for performing cold-stimulation test in patients with Raynaud's phenomenon.

Research paper thumbnail of Regional employment policies in the field of healthcare

Health Economics and Management, 2020

Research paper thumbnail of Mobility of Medical Specialists – A Challenge for the Bulgarian Health System

Health Economics and Management, 2020

Research paper thumbnail of Is the Bulgarian Health Care System Attractive to Young Medical Specialists: A Study of Attitudes among Medical University Students in Bulgaria

Health Economics and Management, 2019

Статията представя авторско анкетно проучване за нагласите за реализация извън страната на обучен... more Статията представя авторско анкетно проучване за нагласите за реализация извън страната на обучени и квалифицирани в България медицински специалисти. Проучването дава възможност да се предвидят тенденциите при осигуреността на здравната система с медицински специалисти в краткосрочен и средносрочен план. Анализирането и оценката на тези нагласи следва да е основа при създаване и прилагане на ефективни политики за задържане на медицинските кадри в страната.

Research paper thumbnail of Stability of Frequent Exacerbator Phenotype in Patients with Chronic Obstructive Pulmonary Disease

Folia Medica, 2018

Background: At present, there is little information in Bulgaria regarding the rate and stability ... more Background: At present, there is little information in Bulgaria regarding the rate and stability of frequent-exacerbation phenotype in COPD patients. Aim: To study the rate and stability of frequent-exacerbation phenotype in COPD patients. Materials and methods: We followed up 465 COPD patients for exacerbations over a 3-year period. Exacerbations were defined as events that resulted in treatment with antibiotics and/or corticosteroids (moderate), or that led to hospitalization (severe). Result: Approximately 10% of the patients had two or more exacerbations per year (frequent-exacerbation phenotype), and this structure stayed stable over the study period. The exacerbation rate in the first year of follow up was 0.33 per stage I COPD patients (according to GOLD stages), 0.49 per stage II COPD patients; 0.69 - for stage III, and 1.06 for stage IV COPD patients. The frequent-exacerbation rate increased from stage I to stage IV by 4.35%, 9.17%, 10.79%, and 20.97%, respectively. A histo...

Research paper thumbnail of GOLD 2017 versus GOLD 2011 - comparison of the risk of exacerbations and mortality in COPD patients

Clinical Problems, 2018

Topic: The new revision of GOLD from 2017 year excluded spirometry as a classification tool for C... more Topic: The new revision of GOLD from 2017 year excluded spirometry as a classification tool for COPD patients. How this changed the exacerbation and mortality risk estimation is understudied. Aim: To study the effect of the GOLD 2017 revision on exacerbation and mortality risk compared to GOLD 2011 classification. Methods: We followed prospectively 465 COPD patients for exacerbations and death during a 3 year period. We classified the patients in ABCD groups according to GOLD from 2011 and 2017. Result: When we classified ABCD groups according to GOLD 2017 we found more low risk patients compared to GOLD 2011 (72.26% vs. 46.83% p Conclusions: The GOLD 2017 classification resulted in a significant movement of patients from high risk groups C and D to low risk groups A and B. This led to a better selection of high exacerbation risk patients in group D who also had a higher CVD rate. There was no significant additional increase in exacerbations and mortality for low risk groups A and B.

Research paper thumbnail of Impact of Air Pollution and Outdoor Temperature on the Rate of Chronic Obstructive Pulmonary Disease Exacerbations

Folia medica, Jan 20, 2017

Environmental pollution can be one of the main risk factors for acute exacerbations of chronic ob... more Environmental pollution can be one of the main risk factors for acute exacerbations of chronic obstructive pulmonary disease (COPD). To study the relationship between air pollution, outdoor temperature and exacerbations of COPD. COPD patients (n=1432) were followed up for one year. The levels of particulate matter up to 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2) and outside temperatures were collected from the Environmental Agency database. A total of 309 acute COPD exacerbations (AECOPD) were recorded in the analysis. The daily mean concentrations of PM10 were found to correlate significantly with the daily mean concentrations of NO2 and SO2 (ρ 0.34 and ρ 0.49, respectively; p=0.0001). The negative correlations between the daily mean temperature and the daily mean levels of PM10, NO2 and SO2 were also significant (ρ -0.44, ρ -0.11, and ρ -0.37, respectively; p=0.0001). The daily number of AECOPD correlated with the mean levels of PM10 in the previous six days (ρ 0.1...

Research paper thumbnail of Inhalation technique in patients with obstructive pulmonary diseases- Most common mistakes and factors, favouring the correct technique

European Respiratory Journal, 2016

Introduction Correct inhalation technique is essential part of obstructive pulmonary diseases tre... more Introduction Correct inhalation technique is essential part of obstructive pulmonary diseases treatment. Aims To test patients9 inhalation technique, to determine most common mistakes during inhalation and to find out factors, which affect the inhalation technique. Methods The inhalation technique of 94 patients with obstructive pulmonary disease (COPD or bronchial asthma) was tested with Vitalograph AIM device at the end of their hospitalization. To test the inhalation technique a disposable inhaler stimulator (MDI with placebo canister or DPI), according to patient9s controller device was used. A short questionnaire was filled. Results A successful first inhalation attempt was performed by 28 (30%) patients, although 96% of all participants claimed that they have correct inhalation technique. The most common mistake with MDI stimulator was poor coordination between activating the device and patient9s inhalation (50% of the patients). The most common mistake with DPI stimulator was that inhalation was not forceful enough (50% of the patients). Patients who visit pulmonologist more often (p=0.02594), live in urban areas (p= 0.0422), have higher educational degree (graduated at least higher school) (p= 0.0460) and are employees (p= 0.0496) present with better inhalation technique. Conclusions There is discordance between the patients9 opinion and the demonstrated inhalation technique. The regular visits in ambulatory practice, living in urban areas, the higher educational degree and the better social status seem to be factors, favouring the correct inhalation technique.

Research paper thumbnail of Frequent COPD exacerbators are not a stabile phenotype

Monitoring airway disease, 2019

je po končanem pravnem študiju, promociji in sodniškem izpitu ter vzporednem študiju glasbe v Gra... more je po končanem pravnem študiju, promociji in sodniškem izpitu ter vzporednem študiju glasbe v Gradcu vstopil v sodniško službo. Kot obetaven kader za prihodnjo slovensko univerzo je dobil državno štipendijo za izpopolnjevanje na univerzi v Leipzigu. Po vrnitvi se je znova zaposlil na okrajnem sodišču v Ljubljani, od koder so ga prestavili v tajništvo Vrhovnega in kasacijskega sodišča na Dunaju, kjer je ostal do razpada monarhije in dosegel naslov dvornega sekretarja oziroma svetnika višjega deželnega sodišča. Po razpadu monarhije je bil imenovan za svetnika Višjega deželnega sodišča v Ljubljani. Tu mu je bilo poverjeno vodenje knjižnice. Napisal je knjižnični red in uredil njeno poslovanje. Ko je bil ustanovljen Oddelek B Stola sedmorice v Zagrebu, se je prijavil za svetnika tega sodišča. Preden je bila njegova prošnja rešena, ga je kralj imenoval za rednega profesorja za državljansko in rimsko pravo na novoustanovljeni juridični fakulteti v Ljubljani. * Akad. zasl. prof. dr. dr. h. c., univ. dipl. pravnik, Pravna fakulteta Univerze v Ljubljani,

Research paper thumbnail of Biochemical Characterization for Lipid Synthesis in Aspergillus niger

Baghdad Science Journal, 2016

A niger, a fungus which doesn't have high ability to production lipid, this fungus has been selec... more A niger, a fungus which doesn't have high ability to production lipid, this fungus has been select to investigate the non oleaginicity. In this search, there are explorations about: i) growth profile ii) enzymes profile iii) isoforms. Growth profile shows that this fungus doesn't have ability to accumulate lipid more than 6% while bio mass are around 10g/l in spite of the presence of glucose in the media till the end of cultivation time and excision of nitrogen within 24 hrs. In enzyme study, we investigate all lipogenic enzymes Malic enzyme (ME), Fatty acid synthase (FAS), ATP: Citrate lays (ACL), NAD + isocitrate dehydrogenase (NAD + ICDH), Glucose-6phosphate (G6PD), and 6-phosphogluconate dehydrogenase (6PGD), all these enzymes show, activities till the end of cultivation time including ACL which is regarded the key enzyme to differentiate between the two species oleaginous and non oleaginous. So, there is no main reason to non oleaginicity for this fungus. A further experiment has been done using Polyacrylamide gel electrophoresis to identify ME isoforms. The result of Polyacrylamide gel electrophoresis shows multi isoforms (A, B, C, D & E), with low intensity of isoform E, the isoforms that may involve in lipid synthesis. We have now studied the biochemistry of A.niger grown under conditions designed to promote lipid accumulation and can now advance a coherent hypothesis to explain why A niger could not accumulate lipid more than 6%. So the absence of isoforme E is the main reason for non oleaginicity in A niger.

Research paper thumbnail of Original Article. Improving the Inhalation Technique in Patients with Obstructive Pulmonary Diseases

Journal of Biomedical and Clinical Research, 2016

SummaryThe study aimed to assess the inhalation technique of patients with bronchial asthma/chron... more SummaryThe study aimed to assess the inhalation technique of patients with bronchial asthma/chronic obstructive pulmonary disease (COPD) via an objective method and to evaluate the effect of training in patients with incorrect technique. Тhe inhalation technique of 120 patients with obstructive pulmonary disease was tested. The patients were divided into two groups: using metered dose inhalers (MDI) - 34 patients (28%) and dry powered inhalers (DPI) - 86 patients (72%). The most frequent mistakes in the MDIgroup were short duration of the inhalation (55.88%) and bad synchronization between activating the canister and the inhalation (29.41%). For the DPIgroup, the inhalation was not forceful enough (48.84%) and the short duration of the inhalation (12.79%). Patients claiming to have good inhalation technique accounted for 97%of those in the MDIgroup, and 96.5%of those in the DPIgroup. There were two patients (5.88%) with correct inhalation technique in the MDIgroup at their first att...

Research paper thumbnail of Do air pollution and outdoor temperature influence the frequency of acute COPD exacerbations?

European Respiratory Journal, 2016

Topic: There is not enough data in Bulgaria about the influence of air pollution and outdoor temp... more Topic: There is not enough data in Bulgaria about the influence of air pollution and outdoor temperature on the frequency of acute exacerbations of COPD (AECOPD). Aim: To study the relationship between the levels of air pollutants and outdoor temperature and frequency of AECOPD. Methods: To observe the frequency of AECOPD we followed 477 hospitalized and ambulatory COPD patients for 3 years. The levels of PM 10 , NO, NO2, SO2 and outdoor temperature were obtained from local environmental office measured by automatic station. Statgraphics, SPSS and Excel were used for statistical analysis. Results and discussion: A total of 708 AECOPD of patients living in the town were found. The mean weekly levels of PM10 were found to correlate with the mean weekly levels of: NO(r=0,68; p= 0,0001), NO2(r= 0,46; p= 0,0001) SO2(r=0,63; p=0,0001) and the mean weekly outdoor temperature (T weekly ) (r=-0,70; p=0,0001). T weekly had a negative correlation also with: NO(r=-0,53; p= 0,0001), NO2( r=-0,19; p= 0,03) and SO2(r=-0,68; p=0,0001). The frequency of AECOPD was found to correlate with: NO(r=0,34; p=0,02), SO2(r=0,31; p=0,0002), PM10 (r=0,26; p=0,001), season (r=0,38 p= 0,0001). It also had a negative correlation with the outdoor temperature (r=-0,38; p= 0,0001). Conclusions: The air pollution and the outdoor temperature are important predictors of AECOPD. The results from our study could be used for applying preventive measures.

Research paper thumbnail of Outcomes in patients with COPD during a 3 year follow-up

European Respiratory Journal, 2015

Introduction: The GOLD 2014 assessment predicts future exacerbations and mortality risk, separati... more Introduction: The GOLD 2014 assessment predicts future exacerbations and mortality risk, separating patients into high symptom groups (B, D) and high risk groups (C, D). Aim: Our aim was to investigate hospitalisations, exacerbations and mortality in a 3 year prospective study in outpatients with COPD. Material and Methods: A total of 262 (210 male and 52 female, mean age 66±9) COPD outpatients were recruited. From all patients 20,2 % were no smokers, 25,2% were active smokers (39,1±20,1 pack/years) and 54,6% were ex-smokers (40,0±31,6). During 2012, 2013 and 2014 all COPD related exacerbations and hospitalisations were tracked down. Data for the mortality and the cause of death is gathered from medical records. Results: According to GOLD 2014 patients were divided as follows: A 69 (26%), B 73 (28%), C 36 (14%) and D 84 (32%). The mean number of hospitalisations for the 3 year period rose from group A to group D (A 0,55±0,9; B 1,41±1,7; C 1,92±2,4; D 2,96±2,9) and in every consecutive year (p Conclusion: The new GOLD 2014 assessment proposal is feasible and valid for assessing future hospitalisations (severe exacerbations) which increase from groups A to B to C to D and predict the mortality risk. In the group of smokers (active and ex-smokers) we found that number of exacerbations and hospitalisations are related with age (p

Research paper thumbnail of An Examination of Ar Information Display with Eye Gaze Input

Research paper thumbnail of Pembangunan Inokulum Untuk Penghasilan Lipid Dan Asid Gamma Linolenik Gla Oleh Cunninghamella Bainieri 2A1

Penerbit Universiti Kebangsaan Malaysia, Apr 1, 2012

... dalam penggunaan substrat serta dapat memendekkan masa pengkulturan dan seterusnya akan menin... more ... dalam penggunaan substrat serta dapat memendekkan masa pengkulturan dan seterusnya akan meningkatkan produktiviti keseluruhan proses kerana masa bagi proses pengkulturan dapat dikurangkan dua hari. ... RUJUKAN Bajpai, PK, Bajpai, P. & Ward, OP 1991. ...

Research paper thumbnail of The risk factors in asthma patients for COVID19 infection

Monitoring airway disease, 2021

Research paper thumbnail of Younger COPD patients – the need for long-term follow-up

Monitoring airway disease, 2020

Research paper thumbnail of Evaluating peanut (Arachis hypogaea L.) seed vigor

Production of seed peanuts requires careful management of several factors that may affect quality... more Production of seed peanuts requires careful management of several factors that may affect quality, for example, adequate water and calcium availability during pod-fill, maturity at harvest, curing and storage at the recommended temperature and seed moisture levels, and shelling and conditioning with min imal mechanical damage. Seed vigor tests may be used to assess storability and suitability for planting. Tests may be categorized as quick tests, which can be performed within 24 hours, and standard germination and stress-type germi nation tests, which require 7 to 12 days. Calcium assay is included as a quick method to assess quality since it is a critical nutrient for seed peanuts. The tetrazolium and electrical conductivity tests both evaluate aspects of tissue integrity. The standard germination test is indicative of seed vigor with > 85% germination considered strong vigor. The accelerated aging and cold germina tion tests are two stress-type methods that are good indicators ...

Research paper thumbnail of Selection of potential petroleum hydrocarbon-degrading bacteria

Research paper thumbnail of Risk contribution of comorbidities in hospitalized patients with Covid 19 pneumonia

Respiratory infections and bronchiectasis, 2021

Research paper thumbnail of Application of a novel finger temperature device in the assessment of subjects with Raynaud's phenomenon

Skin Research and Technology, 2021

INTRODUCTION Finger skin thermometry is one of the most commonly used methods for evaluating the ... more INTRODUCTION Finger skin thermometry is one of the most commonly used methods for evaluating the response of the digital vessels to cold stimulation. The aim of this study was to evaluate the applicability of a novel finger skin temperature device for performing cold-stimulation test (CST) in subjects with primary and secondary Raynaud's phenomenon (RP). METHODOLOGY A total of 155 consecutive subjects were studied. They were divided into three groups: 73 patients with primary RP (8 males, 65 females, mean age 38.5 ± 16.2), 42 patients with secondary RP (4 males, 38 females, mean age 49.6 ± 13.1, connected with lupus erythematosus and systemic scleroderma), and 40 healthy controls (5 males, 35 females, mean age 38.8 ± 16.6). Standardized CST consisting of exposure of both hands to water with a temperature of 10℃ for 5 minutes was performed. Changes in skin temperature of both wrists and 2-5 fingers were measured using a novel finger temperature device (Courage & Khazaka). Measurements were made before and 5, 10, 15, 20, 25, and 30 minutes after cold stimulation. The time of recovery for baseline temperature of all fingers below 15 minutes was considered normal. RESULTS The CST was normal in 6 (8.2%) of the patients with primary RP, in 7 (16.6%) of the patients with secondary RP, and in 28 (70%) of the healthy control subjects. The time of complete recovery of baseline temperature with respect to the first finger and for all 2-5 fingers in the three groups was as follows: 24.8 and 28.5 minutes (primary RP), 21.7 and 26.8 minutes (secondary RP), and 11.1 and 15.2 minutes (healthy subjects). Furthermore, the microcirculation was seriously disturbed (rewarming time >31 minutes of all 2-5 digits of both hands) in 54.1% (n = 79), 34.5% (n = 29) and 5% (n = 4) in the same study groups. DISCUSSION Our results suggested that skin microcirculation is more disturbed in patients with primary RP than in patients with secondary RP. In support of this unexpected finding were the results reported by Ruaro B. et al (2019). They investigated the blood perfusion (BP) by laser speckle contrast analysis (LASCA) at different skin areas of hands and found that it was significantly lower in primary RP than in secondary RP related to systemic sclerosis. CONCLUSION The new finger temperature device used could be considered useful for performing cold-stimulation test in patients with Raynaud's phenomenon.

Research paper thumbnail of Regional employment policies in the field of healthcare

Health Economics and Management, 2020

Research paper thumbnail of Mobility of Medical Specialists – A Challenge for the Bulgarian Health System

Health Economics and Management, 2020

Research paper thumbnail of Is the Bulgarian Health Care System Attractive to Young Medical Specialists: A Study of Attitudes among Medical University Students in Bulgaria

Health Economics and Management, 2019

Статията представя авторско анкетно проучване за нагласите за реализация извън страната на обучен... more Статията представя авторско анкетно проучване за нагласите за реализация извън страната на обучени и квалифицирани в България медицински специалисти. Проучването дава възможност да се предвидят тенденциите при осигуреността на здравната система с медицински специалисти в краткосрочен и средносрочен план. Анализирането и оценката на тези нагласи следва да е основа при създаване и прилагане на ефективни политики за задържане на медицинските кадри в страната.

Research paper thumbnail of Stability of Frequent Exacerbator Phenotype in Patients with Chronic Obstructive Pulmonary Disease

Folia Medica, 2018

Background: At present, there is little information in Bulgaria regarding the rate and stability ... more Background: At present, there is little information in Bulgaria regarding the rate and stability of frequent-exacerbation phenotype in COPD patients. Aim: To study the rate and stability of frequent-exacerbation phenotype in COPD patients. Materials and methods: We followed up 465 COPD patients for exacerbations over a 3-year period. Exacerbations were defined as events that resulted in treatment with antibiotics and/or corticosteroids (moderate), or that led to hospitalization (severe). Result: Approximately 10% of the patients had two or more exacerbations per year (frequent-exacerbation phenotype), and this structure stayed stable over the study period. The exacerbation rate in the first year of follow up was 0.33 per stage I COPD patients (according to GOLD stages), 0.49 per stage II COPD patients; 0.69 - for stage III, and 1.06 for stage IV COPD patients. The frequent-exacerbation rate increased from stage I to stage IV by 4.35%, 9.17%, 10.79%, and 20.97%, respectively. A histo...

Research paper thumbnail of GOLD 2017 versus GOLD 2011 - comparison of the risk of exacerbations and mortality in COPD patients

Clinical Problems, 2018

Topic: The new revision of GOLD from 2017 year excluded spirometry as a classification tool for C... more Topic: The new revision of GOLD from 2017 year excluded spirometry as a classification tool for COPD patients. How this changed the exacerbation and mortality risk estimation is understudied. Aim: To study the effect of the GOLD 2017 revision on exacerbation and mortality risk compared to GOLD 2011 classification. Methods: We followed prospectively 465 COPD patients for exacerbations and death during a 3 year period. We classified the patients in ABCD groups according to GOLD from 2011 and 2017. Result: When we classified ABCD groups according to GOLD 2017 we found more low risk patients compared to GOLD 2011 (72.26% vs. 46.83% p Conclusions: The GOLD 2017 classification resulted in a significant movement of patients from high risk groups C and D to low risk groups A and B. This led to a better selection of high exacerbation risk patients in group D who also had a higher CVD rate. There was no significant additional increase in exacerbations and mortality for low risk groups A and B.

Research paper thumbnail of Impact of Air Pollution and Outdoor Temperature on the Rate of Chronic Obstructive Pulmonary Disease Exacerbations

Folia medica, Jan 20, 2017

Environmental pollution can be one of the main risk factors for acute exacerbations of chronic ob... more Environmental pollution can be one of the main risk factors for acute exacerbations of chronic obstructive pulmonary disease (COPD). To study the relationship between air pollution, outdoor temperature and exacerbations of COPD. COPD patients (n=1432) were followed up for one year. The levels of particulate matter up to 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2) and outside temperatures were collected from the Environmental Agency database. A total of 309 acute COPD exacerbations (AECOPD) were recorded in the analysis. The daily mean concentrations of PM10 were found to correlate significantly with the daily mean concentrations of NO2 and SO2 (ρ 0.34 and ρ 0.49, respectively; p=0.0001). The negative correlations between the daily mean temperature and the daily mean levels of PM10, NO2 and SO2 were also significant (ρ -0.44, ρ -0.11, and ρ -0.37, respectively; p=0.0001). The daily number of AECOPD correlated with the mean levels of PM10 in the previous six days (ρ 0.1...

Research paper thumbnail of Inhalation technique in patients with obstructive pulmonary diseases- Most common mistakes and factors, favouring the correct technique

European Respiratory Journal, 2016

Introduction Correct inhalation technique is essential part of obstructive pulmonary diseases tre... more Introduction Correct inhalation technique is essential part of obstructive pulmonary diseases treatment. Aims To test patients9 inhalation technique, to determine most common mistakes during inhalation and to find out factors, which affect the inhalation technique. Methods The inhalation technique of 94 patients with obstructive pulmonary disease (COPD or bronchial asthma) was tested with Vitalograph AIM device at the end of their hospitalization. To test the inhalation technique a disposable inhaler stimulator (MDI with placebo canister or DPI), according to patient9s controller device was used. A short questionnaire was filled. Results A successful first inhalation attempt was performed by 28 (30%) patients, although 96% of all participants claimed that they have correct inhalation technique. The most common mistake with MDI stimulator was poor coordination between activating the device and patient9s inhalation (50% of the patients). The most common mistake with DPI stimulator was that inhalation was not forceful enough (50% of the patients). Patients who visit pulmonologist more often (p=0.02594), live in urban areas (p= 0.0422), have higher educational degree (graduated at least higher school) (p= 0.0460) and are employees (p= 0.0496) present with better inhalation technique. Conclusions There is discordance between the patients9 opinion and the demonstrated inhalation technique. The regular visits in ambulatory practice, living in urban areas, the higher educational degree and the better social status seem to be factors, favouring the correct inhalation technique.