Papers by Penka S T E F A N O V A Kostadinova
ABSTRACT One of the main activities of general practitioners (GPs) in Bulgaria is the annual ho... more ABSTRACT One of the main activities of general practitioners (GPs) in Bulgaria is the annual holding of a general checkup of people over ‘18 prophylactic examination includes a basic package of activities and research based on who identify as persons with diseases and patients who are at increased risk for developing certain major diseases. The aim of this study was to determine the scope of the population and the views of patients and GPs for conducting check-ups. They are used official data from the National Health Insurance Fund and has held direct individual survey with 229 GPs from three areas of Bulgaria and 515 insured persons over 18 years. It was found that despite the mandatory nature of these reviews had a relatively low range of the underlying population - approximately 50% of adults annually performs check-up. Record the underfunding of this activity. Main drawbacks are indicated in surveys of doctors, insufficient awareness and motivation, and lack of time. The majority of patients consider that these examinations are carried out formally. No resistance, monitoring and reporting on the effect of these examinations.
Keywords: GPs, check-up.
STUDY OF THE ASSOCIATION BETWEEN INTERRELATION APO B/APO A1, TC/HDL-C, LDL-C AND TRIGLYCIRIDE/ HD... more STUDY OF THE ASSOCIATION BETWEEN INTERRELATION APO B/APO A1, TC/HDL-C, LDL-C AND TRIGLYCIRIDE/ HDL-C AND METABOLIC SYNDROME AMONG BULGARIAN POPULATION
Nadenova Galyia Atanasova, Marinov Marin Simeonov, Atanasov Milen Atanasov, Kostadinova Penka Stefanova, Kostadinov Sergey Deyanov, Tsveova Reni Stoyova
АННОТАЦИЯ Цель: Соотношение аполипопротеина В к аполипопротеину А1 (ApoB/ ApoA1) есть мощный клинический индикатор метаболического синдрома.Цель настоящего исследования–исследовать связь между соотношениями ApoB/ApoA1, TC/ HDL-C, LDL-C/HDL-C, триглицериды/HDL-C и компонентами метаболического синдрома (МС) в болгарской популяции. Метод: Было проведено исследование в Плевенском регионе среди 500 клинически здоровых людей, из которых 40.2% мужчин и 59.8% женщин. В критерии включились лица старше18-лет, без пережитого сердечно-содсудистого инцидента и без сахарного диабета. Исследовательская методика включает стандартизированное интервью для оценки факторов риска и лабораторное исследование биохимическим анализатором „Cobas Integra 400 (Roche)”: сахар в крови натощак, серумные триглицериды, общий холестерол, HDL-холестерол, LDL- холестерол, аполипопротеин А-I и аполипопротеин В. Вычислили для всей группы ароВ/ароA1, общий холестерол /HDL-C, LDL-C/ HDL-C и триглицериды /HDL-C. Результат: Частота МС в нашем исследовании составляет 32,6% у мужчин и 26,7% у женщин. С ростом возраста частота МС у женщин нарастает, а у мужчин самая высокая частота в возрасте 36-45 лет. Для лиц с МС величина соотношений apoB/ароA1 и chol/HDL выше в сравнении с теми же без МС. Связь между рссмотренными соотношениями велика (r=0,72 – у людей с МС, а у тех без МС r=0,88). Выводы: Соотношение ApoB/ApoA1 является независимым рисковым фактором для МС. В настоящем исследовании мы оцениваем механизмы, которые лежат в основе связей между соотношениями ApoB/ApoA1, метаболическим синдромом и их компонентами.
ABSTRACT Aim: Interrelation apolipoprotein B/ apolipoprotein A1 /ApoB, ApoA1/ is power clinical indicator for metabolic syndrome. The purpose of this study is to investigate the connection between interrelations ApoB/ApoA1, TC/HDLC, LDL-C/HDL-c, triglyceride/ HDL-C and metabolic syndrome /MS/ components among Bulgarian population. Methods: 500 clinically health people of the region of Pleven (201 men and 299 women) were investigated. Those with MS were selected. Patients were classified in quartiles (the lowest: Q1; the highest: Q4) according to the values of interrelation ApoB/ ApoA1 in sex, anthropometric and hematological characteristics. Results: The MS frequency in our study is 32,6% among men and 26,7% among women. We found significant growing of odds
Евразийский Союз Ученых (ЕСУ) # 5 (26), 2016 | МЕДИЦИНСКИЕ НАУКИ 53
ratios (OR) for participants with MS from Q2 to Q4 quartiles for the interrelation ApoB/ApoA1 among men (OR = 5,34; 95%Cl = 2,95-9,62 and OR = 6,79; 95%Cl = 4,05-12,8) and for women (OR = 2,46; 95%Cl = 1,25-5,12 and OR = 8,37; 95%Cl = 4,25-15,8). These results were corrected according to the age and the blood glucose levels for men (OR = 5,24; 95%Cl = 2,80-9,29 and OR = 7,88; 95%Cl = 4,08-14.9) and for women (OR = 4,40; 95%Cl = 2,24-8,60 and OR = 8,26; 95%Cl = 3,82-16,5). Conclusions: ApoB/ApoA1 interrelation is an independent risk factor for MS. In this study we investigate the mechanisms that are important for the connection between ApoB/ApoA1 interrelation, metabolic syndrome and its components.
Ключевые слова: метаболическим синдромом, соотношения АроВ/АроА1, ТС/HDL-C, LDL-C/HDL-C, TG/HDL-C
Keywords: apolipoprotein B, apolipoprotein A1, metabolic syndrome, cardiovascular risk, ApoB/ApoA1 interrelation
Journal of Biomedical and Clinical Research, 2014
The aim of the study was to identify socioeconomic and psychological determinants of self-rated h... more The aim of the study was to identify socioeconomic and psychological determinants of self-rated health among ambulatory and hospitalized patients. A cross-sectional study was carried-out in 2014. Two hundred and twelve patients over 44 years of age filled in a self-administrated questionnaire. Self-rated health (SRH) was measured by 5-point range scale. The level of well-being (WB), sources of social support, personal financial capacity, social status, etc. were studied as well. Data were processed by SPSS.v.19. Parametric and non-parametric statistical methods were applied. Over 70% of patients evaluated their health as fair and good. The persons with higher WB had higher SRH, that correlation was moderate (r=0.452; p=0.001). In regard to the social status the differences were significant-the unemployed, old age retirees or ill health retirees evaluated their health lower (p<0.05). A proportion of patients indicated two or more sources of emotional and instrumental support, but increased number of support sources had no effect on SRH (p>0.05). Identification of socioeconomic and psychological factors of self-rated health allows clarifying better their effect mechanisms and planning appropriate health services.
Scripta Scientifica Salutis Publicae, 2015
Introduction: Some studies reveal that self-rated health (SRH) and perceived illness vulnerabilit... more Introduction: Some studies reveal that self-rated health (SRH) and perceived illness vulnerability have a mediating role for moderating health behavior and for frequency of completed medical visits. At the same time people with positive SRH possess higher control over their health and evaluate illness vulnerability lower, although the mechanisms of these relations are not clear. Aim: To study statistical relations between the self-rated health, perceived illness vulnerability, perceived controllability over health and health behavior of patients over 44 years of age. Materials and methods: Cross-sectional study was carried-out from February to march 2014. Two hundred and twelve patients over 44 years of age were included in the study. The patients filled in a self-administrated questionnaire. Five-point scale was used for self-rated health measure (1 – excellent health; 5 – poor health). The perceived illness vulnerability to cardiovascular and malignant diseases was assessed. The i...
G eneral health checks are designed to reduce morbidity and prolong life. The theme for the condu... more G eneral health checks are designed to reduce morbidity and prolong life. The theme for the conduct of general check-population is the subject of many studies. Still under discussion whether and to what extent should be carried out this review, what are the pros and cons, what is the effect of their implementation for the individual and society. In Bulgaria after reforms in health care was adopted health insurance model and enhance the role of general practitioners as a key figure for providing primary outpatient treatment. As part of the obligations of the GPs for the implementation of individual contracts with the NHIF are preventive examinations of compulsory insured people over 18 and the formation of risk groups. Since 2006, the total checkup by the GPs is compulsory for all insured people. It includes a basic package of activities and studies on the basis of which are identified as those with diseases and patients who are at increased risk of certain socially significant diseases, such as cardiovascular, malignant diseases and diabetes. Mortality in Bulgaria exceed the EU average by 17 different causes of death as in five, including diseases of the circulatory system, other heart diseases, cerebrovascular disease, our country is in the first place. The purpose of this study is to establish the scope and effectiveness of the program for the prevention of adults conducted by GPs. A direct individual survey with 513 people from Pleven region and 262 GPs from three areas in the country has been carried out. Official data from information databases NHIF and RHIF – Pleven has been used. A lower range of the population was established-less than 50% of eligible. Many people are not sufficiently informed about screening. Greater the percentage of people who believe that the prophylactic examination is necessary, but is formally done by GPs and that studies are insufficient. Doctors also cited as reasons for the failure of the program insufficient awareness of the population, lack of time, insufficient limit obtained from the health insurance fund for research and insufficient motivation. A steady upward trend for the lack of implementation of the program for at-risk groups of population is reported. Lacks sustainability, monitoring and reporting the effect of the program.
Introduction: In average for the range of years 1995 - 2010 the cancer mortality in Bulgaria, for... more Introduction: In average for the range of years 1995 - 2010 the cancer mortality in Bulgaria, for men and women, is about 160 per 100000 population, 15% of the total mortality. Alters from 151 in 2000 to 173 in 2008, varies with amplitude 12% of the average.
Objective: Could this variation be due to natural causes, such as the solar activity? Sun’s magnetic field alters (but sunshine remains constant), which lead to changes in the space around the Sun, repeated in about 11 years. These changes affect the Earth, in particular its biosphere. The aim of this study was to clarify the possible link between solar activity and variation in cancer mortality in Bulgaria.
Material and methods: The analysis was based on data from Eurostat for cancer mortality in Bulgaria and data for solar activity from NASA. For processing the data MS Excel and STATISTIKA were used.
Results and discussion: The analysis shows that the variation in mortality from cancer in Bulgaria is associated with changes in solar activity. The correlation coefficient between mortality and solar activity is of high value -0.720 and high accuracy (with statistical significance level of less than 1%). In male mortality it reaches value - 0.754 with a statistical significance level less than 0.1%. A negative correlation is due to the fact that the peak in cancer mortality is lagged according to the peak of solar activity by about half period: 6 years, and the maximum of solar activity corresponds to the minimum of cancer mortality, and vice versa. This fact could be used for planning of resources for the treatment of cancer patients.
Uploads
Papers by Penka S T E F A N O V A Kostadinova
Keywords: GPs, check-up.
Nadenova Galyia Atanasova, Marinov Marin Simeonov, Atanasov Milen Atanasov, Kostadinova Penka Stefanova, Kostadinov Sergey Deyanov, Tsveova Reni Stoyova
АННОТАЦИЯ Цель: Соотношение аполипопротеина В к аполипопротеину А1 (ApoB/ ApoA1) есть мощный клинический индикатор метаболического синдрома.Цель настоящего исследования–исследовать связь между соотношениями ApoB/ApoA1, TC/ HDL-C, LDL-C/HDL-C, триглицериды/HDL-C и компонентами метаболического синдрома (МС) в болгарской популяции. Метод: Было проведено исследование в Плевенском регионе среди 500 клинически здоровых людей, из которых 40.2% мужчин и 59.8% женщин. В критерии включились лица старше18-лет, без пережитого сердечно-содсудистого инцидента и без сахарного диабета. Исследовательская методика включает стандартизированное интервью для оценки факторов риска и лабораторное исследование биохимическим анализатором „Cobas Integra 400 (Roche)”: сахар в крови натощак, серумные триглицериды, общий холестерол, HDL-холестерол, LDL- холестерол, аполипопротеин А-I и аполипопротеин В. Вычислили для всей группы ароВ/ароA1, общий холестерол /HDL-C, LDL-C/ HDL-C и триглицериды /HDL-C. Результат: Частота МС в нашем исследовании составляет 32,6% у мужчин и 26,7% у женщин. С ростом возраста частота МС у женщин нарастает, а у мужчин самая высокая частота в возрасте 36-45 лет. Для лиц с МС величина соотношений apoB/ароA1 и chol/HDL выше в сравнении с теми же без МС. Связь между рссмотренными соотношениями велика (r=0,72 – у людей с МС, а у тех без МС r=0,88). Выводы: Соотношение ApoB/ApoA1 является независимым рисковым фактором для МС. В настоящем исследовании мы оцениваем механизмы, которые лежат в основе связей между соотношениями ApoB/ApoA1, метаболическим синдромом и их компонентами.
ABSTRACT Aim: Interrelation apolipoprotein B/ apolipoprotein A1 /ApoB, ApoA1/ is power clinical indicator for metabolic syndrome. The purpose of this study is to investigate the connection between interrelations ApoB/ApoA1, TC/HDLC, LDL-C/HDL-c, triglyceride/ HDL-C and metabolic syndrome /MS/ components among Bulgarian population. Methods: 500 clinically health people of the region of Pleven (201 men and 299 women) were investigated. Those with MS were selected. Patients were classified in quartiles (the lowest: Q1; the highest: Q4) according to the values of interrelation ApoB/ ApoA1 in sex, anthropometric and hematological characteristics. Results: The MS frequency in our study is 32,6% among men and 26,7% among women. We found significant growing of odds
Евразийский Союз Ученых (ЕСУ) # 5 (26), 2016 | МЕДИЦИНСКИЕ НАУКИ 53
ratios (OR) for participants with MS from Q2 to Q4 quartiles for the interrelation ApoB/ApoA1 among men (OR = 5,34; 95%Cl = 2,95-9,62 and OR = 6,79; 95%Cl = 4,05-12,8) and for women (OR = 2,46; 95%Cl = 1,25-5,12 and OR = 8,37; 95%Cl = 4,25-15,8). These results were corrected according to the age and the blood glucose levels for men (OR = 5,24; 95%Cl = 2,80-9,29 and OR = 7,88; 95%Cl = 4,08-14.9) and for women (OR = 4,40; 95%Cl = 2,24-8,60 and OR = 8,26; 95%Cl = 3,82-16,5). Conclusions: ApoB/ApoA1 interrelation is an independent risk factor for MS. In this study we investigate the mechanisms that are important for the connection between ApoB/ApoA1 interrelation, metabolic syndrome and its components.
Ключевые слова: метаболическим синдромом, соотношения АроВ/АроА1, ТС/HDL-C, LDL-C/HDL-C, TG/HDL-C
Keywords: apolipoprotein B, apolipoprotein A1, metabolic syndrome, cardiovascular risk, ApoB/ApoA1 interrelation
Objective: Could this variation be due to natural causes, such as the solar activity? Sun’s magnetic field alters (but sunshine remains constant), which lead to changes in the space around the Sun, repeated in about 11 years. These changes affect the Earth, in particular its biosphere. The aim of this study was to clarify the possible link between solar activity and variation in cancer mortality in Bulgaria.
Material and methods: The analysis was based on data from Eurostat for cancer mortality in Bulgaria and data for solar activity from NASA. For processing the data MS Excel and STATISTIKA were used.
Results and discussion: The analysis shows that the variation in mortality from cancer in Bulgaria is associated with changes in solar activity. The correlation coefficient between mortality and solar activity is of high value -0.720 and high accuracy (with statistical significance level of less than 1%). In male mortality it reaches value - 0.754 with a statistical significance level less than 0.1%. A negative correlation is due to the fact that the peak in cancer mortality is lagged according to the peak of solar activity by about half period: 6 years, and the maximum of solar activity corresponds to the minimum of cancer mortality, and vice versa. This fact could be used for planning of resources for the treatment of cancer patients.
Keywords: GPs, check-up.
Nadenova Galyia Atanasova, Marinov Marin Simeonov, Atanasov Milen Atanasov, Kostadinova Penka Stefanova, Kostadinov Sergey Deyanov, Tsveova Reni Stoyova
АННОТАЦИЯ Цель: Соотношение аполипопротеина В к аполипопротеину А1 (ApoB/ ApoA1) есть мощный клинический индикатор метаболического синдрома.Цель настоящего исследования–исследовать связь между соотношениями ApoB/ApoA1, TC/ HDL-C, LDL-C/HDL-C, триглицериды/HDL-C и компонентами метаболического синдрома (МС) в болгарской популяции. Метод: Было проведено исследование в Плевенском регионе среди 500 клинически здоровых людей, из которых 40.2% мужчин и 59.8% женщин. В критерии включились лица старше18-лет, без пережитого сердечно-содсудистого инцидента и без сахарного диабета. Исследовательская методика включает стандартизированное интервью для оценки факторов риска и лабораторное исследование биохимическим анализатором „Cobas Integra 400 (Roche)”: сахар в крови натощак, серумные триглицериды, общий холестерол, HDL-холестерол, LDL- холестерол, аполипопротеин А-I и аполипопротеин В. Вычислили для всей группы ароВ/ароA1, общий холестерол /HDL-C, LDL-C/ HDL-C и триглицериды /HDL-C. Результат: Частота МС в нашем исследовании составляет 32,6% у мужчин и 26,7% у женщин. С ростом возраста частота МС у женщин нарастает, а у мужчин самая высокая частота в возрасте 36-45 лет. Для лиц с МС величина соотношений apoB/ароA1 и chol/HDL выше в сравнении с теми же без МС. Связь между рссмотренными соотношениями велика (r=0,72 – у людей с МС, а у тех без МС r=0,88). Выводы: Соотношение ApoB/ApoA1 является независимым рисковым фактором для МС. В настоящем исследовании мы оцениваем механизмы, которые лежат в основе связей между соотношениями ApoB/ApoA1, метаболическим синдромом и их компонентами.
ABSTRACT Aim: Interrelation apolipoprotein B/ apolipoprotein A1 /ApoB, ApoA1/ is power clinical indicator for metabolic syndrome. The purpose of this study is to investigate the connection between interrelations ApoB/ApoA1, TC/HDLC, LDL-C/HDL-c, triglyceride/ HDL-C and metabolic syndrome /MS/ components among Bulgarian population. Methods: 500 clinically health people of the region of Pleven (201 men and 299 women) were investigated. Those with MS were selected. Patients were classified in quartiles (the lowest: Q1; the highest: Q4) according to the values of interrelation ApoB/ ApoA1 in sex, anthropometric and hematological characteristics. Results: The MS frequency in our study is 32,6% among men and 26,7% among women. We found significant growing of odds
Евразийский Союз Ученых (ЕСУ) # 5 (26), 2016 | МЕДИЦИНСКИЕ НАУКИ 53
ratios (OR) for participants with MS from Q2 to Q4 quartiles for the interrelation ApoB/ApoA1 among men (OR = 5,34; 95%Cl = 2,95-9,62 and OR = 6,79; 95%Cl = 4,05-12,8) and for women (OR = 2,46; 95%Cl = 1,25-5,12 and OR = 8,37; 95%Cl = 4,25-15,8). These results were corrected according to the age and the blood glucose levels for men (OR = 5,24; 95%Cl = 2,80-9,29 and OR = 7,88; 95%Cl = 4,08-14.9) and for women (OR = 4,40; 95%Cl = 2,24-8,60 and OR = 8,26; 95%Cl = 3,82-16,5). Conclusions: ApoB/ApoA1 interrelation is an independent risk factor for MS. In this study we investigate the mechanisms that are important for the connection between ApoB/ApoA1 interrelation, metabolic syndrome and its components.
Ключевые слова: метаболическим синдромом, соотношения АроВ/АроА1, ТС/HDL-C, LDL-C/HDL-C, TG/HDL-C
Keywords: apolipoprotein B, apolipoprotein A1, metabolic syndrome, cardiovascular risk, ApoB/ApoA1 interrelation
Objective: Could this variation be due to natural causes, such as the solar activity? Sun’s magnetic field alters (but sunshine remains constant), which lead to changes in the space around the Sun, repeated in about 11 years. These changes affect the Earth, in particular its biosphere. The aim of this study was to clarify the possible link between solar activity and variation in cancer mortality in Bulgaria.
Material and methods: The analysis was based on data from Eurostat for cancer mortality in Bulgaria and data for solar activity from NASA. For processing the data MS Excel and STATISTIKA were used.
Results and discussion: The analysis shows that the variation in mortality from cancer in Bulgaria is associated with changes in solar activity. The correlation coefficient between mortality and solar activity is of high value -0.720 and high accuracy (with statistical significance level of less than 1%). In male mortality it reaches value - 0.754 with a statistical significance level less than 0.1%. A negative correlation is due to the fact that the peak in cancer mortality is lagged according to the peak of solar activity by about half period: 6 years, and the maximum of solar activity corresponds to the minimum of cancer mortality, and vice versa. This fact could be used for planning of resources for the treatment of cancer patients.