Papers by Mariela Deliverska
Zenodo (CERN European Organization for Nuclear Research), Jan 31, 2018
Regardless of what both patients and medical professionals might think, nowadays there is no free... more Regardless of what both patients and medical professionals might think, nowadays there is no free medicine. The need of changing the pattern is emphasized and people should become more responsible for their own health. The aim is to find a connection between the trust in GPs, prophylactic checkups , new methods of treatment and the willingness of patients to pay for the received medical services. Material and Method: A questionnaire was prepared for the purposes of the study. The methods utilized were a direct individual anonymous questionnaire, statisticaldescriptive, analytical (Chi-square). The answers were examined and statistically processed according to age, gender and education level of the participants. Results: 1. The results regarding the trust in GP is very unconvincingonly 14,5 % believe in their GP. 2. The percentage of believers in prophylactic checkups is high-57,9%. 3.The percentage of those who believe in the new methods and means for treatment is high, over 80%, while no difference is found with respect to the patients' education level. 4. The patients often (86%) pay for the treatment of a specialist. 5. People with higher education more readily pay for medical care. Conclusions: 1. The lack of trust in GP combined with the strong belief in prophylactic checkups and the new methods for diagnostic and treatment of diseases lead to higher expectations of patients towards the medical services and their readiness to pay for these services. 2. The patients indicate readiness to pay for medical services which is a part of the patients' readiness to take care for their own health.
Journal of IMAB - Annual Proceeding (Scientific Papers), Feb 6, 2018
Frontiers in Public Health
Ethical and legal considerations with regards to biometric data usage are directly related to the... more Ethical and legal considerations with regards to biometric data usage are directly related to the right to protection of personal data, which is part of the rights protected under the European Convention of human rights. Specific protection is required to the process and use of sensitive data which reveals certain personal characteristic and is related to the health status of individuals. Biometric data and information on individual upon which people could be identified based on specifics and distinguishing signs. Bulgaria, as a country progressing in terms of integration of digital technologies and as a European Union member state has adopted international and universal legal instruments related on the procession and use of digital data and data protection. On legislative and ethical grounds, it has been established the particular importance of not violating human rights and individual freedoms when processing and using personal data. It has been noted that the processing of special categories of personal data may be necessary for reasons of public interest in the field of public health and that is why under such circumstances it has been permitted the procession to be carried on without the consent of the data subject. Lack of transparency and lawfulness of the processing of personal data could lead to physical, tangible, or intangible damages where processing could lead to discrimination, identity theft, or identity fraud as a result of which may be significant adverse economic or social consequences. Increasingly, widespread use of biometrics in the implementation of medical activities requires the application of a new approach in terms of awareness regarding existing risks to the rights, ethics, and freedoms of all of us, as a user of medical service.
Global Bioethics Enquiry Journal
International Journal of Research -GRANTHAALAYAH
Regardless of what both patients and medical professionals might think, nowadays there is no free... more Regardless of what both patients and medical professionals might think, nowadays there is no free medicine. The need of changing the pattern is emphasized and people should become more responsible for their own health. The aim is to find a connection between the trust in GPs, prophylactic check-ups, new methods of treatment and the willingness of patients to pay for the received medical services. Material and Method: A questionnaire was prepared for the purposes of the study. The methods utilized were a direct individual anonymous questionnaire, statistical – descriptive, analytical (Chi-square). The answers were examined and statistically processed according to age, gender and education level of the participants. Results: 1. The results regarding the trust in GP is very unconvincing – only 14,5 % believe in their GP. 2. The percentage of believers in prophylactic check-ups is high - 57,9%. 3.The percentage of those who believe in the new methods and means for treatment is high, ov...
Biotechnology & Biotechnological Equipment
The purpose of this study was to evaluate the incidence of contact sensitization to metals used i... more The purpose of this study was to evaluate the incidence of contact sensitization to metals used in dental practice among students of dental medicine, students from a dental technician school, dental professionals and patients. A total of 128 participants: 28 dental professionals, 40 students of dental medicine, 38 students from a dental technician school and 22 patients without occupational exposure to metals, were patch tested with potassium dichromate, cobalt(II) chloride hexahydrate, copper(II)sulfate pentahydrate, palladium(II)chloride, aluminium(III)chloride hexahydrate, gold(I)sodium thiosulfate dehydrate, tin and nickel(II)sulfate hexahydrate. The main metal allergens for students of dental medicine were cobalt(II)chloride hexahydrate, gold(I)sodium thiosulfate dehydrate, nickel(II)sulfate hexahydrate and potassium dichromate; for students from the dental technician schoolcobalt(II)chloride hexahydrate, nickel(II)sulfate hexahydrate and gold (I)sodium thiosulfate dehydrate; for dental professionalscobalt(II)chloride hexahydrate, palladium (II)chloride and nickel(II)sulfate hexahydrate, and for dental patientscobalt(II)chloride hexahydrate, nickel(II)sulfate hexahydrate and copper(II)sulfate pentahydrate. There was a significantly higher incidence of sensitization to potassium dichromate (x 2 = 10.497, p = 0.012), palladium(II)chloride (x 2 = 5.381, p = 0.02) and gold(I)sodium thiosulfate dehydrate (x 2 = 6.347, p = 0.018) in the group of students of dental medicine. Our findings confirm the importance of cobalt (II)chloride hexahydrate as contact sensitizer for all the studied groups. Students of dental medicine could be defined as a group of particular risk of contact sensitization with metals. We recommend that knowledge on the sensitizing properties of metals be provided at the very beginning of the course of practical education in dentistry, together with application of adequate preventive measures.
Journal of IMAB - Annual Proceeding (Scientific Papers)
Sensitization to metals is a significant problem for both dental patients treated with dental mat... more Sensitization to metals is a significant problem for both dental patients treated with dental materials and for dental professionals in occupational exposures. The purpose of the present study was to evaluate the incidence of concurrent contact sensitization to relevant for dental practice metals among students of dental medicine, students from dental technician school, dental professionals and patients. Material and Methods: A total of 128 participants were included in the study. All of them were patch-tested with nickel, cobalt, copper, potassium dichromate, palladium, aluminium, gold and tin. The results were subject to statistical analysis (p < 0.05). Results: For the whole studied population, potassium dichromate exhibited concomitant reactivity most often; copper and tin also often manifested co-reactivity. For the groups, exposed in dental practice, potassium dichromate and tin were outlined as the most often co-reacting metal allergens, but statistical significance concerning the co-sensitization to copper and the other metals was established only for aluminium. An increased incidence and OR for concomitant sensitization to cobalt and nickel was established in the group of dental students; to copper and nickel-in the control group; to palladium and nickel-in the group of dental professionals, the group of students of dental medicine and in the control group; to potassium dichromate and cobalt-in the group of dental students; to copper and palladium-in the control group of dental patients; to potassium dichromate and copper-in the group of dental professionals; to copper and aluminum-in the groups of students from dental technician school and of dental professionals; to copper and gold-in the groups of dental professionals and in the group of dental patients; to potassium dichromate and aluminum-in the group of dental professionals; to potassium dichromate and goldin the group of dental professionals, and to aluminium and tin-in the groups of dental professionals and in the group of dental patients. Conclusions: Our data indicate a high risk of concurrent contact sensitization to the studied relevant for dental practice metals. Since the role of occupational exposures can't be excluded, adequate preventive measures and information should be provided. General population also need to be well informed and the European Union regulations to be properly applied.
Journal of IMAB - Annual Proceeding (Scientific Papers)
Adequate and balanced import of essential nutrients is of particular importance for the developin... more Adequate and balanced import of essential nutrients is of particular importance for the developing child's organism. The purpose of the present study was to examine the intake of main macronutrients (proteins, carbohydrates, fats) from the daily diets of children aged 3-15 years. Material and methods: Subjects of the study were 45 children at the average age of 7 ± 2.73 years. Based on children and parents' data, 24-hour dietary registers were obtained for all studied children. The data on received food and fluids from the registers were analyzed, and the daily energy intake values (E%) of proteins, carbohydrates and fats were derived. Results: For all studied children, mean values of protein intake of 15.8 ± 3.5 E%, fat intake of 38.1 ± 7.5 E% and carbohydrate intake of 49.5 ± 7.31 E% were found. Conclusion: The study results show that protein and carbohydrate intake values are consistent with the physiological norms for the age, while the fat intake values are above the recommended in our young patients.
Journal of IMAB - Annual Proceeding (Scientific Papers)
Journal of IMAB - Annual Proceeding (Scientific Papers)
Journal of IMAB - Annual Proceeding (Scientific Papers)
Journal of IMAB - Annual Proceeding (Scientific Papers)
Titanium (Ti) is a non-essential metal element. TiO2 is used predominantly in the form of micro a... more Titanium (Ti) is a non-essential metal element. TiO2 is used predominantly in the form of micro and nanoparticles in consumer products, including cosmetics and food. Because of its excellent biocompatibility, the trade-pure titan and its alloys are widely used as an alternative of certain metals in invasive medicine, surgery, dental medicine. Contemporary data concerning the sources of exposure to titanium, immune reactions to Ti alloys, current knowledge and perspectives of diagnosis of sensitization or allergic reactions to titanium are discussed. Conclusion: TiO2 is much more stable than pure Ti and alloys used in the implants, that should be taken into account when conducting research and analyzing the results. The evidences of possible toxic effects are insufficient. It is difficult to assess the frequency of Ti allergy due to the uncertainty of diagnostic methods, but it is believed that it is very low. This is supported by the evidence that Ti and TiO2 (often as NP) doesn't penetrate through healthy skin. Skin patch testing with currently available formulations of Ti and TiO2 has no significant value in clinical practice, and currently it is assumed that there is no reliable method for diagnosis Ti allergy. The functional analysis of cytokine release and investigation of genetic characteristics could be useful for individual risk assessment in dental implantology. Such studies may also help to investigate separately early and late implant loss, as well as to develop new diagnostic tools.
International Journal of Occupational Medicine and Environmental Health, 2017
The aim of this study has been to evaluate the rate of contact sensitization to some rubber aller... more The aim of this study has been to evaluate the rate of contact sensitization to some rubber allergens and to bisphenol A (BPA) amongst students of dental medicine and dental patients. Material and Methods: A total of 50 participants were included in the study: 40 students of dental medicine exposed to the studied rubber allergens and BPA-based dental materials during the course of their education; 10 dental patients without occupational exposure to the latter substances served as a control group. All of them were patch-tested with the studied rubber allergens and bisphenol A. Results: Highest was the sensitizing action of carba mix, followed by benzoyl peroxide and mercapto mix. The sensitization rate for carba mix was significantly higher for dental students as well as for the whole studied population, if compared to the one for thiuram mix (Chi 2 = 12.9, p < 0.001; Chi 2 = 13.9, p < 0.001), bisphenol A (Chi 2 = 8.9, p < 0.001; Chi 2 = 11.9, p < 0.001), toluenesulfonamide formaldehyde resin (Chi 2 = 10.7, p < 0.001; Chi 2 = 13.9, p < 0.001) and benzoyl peroxide (Chi 2 = 4.7, p = 0.03; Chi 2 = 5.8, p = 0.016), and for dental patients, if compared to the one for mercapto mix (Chi 2 = 7.07, p = 0.008). Concomitant positive skin patch-test reactions to carba mix and to benzoyl peroxide, and to all the studied allergens were established. Conclusions: Carba mix could be outlined as a sensitizer of paramount importance for dental students as well as for dental patients. Benzoyl peroxide was the second ranked sensitizer for dental students. Positive skin patch-test reactions to bisphenol A and toluenesulfonamide formaldehyde resin were established only among the group of dental students.
Journal of Medical and Dental Practice, 2016
The negative impact of healthcare associated infections form patient morbidity and mortality risk... more The negative impact of healthcare associated infections form patient morbidity and mortality risks and also result prolongation in hospitalization of patients, which provides additional costs. Healthcare associated infections, which are directly association with exposure to healthcare facilities or healthcare treatments or procedures, reduce the quality of life. Exercising the right of every patient to put into force a complaint procedure in relation to negative results related to healthcare associated infection in the process of delivery of healthcare services could have a severe impact on the entire system. That is because the appearance of healthcare associated infection involves multiple parties, including the patient, the healthcare provider, the facility in which the patient is treated, the insurance company and health lawyers.
Journal of IMAB - Annual Proceeding (Scientific Papers), 2016
Rare diseases are diseases with a particularly low prevalence. The specificities of rare diseases... more Rare diseases are diseases with a particularly low prevalence. The specificities of rare diseases-limited number of patients and scarcity of relevant knowledge and expertise-single them out as a distinctive domain of very high added value. The international reference for classification of diseases and conditions is the International Classification of Diseases (ICD), coordinated by the World Health Organization (WHO). Patient registries and databases constitute key instruments for the development of clinical research in the field of rare diseases. Rare disease registries include not only diseases that are inherently rare, but also common diseases that are rare in specific populations, especially those defined by demographics. Disease registries create the possibility of assessing the long-term safety and benefit of different treatments, perhaps leading to treatment algorithms that allow more choices for patients and clinicians.
Journal of IMAB - Annual Proceeding (Scientific Papers), 2012
Journal of IMAB - Annual Proceeding (Scientific Papers), 2012
Healthcare personnel, especially those involved in some specific departments and activities (emer... more Healthcare personnel, especially those involved in some specific departments and activities (emergency care, intensive care, surgical interventions, etc.) and nonhealthcare personnel linked to this sector are often face the risk of infection due to injuries caused by needlesticks and other sharps injuries (scalpels, suture equipment, etc.). Health care workers may also incur injuries from improper procedures, such as passing sharps hand-to-hand between team members, placing sharps in a disposal container, or failing to use a safer sharps device. In the community strategy for health and safety at work (2007-2012), the Commission announced its intention to continue its work to improve risk prevention, among other things, relative to needlestick infections. Council Directive 2010/32/EU of 10 May 2010 implementing the Framework Agreement on prevention from sharp injuries in the hospital and healthcare sector provides a framework to put in place and implement practical preventative measures before the publication of the required national legislation in each country.
Journal of IMAB - Annual Proceeding (Scientific Papers), 2016
The incorporation of nanoparticles into glass powder of glass ionomers led to wider particle size... more The incorporation of nanoparticles into glass powder of glass ionomers led to wider particle size distribution, which resulted in higher mechanical values. Consequently they can occupy the empty spaces between the Glass ionomer particles and act as reinforcing material in the composition of the glass ionomer cements. The nanofiller components of nano ionomers also enhance some physical properties of the hardened restorative. Its bonding mechanism should be attributed to micro-mechanical interlocking provided by the surface roughness, most likely combined with chemical interaction through its acrylic/itaconic acid copolymers. The paper reviews their secondary caries prevention-fluoride release properties, mechanical and physical propreties, biocompatibility aspects, and antimicrobial activity.
Medycyna Pracy, 2016
Background: A multitude of methacrylic monomers is used in dentistry. Glutaraldehyde (G) is used ... more Background: A multitude of methacrylic monomers is used in dentistry. Glutaraldehyde (G) is used in dental practice and consumer products as a broad-spectrum antimicrobial agent. The purpose of our study is to evaluate the frequency and the risk of concomitant sensitization to some methacrylic monomers (methyl methacrylate (MMA), triethyleneglycol dimethacrylate (TEGDMA), ethyleneglycol dimethacrylate (EGDMA), 2,2-bis-[4-(2-hydroxy-3-methacrylo-xypropoxy)phenyl]-propane (Bis-GMA), 2-hydroxy-ethyl methacrylate (2-HEMA) and tetrahydrofurfuryl methacrylate (THFMA)) and glutaraldehyde in students of dentistry, students from the dental technician school, dental professionals and dental patients. Material and Methods: A total of 262 participants were included in the study: students of dentistry, students from the dental technician school, dental professionals, and dental patients as a control group. All were patch-tested with methacrylic monomers and glutaraldehyde. The results were subject to the statistical analysis (p < 0.05). Results: Among the group of dental students, the highest frequency of concomitant sensitization was to TEGDMA and G (15.5%). In the group of patients the highest frequency of concomitant sensitization was to EGDMA and G (16.4%). The frequency of concomitant sensitization among dental professionals was much lower, with the highest rate to TEGDMA and G (7.7%), too. We consider the students from the dental technician school, where the exposure to glutaraldehyde is less likely, to be the group at a lesser risk of concomitant sensitization. Conclusions: Dental students and dental patients could be outlined as groups at the risk of concomitant sensitization to glutaraldehyde and methacrylic monomers. For dental professionals, we assumed an increased risk for concomitant sensitization to TEGDMA and aldehydes that are commonly used in dentistry. We consider the students from the dental technician school to be the group at a lesser risk of concomitant sensitization to glutaraldehyde and methacrylic monomers.
SANAMED, 2016
Introduction: Occupational allergic contact sensitization is common in dental personnel. Some of ... more Introduction: Occupational allergic contact sensitization is common in dental personnel. Some of the most common occupational allergens in dental practice are some formaldehyde-releasers, formaldehyde and glutaraldehyde. Aim: The aim of the present study was to evaluate the rate of contact sensitization to formaldehyde, quaternium-15, imidazolidinyl urea, diazolidinyl urea, and to glutaraldehyde in students of dental medicine and dental patients. Material and methods: A total of 50 participants were included in the study: 40 students of dental medicine exposed to formaldehyde-releasers, formaldehyde and glutaraldehyde during the course of their education; 10 dental patients without occupational exposure to the latter substances served as a control group. All of them were patch-tested with the studied allergens. Results: The sensitization rate to formaldehyde was significantly higher in the group of dental patients if compared to the one of dental students (c 2 = 5.37; p = 0.021). Positive skin patch test reactions to quaternium-15 and to imidazolidinyl urea were observed only in the group of dental students. A significantly higher rate of sensitization to diazolidinyl urea, if compared to the one to imidazolidinyl urea (c 2 = 5.4; p = 0.02) and to quaternium-15 (c 2 = 6.76; p = 0.009), as well as to glutaraldehyde, if compared to the one to quaternium-15 (c 2 = 3.96; p = 0.04) for the whole studied population was established. For the whole studied population, significantly increased rate of concomitant sensitization to formaldehyde and glutaraldehyde (c 2 = 6.18 p = 0.013), as well as to diazolidinyl urea and to glutaraldehyde was established (c 2 = 9.12 p = 0.003). Conclusions: We consider the importance of exposure to diazolidinyl urea, quaternium-15, imidazolidinyl urea and glutaraldehyde during the course of practical education in dentistry for the onset of sensitization. The exposure to formaldehyde is ubiquitous and is difficult to distinguish the roles of environmental and occupational exposures. The promotion of proper personal protection as well as adequate information on occupational chemical hazards should start as early as during the first years of education in dentistry.
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Papers by Mariela Deliverska