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This article reviews endovascular management of chronic post-dissection aneurysms of the aortic arch. Therapeutic strategies intended for this complex aortic condition are evolving rapidly to allow the treatment of various hostile aortic anatomy and frail patients. Principles, technical considerations, devices and outcomes of each technique are reviewed and summarized. Hybrid repair offer similar early mortality and stroke rates compared to open conventional surgery, with the advantage of being a less invasive and complex intervention. Arch chimney and other parallel graft techniques present poor long term outcome, and should be limited to emergency situations where no other option is available. Fenestrated stent-grafting is subjected to many technical challenges in aortic arch due to difficulties in stent-graft orientation and fenestration positioning. In situ fenestration is an off-label technique that should only be used as an emergency bailout maneuver, considering that temporary coverage of supra aortic trunk vessel and its long-term durability raise concern. Finally, in experienced hands and appropriate anatomic conditions, arch branched graft technology has shown itself to be a safe and effective alternative to open conventional surgery. No randomized controlled trials have yet compared total endovascular aortic arch repair with hybrid techniques and open arch repair. The management of chronic post- dissection aneurysms of the aortic arch is challenging, decision-making and interventions should continue to be performed in high-volume centers with a dedicated aortic team with an expertise in both open and endovascular repairs.BACKGROUND Herpetic whitlow is a herpes simplex virus infection of the fingers or thumb characterized by erythema accompanied by painful non-purulent vesicles. AIM To draw attention to the typical appearance of herpetic whitlow and to distinguish it from bacterial infections and other skin diseases because of their different management. MATERIALS AND METHODS The patient’s history, dermatological status, and scrapings from the vesicles were taken. The swabs were cultured for isolation of bacteria and fungi. DNA extraction and PCR were performed for detection of HSV. RESULTS Repeated identical infections of the finger were found in the patients’ history, commonly associated with respiratory infections. The cultured swabs for bacterial or fungal detection remained negative. The scraping from vesicle used for viral detection showed positive HSV result. CONCLUSION It is important to distinguish herpetic whitlow from infectious and skin diseases and to learn from yet done mistakes - the patient was previously diagnosed with bacterial whitlow, contact dermatitis and dermatitis of unknown origin. 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.Asthma is the most common chronic respiratory disease worldwide and its prevalence is increasing. Acute asthma complications are often the reason for admission to emergency healthcare service. In our article we present a case of a rare asthma complication – spontaneous pneumomediastinum with a short review of its incidence, etiology, diagnosis and management. Spontaneus pneumothorax is important to differentiate with secondary pneumomediastinum as well as other conditions as cardiac diseases (acute coronary syndrome, pericarditis, cardiac tamponade, pneumopericardium), lung diseases (pneumothorax, pulmonary embolism, tracheobronchial tree rupture), musculoskeletal disorders, and diseases of the esophagus (rupture and perforation o the esophagus). A chest X-ray is often reliable for diagnosis of spontaneous pneumomediastinum and when inconclusive, can be followed by CT. The management is usually conservative with oxygen and analgesia. Surgery is required only in cases of tracheobronchial compression.BACKGROUND Detailed knowledge of the popliteal artery division and possible anatomical variants is of paramount importance for vascular surgery. AIM The aim of the current study was to highlight a rare unilateral case of posterior tibial artery hypoplasia. MATERIALS AND METHODS A dissection was performed at the posterior surface of the tibia in a 78-year-old Caucasian male cadaver of Greek origin. RESULTS The findings were consistent with unilateral posterior tibial artery hypoplasia and fibular artery enlargement. The variant fibular artery supplied the posterior surface of the distal leg and foot. Clinical implications of the fibular artery dominance are discussed. CONCLUSIONS Rare anatomical variants of the tibial artery are of clinical significance to maximize safety and minimize intraoperative complications. 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.Myelomeningocele is a common defect of the development of the neural tube. It is a complex congenital malformation of the central nervous system (CNS) that can be associated with other concurrent anomalies. We report on a case of lumbar myelomeningocele with concomitant CNS malformations we followed up over a period of 15 years. N-Ethylmaleimide A concise literature review has also been performed. The current report illustrates that the myelomeningocele is a complex anomaly that is commonly associated with a variety of other CNS malformations such as hydrocephalus and Chiari malformation. It may follow chronic progressive course with exacerbation of clinical symptoms in the long term. Patients that have undergone surgical correction of this spinal defect should be closely monitored over a long period of time because of the possibility of clinical deterioration of the concomitant anomalies such as hydrocephalus, Chiari malformation and siryngomyelia. 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.THE AIM of the present study was to reveal the characteristics of an. MATERIALS AND METHODS Susceptibility testing, conjugation experiments, isoelectric focusing, PCR and sequencing were carrying out. RESULTS Of 176. CONCLUSIONS To the best of our knowledge this is the first report of DHA-1 producing isolate in Bulgaria. The emergence of DHA-1 producing. 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.INTRODUCTION The main priorities of the implemented health policies in the Republic of Bulgaria are directly aimed at preserving and improving the health of the population, providing equal access of patients to modern and efficient healthcare, promptness and quality, in compliance with the normative requirements of the offered health service. In this sense, the focus of these health policies is to prioritize prevention and prophylaxis of early diagnosis of diseases. It is much more reasonable to prevent the disease or to manage it at an early stage than to slow down the treatment until the pathological processes develop into severe or irreversible complications. AIM The aim of this systematic review is to investigate the effectiveness of existing legal acts governing the implementation of a common health policy in the field of health promotion and prevention. Another aim is to localize regulatory gaps and make relevant optimization suggestions. MATERIALS AND METHODS The analysis of this systematic review is bided the original author and source are credited.AIM To investigate the level of dental fear in middle childhood and the impact of various personal and social factors that contribute to developing dental fear. MATERIALS AND METHODS The study included sixty-seven 6-12-year-old children and their parents, randomly selected while receiving their treatment at the Department of Pediatric Dentistry, Plovdiv. A modified version of Dental Subscale of the Children’s Fear Survey Schedule (CFSS-DS) was used to assess the dental fear of each patient. An interview was conducted with the parents to gather information about patient’s gender and age, parent’s dental anxiety (Corah’s dental anxiety scale-DAS) and pre-appointment preparation of children. RESULTS The results show that the mean of CFSS-DS for children is 30.28±1.17. Concerning the age and gender the comparison between groups of patients with different levels of dental fear demonstrate no significant difference (p>0.05). 60.6%±0.49 of parents prepare their children themselves for the future dental visit and 39.4%±0.49 rely on the dentists to do it. The analysis shows that parent’s dental anxiety and pre-appointment preparation are not associated with the level of dental fear of their children (p>0.05). CONCLUSIONS In middle childhood the majority of children show no or low level of dental fear. The personal and social factors we studied are not determinant risk factors for 6-12-year-old children to develop dental fear. 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.INTRODUCTION Border molding of the edge of the individual impression tray is an important stage of prosthetic treatment of edentulous jaws, which often depends on the final result of the treatment. Classical thermoplastic impression materials for border molding have positive qualities that make them preferable by clinicians for their hardness, unlimited manipulation time and high impression sharpness. Modern silicone impression materials for border molding have long manipulating time and appropriate viscosity to allow dentists to perform functional tests. AIM To determine the accuracy of different impression materials for border molding of individual impression trays. MATERIALS AND METHODS Four impression materials for border molding were laboratory tested Kerr impression compound green sticks and thermoplastic GC Iso functional sticks, additive type silicone Detaseal function and condensation type silicone sta-seal f. A modified individual impression tray designed by authors was used, allowing for laboratory load and stability. Ten impressions were taken and their formed edges were measured at 10 points three times - immediately after hardening/elasification, and 24 hours and 48 hours after hardening/elasification. RESULTS The results were analysed using ANOVA repetition analysis, where a statistically insignificant difference in the accuracy of three of the impression materials for border molding was established, except the C-type of silicone. CONCLUSIONS Good manipulative qualities and measured accuracy in laboratory tests define these materials as very good for border molding procedures. 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.