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RESULTS The pain intensity was reduced and both the functionality and quality of life were improved after shockwave therapy post-treatment (p less then 0.001) and at a 4-week follow-up (p less then 0.001) compared with those found after the treatment. Similar improvements in all three parameters were also observed after ultrasound treatment but the outcomes were not as pronounced as in the shockwave group. CONCLUSION Both radial shockwave and ultrasound therapies were found to be effective in the treatment of rotator cuff tendinopathy, the statistical analysis showing that radial shockwave therapy was superior to the ultrasound therapy post-treatment and at the 4-week follow-up. 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 In children and adolescents, the most common periodontal disease is the plaque-induced gingivitis. AIM The aim of this study was to reveal the bacterial species associated with supragingival plaque of Bulgarian adolescents diagnosed with plaque-induced gingivitis. MATERIALS AND METHODS Supragingival plaque samples from 70 healthy subjects with moderate plaque-induced gingivitis (37 females and 33 males), aged 12-18 years, were obtained and examined microbiologically. RESULTS A total of 224 microorganisms were isolated. Gram-negative bacteria were predominant compared to Gram-positive [132 (59%) vs. 92 (41%). CONCLUSION The most frequently isolated microbiota in our study is part of the normal oral bacterial flora. The presence of anaerobes such as. 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.AIM To present 5 cases of late choroidal detachment occurring spontaneously in pseudophakic glaucomatous eyes with previous trabeculectomy before cataract surgery. We discuss the causes, risk factors, frequency, diagnostic methods, differential diagnosis, and treatment of this disease. MATERIALS AND METHODS In the presented 5 cases the choroidal effusion is proved by ophthalmoscopy and echography. Late choroidal detachment occurs after phacoemulsification 6 months at the earliest and 9 years at the latest (mean period 2.5 years) in glaucomatous eyes with previous trabeculectomy. To prove choroidal detachment we accomplished routine ophthalmological examination including medical history, visual acuity, tonometry, examination of anterior segment (AS) and fundus. We have done B-scan echography using А/В Ocular Ultrasound Aviso Quantel Medical. RESULTS One of the patients had hemorrhagic detachment confirmed by B-scan echography, the other four patients had serous detachment. The examined patients had the glaucomatous disease for 10.4±6.11 years (mean±SD). Mean age at the time of choroidal effusion diagnosis was 76.8±7.6 years (68-87 years). The period between the trabeculectomy and the following phacoemulsification was 6±3.08 years (from 1 to 9 years). All patients received anti-glaucomatous topical therapy, including carbonic anhydrase inhibitors, before the occurrence of the effusion. In all cases conservative treatment with corticosteroids and cycloplegics was enough to overcome the detachment and restore visual acuity. CONCLUSION Late choroidal effusion after phacoemulsification in eyes with previous trabeculectomy is associated with an application of unjustified powerful hypotensive topical medications after cataract surgery associated with an additional reduction of intraocular pressure in most cases. This is an open access article distributed under the terms of the CC0 Public Domain Dedication.Simulation training in medicine is a powerful tool for acquiring knowledge and practical skills in an environment close to the real world. Decreasing training opportunities directly on the patient tend to introduce simulations close to the real hospital environment without compromising the patient’s safety. The aim of the study was to evaluate the effectiveness of simulation training in the Medical Simulation Training Center (MSTC) at the Medical University of Plovdiv. A prospective observational descriptive study was performed at the MSTC at Plovdiv Medical University between September 2017 and March 2019. The study included 245 respondents who participated in one or more practical simulation trainings and were surveyed. The results of the study suggest that the knowledge, skills and attitudes of the trainees improve after training sessions. By increasing the number of visits, the self-esteem and confidence in performing the manipulation also increases, knowledge and technical performance significantly improve and mistakes are reduced. A statistically significant relationship has been demonstrated between the sequence of visits and acquired competencies (p=0.0001). There are no performance mistakes in those attending three or more times, but 16.2% of them still experience uncertainty while performing. Here, however, 83.8% performed the manipulation automatically and without mistakes. Simulation training in medicine is effective and useful. It has its place in the curriculum for students and is a good tool for acquiring knowledge, skills and techniques in postgraduate education.BACKGROUND Cardiopulmonary bypass in cardiac surgery produces systemic inflammatory response and catabolic state. Severe stress frequently causes abnormalities in thyroid hormones in the absence of primary thyroid disease, defined as sick euthyroid syndrome (SES). MATERIALS AND METHODS Supplementation therapy with thyroid and anabolic hormones in combination with an adequate nutritional support has been used to improve outcome in critically ill patient after cardiac surgery. RESULTS Administration of thyroid and anabolic hormones significantly improved patient’s condition. EPZ011989 cell line CONCLUSIONS Supplementation therapy with thyroid and anabolic hormones in combination with an adequate nutritional support could be used to improve hemodynamics, achieve transition to anabolic metabolism and enhance recovery, which could eventually help for a reduction in post-operative morbidity and mortality. This is an open access article distributed under the terms of the CC0 Public Domain Dedication.