DOI: 10.3897/jbcr.e127525

Authors: Anabela Glavanova, Branimir Raduilov, Tsvetelina Miteva, Mariela Kamburova, Ivan Polyakov, Evgeni Mekov

Abstract: Thyroid diseases are common and, in most cases, can be safely and effectively detected and treated in primary medical care. This article aimed to analyze and evaluate the rate of thyroid ultrasonographic abnormalities in a primary medical care practice in Bulgaria. The research was conducted from 2016 to 2021. A random cohort of patients undergone annual preventive screening was included. Demographic information (age and sex) was collected. The descriptions of the ultrasonographic findings were standardized based on the following parameters: deviations in shape, size, position of the thyroid gland, deviations from normal parenchymal echogenicity (hyper-, hypo-, and heteroechogenic parenchyma), presence and size of detectable formations, and presence of calcifications. The total number of participants in this study was 3 178. Of these, 60% (1 907/3 178) were women and 40% (1 271/3 178) were men. The average age of participants was 40.1 ± 11.3 years, and there was no significant difference between the males and females. Deviations from normal ultrasonographic findings were observed in 36.2% (1 151/3 178), with a frequency increasing with age. Detectable formations were seen in 19.7% (625/3 178) of the patients, and those larger than 1 cm accounted for 4.4% (139/3 178) of all cases and 22.2% of all formations (139/625). Calcifications were found in 0.5% (15/3 163). Over 1/3 of the performed thyroid ultrasounds revealed abnormalities. Thyroid ultrasonographic abnormalities were significantly more common in women compared to men, and their frequency increased with age.

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DOI: 10.3897/jbcr.e126717

Authors: Elka Tumbeva, Tsvetelina Valentinova

Abstract: The study aimed to evaluate and analyze the impact of the COVID-19 pandemic on the emotional state of patients in General Medical Practice in Bulgaria. In July-December 2022, a survey was organized among 306 GPs working in primary health care (PHC) in Bulgaria. They represent about 8% of the country’s general practitioners and work in eight regions. An individual self-completion questionnaire was offered. After obtaining permission from the Ethics Committee, respondents were randomly selected. The data was processed with a specialized statistical software package, SPSS 22. The COVID-19 pandemic has increased the number of patients with anxiety and depressive symptoms in the period 2020–2022, according to 95.3% (286) of the GPs surveyed. According to the GPs, the reasons for this were social isolation – 79.4%, negative information from the media – 73.1%, uncertainty – 65%, financial worries – 51.7%, uncertainty about the future – 38.8%, and other – 2.1%. The population of Bulgaria has been greatly affected by the COVID-19 pandemic. The pandemic has increased the number of patients with anxiety and depression in the General Medical Practice for the period 2020–2022. Bulgarians often resort to self-medication despite the easy access to general practitioners and the possibility of consultation with a psychiatrist.

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