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Swiss scientists have developed a tiny implant that warns of a heart attack a few hours before it takes place.

The 14-mm device can be easily implanted under the skin. It regularly measures five indicators, including proteins such as troponin, whose elevated levels signal myocardial injury.

The implant sends information to a smartphone or a computer via the Bluetooth wireless device and gives raise to an alarm when it encounters disturbing results.

Besides being able to recognize the early signs of a heart attack, it can also monitor the level of blood glucose, lactate, and ATP, providing useful physiological information during physical activity or chronic conditions such as diabetes.

The chip is provided with seven biochemical sensors, and should be placed at a depth of about one centimeter under the skin.

Sensors monitor specific molecules such as glucose and cholesterol, depending on what doctors are looking for.

The chip was developed by the Federal Polytechnic Institute in Lausanne by the team of Dr. Giovanni de Micheli.

He points out that except for “early warning”, the implant can be used to monitor patients’ recovery after surgery in real time.

The Health Ministry introduced new specialization rules at the beginning of this year, according to which each clinic is required to conclude an employment contract with the physicians who will work alongside specializing. The aim is to put an end to the free labor of young doctors.

The problem is that most young doctors cannot specialize under the new rules this year, because hospitals have no money with which to pay them salaries. There are no new funds for the recruitment of young doctors and fewer openings are announced for specializing doctors than previous years.

A major problem of the new graduating doctors is the few openings in university hospitals in the country, and there are specialties in those hospitals for which no openings have been announced.

The total number of pediatricians in Bulgaria is 1401. A single pediatrician treats an average of 688 children. Children’s gastroenterologists, however, are a total of 9 specialists for the whole country. There are very few children’s nephrologists and oncologists, but still the medical institutions which will launch a specialization in pediatrics are few and far between. In addition, the appointed according to the new regulation specializing doctors in some hospitals are forced to sign contracts that bind them to remain in the hospital 4-5 years after receiving a specialty. If in this period they decide to leave, they are obliged to return all salaries received over the years.

The regulation also posits some questions that give rise to confusion and uncertainty among specializing doctors in the so-called “specializing doctors status quo”. Most of them want to undergo training according to the new regulation for specializing doctors. Hospitals, however, are not motivated to employ them and for a significant part of them medicine continues to be an expensive hobby – they pay a monthly fee of BGN 180 to work. It is this fee that is one of the main problems among specializing doctors. Most work is at the expense of young doctors, who except working in hospitals often work in another 1-2 places. The reason for this is the low pay and the pursuit of higher incomes. And since quite a lot of them do not receive income from work in clinics, but pay (BGN 180 per month) to treat patients in Bulgaria, this forces them to earn a living by putting in extra work, sometimes unrelated to medicine.

According to Health Ministry’s records hospitals announced 2820 openings for specializing doctors last year, but the actually employed people were 814. The reason was that most of the openings are paid. Among those, the state funded 409 positions, and the major specialties were not sought after by young doctors. For the other openings doctors had to seek education funds on their own, and even for pay for their own work. This year the state will be paying the fee for 415specilizing doctors, but not their salaries. Physicians’ salaries will have to be paid by the hospitals.

Although dozens of young doctors have already begun work under the new Regulation on Specializations, there remain few openings, announced by the largest university hospitals in the country. Many future doctors are considering the question of whether to stay in Bulgaria at all.

Five thousand people less pay contributions to the National Social Security Institute than the people insured in 1993.

Bulgarians have been ill almost two times longer in 2014 than in 2003. This is what the data from the National Social Security Institute budget performance since 2003 has shown.
11 years ago the National Social Security Institute paid an average of five days sick-leave. In 2014 the length of sick-leaves had already become nine days, according to the Institute. Of those nine days, after the changes in 2010, the first 3 are paid for by the employer, while the National Social Security Institute pays only for 6 days.

However, its sickness expenses for paying sick-leave benefits have increased more than 3 times from 2003 to 2014. If 11 years ago BGN 110 million were paid for sick-leaves, during the past year the sum was already BGN 340 million. The reason was the increased amount of pay for sick-leave was due to the higher wages at the time, explained experts from the Institute. The increased illness duration, on the other hand, is due to the changes in the rules for issuing sick-leave – for flu the sick-leave has already become five days, not 3, as it was 3 years ago.

The insured Bulgarians have decreased by 500 000 people from 1993 to 2013, as it becomes clear from the statistics of the Institute. In 1993, 3.030 million working people paid contributions, while in 2013 – the number was 2.4 million people.

The year with the highest number of contributors was 1997, when 3.2 million people paid contributions. The year with the lowest number of contributors was 2002 – only 2 million people paid for health insurance then.

The annual pensions’ payment costs of the Institute in 2003-2014 increased by BGN 5 billion. Eleven years ago BGN 2.8 billion were paid for pensions, while last year a record of BGN 8.1 billion was reached. The NSSI deficit escalated from BGN 500 million to BGN 1.8 billion per year for the same period.

Five times more Bulgarians died before retirement age.

The death benefits of an insured person, who paid the National Social Security Institute, has increased five times for the period of 10 years. In 2003, only BGN 480 thousand were paid for such benefits, while in 2013 – the sum was nearly BGN 2 million. The benefits for a person who died before qualifying for his/her pension rights, were paid to 10 052 heirs.

The amount the National Social Security Institute hands out to the heirs of deceased insured Bulgarians is BGN 540. It is distributed equally among the heirs – spouse or children. According to the Institute, the average amount of compensation received by an heir decreased from BGN 213.20 in 2003 to BGN 193.95 in 2013. An heir received the highest amount in 2007 – BGN 309.17.

Due to the lack of quorum on Friday, discussions around the Health Insurance Act will continue early next Wednesday.

The idea of splitting the health package into basic and additional has been essentially adopted by a majority in the parliament.

On Thursday, the MPs devoted most of their working day to the Health Insurance Act changes, introduced by Minister Petar Moskov. The draft bill went to second reading, where each paragraph is to be voted separately.

The deputies managed to adopt the first three paragraphs, which regulate the technical removal of the word “basic” package from the current law. This means that the main division of the packages into basic and additional is already a fact, although the whole bill is still far from being adopted.

Up to this moment the law stated: “The compulsory healthcare insurance provides a basic package of health services guaranteed by the NHIF budget.” The word “basic” has been removed from this text. The change has been adopted with the votes of the ruling majority.

According to the Minister of Health both – public payments and patients’ out-of-pocket payments – have been increasing during the last ten years. However, the nation’s health indicators have not been improving, but have been getting worse than the European average, explained the Health Minister.

According to Petar Moskov, the argumentation that each patient had been receiving timely treatment for everything then was obviously false and this was easily verifiable and indisputable. For this reason, Moscov believes that the introduction of a basic and an additional package would ensure 100% coverage of the main causes of the nation’s ill health indicators. Which activities would be placed in the basic package and which – in the additional one still remains unknown.  The Ministry of Health is to issue a Regulation regarding this issue.

“The person suffering from heart attack will be admitted to hospital immediately, but whoever wakes up with a pimple on his cheek – will have to wait a little,” defended the idea of Moscov the MP from party GERB Semir Abu Melih.

The session on Friday was not held. The reason was that the MPs failed to form a quorum three times.

It was expected that day that the MPs would begin working on the draft bill with a text, with which almost no group in Parliament agreed – the one to increase the state quota in the NHIF Supervisory Board. The text provides its representatives be increased from four to six, thus the state would receive complete advantage over the other supervisory members. The argument of the Minister for proposing this text was that it would secure the ministry the ability to perform smoothly the policy, which it produced and implemented, and be held responsible for it. The arguments of the opponents of the idea were that the state is among the most defaulting payers of health insurance.

Currently the Supervisory Board of the NHIF consists of nine members, the state representatives being four and those of employers, trade unions and patient organizations – a total of five.
After the failed Parliament Friday session, the adopting of the HIA can continue early next Wednesday.

Immunotherapy is one of the experimental methods for tumor treatment. This approach is based on the understanding that a key to the origins, development and outcome of malignant neoplasms is the immune system. In this line of thought, if the functional status of the latter is fortified in the right way, it is likely that it is activated to such an extent that it would control the tumor process.

There are 4 types of antitumor immunotherapy. The first type is called active non-specific immunotherapy. It refers to substances of natural or synthetic origins. They are introduced into the bloodstream and cause the global activation of all immune system components, including those responsible for antitumor protection.

For example, it was shown that the components of the BCG vaccine can activate anti-tumor white blood cells. This effect is used in the experimental treatment of carcinoma of the bladder and of malignant melanoma. The vaccine is injected into tumor masses and directed the activated the immune cells to the neoplastic process. In some patients, however, the effect is contrary to the desired one. This explains why the considered type of immunotherapy has not been a uniform way for treating these tumors.

Another interesting example of non-specific active immunotherapy is the use of viruses for the experimental treatment of certain tumors. The Duke University, USA, has conducted a clinical study in which the cells of malignant brain tumor – glioblastoma, were infected with a modified embodiment of the polio virus. In statistically significant percentage of cases, this lead to both the direct death of the infected tumor cells and the activation of the immune system which fiercely attacked them.

The second type of anti-tumor immunotherapy is active specific immunotherapy. It is implemented through a variety of vaccines containing molecules found in tumor cells. This means that immunotherapy is directed towards this tumor and does not activate the entire immune system, but only the part of it that is responsible for anti-tumor protection. This is the most intensive form of developing immunotherapy and high hopes have been laid on it.

Interesting forms of this type of immunotherapy are DNA vaccines. Through them the tumor cells are inserted in the so called plasmids that make the cells more visible to the immune system. Vaccines with the so called dendritic cells which are pre-activated tumor killers are also being developed.

The third type of anti-tumor immunotherapy is passive humoral immunotherapy. It consists in introducing specific anti-tumor antibodies in the organism. The latter are fastened to the surface of tumor cells and thus direct the immune system thereto. A serious problem here is the significant antigenic variability of malignant tumors. Therefore, in some cases, the antibodies appear to be “outdated” and are not taken where needed.

The last type is gene immunotherapy. This is the most original and highest form of experimental treatment. The idea of this therapy is to achieve the genetic apparatus of the specific tumor and, figuratively speaking, to suppress the “bad” genes, and stimulate the “good” ones. Gene therapy carries risks for normal cells. Therefore it is subject to strict control.

In conclusion, we can say that science is continuously evolving and perhaps every day it takes a step forward towards improvement. The numerous experimental studies in the field of immunotherapy are an embodiment of this statement. Some forms of immunotherapy give encouraging results. Being still an experimental treatment, however, immunotherapy is the last line of treatment in oncology.