2026-05-17T14:05:58Z https://jbcr.arphahub.com/oai.php

10.1515/jbcr-2015-0096 2013-07-15 jbcr

Three-Dimensional Reconstruction of Arterial-Lymphatic Vascular Complex (Vessel Within the Vessel) in Breast Tissue Ivanov,Ivan Popovska,Savelina Ivanov,Emilian Iliev,Sergey Tonchev,Pencho lymphatic-arterial vascular complex male breast 3D tissue reconstruction Journal of Biomedical and Clinical Research 6(1): 7-11 The phenomenon “vessels within vessels” was initially described by Merchant S et al. as arteries found free-floating inside the lumen of veins. We have described another version of the “vessels within vessels”complex, composed of arteries found inside the lumen of lymphatic vessels. The purpose of the present study was to describe the structure of the lympho-arterial vascular complex in a breast tissue specimen from a male subject using three- dimensional tissue reconstruction. A histological specimen from a 64 year-old male subject diagnosed with gynecomastia was used. The tissue sample was sectioned in a multi-step manner. An overall of approximately 150pm thick tissue material was sampled. Immunostaining with anti-CD34 antibody and anti-podoplanin antibody was performed. Three-dimensional reconstruction of the vessel within the vessel structure was performed with “Reconstruct” software When the reconstruction of the breast parenchyma was revealed as a 3D image, it became apparent that the arterial vessel was situated inside the lymphatic vessel and could be followed along the entire length of the vascular segment studied. We have proved that these vascular complexes are not artificial phenomenon and do exist. The function of the vascular complexes is still uncertain, and is probably related to lymph propulsions in the initial collector vessels. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0096 https://doi.org/10.1515/jbcr-2015-0096 https://jbcr.arphahub.com/article/34289/ https://jbcr.arphahub.com/article/34289/download/pdf/ en

10.1515/jbcr-2015-0097 2013-07-15 jbcr

Multidrug Resistance Among Enterococci at a Tertiary Care Hospital in Northern Bulgaria Hytkova,Hristina Sredkova,Mariya Hitkova,Hristina Ivanov,Kaloyan Popov,Vladimir enterococci antimicrobial resistance Journal of Biomedical and Clinical Research 6(1): 12-17 Multidrug-resistant (MDR) enterococci are a growing threat. The aim of this study was to determine the species distribution and prevalence of multidrug resistance among 100 enterococcal strains, isolated from patients treated in the University Hospital in Pleven, Bulgaria. Susceptibility to 11 antimicrobial agents was determined, using the disc diffusion method according to the performance standards of Clinical Laboratory Standards Institute (CLS1), 2012. All isolates were screened for high-level aminoglycoside resistance and resistance to vancomycin according to the recommendations of CLS1, 2012. For strains with reduced susceptibility to vancomycin, minimal inhibitory concentrations (MIC) of glycopeptides were determined by Etest (Liofilchem, Italy) and by Vitek 2 automated system. Our results demonstrated decreased susceptibility of enterococci to almost all intensively used anti-enterococcal drugs. Resistance to both penicillins (ampicillin and penicillin) among E.faecium strains was significantly higher (83-87%) than among E.faecalis isolates (4-27%). HLGR was detected in 70% of E.faecium and 38% of E.faecalis isolates. All HLGR strains were foundtobemultiple-drug resistant. Of particular note was the emergence of concomitant resistance to 6 antimicrobials in almost 50% of E.faecium isolates. Despite the wide dissemination of MDR E.faecium strains penicillins in our hospital, acquired resistance to vancomycin was not found. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0097 https://doi.org/10.1515/jbcr-2015-0097 https://jbcr.arphahub.com/article/34290/ https://jbcr.arphahub.com/article/34290/download/pdf/ en

10.1515/jbcr-2015-0098 2013-07-15 jbcr

Effect of Aronia Melanocarpa Fruit Juice on Fearning and Memory in the Two-Way Active Avoidance Task in Rats Valcheva-Kuzmanova,Stefka Eftimov,Miroslav Beleheva,Iren Tashev,Roman Beleheva,Stiliana Aronia melanocarpa learning memory active avoidance Journal of Biomedical and Clinical Research 6(1): 18-23 Amnia melanocarpa fruits are one of the richest natural sources of phenolic substances, among them flavonoids, mainly from the subclass of anthocyanins. Flavonoids, which are constituents of Amnia melanocarpa fruit juice, have been found to localize in various brain regions that are important for memory. The aim of the present study was to investigate the learning and memory effects of Amnia melanocarpa fruit juice (AMFJ) in young/healthy male Wistarrats. AMFJ was applied orally for 21 and 30 days at a dose of 10 ml/kg b.w., and comparisons were made with saline-treated (10 ml/kg b.w.) controls. Learning and memory functions were evaluated, using the two-way active avoidance task (shuttle box). Administered for the two treatment periods, the juice significantly increased the number of avoidances on training days 1 and 2, as well as at the retention test (24 h after the 2nd training session). These effects were more pronounced in rats treated with AMFJ for 30 days. The learning and memory effects of AMFJ are probably due to its polyphenolic constituents. The findings from the present study suggest that AMFJ applied subchronically improved learning and memory in young/healthy rats. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0098 https://doi.org/10.1515/jbcr-2015-0098 https://jbcr.arphahub.com/article/34291/ https://jbcr.arphahub.com/article/34291/download/pdf/ en

10.1515/jbcr-2015-0099 2013-07-15 jbcr

Effects of Long-Term Treatment with Atorvastatin and Rosuaastatin on Active Avoidance Test in Intact Rats Georgieva-Kotetarova,Maria Kostadinova,Ivanka Delev,Delian active avoidance learning memory statins Journal of Biomedical and Clinical Research 6(1): 24-28 Statins are widely used for treatment of hyperlipidemia. They have been shown to possess pleiotropic effects apart from their lipid-lowering activity - anti-inflammatory, immunomodulatory, and neuroprotective. Most studies suggest that statins can protect the brain against damage but it is not clear whether they improve cognitive function in patients without neuropathy. The aim of the present study was to investigate the effect of 3-month treatment with atorvastatin and rosuvastatin on learning and memory processes in rats without brain damage. Wistar rats were treated orally for 90 days with atorvastatin and rosuvastatin at a dose of 10 mg/kg b. w. in parallel with the vehicle-treated group. After that period, learning ability and memory retention was evaluated using an active avoidance test - automatic reflex conditioner (shuttle box). The learning session was carried out on 5 consecutive days. Memory retention test was performed on day 12. The following behavioral reactions were investigated: conditioned responses (avoidance), unconditioned responses (escapes), and intertrial crossings. We found increased number of conditioned responses in groups, treated with atorvastatin 10 mg/kg b.w., and with rosuvastatin 10 mg/kg b.w. during the learning session and on the memory retention test, as compared to the same-day control group. The atorvastatin-treated group showed an increased number of unconditioned responses on days 1 and 2, as compared to the control group. In the group treated with Rosuvastatin there was an increased number of escapes on days 1,2 and 4, as compared to the vehicle-treated group. Atorvastatin and rosuvastatin at a dose of 10 mg/kg b.w. improved processes of learning and memory retention after the 3-month treatment. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0099 https://doi.org/10.1515/jbcr-2015-0099 https://jbcr.arphahub.com/article/34292/ https://jbcr.arphahub.com/article/34292/download/pdf/ en

10.1515/jbcr-2015-0100 2013-07-15 jbcr

The Place of Penetrating Keratoplasty in Corneal Diseases Murgova,Snejana Balabanov,Chavdar Yordanov,Georgi penetrating keratoplasty regraft corneal diseases Journal of Biomedical and Clinical Research 6(1): 29-36 The aim of the study was to analyze the results from penetrating keratoplasties (PK) in patients with different comeal diseases. The retrospective study included 124 patients (130 eyes) who underwent penetrating keratoplasty at the Eye Clinic, Pleven, between 1990 and 2011. The patients were divided into four groups, according to the main indication for keratoplasty: 1 - bullous keratopathy - pseudophakic and aphakic bullous keratopathy (PBK and ABK); 2 - degeneration and dystrophy (including keratoconus); 3 - keratitis, scar, trauma; 4 - repeat keratoplasty. The main indications for penetrating keratoplasty included regraft - 27%, PBK - 22.62%, ABK - 11.9% and keratoconus - 10.71%, though the leading cause had been different at different periods of time. By the time of suture removal (8-9 months on the average) in the group of patients with bullous keratopathy, the percentages of clear grafts were as follows: 55.88% in the group of patients with bullous keratopathy, 97.44% in the group with comeal degeneration and dystrophies, and 60% in the group with keratitis, corneal scar and trauma. In patients with regrafts, For the whole period of the study, grafts failed in 61.54% of patients with one regraft, and in 50% of the cases with second and third regrafts. Penetrating keratoplasty proved a valuable method of treatment for a number of comeal diseases. The prognosis and outcome, however, depended on the pathology responsible for comeal blindness. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0100 https://doi.org/10.1515/jbcr-2015-0100 https://jbcr.arphahub.com/article/34295/ https://jbcr.arphahub.com/article/34295/download/pdf/ en

10.1515/jbcr-2015-0101 2013-07-15 jbcr

Comparison of Four Methods for Corneal Thickness Measurement Marinova,Teodora Ivancheva,Vesela Peeva,Svilena Grupcheva,Christina cornea thickness pachymetry optical coherence tomography confocal microscopy Journal of Biomedical and Clinical Research 6(1): 37-42 The aim of the study was to evaluate the thickness of the normal cornea in order to establish correlation between four methods of measuring including: ultrasound pachymetry (USP), anterior segment optical coherence tomography (ASOCT), non-contact tono/pachymetry (TONOPACHY) and laser-scanning confocal microscopy (LSCM). The study was based on evaluating repeatability and comparability of four different methods formeasuring the corneal thickness. Non contact specular microscopy was first performed on all 27 patients (aged between 20 and 24 years) to evaluate corneal characteristics and confirm the absence of pathological changes. Each participant was examined by USP, ASOCT and TONOPACHY, and 13 eyes of 10 persons were also examined by LSCM. The values of average central corneal thickness measured by USP, ASOCT, TONOPACHY and LSCM were 532.20±4.5 pm, 553.33±12.1 pm, were 548.20±5.62 pm and 573.33±7.22 pm, respectively. There was a high correlation between the instruments. The mean differences for central corneal thickness measurements were 41.43±1.67 pm between USP and LSCM, 20.43±2.4 pm between USP and ASOCT, and 22.1 ±3.88 pm between USB and TONOPACHY. Anterior segment optical coherence tomography overestimated corneal thickness as compared with that measured by USP, which is believed to be a gold standard. Anterior segment optical coherence tomography had better agreement with USP, as compared with LSCM. However, the results of measured cornea thickness by TONOPACHY were very close to cornea thickness measured by ASOCT. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0101 https://doi.org/10.1515/jbcr-2015-0101 https://jbcr.arphahub.com/article/34298/ https://jbcr.arphahub.com/article/34298/download/pdf/ en

10.1515/jbcr-2015-0102 2013-07-15 jbcr

Late Prosthetic Vascular Graft Infections after Reconstructions on Aortoiliac Segment: An Eleven Years Experience Beshev,Lyubomir Edreva-Besheva,Valentina Sredkova,Mariya Nguen,Dobromir vascular graft aortoiliac segment late infection Journal of Biomedical and Clinical Research 6(1): 43-50 The purpose of the study was to evaluate the frequency and etiology of late prosthetic vascular graft infections after reconstructions on aortoiliac segment. From 2001 to 2011,545 primary reconstructions were performed on 545 consecutive patients. We had 18 cases of late intracavitary graft infections in 14 of them. A total of 58 clinical specimens collected from patients before, during and after reoperation were analyzed. Pathogens were isolated using conventional methods for aerobic and anaerobic bacteria. The isolates were identified down to species level by conventional biochemical methods, VITEK 2 and mini API Systems (bioMereux, France). During an 11-year period after prosthetic grafting of the abdominal aorta and aortoiliac segment the incidence of late (more than 4 months after implantation) infection was 3.11%. The mean interval between the initial operation and development of infection was 39.2 months (range 4 to 84). Positive microbial cultures were found in 46 clinical specimens. A total of 66 microbial isolates were cultured, comprising 27 clinical strains. Gram-positive bacteria were predominant - 15 (55.55%) strains, followed by Gram-negative bacteria - 9 (3 3.33%), Candida albicans - 2 (7.4%) and Bacteroides fragilis - 1 (3.7%). In 7 cases, the infection was monobacterial, caused predominantly by Staphylococcus species. In the rest of the cases, the infections were polymicrobial, caused by association between two microbial species. Mortality rate was 35.71% (5 cases) - in 4 of them the infection was caused by association between two species of Gram-negative bacteria or between Gram-negative bacteria and Candida albicans. The incidence of late intracavitary vascular graft infection was low. The average period for development of this complication was about 3 years after reconstruction. Among the causative agents, Gram-positive microorganisms had a predominant role but infections caused by Gram-negative bacteria, especially when they were in association, had a worse outcome. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0102 https://doi.org/10.1515/jbcr-2015-0102 https://jbcr.arphahub.com/article/34299/ https://jbcr.arphahub.com/article/34299/download/pdf/ en

10.1515/jbcr-2015-0104 2013-07-15 jbcr

An Angiosarcoma in the Right Atrium: A Case Report Dumitru,Nicoleta Bartos,Daniela angiosarcoma pleurisy pericarditis Journal of Biomedical and Clinical Research 6(1): 57-61 Angiosarcoma is a rare malignant tumor of vascular endothelial cell origin, accounting for 1-2 % of all sarcomas. We present a 24-year-old female patient, initially diagnosed and treated for tuberculous pleurisy for one month. Then transthoracic echocardiography (TTE) revealed a rare cause for the pleural and pericardial effusion - a tumoral mass apparently arising from the right atrium and extending into the upper vena cava. The patient presented with worsening dyspnea, stabbing pain in the right hemithorax and persistent, irritating cough, a recent history of haemoptysis, bilateral pleurisy and hemorrhagic pericardial effusion. The ECG showed sinus rhythm with negative T-waves in leads DI, Dll, aVL, V3 to V6. The TTE showed an irregularly shaped right atrial tumoral mass, not resembling a thrombus, which extended to the upper vena cava. The transesophageal echocardiography showed an invasion of the serous (parietal and visceral) pericardium and a dilated right atrium almost completely occupied by the tumoral mass. The CT scan revealed invasion of the upper vena cava ostium and anterior mediastinum with pretracheal adenopathies, and hemorrhagic pleural and pericardial effusion suggestive of a sarcoma. The histological examination and immunohistochemistry confirmed the diagnosis of angiosarcoma. Although a rare form of malignant tumor that affects the head, neck, breast, bone, liver, spleen and heart, angiosarcoma must be considered as a possible cause of pleural and pericardial effusion, especially in previously healthy young patients. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Case Report text/html info:doi:10.1515/jbcr-2015-0104 https://doi.org/10.1515/jbcr-2015-0104 https://jbcr.arphahub.com/article/34302/ https://jbcr.arphahub.com/article/34302/download/pdf/ en

10.1515/jbcr-2015-0103 2013-07-15 jbcr

Etiology of Diabetic Foot Infection in Patients with Poorly Controlled Diabetes Iliev,Sergey Beshev,Lyubomir Nedyalkov,Kiril Nguen,Dobromir Edreva-Besheva,Valentina Sredkova,Mariya diabetic foot infection etiology Journal of Biomedical and Clinical Research 6(1): 51-56 The aim of the study was to define the spectrum and susceptibility of microorganisms, isolated from diabetic foot ulcers in patients with poorly controlled diabetes, treated at the clinic of surgery, and compare microbial findings of specimens collected superficially and from deep tissues. The study included 19 patients with type 1 and 2 diabetes with clinical signs of infection. All patients were with poorly controlled diabetes and staged from 3rd to 5th grade according to the Wagner diabetic foot scale. Swab samples from non-debrided wounds and biopsy samples from deep tissues were collected from each patient. Specimens were inoculated on media for isolation of aerobic and anaerobic bacteria. Identification and susceptibility testing of the isolated oiganisms were performed by conventional methods, and VITEK 2 and mini API Systems (bioMerieux, France). A total of 88 bacterial isolates were cultured, comprising 56 clinical strains. Gram positive bacteria were the most common isolated organisms (53.57%), followed by Gram negative bacteria (26.78%) and anaerobic bacteria (19.64%). Staphylococcus aureus was the most common organism detected (10 strains), followed by Enterococcus spp. (7 strains), Escherichia coli (7 strains), Bacteroides spp. (6 strains) and various other organisms of low incidence. Polymicrobial infection was detected in 17 (89.47%) of the patients. In most of the cases infections were caused by 3 bacterial species. Mixed aerobic/anaerobic infections were detected in 9 (47.3%) patients. In 15 (78.94%) patients, there was a coincidence of bacterial findings from superficial and deep tissue samples. The strains isolated were susceptible to commonly used antimicrobials for treatment of diabetic foot infection. The predominant part of the diabetic foot infections were polymicrobial, caused by association between two or three microbial species. In half of the cases the infection was mixed. There was a good correlation between microbial findings from superficial swabs and deep tissue specimens when they were delivered to the microbiology laboratory immediately after collection. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0103 https://doi.org/10.1515/jbcr-2015-0103 https://jbcr.arphahub.com/article/34301/ https://jbcr.arphahub.com/article/34301/download/pdf/ en

10.1515/jbcr-2015-0105 2013-12-31 jbcr

Predisposition to Thrombophilia and Hypofibrinolysis in Pulmonary Embolism: Analysis of Inherited Factors Komsa-Penkova,Regina Tonchev,Pencho Kovacheva,Katya Georgieva,Galya Ivanov,Yavor Ivanov,Petar thrombophilia hypofibrinolysis FVL PTA G20210A MTHFR GLPR llb/IIIa PAI-1 pulmonary embolism Journal of Biomedical and Clinical Research 6(2): 73-81 Pulmonary embolism (PE) is a relatively common cardiovascular emergency, though its exact incidence is difficult to assess. Accurate diagnosis is critical because of the high 30-day mortality in patients in whom the diagnosis is missed on admission. Doubt for PE is often raised by the presence of risk factors for venous thromboembolism (VTE), which are categorized into inherited and acquired. Among these, the importance of inherited/genetic thrombophilic factors is increasingly recognized. The most frequent markers of inherited thrombophilia are Factor V Leiden (FVL) and G2021OA prothrombin gene mutation. Among the inherited factors causal to thrombophilia, the C677T variant in methylentetrahydrofolate reductase (MTHFR) gene as well as factors like P1A1/P1A2 polymorphism in platelet glycoprotein Ilb/IIIa (P1A2) and hypofibrinolytic polymorphism 4G/4G in PAI-1 gene are discussed with controversial results. In our study, thrombophilic and hypofibrinolytic genetic variants were identified in 54.2% of 115 patients with PE. The most common significant genetic defects were FVL- 16.5% in patients versus 6.2% in controls (OR=3.102; p=0.05), G20210A PT 5.7% versus 2.1% (OR=2.983; p>0.05). P1A2 was found in 27.3% patients versus 19.9% in controls (OR= 1.523, p>0.05) and PAM 27.8% versus 22.6% (OR =1.501 p>0.05). MTHFR C677T carriage was inverse: 6.7% in patients versus 13.4% in controls. (OR=0.461 p=0.05). Of all the patients studied, 15.65% had a history of recurrent embolic incidents. The risk of recurrence was higher for the carriers of FVL and G20210A prothrombin gene mutation. The association between carriage of thrombophilic genetic factor and the early onset of the first embolic episode was found in the patients with PE. The awareness of risk factors and risk stratification is a critical issue in treatment and prevention policy. Preventive measures should be taken in particular medical conditions. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0105 https://doi.org/10.1515/jbcr-2015-0105 https://jbcr.arphahub.com/article/34303/ https://jbcr.arphahub.com/article/34303/download/pdf/ en

10.1515/jbcr-2015-0106 2013-12-31 jbcr

Assessment of the Effect of Treatment with Neoadjuvant Chemotherapy on Breast Cancer Axillary Lymph Node Popovska,Savelina Ivanov,Ivan Dikov,Dorian neoadjuvant chemotherapy axillary lymph node breast cancer Journal of Biomedical and Clinical Research 6(2): 82-88 Neoadjuvant chemotherapy is the standard of care for patients with locally advanced breast cancer (LABS). The aim of this study was to determine the effects of neoadjuvant chemotherapy on metastatic and nonmetastatic breast cancer axillary lymph nodes (ALNs). Seventy-seven patients with LABS and cytologically documented ALN metastases were treated in two prospective trials. Patients had breast surgery with level I and level II axillary dissection followed by additional chemotherapy or radiation treatment. Clinical nodal status was determined by physical examination and compared with histological and immunohistochemical findings. The regressive changes in primary tumor and ALNs were achieved using scoring systems. Objective clinical response in primary tumor was seen in 48.05% of patients. Histologic evidence of regression was noted in 46 cases (59.75%), with complete histologic regression achieved in 5 cases (6.49%). The number of cases according to the ALNs regression scoring system was as follows: 0 grade - viable metastases without effect - 21 patients (30%); 1 grade - cytotoxic effect in metastases - 20 patients (28.58%), 2 grade - micrometastasis - only3 patients (4.28%); 3 grade - no residual metastatic disease - 1 patient (1.43%); 4 grade - negative ALNs before and after treatment - 25 patients (35.71%). Nodular fibrotic area and iron-loaded macrophages suggested previous presence of tumor metastasis. There was significant relationship between histologic regression in the primary tumor and the presence of effect of cytotoxic agents on ALNs metastases (r=0.9123; p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0106 https://doi.org/10.1515/jbcr-2015-0106 https://jbcr.arphahub.com/article/34305/ https://jbcr.arphahub.com/article/34305/download/pdf/ en

10.1515/jbcr-2015-0107 2013-12-31 jbcr

Abnormal Levels of Inflammatory and Oxidative Stress Markers in Patients with Arterial Hypertension and Diabetes Mellitus Danovska,Maya Alexandrova,Margarita Gencheva,Irena diabetes hypertension inflammation oxidative stress C-reactive protein Journal of Biomedical and Clinical Research 6(2): 89-93 Individuals with hypertension and diabetes mellitus are at high risk of cerebrovascular and cardiovascular morbidity and mortality. Recent advances in the multifactorial pathophysiology of atherogenesis provide important information about the complex interrelations between traditional risk factors, inflammation and oxidative stress in mediating all stages of atherosclerosis. The objective of the study was to determine if some inflammatory and oxidative stress markers in patients with arterial hypertension and diabetes mellitus differ from those in healthy age-matched controls. Our results revealed a significant difference in blood pro/antioxidant activities in hypertensive diabetics and the controls. The investigation of inflammatory and oxidative stress markers along with traditional risk factors proves useful in complex assessment of vascular risk and primary prophylaxis of cerebrovascular and cardiovascular events. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0107 https://doi.org/10.1515/jbcr-2015-0107 https://jbcr.arphahub.com/article/34307/ https://jbcr.arphahub.com/article/34307/download/pdf/ en

10.1515/jbcr-2015-0108 2013-12-31 jbcr

Popliteal Aneurysms as a Cause for Arterial Insufficiency Beshev,Lyubomir Marinov,Angel Andreev,Tihomir Totzev,Nachko Velikov,Valentin Georgiev,Tsvetomir popliteal aneurysm posterior approach PTFE prosthesis Journal of Biomedical and Clinical Research 6(2): 94-99 Clinical manifestations, possibilities for accurate diagnosis of popliteal aneurysms, and operative approaches applied depending on their location are presented, as well as results from treatment over a four-year period. Popliteal artery aneurysms accounted for 5.63% of all 266 cases of acute arterial insufficiency. The mean age of the patients was 68.8 years, and the male:female ratio – 4:1. In five patients (33.33%), the localization of aneurysm was unilateral. In 80% of the cases with bilateral popliteal aneurysms, the aneurysms were combined with aneurysms of other locations. The surgical technique applied was posterior approach with resection of the aneurysm and interposition of a polytetrafluoroethylene (PTFE) prosthesis. The early patency rate of the reconstructed segment was 100%. Late patency rate of the reconstructed segment was 90.9%. Despite the better late results in femoropopliteal reconstruction, we think that a posterior approach with prosthesis implantation is better because it saves the great saphenous vein. The presence of multiple aneurysms in the patients studied (80%) determined the low survival at 5 and 10 years, which makes it comparable to the results from applying the two surgical methods. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0108 https://doi.org/10.1515/jbcr-2015-0108 https://jbcr.arphahub.com/article/34312/ https://jbcr.arphahub.com/article/34312/download/pdf/ en

10.1515/jbcr-2015-0109 2013-12-31 jbcr

Study of the Carrier State for Five BRCA1/BRCA2 Deleterious Mutations in Bulgarian Women with Breast Cancer Kovacheva,Katia Kamburova,Zornica Popovska,Savelina Ivanov,Ivan Simeonova,Maria Angelova,Petia BRCA1 BRCA2 Breast cancer Bulgarian population polymorphism Journal of Biomedical and Clinical Research 6(2): 100-105 Genetic testing for BRCA 1/2 mutation is a well recognized medical management tool. Identification of healthy carriers of such mutations allows effective risk reduction procedures to be performed. There is no data reported on the founder mutations in the Bulgarian population. To evaluate the contribution of genetic factors to breast cancer (BC), we investigated the carrier state of Bulgarian women with BC for five common (according to BIC database) deleterious BRCA1/2 mutations. The list of patients diagnosed with BC between January 2011 and April 2012 was obtained from the Cancer Registry of University Hospital, Pleven. Eighty-two women with BC were interviewed and a pedigree was constructed of each of them. The patients were classified into seven categories, according to personal, disease and family history. Based on the preliminary prepared selection criteria and the personal family history, we defined a target group of 33 Bulgarian women with BC. They were screened for five deleterious mutations: 5382insC in BRCA1 and 6174delT, 6079del4, 8138del5, 5946delCT in BRCA2, by DNA sequencing. The genetic analysis detected none of the tested mutations. Two polymorphic variants were found in BRCA2 gene: c.5744C>T (rs4987117, SNP database) in exonl 1E in one patient and c.7806-14T>C (rs9534262, SNP database) in exonl7 in 22 patients. In conclusion, without basic information on the founder mutations in the population, the genetic screening for the specific mutations in a small group of tested patients is ineffective. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0109 https://doi.org/10.1515/jbcr-2015-0109 https://jbcr.arphahub.com/article/34313/ https://jbcr.arphahub.com/article/34313/download/pdf/ en

10.1515/jbcr-2015-0110 2013-12-31 jbcr

Postoperative Outcomes of Elective Pancreatic Surgery in a Low-Volume Academic Surgical Clinic Julianov,Alexander Karashmalakov,Anatoli Rachkov,Ivan Georgiev,Yonko pancreatic resection volume compli­cations distal pancreatectomy pancreati­coduodenectomy Journal of Biomedical and Clinical Research 6(2): 106-111 According to the volume-outcome concept the postoperative outcome after major pancreatic surgery in high-volume institutions compares favorably to low- volume centers. However, it is not clear whether this is applicable to all low-volume institutions nowadays. The aim of the study was to evaluate the postoperative outcome after major elective pancreatic surgery in a low- volume academic surgical clinic. All consecutive elective major pancreatic cases operated within a 10-year period till October 2013 have been retrospectively reviewed. During the studied period, 36 patients (15 females, 21 males, mean age 54 years, age range 37-76) were scheduled for elective pancreatic surgery and underwent pancreatic resection (n=31, 18 proximal and 13 distal pancreatic resections) or complete pancreatic duct drainage procedure (n=5). Eleven patients had chronic pancreatitis and 25 patients had malignant or benign tumors. Vascular or adjacent organ resection was performed in 9 patients (29% of resections). The overall postoperative morbidity was 36% (n=13), and complications requiring re-operation occurred in 5 patients (14%). The median postoperative hospital stay was 11 days for patients without complications vs. 25 days for patients with any complication. There was no 60- day postoperative mortality or hospital readmission. Major elective pancreatic surgery can be safely performed today in a low-volume academic general surgical clinic, with postoperative outcomes similar to those reported by high-volume centers. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0110 https://doi.org/10.1515/jbcr-2015-0110 https://jbcr.arphahub.com/article/34314/ https://jbcr.arphahub.com/article/34314/download/pdf/ en

10.1515/jbcr-2015-0111 2013-12-31 jbcr

Challenges and Variables Affecting the Success of Sentinel Lymph Node Biospy in Malignant Melanoma a 4-Year Analysis of Clinical Results Dimitrov,Dobromir Kirov,Veselin Ignatov,Borislav Tsankov,Boris Feradova,Hyuliya Vutova,Vasya malignant melanoma retrospective analysis sentinel lymph node biopsy lymph node dissection Journal of Biomedical and Clinical Research 6(2): 112-117 In the last 15 years, sentinel lymph node biopsy (SLNB) for patients with malignant melanoma (MM) has been introduced into the clinical practice. Our aim was to make a retrospective analysis of clinical results in order to assess the success ratio of SLNB and the variables affecting it in MM patients, treated in the Oncology Center at the University Hospital “Dr George Stranski” - Pleven, Bulgaria for a 4-year period. A research index card was used to process the oncologic files of 82 out of 102 patients with MM, treated and monitored at the Oncology centre between 01.01.2008 and 31.12.2011. TNM-stages, Breslow and Clark levels, location, characteristics of the skin lesion, diagnostic excision, type of lymph node dissection, number of SLN, localization of SLN, etc. were registered in the index card. SLNB staging was carried out in 28 patients. Sentinel lymph nodes were found in 22 of them. The success ratio of the method was 78.6%. Histologically, metastatic SLN were found in 4 cases. The Patent Blue Dye method was used in 22 of the cases (78%). A combined radiocolloid and dye method was used in 5 cases (18%). A radiocolloid method was used in 1 case (4%) only. Our research showed that more therapeutic lymph node dissections were performed in cases of locally advanced MM, which in turn worsened the clinical results. According to our research, the SLNB success ratio depends on the precision of diagnostic excision (p=0.019), lesion location (p=0.015), Clark level (p=0.0229), mapping method (p=0.08) and the type of melanoma (p=0.088). info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0111 https://doi.org/10.1515/jbcr-2015-0111 https://jbcr.arphahub.com/article/34315/ https://jbcr.arphahub.com/article/34315/download/pdf/ en

10.1515/jbcr-2015-0112 2013-12-31 jbcr

Risk Factors for Coronary Artery Diseases: A Study Among Patients With Ischemic Heart Disease in India (Kerala) , Attacheril,Thankachan Balakrishnan,N. Gaydarova,Diana Stancheva,Nadya Gerchev,Ivan coronary artery disease risk factors hypertension diabetes mellitus dyslipidemia body mass index Journal of Biomedical and Clinical Research 6(2): 118-124 Coronary artery disease (CAD) is a condition that develops due to accumulation of atherosclerotic plaque in the epicardial coronary arteries, leading to myocardial ischemia. It is the leading cause of death worldwide and is a common complex disease. A study was carried out in a group of 496 patients with acute coronary syndrome or with angiographic or stress test evidence for coronary artery disease, admitted to the Department of Cardiology at Lourdes Heart Institute and Neuro Centre during the period June-August 2012. The risk factors studied were hypertension, diabetes mellitus, dyslipidemia, body mass index, smoking and family history of CAD. The results demonstrated that in both males and females of the Indian population studies, diabetes and dyslipidemia were major risk factors for CAD, while hypertension was not a major risk factor. Therefore, early detection and treatment of diabetes mellitus and dyslipidemia play a vital role in prevention of CAD in Indian population. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0112 https://doi.org/10.1515/jbcr-2015-0112 https://jbcr.arphahub.com/article/34316/ https://jbcr.arphahub.com/article/34316/download/pdf/ en

10.1515/jbcr-2015-0113 2013-12-31 jbcr

Evaluation of Recovery of Activities of Daily Living in Patients with Sequelae from Cerebral Vascular Disease Vacheva,Danelina Simeonova,Verjinia Stamenov,Boyko rehabilitation occupational therapy cerebrovascular disease Journal of Biomedical and Clinical Research 6(2): 125-130 Bulgaria ranks first in the world in incidence, morbidity and death associated with cerebrovascular disease. The aim of the study was to investigate, follow-up and register recovery of activities of daily living (using the toilet and maintaining personal hygiene) in patients with sequelae from cerebrovascular disease in a subacute stage, who underwent physiotherapy and rehabilitation. Sixty-one patients were included and followed up. They were given tailored physiotherapy and rehabilitation. This included kinesitherapy, occupational therapy and electrotherapy. All the patients filled in self-assessment questionnaires before and after the rehabilitation course. Major parameters were assessed, irrespective of the limb affected -dominant or non-dominant. Results were analyzed using the Wilcoxon rank test. At the end of the rehabilitation course, the Wilcoxon curves were driven to the right, confirming improvement concerning independence, irrespective of involvement of dominant or non-dominant limb. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Research Article text/html info:doi:10.1515/jbcr-2015-0113 https://doi.org/10.1515/jbcr-2015-0113 https://jbcr.arphahub.com/article/34319/ https://jbcr.arphahub.com/article/34319/download/pdf/ en

10.1515/jbcr-2015-0114 2013-12-31 jbcr

Rare Case of Human Visceral Linguatuliasis in Bulgaria Diagnosed on Biopsy Specimen Mateva,Svetlana Nikolova,Margarita Karaivanov,Milen Marinova,Petya Linguatula serrata visceral linguatuliasis Journal of Biomedical and Clinical Research 6(2): 131-134 We report a rare case of visceral linguatuliasis in a 9-year-old boy. The diagnosis was made incidentally on a biopsy specimen obtained during laparotomy on account of an acute appendicitis. An encysted parasite was found in a mesenteric lymph node and diagnosed as Linguatula serrata larva mainly based on its typical appearance. The vermiform appendix showed only lymphoid hyperplasia and no features of inflammation. The patient made an uneventful recovery after the operation and was discharged. He is being followed up. To our knowledge this is the first officially reported case of human linguatuliasis in Bulgaria. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Case Report text/html info:doi:10.1515/jbcr-2015-0114 https://doi.org/10.1515/jbcr-2015-0114 https://jbcr.arphahub.com/article/34321/ https://jbcr.arphahub.com/article/34321/download/pdf/ en

10.1515/jbcr-2015-0115 2013-12-31 jbcr

A Rare Case of Subtentorial Arterio-Venous Malformation Case Report Totsev,Nachko Andreev,Tihomir Danovska,Maya Ovcharov,Mladen subtentorial arteriovenous malformations CTA Journal of Biomedical and Clinical Research 6(2): 135-138 The majority - over 80%, of arteriovenous malformations (AVMs) are supratentorial. The infratentorial AVM are uncommon and different from other intracranial AVMs in terms of history, diagnosis, treatment, prognosis, and follow up. The authors present a case of an intracranial hemorrhage, caused by rupture of an AVM in the posterior cranial fossa. Native (unenhanced) CT and computed tomography angiography (CTA) images of this rare location of AVM are presented. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Case Report text/html info:doi:10.1515/jbcr-2015-0115 https://doi.org/10.1515/jbcr-2015-0115 https://jbcr.arphahub.com/article/34322/ https://jbcr.arphahub.com/article/34322/download/pdf/ en

10.1515/jbcr-2015-0116 2013-12-31 jbcr

Internal Incarceration of Left Paraduodenal Hernia with Necrosis of Proximal Jejunum and Atypical Reconstruction of the Passage: A Case Report Tonchev,Pencho Iliev,Sergei Presolski,Ivailo internal hernia paraduodenal hernia duodenal occlusion duodenojejunostomy duodenal diverticulzation Journal of Biomedical and Clinical Research 6(2): 139-142 Internal hernias are rare and most of them are diagnosed intraoperatively. We present a case of a 53-year-old man with proximal intestinal obstruction, caused by incarcerated internal hernia. During the operation, a proximal portion of 40 cm of the jejunum was found herniated and strangulated in the lesser sac through an opening of the transverse mesocolon. The jejunum was necrotic and local purulent peritonitis was present. After resection of the proximal 40 cm of the jejunum, the passage was restored using an unconventional approach. The distal duodenum was closed and, to protect the stump, the duodenum was ligated between its second and third parts. A latero-lateral anastomosis was made between the first part of duodenum and the jejunum. Anatomical, clinical and radiological findings, diagnosis and treatment of paraduodenal hernias are discussed in brief. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2013 Case Report text/html info:doi:10.1515/jbcr-2015-0116 https://doi.org/10.1515/jbcr-2015-0116 https://jbcr.arphahub.com/article/34323/ https://jbcr.arphahub.com/article/34323/download/pdf/ en

10.2478/jbcr-2018-0013 2014-01-24 jbcr

Prevention of Preterm Birth Ivanov,Ivan Buzalov,Stefan Hinkova,Nadezhda preterm birth high-risk group screening Journal of Biomedical and Clinical Research 11(2): 95-104 Preterm birth (PTB) is a worldwide problem with great social significance because it is a leading cause of perinatal complications and perinatal mortality. PTB is responsible for more than a half of neonatal deaths. The rate of preterm delivery varies between 5-18% worldwide and has not decreased in recent years, regardless of the development of medical science. One of the leading causes for that is the failure to identify the high-risk group in prenatal care. PTB is a heterogeneous syndrome in which many different factors interfere at different levels of the pathogenesis of the initiation of delivery, finally resulting in delivery before 37 weeks of gestation (wg). The various specificities of risk factors and the unclear mechanism of initiation of labour make it difficult to elaborate standard, unified and effective screening to diagnose pregnant women at high-risk for PTB correctly. Furthermore, they make primary and secondary prophylaxis less effective and render diagnostic and therapeutic measures ineffective and inappropriate. Reliable and accessible screening methods are necessary for antenatal care, and risk factors for PTB should be studied and clarified in search of useful tools to solve issues of risk pregnancies to decrease PTB rates and associated complications. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.2478/jbcr-2018-0013 https://doi.org/10.2478/jbcr-2018-0013 https://jbcr.arphahub.com/article/34509/ https://jbcr.arphahub.com/article/34509/download/pdf/ en

10.2478/jbcr-2018-0016 2014-01-24 jbcr

Association Between Chromosome 4Q25 Polymorphism RS2200733 and the Incidence of Atrial Fibrillation in Bulgarian Patients Yakova-Hristova,Dilyana Hristov,Martin Rashev,Tihomir Todorova,Yoana Tonchev,Pencho Stancheva-Hristova,Nadya atrial fibrillation chromosome single nucleotide polymorphisms Journal of Biomedical and Clinical Research 11(2): 118-122 Atrial fibrillation (AF) is the commonest type of arrhythmia seen in everyday clinical practice, which leads to a significant increase in both morbidity and mortality. Its incidence increases with age and tends to turn into an epidemic. The cause of AF in 10-20% of cases remains unknown. Several mutations and polymorphism that might be responsible for the development of AF have been found, including single nucleotide polymorphisms (SNPs) - rs2200733 and rs10033464 in the long arm of the fourth chromosome. These polymorphisms are selected o the basis of genome- wide association study in Iceland from 2007, the results from which were later confirmed in 4 other large populations. The rs2200733 is a common noncoding polymorphism, described in National Center for Biotechnology Information (NCBI) database dbSNP like NC_000004.12:g.110789013C>T, with a frequency of the less common allele between 0.1 and 0.24. In order to investigate the association between the rs2200733 polymorphism in chromosome 4q25 and the development of AF, we studied the frequency of this polymorphism in patients with heart diseases from the Pleven region, and thus evaluate the relationship between the individual genotype and the clinical condition of the patients. We carried out a case-control study on 80 patients: 40 with AF and 40 without AF- from the Pleven region. None of these had structural heart disease. The study was conducted between November 2015 and November 2017. With deoxyribonucleic acid (DNA) analysis, we determined rs2200733 polymorphism, using a TaqMan-based polymerase chain reaction (PCR). The Cochran-Armitage trend test, the Chi-Squared Pearson correlation, Fisher test we used confirmed the statistically significant association between the rs2200733 polymorphism in chromosome 4q25 and the development of AF. In the population examined, the genotypic frequencies were as follows: CC - 45 (56.2%), CT - 19 (23.8%), TT - 16 (20%), with value of Chi-Square (χ2) 24.496, df=2, p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.2478/jbcr-2018-0016 https://doi.org/10.2478/jbcr-2018-0016 https://jbcr.arphahub.com/article/34513/ https://jbcr.arphahub.com/article/34513/download/pdf/ en

10.2478/jbcr-2018-0019 2014-01-24 jbcr

UV Light Stimulated Activation of Camkii in Human Epidermoid Carcinoma A431 Cells Kalenderova,Silvia Lozanova,Vesela Praskova,Maria Lozanov,Valentin CaMKII apoptosis caspases cell line A431 Journal of Biomedical and Clinical Research 11(2): 135-140 The Ca2+/calmodulin dependent kinase II (CaMKII) represents a family of serine/threonine kinases with diverse functions, implicated in various signalling pathways in the cell, especially in those controlling cellular proliferation and cellular death. The human epidermoid carcinoma cell line A431 is an established model for the study of the cell cycle and cancer-associated signalling, in which the role of CaMKII is not so well elucidated. Therefore, the present study aimed to investigate the role of CaMKII in the induction of apoptosis in the cell line A431 following ultraviolet (UV) irradiation and to determine the downstream events with a focus on the caspase cascade. For the latter purpose, we employed a method initially developed for the simultaneous determination of the activity of 10 different caspase enzymes. Following exposure to UV light, we observed activation of the activator caspase-8 followed by activation of the effector caspase-3, triggering apoptosis in the epidermoid carcinoma cell line A431. The results supported a pivotal role of caspases and demonstrated that a protein kinase cascade involving caspases-8 and -3 is the main pathway driven in UV-induced apoptosis in the human carcinoma cell line A431, and apoptotic stimuli triggering this pathway passed through activation of the kinase CaMKII. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.2478/jbcr-2018-0019 https://doi.org/10.2478/jbcr-2018-0019 https://jbcr.arphahub.com/article/34516/ https://jbcr.arphahub.com/article/34516/download/pdf/ en

10.1515/jbcr-2015-0117 2014-11-28 jbcr

Does Mefloquine (Lariam®) Therapy Improve the Prognosis of Human JC Polyomavirus-Induced Progressive Multifocal Leukoencephalopathy? Kalvatchev,Zlatko Tsekov,Iliya progressive multifocal leukoencephalopathy PML JC JCV Lariam® mefloquine Journal of Biomedical and Clinical Research 7(1): 3-7 Progressive multifocal leukoencephalopathy (PML) is ademyelinating disease caused by infection with Polyomavirus hominis 2, popularly known as JC virus (JCV). The disease is usually fatal as it develops due to the progressive destruction of oligodendrocytes in multiple brain foci. Several substances that show effect against JCV have been investigated. However, only the antimalarial drug mefloquine has been reported to significantly influence the viral replication both in vitro and following in vivo therapy with good penetration and distribution of the drug at efficacious concentrations into the central nervous system (CNS). The current material presents some of the available published data, suggesting that the activity of mefloquine against JCV be considered for treatment of patients with PML. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Review Article text/html info:doi:10.1515/jbcr-2015-0117 https://doi.org/10.1515/jbcr-2015-0117 https://jbcr.arphahub.com/article/34324/ https://jbcr.arphahub.com/article/34324/download/pdf/ en

10.1515/jbcr-2015-0118 2014-11-28 jbcr

Caveolin-1 in Tumour Cells is Predominately Expressed in the Basal Subtype of Triple-Negative Breast Carcinoma Popovska,Savelina Ivanov,Ivan Ooi,Akishi caveolin immunoh stromal cells triple-negative breast cancer Journal of Biomedical and Clinical Research 7(1): 8-14 Triple-negative breast cancer (TNBC) is a subtype of breast cancer which is clinically negative for expression of steroid hormones and HER2 protein. According to DNA microarray profiling, breast cancer was divided into several molecular subgroups, including Luminal A and Luminal B; HER2 overexpressing; normal breast- like and basal-like subtype. TNBC comprises tumours that express heterogeneous molecular and immunohistochemical phenotype, thus determining different prognosis. The majority of TNBC carry the “basal-like” molecular profile on gene expression arrays. Basal-like carcinomas of the breast associated with poor prognosis often correlate with expression of Caveolin-1. The study aimed to investigate the expression of caveolin-1 in the tumour cells and in the stromal component of the tumour among the group of TNBC and compare it to the expression of caveolin-1 in a control group with non-TN breast cancer. Whole tissue sections were used. Formalin fixed, paraffin embedded tissue materials from 101 patients diagnosed with invasive breast cancer during the period 2004-2007 were investigated in a retrospective study. A multistep approach was used to separate the different subtypes of breast cancer. During the first step the breast tumours were separated according to their ER, PgR, HER 2 and proliferative activity, using the Ki-67 index. The triple- negative tumours were additionally tested for EGFR and CK5/6. The basal breast cancer group was finally subdivided into basal and baso-luminal according to the type of expression of basal cytokeratins. caveolin-1 expression was examined in the tumour parenchyma and stroma. According to our results, caveolin-1 expression in breast cancer was significantly associated with basal biomarkers expression (basal and baso-luminal type of BC) χ2= 33.4; p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0118 https://doi.org/10.1515/jbcr-2015-0118 https://jbcr.arphahub.com/article/34325/ https://jbcr.arphahub.com/article/34325/download/pdf/ en

10.1515/jbcr-2015-0119 2014-11-28 jbcr

Experimental Model of Blunt Chest Trauma in Rats Novakov,Ivan Delev,Delyan Bachurska,Svitlana Staikov,Dmitrii blunt chest contusion myocardial contusion rats Journal of Biomedical and Clinical Research 7(1): 15-19 The aim of the study was to present our own experimental model of blunt chest trauma in small laboratory animals. Fifteen Wistar albino rats (body weight 290.0-320.0 g) were used in the experiment. An originally designed platform was used to inflict blunt thoracic trauma in the rats. Gross examination and histological evaluation of the heart and lung were performed. It was established that blunt chest trauma caused three thoracic injuries: bilateral lung contusion, myocardial contusion and hemopericardium. These thoracic injuries occurred as a result from direct compression of the chest wall towards the lung and the heart. The severity of lung parenchymal and myocardial pathological findings depended on the energy of blunt chest trauma. The study presents a reproducible small-animal experimental model of blunt chest trauma. The model gives opportunities for further studying different aspects of lung and myocardial contusion. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0119 https://doi.org/10.1515/jbcr-2015-0119 https://jbcr.arphahub.com/article/34328/ https://jbcr.arphahub.com/article/34328/download/pdf/ en

10.1515/jbcr-2015-0120 2014-11-28 jbcr

Leptin and Gaba Interactions on Thermoregulation of Rats Yakimova,Krassimira Nikolov,Rumen Todorov,Ivan Hristov,Milen Leptin GABAB-agonist and antagonist firing rate PO/AH neurons Journal of Biomedical and Clinical Research 7(1): 20-24 Leptin inhibits feeding, reduces body weight and increases thermogenesis. Experimental data suggest involvement of GABAergic mechanisms in the regulation of feeding behavior and energy balance. The present study was set to determine the effect of combinations from leptin, GABAB-agonist baclofen and GABAB-antagonist CGP35348 on thermoregulation of male Wistar rats, using in vivo and in vitro experiments. The substances used for in vivo experiments were administered intraperitoneally (i.p.). The measurement of the body temperature was done via thermistor probes (TX8) and monitored on multichannel recorder Iso-Thermex16. In vitro experiments were conducted on rat PO/AH neurons, recorded extracellulary by conventional electrophysiological equipment, using brain slice preparations. The separate intraperitoneal injection of leptin as well as GABAB-antagonist CGP35348 produced significant hyperthermia in rats while the GABAB-agonist baclofen caused a decrease in the core body temperature. The probable synergy between the hyperthermic effects of leptin and GABAB-antagonist did not occur. On the contrary, the effect of this combination was lower as compared to the result of the separate administration of GABAB-antagonist. When leptin was applied just prior to GABAB-agonist baclofen, neither of their separate effects appeared. In vivo effects determined correlated with in vitro changes of firing rate observed in PO/AH neurons. The data from this study provide a new point of view concerning the interactions of leptin and GABA on the level of thermoregulation. These results represent a step forward in understanding the complicated mechanisms involved in thermoregulation. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0120 https://doi.org/10.1515/jbcr-2015-0120 https://jbcr.arphahub.com/article/34329/ https://jbcr.arphahub.com/article/34329/download/pdf/ en

10.1515/jbcr-2015-0121 2014-11-28 jbcr

Assessment of the Impact of Oxidative Stress on Frozen Seminal Plasma in Fertile and Infertile Men by Examining the Total Antioxidant Capacity Rilcheva,Violeta Ayvazova,Nina Martinov,Danail Ivanov,Cvetomir Konova,Emiliana seminal plasma male infertility oxidative capacity Journal of Biomedical and Clinical Research 7(1): 25-30 The aim of the study was to explore the impact of oxidative stress on frozen seminal plasma in fertile and infertile men by examining the total antioxidant capacity. Patients: Infertile patients from male infertility clinic with various diagnoses and fertile men. Design: Seminal plasma from proven fertile men [n=50] and infertile patients [n=50] were examined for total antioxidant capacity (TAC) level, semen parameters such as morphology, motility and concentration, and DNA integrity test. Interventions: Seminal plasma TAC measurement by luminometric assay using the TAC assay kit, semen analysis parameters, DNA integrity test. Fertile men showed higher TAC values (median and SD): 1201µM (SD±548), as compared with the infertile patients: 831μM (SD±343). The result from sperm morphology of fertile patients showed a mean percentage of 4.8 % (SD±1.68) whereas the percentage in the infertile group was 2.68% (SD ±1.68). The same group of samples, analyzed for DNA damage showed a mean of DFI 10.38% (SD±5.17%) in fertile men and a mean of DFI 17.22% (SD±7.22%) in infertile men. Total antioxidant capacity of the seminal plasma as measured by the luminоmetric assay is a reliable and simple test for diagnosing and management of male infertility. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0121 https://doi.org/10.1515/jbcr-2015-0121 https://jbcr.arphahub.com/article/34330/ https://jbcr.arphahub.com/article/34330/download/pdf/ en

10.1515/jbcr-2015-0122 2014-11-28 jbcr

Family Factors and Risk Sexual Behaviour in Students Aged 12-18 Simeonova,Joana Tzvetanova,Nevena Tzvetanova,Yanka risk sexual behavior sexual coercion incomplete family poor interaction Journal of Biomedical and Clinical Research 7(1): 31-36 The aim of this study was to identify family factors determining risk sexual behavior among students aged 12- 18 in Veliko Turnovo region. A cross-sectional study was conducted in 2014. Three hundred and ten students were included in a representative sample of students attending seven schools in Veliko Turnovo region. The respondents filled in a self-administered questionnaire, designed to collect data on family interactions, acts of sexual coercion, parental social status and their influence on the sexual behavior of the students. Data were processed using SPSS.v.19. Parametric and non-parametric statistical methods were applied. About one-fifth of the students were nurtured in incomplete families. History of a sexually transmitted diseases correlated with type of family (p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0122 https://doi.org/10.1515/jbcr-2015-0122 https://jbcr.arphahub.com/article/34331/ https://jbcr.arphahub.com/article/34331/download/pdf/ en

10.1515/jbcr-2015-0123 2014-11-28 jbcr

A Prospective Study on 25 Hydroxyvitamin D Serum Levels in Patients with Relapsing-Remitting Multiple Sclerosis Slavov,Georgi Manova,Maria Trenova,Anastasiya Kostadinova,Ivanka Pavlov,Pavel Mateva,Nonka vitamin D multiple sclerosis EDSS Journal of Biomedical and Clinical Research 7(1): 37-41 To assess the changes in the serum concentrations of 25(ОH)D in relapse and remission and their relation to the degree of neurological deficit. We analyzed 53 subjects (30 controls and 23 patients) from October 2012 to Маy 2013. Diagnosis was based on McDonald 2010 criteria. The severity of neurological deficit was assessed by the Expanded Disability Status Scale. Serum concentrations of 25(ОH)D (nmol/l) were measured by ELISA once in controls and twice in patients - in relapse and remission. Mean levels in all groups were in the mild to moderate deficiency range, being lowest in the patients in relapse (controls 31.46±7.3; relapse 26.93±7.44; remission 28.06±7.28). There was a trend for lower levels of 25(ОH)D in healthy females in comparison to their male counterparts, and in female patients in relapse as compared to males (female controls - 26.56±8.4, male controls - 41.35±11.86; females in relapse - 26.33±10.03, males in relapse - 28.06±11.08). Negative statistically significant correlations between the concentrations of 25(ОH)D during relapse and remission and the degree of neurological deficit in the corresponding period were found (cc. -0.593, Sig 0.03, relapse; -0.46, Sig 0.024, remission). Assessment of the risk for development of MS, regarding the 25(ОH)D showed protective effect with respect to the risk of disease occurrence (ОR: 04125 relapse; 0.578 remission). info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0123 https://doi.org/10.1515/jbcr-2015-0123 https://jbcr.arphahub.com/article/34332/ https://jbcr.arphahub.com/article/34332/download/pdf/ en

10.1515/jbcr-2015-0124 2014-11-28 jbcr

Correlation Between Self-Rated Health and Socioeconomic and Psychological Charasteristics of Ambulatory and Hospitalized Patients Over 44 Years of Age Simeonova,Joana Velkova,Angelika Tsvetkova,Silvia Kostadinova,Penka Hristova,Petkana Kamburova,Mariela self-rated health well-being social support social status financial capacity Journal of Biomedical and Clinical Research 7(1): 42-46 The aim of the study was to identify socioeconomic and psychological determinants of self-rated health among ambulatory and hospitalized patients. A cross-sectional study was carried-out in 2014. Two hundred and twelve patients over 44 years of age filled in a self-administrated questionnaire. Self-rated health (SRH) was measured by 5-point range scale. The level of well-being (WB), sources of social support, personal financial capacity, social status, etc. were studied as well. Data were processed by SPSS.v.19. Parametric and non-parametric statistical methods were applied. Over 70% of patients evaluated their health as fair and good. The persons with higher WB had higher SRH, that correlation was moderate (r=0.452; p=0.001). In regard to the social status the differences were significant - the unemployed, old age retirees or ill health retirees evaluated their health lower (p0.05). Identification of socioeconomic and psychological factors of self-rated health allows clarifying better their effect mechanisms and planning appropriate health services info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Case Report text/html info:doi:10.1515/jbcr-2015-0124 https://doi.org/10.1515/jbcr-2015-0124 https://jbcr.arphahub.com/article/34333/ https://jbcr.arphahub.com/article/34333/download/pdf/ en

10.1515/jbcr-2015-0125 2014-11-28 jbcr

Uterine Angiomyolipoma: A Case Report, Differential Diagnosis with Pecoma and Review of the Literature Totev,Tihomir Mateva,Svetlana Nikolova,Margarita Gorchev,Grigor angiomyolipoma EComa angiolipoleiomyoma Journal of Biomedical and Clinical Research 7(1): 47-52 Angiomyolipomas are benign mesenchymal neoplasms, presenting with a variable mixture of adipose tissue, smooth muscle and vascular component. Although they are typically found in the kidneys, many cases of extrarenal angiomyolipomas have been reported. They are extremely rarely present in the uterus. We describe a case of a 56-year-old woman, operated on for leiomyoma. Total laparohysterectomy and bilateral adnexectomy was performed. After histological and immunohistochemical examination, the final diagnosis of uterine angiomyolipoma was made. Renal and extrarenal angiomyolipomas are compared in regard to clinical and morphological aspect and their difference from PEComas is dicussed. PEComas have been defined during the last decade and there are still issues regarding terminological clarity and overlapping. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Case Report text/html info:doi:10.1515/jbcr-2015-0125 https://doi.org/10.1515/jbcr-2015-0125 https://jbcr.arphahub.com/article/34334/ https://jbcr.arphahub.com/article/34334/download/pdf/ en

10.1515/jbcr-2015-0126 2014-11-28 jbcr

A Case of “Rayism”- Tropical Stingray Intoxication with a Favorable Outcome Iliev,Yanko Bozhilov,Vladimir intoxication tropical stingray thermal therapy Journal of Biomedical and Clinical Research 7(1): 53-55 Tropical fresh water stingrays have become quite popular among amateur and professional aquarists due to their attractive appearance. However, the species may have a high life-threatening potential. Stingray intoxication is rare in Eastern Europe and there is no specific antivenin available. We present the first case of “rayism” - envenomation caused by sp. Reticulatus in Eastern Europe. The patient was a 63-year-old amateur aquarist, with a history of ischaemic heart disease and allergy to NSAIDs. He got stung while cleaning a stingray fish tank and was admitted to the department of clinical toxicology 40min following the incident, with symptoms of moderate intoxication: accentuated local toxic syndrome - mild bleeding at the sting site, worsening and excruciating (8- 9/10) pain in his left hand and forearm, feeling of “burning” in the arm, accompanying toxic symptoms - vertigo, malaise, fatigue, sweating and tightness in the chest. No antitoxin was available and the treatment plan included local aseptic treatment of the wound, anti- tetanus prophylaxis, fluoroquinolone-type antibiotic prophylaxis, antihistamine, a corticosteroid and i.v. infusions. Thermal therapy (immersing the arm in hot, 45℃ tap water) completely reduced the pain within 5 hours. Full recovery was achieved on the 3rd day after the exposure. A toxicologist should react adequately in the setting of a rare intoxication even when a specific antidote is not available. Thermal therapy proved to be effective in the case of stingray envenomation. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Case Report text/html info:doi:10.1515/jbcr-2015-0126 https://doi.org/10.1515/jbcr-2015-0126 https://jbcr.arphahub.com/article/34336/ https://jbcr.arphahub.com/article/34336/download/pdf/ en

10.1515/jbcr-2015-0127 2014-11-28 jbcr

Extra-Abdominal Musculo-Aponeurotic Fibromatosis: A Case with Metachronous Multicentric Lesions of the Right Thigh Popovska,Savelina Betova,Tatyana Petrov,Кrasimir musculoaponeurotic fibromatosis aggressive fibromatosis deep extra-abdominal fibromatosis Journal of Biomedical and Clinical Research 7(1): 56-58 Fibromatoses are a group of benign proliferations of fibrous tissue with clinical behaviour ranging from that of truly malignant tumours to that of benign reactive fibrous proliferations. Some of the superficial fibromatoses are fairly common but deep ones, also known as desmoid tumours or musculoaponeurotic fibromatoses, are rare. We describe a case of extra-abdominal musculo- aponeurotic fibromatosis in a 22-years old male. He underwent 14 operations for a period of 9 years for fibromatosis of the posterior surface of the right lower limb. The histological findings of the lesions were similar consistent across surgeries and consistent with a diagnosis of aggressive extra-abdominal fibromatosis. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Case Report text/html info:doi:10.1515/jbcr-2015-0127 https://doi.org/10.1515/jbcr-2015-0127 https://jbcr.arphahub.com/article/34337/ https://jbcr.arphahub.com/article/34337/download/pdf/ en

10.1515/jbcr-2015-0128 2014-11-28 jbcr

Risks of Oral Methotrexate Administration in Outpatients Ganeva,Maria Gancheva,Tanya Baldaranov,Ivan Kiriyak,Nataliya Hristakieva,Evgeniya methotrexate adverse drug reactions pancytopenia Journal of Biomedical and Clinical Research 7(1): 59-64 Methotrexate (MTX) is a cytostatic agent used in oncology. Because of its immunosuppressive properties, MTX is also used in autoimmune disorders. Low-dose MTX regimens in the treatment of rheumatoid arthritis and severe psoriasis are considered to be safe. However, pharmacovigilance centers warn of serious and even fatal incidents due to errors in oral MTX administration. The aim of this case series presentation was to identify the specific factors related to the development of adverse drug reactions (ADRs) induced by MTX. A prospective pharmacovigilance study was conducted at the Clinic of Dermatology, University Hospital, Stara Zagora. We report 3 cases of patients with psoriasis vulgaris in which severe haematological abnormalities associated with previous administration of MTX were detected during hospitalization. A 73-year old female with malaise, vomiting and oral ulcers who had taken approximately 120 mg MTX was found to have pancytopenia. A 59-year old male hospitalized for psoriatic erythroderma who had erroneously taken 10 mg MTX daily instead of weekly for 8 days, was diagnosed with bicytopenia and toxic hepatitis. An 88-year old male with psoriatic arthritis presented with aphthous stomatitis, erosive crusted lesions, ecchymoses and aplastic anemia 2 weeks after treatment with 12.5 mg MTX once weekly plus i.m. Movalis®, followed by Diclophenac Duo®. The main predisposing factors for the development of these ADRs were patient-related dosage errors and concomitant administration of NSAIDs. Safe use of oral MTX requires clear dosing instructions and strict patient compliance. Potential drug interactions of MTX with other drugs should also be considered. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Case Report text/html info:doi:10.1515/jbcr-2015-0128 https://doi.org/10.1515/jbcr-2015-0128 https://jbcr.arphahub.com/article/34338/ https://jbcr.arphahub.com/article/34338/download/pdf/ en

10.1515/jbcr-2015-0129 2014-12-31 jbcr

Leptin And Ghrelin – The New Old Players In Obesity And Depression Sandeva,Rositsa Mihaylova,Stanislava Sandeva,Gergana leptin ghrelin obesity depression Journal of Biomedical and Clinical Research 7(2): 75-80 The participation of the anorexigenic peptide leptin and the orexigenic peptide ghrelin in the pathogenesis of metabolic syndrome and obesity is well studied. In this review, we are taking a look at the structure, anatomical expression, regulation, receptors and physiological functions of these two neuropeptides. Leptin is produced almost exclusively in adipose tissue. It acts on the brain and is a key element in long-term regulation of energy balance. Leptin suppresses appetite and reduces body weight. Besides its central effects, important aspects of its action on peripheral tissues have been discovered recently: direct regulation of immune cells, pancreatic beta cells, adipocytes and muscle cells. Ghrelin is an endogenous ligand for the active form of the growth hormone receptor (GHS-R1a) and stimulates food intake and growth hormone secretion. We focus on the role of leptin and ghrelin in central nervous system neural mechanisms that are associated with depression. Studying new aspects of these two neuropeptides aims to expand our knowledge of the pathogenesis and therapeutic approaches to diseases with which they are associated: obesity, depression, type 2 diabetes, essential hypertension, and more. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0129 https://doi.org/10.1515/jbcr-2015-0129 https://jbcr.arphahub.com/article/34339/ https://jbcr.arphahub.com/article/34339/download/pdf/ en

10.1515/jbcr-2015-0130 2014-12-31 jbcr

Effects Of Ferulic Acid On Exploratory Behavior And Locomotor Activity In Rats Valcheva-Kuzmanova,Stefka Georgieva,Antoaneta Belcheva,Stiliana Tashev,Roman ferulic acid exploratory behavior locomotor activity rats Journal of Biomedical and Clinical Research 7(2): 81-87 Ferulic acid (FA), called also hydroxycinnamic acid, is a polyphenol compound found in many foods such as coffee, apples, rice, oats and wheat. It acts as an antioxidant but its other activities in vivo have not been well studied as a whole. The aim of the present study was to investigate the effects of FA on exploratory behavior and locomotor activity in male Wistar rats. FA was administrated orally (20 mg/kg) to different groups of rats for 7, 14, 21 and 30 days. These groups were compared respectively with saline-treated controls. At the end of each experimental period, the changes in exploratory behavior and locomotor activity were recorded in an Opto Varimex apparatus (Columbus Instruments, USA). The number of horizontal and vertical movements recorded every minute for the first 5 min served as a measure of exploratory activity and habituation to the new environment. The total number of movements during the first 5 min and during the whole 10-min period of observation was used as a measure of locomotor activity. It was found that FA at all doses for all treatment periods did not significantly affect exploratory behavior and locomotor activity of rats, when compared with the saline-treated controls. At all testing periods, FA did not disturb habituation. As habituation is considered an elementary form of learning, the present study suggested that FA did not disturb the memory and learning processes in rats. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0130 https://doi.org/10.1515/jbcr-2015-0130 https://jbcr.arphahub.com/article/34340/ https://jbcr.arphahub.com/article/34340/download/pdf/ en

10.1515/jbcr-2015-0131 2014-12-31 jbcr

Pharmacokinetics Of Zinc In Broiler Chickens After Single Intraingluvial Administration With Zinc Aspartate Ivanova,Sofiya Dimitrova,Dimitrichka Petrichev,Metodi Parvanova,Liliana Kalistratov,Georgi Vezenkov,Lubomir pharmacokinetics chickens zinc aspartate Journal of Biomedical and Clinical Research 7(2): 88-92 The pharmacokinetics of zinc was investigated in broiler chickens after single crop intubation of 50 mg/kg 5% zinc aspartate suspension in 2% carboxymethyl cellulose solution. Blood serum zinc concentrations were assayed on a biochemical analyzer. The pharmacokinetics of zinc was evaluated using two approaches – compartmental method and non-compartmental analysis using pharmacokinetic software (TopFit, v. 2.0). After the intraingluvial application, zinc was rapidly absorbed (t1/2abs. =0.1040.02 h) by the alimentary system of birds attaining Cmax of 63.603.94 mol/ml by hour 0.77 (compartmental method) and Cmax =69.274.35 mol/ml by hour 0.92 h (non-compartmental method). It is characterized with a long biological half-life (t1/2) of 13.821.63 h (compartmental analysis) and 15.961.73 h (non-compartmental analysis) and long mean residence times (MRT) 20.122.35 h and 23.002.50 h, respectively. The distribution in blood and extracellular fluid was good as seen from Vd(area) values 0.770.05 l/kg (compartmental analysis) and 0.650.05 l/kg (non-compartmental analysis). info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0131 https://doi.org/10.1515/jbcr-2015-0131 https://jbcr.arphahub.com/article/34341/ https://jbcr.arphahub.com/article/34341/download/pdf/ en

10.1515/jbcr-2015-0132 2014-12-31 jbcr

Interaction Of Propylthiouracil With Model Systems Generating A Superoxide Radical Valcheva-Traykova,Maria Traykov,Trayko Bocheva,Georgeta propylthiouracil xanthine oxidase superoxide radical free radicals formation Journal of Biomedical and Clinical Research 7(2): 93-98 Propylthiouracil is used against Grave's Disease and for developing animal models of hypothyroidism. Apart from depressed metabolism, free radical-induced tissue damage has been registered as an effect from this drug. Superoxide is essential for generation of free radicals in tissues. The mutual effects of Propylthiouracil and superoxide radical have not been well investigated.The in vitro effects of Propylthiouracil on the free radicals in three model systems generating superoxide were measured using luminol-dependent chemiluminescence and spectrophotometry. The drug did not affect the formation of free radicals in the presence of potassium superoxide and in pyrogallol-oxygen solutions, while in the presence of the xanthine/xanthine oxidase system a distinct prooxidant effect was registered. The investigation of the system propylthiouracil/xanthine oxidase showed mild free radicals formation along with decreasing intensities of the drug's UV-specter.Our in vitro investigation indicated that, along with the transformation of xanthine to uric acid over xanthine oxidase, some free radicals may be produced due to the interaction of propylthiouracil with the enzyme. It was proposed that this might contribute to the in vivo free radicals-induced tissue damage observed in the presence of propylthiouracil. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0132 https://doi.org/10.1515/jbcr-2015-0132 https://jbcr.arphahub.com/article/34343/ https://jbcr.arphahub.com/article/34343/download/pdf/ en

10.1515/jbcr-2015-0133 2014-12-31 jbcr

Localization Of MMP-2 And MMP-9 In Canine Mammary Gland During Pregnancy Pupaki,Despina Ankova,Dessislava Vasilev,Veselin Rashev,Pavel MMP-2 MMP-9 mammary gland pregnancy Journal of Biomedical and Clinical Research 7(2): 99-104 The mammary gland is unique in its development because most of its branching occurs in adolescent rather than in prenatal development. During early pregnancy extensive ductal side branching occurs while during the second half, secretory lobuloalveolar units are formed within the mammary gland. As modulators of the extracellular matrix, matrix metalloproteinases (MMPs) are the major enzymes taking part in the development of the gland. The activity of MMP-2 and MMP-9 has mostly been associated with tumor progression, while their participation in the physiological development of the mammary gland is not well characterized. In the present study the cell-specific localization of MMP-2 and MMP-9 in the developing dog mammary gland during pregnancy was investigated. In the early stages, both gelatinases were present, being located mostly in the epithelium of the ducts and less so in the surrounding stroma. After the formation of alveoli, MMP-2 was still present but MMP-9 was absent from the glandular epithelium and the stroma, being present only in the epithelium of the larger ducts. The results show that most likely, both gelatinases take part in ductal branching during early pregnancy, but only MMP-2 is associated with the differentiated stage of lactation. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0133 https://doi.org/10.1515/jbcr-2015-0133 https://jbcr.arphahub.com/article/34344/ https://jbcr.arphahub.com/article/34344/download/pdf/ en

10.1515/jbcr-2015-0134 2014-12-31 jbcr

Correlations Between Acute Ischemic Stroke And Its Associated Cardiovascular Diseases Arabadzhieva,Daniela Kaprelyan,Ara Slavov,Zdravko Georgieva,Zhaneta Tsukeva,Aleksandra acute ischemic stroke associated cardiovascular diseases cardiovascular risk correlation analysis Journal of Biomedical and Clinical Research 7(2): 105-109 The objective of this study was to analyze the association between some cardiovascular diseases and acute ischemic stroke. A total of 258 acute ischemic stroke patients (mean age 70.59±7.22 years) were examined. The presence of eight cardiovascular diseases and pathological conditions was analyzed: arterial hypertension, hypertensive heart, atrial fibrillation, myocardial infarction, ischemic heart disease, effort angina pectoris, coronary atherosclerosis, and heart failure. Data were statistically processed by variation and correlation analysis. Most male and female patients presented with four accompanying cardiovascular diseases (27 or 20.93% and 31 or 24.03% of the cases, respectively). There were two groups of four variables each - with a relatively strong and a moderate, as well as with a weak correlation (r info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0134 https://doi.org/10.1515/jbcr-2015-0134 https://jbcr.arphahub.com/article/34345/ https://jbcr.arphahub.com/article/34345/download/pdf/ en

10.1515/jbcr-2015-0135 2014-12-31 jbcr

Metabolic Disturbances In The Patients With Acute Ischemic Stroke Arabadzhieva,Daniela Kaprelyan,Ara Georgieva,Zhaneta Slavov,Zdravko Tsukeva,Aleksandra acute ischemic stroke blood glucose lipids creatinine urea Journal of Biomedical and Clinical Research 7(2): 110-115 The purpose of this study was to analyze the disturbances of glucose, lipid and protein metabolism in acute ischemic stroke patients. A total of 258 patients (mean age 70.9±7.22 years, range 49-92 years) were studied. The following parameters were examined: blood glucose, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol, creatinine, and urea. Data were statistically processed by variation and correlation analysis. Our results demonstrated abnormal values of these laboratory parameters in most patients. The mean concentrations of triglycerides, total cholesterol and LDL-cholesterol were higher in females, while these of blood glucose were higher in males, especially in the age group between 76 and 80 years. Pearson’s correlation coefficient was highest between the variables ‘total cholesterol’ and ‘LDL-cholesterol’ (r=0.797) but moderate - between some of the rest variables such as ‘creatinine’ and ‘urea’ (r=0.575); ‘total cholesterol’ and ‘triglycerides’ (r=0.565); ‘total cholesterol’ and ‘urea’ (r=0.428); ‘triglycerides’ and ‘urea’ (r=0.370) and ‘LDL-cholesterol’ and ‘urea’ (r=0.301). In conclusion, the metabolic disorders are relatively common among acute ischemic stroke patients and play a specific role as risk factors for this disease. These parameters should regularly be controlled within the outpatient practice in order to warrant an effective prevention of acute ischemic stroke. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0135 https://doi.org/10.1515/jbcr-2015-0135 https://jbcr.arphahub.com/article/34346/ https://jbcr.arphahub.com/article/34346/download/pdf/ en

10.1515/jbcr-2015-0136 2014-12-31 jbcr

Occupational Risk And Health Status Of Workers In The Production Of Heat Kuneva,Tanja Stoyneva,Zlatka Medjidieva,Daniela Apostolova,Diana Kuzmov,Shiboy Oncheva,Gergina occupational risk occupational diseases toxic pneumofibrosis hepatitis Journal of Biomedical and Clinical Research 7(2): 116-122 The health status of 1515 workers employed in heat production was investigated. The subjects studied were divided in four groups according to occupation and occupational risk factors: vibration, noise, dust, metal aerosols, overloading of the musculoskeletal and peripheral nervous system, and organic solvents. The control group included 152 administrative staff members. High prevalence of socially significant diseases – cardiovascular, endocrine and metabolic was detected in all the groups surveyed. The frequency of diseases of the cardiovascular system and the respiratory system was 2.7 times higher than that in the control group. Statistically reliable higher prevalence of lung diseases in the studied risk groups was found, especially in the group of welders and chemists: 45.3% и 17.4% respectively, as compared to 4.3% in the controls. These finding corresponded to the occupational risk. The following occupation diseases were diagnosed: pneumoconiosis in 26.6% and toxic pneumofibrosis in 5.1% of electric welders. As regards the group of chemists, toxic pneumofibrosis was found in 6.5%. toxic effects of irritants - in 6.5 %, and chronic intoxication with organic radicals - in 0.7 % of them. Occupational auditory neuritis was diagnosed in 1% of the turbine operators and crane operators. The relative share of workers with peripheral nervous system pathology (radiculopathies, polyneuropathies, distal sympathetic neuropathy, mononeuropathy) was reliably higher than that in the control group, and the frequency increased among the workers with more than ten years of service and older than 40. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0136 https://doi.org/10.1515/jbcr-2015-0136 https://jbcr.arphahub.com/article/34350/ https://jbcr.arphahub.com/article/34350/download/pdf/ en

10.1515/jbcr-2015-0137 2014-12-31 jbcr

Risk Of Lead Intoxication In Exposed Workers Kuneva,Tanja Apostolova,Diana Stoyneva,Zlatka Ivanova,Aneta Boyadzhieva,Vladimira Yosifcheva,Kristina risk lead intoxication antidote therapy Journal of Biomedical and Clinical Research 7(2): 123-127 A clinical observation of 15 workers exposed to lead, engaged in recycling of lead accumulators, was carried out. The exposition to lead aerosols varied from 2 months to 14 years. High levels of lead absorption and excretion after application of antidote therapy were found in all workers followed up. There were no manifestclinical signs and symptoms in 7 workers whom we suspected to be lead carriers. Anemia was diagnosed in 8 of the investigated persons. Severe form of intoxication, including paresis of both radial nerves, was established in one worker. Subacute lead poisoning, presenting with lead colic, anemia, toxic hepatitis and toxic polyneuropathy, was diagnosed in three persons with only several months of intensive lead exposure. Association between lead exposure, metal absorption and clinical symptoms in investigated persons were discussed. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0137 https://doi.org/10.1515/jbcr-2015-0137 https://jbcr.arphahub.com/article/34351/ https://jbcr.arphahub.com/article/34351/download/pdf/ en

10.1515/jbcr-2015-0138 2014-12-31 jbcr

Overweight, Obesity, And Related Diseases Among Workers With Different Workload Gidikova,Pavlina Sandeva,Gergana Haracherova,Kamelia Sandeva,Rositsa overweight obesity workload chronic non-infectious diseases Journal of Biomedical and Clinical Research 7(2): 128-133 A person's weight depends on major factors like genetics, diet, and physical activity. Physical activity in adults is defined mainly by workload – light, moderate or heavy. The aim was to explore associations between weight and chronic non-infectious diseases in workers with different physical activity. The subjects included in the study were 224 male and 249 female employees, divided by workload based on their job description. Body mass index (BMI) and disease incidence were calculated, and statistical analysis was performed. The highest percentage of overweight and obese subjects was found in men with light workload. The mean BMI for men (27.434.85) was significantly higher than that for women (25.875.06). Analysis of obesity-associated diseases showed that in workers with higher BMI there was a higher incidence of endocrine disorders, musculoskeletal and related neurological diseases. Diseases of the circulatory system were highly prevalent in both overweight/obese and underweight employees. In conclusion, physical activity at work contributes to changes in BMI in the working population. Obesity-associated circulatory, endocrine and musculoskeletal diseases were highly prevalent in the groups with higher BMI. The prevalence in employees without diseases was in inverse relation to BMI. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0138 https://doi.org/10.1515/jbcr-2015-0138 https://jbcr.arphahub.com/article/34352/ https://jbcr.arphahub.com/article/34352/download/pdf/ en

10.1515/jbcr-2015-0139 2014-12-31 jbcr

Risk Sexual Behaviour In Students Aged 12-18 Tzvetanova,Nevena Simeonova,Joana Tzvetanova,Yanka risk sexual behavior student Journal of Biomedical and Clinical Research 7(2): 134-140 The aim of this study was to identify risk sexual behavior in students aged 12-18 in Veliko Turnovo region. A cross-sectional study was carried-out in 2014. Three hundred and ten students attending seven schools filled in a self-administered questionnaire. The questionnaire included 48 questions, sixteen of which collected information about sexual behaviour, regarding contraception, casual sex with different partners, sexually transmitted diseases (STD), hygiene after sex, etc. The data were processed with SPSS.v.19. Parametric and non-parametric statistical methods were applied. Over 50% of the students reported being sexually active, most of them since they turned 16. Almost half of the respondents had had casual sexual partners and 46 percent had had sex within a week after initiation of a new relationship. Less than one third of the students reported safe sex behaviour. Seven percent of the students had a history of STDs, and one in six did not practice proper hygiene after sex. Identification of all aspects of risk sexual behavior in students aged 12-18 provides an opportunity to study the problem systematically and comprehensively. Planning and implementation of effective health education programs in schools require the application of an integrated approach with the participation of students, teachers, parents, health professionals and policy makers. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0139 https://doi.org/10.1515/jbcr-2015-0139 https://jbcr.arphahub.com/article/34353/ https://jbcr.arphahub.com/article/34353/download/pdf/ en

10.1515/jbcr-2015-0140 2014-12-31 jbcr

Attitudes Of Regular Alcohol Drinking Adolescents To Intersubjective Relations And Everyday Life Sarov,Georgi significant others attitudes alcohol Journal of Biomedical and Clinical Research 7(2): 141-147 It is well known that some psychological features of adolescents as extraversion, risk-taking and impulsivity positively associate with substance abuse. The aim of the study was a description of psychological features of adolescents associated with regular alcohol drinking. We conducted a survey using an original questionnaire, classifying alcohol drinking as regular, social (incidental) and abstinence. The adolescents were asked to evaluate their own patterns of drinking. Of the 903 investigated students (aged 15-19), 169 identified themselves as regular alcohol drinkers (RDA), and 279 – as abstainers (NDA). These two groups were compared statistically in terms of a wide range of self-described psychological features. It was found that RDA were more likely to strive for dominant positioning in intersubjective relations (OR 1.8, 95%CI 1.22-2.65), more likely to avoid academic obligations (OR 1.61, 95%CI 1.08-2.39), and more likely to postpone their duties in everyday life (OR 1.81, 95%CI 1.23-2.67). It seems that regular drinking positively associates with egocentric personality traits and help is needed in personality development that could have a positive secondary effect on alcohol prevention. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0140 https://doi.org/10.1515/jbcr-2015-0140 https://jbcr.arphahub.com/article/34354/ https://jbcr.arphahub.com/article/34354/download/pdf/ en

10.1515/jbcr-2015-0141 2014-12-31 jbcr

Dry Age-Related Macular Degeneration – A New Approach In Optical Coherence Tomography Monitoring And Quantitative Assessment Hristova,Elitsa Zlatarova,Zornitsa optical coherence tomography dry Journal of Biomedical and Clinical Research 7(2): 148-154 The purpose of the study was to present the ability of Drusen analysis software tool to measure drusen area and volume in patients with dry age-related macular degeneration (AMD). Eleven patients with confirmed dry AMD aged 59-74 years were scanned with 3D OCT-2000 Topcon 3D Macula scanning protocol by a single operator. All subjects underwent a complete ophthalmologic examination including best corrected visual acuity, indirect biomicroscopy, tonometry, fluorescein angiography and OCT. Drusen analysis was performed on the macula with 6.0 × 6.0 mm volume cube scans and 512×128 pixels scan resolution. The results were presented along with calculated values in two clearly arranged reports. Mean follow-up period was 19 months (6-40). Count, area occupation, volume of the drusen and 3D retinal pigment epithelium (RPE) elevation map were presented in a Macula drusen analysis report. Drusen count and volume in 6 patients were increased at the end of follow-up period. There were 5 patients with regression in drusen count and area and volume of the drusen in 3 of them were higher than on previous examination. Another 2 were with regression not only in drusen count but also in their area and volume. With this software tool the status of RPE can be objectively and automatically examined in detail and can be followed up over time. OCT allows for precise quantitative evaluation and study of microstructural changes in patients with dry AMD and provides three-dimensional information of macular pathology in situ and in real time. This could be useful for determining stages and monitoring the progression of AMD. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0141 https://doi.org/10.1515/jbcr-2015-0141 https://jbcr.arphahub.com/article/34355/ https://jbcr.arphahub.com/article/34355/download/pdf/ en

10.1515/jbcr-2015-0142 2014-12-31 jbcr

Pulmonary Gangrene - Severe And Rare Complication Of Pneumonia Petrova,Guergana Perenovska,Penka Miteva,Dimitrinka Kabakchieva,Radost Brankov,Ognyan Drebov,Rosen pneumonia gangrene children Journal of Biomedical and Clinical Research 7(2): 155-160 Pneumonia is an inflammatory lung disorder characterized by consolidation due to presence of exudates in the alveolar spaces. Most pneumonias can be effectively treated with appropriate oral antibiotics, with intravenous antibiotics being reserved for those with severe infections. We present two cases of girls admitted in our clinic with pneumonia where our conventional therapy was not sufficient. Case 1: A 15-year-old girl with cystic fibrosis, with left lobular pneumonia, for which an aggressive conservative treatment was initiated. After significant improvement, sudden detorioration and pneumothorax of the left lung occurred. She was transferred to the surgical department for intervention. Due to failure to respond to initial drainage she underwent thoracotomy and resection of the left lower lobe of the lung. The histology result confirmed gangrene. Case 2: A four-year old girl was treated for pneumonia in the right lung with aggressive intravenous antibiotic. After temporary improvement sudden deterioration was observed. The patient was transferred to the surgery department, where pulmonary gangrene was confirmed. After the lower lobe of the right lung was resected, she was discharged in good health. The careful follow up, accurate diagnosis and correct medication choice are crucial for reducing the complications of “common” pneumonia. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2014 Research Article text/html info:doi:10.1515/jbcr-2015-0142 https://doi.org/10.1515/jbcr-2015-0142 https://jbcr.arphahub.com/article/34357/ https://jbcr.arphahub.com/article/34357/download/pdf/ en

10.1515/jbcr-2015-0143 2015-06-22 jbcr

Effect Of High-Fructose Solution On Body Weight, Body Fat, Blood Glucose And Triglyceride Levels In Rats Sandeva,Rositsa Mihaylova,Stanislava Sandeva,Gergana Trifonova,Katya Popova-Katsarova,Ruska high-fructose diet obesity body weight blood glucose blood triglycerides Journal of Biomedical and Clinical Research 8(1): 5-8 In Europe, as well as in Bulgaria, consumption of soft drinks and confectionery has increased during the last three decades and is partly responsible for the epidemic-like increase in obesity. These foods, originally sweetened by sucrose, are now sweetened by other caloric sweeteners such as fructose. In this study we investigated the effect of an eight-week intake of 20% fructose solution on body weight in rats. Two adult rat groups (aged 120±6 days) of Wistar line were studied: a Control group (C; n=10; 5 male and 5 female rats) received water and standard rodent chow, and a Fructose group (F; n=12; 6 male and 6 female rats) who received 20% fructose-in-drinking-water solution and regular rodent chow. All animals were weighed and measured (nose to anus length), and the Lee index (equivalent of BMI in rats) was calculated. Body fat was also analyzed. As indicators of increased caloric intake of the Fructose group we investigated glucose, triglycerides and cholesterol (total, HDL and LDL) in blood. In conclusion, consumption of fructose solution in rats resulted in increased body weight, length and measured body fat, increased blood glucose, total cholesterol and triglycerides in the Fructose group, as compared to the controls. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0143 https://doi.org/10.1515/jbcr-2015-0143 https://jbcr.arphahub.com/article/34358/ https://jbcr.arphahub.com/article/34358/download/pdf/ en

10.1515/jbcr-2015-0144 2015-06-22 jbcr

Experimental Study On The Development Of Tolerance And Withdrawal Syndrome To Pentylenetetrazole-Induced Seizures In Rats Treated With Retigabine Apostolova,Elisaveta Kokova,Vesela Peychev,Lyudmil retigabine tolerance withdrawal PTZ rats Journal of Biomedical and Clinical Research 8(1): 9-12 The aim of the study was to evaluate seizure liability in rats against the convulsant pentylenetetrazole (PTZ) during a 14-day treatment with retigabine (RTG). The seizure liability was also studied on the 1st, 2nd and 3rd day after the abrupt determination of its administration. Male Wistar rats were divided in groups of 10 and treated orally for 14 days (1st – 6th group with distilled water, and 7th – 12th group with retigabine (RTG) at a dose of 60 mg/kg bw The tolerance to the anticonvulsant effect of RTG was studied using subcutaneous injection of PTZ (120 mg/kg bw) on the 1th and 14th day. To determine the possible neuronal hyperexcitability on the 1st, 2nd and 3rd day after termination of drug administration, a lower dose of PTZ (65 mg/kg bw) was used. According to our results there was no change in the anticonvulsant activity of RTG during the whole period of treatment. The study on withdrawal syndrome showed slightly decrease of the effect on the first day after the last treatment, but with no significant difference to the controls. The anticonvulsant effect of RTG on the 2nd and 3rd day was close to that in the control group. Our results showed no development of tolerance on subchronic treatment with RTG. There was no significant change in the neuronal hyperexcitability on the 1st, 2nd and 3rd day after the termination of treatment. Based on these results we can suggest that RTG has no potential to develop withdrawal syndrome. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0144 https://doi.org/10.1515/jbcr-2015-0144 https://jbcr.arphahub.com/article/34360/ https://jbcr.arphahub.com/article/34360/download/pdf/ en

10.1515/jbcr-2015-0145 2015-06-22 jbcr

Effect Of Handedness On Functional Organization Of Bimanual Isometric Handgrip Kolev,Nikolai Halacheva,Ljudmila handgrip maximal force bilateral deficit handedness Journal of Biomedical and Clinical Research 8(1): 13-18 The aim of this study was to examine force production during maximal isometric handgrip in unilateral (UL) and bilateral (BL) tasks in right- and left-handed subjects. Ten right-handed (RH) and 8 left-handed (LH) young men were studied. The subjects were instructed, after a command, to perform a shot-like handgrip, raising maximal force as fast as possible. Three series were performed as follows: 1) UL - right handgrip; 2) UL - left handgrip; 3) BL handgrip. We measured peak force, time to peak of force and rate of force. The BL/UL ratios for the right (R) and left (L) hand and L/R ratios for the UL and BL tasks were calculated. The L/R ratios for peak force and force rate in RH group ranged across all tasks and conditions from 0.71 to 0.75. They were significantly lower than 1 (p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0145 https://doi.org/10.1515/jbcr-2015-0145 https://jbcr.arphahub.com/article/34364/ https://jbcr.arphahub.com/article/34364/download/pdf/ en

10.1515/jbcr-2015-0146 2015-06-22 jbcr

Translation, Adaptation And Validation Of The Bulgarian Version Of The SIDAED Questionnaire Kuzmanova,Rumyana Stefanova,Irina Velcheva,Irena Stambolieva,Katerina SIDAED questionnaire epilepsy adverse events antiepileptic treatment quality of life in epilepsy inventory Journal of Biomedical and Clinical Research 8(1): 19-25 The aim of the study is the translation, adaptation and validation of Side effects of antiepileptic drugs questionnaire in Bulgarian language (SIDAED-BG) in order to use it for objective monitoring of patients with epilepsy. One hundred and thirty one patients (mean age 40.13±13.37 years) took part in the investigation. The internal consistency and test-retest reliability were tested by Cronbach's α and ICC estimations. The convergent construct validity was evaluated by estimating the correlation of SIDAED-BG with the QOLIE-89 and the discriminant validity - by evaluation of the difference between SIDAED-BG scores and clinical parameters such as type of epilepsy using Kruskal-Wallis ANOVA. The Cronbach's α of the total scale was 0.93. The test-retest reliability was higher and determined the strong positive correlations between the first and second examination. The SIDAED-BG questionnaire showed good internal consistency (Cronbach's alpha ranged from 0.37 to 0.86) and the scores significantly correlated with other questionnaires such as QOLIE-89 and showed a good discriminative validity between groups with different levels of self-assessed adverse effects of antiepileptic drugs. The Bulgarian version of SIDAED is a reliable and valid tool in assessing the patient-reported adverse effects of antiepileptic drugs and their impact on the patient's outcome. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0146 https://doi.org/10.1515/jbcr-2015-0146 https://jbcr.arphahub.com/article/34365/ https://jbcr.arphahub.com/article/34365/download/pdf/ en

10.1515/jbcr-2015-0147 2015-06-22 jbcr

Myocardial Infarction And Ischemic Heart Disease In Patients With Acute Ischemic Stroke Arabadzhieva,Daniela Georgieva,Zhaneta Kaprelyan,Ara Slavov,Zdravko acute ischemic stroke myocardial infarction ischemic heart disease correlation analysis Journal of Biomedical and Clinical Research 8(1): 26-29 The aim of the investigation was to analyze the correlation between myocardial infarction and ischemic heart disease, on the one hand, and acute ischemic stroke (AIS), on the other hand. We studied 258 AIS patients (mean age 70.9±7.22 years, range 49-92 years) hospitalized in 2007-2013 in the First Clinic of Neurology, St. Marina University Hospital of Varna. The diagnosis of acute ischemic stroke was confirmed by Doppler sonography and computed tomography of the cerebral circulation. Data were statistically processed by variation and correlation analysis. Our results proved a relatively strong correlation between effort angina pectoris and ischemic heart disease (Pearson's coefficient: r=0.643) as well as a weak correlation between ischemic heart disease and myocardial infarction (Pearson's coefficient: r=0.243) among acute ischemic stroke patients. The well-known risk factors for these cardiovascular diseases such as obesity, tobacco smoking, low physical activity and alcohol abuse were common among the patients with acute ischemic stroke, too. In conclusion, both myocardial infarction and ischemic heart disease are strongly associated with the development of acute ischemic stroke. Such patients require strict and regular control by general practitioners. They should observe an appropriate diet and adhere to a healthy life-style. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0147 https://doi.org/10.1515/jbcr-2015-0147 https://jbcr.arphahub.com/article/34366/ https://jbcr.arphahub.com/article/34366/download/pdf/ en

10.1515/jbcr-2015-0148 2015-06-22 jbcr

Multivessel Disease As A Prognostic Factor For Mortality In STEMI Patients Karamfiloff,Kiril Karamfiloff,Kiril Georeva,Petya Trendafilova,Diana Jorgova,Julia STEMI mortality multi-vessel disease Journal of Biomedical and Clinical Research 8(1): 30-34 The main objective of this analysis was to define the influence of multivessel disease involvement compared to single vessel disease on mortality rates in STEMI patients. The retrospective study included 549 patients, hospitalized with STEMI in St. Ekaterina University Hospital (age - 62.66±12.56; women - 31.3%) from 01.06.2008 to 30.06.2011. One-vessel disease was found in 232 patients (44%) as compared to two-vessel disease in 165 patients - 31% and multivessel disease in 130 patients - 25%. There was LM stenosis (>30) in 11 patients (2%); ostial lesion in 33 patients (6.3%); presence of Ca in 37 patients (7%). A stent was implanted in 484 patients (91.8%), and GP IIb/IIIa was used in 400 patients (75.9%). There was significant increase in mortality rates in patients with multivessel disease: 15.6% - 46 patients, compared to one-vessel disease - 6.5% (15 patients) (p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0148 https://doi.org/10.1515/jbcr-2015-0148 https://jbcr.arphahub.com/article/34368/ https://jbcr.arphahub.com/article/34368/download/pdf/ en

10.1515/jbcr-2015-0149 2015-06-22 jbcr

Effects Of Glucose And Bilirubin On The Kinetic Jaffe's And The Enzymatic Methods For Serum Creatinine Assay Gencheva,Irena Ruseva,Adelaida creatinine enzymatic assay Jaffe kinetic method glucose bilirubin Journal of Biomedical and Clinical Research 8(1): 35-39 The enzymatic method for the determination of serum creatinine is accepted as one of the most accurate methods in a clinical laboratory. This method was used on a biochemistry auto analyzer (Cobas Integra 400) to determine serum creatinine at the laboratory of University Hospital – Pleven. The characteristics and reliability of this enzymatic method for creatinine were compared with the Jaffe kinetic method. Effects of some interfering substances like bilirubin and glucose on the Jaffe kinetic method and the enzymatic method were compared. Glucose and bilirubin inhibit the reaction between creatinine and alkaline picrate. Glucose slowly reduces picric acid to picrate, while the bilirubin present in a sample is oxidized to biliverdin under alkaline conditions. This leads to a decrease in absorbance at 520 nm. We measured creatinine in serum samples with the enzymatic method and the Jaffe kinetic method in samples divided into four groups: group I –samples without bilirubin and glucose ; group II –samples with high level of glucose; group III - samples with high level of bilirubin, group IV – all samples. For Group I, the correlation coefficient obtained by comparing the enzymatic creatinine method and Jaffe's kinetic method was R = 0.983. There was a very good agreement between the two methods in terms of correlation coefficient even in the samples with high levels of glucose or bilirubin. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0149 https://doi.org/10.1515/jbcr-2015-0149 https://jbcr.arphahub.com/article/34369/ https://jbcr.arphahub.com/article/34369/download/pdf/ en

10.1515/jbcr-2015-0150 2015-06-22 jbcr

Levels Of Resistin And Visfatin In Patients With Metabolic Syndrome Rayanova,Ginka Ganeva,Silvia Todorova,Katya Lukanov,Tsvetan Gecheva,Svetla metabolic syndrome fat tissue adipokines resistin visfatin Journal of Biomedical and Clinical Research 8(1): 40-45 The aim of the study is to investigate the serum levels of adipokines-resistin and visfatin in patients with metabolic syndrome. A prospective study was performed, including 153 (103 female, 50 male) subjects with metabolic syndrome. Carbohydrate metabolism was estimated by oral glucose tolerance test with 75g of glucose. Of the subjects investigated, 40 were with normal glycaemic tolerance, 40 - with impaired fasting glycaemia, 28 - with impaired glucose tolerance and 45 - with newly diagnosed diabetes mellitus type 2. The results were compared to those in a control group of 20 subjects without findings indicating metabolic syndrome. The serum levels of resistin and visfatin were measured with an enzyme immunoassay method (ELISA, BioVendor Laboratory Medicine, Inc., Czech Republic). There were significant differences in body mass index, waist circumference, systolic blood pressure, plasma level of blood glucose and serum level of triglycerides between the examined subjects with metabolic syndrome, as compared with the control group. The amount of serum resistin in subjects with metabolic syndrome and newly diagnosed diabetes mellitus type 2 was significantly higher, as compared to the controls. Subjects with metabolic syndrome and pathological glucose tolerance-impaired fasting glycaemia, impaired glucose tolerance and newly diagnosed diabetes mellitus type 2 were found with a significantly higher serum level of visfatin, as compared to normal glucose tolerance and to the controls. Subjects with metabolic syndrome and pathological glucose tolerance-impaired fasting glucose, impaired glucose tolerance and newly diagnosed diabetes mellitus type 2 exhibited significantly changes in serum levels of adipokines-resistin and visfatin. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0150 https://doi.org/10.1515/jbcr-2015-0150 https://jbcr.arphahub.com/article/34370/ https://jbcr.arphahub.com/article/34370/download/pdf/ en

10.1515/jbcr-2015-0151 2015-06-22 jbcr

Plasma Homocysteine Level And C677T Polymorphism In MTHFR Gene In Patients With Acute Coronary Syndrome Grek,Andrey Prystupa,Lyudmyla Sytnik,Tatiana MTHFR acute coronary syndrome cardiovascular diseases homocysteine Journal of Biomedical and Clinical Research 8(1): 46-51 Cardiovascular diseases (CVD) of atherosclerotic origin and accompanying complications are a major cause of mortality in the world and Ukraine, in particular. Endothelial dysfunction is the key cause of atherosclerosis and atherothrombosis. One of the causes of endothelial dysfunction is hyperhomocysteinemia that may occur on the background of MTHFR (methylenetetrahydrofolate reductase) mutation.Thus, the goal of the study was to investigate the interrelation between homocysteine (Hc) level and MTHFR polymorphism in patients with acute coronary syndrome (ACS).161 patients with ischemic heart disease and ACS have been examined. The control group comprised 87 healthy individuals. Homocysteine level was the highest in the patients having ACS with ST-segment elevation and complicated course, and was 1.8 times higher than Hc level in the control group. The patients with the most severe ACS course comprised 27 % of homozygotes for the major allele C and 41 % of homozygotes for the minor allele T. Comparing the distribution of MTHFR gene C677T polymorphism in patients with ACS that were stratified by plasma Hc level, we observed a statistically significant association, P < 0.030 by chi-square test. We confirmed that these patients had a high T/T genotype frequency of MTHFR C677T polymorphism. The obtained data proved the association of T/T genotype of MTHFR C677T polymorphism with increased Hc level as well as ACS severity. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0151 https://doi.org/10.1515/jbcr-2015-0151 https://jbcr.arphahub.com/article/34371/ https://jbcr.arphahub.com/article/34371/download/pdf/ en

10.1515/jbcr-2015-0152 2015-06-22 jbcr

Perioperative Outcomes Of Laparoscopic Hysterectomy: Comparison With Abdominal, Vaginal, And Robot-Assisted Surgical Approaches Tomov,Slavcho Gortchev,Grigor Tantchev,Latchesar Dimitrov,Todor Tzvetkov,Chavdar Popovska,Savelina laparoscopic hysterectomy peri-operartive outcome comparative analysis surgical approaches Journal of Biomedical and Clinical Research 8(1): 52-60 Selection of an appropriate surgical method for hysterectomy in an individual patient is currently an issue that remains open and debatable. This study aimed to analyze perioperative outcomes in gynecologic patients who underwent laparoscopic hysterectomy at a single institution during a 6-year period and to compare the data for simple hysterectomy patients treated with different surgical approaches. The study included a retrospective analysis of demographics, pre- and post-operative characteristics of 1,023 patients, operated on using four types of simple hysterectomy approaches: 635 laparoscopic hysterectomies (62.1%), 289 total abdominal hysterectomies (28.3%), 45 total vaginal hysterectomies (4.4%) and 54 robotic-assisted hysterectomies (5.3%). For the laparoscopic hysterectomy group, the mean operative time was shorter as compared to the abdominal and vaginal hysterectomy groups (p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0152 https://doi.org/10.1515/jbcr-2015-0152 https://jbcr.arphahub.com/article/34374/ https://jbcr.arphahub.com/article/34374/download/pdf/ en

10.1515/jbcr-2015-0153 2015-06-22 jbcr

Biliopancreatic Diversion With Duodenal Switch. Long Term Weight Loss Stoyanov,Toni Sanchez,Pedro Calero,Antonio Moreno,Augustina Blazquez,Emilio Rebollo,Servando duodenal switch obesity metabolic syndrome bariatric surgery Journal of Biomedical and Clinical Research 8(1): 61-67 Biliopancreatic derivation with duodenal switch (BPDDS) as an operative technique in the management of morbid obesity was created as an alternative to BPD (Scopinaro's operation), because of BPD-DS's fewer malabsorption side effects, better restrictive effect to the stomach remnant, fewer peptic ulcers and dumping syndromes, as well as lower morbidity and mortality rate. Between January 2003 and June 2012 in the University Hospital Center of Albacete, 141 patients with morbid obesity underwent BPD-DS. The patients were divided in groups according to four criteria: length of the common channel, age, gender and initial Body Mass Index. On the 6th postoperative year in our study the percent of excessive body weight loss was 67.6% and the percentage of excessive BMI loss was 73%. According to the evaluation announced by Hess D.S. & Hess D.W, our results could be assessed as successful after 6 months, good on the first year, excellent on the second, and good from 3rd to 9th postoperative years. Our results confirm the hypothesis that the biliopancreatic derivation with duodenal switch is a bariatric intervention, which leads to a significant weight loss, well preserved in time. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0153 https://doi.org/10.1515/jbcr-2015-0153 https://jbcr.arphahub.com/article/34375/ https://jbcr.arphahub.com/article/34375/download/pdf/ en

10.1515/jbcr-2015-0154 2015-06-22 jbcr

Analysis Of Labour Inspectors’ Temporary Incapacity For Work Georeva,Petya Kuneva,Tanya Karamfiloff,Kiril Stoykova,Jivka psychosocial factors professional stress labour inspectors temporary incapacitation morbidity structure Journal of Biomedical and Clinical Research 8(1): 68-71 It is known that increased morbidity with temporary incapacity for work (MTIW) is related to stress level and psychosocial factors at work. Practices for stress management, conflict avoidance and optimization of working conditions are known to reduce MTIW level. The aim of the present study was to analyze MTIW and propose measures to optimize and reduce strain at work. The study covered MTIW in labour inspectors, a total of 334 people, men and women aged from 24 to 69. The evaluation was based on 11 of the generally accepted indices. MTIW structure was analyzed. MTIW was rated as high according to case frequency and as very high according to day frequency. The average duration of a TI case was 12.63, and the relative share of people who were frequently taken ill for a long period was 12.81. In the ITI structure, diseases of the respiratory system (42.0%) ranked first, followed by diseases of the nervous system (18.8%), the digestive system (9.9%), CVS (8.3%) and MSS (7.2%). These 5 groups of diseases covered 86.2% of all diagnoses. The remaining 7 groups of diseases covered less than 14% of the diagnoses. The group of people most frequently taken ill for long periods included 28 inspectors who had used 42.5% of the total number of days. Two inspectors with 140 days of absence from work were cases of TI resulting from severe stress and adaptation disorder. Measures were proposed regarding the reduction of strain at work and the risk of stress. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0154 https://doi.org/10.1515/jbcr-2015-0154 https://jbcr.arphahub.com/article/34377/ https://jbcr.arphahub.com/article/34377/download/pdf/ en

10.1515/jbcr-2015-0155 2015-06-22 jbcr

Comparative Analysis And Evaluation Of Occupational Stress In Control Activities Georeva,Petya Kuneva,Tanja Bakova,Desislava Karamfiloff,Kiril Stoykova,Jivka psychosocial factors professional stress early manifestation labour inspectors construction activities inspectors Journal of Biomedical and Clinical Research 8(1): 72-75 Psychosocial factors (PSF) are leading among the new risks and modern challenges in providing safe and healthy conditions at work. Due to the high mental strain, inspectors are at highest risk for stress at work. The aim of the present study was to make a comparative analysis of PSFs in control activities, rate them and investigate subjective perception of stress at work. Two exhaustive cross-sectional studies were conducted consecutively, involving 338 and 355 inspectors, respectively, working at two organizations with control activities. The inspectors were men and women aged from 24 to 70. The statistical processing of data utilized the SPSS software version 17, at a significance level of p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0155 https://doi.org/10.1515/jbcr-2015-0155 https://jbcr.arphahub.com/article/34382/ https://jbcr.arphahub.com/article/34382/download/pdf/ en

10.1515/jbcr-2015-0156 2015-06-22 jbcr

The Presence Of Non-Drinking Parent Behavioral Model In A Family Prevents Adolescents From Social Alcohol Chamova,Galya Sarov,Georgi adolescence social drinking Journal of Biomedical and Clinical Research 8(1): 76-80 Parental alcohol drinking is associated with an increased risk of alcohol consumption in adolescents and social drinking is often the first step to regular alcohol consumption. The purpose of the study was to investigate the association between social drinking in adolescence and parental alcohol consumption. We conducted a survey, using a self-completed questionnaire about alcohol drinking habits. Of 903 students (aged 15-19), 279 (30.9%) were found to be abstainers (NDA) and 455 (50.39%) were social drinkers (SDA). These two groups were statistically compared for drinking patterns of their parents. It was found that SDA are fourfold less likely than NDA to have two alcohol abstaining parents (OR=0.26, 95%CI =0.19-0.37) and fourfold more likely to have two alcohol drinking parents (OR=3.89, 95%CI =2.77-5.45). There were no significant differences between SDA and NDA regarding probability to have one abstaining and one socially drinking parent, and SDA were less likely to have one abstaining and one regularly drinking parent (OR=0.54, 0.37-0.8). The social learning theory explains well adolescent drinking patterns when there is no contradiction in parental modeling. It seems, however, that the presence of contradicting patterns of parental alcohol drinking needs another explanation. Since contradicting parental modeling prevents adolescents from social drinking, it could be considered in health prevention intervention. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0156 https://doi.org/10.1515/jbcr-2015-0156 https://jbcr.arphahub.com/article/34384/ https://jbcr.arphahub.com/article/34384/download/pdf/ en

10.1515/jbcr-2015-0157 2015-06-22 jbcr

A Rare Case Of A Trans-Stomal Hernia, Combined With Undiagnosed Mediastinal Lymphadenopathy In A Patient With Rectal Cancer Tsvetanova,Kamelia Dimitrov,Dobromir Feradova,Hyuliya Nanev,Vasil Ivanov,Tsvetomir Dimitrov,Todor rectal cancer transstomal hernia lymph node metastases Journal of Biomedical and Clinical Research 8(1): 81-85 Colon cancer is one of the most common malignant diseases with high grade of malignancy and mortality at high rate. Approximately one million people are diagnosed with colorectal cancer each year. Metastases affect mostly the liver, followed by the lungs. Here is a rare case of a patient with rectal cancer without disease progression or recurrence who underwent surgery due to a trans-stomal hernia, combined with high transstomal fistula of the ileum. Acute respiratory failure developed in the postoperative period and led to fatal deterioration as a result of enlarged metastatic mediastinal lymph nodes, which was very difficult to diagnose. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0157 https://doi.org/10.1515/jbcr-2015-0157 https://jbcr.arphahub.com/article/34385/ https://jbcr.arphahub.com/article/34385/download/pdf/ en

10.1515/jbcr-2015-0158 2015-12-10 jbcr

Genetic Disorders Affecting Tubulin Cytoskeleton Markova,Maya Chakarova,Irina Zhivkova,Ralitsa Nikolova,Venera Hadzhinesheva,Valentina Delimitreva,Stefka microtubules spindle apparatus oocytes mutation infertility Journal of Biomedical and Clinical Research 8(2): 97-103 The tubulin cytoskeleton is vital for maintenance and dynamics of eukaryotic cells and molecular defects in its components can lead to serious conditions. So far, mutations in genes for alpha-, beta- and gamma-tubulin, motor proteins of the kinesin and dynein family, microtubule-associated and centrosomal proteins have been found to cause disorders in humans. Most phenotypic effects are on the nervous system, leading to abnormal brain development (e.g. lissencephaly and microcephaly) or to neurodegeneration in later life (e.g. amyotrophic lateral sclerosis and frontotemporal dementia). Another group of disorders include the ciliopathies, caused by defects in the axoneme. They include primary ciliary dyskinesia (immotile cilia syndrome), which is characterized by chronic respiratory infections, male infertility and randomly established left-right asymmetry. In most cases, the underlying defects are in axonemal dynein. Mutations in genes for centrosomal components have been shown to cause cortical dysplasia and dwarfism by disrupting the mitotic spindle, and some cases of infertility with maturation arrest are likely to be caused by unidentified mutations damaging the meiotic spindle. In view of these diverse phenotypes, knowledge about mutations affecting tubulin cytoskeleton becomes increasingly useful for clinical practice. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Review Article text/html info:doi:10.1515/jbcr-2015-0158 https://doi.org/10.1515/jbcr-2015-0158 https://jbcr.arphahub.com/article/34386/ https://jbcr.arphahub.com/article/34386/download/pdf/ en

10.1515/jbcr-2015-0159 2015-12-10 jbcr

Alcohol Septal Ablation , Marchev,Sotir Kuzmanov,Boyko hypertrophic cardiomyopathy left ventricular outflow obstruction alcohol septal ablation Journal of Biomedical and Clinical Research 8(2): 104-111 Since 1994, alcohol septal ablation (ASA) has been used as a minimally invasive treatment of patients with hypertrophic obstructive cardiomyopathy, resistant to conservative medical therapy. This catheter-based intervention consists of injecting absolute alcohol in a septal perforator to induce infarction of the hypertrophied septum and thus diminish the left ventricle outflow tract obstruction. This reduction of the gradient is associated with reduction of symptoms and left ventricle remodeling. The procedure was improved after the introduction of myocardial contrast echocardiography for visualization of the area at risk of infarction and reduction of the alcohol amount. Major complications of ASA are rare but centers with experience have reported conduction disorders - about 10% of patients needed permanent pacing because of complete AV block. Large randomized prospective studies have not yet compared alcohol septal ablation to the gold standard for treatment of hypertrophic obstructive cardiomyopathy - surgical myomectomy. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Review Article text/html info:doi:10.1515/jbcr-2015-0159 https://doi.org/10.1515/jbcr-2015-0159 https://jbcr.arphahub.com/article/34388/ https://jbcr.arphahub.com/article/34388/download/pdf/ en

10.1515/jbcr-2015-0160 2015-12-10 jbcr

Antihypertensive Effect Of Magnesium Sulfate (Cormagnesin®) And Its Combination With Furosemide On Conscious Spontaneously Hypertensive Rats Simeonova,Katerina Dimitrov,Krassimir Danchev,Nikolay magnesium sulfas antihypertensive effect SHR Journal of Biomedical and Clinical Research 8(2): 112-117 The present study demonstrates the antihypertensive effect of magnesium sulfate (Cormagnesin®) and its combination with Furosemide on conscious spontaneously hypertensive rats (SHR) after intravenous infusion. Experiments were carried out on six groups of conscious male SHR (n=6). Under short anesthesia the rats were chronically instrumented for intravenous (i.v.) drug administration. The arterial blood pressure (AP) was measured by indirect tale method. Cormagnesin® was applied by i.v. infusion in doses of 5, 20 and 40 mg/kg; and furosemide (10 mg/kg) was applied intraperitoneally. Experimental results showed significant decrease of AP after i.v. infusion of 20 mg/kg Cormagnesin® as well as after application of the Cormagnesin® and furosemide combination. The hypotensive effects of 40 mg/kg Cormagnesin® and of furosemide were not significant. There was no significant difference between the antihypertensive effects of Cormagnesin® and its combination with furosemide but the combination showed much better hypotensive effect than Furosemide (p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0160 https://doi.org/10.1515/jbcr-2015-0160 https://jbcr.arphahub.com/article/34389/ https://jbcr.arphahub.com/article/34389/download/pdf/ en

10.1515/jbcr-2015-0161 2015-12-10 jbcr

Comparative Study Of The Protective Effect Of Aronia Melanocarpa Fruit Juice And Quercetin In A Model Of Paracetamol-Induced Hepatotoxicity In Rats Valcheva-Kuzmanova,Stefka fruit juice quercetin paracetamol hepatotoxicity rats Journal of Biomedical and Clinical Research 8(2): 118-123 Aronia melanocarpa fruit juice (AMFJ) is very rich in polyphenolic compounds. Quercetin is a naturally occurring flavonoid, one of AMFJ polyphenols. The aim of the present study was to investigate the effect of AMFJ in comparison with quercetin in a model of paracetamol-induced hepatotoxicity in rats. AMFJ at doses of 2.5 and 5.0 ml/kg and quercetin at doses of 50 and 100 mg/kg were administered daily orally from day 1 to day 7 to different animal groups. Paracetamol was applied intraperitoneally (1.0 g/kg) on day 5. Blood and liver ware taken for biochemical investigations on day 7. Liver toxicity was estimated by the serum activities of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Oxidative stress was estimated by the levels of thiobarbituric acid reactive substances (TBARS) in liver homogenate and serum. Paracetamol caused a significant elevation of serum AST and ALT, and induced lipid peroxidation as measured by the significant increase of TBARS in serum and liver. In animals pretreated either with AMFJ or quercetin, liver enzyme activities did not differ significantly from the control levels. Both AMFJ and quercetin prevented the elevation of TBARS in the liver at the two applied doses and in the serum only at the higher of the tested doses. In the present model of paracetamol-induced hepatotoxicity, the protective effect of AMFJ was comparable to that of quercetin. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0161 https://doi.org/10.1515/jbcr-2015-0161 https://jbcr.arphahub.com/article/34391/ https://jbcr.arphahub.com/article/34391/download/pdf/ en

10.1515/jbcr-2015-0162 2015-12-10 jbcr

SND Rs1799889(-) In The Promotor Of The Plasminogen Activator Inhibitor-1 Gene Contributes To The Risk Of DVT In Women Komsa-Penkova,Regina Golemanov,Georgi Cankov,Boris Beshev,Lubomir Ivanov,Petar Tonchev,Pencho deep venous thrombosis thrombophilia Rs1799889(-)s PAI-1 Journal of Biomedical and Clinical Research 8(2): 124-132 The incidence of deep venous thrombosis (DVT) depends on the specific genotype, inheritance of prothrombotic polymorphisms and the influence of environmental risk factors. Rs1799889(-) polymorphism in the promotor of PAI-1 gene has been described as a risk factor for hypercoagulable state. Objective: To evaluate the contribution of thrombophilic rs1799889 (-) in the promotor of PAI-1 gene on the incidence of DVT in women and men in groups below and above 45 years of age. Тhere was significantly higher rs1799889 (-) polymorphism carriage among female patients with DVT vs controls (Chi squared =5.506, OR=2.170, p=0.021) but not in male patients (Chi squared =0.090 OR=1.147, p=0.825). A significant contribution of rs1799889 (-) polymorphism to early onset of the disease was found in female patients aged 45+ and carriers of the polymorphism (Chi squared =7.476, p=0.006), but not in young women. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0162 https://doi.org/10.1515/jbcr-2015-0162 https://jbcr.arphahub.com/article/34392/ https://jbcr.arphahub.com/article/34392/download/pdf/ en

10.1515/jbcr-2015-0163 2015-12-10 jbcr

Penetrating Keratoplasty For Treatment Of Bullous Keratopathy V. Murgova,Snezhana Balabanov,Chavdar penetrating keratoplasty bullous keratopathy Journal of Biomedical and Clinical Research 8(2): 133-136 The aim of the retrospective study was to analyze results after penetrating keratoplasties in patients with bullous keratopathy. The study included 60 patients with bullous keratopathy who underwent penetrating keratoplasty for the period 1990-2011, at the Eye Clinic of Pleven University Hospital. The average age of patients was 67 years (range 29-84 years). Additional risk factors were registered in 22.67% of the patients. Early postoperative complications occurred in 56.79%. In the early postoperative period, 81.31% of the patients had clear graft and improvement of visual acuity was achieved in 83.77%. In the late postoperative period, the graft failed in 28.95% of the patients. These results suggest that bullous keratopathy is an important complication after cataract surgery, and improvement of vision is possible only with keratoplasty. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0163 https://doi.org/10.1515/jbcr-2015-0163 https://jbcr.arphahub.com/article/34394/ https://jbcr.arphahub.com/article/34394/download/pdf/ en

10.1515/jbcr-2015-0164 2015-12-10 jbcr

Municipalities And Health – Citizens' Expectations About Local Health Policies Velkova,Angelika Kirova,Paulina health municipality well-being health policy citizens Journal of Biomedical and Clinical Research 8(2): 137-144 The aim of this study was to explore citizens' expectations about local health policies in order to create an adequate strategy. Local authorities in many countries place health in the core of their strategic planning aiming to create and improve a health-supporting social and physical environment, as they usually have primary responsibility for planning and/or delivering many of the services that are crucial to addressing the social determinants of health. Local health policies are created in consultation with local health services, NGOs and citizens. The survey was conducted among 400 citizens of Pleven Municipality. Of these, 335 (83.75%) responded to the invitation. Information on health problems and determinants of health was collected through a direct inquiry survey. The majority of citizens considered the impact of environmental, educational, cultural and economic factors as well as public security on their health. They expected that more purposeful efforts of the local authorities be directed for improving living conditions and inequalities in health. The citizens are willing to work together with municipalities to create health policies, which reduce negative factors and increase positive ones. They are aware that local policies and decisions have a very significant impact on the economic, social and environmental factors affecting health and well-being and therefore municipalities play a key role in improving and protecting the health of their citizens. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0164 https://doi.org/10.1515/jbcr-2015-0164 https://jbcr.arphahub.com/article/34395/ https://jbcr.arphahub.com/article/34395/download/pdf/ en

10.1515/jbcr-2015-0165 2015-12-10 jbcr

Significant Others And Social Alcohol Use In Adolescents Chamova,Galya Sarov,Georgi parental behavior significant others behavioral modeling Journal of Biomedical and Clinical Research 8(2): 145-149 The association between adolescent drinking and drinking of significant others is well known but underlying mechanisms are still not well understood. The purpose of the study was to investigate the association between social drinking in adolescents and drinking patterns of their significant others. We conducted a survey using a self-completed questionnaire on alcohol drinking habits. Of 903 students (aged 15-19), 279 (30.9%) were found to be abstainers (NDA) and 455 (50.39%) – social drinkers (SDA). These two groups were compared statistically about drinking patterns of their significant others. It was found that SDA were more likely to have fathers (OR=0.26; 95%CI=0.19-0.37), mothers (OR=0.26; 95%CI=0.19-0.37), friends (OR=0.26; 95%CI=0.19-0.37) and lovers (OR=0.26; 95%CI=0.19-0.37) that drank socially than NDA, but there were no significant differences in regular drinking of their fathers, friends and lovers. Only SDA mothers were more likely to drink regularly (OR=0.26; 95%CI=0.19-0.37). SDA were also more likely to receive alcohol offers from all their significant others, except from lovers. Social drinking in adolescence seems to be strongly socially motivated by drinking modeling and social pressure. The SDA mothers’ regular drinking is hard to explain in terms of social learning and social control theory and needs an alternative explanation. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0165 https://doi.org/10.1515/jbcr-2015-0165 https://jbcr.arphahub.com/article/34397/ https://jbcr.arphahub.com/article/34397/download/pdf/ en

10.1515/jbcr-2015-0166 2015-12-10 jbcr

Assessment Of Medical, Nurse And Midwife Students Of Their Training In Communication Skills Valentinova,Tsvetelina Balashkova,Magdalena Nedkova-Milanova,Vania Gadjelova,Lyubomira communication skills training medical nursing and midwifery students Journal of Biomedical and Clinical Research 8(2): 150-153 This study aimed to investigate the opinion of students of medicine, nursing and midwifery on their training in communication skills as an optional course. The participants included in the study were 126 students altogether. Information was gathered using a self-administered questionnaire. The results showed the level of motivation to participate in the training process, the results desired and achieved by the students and their evaluation of the quality of the training. The respondents were convinced that such training would be an asset for their future work as medical professionals and they were satisfied with the quality of training. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0166 https://doi.org/10.1515/jbcr-2015-0166 https://jbcr.arphahub.com/article/34398/ https://jbcr.arphahub.com/article/34398/download/pdf/ en

10.1515/jbcr-2015-0167 2015-12-10 jbcr

Comparative Sociometric Profile Of Regular Alcohol Drinking Adolescents Sarov,Georgi sociometry significant others adolescence alcohol Journal of Biomedical and Clinical Research 8(2): 154-159 Jacob Moreno defined sociometry as “the inquiry into the evolution and organization of groups and the position of individuals within them”. Every person composes their own group of significant others and the social relations in this dominated by the person group of the most important people in their life is called sociometric profile. The sociometric profile provides an opportunity to reveal social bonds, dependences and influences that impact one's behavior. The aim of the study was to describe the sociometric profile of regularly drinking adolescents as a result from comparison with the sociometric profile of non-drinking adolescents. We conducted a survey among 903 students (aged 15-19), by means of a self-administered questionnaire about relations with father, mother, friends and lovers. Of these, 169 identified themselves as regular drinkers (RDAs) and 279 ‒ as abstainers (NDAs). We compared these groups to reveal the comparative sociometric profile of drinking adolescents. It was found that RDAs were significantly more likely to be: 1) highly dependent on their lovers (OR=1.6); 2) detached from their mothers (OR=4.55); 3) in ambivalent relations with their friends; 4) without significant differences in relations with their fathers. It seems that the Stars of RDAs are their lovers, the Isolates are their mothers and friends are their ambivalent Mutual Choice. This comparative sociogram suggests that lovers are likely to be the most influencing person among RDAs' significant others and intimate relations might be the main target in alcohol prevention programs. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Research Article text/html info:doi:10.1515/jbcr-2015-0167 https://doi.org/10.1515/jbcr-2015-0167 https://jbcr.arphahub.com/article/34400/ https://jbcr.arphahub.com/article/34400/download/pdf/ en

10.1515/jbcr-2015-0168 2015-12-10 jbcr

Congenital Cystic Adenomatoid Malformation Of The Lung: A Case Report And Review Of The Literature Malinova,Doroteya Kolova,Penka Radev,Radoslav congenital cystic adenomatoid malformation types prognosis Journal of Biomedical and Clinical Research 8(2): 160-163 Congenital cystic adenomatoid malformation (CCAM) is a rare abnormality of lung development. It was classified into 5 types by Stocker in 2002 and is also known under the name of congenital pulmonary airway malformation (CPAM). Cases are typically identified prenatally by routine ultrasonography screening. CCAM may present in the older child and adult as an incidental finding. The case presented is of a 21-year-old male patient who suffered from pulmonary infections with a recurrent productive cough 3-4 times the last 4 years. CT scanning of the thorax showed multiple cystic lesions in the right middle and lower lobes. The areas with the lesions were resected. The macroscopic and histological findings were typical for congenital cystic adenomatoid malformation type 2, which was the final diagnosis. Clinical presentations and prognosis depend on the type of lesion and its sequelae. The diagnosis is confirmed histologically. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Case Report text/html info:doi:10.1515/jbcr-2015-0168 https://doi.org/10.1515/jbcr-2015-0168 https://jbcr.arphahub.com/article/34401/ https://jbcr.arphahub.com/article/34401/download/pdf/ en

10.1515/jbcr-2015-0169 2015-12-10 jbcr

A Variation In The Origin And Course Of The Posterior Circumflex Humeral Artery And The Deep Brachial Artery: Clinical Importance Of The Variation Iliev,Alexandar Mitrov,Lazar Georgiev,Georgi P. posterior circumflex humeral artery deep brachial artery variation clinical significance Journal of Biomedical and Clinical Research 8(2): 164-167 A case of an unusual variation of the blood supply of an upper limb is presented. During a routine anatomical dissection, it was found that the posterior circumflex humeral artery had an unusual course and branching. It arose as a branch of the brachial artery, not the axillary one, and it did not accompany the axillary nerve. It ran under the lower border of the teres major muscle instead of passing through the lateral axillary foramen, then followed its usual course around the surgical neck of the humerus, supplying the deltoid muscle. It was also found that instead of arising from the brachial artery, the deep brachial artery arose from the posterior circumflex humeral artery. Variations are reported and their clinical relevance is discussed. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Case Report text/html info:doi:10.1515/jbcr-2015-0169 https://doi.org/10.1515/jbcr-2015-0169 https://jbcr.arphahub.com/article/34402/ https://jbcr.arphahub.com/article/34402/download/pdf/ en

10.1515/jbcr-2015-0170 2015-12-10 jbcr

Epidermoid Cyst Of Posterior Cranial Fossa Associated With Congenital Dermal Sinus Tract – A Case Report And Review Of The Literature Drinking Malinova,Doroteya Kolova,Penka Georgiev,Radoslav epidermoid cyst differential diagnosis intracranial tumor Journal of Biomedical and Clinical Research 8(2): 168-171 Epidermoid cysts are benign lesions composed of ectodermal structures. They account for less than 2% of primary intracerebral tumors. They can be present at birth (congenital cysts), or can be acquired cysts (after surgery or trauma). Some cysts are asymptomatic but depending on their location, they may cause symptoms such as headache, vertigo, seizures, focal deficits, increased intracranial pressure. The major differential diagnosis of epidermoid cysts are dermoid cyst, any cystic neoplasm, craniopharyngioma, arachnoid cyst. A 39-year-old female patient with complaints of headache, vertigo, nausea and vomiting was admitted to the hospital. Radiological data suggested intracranial tumor in fossa posterior. Craniotomy was performed and the biopsy specimen demonstrated the mass lesion to be an epidermoid cyst of the intracranial dermal sinus tract. Intracranial cystic-appearing masses can be problematic for both radiologists and physicians. Important characteristics demonstrated by computed tomography scans and classical magnetic resonance imaging sequences are significant for the accurate diagnosis, but the imaging appearances of intracranial cystic lesions are sometimes nonspecific, and the diagnosis is usually established by histological examination. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2015 Case Report text/html info:doi:10.1515/jbcr-2015-0170 https://doi.org/10.1515/jbcr-2015-0170 https://jbcr.arphahub.com/article/34403/ https://jbcr.arphahub.com/article/34403/download/pdf/ en

10.1515/jbcr-2016-0001 2016-09-30 jbcr

Langerhans-Cell Histiocytoses - Epidemiology, Classification, Clinical Features, Diagnosis, Complications, Treatment and Prognosis Papochieva,Vera Miteva,Dimitrinka Perenovska,Penka Petrova,Guergana Langerhans cells granuloma bone skin lung histiocytosis Journal of Biomedical and Clinical Research 9(1): 3-16 Histiocytoses comprise a group of diverse diseases of unknown etiology with various clinical presentation and evolution. The underlying pathology is characterised by accumulation and infiltration of variable numbers of cells of the monocyte-macrophage line in the affected tissues and organs. Histiocytoses are divided into three major classes: Langerhans cell histiocytosis (LCH), non- Langerhans cell histiocytosis, and malignant histiocytic disorders. The term LCH (also known in the past as histiocytosis X) encompasses the following rare diseases: Eosinophilic Granuloma, Hand-Schuller-Christian disease, Letterer-Siwe disease, Hashimoto-Pritzker disease, in which accumulation of pathologic Langerhans cells (LCs) leads to tissue damage. LCs usually reside in the skin and ensure protection against infections by destroying foreign substances. LC accumulation is caused by antigen stimulation and inadequate immune response. Thus, clinical LCH manifestations range from isolated disease with mono- or multifocal bone lesions to disseminated multisystem disease. LCH is a rare disease, affecting mainly children and young smokers, aged 20-50 years. Lung involvement in LCH usually presents as a mono-system disease and is characterized by Langerhans cell granulomas (LCG) infiltrating and impairing the distal bronchioles. The definite diagnosis is based on lung biopsy of CAT selected LCG areas. So far, there is no an effective treatment, but the better understanding of the mechanisms involved in the pathogenesis of the disease would help in the development of effective therapeutic strategies in the future. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0001 https://doi.org/10.1515/jbcr-2016-0001 https://jbcr.arphahub.com/article/34408/ https://jbcr.arphahub.com/article/34408/download/pdf/ en

10.1515/jbcr-2016-0002 2016-09-30 jbcr

Biobanks and Public Health: A New Challenge for Public Engagement and Trust Caenazzo,Luciana Tozzo,Pamela biological specimen banks public health trust patient engagement Journal of Biomedical and Clinical Research 9(1): 17-20 Modem biobanks should be considered as important structural platforms for sharing samples and data, providing benefits that go beyond those of a single study. To increase the impact of biobanking on feasible strategies to protect and improve peoples’ health, it could be useful to increase awareness about biobank research potential in the scientific community, as well as to promote collaboration among different fields of expertise. The basis for involvement of biobanks in public health has already been partly built up, emphasising the synergy in organising efforts and the openness to infrastructure collaboration, to ensure reliable long-term funding and resource sharing to the benefit of all. To obtain the maximum benefits possible from biobanks, which currently constitute a set of heterogeneous structures, a strategy of coordinated governance is needed, based on harmonisation of different aspects, built on the consensus of all stakeholders involved and society in general. It is important that researchers strive to understand public attitudes in this biobanking involvement so that the relationships between public trust in biobanking, donors’ behaviours and support for public-health involvement in the health-care system can be better understood. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0002 https://doi.org/10.1515/jbcr-2016-0002 https://jbcr.arphahub.com/article/34410/ https://jbcr.arphahub.com/article/34410/download/pdf/ en

10.1515/jbcr-2016-0003 2016-09-30 jbcr

Sperm DNA Integrity Test and Assisted Reproductive Technology (Art) Outcome Rilcheva,Violeta Ayvazova,Nina Ilieva,Lyubomira Ivanova,Svetlana Konova,Emiliana sperm DNA fragmentation male infertility ICSI pregnancy rate pregnancy loss Journal of Biomedical and Clinical Research 9(1): 21-29 The objective of the study was to investigate the influence of sperm DNA fragmentation index (DFI) by DNA integrity test on pregnancy outcome and pregnancy loss after assisted reproductive technology (ART) procedure: autologous intracytoplasmic sperm injection (ICSI), donation eggs ICSI, and intrauterine insemination (IUI). We investigated men from 531 couples undergoing autologous ICSI procedure (n=416), from couples undergoing donation eggs procedure (n=39) and IUI (n=76). We performed the following interventions: semen analysis, DNA integrity test, embryo scoring by Gardner and Schoolcraft grading system (1999). The study showed no statistically significant differences between the group regarding pregnancy rate (χ2=0.55; p>0.05; OR=1.25, 95% Cl 1.23-1.46; p>0.05). However, with increased levels of DFI, the number of pregnancy losses became higher (including biochemical pregnancies and spontaneous abortions) at OR=5.65 (95% Cl 4.32-7.11; p=0.05). We examined the percentage of grade I blastocysts (by Gardner and Schoolcraft, 1999) before donation eggs embryo transfer and found a statistically significant correlation with both the DFI (χ2=7.80; p27% were associated with increased riskofearlypregnancyloss. Men with infertility should undergo DNA fragmentation assay in addition to the standard semen analysis. When DFI exceeds 27%, ICSI should be a method of choice, even in cases where the conventional parameters of semen analysis tests are normal. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0003 https://doi.org/10.1515/jbcr-2016-0003 https://jbcr.arphahub.com/article/34411/ https://jbcr.arphahub.com/article/34411/download/pdf/ en

10.1515/jbcr-2016-0004 2016-09-30 jbcr

Statistical Analysis of the Forensic Autopsies, Performed in the Department of Forensic Medicine of University Hospital Pleven for the Period 2009-2013 (A Preliminary Report) Dekov,Dancho Ivanov,Ivan Kostadinov,Sergey Popovska,Savelina Lisaev,Petko Dorovski,Plamen forensic medicine mortality determinants analysis Journal of Biomedical and Clinical Research 9(1): 30-36 The study is a statistical analysis of the dynamics and structure of forensic autopsies performed on dead bodies and body remains at University Hospital “Dr. Georgi Stranski” in Pleven. The study was based on forensic autopsy records database and forensic autopsy reports for the period 2009-2013. A total of 976 cases, including forensic autopsies, exhumations, examination of bone remains and inspection of dead bodies at the site of death (without following forensic autopsy), were analyzed. The studied data was coded and processed with Microsoft Excel software. A detailed data analysis of the number of autopsies, frequency of death by cause, distribution of death by gender, age, residence, place of death and its forensic category is presented. According to our results, the deaths due to diseases comprised 35% of all forensic autopsies. The most common cause of violent death was damage by mechanical factors (53%), followed by asphyxia (24.7%). The most common mechanical factor was vehicle crash trauma, followed by falling (22.5%). Accidents were the most common cause of death 62%, followed by suicides (31 %) and homicides 7%. Fifty-nine percent of the suicides were by hanging. The preliminary analyses of the studied data lead to several conclusions. The number of forensic autopsies was found to be progressively decreasing, but the road traffic death rate remained unchanged. Most of the forensic autopsies were performed in July. The highest death rates by age was observed in the age group between 51 and 60 years, with predominance of males over females (3.3 males: 1 females). info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0004 https://doi.org/10.1515/jbcr-2016-0004 https://jbcr.arphahub.com/article/34412/ https://jbcr.arphahub.com/article/34412/download/pdf/ en

10.1515/jbcr-2016-0005 2016-09-30 jbcr

The Personalities of Significant Others in Association with Regular Drinking in Adolescence Sarov,Georgi significant others personality alcohol adolescence Journal of Biomedical and Clinical Research 9(1): 37-41 It is well known that some psychological features of adolescents are positively associated with alcohol drinking but less attention is paid to the psychological features of their significant others. The aim of the study was to describe a common psychological profile of significant others to regularly alcohol drinking adolescents. A survey was conducted using an original questionnaire, which classifying alcohol drinking as regular, social (incidental) and abstinence. Of 903 students (aged 15-19), 169 identified themselves as regular drinkers (RDA) and 279 - as abstainers (NDA). The significant others of these two groups were compared statistically in terms of a wide range of psychological features. It was found that RDAs were significantly more likely to have: fathers (OR=1.94; 95% Cl 1.04-3.62) and friends (OR=l .55; 95% Cl 1.02-2.36) that tended to avoid obligations in favor of pleasure; extravert friends (OR=1.55; 95% Cl 1.06-2.28) and lovers (OR=1.72; 95% Cl 1.14-2.59); impulsive lovers (OR=l .76; 95% Cl 2.86- 1.08), and obeying (OR=l .95; 95% Cl 1.01-3.80) friends; conventional fathers (OR=2.17; 95% Cl 1.27-3.72) and less likely to have independent mothers (OR=0.57; 95% Cl 0.32-0.99) and hardworking friends (OR=0.58; 0.35- 0.95). It seems that significant others of RDAs are less likely to exhibit models of rational reactions in everyday life that prevent adolescents from developing rational personality, thus making it possible to increase the probability of regular drinking in adolescence. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0005 https://doi.org/10.1515/jbcr-2016-0005 https://jbcr.arphahub.com/article/34413/ https://jbcr.arphahub.com/article/34413/download/pdf/ en

10.1515/jbcr-2016-0006 2016-09-30 jbcr

Risk Cluster Associated with Social Drinking in Adolescence Chamova,Galya Sarov,Georgi risk cluster parents friends significant others adolescents alcohol Journal of Biomedical and Clinical Research 9(1): 42-47 Recent scientific evidence has shown that risk behaviors tend to form a risk cluster, but less attention is paid to clustering ability of light forms of risky behavior like social drinking. The objective of the study was to analyze the risk clustering potential of social drinking. We conducted a survey using a self-completed questionnaire. Of 903 students (aged 15-19), 279 (30.9%) were found to be abstainers (NDA), and 455 (50.39%) were social drinkers (SDA). These two groups were compared statistically, concerning smoking and drugs use among them and their significant others. SDAs were more likely to smoke (OR=3.29; 95% Cl 2.35-4.59) than NDAs but not more likely to use soft drugs. Their fathers (OR=1.4; 95% Cl 1.04-1.89), friends (OR=1.78; 95% Cl 1.31-2.42) and lovers (OR=2.01; 95% Cl 1.39-2.89) were also significantly more likely to smoke, but only friends were more likely to use soft drugs (OR=1.75; 95% Cl 1.19- 2.58). SDAs were also more likely to start smoking in order to be closer to their peers (OR=l .84; 95% Cl 1.01- 3.37) and to smoke when communicate with peers (OR=2.12; 95% Cl 1.40-3.21). Risk clustering in social drinking adolescents is limited to smoking and does not expand to drug use, irrespective of provocation by friends. Heavy smoking among SDAs’ significant others might contribute for SDA smoking. So SDAs seem to be resistant to the psycho-social mechanisms adding drug use to drinking but sensitive to psycho-social mechanisms adding smoking to drinking. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0006 https://doi.org/10.1515/jbcr-2016-0006 https://jbcr.arphahub.com/article/34414/ https://jbcr.arphahub.com/article/34414/download/pdf/ en

10.1515/jbcr-2016-0007 2016-09-30 jbcr

Toxicological Chemical Analysis of Methanol in Blood of Patients with Acute Ethanol Intoxication for Determining Detectable Quantities of Methanol and Analysis of the Correlation Between Ingested Alcohol Bonchev,Georgi Zlateva,Snezha Yovcheva,Marieta ethanol methanol Journal of Biomedical and Clinical Research 9(1): 48-54 The aim of the study was to carry out a toxicological chemical analysis of methanol in detectable quantities in the blood of patients with acute alcohol intoxication. Blood samples from 85 patients with acute alcohol intoxication were analysed for the presence of methanol. All patients with acute methanol intoxication were excluded from the study. The methods of gas chromatography with vapor-phase analysis (head-space) and flame ionization detection (FID) were used. The limit of detection (LOD=0.015 g/L) and the limit of quantification (LOQ=0.025 g/L) of methanol in whole blood were evaluated. In 30% of the cases, methanol was found in the blood in detectable quantities. The levels of methanol were on the average 5 to 6 times lower than the toxic methanol level (0200 g/L) and they were not due to natural metabolic processes (ingestion of fruit, fruit juices or vegetables). No reliable statistically linear correlation between the concentration of ethanol and methanol was found. Methanol subintoxications are major factors in alcohol intoxications, in which the quantity of the alcohol ingested is not as important as its quality. Chronic methanol subintoxication of people who often consume alcohol of poor quality is discussed. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0007 https://doi.org/10.1515/jbcr-2016-0007 https://jbcr.arphahub.com/article/34415/ https://jbcr.arphahub.com/article/34415/download/pdf/ en

10.1515/jbcr-2016-0008 2016-09-30 jbcr

Hypothermia in a Patient Treated with Antipsychotics Andreeva-Gateva,Pavlina Gatev,Tzvetelin Nachova,Ralitza Tafradjiiska-Hadjiolova,Radka Grozeva,Maria hypothermia ischemic stroke schizophrenia antipsychotic drugs Journal of Biomedical and Clinical Research 9(1): 55-58 We present a case of 58-year-old female patent with a long-term history of paranoid schizophrenia treated with different antipsychotics. She died with sign and symptoms of hypothermia. Autopsy revealed an ischemic stroke. We could not exclude involvement of antipsychotic medications as culprits. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0008 https://doi.org/10.1515/jbcr-2016-0008 https://jbcr.arphahub.com/article/34416/ https://jbcr.arphahub.com/article/34416/download/pdf/ en

10.1515/jbcr-2016-0009 2016-09-30 jbcr

Genetic Polymorphisms, Plasma Levels of Lipoprotein (A) and its Possible Links with Degenerative Aortic Stenosis Tomova,Vesela Rashev,Tihomir Atanasova,Milena aortic stenosis genetic polymorphisms rs1544410 LPA locus valvular calcification “kringle” IV repeat Journal of Biomedical and Clinical Research 9(1): 59-64 Degenerative aortic stenosis is the second most common acquired valvular heart disease in adults (after mitral insufficiency) and the second most common cause for cardiac surgery (after coronary heart disease). The reasons for the occurrence of these diseases (congenital abnormality of the valve: bicuspid aortic valve disease, advanced renal failure, impaired calcium-phosphorus metabolism) have been established only in a small portion of these patients. The absence of a specific reason, causing calcification and narrowing of the aortic valve in recent years has challenged researchers to start investigating genetic factors that may correlate with the development of degenerative aortic stenosis. Regardless of the conducted studies, knowledge and identification of predictive genetic factors in the occurrence and progression of aortic stenosis are still insufficient. It is assumed that a specific genetic variant in the Lipoprotein (a) locus (LPA locus), reflected by the Lipoprotein (a) [Lp(a)] plasma levels, is connected to the pathology of aortic stenosis in multiethnic groups. The study of the genetic nature of aortic stenosis and significance of Lp( a) plasma levels and genetically determined variations of its structure associated with the manifestation and progression of valvular calcification in the future might provide predictive intervention. Similar studies relating to genetic polymorphisms in LPA locus, plasma concentrations of Lp(a) and their correlation with aortic stenosis have not beenconducted in Bulgaria so far. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0009 https://doi.org/10.1515/jbcr-2016-0009 https://jbcr.arphahub.com/article/34418/ https://jbcr.arphahub.com/article/34418/download/pdf/ en

10.1515/jbcr-2016-0010 2016-09-30 jbcr

Preliminary Data from a Study on Polymorphism RS4244285 of P4502c19 Cytochrome Gene in Patients with Acute Coronary Syndrome, Undergoing Treatment with Dual Antiplatelet Therapy With Clopidogrel and Aspirin Kovacheva,Katya Nikolova,Petya Hristov,Valentin Pendicheva,Diana Marchev,Sotir Rashev,Tihomir CYP2C19 polymorphism Clopidogrel Acute Coronary Syndrome in-stent thrombosis Journal of Biomedical and Clinical Research 9(1): 65-71 Administration of antiplatelet therapy Aspirin and Clopidogrel (CLP) is a corner stone inpatients with Acute Coronary Syndrome (ACS) undergoing Percutaneous Coronary Intervention (PCI) with/without stent implantation. The CYP2C19*2 allele is the most important genetic variant determining response to CLP. We aim to investigate frequency of CYP2C19*2 polymorphism in patients with ACS and significance for the individual response to CLP therapy. The preliminary data of a study including a total of 120 patients with ACS undergoing PCI with stent placement and treated with dual antiplatelet therapy (CLP and Aspirin) are presented. So far 18 patients (41-81 year age) are tested for CYP2C19*l/*2 polymorphisms. The genotype CYP2C19*1/*1; CYP2C19*l/*2 and CYP2C19*2/*2 is demonstrated in 50%, 33%, 17% respectively, of the patients. The established frequency of CYP2C 19*2 allele (33%) is significantly higher (x2=5.220; p=0.022) than in healthy Bulgarian individuals (16%). In-stent thrombosis have developed 3 (17%) of patients: 2 are C YP2C19* l/*2 carriers, and 1 - homozygous CYP2C19*2/*2. The preliminary data demonstrate high prevalence of CYP2C19*2 polymorphism in patients with ACS and point to significance of the variant for CLP therapy. Further extension of the study with larger samples and monitoring of the patients are required to determine the effects of the polymorphism on the prognosis for major adverse cardiovascular events. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0010 https://doi.org/10.1515/jbcr-2016-0010 https://jbcr.arphahub.com/article/34420/ https://jbcr.arphahub.com/article/34420/download/pdf/ en

10.1515/jbcr-2016-0011 2016-09-30 jbcr

Alterations in Platelet Activity and Elastic Modulus of Healthy Subjects, Carriers of G20210A Polymorphism in the Prothrombin Gene Komsa-Penkova,Regina Todinova,Svetla Andreeva,Tonya Krumova,Sashka Taneva,Stefka Golemanov,Georgi platelet activity elasticity modulus G20210A polymorphism Journal of Biomedical and Clinical Research 9(1): 72-79 Platelet activation is a complex process in which platelet reorganization takes place associated with changes in the cell shape, topology, membrane elasticity and microparticle production. The aim of this study was to investigate the changes/aberrations in the platelet activity, elasticity and morphology in healthy subjects, carriers of A allele of prothrombin G20210A polymorphism. Blood samples from 18 healthy subjects were used for platelet analysis by force-mode atomic force microscopy. Restriction analysis was used to investigate the carriage of G20210A polymorphism in the prothrombin gene. Flow- cytometry was applied to evaluate platelet activation. Young’s modulus of the plasma membranes of platelets derived from healthy subjects, carriers of variant A allele of prothrombin 20210G>A polymorphism (407±69 kPa) is two times higher than the one determined for non­carriers (195.4±48.7 kPa; pA polymorphism (5.0%) than in non-carriers (1.3%). Platelets isolated from healthy carriers of variant A allele of prothrombin 20210G>A polymorphism exhibited a higher level of activity and a higher degree of stiffness at the stage of spreading as compared to platelets from non­carriers. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0011 https://doi.org/10.1515/jbcr-2016-0011 https://jbcr.arphahub.com/article/34421/ https://jbcr.arphahub.com/article/34421/download/pdf/ en

10.1515/jbcr-2016-0012 2016-09-30 jbcr

Ovarian Brenner Tumors Revisited: Do We Have Space for Malignant Tumorsvand Methanol Ivanova,Vesela Karaivanov,Milen Dikov,Tihomir borderline/atypical proliferative Brenner tumor histology immunohistochemistry Journal of Biomedical and Clinical Research 9(1): 80-84 We present a case of a 75-year-old female who underwent a total abdominal hysterectomy with bilateral salpingooophorectomy for an ovarian tumor. Hematoxylin-eosin- stained slides from tumor specimen revealed 1) focci of benign Brenner tumor; 2) mucinous cysts and 3) intracystic papillary projections resembling low-grade papillary transitional cell carcinoma (Grade 1-2) with squamous differentiation and comedo-type necrosis; 4) focal areas resembling noninvasive papillary transitional cell carcinoma Grade 3. Immunohistochemical investigation with a panel of antibodies (p63, p53, Ki-67, Wilms Tumor 1 - WT1, pi 6) was initiated. Areas resembling urothelial carcinoma showed diffuse nuclear positive reaction for p63 and wild-type expression of p53. Ki-67-nuclear positivity varied from less than 5% up to 30% in areas resembling high-grade urothelial carcinoma. WT1 expression was not seen. Weak but still exceeding background staining was observed in predominantly cytoplasmic fashion with few scattered positive nuclei in transitional cell nest of the benign component. No reactivity, however, was seen within the proliferative component. The histopathological diagnosis was a borderline/atypical proliferative Brenner tumor. The patient has been regularly followed up and is at present disease-free 5 years after diagnosis. In this paper, the authors describe the morphological characteristics of Brenner tumors and address some debatable issues in the light of recent immunohistochemical and molecular studies. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Case Report text/html info:doi:10.1515/jbcr-2016-0012 https://doi.org/10.1515/jbcr-2016-0012 https://jbcr.arphahub.com/article/34422/ https://jbcr.arphahub.com/article/34422/download/pdf/ en

10.1515/jbcr-2016-0013 2016-09-30 jbcr

Well-Differentiated Liposarcoma of The Larynx: A Case Report and Review of Literature Mateva,Svetlana Nikolova,Margarita Valkov,Alexandar Nikolova,Margarita liposarcoma larynx well-differentiated Journal of Biomedical and Clinical Research 9(1): 85-89 Liposarcoma is one of the most common soft tissue sarcomas in adults with a relative incidence amongst other sarcomas ranging from 9.8% to 16%. It usually locates in the limbs and retroperitoneum. Primary liposarcomas of the larynx and hypopharynx are rare, comprising less than 20% of all head and neck liposarcomas. According to World Health Organization, these tumors are divided into four histologic types, and well-differentiated liposarcoma is the most common one. It is a tumor of low-grade malignancy that may recur locally, but does not metastasize. We present a case of laryngopharyngeal well- differentiated liposarcoma in an old patient with two previous removals. We also discuss recently published cases with this unusual location of liposarcoma. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Case Report text/html info:doi:10.1515/jbcr-2016-0013 https://doi.org/10.1515/jbcr-2016-0013 https://jbcr.arphahub.com/article/34423/ https://jbcr.arphahub.com/article/34423/download/pdf/ en

10.1515/jbcr-2016-0027 2016-12-31 jbcr

Erratum. Ovarian Brenner Tumors Revisited: Do We Have Space for Malignant Tumors? Ivanova,Vesela Karaivanov,Milen Dikov,Tihomir Journal of Biomedical and Clinical Research 9(2): 1-1 info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Corrigenda text/html info:doi:10.1515/jbcr-2016-0027 https://doi.org/10.1515/jbcr-2016-0027 https://jbcr.arphahub.com/article/34424/ https://jbcr.arphahub.com/article/34424/download/pdf/ en

10.1515/jbcr-2016-0014 2016-12-31 jbcr

Approaches for Health Technology Assessment in Europe: Situational Analysis Djambazov,Slaveyko Vekov,Toni health technology assessment cost effectiveness HTAagencies agencies forНТА Journal of Biomedical and Clinical Research 9(2): 101-106 Health technology assessment (HTA) isaprocess, which should answer the question“Isagiven health technology/medication worth its price for the value it provides?” In the spirit of the amendments to the Bulgarian Health Insurance Act and institutionalization of HTA, our team prepared this situational evaluation aiming to throw light on the practices and approaches to HTAin European countries. As awhole,we can identify two types of agencies that perform it: those servicing the population of an entire nation oraregion, and those working at the level of hospitals oranetwork of hospitals. All the agencies studied have two common characteristics. First, they were created withanon-profit purpose and second, all of them are financed by public funds inavariety of ways. It also becomes clear from the comparative analysis performed that the ways HTAis conducted in Europe differ from country to country. Irrespective of the variations, the common aspiration is that the value forapatient, to which the approved health technologies contribute, should be greater than the price to be paid for them. Bulgaria is may be the last EUstate to implement HTAin its domestic legislation and this also gives the advantage of having and using the experience of the other countries. Establishing an independent structure, which is appointed to prepare local health technologies assessment would result in transparent decision-making, participation of all concerned parties and optimization of the budget for medicines regarding the effectiveness/benefit ratio, as well as expenses. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Review Article text/html info:doi:10.1515/jbcr-2016-0014 https://doi.org/10.1515/jbcr-2016-0014 https://jbcr.arphahub.com/article/34426/ https://jbcr.arphahub.com/article/34426/download/pdf/ en

10.1515/jbcr-2016-0015 2016-12-31 jbcr

Improving the Inhalation Technique in Patients with Obstructive Pulmonary Diseases Ivanova,Zlatina Kyuchukov,Nikolay Krachunov,Iliya Yanev,Nikolay Glogovska,Pavlina Pavlov,Plamen inhaler obstructive diseases drug misuse Journal of Biomedical and Clinical Research 9(2): 107-113 The study aimed to assess the inhalation technique of patients with bronchial asthma/chronic obstructive pulmonary disease (COPD) via an objective method and to evaluate the effect of training in patients with incorrect technique. Тhe inhalation technique of 120 patients with obstructive pulmonary disease was tested. The patients were divided into two groups: using metered dose inhalers (MDI) - 34 patients (28%) and dry powered inhalers (DPI) - 86 patients (72%). The most frequent mistakes in the MDIgroup were short duration of the inhalation (55.88%) and bad synchronization between activating the canister and the inhalation (29.41%). For the DPIgroup, the inhalation was not forceful enough (48.84%) and the short duration of the inhalation (12.79%). Patients claiming to have good inhalation technique accounted for 97%of those in the MDIgroup, and 96.5%of those in the DPIgroup. There were two patients (5.88%) with correct inhalation technique in the MDIgroup at their first attempt, and 31 patients (36.05%) in the DPIgroup. We found that in the MDIgroup there wasasignificant reduction in the number of mistakes (p info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0015 https://doi.org/10.1515/jbcr-2016-0015 https://jbcr.arphahub.com/article/34427/ https://jbcr.arphahub.com/article/34427/download/pdf/ en

10.1515/jbcr-2016-0016 2016-12-31 jbcr

Matrix Metalloproteinase Mmp-2 and Mmp-9 Activities in Seminal Plasma Ayvazova,Nina Rilcheva,Violeta Konova,Emiliana Roussev,Roumen Rashev,Pavel sperm quality parameters infertility DNAdamage Journal of Biomedical and Clinical Research 9(2): 114-120 Matrix metalloproteinases (MMPs) areagroup of proteases containing Zn ions asacofactor, which are involved in degrading ofalarge number of extracellular matrix proteins, and bioactive molecules. They also playamajor role in processes such as cell proliferation, cell migration, differentiation and apoptosis. Very little is known about the expression and function of MMPs in the male reproductive tract. Occurrence of MMP-2 and MMP-9 activity in human seminal plasma has been previously reported but their origin and function are still not fully understood. The aim of this study was to examine the presence of MMP-2 and MMP-9 in normal and abnormal human sperm samples and find if any correlation existed between the levels of expression of MMPs and fertilization potential of the spermatozoa. Human spermsamples were examined for the presence of MMP-2 and MMP-9 by gel zymography and western blot analysis. A DNAfragmentation test was performed. The samples were divided into two groups - samples with normozoospermia and teratozoospermia. The gelatin zymography showed gelatinolytic bands with molecular weight 64 and 72 k Da corresponding to active and inactive form of MMP-2. MMP-9 was not detected. The MMP-2 enzymatic activity appeared to be much higher in samples with compromised sperm morphology as compared to the normozoospermic samples. The mean DNAfragmentation index (DFI) of the group with teratozoospermia was relatively higher (22.16%) and over the upper reference limits, compared to the normozoospermic group, in which it was within the normal range (17.26%). info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0016 https://doi.org/10.1515/jbcr-2016-0016 https://jbcr.arphahub.com/article/34428/ https://jbcr.arphahub.com/article/34428/download/pdf/ en

10.1515/jbcr-2016-0017 2016-12-31 jbcr

Diagnostic and Prognostic Potential of Oxidative Stress Markers in Adults with Immune Thrombocytopenia Bogdanov,Lachezar Alexandrova,Margarita Atanasova,Milena Tzvetkov,Nikolay immune thrombocytopenia oxidative stress vanin-1 lipid hydroperoxides Journal of Biomedical and Clinical Research 9(2): 121-125 Immune thrombocytopenia (ІTP) is one of the most common causes of clinically overt hemorrhage. Despite the progress made in recent years in clarifying the pathogenesis of the disease, the exact unlockmechanisms still remain unclear. The aim of the study was to correlate the oxidative stress markers and the severity of immune thrombocytopenia in adults and to investigate their predictive value of transforming the acute formof ITPinto chronicІTP.We studiedatotal of 58 subjects (14 patients with newly diagnosedІTP, 13 patients with chronic form ofІTR, and 31 controls). The plasma levels of human pantetheinase ( vanin-1) and lipid hydroperoxides were measured using commercial assay kits.We found that the form of the disease was not significantly related to the plasma vanin-1 levels (p=0.120). Asignificant difference in the vanin-1concentrations was observed between newly diagnosed IPTand the controls (p=0.046). Further studies with larger and more homogenous groups of patients and including more indicators of oxidative stress are needed to be able to draw statistically valid conclusions about the role of oxidative biomarkers in diagnosing and treatment ofІTP. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0017 https://doi.org/10.1515/jbcr-2016-0017 https://jbcr.arphahub.com/article/34429/ https://jbcr.arphahub.com/article/34429/download/pdf/ en

10.1515/jbcr-2016-0018 2016-12-31 jbcr

Diagnostic Value of Tru-Cut Biopsy in Diagnosing Breast Lesions Dimitrov,Dobromir Karamanliev,Martin Deliyski,Tashko Gabarski,Anislav Vatov,Petar Gencheva,Ruzha tru-cut biopsy core needle biopsy breast lesions Journal of Biomedical and Clinical Research 9(2): 126-129 Breast cancer is the most common cancer in women worldwide. The standard for detecting it includes clinical exam, mammography and fine-needle aspiration cytology. Our aim was to establish the role of the tru-cut biopsy in the diagnosis of malignant breast lesions. We provideatwo-year retrospective clinical study defining 98.67%sensitivity, 100%specificity, 100%positive predictive value, 80%negative predictive value and an overall diagnostic accuracy of 98.73%. In 89.1%of the malignant lesions, the sample was adequate to define the receptor status. Therefore, tru-cut biopsy is an easy, cheap, safe and accurate alternative to fine-needle aspiration cytology in the diagnosis of breast lesions. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0018 https://doi.org/10.1515/jbcr-2016-0018 https://jbcr.arphahub.com/article/34430/ https://jbcr.arphahub.com/article/34430/download/pdf/ en

10.1515/jbcr-2016-0019 2016-12-31 jbcr

Demographic Changes in the Population of Bulgaria as Challenges for Anaesthesiologists Radev,Vladimir Radev,Radko Arabadzhieva,Daniela Petrov,Vladin Kolev,Nikolay Geriatric anesthesiology Bulgarian demographics descriptive statistic Journal of Biomedical and Clinical Research 9(2): 130-133 In the past two decades, the demographic crisis in Bulgaria has been widely debated. According to the National Statistical Institute (NSI), the proportion of people aged 65 and over is increasing, despite the general population decline in the country. To investigate whether the age structure of patients operated on has changed during the past 10 years and assess the need to reorganize the training of anesthetists,aretrospective study in the anesthesia electronic database of the University Hospital in Rouse was carried out. The data of anesthesia performed by anesthesiologists in 2005, 2010 and 2015 in patients aged 65 and over were summarized. The distribution of these patients by ASA Physical Classification System and frequency of complications during anesthesia were analyzed. The average annual number of anaesthesias for the three years was almost unchanged and amounted to about 5500. The proportion of patients aged 65 and over increased from 30.54%in 2005 to 35.72%in 2010, and 37.81%in 2015. The distribution of patients in according to the ASA Classification changed significantly: the percentage of patients ASAI-IIdropped from 36.19%in 2005 to 11.85%in 2015. The patients in the ASA III-IVgroups for the three analyzed years was 41.86%, 58.66%and 65.30%, respectively, and this was mainly due to the increase in the ASAIVpatients. It is necessary to build multidisciplinary teams and prepare specialized protocols for behavior in geriatric patients. It is imperative that anesthesiologists possess specialized knowledge about age-related organ changes and their effects on anesthesia. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0019 https://doi.org/10.1515/jbcr-2016-0019 https://jbcr.arphahub.com/article/34431/ https://jbcr.arphahub.com/article/34431/download/pdf/ en

10.1515/jbcr-2016-0020 2016-12-31 jbcr

Prevalence of HPV16 IgG Antibody and Rt-Pcr DNAdetection in Patients with Laryngeal Carcinoma and Cervical Dysplasia Nikolov,Georgi Karcheva,Milena Tsvetkov,Chavdar Valkov,Alexandar R.,Rashev Blazhev,Alexandar HPV prevalence HPV16-DNAdetection prophylaxis Journal of Biomedical and Clinical Research 9(2): 134-138 Human papillomaviruses (HPVs) are associated with the most common sexually transmitted infections. It is well documented that high-risk (HR)-HPVtypes are etiologically associated with some cancers. The aim of the study was to investigate HPV16-DNApositivity and prevalence of Ig Gantibody against HPV16 in patients with laryngeal carcinoma and precancerous lesions of cervix uteri in Pleven region, Bulgaria. Material/Methods: We performedacross-sectional study and investigated clinical materials. Attached is real-time PCR-analysis for detection of HPV16-DNA. HPVspecific antibody response by enzyme-linked immunosorbent assay (ELISA) test for detection and quantification of specific Ig Gantibodies in serum were used. Results: For the six-month period, 30 samples were collected and tested. Fourteen of them were found in patients with carcinoma of the larynx and sixteen - in patients with various lesions of cervix uteri.We found that six patients (42.8%) in the first group and eight patients (50%) in the second group were HPV16-DNA-positive. Different age groups were affected. The sera analyzed in this study showed that seven patients (50%) with carcinoma of the larynx were seropositive of whom four (57%) were males. Fourteen of the females with dysplasia (88%) were seropositive. Matching DNApositivity and antibody response were found in 29%of the patients with laryngeal cancer. The match was found in 50%of the females with cervical dysplasia. Conclusions: Real-time PCRisarapid, cost-effective method for detection of HPVs.Ahigh level of seropositivity was found in the two groups of patients. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0020 https://doi.org/10.1515/jbcr-2016-0020 https://jbcr.arphahub.com/article/34433/ https://jbcr.arphahub.com/article/34433/download/pdf/ en

10.1515/jbcr-2016-0021 2016-12-31 jbcr

Sensitization to Aeroallergens in Pediatric Patients with Allergic Rhinitis and Asthma Balgaranov,Nikolay Nikolov,Lachezar Kolarova-Yaneva,Nadia Nedkova,Vania Tabakova,Kristina Donev,Viktor sensitization allergens child asthma in children allergic rhinitis Journal of Biomedical and Clinical Research 9(2): 139-144 Asthma and allergic rhinitis are common in childhood. Establishing sensitization to aeroallergens is crucial to effectively prevent exacerbation of these respiratory allergic diseases. The study aimed to evaluate sensitization to the most common aeroallergens in children with asthma and allergic rhinitis.We establishedacorrelation between patients sensitized to indoor, outdoor and simultaneously to both allergens. The study population consisted of 276 patients (168 boys and 108 girls) ages 4 to 16 years with asthma (A) and allergic rhinitis (AR). Skin prick tests were performed with 21 commercial allergen extracts: pollens, mites, epithelia and insects, and molds. We found that 217 patients were sensitized to at least one aeroallergen: 117 patients hadapositive result to mites, 92 to pollens, 72 to epithelia and insects, and 63 - to mold allergens. Dermatophagoides pteronyssinus was the most prevalent aeroallergen. Sensitized only to indoor allergens were 104 patients, 60 - only to outdoor allergens, and 53 were sensitized to both. Mites were the most frequent aeroallergens in children with Aand AR. Lately there has been foundasignificant increase in rates of sensitization to mold allergens, especially to Alternaria alternata. Our study has confirmed the dominant role of indoor allergens in children with respiratory allergic diseases. info:eu-repo/semantics/altIdentifier/eissn/1313-9053 info:eu-repo/semantics/altIdentifier/pissn/1313-6917 info:eu-repo/semantics/openAccess CC BY-NC-ND 4.0 Medical University - Pleven 2016 Research Article text/html info:doi:10.1515/jbcr-2016-0021 https://doi.org/10.1515/jbcr-2016-0021 https://jbcr.arphahub.com/article/34434/ https://jbcr.arphahub.com/article/34434/download/pdf/ en cGFnZT0xJnNldD1qYmNyJmZyb209JnVudGlsPSZtZXRhZGF0YV9wcmVmaXg9b2FpX2Rj