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Open access

Galya D. Chamova and Georgi M. Sarov

Summary

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.

Open access

Monika Pędracka and Jacek Gawłowicz

Summary

Introduction. The treatment of epilepsy is still a major challenge. Despite the introduction of many new antiepileptic drugs, approximately 30% of patients still remain drug resistant. In the absence of a satisfactory therapy outcome, which is sometimes associated with numerous side effects, there is a need for new and effective drugs with low toxicity. Cannabinoids have been shown in preliminary animal model studies and in studies of patients with epilepsy to have antiepileptic activity.

Aim. The aim of this paper is to review current reports on the role of the endocannabinoid system and cannabinoids in the treatment of epilepsy.

Methods. Articles from PubMed and Scopus published up to 2015 concerning the role of cannabinoids and the endocannabinoid system in the treatment of epilepsy are reviewed.

Review and Discussion. Cannabis has been used for thousands of years in the treatment of various diseases. They contain cannabinoids, which act on the endocannabinoid system which regulates many biochemical and physiological processes. By affecting glutamate and gamma-aminobutyric acid (GABA) neurotransmission cannabinoids have the ability to affect seizure threshold. The best known cannabinoid is cannabidiol, which inhibits the occurrence of seizures without causing significant side effects in humans and animals. However, only a small number of double blind, randomized and placebo controlled studies have been published to date.

Conclusions. The role of cannabinoids in the treatment of epilepsy is not well defined because these substances have shown pro-convulsive actions in some animal studies and also there are not many randomized trials performed to date. The existing human data do not support the conclusion that cannabinoids are effective and safe in the treatment of epilepsy, but do encourage further studies on a larger group of patients.

Open access

Athanasios Covanis

Open access

Snezhana V. Murgova and Chavdar B. Balabanov

Summary

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.

Open access

Angelika S. Velkova and Paulina H. Kirova

Summary

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.

Open access

Athanasios Covanis

Summary

Introduction. Eyelid myoclonia and absences (ELMA) was first described by Jeavons in 1977 as a separate type of photosensitive epilepsy.

Aim and method. The aim is to consider the updated electro-clinical pathophysiology and to discuss terminology, classification and differential diagnosis. The review includes our own research and relevant papers on the subject of Jeavons syndrome (JS).

Review and differential diagnosis. Definition: Jeavons syndrome is a generalized idiopathic (genetic) epilepsy syndrome (IGE) characterized by eyelid myoclonia, other seizures (absences, myoclonic and or generalized tonic-clonic) and EEG paroxysms induced by voluntary or on command eye closure, in the light and photosensitivity. Demographical data: The prevalence of JS has been reported to vary from 7.3% to 12.9% among idiopathic generalized epilepsies and 2.5% to 2.7% among all patients with epileptic disorders.

Etiology: JS, as is the case for all idiopathic generalized epilepsies, is genetic and the familial preponderance and concordance is high. Pathophysiology: Three factors are important in order for JS to manifest clinically; the genetic predisposition, the voluntary or on command eye closure and the light input. Clinical forms of JS: we have identified four forms of JS; early onset (< 4 years), mild form, classical form and an ELMA-JME form. Diagnosis: the diagnosis of JS is based on the history, clinical observation and provocation and the confirmation with an EEG. Differential diagnosis: is easily made from tics, other idiopathic generalized or focal cryptogenic/symptomatic epilepsies.

Conclusion. JS is characterized by unique electro-clinical features evoked by voluntary or on command eye closure in the light and photosensitivity.

Open access

Sergiusz Jóźwiak and Katarzyna Kotulska

Open access

Maya D. Markova, Irina V. Chakarova, Ralitsa S. Zhivkova, Venera P. Nikolova, Valentina P. Hadzhinesheva and Stefka M. Delimitreva

Summary

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.

Open access

Doroteya V. Malinova, Penka L. Kolova and Radoslav I. Georgiev

Summary

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.