Ivan P. Novakov, Delyan P. Delev, Svitlana Y. Bachurska and Dmitrii G. Staikov
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.
Savelina L. Popovska, Tatyana M. Betova and Кrasimir T. Petrov
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.
Joana I. Simeonova, Nevena V. Tzvetanova and Yanka I. Tzvetanova
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<0.05). Poorer family interactions (rare family dinners and no conversations about sex) determined acts of risk sexual behavior - accidental contraceptive use during sex and postponing an obstetric examination (p<0.05). Students reporting sexual coercion had also had frequent casual sexual intercourse (p<0.05). Identifying family factors is of essential importance in planning effective sexual health education at school.
Krassimira S. Yakimova, Rumen P. Nikolov, Ivan G. Todorov and Milen H. Hristov
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.
Georgi S. Slavov, Maria G. Manova, Anastasiya G. Trenova, Ivanka I. Kostadinova, Pavel I. Pavlov, Nonka G. Mateva and Zahari I. Zahariev
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).
Maria G. Ganeva, Tanya T. Gancheva, Ivan D. Baldaranov, Nataliya J. Kiriyak and Evgeniya H. Hristakieva
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.
Tihomir P. Totev, Svetlana A. Mateva, Margarita R. Nikolova and Grigor A. Gorchev
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.
Maya P. Danovska, Margarita L. Alexandrova and Irena I. Gencheva
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.
Savelina L. Popovska, Ivan N. Ivanov and Dorian Y. Dikov
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<0.00001). As chemotherapy is widely used in the treatment of breast carcinoma, pathologists should be aware of chemotherapy-induced changes in metastatic and in nonmetastatic ALNs.