Savelina L. Popovska, Tereza B. Dineva and Polina D. Damyanova
Lung cancer is still the leading cancer-related cause of death with a high incidence rate in the whole world. Treatment options – surgery, radiotherapy, and chemotherapy, depending on the stage of the disease. During the last decade, many molecular alterations were discovered that led to impressive changes in treatment. Personalized approaches, including target therapies with specific inhibitor drugs, became a part of the standard therapies. This article reviews current molecular biomarkers used in clinical practice to treat lung cancer patients.
Vanya S. Popova, Svetla O. Blajeva, Margarita L. Alexandrova, Tsvetan H. Lukanov, Silvia Y. Naneva and Nikolay T. Tzvetkov
Chronic lymphocytic leukemia is one of the most common types of leukemia in adults. It belongs to the group of indolent lymphoproliferative disorders and has a slow clinical course. Approximately 50% of newly diagnosed patients do not require treatment for years. A better understanding of the pathophysiology of the disease has led to the development of models for assessment of the risk.
Our study aimed to evaluate the prognostic significance of the serum marker beta-2 microglobulin (82M) and the flow cytometric marker CD49d in patients with early-stage of B-chronic lymphocytic leukemia (B-CLL) as well as look for a correlation between CD 49d and the early stages of the disease. For this purpose, analysis of 30 untreated patients with known and newly diagnosed B-CLL was carried out. The following methods were used: documentary, flow cytometric analysis of peripheral blood, Rai staging system and chi-square test of independence (Fisher’s Exact Test). The results from our study showed that a small number of patients in the early stage of the disease have high levels of CD49d expression and beta-2 microglobulins. In eight of 29 patients, the flow cytometric marker was higher than 30%, and in ten out of 29 patients, the B2M was above the reference range. No significant correlation between the two markers in early stage B-CLL patients was found.
Paulina Tr. Vladova, Sergey D. Iliev and Savelina L. Popovska
According to the consensus and the recommendations of the European Neuroendocrine Tumor Society (ENETS), the frequency of appendicular neuroendocrine tumors (NETs) is 0.15-0.6/100 000 a year. They are found a little more often in women aged between 40 and 50. Neuroendocrine neoplasms of the appendix are about 30 to 80% of all appendicular tumors. Their evolution is usually asymptomatic. They are diagnosed accidentally during a conventional or laparoscopic appendectomy. In the past, the surgical approach used to depend on the localization of the tumor. Currently, its localization is not a significant factor in the choice of a surgical approach. Our purpose wass to present the consensus guideline and the recommendations of ENETS 2017 for surgical procedures in neuroendocrine neoplasms of the appendix and analyze the difference in the survival rate in different surgical interventions. The literature overview includes studies on surgical treatment of neuroendocrine neoplasms of the appendix and takes into consideration the last consensus guideline of ENETS 2017 on the topic. ENETS recommends a simple appendectomy in well- differentiated appendix tumors smaller than 2 cm, regardless of their localization. Right hemicolectomy is performed for in tumors sized between 1 cm and 2 cm with positive resection lines, with deep mesoappendiceal invasion, high proliferation activity (G2) and vascular invasion. For tumors over larger than 2 cm – right hemicolectomy is recommended. Although current studies have pointed out no significant differences in survival rates between appendectomy for neuroendocrine neoplasms of the appendix and right hemicolectomy, ENETS 2017 suggests that the latest consensus guidelines should be followed.
Gergana N. Sandeva, Rositsa P. Deliradeva and Pavlina L. Gidikova
Assessment of work ability is an important aspect of occupational medical services, the main goal being to maintain employees’ health, well-being and efficiency. The aim of the study was to evaluate and compare the work ability of workers employed by two machinery factories. We used the Work Ability Index (WAI) questionnaire to assess 165 workers of an iron casting factory A and 166 workers in a press-forging plant B. The data obtained were evaluated and compared based on gender, age, length of service and occupation. Mean WAI for the two factories were almost identical (43.3±4.9 for Factory A and 43.3±4.6 for Factory B), both indicating good overall work ability. The lowest mean WAI (37.7) was registered for the crane operators from Factory B, and the highest (47.2) - for the molders in Factory A. The female production workers in Factory A had a significantly lower WAI as compared to their male counterparts (p=0.001). WAI also varied significantly between different age groups and occupations in the two plants. Significant negative correlations were found between work ability and length of service, as well as between psychological resources and gender (Factory A) and the length of service (Factory B). WAI is a useful tool in finding vulnerable workers who need more attention from occupational health specialists.
Joana I. Simeonova, Snejanka T. Tisheva-Gospodinova, Yoana M. Todorova, Petkana A. Hristova, Asia N. Yanakieva and Martin I. Hristov
The aim of the cross-sectional study was to estimate the absolute 10-year risk for fatal cardiovascular disease (CVD) in patients with hypertension by Systematic Coronary Risk Estimation (SCORE). The study was carried out in 2016 as part of Project No 4/2016. Ninety-one patients aged 40-89 years were included. The mean age of the sample was 66.0±11.0, and 44.0% were males. Information of the patients’ risk profile included about age, gender, blood pressure, smoking and total cholesterol. The patients with hypertension were stratified according to a 10-year absolute risk of CVD. Data were processed by Statistical Package for Social Science versions 19.0 (SPSS.v.19.0). Over two-thirds of the patients had 1 stage hypertension (31.9%) and 2 stage hypertension (37.4%). Median systolic blood pressure on admission to the clinics was 160 mg Hg, and median diastolic blood pressure was 90 mm Hg. Total serum cholesterol values exceeded 4.9 mmol/L in 64.0% of the patients. Smokers accounted for about one-fourth of the patients, most of them having smoked for 40 years. The mean number of risk factors for CVD was 3.0. Over 65% of the patients were found to be at a very high 10-year absolute risk of fatal CVD by SCORE. Cardiovascular risk assessment has important role in prevention of morbidity, premature death and disability of CVD.
Armine V. Grigoryan, Aneliya A. Dimitrova, Krasimir G. Kostov, Adelaida L. Russeva, Milena A. Atanasova, Alexander B. Blagev, Tatyana M. Betova and Radoslav G. Trifonov
Osteoporosis is a systemic skeletal disease characterized by decreased bone mass, destruction of the microarchitectonics of bone structure and a high risk for fracture. One of the criteria for altered bone homeostasis includes the changes in serum levels of alkaline phosphatase (ALP) and the activity of matrix metalloproteinases (MMPs). The purpose of this study was to determine the serum concentrations of calcium (Ca2+), phosphorus (P), magnesium (Mg2+), alkaline phosphatase (ALP) and MMP-9 in ovariectomized rats. We used 35 female Wistar rats at reproductive age (2 months) divided into 2 groups: a control group (G1-SHAM) – 20 animals subjected to “false” ovariectomy and placebo-operation, and an ovariectomized group (G2-OVX) – 15 animals subjected to bilateral ovariectomy. Blood was collected from the abdominal aorta for testing levels of Ca2 +, P, Mg2+, ALP and MMP-9. No statistically significant differences in serum concentrations of Ca2+, P and Mg2+ were found between G2 and G1 (p>0.05). The values of ALP and MMP-9 in rats of G2 were statistically significantly increased, as compared to G1 (p<0.05). The serum activity of ALP, which is a marker for bone formation, was increased in OVX-induced osteoporosis. Elevated serum MMP-9 levels in G2 confirmed the hypothesis that it is a marker for osteoclast activity.
Eleven retired sportsmen, who had a career in contact sports (three boxers, four footballers, four wrestlers) and one cyclist with a history of several falls from a bicycle and had been diagnosed with a cerebrovascular trauma, were investigated with auditory cognitive P300. The age range was aged between 26 and 63 years. Ten out of the twelve presented cognitive wave latency between 512 msec and 928 msec. This finding made us conclude that repetitive minor head injuries (mHI) that they inevitably had experienced during their carrier has led to cognitive problems in older age.
Tatyana M. Betova, Savelina L. Popovska, Radoslav G. Trifonov, Konstantina S. Karakadieva, Genoveva B. Valcheva and Lachezar S. Tanchev
Desmoid-type fibromatosis is a rare mesenchymal neoplasm with locally aggressive, infiltrating and destructive growth that is not characterized by a metastatic potential. According to their anatomical position, desmoid-type fibromatoses can be divided into three groups: extra-abdominal, intra-abdominal, and fibromatoses of the abdominal wall. Mesenteric fibromatoses account for 8% of the intra-abdominal ones. The latter are characterized by myofibroblastic proliferation and infiltration of both the pelvic and abdominal organs. We report a 26-year-old woman who complained of abdominal enlargement, feeling of heaviness, discomfort and reflux, which symptoms dated back 1-2 months prior to hospitalization. The patient underwent laparotomy due to subocclusive symptoms. Intraoperatively, a tumor sized 30 cm in diameter was found. The tumor originated from the mesentery and infiltrated in the jejunum, the entire ileum, and part of the caecum with perforation towards the abdominal cavity. The histological and immunohistochemical examinations are important for clarification of the diagnosis. The treatment requires a multidisciplinary approach, in which the surgical method has the key role.
Rumyana N. Kuzmanova, Irina Ts. Stefanova and Katerina I. Stambolieva
In recent years focus has been increasingly placed on impulse control disorders (ICDs) in patients with Parkinson’s disease (PD). ICDs include pathological attraction to gambling, compulsive shopping, compulsive eating and compulsive sexual behaviour and are associated mostly with the intake of dopamine agonists. Another impulsive and compulsive behaviour in PD is the dopamine dysregulation syndrome, which is associated with compulsive intake of L-dopa, and short-acting dopamine agonists. Diagnostics and prevention of this group of disorders is essential, considering the difficulties related to their treatment and their negative impact on the patients themselves as well as on their relatives.
Tihomir P. Totev, Grigor A. Gorchev, Slavcho T. Tomov, Ina D. Filipova and Nadezhda H. Hinkova
The presence of functioning endometrial glands and stroma outside the uterine cavity is defined as endometriosis. Its incidence is approximately 10-15% of women of fertile age. Incisional endometriosis following obstetric or gynecologic surgery is reported in 0.03-1.08% of women. Most of the cases reported in the literature are related to caesarean section and have required a differential diagnosis with a hernia, abscess, granuloma or lipoma. The diagnosis is based on histological findings. We describe incisional endometriosis in four patients operated on at St. Marina Hospital – Pleven for one year.