Colorectal cancer in pregnant women is rare and represents a diagnostic and therapeutic challenge for clinicians. We present a case of a 38-year-old pregnant woman, diagnosed with colorectal cancer and liver metastases during the 29th week of gestation. After clinical evaluation and making the diagnosis, the patient underwent an emergency cesarean section (C-section) and bypass anastomosis between the transverse colon and sigmoid colon. The babies were born healthy without any complications. After recovery, the mother started treatment with chemotherapy, but two months later she died due to the spread of the disease. Cancer during pregnancy is always a challenge for diagnosis and treatment.
With time, medical and pharmaceutical research has advanced significantly. However, one of the major issues is how to administer the active substance. Among these, it counts over- or under-dosage of the active substance, low response to treatment, or increased clinical risk of the patient. An innovative method able to avoid these obstacles is represented by controlled release systems for active substances. The interest for these systems came with allowing encapsulation in the antibiotic release matrices, local anesthetics, protein or other substances. Moreover, a number of such vehicles are now available to release controlled substances used predominantly in the anesthesia and intensive care unit.
Detection of mutations in breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2) gene is an effective method of early diagnosis and prevention of breast cancer (BC). The mutational spectrum of both genes in Bulgarian population has not been studied in depth. The aim of this study was to investigate the prevalence of five deleterious BRCA1/2 point mutations in high-risk BC women, selected according to the National Comprehensive Cancer Network (NCCN) Guidelines including early age of onset, triple-negative BC and family history of breast or ovarian cancer. The prevalence of two BRCA1 mutations (C61G and 5382insC) and three BRCA2 mutations (6079del4, 9326insA and 9908delA) was evaluated in 80 females with BC, obtained from the Cancer Registry of University Hospital - Pleven. Genetic testing was performed by direct DNA sequencing. One deleterious mutation (5382insC in exon20 in BRCA1) was been found in two patients (2.5%). Both women were diagnosed with BC before age 45. The prevalence of BRCA mutations established in our study was lower than the one found in another preliminary study on Bulgarian population. We concluded that this discrepancy was due to the genetic heterogeneity of the population and the specific mutational spectrum of the BC patients from the Pleven region.
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.
Sedation and analgesia may be needed for many interventional or diagnostic procedures, whose number has grown exponentially lately. The American Society of Anesthesiologists introduced the term “procedural sedation and analgesia” (PSA) and clarified the terminology, moderate sedation and Monitored Anesthesia Care. This review tries to present a nondissociative sedation classification, following ASA guidelines as well as pre-procedural assessment and preparation, in order to choose the appropriate type and level of sedation, patient monitoring and agents, which are most commonly used for sedation and/or analgesia, along with their possible side effects. The paper also lists the possible complications associated with PSA and a few specific particularities of procedural sedation.
The objective of this study was to investigate the attitudes and expectations of fourth-year student nurses regarding their professional fulfillment after completing basic education. A questionnaire survey was carried out in six higher educational institutions in the Republic of Bulgaria - Pleven, Sofia, Varna, Stara Zagora, Plovdiv, and Ruse. Almost half of the students involved (114, 49.10%), planned to apply for a master’s degree in management of health care, and 62 (26.70%) preferred fulfillment abroad. Concerning the place of work, 80 (34.50%) of the respondents wished to specialize in surgical care. Of this latter group, 108 (46.60%) expressed the opinion that they would obtain excellent training in surgical units, and 62 (26.70%) expected to like the specificity of work in such units. The most significant influence on professional orientation in the area of surgical care of the future nurses was that of the tutors from the clinical bases - 90 (38.80%).
Pure and nitrogen-doped titanium dioxide (N-doped TiO2) photocatalysts were prepared by non-aqueous sol-gel method by means of the reaction between titanium (IV) chloride (TiCl4) and C6H5CH2 OH (benzyl alcohol), used as precursors and urea serving as a nitrogen source. The phase formation and short-range order of the resulting particles were characterized by X-ray powder diffraction (XRD) and infrared (IR) spectroscopy. The crystallite size of as-prepared composite powders was in the range 12-35 nm. The aim of this work was to investigate the efficiency of N-doped TiO2 as a photocatalyst in degradation of model organic pollutants - dyes Reactive Black 5 (RB5) and Malachite Green (MG), under ultraviolet (UV) and visible (Vis) irradiation. 0ur results indicated that synthesized N-TiO2 nanocomposites slightly improved the photocatalytic activity under UV irradiation, compared to the pure titanium dioxide (TiO2), and had no effect under Vis light illumination.
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.
Acute coronary syndromes are usually triggered by the erosion or rupture of a vulnerable coronary plaque. A vulnerable plaque (VP) is an atheromatous plaque which, after suffering different transformations, is prone to rupture causing an acute coronary event. Such a VP carries inside several biomarkers considered as “signatures of vulnerability”, which, if identified, can prompt timely initiation of therapeutic measures in order to prevent the development of an acute myocardial infarction. The most freqeuntly used techniques for identification of vulnerability markers are computed tomographic angiography (CTA), intravascular ultrasound and optical coherence tomography. Endothelial shear stress (ESS) represents a new promising biomarker associated with plaque vulnerability. Determination of ESS is nowadays possible using noninvasive imaging techniques, based on complex computational post-processing of multiple datasets extracted from CTA images and advanced computational fluid dynamics technologies. The aim of this systematic review was to evaluate the role of the coronary ESS, determined using advanced computational techniques for image post-processing, as a feature associated with CTA-derived biomarkers of atheromatous plaque vulnerability, underlining the conceptual differences between high ESS and low ESS as promotors of vulnerability.