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Cutaneous Manifestations of Brucellosis

References Marston JA. Report on fever-Malta. Army Medical Department Reports 1861. 1863;3:486-521. Bruce D. Note on the discovery of a microorganism in Malta fever. Practitioner, London. 1887;39:161-70. Bang B. Die Aetiologie des senchenhaften ("infectiosen") Verwerfens. leitschrift fur Tiermedicin. 1897;1:241-78. Bolognia JL, Braverman IM. Skin Manifestations of Internal Diseases; Brucellosis In: Anthony S., Fauci et al. Harrison's principles of internal

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Crohn’s Disease Ocular Manifestations

References 1 . Hindryckx, P. et al. Clinical trials in luminal Crohn’s disease: A historical perspective. - J. Crohns. Colitis, 2014, May 16, pii: S1873-9946 (14) 00152-4. 2 . Burgdorf , W. Cutaneous manifestations of Crohn’s disease. - J. Am. Acad. Dermatol., 5, 1981, 689. 3 . Wakefield, A. J., A. M. Sawyerr et A. P. Dhillon. Pathogenesis of Crohn’s disease: multifocal gastrointestinal infarction. - Lancet, 2, 1989, (8671), 1057-1062. 4 . Bernstein, C. N. et al. The prevalence of

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Oral Manifestations of Celiac Disease

ABBREVIATIONS: CD - Celiac disease HLA DQ2 - Human leukocyte antigen DQ2 HLA DQ8 - Human leukocyte antigen DQ8 IgA - Immunoglobulin A IgG - Immunoglobulin G GIT - Gastrointestinal tract TTG - Tissue transglutaminase EMA - Endomysial antibody RAS - Recurrent aphthous stomatitis AIDS - Acquired immune deficiency Syndrome REFERENCES 1. Rashid M, Zarkadas M, Anca A LH. Oral manifestations of celiac disease. A case report and review of the literature. Can Dent Assoc 2010; 77: 1–6. 2. Gujral N, Freeman HJ

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Neuropsichyatric Manifestations of Systemic Lupus Erythematosus: Diagnosis and Treatment Approach

clinical management of the neuropsychiatric manifestations of lupus. J Autoimmun 2016;74: 41-7. 12. Perricone C, Pendolino M, Olivieri M, Conti F, Valesini G, Alessandri C. Neuropsychiatric manifestations associated with anti-endothelial cell antibodies in systemic lupus erythematosus. Isr Med Assoc J 2015;17:171-8. 13. Gerosa M, Poletti B, Pregnolato F, et al. Antiglutamate receptor antibodies and cognitive impairment in primary antiphospholipid syndrome and systemic lupus erythematosus. Front Immunol 2016;7:5. 14

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Cutaneous Manifestations of Cystic Fibrosis

REFERENCES 1. Bernstein ML, McCusker MM, Grant-Kels JM. Cutaneous manifestations of cystic fibrosis. Pediatr Dermatol . 2008;25:150-157. 2. Strandvik B. Relation between essential fatty acid metabolism and gastrointestinal symptoms in cystic fibrosis. Acta Paediatr Scand Suppl . 1989;363:58-63. 3. Darmstadt GL, McGuire J, Ziboh VA. Malnutrition-associated rash of cystic fibrosis. Pediatr Dermatol . 2000;7:337-347. 4. Phillips RJ, Crock CM, Dillon MJ, et al. Cystic fibrosis presenting as kwashiorkor with florid skin rash. Arch Dis Child

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Analysis of the Differences Given by the Presence / Absence of Peripheral Manifestations of Ankylosing Spondylitis


Objectives. Our study aimed to compare to what extent the characteristics of patients with ankylosing spondylitis (AS) differ, depending on the presence / absence of peripheral manifestations of the disease.

Materials and method. We analyzed a batch of 124 patients admitted to the rheumatology clinics of two hospitals, with ankylosing spondylitis according to the modified New York criteria. All individual patient characteristics were documented from patient observation sheets. We divided the population into two groups: the P + group representing the patients with peripheral manifestations of arthritis or enthesitis (N = 56) and the P- group representing the patients without the peripheral manifestations (N = 68). Statistical processing was performed using IBM SPSS and Microsoft Excel.

Results. In the subtype of patients P+ the mean age was 45.14 14.16 years, and in the subtype P- mean age was 43.84 years 12.58 years. Gender distribution of patients in the two subgroups shows higher frequencies for patients without peripheral manifestations P- in both genders, respectively 55.4% in males and 52.2% in females. The highest frequencies were registered at the normal BMI of 18.5-24.9 in both sublots, respectively 51.8% for the P+ patients and 45.6% for the P- patients. The degree of activity of the disease, based on the ASDAS - CRP score, within both P + and P- subgroups, revealed a majority of patients with inactive disease (≤ 1.3). Within the P+ and P- sublots, most patients had the BASDAI index in the range 0-0.9, that is 67.9% of the patients in the P+ sublot and 64.7% of those in the P- sublot, respectively. This shows that the majority of patients in both subgroups had a good therapeutic response to biological treatment, with symptoms such as pain and / or fatigue absent or very low in intensity.

There were no statistically significant differences between the two subgroups.

Conclusion. Even though there were no major paraclinical differences between the patients with pure axial ankylosing spondylitis and patients with AS with peripheral manifestations, the patients with peripheral manifestations of the disease should be approached by a multidisciplinary team.

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Current aspects of polycystic ovary syndrome I: definition, pathophysiology, clinical manifestations, diagnosis and complications


Polycystic ovary syndrome (PCOS) is the most frequent endocrine disease among women with childbearing potential, the best-known cause of hirsutism, with a hypothesized prevalence of 8-22%. The first part of the paper discusses the conceptional evolution of the syndrome, from its description in 1935 by Stein and Leventhal till today. It describes the changes in the criteria systems, emphasizing that the Rotterdam criteria, proposed in 2003 by the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine, are still valid today. This system basically differs from earlier (1990) NIH-criteria in one aspect: it introduced two newer phenotypes, one without hyperandrogenism and the other with ovulatory cycles, so it distinguishes 4 phenotypes. The etiology and pathogenesis of PCOS is heterogeneous, multifactorial, poorly understood. We present the 3 leading hypotheses (1 - hypothalamo-hypophyseal disturbances, 2 – primary enzyme disorders in ovarian, or ovarian/adrenal steroidogenesis, resulting primarily in hyperactivity of 17alpha-hydroxylase/17,20-lyase, 3 – insulin resistance-hyperinsulinism and other metabolic dysfunctions). We emphasize the role of genetically determined hyperandrogenism, that of insulin resistance-hyperinsulinism and the importance of reinforcing each other. Subsequently, the aggravating aspects of the frequently associated metabolic syndrome are discussed, and then the effects of the mentioned pathological processes on the endocrine and other organ structures participating in the regulation of sexual functions. We stress the hypothetical role of perinatal and pubertal androgen exposition in the pathogenesis of PCOS. The mechanisms of anovulation and those of the endometrial lesions are discussed, too. The clinical manifestations, the paraclinical and laboratory examinations, the positive and differential diagnosis and the complications are also presented. We intend to deal with the therapeutic aspects of PCOS in an upcoming paper.

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Cutaneous Manifestations of Toxoplasmosis: a Case Report

. Mawhorter SD, Effron D, Blinkhorn R, Spagnuolo PJ. Cutaneous manifestations of toxoplasmosis. Clin Infect Dis 1992;14(5):1084-8. 9. Binazzi M. Profile of cutaneous toxoplasmosis. Int J Dermatol 1986;25(6):357-63. 10. Fong MY, Wong KT, Rohela M, Tan LH, Adeeba K, Lee YY, et al. Unusual manifestation of cutaneous toxoplasmosis in a HIV-positive patient. Trop Biomed 2010;27(3):447-50. 11. Rongioletti F, Delmonte S, Rebora A. Pityriasis lichenoides and acquired toxoplasmosis. Int J Dermatol 1999;38:372-4. 12. Lapetina F. Toxoplasmosis and

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Systemic Manifestations of Pseudoexfoliation

References 1. Schlotzer-Schrehardt U, Naumann GO: Ocular and systemic pseudoexfoliation syndrome. Am J Ophthalmol 2006; 141: 921-37. 2. Schlotzer-Schrehardt UM, Koca MR, Naumann GO, Volkholz H: Pseudoexfoliation syndrome. Ocular manifestation of a systemic disorder? Arch Ophthalmol 1992; 110: 1752-6. 3. Streeten BW, Li ZY, Wallace RN, Eagle RC Jr, Keshgegian AA: Pseudoexfoliative fibrillopathy in visceral organs of a patient with pseudoexfoliation syndrome. Arch Ophthalmol 1992; 110: 1757-62. 4

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Political Participation And Protest Regulations In The Republic Of Bulgaria In 2013

Bibliography Blackwell, compilers: David Miller and others, Encyclopedia of Political Thought . CSD, S., 1997, p. 375. Edited by Georgi Yankov, Political Science . UP “Economy”, 2001, p. 9. Constitution of the Republic of Bulgaria. Available at Law on gatherings, meetings and manifestations, Prom. SG. 10/2 Feb 1990, amend. SG. 11/29 Jan 1998. Available at

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