MIRNAS AS BIOMARKERS IN AUTOIMMUNE RHEUMATIC DISEASES

MicroRNAs (miRNAs) are small non-coding single-stranded RNAs of about 22 nucleotides in length that act as post-transcriptional regulators of gene expression. Depending on the complementarity between miRNA and target mRNA, cleavage or destabilization of mRNA or translational suppression occurs within the RISC complex. As gene expression regulators, miRNAs are involved in a variety of biological functions. Dysregulation of miRNAs and their target genes contribute to pathophysiology of many disorders including autoimmune rheumatic diseases. For example, dysregulation of miR-155, miR-146a or miR-203 have been known for a long time to contribute to aggressive behavior of synovial fibroblasts and inflammatory milieu in rheumatoid arthritis. Dysregulation of miR-155 or miR-130b infl uence inflammatory or resident renal tubular cells in systemic lupus erythematosus. MiR-29 appears a key regulator of collagen expression in systemic sclerosis. Many miRNAs have been shown to be of therapeutic potential in in vivo animal models. MiRNAs are also present extracellularly in body fluids. Their incorporation into membrane vesicles or protein complexes with Ago2, HDL or nucleophosmin 1 protects them against RNases. Cell-free miRNAs can be delivered to another cell in vitro and maintain their functional potential. Therefore, miRNAs can be considered mediators of intercellular communication. Remarkable stability of cell-free miRNAs makes them accessible in body fluids. However, their origin, target tissue/organ or mechanism of action at the targeted site remains to be elucidated. We aim to summarize growing pieces of evidence supporting diagnostic and prognostic potential of cell-free miRNAs in autoimmune rheumatic diseases such as rheumatoid arthritis, axial spondyloarthritis, systemic lupus erythematosus, systemic sclerosis, idiopathic inflammatory myopathies or Sjögren´s syndrome. Acknowledgement: Projects MHCR 023728. References: 1. Filková M, Jüngel A, Gay RE, Gay S. MicroRNAs in rheumatoid arthritis: potential role in diagnosis and therapy. BioDrugs. 2012 Jun 1;26(3):131–41

Approaches for evaluation of thoracic kyphosis

The advanced age in people leads to a trend toward increasing the kyphotic curve in the thoracic section of the spine.This report aims to provide an updated overview of the approaches for evaluation of thoracic kyphosis applied in practice and to analyse the most popular of them.Methods The study was conducted in the period September 2020 - February 2021. The strategies for selecting scientific articles are tailored to the following keywords: kyphosis, hyperkyphosis, body posture, elderly people and diagnostics, published in Web of Science, MEDLINE, PubMed. Articles which duplicate or overlap with intervention studies evaluating the effect of surgical procedures and studies in children or in people with hyperkyphosis caused by any disease and scoliosis are excluded.Results 941 summaries were reviewed to select 49 studies meeting the inclusion and exclusion criteria. A variety of approaches to measuring thoracic kyphosis have been identified in the examined studies.Conclusion Each measurement method has its own characteristics, advantages and disadvantages. Some clinical measurement methods are easy to use in clinical practice and the result thereof is immediately available, thus making exposure to radiation unnecessary

MIRNAS AS BIOMARKERS IN AUTOIMMUNE RHEUMATIC DISEASES

MicroRNAs (miRNAs) are small non-coding single-stranded RNAs of about 22 nucleotides in length that act as post-transcriptional regulators of gene expression. Depending on the complementarity between miRNA and target mRNA, cleavage or destabilization of mRNA or translational suppression occurs within the RISC complex. As gene expression regulators, miRNAs are involved in a variety of biological functions. Dysregulation of miRNAs and their target genes contribute to pathophysiology of many disorders including autoimmune rheumatic diseases. For example, dysregulation of miR-155, miR-146a or miR-203 have been known for a long time to contribute to aggressive behavior of synovial fibroblasts and inflammatory milieu in rheumatoid arthritis. Dysregulation of miR-155 or miR-130b infl uence inflammatory or resident renal tubular cells in systemic lupus erythematosus. MiR-29 appears a key regulator of collagen expression in systemic sclerosis. Many miRNAs have been shown to be of therapeutic potential in in vivo animal models. MiRNAs are also present extracellularly in body fluids. Their incorporation into membrane vesicles or protein complexes with Ago2, HDL or nucleophosmin 1 protects them against RNases. Cell-free miRNAs can be delivered to another cell in vitro and maintain their functional potential. Therefore, miRNAs can be considered mediators of intercellular communication. Remarkable stability of cell-free miRNAs makes them accessible in body fluids. However, their origin, target tissue/organ or mechanism of action at the targeted site remains to be elucidated. We aim to summarize growing pieces of evidence supporting diagnostic and prognostic potential of cell-free miRNAs in autoimmune rheumatic diseases such as rheumatoid arthritis, axial spondyloarthritis, systemic lupus erythematosus, systemic sclerosis, idiopathic inflammatory myopathies or Sjögren´s syndrome. Acknowledgement: Projects MHCR 023728. References: 1. Filková M, Jüngel A, Gay RE, Gay S. MicroRNAs in rheumatoid arthritis: potential role in diagnosis and therapy. BioDrugs. 2012 Jun 1;26(3):131–41

Constructivism and Training at the Medical College

In the modern democratization and humanization of college education, the implementation of personality-oriented learning is associated with the introduction of innovations in the educational process. The rapid development of computer and information technology has aided the overall transition process; however, it has created new challenges for both teachers and students, as well as for learning technology as a whole. The constructivist approach is one of the leading directions in modern psychology and pedagogy. This is a holistic approach based on the understanding that in the process of learning, new knowledge is formed and structured through previous experience, the activity of learners, and their social interaction. The purpose of this article is to reveal the main characteristics of modern medical college education as well as the potential for updating it in accordance with constructivist principles and the changing requirements for an innovative educational process. Materials and methods: Review and analysis of scientific literature sources related to the theory of constructivism and its practical implementation in medical education. The following databases were searched for literature sources: Google Scholar, Research Gate, PubMed, etc. Results and discussion: The analysis of scientific literature sources directs our attention to the study about the theory of constructivism and its practical application in medical education. Conclusion: In order to optimize the training of future health care professionals and implement an innovative educational process, there is a need to develop and apply an interactive approach based on the theory of constructivism. In the light of modern pedagogical science, the constructivist theory elucidates how to learn and how to teach by placing the student and the teacher in new roles that meet the needs of modern training

The Impact Of The Contemporary Way Of Life On The Posture Of The Body In Children

The contemporary model of life affects our health in physical, psychological and social aspect. It is characterized by decreased physical activity and increased time spent sitting.The purpose of this study is to determine the impact of modern lifestyle on the posture of the body in children.Scientific publications in medical databases, including original empirical and theoretical developments exploring physical activity, sedentary behavior and posture of the body in children, have been studied.Reduced physical activity and sedentary behavior have a negative impact on the posture of the body in children. It is advisable to promote a healthy lifestyle by improving physical activity and reducing screen time in order to create the conditions for the proper development of the skeletal and muscular system

Influence of the Exercises with Sports Hammock on Functional Durability of the Postural Stability Muscles

INTRODUCTION: `Good posture` is the position of the body that imposes minimal stress on muscles and negligible load on joints in order to maintain balance. This is achieved by keeping the muscle balance necessary for proper development and functioning of the locomotor system.AIM: The aim of this study is to determine the influence of exercising with sports hammock on functional endurance of the postural stability muscles.MATERIALS AND METHODS: The survey was conducted between February 2014 and December 2015 among 200 children aged between 5 and 7 years in the city of Varna. The test of Matthiass, the test of Kiel and the test of sustained balance were used for the assessment of the functional endurance at the beginning as well as at the end of the survey. For one half of the children (n=100), exercising with sports hammock was applied, while the rest of the children remained as a control group. Descriptive methods and hypothesis testing (Student`s t-test) were used for data analysis.RESULTS AND CONCLUSIONS: The differences between the initial and final means in all tests of endurance for the children of the intervened group are positive and statistically significant, i.e. all the tests demonstrate improvement (p<0.0001). Upon completion of the test of Kiel on static and strength durability of the abdominal muscles the best improvement is observed in the experimental group (exercises with sports hammock): +0.94 seconds (p< 0.0001). The improvement is significant also in comparison with the results of the children from the control group

Visual criteria for the shift of the general center of gravity of patients with chronic hip instability

те болкови синдроми, които се провокират от неоптималната статика, стои функционалната хиповъзбудимост и хипотония на постуралната мускулатура на тялото и намаляване на активността на рефлекса им за разтягане, който е необходим за поддържане на оптималната статика. Клинично хипоактивността на миотатичния рефлекс се проявява във вид на мускулни болкови синдроми в статично и динамично претоварени структури.Изместването на залавните места на патобиомеханично значимите скъсени и отпуснати мускули предизвиква статичните претоварвания и се съпровожда от асиметрия и стрес в ставните повърхности на носещите стави. Под действието на гравитационните сили и вследствие на промяната на силовия баланс на мускулите тази асиметрия се засилва. Развиват се патологии, като дегенеративно-дистрофични заболявания на тазобедрената става (ТБС), често съпроводени от функционални промени в гръбначния стълб.Цел: Изследване на взаимовръзката между посоката на изместване на общия център на тежестта (ОЦТ) на пациента и функционалната хиповъзбудимост на мускулите - стабилизатори на ТБС.Резултати и обсъждане: Проведеното изследване показва, че посоката на изместване на ОЦТ на пациента с хронична нестабилност на ТБС често съвпада със страната на разположение на хипотоничните m.rectus femoris и m.iliopsoas.Изводи: Прилагането на методите за визуална диагностика от приложната кинезиология позволява в ранен стадий да се намери зависимостта между сколиотичните промени на поясния дял и клиничните прояви на нестабилност на ТБС.Introduction: At the base of the formation of muscle pain syndromes, which are provoked by the poor static, stand functional increased excitability and postural hypotension of the muscles of the body and reducing the activity of their stretch reflex, which is necessary to maintain optimum statics. Clinically, the hypoactivity of the stretch reflex is manifested as muscle pain syndromes in statically and dynamically exerted structures. Relocation of prehensile places of pathologically important biomechanical shortened and floppy muscles produces static overloads and is accompanied by asymmetry and stress in the articular surfaces of the bearing joints.Under the action of gravitational forces and as a result of the change in muscle force balance, this asymmetry is strengthened. Pathologies such as degenerative-dystrophic diseases of the hip joint, develop, often matched by functional changes in the spine.Aim: The aim of this paper is to explore the interconnection between the direction of displacement of the patient‘s general center of gravity and the functional increased excitability of the muscles - the hip stabilizers.Discussion: The conducted study indicates that the direction of displacement of the general center of gravity of the patient with chronic instability of the hip joint often coincides with the side of location of hypotonic m.rectus femoris and m.iliopsoas.Conclusion: Applying the methods of visual diagnostics from applied kinesiology allows, at an early stage, to find a relationship between the scoliotic changes in the lumbar portion and the clinical manifestations of hip joint instability

THE ROLE OF EARLY PROPHYLAXIS IN MANAGING OSTEOPOROSIS

The osteoporosis is one of the diseases with the biggest medico-social significance.The medical experts forecast its significant increase in the future, because of the growing life expectancy in the developed nations. An insufficient use of prophylaxis is present, wherefore emerges a need of analysis of the possibilities of their more efficient application.The goal of this review is to summarize the main risk factors of development of osteoporosis and to highlight the most efficient prophylaxis measures in order to curtail it.It`s never too early to invest in one`s bone health. The prophylaxis of the osteoporosis must begin from childhood through providing the necessary conditions for optimal growth and development of the bone structure. The bone mass, acquired in the maturing phase is a key factor in determining the risk of osteoporosis later in life. The bigger the peak bone mass, acquired while maturing, the lower the risk of bone density loss in the menopause period. That`s why it`s important to lay down the prophylaxis` foundation since childhood and to continue throughout lif

Main Aspects Of The Consequences Of Poor Body Posture In Children

През последните години физическата активност сред децата и младите хора се заменени от дейности, които в по-голяма степен са свързани със заседяване. Под влияние на тези нездравословни модели на живот позата на децата се променя.Целта на настоящата разработка е да се проучат основните аспекти на последствията от неправилната поза на тялото върху здравето на децата и да се изготвят насоки за превенция и профилактика.Проучени са обширен брой научни публикации по този проблем. Очертани са основните насоки за превенция и профилактика на неправилната поза при децата.Очертава се негативна тенденция за нарастващо разпространение на неправилна стойка на тялото при децата и юношите. Тя се отразява отрицателно върху различни органи и системи. Уместно е да се предприемат своевременни действия, които да доведат до отстраняване на тези неблагоприятни условия за растеж и развитие и до подобряване на физическата активност. In recent years, the physical activity among children and young people has been replaced by activities that are more closely related to lack of movement. Under the influence of these unhealthy models of life, the posture of children has changed.The aim of this study is to explore the main aspects of the consequences of the change in body posture in children and to provide guidance on prevention and prophylaxis.A large number of scientific publications on this issue have been studied. The key guidelines for prevention and prophylaxis of poor posture in children are outlined.A negative trend toward a growing spread of poor body posture in children and adolescents is observed. It affects negatively different organs and systems. It is appropriate to take timely action to remove these unfavorable conditions for growth and development and to improve physical activity

The effect of polarized polychromatic non-coherent light (Bioptron) therapy on patients with lower back pain

INTRODUCTION: Lately the polarized polychromatic non-coherent lower energy light emitted by the Bioptron lamp has become more widely used in the physiotherapeutic practice.AIM: To study the effect of polarized polychromatic incoherent low energy light on pain, motor activity and quality of life in patients with vertebrogenic lower back pain and to compare it with other methods used in practice.MATERIALS AND METHODS: Object of the study were 60 patients with lower back pain. A control group (N=30, age 46±11.5 y.) was treated with basic therapy and the Bioptron apparatus. Functional tests of the motor activity (test of Thomayer and test of Schober), evaluation of the pain using visual analogue scale (VAS) evaluation of the quality of life using the Roland-Morris test in the beginning, at the end and 1 month after the treatment were used to evaluate the effectiveness of treatment.RESULTS: The results have a statistical significance of (p<0.05) for both groups regarding the reduction of the pain syndrome, the functional tests for mobility in the lumbar region and the quality of life. There`s also a statistical significance in comparing the results of the test group (TG) and the control group (CG) (p<0.05).CONCLUSION: Both methods reduced pain, improved the mobility of the lumbar region and improved the quality of life of patients with lower back pain. The complex methodology incorporating basic treatment with the use of polarized polychromatic non-coherent low energy light yielded better results than just basic treatment