Sexually Transmitted Infections Management Legal Regulation in Bulgaria: Present Situation and Challenges

Introduction: Sexually transmitted infections (STIs) continue to be a significant public health problem with numerous health social, ethical and economic dimensions. The goal of this study is to present and discuss the Bulgarian legal framework dimensions related to the management of the spectrum of STIs, and associated public health challenges. An analysis of Bulgarian legislation normative documents connected with the presented problematic was applied. Results: For the effective STIs-spectrum management, the presented normative acts envisage a number of rules and requirements for conducting preventive, diagnostic and treatment activities. These rules are not sufficient and cannot cover all cases in the practical work of medical professionals most of them serve as general guides. The main problem that is emerging is the lack of financial resources and sources of funding. Conclusion: Despite the large legal framework, most documents are only a framework, without specifics in the organization and lack of funding for regulated activities

Testing 6,8^{6,8}He density distributions by calculations of total reaction cross-sections of 6,8^{6,8}He+28^{28}Si

Calculations of the $^{6,8}$He + $^{28}$Si total reaction cross sections at intermediate energies are performed on the basis of the Glauber-Sitenko microscopic optical-limit model. The target-nucleus density distribution is taken from the electron-nucleus scattering data, and the $^{6,8}$He densities are used as they are derived in different models. The results of the calculations are compared with the existing experimental data. The effects of the density tails of the projectile nuclei as well as the role of shell admixtures and short-range correlations are analyzed.Comment: 10 pages, 5 figures. Submitted to the International Journal of Modern Physics

Idiopathic intracranial hypertension (IIH) - observations on 6 clinical cases

Идиапатичната интракраниална хипертензия (ИИХ) е неврологично заболяване, което клинически протича основно с офталмологична симптоматика.Цел: Да се направи литературен обзор и се представят дългосрочните наблюдения върху клинични случаи с ИИХ.Материал и методи: Литературният обзор е изграден на базата на търсене в 4057 заглавия в PubMed, от които 206 пълнотекстови статии от последните 5 г. Представят се и се обсъждат резултатите от дългосрочното наблюдение върху 6 клинични случая с различна динамика на заболяването в хода на лечението и проследяването.Резултати: Диагнозата се постави на базата на клиничната картина, наличието на едем на папилите и изключване на други заболявания, протичащи с интракраниална хипертензия (липса на промени в лабораторното изследване на лумбален пунктат и липсата на находка при КАТ и ЯМР на гл. мозък, отхвърляне на тромбоза на церебралните венозни синуси чрез ЯМР венография). При първите двама пациенти се проведе неврохирургично лечение (вентрикуло-перитонеален шънт), поради тежко протичане на заболяването. Дългосрочният резултат бе неблагоприятен. При останалите 4 пациента, поради по-леката тежест на заболяването, се проведе консервативно лечение с високи дoзи Acetazolamide и последващо титриране на дозата за минимум 9-12 месеца. При всички се постигна успех с възстановяване на зрителната функция, обратно развитие на едема на папилите и задържане на ефекта в рамките на 2-4 години.Заключение: Своевременната диагностика и лечение, както и добрата интердисциплинарна колаборация са основни фактори, които могат да предотвратят развитието на тежка двустранна необратима загуба на зрителна функция при пациенти с ИИХ.Idiopathic intracranial hypertension (IIH) is a neurological disease that has predominantly ophthalmological clinical signs.Aim: To perform review of literature and present the long-term observation results on clinical cases with IIH.Material and methods: The literature review is based on PubMed search of 4057 publications, among which 206 full text articles from the last 5 years. We present and discuss our observations on 6 clinical cases with different clinical characteristics and response to treatment in the long-term follow-up course.Results: The diagnosis was based on the clinical picture, presence of papilledema, and exclusion of other diseases that can cause intracranial hypertension (check-up of cerebrospinal fluid, cranial CTscan and MRI, exclusion of thrombosis of the cerebral venous sinuses - MRI venography). The first two presented patients underwent neurosurgical treatment (ventriculo-peritoneal shunting), because of the severe course of the disease. The long-term result was unfavorable. The rest 4 patients, due to the moderate severity of the disease, were treated conservatively with high dose Acetazolamide and titration of the dose for a minimum of 9-12 months. In all 4 patients there was successful recovery of visual function, absorbtion of the papilledema and retention of the result for a period of 2 to 4 years.Conclusion: The correct timely diagnosis and treatment, along with good interdisciplinary collaboration, are the main prerequisite factors that can prevent severe bilateral irreversible loss of visual function in patients with IIH

Charge and matter distributions and form factors of light, medium and heavy neutron-rich nuclei

Results of charge form factors calculations for several unstable neutron-rich isotopes of light, medium and heavy nuclei (He, Li, Ni, Kr, Sn) are presented and compared to those of stable isotopes in the same isotopic chain. For the lighter isotopes (He and Li) the proton and neutron densities are obtained within a microscopic large-scale shell-model, while for heavier ones Ni, Kr and Sn the densities are calculated in deformed self-consistent mean-field Skyrme HF+BCS method. We also compare proton densities to matter densities together with their rms radii and diffuseness parameter values. Whenever possible comparison of form factors, densities and rms radii with available experimental data is also performed. Calculations of form factors are carried out both in plane wave Born approximation (PWBA) and in distorted wave Born approximation (DWBA). These form factors are suggested as predictions for the future experiments on the electron-radioactive beam colliders where the effect of the neutron halo or skin on the proton distributions in exotic nuclei is planned to be studied and thereby the various theoretical models of exotic nuclei will be tested.Comment: 26 pages, 11 figures, 3 tables, accepted for publication in Phys. Rev.

Digalactosyl-diacylglycerol-deficiency lowers the thermal stability of thylakoid membranes

We investigated the effects of digalactosyl-diacylglycerol (DGDG) on the organization and thermal stability of thylakoid membranes, using wild-type Arabidopsis thaliana and the DGDG-deficient mutant, dgd1. Circular-dichroism measurements reveal that DGDG-deficiency hampers the formation of the chirally organized macrodomains containing the main chlorophyll a/b light-harvesting complexes. The mutation also brings about changes in the overall chlorophyll fluorescence lifetimes, measured in whole leaves as well as in isolated thylakoids. As shown by time-resolved measurements, using the lipophylic fluorescence probe Merocyanine 540 (MC540), the altered lipid composition affects the packing of lipids in the thylakoid membranes but, as revealed by flash-induced electrochromic absorbance changes, the membranes retain their ability for energization. Thermal stability measurements revealed more significant differences. The disassembly of the chiral macrodomains around 55°C, the thermal destabilization of photosystem I complex at 61°C as detected by green gel electrophoresis, as well as the sharp drop in the overall chlorophyll fluorescence lifetime above 45°C (values for the wild type—WT) occur at 4–7°C lower temperatures in dgd1. Similar differences are revealed in the temperature dependence of the lipid packing and the membrane permeability: at elevated temperatures MC540 appears to be extruded from the dgd1 membrane bilayer around 35°C, whereas in WT, it remains lipid-bound up to 45°C and dgd1 and WT membranes become leaky around 35 and 45°C, respectively. It is concluded that DGDG plays important roles in the overall organization of thylakoid membranes especially at elevated temperatures

Stratifying patients with peripheral neuropathic pain based on sensory profiles : algorithm and sample size recommendations

In a recent cluster analysis, it has been shown that patients with peripheral neuropathic pain can be grouped into 3 sensory phenotypes based on quantitative sensory testing profiles, which are mainly characterized by either sensory loss, intact sensory function and mild thermal hyperalgesia and/or allodynia, or loss of thermal detection and mild mechanical hyperalgesia and/or allodynia. Here, we present an algorithm for allocation of individual patients to these subgroups. The algorithm is nondeterministic-ie, a patient can be sorted to more than one phenotype-and can separate patients with neuropathic pain from healthy subjects (sensitivity: 78%, specificity: 94%). We evaluated the frequency of each phenotype in a population of patients with painful diabetic polyneuropathy (n = 151), painful peripheral nerve injury (n = 335), and postherpetic neuralgia (n = 97) and propose sample sizes of study populations that need to be screened to reach a subpopulation large enough to conduct a phenotype-stratified study. The most common phenotype in diabetic polyneuropathy was sensory loss (83%), followed by mechanical hyperalgesia (75%) and thermal hyperalgesia (34%, note that percentages are overlapping and not additive). In peripheral nerve injury, frequencies were 37%, 59%, and 50%, and in postherpetic neuralgia, frequencies were 31%, 63%, and 46%. For parallel study design, either the estimated effect size of the treatment needs to be high (> 0.7) or only phenotypes that are frequent in the clinical entity under study can realistically be performed. For crossover design, populations under 200 patients screened are sufficient for all phenotypes and clinical entities with a minimum estimated treatment effect size of 0.5.Peer reviewe

In vivo NMR as a tool for probing molecular structure and dynamics in intact Chlamydomonas reinhardtii cells

Solid state NMR/Biophysical Organic Chemistr

Regulation of peripheral blood flow in Complex Regional Pain Syndrome: clinical implication for symptomatic relief and pain management

Background. During the chronic stage of Complex Regional Pain Syndrome (CRPS), impaired microcirculation is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Several mechanisms may be responsible for the ischemia and pain in chronic cold CPRS. Discussion. The diminished blood flow may be caused by either sympathetic dysfunction, hypersensitivity to circulating catecholamines, or endothelial dysfunction. The pain may be of neuropathic, inflammatory, nociceptive, or functional nature, or of mixed origin. Summary. The origin of the pain should be the basis of the symptomatic therapy. Since the difference in temperature between both hands fluctuates over time in cold CRPS, when in doubt, the clinician should prioritize the patient's report of a persistent cold extremity over clinical tests that show no difference. Future research should focus on developing easily applied methods for clinical use to differentiate between central and peripheral blood flow regulation disorders in individual patients

Extracellular vesicle sorting of α-Synuclein is regulated by sumoylation

Extracellular α-Synuclein has been implicated in interneuronal propagation of disease pathology in Parkinson’s Disease. How α-Synuclein is released into the extracellular space is still unclear. Here, we show that α-Synuclein is present in extracellular vesicles in the central nervous system. We find that sorting of α-Synuclein in extracellular vesicles is regulated by sumoylation and that sumoylation acts as a sorting factor for targeting of both, cytosolic and transmembrane proteins, to extracellular vesicles. We provide evidence that the SUMO-dependent sorting utilizes the endosomal sorting complex required for transport (ESCRT) by interaction with phosphoinositols. Ubiquitination of cargo proteins is so far the only known determinant for ESCRT-dependent sorting into the extracellular vesicle pathway. Our study reveals a function of SUMO protein modification as a Ubiquitin-independent ESCRT sorting signal, regulating the extracellular vesicle release of α-Synuclein. We deciphered in detail the molecular mechanism which directs α-Synuclein into extracellular vesicles which is of highest relevance for the understanding of Parkinson’s disease pathogenesis and progression at the molecular level. We furthermore propose that sumo-dependent sorting constitutes a mechanism with more general implications for cell biology.Instituto de Investigaciones Bioquímicas de La Plat