Pharmacists’ attitudes and preparedness prior to introducing the system of electronic prescriptions in Bulgaria

INTRODUCTION: By introducing electronic prescribing in December 2020, Bulgaria took a major step towards the digitalization of healthcare in the country. The regulatory framework was swiftly changed which resulted in little time for testing and implementing the e-prescription system.AIM: This study aims to explore the awareness, preparedness and attitudes of pharmacists towards the innovation prior to its mandatory launch.МATERIALS AND METHODS: A sociological method was used: a face-to-face anonymous survey among pharmacists in the region of Varna, utilizing paper questionnaires.RESULTS: The results showed the respondents’ positive attitudes and well equipped pharmacies. However, a number of challenges were also identified, such as insufficient information and trainings, a short trial period leading to concerns and lack of confidence in community pharmacists.CONCLUSION: The functioning e-healthcare system is a priority goal of healthcare development in Bulgaria. The introduction of the electronic prescription is an important step for the future digital transition in our country. Despite pharmacists’ positive attitudes towards the innovations and the expectations that it would enhance medical care, we should note that at the start of the project the focus was more on technological performance and not on staff training.  Trainings, time and experience are needed to build an effective functioning system in support of professionals and society

Specialized Electronic Tracking and Analysis System for the medicinal products (SETASMP) - challenges and attitudes for community pharmacists

The specialized electronic system for tracking and analyzing medicines / SETASMP/, included in The Positive Drug List / PDL/, is used to collect information for delivered/ sold medicines in the country. The main purpose is to provide people’s access to medicines and to prevent their shortage and lack.Aim: To track the awareness, attitudes, and the need of additional training to work with SETASMP among pharmacists in community pharmacy, in the process of introduction to practice.Materials and methods: An anonymous survey was conducted on the territory of Varna, among pharmacists in community pharmacy. Descriptive statistics, graphical analysis of results and non-parametric methods for hypothesis check are applied.Results: There is uncertainty between the respondents, connected with the technical performance in the daily work with the system. At the time of the survey, there is a lack of positive attitude of the pharmacists towards the benefit of SETASMP and the set goals. There is a desire for additional courses or training for pharmacists, related to practical application. No statistical significance was found between the experience of the pharmacist and the need for clarification and training for working with SETASMP

ASSIMILATION OF NUTRIENTS FROM COMMON WHEAT (TRITICUM AESTIVUM L.) DEPENDING ON SOME AGRONOMY FACTORS

The genotype specificity in the uptake of the main nutrients according to the fertilization rate was investigated in Triticum aestivum L. varieties under conditions of a vegetation experiment. Four fertilization rates were tested: N0P0K0, N200P200K200, N400P200K200 and N600P200K200. The response of the varieties to the nutrition conditions provided was studied during several stages of growth and development. The different nutrition regimes used lead to manifestation of the specific abilities of the varieties to take up nutrients. Genotype and mineral fertilization had a higher effect on nutrients uptake than stage of development. During the initial stage of wheat development, the differences established in the uptake of macro elements were greater between the varieties than between the individual fertilization rates. The differences were most evident at maturation. This specificity was well expressed in nitrogen and phosphorus uptake in total biomass and to a lesser extends - in potassium uptake. Varieties Slaveya and Milena had highest amounts of nitrogen uptake in grain

CLINICAL RELEVANCE OF PRECORE MUTATIONS OF HEPATITIS B VIRUS IN CHRONIC LIVER DISEASE

Introduction: Hepatitis B is one of the most frequent etiological factors for chronic liver diseases worldwide. Recent studies have suggested the important role of the genetic diversity of the virus on natural course of hepatitis B. Hepatitis B e-antigen negative type of chronic hepatitis is associated with mutations in the precore region and basic core promoter of hepatitis B viral genome. Aim of study was to identify precore mutations in viral genome of patients with chronic hepatitis B and to evaluate clinical patterns of liver disease related to this type of hepatitis B. Methods: Sixty seven patients with hepatitis B were included in the study. In order to evaluate the clinical patterns of chronic liver disease related to hepatitis B viral infection, biochemical and virological investigations were done, as well as a quantification of serum viral load. All patients under went liver biopsy and semiquantification of necroinflammation and/or fibrosis according to Knodell scoring was done. In the group of e anti en-negative patients, molecular analysis was performed in order to identify presence of mutations in precore region of the virus. Results: Study group was divided in 25 HBe Ag-positive and 42 HBe Ag-negative subjects. Alanin-aminotransferase activity and level of viral load were higher in HBe Ag-positive (p < 0.05), but average age and histology activity index were significantly higher in the HBeAg-negative patients (p < 0.01). Precore mutants were found in 38 of 42 patients with HBe Ag-negative hepatitis (90%). Fibrosis was found in 30/38 cases with mutations. Discussion: Mutations in precore region of HBV in HBe Ag-negative patients were more prevalent in older age and were associated with higher rate of fibrosis in liver tissue, meaning more advanced stage of the disease. This could be a consequence of longer duration of HBV infection or more severe clinical course of the disease. Conclusion: Our results suggest that precore mutations are highly responsible for the development of hepatitis B e antigen-negative chronic liver disease in our patients. These mutations are associated with more progressive liver disease and with older age of the patients

Mid-term Evaluation of NGO Programmes Under EEA Grants 2009-2014

The EEA Financial Mechanism (2009-2014) have committed 160,4 million to support seventeen NGO Programmes in sixteen countries: Bulgaria, Croatia, Cyprus, the Czech Republic, Estonia, Greece, Hungary, Latvia, Lithuania, Malta, Poland, Portugal, Romania, the Slovak Republic, Slovenia and Spain. The overall objective of the EEA Grants NGO Programmes is strengthened civil society development and enhanced contribution to social justice, democracy and sustainable development in each of the beneficiary countries. As of 30 of June 2014, 957 projects in total of 53,793,561 have been supported mainly in the fields of democracy, citizen participation, human rights, social justice and empowerment, sustainable development and provision of basic welfare services. The mid-term evaluation of the NGO Programmes funded by the EEA Financial Mechanism (2009- 2014) is an independent formative evaluation. Its objective was two-fold: 1) to assess the progress and needs for improvement of the current Programmes, and 2) to inform policies for the next financial period. The main purpose of this evaluation was to provide an expert independent mid-term assessment of the contribution of the EEA Grants 2009-2014 to the NGO sectors in the beneficiary states operating NGO Programmes. The evaluation was of dual nature: (1) of a formative evaluation to identify progress and needs for improvement of the current Programmes and (2) of a forward oriented strategic review to inform policies for the next financial period

Enhanced solubility of rapeseed meal protein isolates prepared by sequential isoelectric precipitation

The solubility of plant protein isolates is a key determinant of their potential application. Two protein isolates (PI) from ethanol-treated industrial rapeseed meal, PI10.5–2.5 and PI2.5–8.5, were prepared by sequential isoelectric precipitation of alkali-extracted proteins (pH 12) starting from pH 10.5 to 2.5 or from pH 2.5 to 8.5, respectively. Biochemical analyses revealed that PI2.5–8.5 contained a higher amount of crude protein (72.84%) than PI10.5–2.5 (68.67%). In the same protein isolate, the level of total phenols (0.71%) was almost two-fold higher than that in PI10.5–2.5 (0.42%). No glucosinolates were established in both protein isolates. SDS-PAGE analysis demonstrated that PI10.5–2.5 contained 10 to 15 kDa protein fractions in a relatively higher amount, while PI2.5–8.5 was enriched in 18 to 29 kDa protein fractions. PI10.5–2.5 exhibited high solubility, varying from 41.74% at pH 4.5 to 65.13% at pH 6.5, while PI2.5–8.5 was almost two-fold less soluble under the same conditions. Up to pH 5.5, the addition of NaCl at 0.03 and 0.25 M diminished the solubility of PI2.5–8.5, while the solubility of PI10.5–2.5 was increased. The supplementation of PI10.5–2.5 with 0.25 M NaCl enhanced the protein solubility to 56.11% at pH 4.5 and 94.26% at pH 6.5. The addition of 0.03 M NaCl also increased the solubility of this protein isolate but to a lower extent. Overall, the approach for sequential precipitation of proteins influenced the biochemical characteristics, protein fractional profile and solubility of prepared protein isolates.info:eu-repo/semantics/publishedVersio

Tau’s Three-Repeat Domain and EFhd2 Co-incubation Leads to Increased Thioflavin Signal

Aggregation of the protein tau is a pathological hallmark of Alzheimer’s disease (AD) and related disorders. However, the molecular mechanisms that lead to tau protein aggregation are still unclear. Previously, we showed that EFhd2 protein is associated with pathological aggregated forms of tau in AD brain. Further, immuno-gold analyses of purified tau aggregates showed that EFhd2 co-localized with filamentous tau structures. We demonstrated that EFhd2’s coiled-coil domain is required for its association with tau proteins. However, it is unknown the role that EFhd2 plays in tau aggregation. Here, we show that incubation of K19-tau with substoichiometric amount of EFhd2 promote the formation of amyloid structures in vitro. The result suggests that EFhd2 may play a role in the biogenesis of aggregated tau

Phytochemical analysis of leaves and stems of Physalis alkekengi L. (Solanaceae)

Physalis alkekengi L. (Solanaceae) is encountered in different regions of Bulgaria as a wild growing or ornamental plant. The objective of this work was to characterize the phytochemical composition (macro and micro components) of the leaves and stems of two local phenotypes (PA-SB and PA-NB), with the view of revealing their use potential. The dry leaves contained (DW) protein (16.25 and 19.27%), cellulose (25.16 and 25.31%), and ash (18.28 and 16.16%) and the stems contained protein (6.83 and 7.35%), cellulose (39.34 and 38.25%), and ash (15.01 and 7.48%) for PA-SB and PA-NB, respectively. The dominant amino acids (by HPLC) in the leaves of both phenotypes were arginine (21.3-22.3 mg/g) and aspartic acid (8.8-18.4 mg/g), and those in the stems were proline and aspartic acid for PA-SB (8.8, 7.7 mg/g); isoleucine and tyrosine for PA-NB (12.8, 6.6 mg/g). Mineral elements, determined by AAS (K, Ca, Mg, Na, Cu, Fe, Zn, Mn, Pb, Cr), also varied between phenotypes and plant parts. The leaves alone were further processed by extraction with n-hexane, for the identification of leaf volatiles (by gas chromatography-mass spectrometry). The analysis identified 28 components (97.99%) in the leaf extract of PA-SB and 32 components (97.50%) in that of PA-NB. The volatile profile of PA-SB leaves was dominated by diterpenes (49.96%) and oxygenated sesquiterpenes (35.61%), while that of PA-NB was dominated by oxygenated aliphatics (40.01%) and diterpenes (35.19%). To the best of our knowledge, the study provides the first data about the phytochemical composition of the leaves and stems of P. alkekengi from Bulgaria, in a direct comparison of phenotypes from two distinct wild populations, which could be of further scientific interest.AlMaarefa University, Riyadh, Saudi Arabia; [2021-29]The authors deeply acknowledge the Researchers Supporting Program (TUMA Project-2021-29), AlMaarefa University, Riyadh, Saudi Arabia, for supporting steps of this work

Effects of polyphenol supplementation to in vitro antioxidant potential of citrus juices

Food preparations containing substances with antioxidant activity have considerably aroused the interest of consumers, which has led to the marketing of a number of dietary supplements such as resveratrol, hesperidin or chlorogenic acid. On the other hand, natural antioxidants present in citrus fruit juices, together with dietary supplements, could contribute to an enhancement of their antioxidant properties and, in turn, alter their physiological impacts. The aim of the study was to evaluate the effect of supplementation of freshly squeezed citrus juices with resveratrol, hesperidin and chlorogenic acid on the in vitro antioxidant potential of the juices. The solutions of juices, selected polyphenols and the mixtures of solutions of juices and solution of polyphenols were analyzed to determine total polyphenol concentration using the Fast Blue method and total antioxidant potential by the ABTS method. As a result three different types of interactions were established: synergistic of chlorogenic acid which additionally increased the antioxidant potential by 35 - 38% over theoretical predictions, additive - after addition of resveratrol, and antagonistic - in the case of hesperidin. While the antioxidant potential was substantially higher in the mixture of mandarin juice with chlorogenic acid, the measured total polyphenol concentration decreased. Also a considerable decrease in the concentration of polyphenols was measured in the mixtures of mandarin and orange juices with resveratrol, all these possibly due to the sensitivity to other substances present in juices of the analytical method applied. A correlation between antioxidant potential of all examined solutions and total polyphenol concentration was found (r2 = 0.8879)

Immunohistochemical Expression of TGF-Β1, SMAD4, SMAD7, TGFβRII and CD68-Positive TAM Densities in Papillary Thyroid Cancer

BACKGROUND: Papillary thyroid carcinoma (PTC) accounts for 80% of the thyroid malignancies that are characterised by slow growth and an excellent prognosis. Over-expression of SMAD4 protein restores TGF-β signalling, determines a strong increase in anti-proliferative effect and reduces invasive potential of tumour cells expressing it.AIM: The study aimed to analyse the immunohistochemical expression of TGF-β1 and its downstream phosphorylated SMAD4, element and of the inhibitory SMAD7 PTC variants and their association with the localisation of TAMs within the tumour microenvironment.METHODS: For this retrospective study we investigated 69 patients immunohistochemistry with antibodies against TGF-β, TGF – β-RII, SMAD4, SMAD7, CD68+ macrophages.RESULTS: Patients with low infiltration with CD68+ cells in tumour stroma has significantly shorter survival (median of 129.267 months) compared to those with high CD68+ cells infiltration (p = 0.034). From the analysis of CD68+ cells in tumour border and tumour stroma correlated with expression of TGF-β1 / SMAD proteins, we observed that the positive expression of TGF-β1 in tumour cytoplasm, significantly correlated with increased number of CD68+ cells in tumour border (X2 = 5,945; р = 0.015).CONCLUSION: TGF-β enhances motility and stimulates recruitment of monocytes, macrophages and other immune cells while directly inhibiting their anti-tumour effector functions