Neuropsychological and neuroimaging markers in prediction of cognitive impairment after ischemic stroke: a prospective follow-up study

Background There are few longitudinal studies with controversial results examining delayed changes in cognition after ischemic stroke and predictive values of neuropsychological and neuroimaging markers

Preference for laboratory test results notification among different healthcare players in Northeastern Bulgaria

IntroductionAs continuously growing number of people is using online sources for health information and services, the concept of eHealth is progressively developing and is a high-priority topic for the European Union. The absence of centralized internet-based eHealth platform in Bulgaria results in deficiency in the information exchange among physicians and other healthcare providers. The question about the readiness and the attitude towards eHealth concept among all participants in the health care system in Bulgaria still remains to be clarified and the purpose of the current study is to assess the opinion of health care providers and consumers about the electronic way of receiving laboratory test results. We also try to explore the existing preference trend in relation to the socio-demographic characteristics of the studied population.Material and methodsIn the current work, we investigated the needs and recommendations of 1039 patients, laboratory stuff and out-of-hospital general practitioners in the Northeastern Bulgaria (regions Varna, Dobrich and Shumen).ResultsThe results show that laboratory results are preferred in electronic form and there is a significant need for better online communication between different participants in the healthcare system. In this context, we also summarize a model for improvement in the interaction among healthcare providers.ConclusionThe actual opportunities for online communication provoke active participation of all players in the health service market and require a novel model of communication among healthcare providers

Epstein-Barr virus - molecular basis for malignant transformation

Epstein-Barr (EBV) is a widespread virus which can be detected in more than 90% of world population. Primary EBV infection during adolescence and adultness results in infectious mononucleosis, while in children it is usually asymptomatic. EBV is responsible for different malignant forms of B-cell or epithelial cancers, such as Hodgkin's and non-Hodgkin`s lymphoma, Burkitt's lymphoma, post-transplant lymphoproliferative disorders, nasopharyngeal carcinoma, hairy leukoplakia and HIV-associated lymphomas. Evidence exists that infection with EBV is also linked with a higher risk of hepatocellular and gastric cancers, as well as autoimmune diseases.EВV shows two alternative life cycles - latent and lytic. After the primary infection, the virus remains in B lymphocytes in latency, while the lytic infection takes place predominantly in the epithelial cells and can last for months with constant virus release in saliva and nasopharyngeal secretion. Unlike other herpes viruses, development of oncological diseases is linked with the latent cycle, as a result of immune response‘s failure to control latently infected cells.With the present work we try to concisely review the current knowledge about mechanisms of EBV pathogenesis in humans and to summarize recent findings in the field

Neuropsychological and neuroimaging markers in prediction of cognitive impairment after ischemic stroke: a prospective follow-up study

Background There are few longitudinal studies with controversial results examining delayed changes in cognition after ischemic stroke and predictive values of neuropsychological and neuroimaging markers

Acute Management of Deep Facial Burns

Introduction: Management of deep facial burns is a serious challenge for many reasons: a considerable anatomic and functional diversity is concentrated in a small space, a uniform treatment does not exist, late sequelae are frequent and may be severe, and the literature on the subject is ambiguous.Aim: To analyse management of deep facial burns.Patients and methods: A retrospective medical chart review was conducted for 569 patients with deep facial burns hospitalized between January 2005 and January 2015. Demographic data, type, depth and size of burns, chronology and type of surgical treatment, length of hospital stay, and type and incidence of late sequelae were analysed and compared.Results: Over 10 years, 596 patients with deep facial burns, 216 (36.24%) females and 380 (63.76%) males, aged from 5 months to 95 years (mean 39.5±26 years) were treated. The most common burn agents were hot liquids and flames. The mean total body surface area (TBSA) burned was 17±13.3%. Concomitant eye injury was detected in 63 (10.6%) patients. Priority was given to the early, meticulous, staged surgical approach aimed at sparing the survived tissues and rapid wound closure. Follow-up ranged from 3 months to 5 years. Late functional sequelae were documented for 50 (8.38%) patients and ocular sequelae - for 33 (5.54%) of them. There was no incidence of secondary corneal perforation or definitive loss of vision.Conclusions: Adequate and up-to-date acute management of deep facial burns based on early, judicious, surgical approach could limit initial damage and reduce late sequelae

ANALYSIS OF THE RESULTS OF APPLYING THE METHOD PLATELET-RICH PLASMA (PRP) FOR THE TREATMENT OF PROBLEMATIC SKIN WOUNDS

OBJECTIVE: To show analysis of the results of applying the method platelet-rich plasma (PRP) for the treatment of problematic skin wounds. The paper’s objective is to prove its reliability and relevance, to evaluate its efficiency and applicability to Bulgarian patients. MATERIAL AND METHODS: Out of a total of 154 hospitalized patients with problematic skin wounds 83 have been treated with platelet-rich plasma, comprising the Experimental group (EG), and 71 patients with similar wounds have been treated by using traditional methods for the respective pathology at the Department of Orthopedics and Traumatology, Vessel and Plastic Surgery Department, comprising the Control Group (CG). Data on the condition of monitored symptoms of researched cases was collected for the research. A variable is defined for every symptom and its value and weight is correspondingly introduced. Scores introduced by Cancela AM are used for the assessment of the respective wound. Each of these scores is used for assessing specific wound parameters: Total Wound Score (TWS); total anatomic score (TAS) of wound and Total Score of Wound data (TSWD). RESULTS: Analysis of variance was performed to achieve the objectives and solve the research tasks; variables containing information on initial and final data from each series of experiments have been analyzed in order to determine basic numerical characteristics of variables, and by comparative analysis to check how they tend to vary in experimental (EG) and control (CG) group. Statistical survey shows that the platelet-rich plasma method gives significant results when treating problematic skin wounds leading to full recovery as compared to traditional methods typical for the pathology. The graphical interpretation allows to identify forecast relations between assessed aspects of problematic wounds and weeks of treatment. CONCLUSION: By analyzing the results of our study we can conclude that the use of platelet-rich plasma to treat problematic skin wounds is a safe and effective treatment method. It is not universal for every wound, but follows the principles of biological wound treatment and leads to full recovery of high percentage of problematic skin wounds. We support proponents of the application of platelet-rich plasma to treat problematic skin wounds

PLATELET RICH PLASMA (PRP) APPLICATION IN TOTAL KNEE ARTHROPLASTY (TKA)

PURPOSE: To find out the PRP application effects in TKA on pain syndrome, wound healing, postoperative blood loss, range of motion and the knee circumference (centimetry). MATERIAL AND METHOD: The preparation of the platelet-rich plasma is based on our treatment algorithm. 20 patients have been subject to TKA within the period from October 2012 to November 2014 and underwent TKA, as platelet rich plasma was used intraoperatively. The average patient age is 72,3; 9 male and 11 female patients. Control group consisted of 17 patients, who underwent surgery in the same period but no platelet rich plasma was used during surgery. Average patient age 73,1; 8 male and 9 female patients. RESULTS: The following results have been reported for the PRP group of patients: the average amount of blood in the aspiration drainage tube in 24 hours - 285 ml.; postoperative pain on the 1st postoperative day was - 7 p., on the 5th day - 5 p., on the 10th day - 2 p., average circumference (centimetry) of the knee between the 1st and the 10th postoperative day decreased on average by 1,5-2 cm., range of motion – reported average degrees per patient on the 1st postoperative day in sagittal plane: 0-10-20 degrees; on the 10th postoperative day: 0-0-55 degrees, surgical wounds of all patients healed primarily without any complications. No PRP group: average amount of blood in the aspiration drainage in 24 hours – 300 pl., postoperative pain on the 1st, 5th , and 10th postoperative day - 8 p., on the 5th day - 6 p., on the 10th day - 3 p., average knee circumference (centimetry) between 1 and 10 postoperative day has decreased by 1 cm on average, range of motion - reported average degrees per patient on the 1st postoperative day in sagittal plane 0-5-20 degrees, on the 10th: 0-0-50 degrees, surgical wounds healed primarily without any complications in 10 patients, but in 7 patients we observed superficial wound edge skin necrosis. CONCLUSION: Our results unequivocally show that platelet-rich plasma reduces postoperative blood loss and the use of narcotics, improves the range of motion and the circumference of the operated joint and it is crucial for the most common postoperative complications of TKA: namely dermal wound problems

FAST TRACK SURGERY IN TOTAL KNEE ARTHROPLASTY - A REVIEW.

The number of orthopedic surgeons who are convinced in the need for significant changes in planned total knee arthroplasty (TKA) is increasing slowly and steadily. A new approach to pain control has been developed over the past 10-15 years, and the introduction of techniques to reduce perioperative stress, and the use of minimally invasive surgical techniques can help limit postoperative complications and shorten recovery time. This type of optimization is regarded as Fast-track Care program, where improved healing process is particularly useful to comorbid patients

Generation of KCL034 clinical grade human embryonic stem cell line

AbstractThe KCL034 human embryonic stem cell line was derived from a normal healthy blastocyst donated for research. The ICM was isolated using laser microsurgery and plated on γ-irradiated human foreskin fibroblasts. Both the derivation and cell line propagation were performed in an animal product-free environment and under current Good Manufacturing Practice (cGMP) standards. Pluripotent state and differentiation potential were confirmed by in vitro assays. The line was also validated for sterility, specific and non-specific human pathogens

Anti-Coronavirus Efficiency and Redox-Modulating Capacity of Polyphenol-Rich Extracts from Traditional Bulgarian Medicinal Plants

Background: The use of various herbal therapists as part of traditional medicine in different parts of the world, including Bulgaria, is due to the knowledge accumulated over the centuries by people about their valuable biological activities. In this study, we investigate extracts from widely used Bulgarian medicinal plants for their ability to prevent the coronavirus infection of cells by testing different mechanisms of antiviral protection, their polyphenol content, and redox-modulating capacity. Methods: The influence on the stage of viral adsorption, the inhibition of extracellular virions, and the protective effect on uninfected cells of the plant’s extracts were reported by the end-point dilution method, and virus titer (in Δ lgs) was determined as compared to the untreated controls. The total content of polyphenols and flavonoids was also determined. We tested the antioxidant power of the extracts by their ability to inhibit the generation of superoxide anionic radicals and to scavenge DPPH radicals. We determined their iron-reducing, copper-reducing, and metal-chelating antioxidant powers. Results: Most of the extracts tested suppress the extracellular virions of HCov. They also inhibit the stage of viral adsorption to the host cell to varying degrees and have a protective effect on healthy cells before being subjected to viral invasion. The examined extracts contained significant levels of polyphenols and quercetin-like flavonoids and showed remarkable antioxidant, radical, and redox-modulating effects. Conclusions: All of these 13 extracts from Bulgarian medicinal plants tested can act as antioxidants and antiviral and symptomatic drugs for the management of coronavirus infection