Arterial hypertension and cerebrovascular disease

Артериалната хипертония е най-важният рисков фактор за развитието на мозъчно-съдова болест (МСБ) и най-вече на нейната най-тежка изява - мозъчния инсулт. Ето защо най-точният критерий за нивото на контрол на хипертонията в дадена популация е понижаването на болестността и смъртността от мозъчни инсултиArterial hypertension is the most important risk factor for development of cerebrovascular disease and stroke in particular. That is why the most accurate marker for the level of control of hypertension is stroke mortality and morbidity

How COVID-19 affected the control of hypertension and comorbitities in one cardiological outpatient practice in Bulgaria?

COVID-19 pandemic affected directly and indirectly the healthcare system in Bulgaria in a very negative manner. The hospitals were flooded with COVID cases and patients were afraid to attend even the outpatient clinics. That resulted in increased mortality and poor control of cardiovascular diseases. We studied the results from the mandatory annual examinations of hypertensive patients in one cardiological outpatient practice in Sofia, Bulgaria in 2021 and 2022. The results showed low level of attendance by the patients in 2021 and poor control of hypertension and comorbidities, that continued even in the post-covid year – 2022

Comparative Characteristics of Total Phenols in Water Infusions of Bulgarian Medicinal Plants

The aim of the study is a comparative evaluation of the antioxidant polyphenolic composition in Bulgarian medicinal plants and their fruits by determining the degree of similarity. In the present study, 18 different Bulgarian medicinal plants were studied, and for the determination of total phenols, a Folin-Chocalto reagent was used, oxidizing the phenols to a blue complex, which was determined spectrophotometrically at a wavelength of λ = 750 nm. The following ratios were kept in the preparation of the infusions: 1 g of drug/100 g of distilled water, and 5 g of fruit/100 g of distilled water. A comparative characterization of the selected medicinal plants and their fruits was performed by applying calculation methods and cluster analysis. The degree of similarity between the polyphenolic content of medicinal plants and their fruits was assessed to provide data for the development of effective antioxidant plant combinations. The results show that hawthorn flower infusions have the highest values of total phenols (191.35 ± 2.91 mg GAE/100 ml), followed by decocts of rose hips (166.50 ± 0.5 mg GAE/100 ml), forming individual clusters at hierarchical cluster analysis

Characterization of the RNA binding and RNA degrading subunits of the eukaryotic exosome

The exosome is an essential complex of ten proteins involved in the processing and degradation of many RNAs in the cell. These include various stable RNAs, mRNAs, and aberrant transcripts both in the nucleus and in the cytoplasm. In this work I characterize the three members of the exosome “cap”, the RNA binding proteins Rrp4, Rrp40, and Csl4. I determine that in spite of their structural similarity, they each have a unique essential role. Second, I determine that two of the cap proteins Rrp4 and Rrp40 have a role in bridging subunits of the PH ring of the exosome. The third cap protein Csl4 was shown not to have a bridging role. Further, I show that stable interaction with the exosome is not required for the essential role of Csl4. In addition, I look at the physiological importance of the nuclease domains of the exosome. I show that the exonuclease is the primary activity for the exosome and that in its absence the iron starvation response of the cell is activated. Despite numerous studies of the exosome, only a few address the physiological relevance of the catalytic activity. This work shows that the exonuclease of the exosome is important for oxidative stress protection and affects glucose metabolism and provides a basis for future research into the physiological importance of this essential RNase

Health technology assessment of Ixekizumab for treatment of plaque psoriasis in Bulgaria

Целта на изследването е чрез анализ на публикувани данни от оценки на здравни технологии за лечение на плакатен псориазис (ПП), проведени в други страни, да се моделират разходите и здравните ползи на ixekizumab в сравнение с терапевтичните алтернативи, използвани в българската клинична практика. Косвеното сравнение чрез мрежов метаанализ включва ixekizumab, secukinumab, ustekinumab, adalimumab, etanercept, infliximab. Използваният икономически анализ е разход-полезност. Проучването стига до извода, че Ixekizumab е разходно ефективна терапия за лечение на пациенти с плакатен псориазис, след неуспех със стандартна терапия в България, в сравнение с ustekinumab, adalimumab и infliximab.The aim of the study is to analyze the published data from health technology assessments for the treatment of plaque psoriasis (PS) conducted in other countries to model the costs and health benefits of ixekizumab compared to the therapeutic alternatives used in Bulgarian clinical practice. Indirect comparison through network meta-analysis includes ixekizumab, secukinumab, ustekinumab, adalimumab, etanercept, infliximab. The economic analysis used is cost-utility. The study concludes that Ixekizumab is a cost-effective treatment for patients with plaque psoriasis after failure with standard therapy in Bulgaria compared to ustekinumab, adalimumab and infliximab

COVID-19 AND REGIONAL HEALTH INEQUALITIES IN BULGARIA

Purpose: The study aims to analyze regional health and socioeconomic inequalities in Bulgaria. Methods: An ecological epidemiological study was conducted. The 28 regions in Bulgaria were compared according to death rates due to COVID-19, the share of people 65+, availability of physicians, hospital beds for active and intensive care per 10,000 people, and the average annual salary of employed people /2021/. Data were statistically processed with SPSS v.26, the Pearson coefficient was used. Results: The death rates due to COVID-19 in Bulgaria vary widely, and the regions with the highest rates in 2021 are Kyustendil /642.440/0000/, Vidin /591.150/0000/, Montana /533.980/0000/, Gabrovo /533.480/0000/ and Vratsa /531.900/0000/. All five regions have ageing rates higher than the national average of the availability of physicians per population - lower than the average, respectively 36.60/0000, 35.50/0000, 34.90/0000, 37.60/0000 and 38.10/0000. Among the areas with high levels of death rates, Vidin stands out with very low availability of hospital beds for active and intensive treatment - 37.80/0000, but Gabrovo and Montana have higher. A moderate correlation was found between the death rate due to COVID-19 and the ageing of the population, but for other factors, no correlation was established. Conclusions: Reducing regional health inequalities in Bulgaria is one of the possible ways to control and reduce the death rate in the country, especially due to COVID-19

On the effect of chelating agents and antioxidants on cadmium-induced organ toxicity. An overview

Cadmium (Cd) has been classified as a human carcinogen. The World Health Organization (WHO) reported that the concentration of Cd in the environment has rapidly increased in the last few years. In many epidemiological studies, the correlation between environmental exposure of humans to Cd and diseases such as stroke, ischemia, renal and hepatic dysfunction, anemia, osteoporosis and diabetes has been discussed. For the treatment of heavy metal intoxications a therapy with chelating agents has been applied. A chelating agent is a compound that binds the toxic metal ion thus promoting its excretion by the living organisms. Recently, it has been found that Cd-induced toxicity is a result of formation of reactive oxygen species (ROS). These results increased the interest towards the antioxidants as possible agents for the treatment of Cd-induced organ toxicity. Herein, we present summary and discussion of the literature data for the influence of chelating agents and antioxidants on Cd-induced pathological conditions in Cd-intoxicated animals

Agricultural Academy

Pulmonary alveolar proteinosis (PAP) is a heterogenous disorder of genetic or acquired etiologies characterized by intraalveolar accumulation of lipoproteinaceous material. The clinical course of the disease is variable, ranging from spontaneous remission to respiratory failure. The aim of the present study was to compare the biochemical and biophysical characteristics of broncho-alveolar lavage (BAL) from a patient with PAP, during the whole lung lavage (WLL) taken after each stage of the procedure. For this purpose biochemical and biophysical analysis of the clinical samples were made. The phospholipids (PLs) and the proteins concentrations of the samples were measured. For determination of protein content in broncho-alveolar lavage samples Lowry protein assay (Peterson's modifi cation) was used. The PL's concentration was determined via extraction by the method of Blight and Dyer. Thin-layer chromatography was used for determining the phospholipid profi le of the separate phospholipid components. In addition, by using the method of Axisymmetric Drop Shape Analysis, the surface characteristics: equilibrium, maximal and minimal surface tension during 10 cycles of compression-decompression in the dynamic conditions, were determined. Our results showed consecutive proteins and phospholipids content decrease during the procedure. Logically, the equilibrium surface tension was increased as a result of the decreased Phospholipids/Proteins ratio. After WLL the physiological condition of the patient was improved. The present study will be of great interest for effective implementation of the procedure of whole lung lavage in the clinical practice

Un nouveau faciès lamellaire du début du Paléolithique supérieur dans les Balkans

Après Bacho Kiro et Temnata, la grotte de Kozarnika est la troisième grande séquence pléistocène récemment établie dans la région de l‘est des Balkans. La fouille, menée dans le cadre d’une coopération entre l’Académie bulgare des sciences – Institut d’Archéologie à Sofia et UMR 5199 du CNRS, PACEA - Université Bordeaux 1, a permis la découverte d’une séquence, datant du Paléolithique inférieur (non Acheuléen), Paléolithique moyen (Moustérien - Levallois) et du Paléolithique supérieur, daté entre 39 et 11 Ka BP (Guadelli et al. 2005). Le niveau VII, localisé à la base du Paléolithique supérieur, daté entre 39 et 36 Ka BP a livré une industrie lithique à débitage et outillage lamellaire, inédite à l’échelle régionale. Cet outillage est composé de pièces à dos et à retouche fine, abrupte, et semi-abrupte, parfois bilatérale directe appointant ou alterne. Dénommée “ Kozarnikien ” en attente d’études plus complètes, cette industrie présente des analogies dans la composante lamellaire tant avec l’Ahmarien ancien du Levant qu’avec certains ensembles de proto-Aurignacien au sud de l’Europe. En l’absence d’autres éléments caractéristiques de l’Aurignacien typique, cette industrie montre des tendances technologiques et typologiques dont on trouve la continuité dans les niveaux sus-jacents gravettiens de la séquence. Le Kozarnikien peut donc représenter une étape précoce de formation de technocomplexe lamellaire à pièces à dos. Le Kozarnikien suggère aussi qu’on ne peut plus soutenir le rôle exclusif de l’Aurignacien dans le passage du moustérien européen au Paléolithique supérieur. Il devient de plus en plus évident qu’au tout début de cette transformation, ont été engagées des traditions culturelles différentes et précédant l’Aurignacien.With Bacho Kiro and Temnata, Kozranika cave is the third major pleistocene sequence recently investigated in the Eastern Balkans. Excavations, conducted in collaboration of the Bulgarian Academy of sciences-National Institute of Archaeology at Sofia and the University of Bordeaux 1- Institute of Prehistory and Quaternary Geology –CNRS, PACEA, UMR 5199, revealed a sequence starting with non-Acheulean Lower Palaeolithic (LP), Levaloisian Moustérian Middle Palaeolithic (MP) and Upper Palaeolithic(UP) dated between 39 Ky BP and 11 Ky BP (Guadelli et al. 2005). Level VII, at the base of the UP (39-36 Ky BP) contains an assemblage locally unknown, characterized by a bladelet technology and tools made on bladelets: regular backed pieces and bladelets with thin, abrupt or semi-abrupt, often bilateral convergent or alternate retouch. Named temporarily “ Kozarnikian ” awaiting for further studies, this assemblage shows some analogies with the archaic Ahmarian from Levant and South-European Proto-Aurignacian as well. Given the lack of diagnostic artefacts of typical Aurignacian, this assemblage shows technological and typological tendencies observed in the overlaying Gravettian industries. The Kozarnikian might be considered as a possible precursor of technocomplexes with bladelet technology and backed pieces and thus,suggesting that the role of Aurignacian in transition between the European Mousterian and the UP is not unique nor exclusive. It becomes more and more obvious that, at the beginning of this transformation, preceding the Aurignacian, different cultural traditions where involved

Subarctic climate for the earliest Homo sapiens in Europe

Acknowledgments The re-excavation of Bacho Kiro Cave was jointly conducted by the National Institute of Archaeology with Museum, Bulgarian Academy of Sciences, Sofia and the Department of Human Evolution at the MPI-EVA. We would like to thank the National Museum of Natural History (Sofia), the Archaeology Department at the New Bulgarian University (Sofia), the Regional Museum of History in Gabrovo, and the History Museum in Dryanovo for assistance on this project and the opportunity to study the Bacho Kiro Cave faunal material. We would like to thank M. Trost, S. Hesse, M. Kaniecki, and P. Dittmann (MPI-EVA) for technical assistance during stable isotope sample preparation. S. Steinbrenner is thanked for technical assistance with TC/EA-IRMS maintenance. Thanks are also due to H. Temming and U. Schwarz (MPI-EVA) for the production of microCT scans and replicas of the sample materials. We would also like to acknowledge the assistance of to D. Veres with taking OSL samples. Last but not least we would like to thank the handling editor, S. Ortman, as well as three anonymous reviewers for their thoughtful comments that greatly improved this manuscript. Funding: The field work was financed by the Max Planck Society. The stable isotope work was funded by the Max Planck Society as part of S.P.’s doctoral project. S.P. was supported by the Max Planck Society and the University of Aberdeen. K.B. was supported by a Philip Leverhulme Prize from The Leverhulme Trust (PLP-2019-284). N.B.’s work was supported as part of a grant by the German Research Foundation (“PALÄODIET” Project 378496604). V.A. was supported by a grant from the Foundation for Science and Technology, Portugal (IF/01157/2015/CP1308/CT0002). Author contributions: The study was devised by S.P., K.B., S.P.M., J.-J.H., and T.T. Archaeological excavation was undertaken by N.S. and T.T. in collaboration with Z.R. and S.P.M. who all contributed contextual information. V.A. collected sedimentological data at the site and untertook micromorphological investigations that provided information on site formation for this study. Zooarchaeological and paleontological analyses were performed by G.M.S. and R.S. OSL dating was carried out by T.L. Radiocarbon dating and recalibration of radiocarbon dates were conducted by H.F. MC-ICPMS analysis was conducted by N.B. and S.P. Sampling, sample processing for oxygen and strontium stable isotope analysis, and TC/EA-IRMS analysis were carried out by S.P. Code and data analyses were written and conducted by S.P. N.-H.T. consulted on statistical analysis and coding. S.P. wrote the paper with input from all authors. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials.Peer reviewedPublisher PD