Pathogenesis Of Epstein-Barr Virus Associated Infectious Mononucleosis

Инфекциозната мононуклеоза (ИМ) е клиничен синдром, който най-често се свързва с първична инфекция с вируса на Епщайн и Бар. Открит е през 1964 г. от Майкъл Антъни Епщайн и Ивон Бар с помощта на електронна микроскопия в клетъчна линия от биопсичен материал от лимфом (Лимфом на Бъркит) на дете от Африка. Това е първият описан онкогенен вирус при хората. Понастоящем в международната класификация на вирусите той се води човешки гамахерпесен вирус 4 (Human gammaherpesvirus 4), четвъртият по ред на откриване представител на това семейство. EBV e широко разпространен и над 90% от възрастното население е инфектирано с него. Заразяването става най-вече с орофарингеалните секрети и затова в литературата ИМ се означава още като болест на целувката. Първоначално вирусът се реплицира в епитела на фаринкса и след това инфектира В-лимфоцитите на подлежащата лимфоидна тъкан. Чрез циркулиращите лимфоцити инфекцията се генерализира. EBV остава в латентно състояние в В-лимфоцитната популация и тези клетки са резервоар на вируса през целия живот. Инкубационният период на заболяването е 4-6 седмици и протича с триадата – треска със силна отпадналост, лимфаденопатия и фарингит. По време на втора-трета седмица от заболяването се установяват левкоцитоза с лимфоцитоза, с преобладаване на атипични лимфоцити. За серологична диагноза се търсят антитела срещу вирусните антигени, като анти-VCA IgM и IgG, които са положителни, а антителата срещу EBNA1 (EB nuclear antigen) липсват през острата фаза на инфекцията. Връзката на ИМ с Ходжкинови лимфоми я прави социално значимо заболяване и изисква точно поставяне на диагнозата, подкрепено от съответните лабораторни изследвания.Infectious mononucleosis (IM) is a clinical syndrome that is most commonly associated with primary Epstein – Barr virus (EBV) infection. It was discovered in 1964 by electron microscopy of cells cultured from Burkitt`s lymphoma tissue by Michael Anthony Epstein and Yvonne Barr in a child from Africa. This is the first human oncogenic virus described. At present, in the international classification of viruses it is Human gammaherpesvirus 4, the fourth in order of discovery representative of this family. EBV is widespread and over 90% of the adult population in the world is infected with it. The infection is transmitted mostly by oropharyngeal secretions and because of this in the literature, IM is also referred to as the “Kissing Disease”. Initially, the virus replicates in the pharynx epithelium and then infects the lymphocytes of the underlying lymphoid tissue. Infection is spread in the whole body by circulating lymphocytes. EBV remains dormant in the B-lymphocyte population and these cells are a reservoir of the virus throughout life. The incubation period is 4-6 weeks and disease occurs with the classical triad - a fever with severe fatigue, lymphadenopathy and pharyngitis. Leukocytosis with lymphocytosis, predominantly with atypical lymphocytes, are detected during the second or third week of the disease. For serological diagnosis, antibodies against viral antigens such as anti-VCA Ig M and Ig G are positive, and antibodies to EBNA1 (EB nuclear antigen) are not seen in the acute phase of EBV infection. The connection between IM and Hodgkin's lymphomas makes IM a socially significant illness and requires accurate diagnosis supported by appropriate laboratory studies

Zoonotic paramyxoviruses. Genus Henipavirus

Over the last two decades, data has been accumulated for zoonotic paramyxoviruses, also affecting human pathology. Of greatest importance are the two species of genus Henipavirus of family Paramyxoviridae – Hendra virus (HeV) and Nipah virus (NiV), that cause severe and lethal infections in humans and animals, for which they have been classified as class C bioterrorism agents by the CDC. Our goal is to research and study scientific medical publications on epidemiology and the medico-social significance of these two little known viruses. To achieve this, we used the documentary method by studying full-text scientific publications.Both the Hendra and Nipah viruses have a restricted range of distribution and are mainly found in animals, most often in fruit bats (flying foxes, megabats), pigs and horses. In the period from 1994 to 2009 only seven cases of human Hendra virus infection have been documented, while the Nipah virus has a more prominent virulence towards humans and has caused numerous cases and almost annual epidemics in Malaysia and India. The knowledge and public awareness of newly emergent viral infections is important for their control and the creation of effective measures for the prevention of their spread

Research On Epstein-Barr Virus In Patients With Non-Hodgkin Lymphomas

Въведение: Епщайн-Бар вирусът (EBV) е гамахерпесен вирус, широко разпространен в целия свят. След първична инфекция най-често в детството и юношеския период вирусът остава в латентно състояние в В клетките и периодично може да реактивира, особено при имуносупресия и имунен дефицит. ЕBV се асоциира с инфекциозна мононуклеоза, но е патогенетично свързан с редица малигнени заболявания, вкл. и неходжкинови лимфоми (НХЛ).Цел: С това проучване искаме да анализираме честотата на инфекция с EBV при пациенти с неходжкинови лимфоми.Материали и методи: Включени са 120 лица, изследвани за наличие на anti-VCA IgM и anti-VCA IgG чрез ELISA в периода 2010-2016 г. Данните са от вирусологична лаборатория при УМБАЛ „Св.Марина“ – Варна.Резултати: Установихме 7.5% anti-VCA IgM и 95.8% anti-VCA IgG, положителни резултати. От изследването за anti-VCA IgM по-висок относителен дял (12.5%) имат положителните жени в сравнение с този на мъжете (3.1%) (p>0.05).Изводи: В нашето проучване заразените с ЕBV пациенти с НХЛ имат сигнификанто по-висок относителен дял от средния за региона (83.0%).Introduction: The Epstein-Barr virus (EBV) is a gammaherpesvirus widely spread throughout the world. After primary infection, most often during childhood and adolescence, the virus remains latent in B cells and can be periodically reactivated, especially in patients with immunosuppression and immune deficiency. EBV is associated with infectious mononucleosis, however it is also pathogenetically associated with a number of malignancies, including non-Hodgkin lymphoma (NHL).Aim: With this study we want to analyze the incidence of EBV infections in patients with non-Hodgkin lymphomas.Materials and Methods: We analyzed 120 patients tested for the presence of anti-VCA IgM and anti-VCA IgG by ELISA in the period 2010-2016. Data is provided by the Virology Laboratory at St.Marina University Hospital in Varna.Results:We found 7.5% anti-VCA IgM and 95.8% anti-VCA IgG positive results. When analyzing the results for the anti-VCA IgM, a higher proportion (12.5%) of positive results was shown in women compared to men (3.1%) (p>0.05).Conclusion: Our study showed that there was a significantly higher proportion of EBV-infected patients with NHL than the average for the region (83.0%)

Endodontic irrigation

Introduction: The removal of pulp tissue and dentin debris from the root canal system, as well as the chemical and mechanical cleaning of the root canal system, are all necessary for an endodontic procedure to be successful. It is challenging to completely treat the dentinal surface of the root canal due to the complex root-canal shape, extra lateral canals, and the characteristics of the apical delta. Large portions of the main canal are still untreated and uncleaned according to numerous studies. The canal contents are evacuated to varied degrees and part of it is pushed apically and towards the walls during the shaping of the canal space without irrigants, resulting in the formation of a dense contaminant layer. Because of this, irrigation plays an essential role in endodontic therapy. The irrigant must be delivered to the prepared root space in order to be distributed to all areas, including mechanically untreated ones.Aim:  The primary goal of this article is to investigate the properties of various types of irrigation solutions, the concentrations at which they are used in modern dentistry, and how their effectiveness can be increased.Materials and Methods: For this research investigation, data were gathered from online databases.Results: Some of the most widely used irrigation solutions are sodium hypochlorite, EDTA, sterile water or saline, citric acid, and other combined solutions.Conclusion: The main issues with using irrigation solutions are their inability to reach the most complex anatomical structures in the apical third, the clinical usage time, and their toxicity to the periapical tissues.Keywords: irrigation, sodium hypochloride, EDTA, citric aci

Tuberculosis Infection Control and Prevention in Bulgaria

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, and it most often affects the lungs. In Bulgaria, the incidence of tuberculosis has decreased from 27,9 cases per 100,000 people in 2011 to 9,7 cases per 100,000 people in 2021. The number of registered cases of tuberculosis varies significantly by region. In Northwestern and Central Bulgaria, the incidence is above the national average. TB spread control should be carried out by conducting specific immunoprophylaxis, providing timely diagnosis and treatment of new patients, reducing poverty, and providing access to health education for the most vulnerable groups

Innovative technologies in laboratory medicine for prevention and control of chronic diseases

Въвеждането на иновативни методи и технологии за диагностика и лечение е процес от ключово значение за развитието на медицината. Лабораторните изследвания, подпомагащи поставянето на правилна диагноза и проследяване на всички заболявания, са основани на принципи и стандарти за добра практика. В проследяването на лабораторните параметри на пациентите с хронични заболявания новите технологии в ежедневието навлизат с бързи темпове. Публикацията представя перспективите и възможните ползи на тестовете, провеждани в дома на пациентите или от тях самите.The introduction of innovative methods and technologies for the diagnosis and treatment process is crucial to the development of medicine. Laboratory studies supporting a correct diagnosis and monitoring of all diseases are based on the principles and standards of good practice. In the researches of the laboratory parameters of patients with chronic diseases, new technologies are entering with a rapid pace. The article presents the prospect of possible benefits of the tests, which are acomplished at patients` homes or by themselves

Postoperative pain after root canal treatment

The main goal of endodontic treatment is biomechanical preparation of the root canal, which includes (cleaning, shaping, disinfection) and its hermetic sealing as well as providing conditions for the healing of periradicular tissues. During the shaping of the root canal space products such as dentinal debris, microorganisms, or pulp residues are extruded into periapical tissues. This leads to irritation of the periodontal tissue, which in turn induces postoperative pain. It can be defined as onset of pain or other discomfort in the area of an endodontically treated tooth that occurs within a few hours or a few days after root canal treatment. The patient may feel slight pain in the tooth when chewing, biting, and local symptoms in the area of the oral mucosa such as redness, or a feeling of dull constant pain in the area of the periapex may be observed. Postoperative pain is defined as an unpleasant condition that often occurs after root canal treatment. It occurrence was found to vary between 3 to 58%. This severe pain was observed in 12% of patients within 24–48 hours after endodontic treatment. If it remains neglected, this sensitivity may cause suffering, compromise the quality of life, have psychosocial consequences, and become a public health problem

Hepatitis D virus in Bulgaria: virology, epidemiology and pathogenesis in chronic HBV carriers with liver dysfunction

Inroduction: Hepatitis D (HDV) is the most interesting and unique among animal viruses. It causes viral hepatitis D only in individuals already infected with HBV (hepatitis B). This dual    infection leads to the most aggressive hepatic dysfunction of all human viral hepatitis.Aim: This study was made to outline the hepatitis D virus among patients with chronic liver disorders in northeastern Bulgaria, in the sight of virus epidemiology, pathogenicity and viral genotype.Materials and methods: This is a retrospective study conducted between 2013-2019 at St. Marina University Hospital,Varna, Bulgaria. We have analyzed 418 serum samples from 391 patients with chronic liver disease using ELISA, PCR and HDV sequencing and genotyping.Results and Discussion: From 391 patients with chronic liver abnormalities, 16.6% (95% CI: 15.9% - 23.8%, n = 65) had an etiological association with HDV in ELISA. We found HDV RNA positive results in 63 out of all 65 anti-HDV Ab (antibody) positive patients (96.9%). Twenty-four of them, or 38.1% (95% CI: 26.1% - 51.2%, n = 24), were on antiviral HBV/HDV therapy. For five of them, or 20.8% (95% CI: 7.1% - 42.2%, n = 5), HDV genotype I was found.Conclusion: HDV infection has still many mysteries to discover - in terms of pathogenesis, clinical outcome in chronic HBV/HDV-infected individuals, as well as genotype variations and their role in avoiding immune elimination of the virus. All these unanswered questions pose a great challenge to the scientific thought and efforts of humankind to reduce and gradually eliminate viral hepatitis D

Results of a Survey on the Aspects of Menopausal Symptoms and Medication Therapy

Introduction The period of menopause is accompanied by termination of the menstrual cycle. It is assumed to start from the 12th consecutive month of missing menstruation. In most cases, menopause occurs in the period between 40 and 50 years of age.AimThe objective of this present work is to present and analyze certain aspects of the menopausal symptomatic and the medication therapy in the menopause period.Materials and Methods A study using a direct anonymous survey was conducted on the territory of Varna Municipality during the period January – March 2018. The data collected from the survey was processed using the SPSS statistical software.SymptomsThe transition to menopause plays an important role in the etiology of symptoms described as hot flashes, nighttime sweating, mood changes, sleep disturbance, and sexual dysfunction. Therapy Approaches Hormone substitution therapy is an approach, which includes taking of hormones (estrogen and progesterone) for treatment of the symptoms of menopause and aging. Pharmacies offer a wide range of estrogen therapy medicinal products in the form of pills, plasters, suppositories, etc.Natural products therapy for menopausal symptoms includes herbs and other plant and non-plant additives.Conclusion Menopause is a natural stage in the aging process of the female organism. We are of the opinion that successful identification of the symptoms in the transitional period to menopause, and increased awareness of mature women as regards the therapy approaches available to apply, would have a significant positive impact on women’s health and social well-being

Irrigation protocol in endodontics—a review

For an endodontic treatment to be successful, the pulp tissue and dentin debris from the root canal system must be removed, and the root canal system must also be chemically and mechanically cleaned. The solutions most commonly used in endodontic therapy are: hypochlorite, citric acid, ethylenediamine tetraacetic acid (EDTA), saline or distilled water, and alcohol. Irrigation solutions must eliminate microorganisms, affect both organic and inorganic matter, remove the smeared layer and stimulate the healing process. During the shaping of the canal space without irrigants, the canal contents are evacuated to varying degrees, and some are pushed apically and towards the walls, resulting in the creation of a dense contaminant layer. As a result, irrigation is quite important