Who should consult patients about medicines according to the information provided in leaflets?

Materials and methods: Information was extracted from the patient leaflets of 2500 medicines with marketing authorization and available on the Bulgarian market, representing all anatomical groups of the ATS classification. The analysis in the present study focused on one criterion, namely which medical specialist is indicated in the leaflet in the field "consult (ask questions to) if you need with...".Results: In 63.4% of the leaflets, it is written that if more information is needed, the patient should consult a doctor or pharmacist. In 19.4% of leaflets, patients are referred for consultation with a pharmacist only. In 7.7% of leaflets, several options are listed, namely: doctor, pharmacist or nurse. Only 3.3% of the drugs studied gave a recommendation to seek information only from a doctor.Conclusion: The pharmacist was the most frequently cited healthcare professional for medication consultation, listed in 90% of patient leaflets. In this regard, he should be prepared to give advice on the correct way of taking the medicines and rational medicinal use

Obesity in Pregnancy – Implications on Pregnancy Events

BACKGROUND: Overweight and obesity are serious health problems in most developed countries. The percentage of young women with excessive weight who get pregnant continues to grow every year. This raises a concern about the risks of the mother and the baby during pregnancy and after birth. AIM: This study aims to determine health risk for overweight mothers and especially the risk for preterm birth. MATERIALS AND METHODS: This is a prospective and retrospective study taking place in the outpatient clinic of the University Hospital “Maichin Dom”. Our study included 105 pregnant women with BMI ≥25 kg/m2 as a case group and 91 pregnant women with BMI within normal limits as a control group. RESULTS: Mean BMI in the case group was 34.79 ± 3.71 kg/m2 and 20.20 ± 2.24 kg/m2 in the control group. Among 105 women in the case group, we registered 24.8% (n = 26) who gave birth before term. Preterm births among 91 women in the control group were registered in 17.6% (n = 16) patients. We found a significant correlation between increased BMI and the risk of increased systolic and diastolic blood pressure. Moreover, we found comorbidities in 43.8% of cases and 24.2% of controls. CONCLUSION: Maternal overweight and obesity during pregnancy are associated with increased risks of preterm delivery and complications of pregnancy. Extra efforts should be made to help women lose weight before this important period of life

Clinical cases of pulmonary tuberculosis as a result of TNF antagonist therapy

През последните 12 години антагонистите на TNF са били успешно използвани за лечение на много пациенти страдащи от хронични възпалителни заболявания. Това лечение увеличава риска от туберкулоза до 25 пъти. Дължи се на факта, че TNF и TNF-рецепторите играят важна роля в медиирането на имунния отговор при остри и хронични възпаления. Ето защо всички пациенти, на които предстои подобно лечение трябва да бъдат подложени на стриктна оценка за изключване на активна и латентна туберкулозна инфекция. През 2010 г. беше публикуван консенсус на TBNET, озаглавен „Рискът от туберкулоза, свързан с лечение с TNF антагонисти`.В изложението са представени два случая на белодробна туберкулоза, които са наблюдавани в хода на провеждано лечение с TNF антагонисти при болни с доказани възпалителни заболявания на червата.During the past 12 years TNF antagonists have been successfully used for the treatment of many patients suffering from chronic inflammatory diseases. This treatment increases the risk of tuberculosis up to 25 times. This is due to the fact that TNF and TNF-receptors play an important role in mediating the immune response in acute and chronic inflammation. Therefore all patients undergoing such treatment should be subject to rigorous assessment to exclude active and latent tuberculosis infection. In 2010 a TBNET consensus was published entitled "The risk of tuberculosis related to TNF therapies." In this article we present two cases of pulmonary tuberculosis, which were observed in the course of an ongoing treatment with TNF antagonists in patients with proven inflammatory bowel disease

On the Classification of Bulk and Boundary Conformal Field Theories

The classification of rational conformal field theories is reconsidered from the standpoint of boundary conditions. Solving Cardy's equation expressing the consistency condition on a cylinder is equivalent to finding integer valued representations of the fusion algebra. A complete solution not only yields the admissible boundary conditions but also gives valuable information on the bulk properties.Comment: 7 pages, LaTeX; minor correction

Immune response – genesis, duration, and strength in patients with moderate and severe coronavirus infection of different age groups

Acquired (adaptive) immunity is a major factor determining effective immune response against a few infectious diseases. The immune response during recovery from COVID-19 is complex, involving both cellular and humoral adaptive immunity. The purpose of the study is to determine the intensity and effectiveness of the immune response at the end of the second year after discharge from the hospital in patients who have suffered from moderate and severe forms of coronavirus infection. A study among 2683 patients who suffered from moderately severe and severe coronavirus SARS-CoV2 infection with recorded complications which have not received a vaccine against SARS-nCoV-2 was performed. In the studied group of patients there were no deaths. In the whole cohort, the share of underlying prehospital comorbidity was also analyzed. The immune response induced because of moderate and severe infection with COVID-19 could serve as source of protection from recurrent severe infection for patents of different ages with various comorbidities

Boundary Conditions in Rational Conformal Field Theories

We develop further the theory of Rational Conformal Field Theories (RCFTs) on a cylinder with specified boundary conditions emphasizing the role of a triplet of algebras: the Verlinde, graph fusion and Pasquier algebras. We show that solving Cardy's equation, expressing consistency of a RCFT on a cylinder, is equivalent to finding integer valued matrix representations of the Verlinde algebra. These matrices allow us to naturally associate a graph $G$ to each RCFT such that the conformal boundary conditions are labelled by the nodes of $G$. This approach is carried to completion for $sl(2)$ theories leading to complete sets of conformal boundary conditions, their associated cylinder partition functions and the $A$-$D$-$E$ classification. We also review the current status for WZW $sl(3)$ theories. Finally, a systematic generalization of the formalism of Cardy-Lewellen is developed to allow for multiplicities arising from more general representations of the Verlinde algebra. We obtain information on the bulk-boundary coefficients and reproduce the relevant algebraic structures from the sewing constraints.Comment: 71 pages. Minor changes with respect to 2nd version. Recently published in Nucl.Phys.B but mistakenly as 1st version. Will be republished in Nucl.Phys.B as this (3rd) versio

Level of hypertension treatment adherence during pandemic

Adherence to antihypertensive medications is the cornerstone for achieving metabolic syndrome control. The aim of this study was to explore how the pandemic has affected the adherence of patients with high BP to prescribed antihypertensive drugs. This multicentre observational study utilized self-completed questionnaires among patients between June and November 2020. Overall, 842 patients were included in the study. The likelihood of adherence was assessed using the 5‐item version of the Medication Adherence Report Scale (MARS-5Professor Rob Horne). The average MARS score of the sample was 16.81, the median was 4.162, and the most common value was 3 (24.5% of respondents) for the patients treated during the pandemic. The study suggests that several sociodemographic factors but not the COVID pandemic play a role in treatment adherence

Prevention of cardiovascular diseases

Cardiovascular diseases (CVD) are socially significant diseases due to high morbidity and loss of people of working age. In Bulgaria, they are the leading cause of mortality among the population and are a consequence of the effect of cardiovascular risk factors. The draft of the National Health Strategy (NHS) 2021–2030 reports on their wide distribution, as well as on the insufficient knowledge, skills and motivation for their prevention and control. The purpose of this review is to address the prevention of cardiovascular disease, which is a significant problem worldwide. Prevention goals for patients with established cardiovascular disease and those at high risk include smoking cessation, healthy eating, physical activity, and lowering body mass index. There are various methods that are part of health promotion to reduce CVD risks. These methods include motivational interviewing, non-pharmacological means, the use of certain medications for CVD prevention, as well as physical activity. Strategies for effective primary prevention refer to engaging the patient to change their lifestyle and identifying risk factors, while secondary prevention is aimed at activities to detect the disease early and to slow down its progression. It is necessary to create a strategy for timely preventive actions with a view to preventing the negative influence of risk factors and improving people‘s heart health