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

Endometriosis - Review Of Current Therapeutic Aproaches For Disease Control

Ендометриозата е хронично естроген-зависимо заболяване, което се характеризира с развитие на ендометриална тъкан извън маточната кухина. В световен мащаб засяга около 10% от жените. Заболяването може да причини дисменорея, хронична тазова болка, диспареуния и инфертилитет. Медикаментозното лечение играе ключова роля в контрола на заболяването. В повечето случаи е наложително лекарствената терапия да бъде комбинирана с хирургична, за да бъде постигнато пълно излекуване. Подходът при избор на подходящо медикаментозно лечение трябва да бъде индивидуализиран, като бъде съобразен с тежестта на ендометриозата, ефикасността на лекарството, страничните му ефекти, желанието на пациентката, възрастта ѝ и репродуктивните ѝ планове. Голяма част от използваните днес лекарства за лечение на ендометриоза целят потискане на овариалната функция. Най-често прилаганите и показващи най-добри резултати са комбинираните орални контрацептиви, аналозите на гонадотропин-освобождаващия хормон и прогестините. Освен тези утвърдени терапии, съвременното лечение включва и нови хормонално и нехормонално-базирани терапевтични подходи, които модулират различни патогенетични механизми. В този обзор ще бъдат разгледани настоящите терапевтични опции - както класическите, така и по-новите, все още неодобрени медикаменти за лечение на ендометриоза.Endometriosis is an estrogen-dependent chronic disease characterized by the presence of endometrial tissue outside the uterine cavity. Globally, it affects about 10% of women worldwide. It causes dysmenorrhea,chronic pelvic pain, dyspareunia, and infertility.Medication treatment plays a key role in disease management. In most cases, medications should be combined with surgery in order to eradicate the disease. The medication treatment should be individualized considering the severity of endometriosis, efficacy of the drug, its side effects, patient`s preferences, age, and reproductive plans. Nowadays, most of the drugs used to treat endometriosis aim to suppress ovarian function. The most widelyused and with the best therapeutic outcomes are the combined oral contraceptives, gonadotropin-releasing hormone agonists, and progestins. In addition to these well-established therapies, new horomonal and non-hormonal therapeutics that modulate various pathogenic pathways are available. We review currently availabletreatment options - the classical ones and the new therapies that are still not approved

Detection of pathogenic variants in Alzheimer’s disease related genes in Bulgarian patients by pooled whole-exome sequencing

AbstractIn an effort to better understand the complex genetic background of Alzheimer’s disease (AD) we performed high-coverage whole-exome sequencing of a DNA pool assembled of 66 Bulgarian AD patients. We focused our analysis on genes demonstrated to have association with AD in previous studies, i.e. PSEN1, PSEN2, APP, APOE, TREM2, HFE, CLU and CR1. In these genes, we established six pathogenic/likely pathogenic variants in the sequenced pool, three common and three rare. Two of these variants showed statically non-significant difference between Bulgarian AD patients and Bulgarian control exomes, the hemochromatosis variant rs104894002 (HFE) and rs7412 (APOE), which, notwithstanding its pathogenicity score, has putative protective role against AD. Three of the remaining four pathogenic/likely pathogenic variants were estimated to significantly differ in frequency between the analyzed AD patient pool and controls. These are the rs429358 (APOE) polymorphism, a well-established risk factor for Alzheimer’s disease, the rs28936380 (PSEN2) and rs104894002 (TREM2), also ascertained to be associated with AD. The performed study validates the role of three pathogenic/likely pathogenic variants in AD related genes in the multifaceted genetic etiology of Alzheimer’s disease