INNOVATIVE STRATEGIES OF PHARMACEUTICAL COMPANIES AS A FACTOR FOR ECONOMIC AND BUSINESS DEVELOPMENT

The pharmaceutical industry creates innovative products and services related to health promotion, disease prevention, diagnosis, treatment and rehabilitation, used for generation of the final output - improvement of the population health status. The new health services or products are type of innovations and they are created for the purpose of solving socially significant problems and to meet the priorities, objectives and innovation strategies for economic growth of the companies. The development of an innovation strategy within a pharmaceutical company is based on forecasts of the economic, research and technical development of the pharmaceutical sector.The pharmaceutical industry creates innovative products and services related to health promotion, disease prevention, diagnosis, treatment and rehabilitation, used for generation of the final output - improvement of the population health status. The new health services or products are type of innovations and they are created for the purpose of solving socially significant problems and to meet the priorities, objectives and innovation strategies for economic growth of the companies. The development of an innovation strategy within a pharmaceutical company is based on forecasts of the economic, research and technical development of the pharmaceutical sector

ANEMIC SYNDROME ASSOCIATED TO PARVOVIRUS B19 INFECTION IN PATHOLOGY PREGNANCY WOMEN

Viral infections during pregnancy on a world scale are one of the main reasons for severe complications and mortality of the mother and fetus. The post-infectious anemic syndrome is characterized by low serum iron and increased hepcidin, which is the cause for iron accumulation in the endothelial macrophage system and iron deficiency for the needs of erythropoiesis. Probably the increased hepcidin plays a protective role against the growth of microorganisms by reducing extracellular iron. On the other hand, the increased hepcidin may lead to iron deficiency and to inability for effective compensation upon oral supplementation because it suppressed intestinal iron absorption. This study aims to determine the involvement of parvovirus B19 in the anemic syndrome development in the course of/during pathological pregnancy. Materials and Methods: In total 47 serum samples of pregnant women with anemia hospitalized in University Obstetrics and Gynecology Hospital “Maichin Dom”,were tested. Three newborn babies were also included in the study. Serological (ELISA), molecular (PCR), and immunological (CLIA) methods were used. The statistical processing of the results is based on paired Student's t-test and Pearson's correlation. Results and discussion: 9/47 (19.1%) of patients showed presence of B19V-IgM antibodies. B19-IgG antibodies were detected in 19/47 (40.4%) women. The PCR analysis showed presence of viral DNA in all patients with positive B19V-IgM antibodies. B19V-IgM antibodies were proved in one of the newborn and viral DNA was detected. All three babies were positive for B19V-IgG antibodies. In four of the positive patients with the three diagnostic markers for acute infection, the anemia was determined as iron-deficiency according to the low serum levels of hepcidin 2.54 ± 0.4 μg/L compared to control group of pregnant women without anemia (21.7 ± 3.1 μg/L: P<0.001). In the remaining women with a proven acute B19V infection, we found a statistically significant increased level of serum hepcidin (65.3 ± 5.7 μg/L; P<0.001) compared to non anemic pregnant women. Conclusion: Assessment of the frequency and the grade of involvement of parvovirus B19 in the anemic syndrome development during pregnancy and determination of the serum level of hepcidin would contribute to the etiological clarification of the occurred anemic syndrome and would prevent improper iron supplementation by pregnant women

Vaccinium Vitis-Idaea L., Origin from Bulgaria Indicate in Vitro Antitumor Еffect on Human Cervical and Breast Cancer Cells

Cancer is a socially significant disease. Along with efforts to understand the complex genetic/epigenetic factors that trigger a carcinogenesis, it is also necessary to analyze the potential natural active substances that may delay or even stop neoplastic transformation. Promising candidates are Bulgarian cranberries from high mountain plant populations, which are rich in phenolics and anthocyanins and have proven beneficial effects on human body.The present study aims to evaluate in vitro, antitumor activities of total extracts and purified nonanthocyanin and anthocyanins fractions of Vaccinium vitis-idaea L., picked in Bulgaria on human cervical (HeLa) and breast (MCF7) cancer cell lines, as well as to examine some of the apoptotic mechanisms underlying them.Materials and methods: Four methanol extracts and respective number of purified B- nonanthocyanin / C- anthocyanins fractions of Bulgarian lingonberry were used. Antitumor effect was established by Trypan Blue method, monitoring of morphological changes and МТТ cell viability assay. Assessment of apoptotic activity was performed using DNA fragmentation method.Results: The results from МТТ analyses showed that B- nonanthocyanin fractions of Bulgarian lingonberry have well expressed inhibitory effect on survival of tested tumor cells. The observed effect dependent of the dose administered and were stronger in relation with the high-mountain populations and HeLa cell line. The integrity of the extracted DNA from treated survival cells indicates possible apoptosis mechanisms under the action of biologically active ingredients from lingonberries.Conclusion: Survey of antitumor activities of Bulgarian lingonberries based on molecular methods, could contribute to establish the natural substances useful for human health in general and practical oncology

Dried Blood Spots as a Clinical Samples for Laboratory Diagnosis and Surveillance of Vaccine-Preventable Diseases in Bulgaria

In recent years the dried blood spots (DBS) had new and innovative applications in medicine, neonatology, virology and microbiology. This study aimed to evaluation of the frequency of detection of viral IgM/IgG markers in dried blood spots and introducing an easy-to-implement protocol for serum extraction in measles, mumps and rubella surveillance. The total 204 clinical samples (102 serum samples and 102 dried blood spots) collected from 102 patients were included. All specimens were tested for presence of specific viral markers (IgM and IgG antibodies) by a commercial indirect enzyme-linked immunosorbent assay (ELISA). Of all tested patients, three (3/102, 2.94%, 95% CI: 0 ÷ 6.22) were confirmed for acute measles infection and two (2/102, 1.96%, 95% CI: 0 ÷ 4.65) for mumps. Double positive ELISA-IgM results were found in their serum samples and DBS. No acute rubella infection and rubella IgM marker were detected in both clinical samples. By immunoassay analysis of all 102 patients, measles, mumps and rubella IgG were found in 83/102 (81%, 95% CI: 73.40 ÷ 88.60), 76/102 (75%, 95% CI: 66.60 ÷ 83.40) and 79/102 (77%, 95% CI: 68.83 ÷ 85.17) serum samples.  Comparative results were obtained in the adequately obtained DBS. Viral IgG seroprevalence in DBS were obtained in 79/102 (77%, 95% CI: 68.83 ÷ 85.17) for measles, 69/102 (68%, 95% CI: 58.67 ÷ 77.33) for mumps and 73/102 (72%, 95% CI: 63 ÷ 81) for rubella, respectively. Double negative results for each screened viral markers were proven in six tested patients.The study shown higher extinction value (Ratio and NovaTec units) in DBS compared to serum samples of same persons were calculated. Our studies show over 90% coincidence in combined ELISA assay of viral markers against measles, mumps, and rubella in serum samples and DBS. DBS clinical approach is non-aggressive and more acceptable to the public (including young children, pregnant women, etc.). It has a variety of new and innovative applications in medicine and in particular in the laboratory diagnosis of acute and past (presence of protective immunity) measles, mumps and rubella infection in the phase of elimination

A Review on Antitumor and Antiviral Potential of Cranberries (Vaccinium Vitis-Idaea) Origin from Bulgaria

A major goal in antitumor and antiviral therapy is to find active ingredients that selectively suppress the proliferation of tumor cells or inhibit viral replication and proliferation. In this connection, the antitumor and antiviral activity of natural products with proven phytochemical properties and pharmacological significance are actively investigated. A promising candidate are Bulgarian cranberries from high mountain plant populations, which are a valuable natural source of food and have proven healing properties in urinary tract infections, eye diseases and cardiovascular disorders, as well as prevention of hypertension and diabetes. The active components of Vaccinium vitis-idaea L. are polyphenols and anthocyanins which belong to classes of plant components with high antioxidant, antimicrobial, cytotoxic and antiproliferative activity. Cranberries contain a high percentage and variety of vitamins (A,  E, C,  etc.) and a number of minerals (K, Ca, Mg, P, Na). In the world regions where endemic measles outbreaks occur, for secondary prevention and avoidance of complications including blindness, WHO recommends the use of high doses of vitamin A in children under 5 years of age. Bulgarian cranberries are a valuable source of vitamins A and C.The assessement of biological activity of the individual components and fractions in the composition of the Bulgarian cranberries may help to identify substances with antitumor and/or antiviral activity that could potentially be useful in future development of new therapeutic agents

Attitudes towards Development of Innovative Pharmaceutical Products in Bulgaria /// Нагласи за развитие на иновативни фармацевтични продукти в България

Innovations in the pharmaceutical industry and medicine are major advances in the field of healthcare. They are the latest kind of generations, offering a new, modern and conforming European standard of treatment, consisting of creating specialized, innovative products, state-of-the-art medical equipment, and introducing new models of medical health care. In the context of a dynamic and fast growing society, the requirements for professionalism and improvement of healthcare services, as well as the use of innovative approaches in solving socially significant problems are growing. In this respect, health innovation is structured and organized process of seeking and offering desirable changes that would provide modern and improved model of health care and better efficacy in the health system. The need for innovations in healthcare and pharmacy has never been greater than it is nowadays. Consumer demand and expectations are rising. Modern society is facing the question how healthcare should be better targeted, effective and improved, how to ensure quality and new kind of health services. Innovations in the field of medicine and pharmacy are the subject of increased attention to various researchers because this issue emerges as a new scientific field of research related to the improvement of medical science, its product diversification and the improvement of life of people by providing new alternatives for treating various diseases.[BG] Иновациите в областта на фармацията и медицината представляват сериозен напредък в сферата на здравеопазването. Те са генерации от най-ново поколение, предлагащи нов, модерен и отговарящ на европейските стандарти начин на лечение, изразяващ се в създаване на специализирани, иновативни продукти, най-модерна медицинска апаратура и внедряване на нови модели на здравни грижи и медицинско обслужване. В условията на едно динамично и бързо развиващо се общество, нарастват и изискванията за професионализъм и подобряване на обслужването в сферата на здравеопазването, както и за използване на новаторски подходи при решаване на социално-значими за обществото и неговото здраве проблеми. В този смисъл, иновацията в сферата на здравеопазването е целенасочен, добре структуриран и организиран процес на търсене и предлагане на желани промени, които биха предоставили един по - модерен и подобрен модел на здравна грижа, и по - добра ефикасност в дадена здравна система. Необходимостта от иновации в сферата на здравеопазването и фармацията никога не е била по-голяма, отколкото в днешно време. Потребителското търсене и очаквания се повишават. Пред съвременното общество стои въпроса, как здравеопазването да бъде по - добре ориентирано, ефективно и усъвършенствано, как да се гарантират качествени и нов вид здравни услуги. Иновациите или нововъведенията в областта на медицината и фармацията са обект на засилено внимание на различни изследователи, защото този проблем се очертава като ново научно поле на научни изследвания, свързани с усъвършенстването на медицинската наука, разнообразяването й в продуктово отношение, както и подобряването на живота на хората, чрез предоставяне на нови алтернативи за лечение на различни заболявания

Carpal tunnel syndrome - anatomical variations and tests for their diagnosis

Карпал тунел синдромът е най-честият компресивен синдром и представлява натиск или тензия на нервус медианус на ниво китка. Вторично се развива при обем заемащи процеси в канала, като напр. анатомични варианти на мускулите и сухожилията в областта на китката. Поради тяснато пространство на канала, всяка промяна във формата или местоположението на тези структури води до притискане на n. medianus. Цел на настоящата статия е да направи кратък литературен обзор на анатомичните вариации на мускули и сухожилия в областта на карпалния тунел, които могат да доведат до затруднение при поставяне на диагнозата и неуспехи при физикалната и оперативната терапия, както и на провокативните тестове за тяхното установяване.Carpal tunnel syndrome is the most common com- pressive syndrome and is presented with pressure or tension of the median nerve at the level of the wrist. Secondary develops due to volume-occupying pro- cesses in the chanel, as anatomical variants of mus- cles and tendons in the carpal region. In the narrow space of the carpal tunnel every change in the mor- phology and position of these structures causes com- pression of the median nerve. The aim of this article is a brief overview of the anomalous muscles and ten- dons in the area of carpal tunnel that lead to diagnos- tic difficulties and low efficiency of physiotherapy and surgical interventions and provocative tests for their establishment

Point Shear Wave Elastography and 2-Dimensional Shear Wave Elastography as a Non-Invasive Method in Differentiating Benign from Malignant Liver Lesions

Non-invasive, ultrasound-based methods for visualizing and measuring tissue elasticity are becoming more and more common in routine daily practice. An accurate diagnosis of malignant and benign tumors is essential for determining the appropriate treatment. Despite the wide use of imaging techniques, the investigation for assessing the elasticity of focal liver lesions and their differentiating is still continuing. Aim: To investigate the value of point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) for the differential diagnosis of benign and malignant focal liver lesions. Materials and Methods: A total of 125 adult patients were included from the Clinic of Gastroenterology of University Hospital Kaspela, Plovdiv city, Bulgaria, in the period from January 2021 to July 2022. Participants were divided into two groups—with benign (hemangiomas) and malignant focal liver lesions (hepatocellular carcinoma). The group with benign lesions included 63 patients and the group with malignant focal liver lesions (FLLs)—62 patients. Point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) integrated in the same ultrasound machine (Esaote MyLab™ 9Exp) were performed for each lesion. Results: Malignant FLLs have significantly higher stiffness in both pSWE (2.52–4.32 m/s, 90% CI: 2.37 to 2.68, 90% CI: 4.19 to 4.55) and 2d-SWE (2.52–4.43 m/s, 90% CI: 2.31 to 2.65, 90% CI: 4.27 to 4.61). Conclusion: 2D-SWE and pSWE could provide complementary data about FLLs. They enable us to conveniently and easily obtain accurate stiffness information of FLLs

MODERN DIMENSIONS OF THE POLICIES AND STRATEGIES "ANTIPOVERTY" IN REPUBLIC OF BULGARIA IN THE CONTEXT OF THE EUROPEAN SOCIAL MODEL

В настоящата публикация са разгледани, някои основни проблеми залегнали в разработения проект. Доколко обема позволява засегнати са основните теоретико-концептуални основи на бедността, видовете и функциите и. Акцентът се поставя най вече върху гъвкавостта на трудовия пазар, на икономическата активност и заетост. Обосновани са регионите с най-висока бедност в страната.Разкриват се най-търсените и прилагани програми и мерки за заетост в регионите с най-висока безработица и се акцентира върху тяхната ефективност. Въз основа на мненията на специалистите, занимаващи се с разглежданите проблеми от областите с високо равнище на бедност са направени критични бележки относно ефективността на тяхното използване. Същевременно се поставят и разглеждат проблемите на политиката на социалното подпомагане за намаляване на бедността като се открояват програмите за гарантиран минимален доход и целевото енергийно регулиране с цел снижаване равнището на бедност в най-бедните региони. Some fundamental problems underlined in the project are discussed. In so far as the volume allows, the basic theoretical and conceptual foundations of poverty its functions and types are affected. The focus is primarily on labor market flexibility, on economic activity and employment. The regions with the highest poverty in the country are justified. The most sought and implemented programs and measures for employment with the regions with the highest unemployment rates are disclosed. The emphasis is placed on their effectiveness. Based on the opinions of specialists dealing with the problems of areas with high level of poverty, some critical remarks about the effectiveness of their use are made. At the same time, policy problems of social assistance for poverty reduction are placed and processed. Programs for guaranteed minimum income and target energy assistance carried out to reduce poverty in the poorest regions are highlighted