Levels of Lymphocyte Subpopulations in Peripheral Blood among Patients with Diabetes

The aim of the study was to investigate the lymphocyte (lymph) subpopulations in peripheral blood as a part of the immune response among patients with diabetes mellitus type 1 (DMT1) and diabetes mellitus type 2 (DMT2). Patients and methods: A prospective, cross-sectional, comparative, “case-control” study was conducted among 22 patients with DMT1 and 70 patients with DMT2. The levels of lymph subtypes [general nonspecific T-lymph (CD3+); T-helper lymph (CD4+); T-cytotoxic lymph (CD8+), natural killers [NK cells (CD3\ CD16+/CD56)] and B-lymph (CD19+)] in blood was measured and compared by flow-cytometric analisys (FAC Sort, BD). Results were compared to those of 21 healthy persons. The data was processed using the statistics software. Results: Patients with DMT1 had longer duration of the disease, compared to patients with DMT2. No significant differences between arterial blood pressure, НвА1с levels and lipid profile among the patients with DMT1 and DMT2 were present. There were no differences in the total leukocyte count between the groups (DMT1-6,91 ± 1,32.109/l; DMT2-7,28 ± 1,85.109/l; controls-6,89 ± 1,07.109/l). The results from the flowcytometric investigation showed significantly higher absolute number of T-all lymph (CD3+), Th lymph (CD4+) and all NK (CD3\ CD16+/CD56), as well as a lower absolute number of Ts (CD8+) and B (CD19+) lymph among the diabetic patients compared to healthy subjects. The Th/Ts ratio in patients with DMT1 (2,02 ± 0,44) and DMT2 (2,36 ± 0,37) was also significantly higher compared to ratio of controls (1,02 ± 0,06). No significant differences were noted in the lymph subpopulations between the two groups with DM. Conclusions: Changes of lymph types in peripheral blood in diabetic patients demonstrate immune activation and dysregulation among the two types of diabetes.

Clinicopathological Significance of BRAF (V600E), NRAS (Q61K) and TERT (C228T, C250T and SNP Rs2853669) Mutations in Bulgarian Papillary Thyroid Carcinoma Patients

Introduction: Thyroid carcinoma is the most common endocrine cancer. Some somatic mutations in genes (BRAF, NRAS and TERT) involved in key signaling pathways and genome stability have been recently identified to play an important role in its development. Very little research has been done on their frequency and clinical relevance in Bulgarian patients with papillary thyroid cancer (PTC). This study is focused on investigating somatic mutation frequency in Bulgarian patients with PTC and their association with clinicopathologic features. Material and Methods: The study included 50 PTC from Bulgarian patients analyzed for mutations in BRAF (V600E), NRAS (Q61K), single nucleotide polymorphism (SNP) rs2853669 and TERT (C228T and C250T) genes by Sanger sequencing. The results were interpreted using Benchling and SeqScape software, and statistical analysis performed with SPSS. Results: In the studied PTC group BRAF(V600E) and TERT (C228T) mutations were found with frequency of 24% and 2%, respectively. Co-occurrence of both mutations was found in 1 patient (2%). The mutations Q61K (NRAS), and C250T (TERT) were not detected. The SNP rs2853669 was found in 18 patients (52.9%). Correlation analysis with the clinical characteristics of the patients revealed statistically significant association with larger size of the tumor for BRAF(V600E) and smaller tumor size for rs2853669. Conclusion: In the present pilot study, we found that BRAF(V600E) and rs2853669 in TERT are common among PCT patients. While the presence of BRAF V600E mutation was associated with large tumors, the presence of rs2853669 in TERT was found in the majority of PCT below 2 cm. More extensive molecular genetic analysis of TERT, BRAF or RAS mutations in larger sample is needed to further elucidate the clinically important diagnostic and prognostic biomarkers for thyroid cancer.

Shift Work and Occupational Stress in Hospital Nurses in Sofia

Prevalence of shift work and occupational stress is one of the highest in nursing compared to other sectors. For years Bulgaria is facing nurses’ shortage, which contributes to their long working hours. The aim of the study was to follow the working time arrangements, stressors and health symptoms in hospital nurses in Sofia. Methods: The study is cross-sectional and comprised 1292 female nurses of average age 50.0 ± 10.2 years from 19 hospitals in Sofia. The anonymous questionnaire was filled, including demographic information, working hours and shift system, with special attention to night work and long working hours, stress and health symptoms. Statistical analysis was carried using SPSS. Results: The shift work, night work, including 5 and more night shifts per month and the extended shifts were common among the studied nurses with the greatest deal of the emergency and intensive care unit nurses, followed by department nurses. The high rates of overtime and second job contributed to long working hours of 51-60 hours per week in 16.9 % of the nurses and > 61 hours in 11.1 %. About 90 % of the nurses felt under strain and experienced emotional dissonance while working with patients. Work-related stress, night work and long working hours were related to self-rated emotional and physical exhaustion and poor health. Discussion: The work-related stress, night work and the long working hours raise health concerns for occupational health of hospital nurses. Urgent preventive measures are needed to control stress and reduce working hours and night work.

Ghrelin Expression in Mast Cells of Infant Lung with Respiratory Distress Syndrome

This article sheds light on some features of ghrelin (GHR)- and tryptase (Try)-positive mast cells (MCs) distribution in human lung of preterm newborns with respiratory distress syndrome (RDS). GHR possessed anti-inflammatory activity and reliable therapeutic properties in some lung diseases. So far, GHR expression has been defined predominantly in neuroendocrine cells of bronchial mucosa in fetal and infant lungs. Lung tissue from 8 dead newborns with RDS were investigated immunohistochemically with anti-GHR and anti-Try antibodies. The number of GHR+ and Try+ MCs was determined in three locations –bronchi, bronchiole and in alveolar septa. MCs were more numerous around main bronchi with diminishing numbers around bronchiole and in alveolar septa. The number of MCs in the latter was increased in newborns with pneumonia. The number of GHR+ MCs in alveolar septa was lower in newborns with RDS as compared to newborns with RDS combined with pneumonia (2.83 ± 1.13 vs 4.81 ± 2.6, p < 0.001). The amount of Try+ MCs along bronchial wall was significantly more than GHR+ MCs in RDS newborns (6.97 ± 4.53 vs 3.85 ± 4.30, p = 0.001). It could be supposed that pulmonary MCs increased in newborn lungs in inflammatory process. MCs in human lung contained GHR peptide that had immunomodulatory function and participated in hormone regulation of inflammation.

The Endogenous Cannabinoid and the Nitricoxidergic Systems Differently Influence Heat and Cold Stress-Induced Analgesia

Stress-induced analgesia (SIA) is a well-known phenomenon, in which mechanisms of development opioid and non-opioid components take part. The endogenous cannabinoid system (ECS) takes part in the non-opioid pathways and modulates nociception. Nitric oxide (NO) is also proverbial to interfere with pain perception. The present study was performed to investigate the effects from interaction between the ECS and NO after heat (heat stress) or cold (cold stress) exposure. Male Wistar rats subjected to one hour of heat or cold stress were injected with different combinations of cannabinoid receptor type 1 (CB1) agonist anandamide (AEA) or antagonist (AM251) along with NO-donor, NO-precursor or inhibitor of the NO-synthase (NOS). Nociception was evaluated using Paw pressure (Randall-Selitto) test. The results showed that AEA-administration immediately after the end of stress let to a tendency to increase cold-SIA, but decreased heat-SIA. AEA along with NO-donor increased both cold- and heat-SIA but to a different degree. AM251 and NOS-inhibitor decreased SIA. Our experiments confirmed that the endogenous cannabinoid and the nitricoxidergic systems interact between them in the modulation of SIA. The ECS exerts a more prominent influence on cold rather than heat SIA. Differences in modulation probably depend on the type of stress, due to the different participation of ECS in the mechanisms of SIA development.

Effectiveness of Velscope and Vizilite Plus Systems in Diagnostics of Oral Lesions

Aim: To compare the level of diagnostic coincidence between classical (standard) method and VELscope and ViziLite Plus systems in the diagnosis of different oral lesions. Material and methods: 184 oral lesions were examined using classical method, VELscope and ViziLite Plus systems, and after that underwent a pathohistological examination for diagnosis proof. The percentage of diagnostic coincidence for various types of lesions was analyzed for the three methods compared. Results: The results demonstrated the highest coincidence rate for lesions diagnosed with VELscope – 35 (83.3%), followed by those with classical method – 80 (80.8%), and those with the application of ViziLite – 33 (76.7%). In premalignant and malignant lesions, the highest percentage of diagnostic coincidence was reported using the classical method – 14 (93.3%), for non-malignant lesions using VELscope – 28 (84.8%), for inflammatory and reactive lesions using VELscope – 14 (82.4%) and for lesions associated with general disease and systemic medication again using VELscope – 11 (91.7%). Conclusion: Non-invasive methods, tested in the study, have different diagnostic properties when differentiating particular clinical types of lesions. They are highly sensitive to changes in the oral mucosa but the final diagnosis must always be proved with biopsy.

Effects of Probiotics on Human Health and Disease: A Review

Alteration of the gut microbiome in order to achieve a balance in the normal flora of the intestine could be very beneficial in maintaining the health of the human. Probiotics are living microbial supplements that are added to the diet and have beneficial effects on the host by improving the balance of the intestinal microflora. The purpose of this study is to review previous studies on the effects of probiotics on human health and various diseases. The Farsi and English electronic databases such as, SID, Iranmedex, Magiran, Google Scholar, PubMed and ISI Web of Knowledge were searched and the published articles that have studied the effects of probiotics on the prevention and treatment of various diseases were included in the study. The review of published articles related to the subject showed that consumption of probiotics, prebiotics and proper diet have the significant effects on the health of the digestive system and has reduced and improved symptoms of different disorders and diseases. Further research is needed to better understand the underlying mechanisms of probiotic function and confirm the role of the probiotics in preventing and treating various types of cancers and other diseases.

A Study of Paratyphoid Fever in Bulgarian Children

Objective. To study both the molecular discrimination of D-tartrate fermenting and non-fermenting strains of Salmonella enterica subsp. enterica serotype Paratyphi B isolated from patients with paratyphoid fever and the clinical course of this disease. Materials and methods. The isolates examined were from children aged 3 months to 9 years. A total of 33 Salmonella strains were serotyped as Salmonella Paratyphi B, with an antigenic formula based on O- and H- antigens: 1,4, [5], 12: b: 1,2 by Kauffmann–White classification. Results. Multiplex PCR analysis confirmed all tested strains as d-tartrate fermenting (dT+), also referred to as variant Java. Discussion. We found that the most common cause of paratyphoid fever among children in Bulgaria is variant Java Salmonella Paratyphi B. Most children had classic symptoms of acute gastroenteritis – fever, watery diarrhea and vomiting.

Physicochemical Research of Clinically Retrieved CU-NI-TI Orthodontic Archwires

In modern orthodontics, thermally activated archwires are used more widely in clinical practice, because they have unique properties like superelasticity and bio-compatibility. The aim of the present study was to characterize commercial 35° C Cu-NiTi archwires in terms of their phase transition behavior, chemical composition, surface topography properties after clinical usage, as well as the influence of the autoclaving process. Materials and methods. 35° C Thermo-Active Copper NiTi (CuNiTi) of ORMCO, Glendora, CA, USA (as-received, as-received autoclaved and clinically retrieved) with rectangular cross-section and dimension 0.016x0.022 inch, were investigated. The physicochemical research was conducted via Differential Scanning Calorimetry (DSC), Scanning Electron Microscopy (SEM), Energy Dispersive Spectroscopy (EDX) and X-ray Diffraction Analysis (XRD). The autoclaving was done in Runyes model B autoclave. Results. The DSC results revealed the austenite start (9.8° C; 26.47° C) and austenite finish (28° C; 31.74° C) temperatures for the as-received and autoclaved archwires respectively. For clinically retrieved samples the austenite finish temperature (Af) is around 27° C. The XRD patterns of the as-received and clinically retrieved samples show almost identical diffraction patterns. Rough surface of the CuNiTi alloy was revealed by the SEM analysis. Autoclaving process seems to have no effects on archwires’ structure and chemical composition. Chemical content of the investigated as-received CuNiTi are Ni, Ti and Cu: 47.07 wt% and 46.81 wt% and 6.11 wt%, respectively. The autoclaving process seems to have little influence on the transition temperature. The results from our study showed little difference (~7 °C) in the finish transition temperatures (Af), compared to the manufacturer’s claim. No intermediate R phase was detected by DSC. Conclusion. A good knowledge of the structural changes that occur in CuNiTi alloys in the oral cavity is useful for the orthodontists in order to optimize orthodontic treatment.

Frequency of Pelvic Lymphatic Metastases in Patients with Cervical Cancer – A Retrospective Study

Introduction and objective: The aim of this study was to determine the incidence of pelvic lymph metastases in cervical cancer, depending on the biology of the tumor and the new changes in the staging. Material and methods: A retrospective database analysis involving 85 patients with cervical carcinoma for a 5-year period was performed. Various factors were analyzed for the purpose of the study. Results: In 20% of our patients lymph metastases were found with more frequent locus in the right lymph chains. The average number of metastases was equal to or greater than 2. Moderately differentiated cervical carcinomas metastasized most commonly. The most frequent were metastases in squamous cell carcinoma and in Stage 2B under the TNM classification. After changes in FIGO’s classification the presence of positive lymph nodes defined the disease as III stage. Conclusion: Our study confirms that cervical carcinoma metastasizes in the pelvic lymph nodes before it reaches the para-aortic lymph nodes.