Real-world effectiveness of fingolimod in patients with multiple sclerosis in Bulgaria

INTRODUCTION

Fingolimod, a sphingosine-1-phosphate receptor agonist used for the treatment of multiple sclerosis (MS). Our goal was to assess the impact of fingolimod on quality of life in patients with relapsing-remitting multiple sclerosis (RRMS) after 2 years of treatment in this real-world study.

PATIENTS AND METHODS

This was a 2-year, prospective, observational study conducted in Bulgaria in RRMS patients treated with fingolimod. Quality of life was assessed using the Bulgarian-language version of the MSQoL-54 scale. The primary endpoint was the change from baseline in the MSQoL-54 score after 2 years of treatment. Secondary endpoints included the change from baseline in the MSQoL-54 score after one year of treatment, furthermore the assessment of depression level using the Hamilton D-17 score.

RESULTS

A total of 87 eligible patients were included in the study with a mean age of 38.7 ± 8.45 years. The median Expanded Disability Status Scale (EDSS) score was 3.5 points. We found statistically significant improvement in 10 subscales at month 12 and in seven subscales at month 24. The mental health composite score increased from 64.0 ± 16.69 points to 67.5 ± 15.94 points at month 24 (p = 0.012). The physical health composite score increased from 61.7 ± 17.61 to 66.3 ± 16.70 (p = 0.001). Depression level measured by the HAM-D17 decreased significantly by month 12 and month 24. The EDSS score decreased or remained stable in more than half of the patients (61.6%). We detected better quality of life in patients with a lower EDSS score.

CONCLUSIONS

Quality of life scores and the depression level are improved in RRMS patients treated with fingolimod over 2 years in real-life setting.

Welfare of pigs on farm

This scientific opinion focuses on the welfare of pigs on farm, and is based on literature and expert opinion. All pig categories were assessed: gilts and dry sows, farrowing and lactating sows, suckling piglets, weaners, rearing pigs and boars. The most relevant husbandry systems used in Europe are described. For each system, highly relevant welfare consequences were identified, as well as related animal-based measures (ABMs), and hazards leading to the welfare consequences. Moreover, measures to prevent or correct the hazards and/or mitigate the welfare consequences are recommended. Recommendations are also provided on quantitative or qualitative criteria to answer specific questions on the welfare of pigs related to tail biting and related to the European Citizen's Initiative 'End the Cage Age'. For example, the AHAW Panel recommends how to mitigate group stress when dry sows and gilts are grouped immediately after weaning or in early pregnancy. Results of a comparative qualitative assessment suggested that long-stemmed or long-cut straw, hay or haylage is the most suitable material for nest-building. A period of time will be needed for staff and animals to adapt to housing lactating sows and their piglets in farrowing pens (as opposed to crates) before achieving stable welfare outcomes. The panel recommends a minimum available space to the lactating sow to ensure piglet welfare (measured by live-born piglet mortality). Among the main risk factors for tail biting are space allowance, types of flooring, air quality, health status and diet composition, while weaning age was not associated directly with tail biting in later life. The relationship between the availability of space and growth rate, lying behaviour and tail biting in rearing pigs is quantified and presented. Finally, the panel suggests a set of ABMs to use at slaughter for monitoring on-farm welfare of cull sows and rearing pigs.

DNA-hydrolyzing catalytic IgGs from schizophrenia patients do not affect cell viability of the SH-SY5Y human neuroblastoma cell line

Introduction

DNA-hydrolyzing catalytic IgGs have caspase-dependent cytotoxic effects in autoimmune diseases. Recently, DNA-hydrolyzing IgGs have been discovered in schizophrenia. However, their cytotoxic properties have not been studied.

Objectives

To assess the effect of serum IgGs with DNA-hydrolyzing activity of schizophrenia patients on the cell viability of the SH-SY5Y human neuroblastoma cell line.

Methods

Serum of 8 patients with paranoid schizophrenia in the acute phase and 7 mentally and somatically healthy persons were used. IgG was purified from serum by affinity chromatography on Protein-G-Sepharose columns. The DNA hydrolyzing activity of IgG was assessed by the degree of hydrolysis of the pBluescript plasmid. The cell viability of the SH-SY5Y human neuroblastoma cell line after exposure to purified IgG preparations was assessed by high-throughput screening on the CellInsight CX7 platform (Thermo Scientific, USA) using the fluorescent dyes propidium iodide and Hoechst.

Results

Of the 8 IgG preparation obtained, 4 drugs had high DNA-hydrolyzing activity. All tested IgG preparations from healthy donors were inactive. One-way ANOVA analysis of the proportion of dead cells of the SH-SY5Y line after exposure to antibodies (0.1 mg/ml) showed no significant differences in the proportion of dead cells (p=0.688 after 24 hours; p=0.831 after 48 hours). Similar results were obtained at a higher concentration of antibodies - 0.2 mg/ml.

Conclusions

Thus, it has been shown in vitro that IgGs isolated from the serum of schizophrenia patients with or without DNA-hydrolyzing activity does not exhibit cytotoxic properties against the SH-SY5Y human neuroblastoma cell line. Support by Grant of RSF № 18-15-00053P.

Disclosure

No significant relationships.

Development of approaches to stratification of patients with schizophrenia based on cytokine levels using cluster analysis

Introduction

Alterations in a variety of immune parameters, including abnormal cytokine levels, are known to be found in schizophrenia. These changes can be useful in identifying patients with the most severe immune abnormalities.

Objectives

To develop approaches to stratification of schizophrenia patients based on cytokine levels using cluster analysis.

Methods

We recruited 53 patients (25 women/28 men) with a verified diagnosis of simple or paranoid schizophrenia and 37 healthy individuals (19 women/18 men) in our study. Serum levels of IL-1β, IL-2, IL-4, IL-6, TNFα, INFα, BAFF, GM-CSF, NGFβ, NRG1, and GDNF were determined using a MAGPIX multiplex analyzer (Luminex, USA). Statistical analysis was performed in Statistica 10.

Results

Principal component analysis and partial least-squares discriminant analysis showed that the combined multi-cytokine profiles of the studied groups differ. The results of the k-means cluster analysis are presented in Table 1 The most reliable results are obtained by a combination of 4 variable: IL-1β, IL- 4, BAFF and GDNF. Table 1 Percent of individuals classified in different clusters depending of number of parameters using for classification.

Number of variables for classification	Healthy individuals		Schizophrenia patients
	Cluster 1	Cluster 2	Cluster 1	Cluster 2
10 variables	5,4	96,4	26,4	73,6
4 variables	0	100	11,1	88,9
3 variables	2,7	97,3	29,6	70,4
2 variables	8,1	91,9	20,4	79,6

Conclusions

A subgroup (сluster 1) of schizophrenic patients with severe immune abnormalities was identified using data on the levels of IL-1β, IL-4, BAFF and GDNF. Anti-inflammatory therapy is recommended for this subgroup of patients. Support by Grant of RSF № 21-75-00102.

Disclosure

No significant relationships.

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The potential protein marker of bipolar disorder

Introduction

Difficulties in the diagnosis of bipolar disorder (BD) are associated with a lack of understanding of the mechanisms of its pathogenesis. Identification of proteins involved in the pathogenesis of BD will bring us closer to an understanding of its mechanisms and can help in diagnosis.

Objectives

The search of proteomic biomarkers of bipolar disorder.

Methods

We performed a proteomic analysis of the serum of 16 healthy people and 33 patients with BD. Patients were hospitalized in an acute state of the depressive phase, and they did not receive therapy for more than 6 months. Blood was collected before the start of therapy. Serum was purified from major proteins by affinity chromatographyandseparatedby1D-electrophoresis. After trypsinolysis, the proteins were identified by HPLC/mass spectrometry. The ELISA kit was used to determine the amount of zNMDAR1.

Results

We identified a protein that does not occur in healthy people: a subunit of the glutamate NMDA receptor zeta-1 (zNMDAR1). As a result, we found a statistically significant (p = 0.037) almost fivefold increase in the concentration of this protein in the serum of patients with bipolar disorder (0.64 [0.18; 0.78] ng/ml) compared with healthy individuals.

Conclusions

Thus, in bipolar disorder NMDAR is damaged, which can lead appearance of their subunits in the serum, and which indicated a violation of glutamatergic neurotransmission. Then this protein claims the role of markers of bipolar disorder. Mass spectrometric analysis was carried out of the “Human Proteome” Core Facility of the Institute of Biomedical Chemistry Moscow. RSW project, state registration number AAAA-A19-119020690013-2.

Disclosure

No significant relationships.

Superoxide dismutase activity of serum IgG in acute illness and remission period of schizophrenia

Introduction

According to recent research violations of the oxidative-antioxidant balance may play an important role in the pathogenesis of schizophrenia, by changing generate, conduct and reproduce a nerve impulse. Antibodies with oxidoreductase activity may be involved in protection against oxidative stress in schizophrenia.

Objectives

The study was to compare the superoxide dismutase (SOD) activity of IgG in patients with acute schizophrenia and during remission.

Methods

The study included 20 patients with acute schizophrenia (mean PANSS total score 94,3±14), 18 people with schizophrenia during remission (mean PANSS total score 54,7±9), and 10 healthy individuals. All participants signed informed consent for the research. Isolation of IgG from blood serum was performed using affinity chromatography on Protein-G-Sepharose columns. The homogeneity of the substances is confirmed by the SDS PAGE method. SOD activity of IgG was carried out spectrophotometrically. Statistical processing was conducted with Statistica v.10.

Results

IgG of schizophrenia patients and healthy individuals have a SOD activity and studied activity is proved to be antibodies intrinsic property. The activity of antibodies in acute schizophrenia was 1.7 times higher than in healthy individuals (p<0.05). In patients with schizophrenia during remission SOD activity of IgG was 2.4 times higher than in healthy individuals (p<0.05).

Conclusions

We can assume that in the conditions of oppression antioxidant activity in schizophrenia patients, antibodies partially take over the function of protecting the body from patients with generalized oxidative stress. This work is supported by the Russian Scientific Foundation, grant # 18-15-00053P.

Disclosure

No significant relationships.

Ammonio Methacrylate Copolymer (Type B)-Diltiazem Interactions in Solid Dispersions and Microsponge Drug-Delivery Systems

This paper presents a complex analytical study on the distribution, solubility, amorphization, and compatibility of diltiazem within the composition of Eudragit RS 100-based particles of microspongeous type. For this purpose, a methodology combining attenuated total reflectance Fourier transform infrared (ATR-FTIR) absorption spectroscopy, differential scanning calorimetry (DSC), scanning electron microscopy with energy-dispersive X-ray microanalysis (SEM-EDX), and in vitro dissolution study is proposed. The correct interpretation of the FTIR and drug-dissolution results was guaranteed by the implementation of two contrasting reference models: physical drug–polymer mixtures and casting-obtained, molecularly dispersed drug–polymer composites (solid dispersions). The spectral behavior of the drug–polymer composites in the carbonyl frequency (νCO) region was used as a quality marker for the degree of their interaction/mutual solubility. A spectral-pattern similarity between the microsponge particles and the solid dispersions indicated the molecular-type dispersion of the former. The comparative drug-desorption study and the qualitative observations over the DSC and SEM-EDX results confirmed the successful synthesis of a homogeneous coamorphous microsponge-type formulation with excellent drug-loading capacity and “controlled” dissolution profile. Among them, the drug-delivery particles with 25% diltiazem content (M-25) were recognized as the most promising, with the highest population of drug molecules in the polymer bulk and the most suitable desorption profile. Furthermore, an economical and effective analytical algorithm was developed for the comprehensive physicochemical characterization of complex delivery systems of this kind.

Intraoperative neuromonitoring (IONM) in thyroidectomy for carcinoma in an high volume academic Hospital

BACKGROUND

The diagnosis of thyroid carcinoma has changed in last decades, as the surgical technique during thyroidectomy (endoscopic surgery, robotic surgery, new energy device, intraoperative neuromonitoring).

METHODS

We analyzed patients undergone to thyroidectomy or lobectomy for thyroid carcinoma from January 2010 to December 2019 at the General Surgery Unit of the Hospital - University of Parma. We divided patients into two groups, based on the use or not of IONM.

RESULTS

We analyzed data about 638 patients, 486 (76.2%) female and 152 (23.8%) male, with a mean age of 51.8 years. Totally, 574 patients underwent total thyroidectomy and lymphadenectomy was performed in 39 patients. The lobectomy rate was higher in interventions with neuromonitoring (13.93%) than in those without IONM (3.06%). Considering the incidence of postoperative complications and the presence of infiltration of perithyroid tissues or thyroiditis or lymph node metastasis at the histological report, a statistically significant percentage of dysphonia and paraesthesia was recorded only in patients with infiltration of perithyroid tissues (p <0.0001). There was no significant difference in postoperative blood calcium values. The use of intraoperative neuromonitoring has not significantly changed the incidence of postoperative complication.

CONCLUSIONS

Our study did not show a protective impact of the use of intraoperative neuromonitoring during thyroidectomy on the incidence of postoperative complications but confirmed that it increases the surgeon's feel safety during surgery and facilitates the identification of any undetected nerve lesion with visually intact nerve, inducing the interruption of the thyroidectomy after lobectomy alone, reducing the risk of bilateral recurrent paralysis.

Lep gene and leptin concentration in serum of schizophrenia patients with metabolic syndrome

Introduction

Schizophrenia is associated with lower life expectancy due to cardiovascular disease. Metabolic syndrome (MetS) occupies an important place among the main problems. Indicators of hormones regulating metabolism may be appealing candidates as biomarkers of metabolic side-effects. Certain role belongs to genetic factors that might be the basis of sensitivity to development of MetS.

Objectives

The aim is to study polymorphisms of leptin gene (LEP) and serum leptin concentration in schizophrenia patients with metabolic syndrome.

Methods

After obtaining informed consent, patients with schizophrenia (ICD-10: F20) were included: 91 patients for biochemical research and 463 patients for genotyping. Patients were divided into two groups: 46 (119) with MetS; 45 (344) without it. Concentration of leptin was measured on an analyzer MAGPIX (Luminex, USA). Determination of 4 polymorphisms (rs2167270, rs3828942, rs10954173, rs4731426) of LEP was performed by PCR. Differences were considered significant at p<0.05.

Results

The leptin concentration is significantly (p<0.001) higher in MetS (13511.5 [7392.5; 28278.75] pg/ml) compared to patients without MetS (6662 [2131.5; 11380] pg/ml). Significant differences were found in the distribution of rs3828942 (GG:GA:AA): 25.9%:44%:30.2% in MetS and 31.2%:52.6%:16.2% without MetS (χ²=10.545, p=0.005). The genotype AA and the allele A have a predisposing effect on the development of MetS (OR₁=2.247, C.I:1.248-4.046; OR₂=1.475, C.I:1.093-1.991, χ²=6.49, p=0.01).

Conclusions

A number of features are observed in patients with MetS, which impair the functioning of patients. These investigations should aim to optimize the approach to assess the risk of MetS. The study was supported by grants from the RSF 19-75-10012 (genetic research) and 18-15-00011 (determination of leptin concentration)

Disclosure

The study was supported by grants from the Russian Science Foundation №19-75-10012 (genetic research) and №18-15-00011 (determination of leptin concentration)

Neuron-specific enolase during the therapy in patients with alcohol use disorder and mood disorders

Introduction

Studies of the pathophysiology of mental disorders indicate the involvement of neurobiological processes, including the release of neurospecific proteins in biological substances.

Objectives

The purpose of this study was to research the level of neuron-specific enolase in patients with alcohol use disorder and mood disorders during the therapy.

Methods

The studied groups included patients with alcohol use disorder (AUD, F10.2, ICD-10; n=41), patients with mood disorders (MD, F32, F33, ICD-10; n=39), patients with co-morbidity of AUD and MD (n=31) and 20 healthy controls. Severity of depressive symptoms was assessed with HDRS-17 and CGI-S scales. The concentration of NSE were measured in serum by enzyme immunoassay. Рarticipants of the study were examined with clinical scales and laboratory analysis at baseline and on the 28th day of treatment. For statistical analysis we used the SPSS software.

Results

The results of the study showed that all patients are characterized by an increased level of NSE (p>0.005 compared with control). Patients with AUD characterized by changes in the concentration of NSE during therapy (p>0.005 compared with patients after therapy). In patients with MD revealed correlation between the level of NSE on the 28th day of antidepressive therapy and the HDRS-17 score before treatment (r=0,421; p=0,018). In patients with co-morbidity correlation between the level of NSE and the CGI-S score before therapy was found (r=-0,537; p=0,001).

Conclusions

The revealed correlations indicate the relationship between the severity of depressive symptoms and the level of NSE. Disclosure statement: This study was supported by the Russian Science Foundation, grant No. 19-15-00023.

Conflict of interest

Disclosure statement: This study was supported by the Russian Science Foundation, grant No. 19-15-00023.

Efficacy and safety of beta-blockers and prolonged bronchodilators in patients with heart failure with coronary artery disease and moderate to severe COPD

Purpose

To compare clinical efficacy and safety of various treatment regimens with the inclusion of beta-blockers, RAAS antagonists (ACE inhibitors or ARBs), prolonged bronchodilators (LABA, LAMA) in heart failure patients with CAD and COPD.

Methods

385 patients (292 men and 93 women), aged 66.3±4.1 years, with CHF classes II to III (NYHA) combined with moderate to severe COPD (GOLD) and with LVEF less than 45% were randomized into nine groups: enalapril + LAMA (control group), nebivolol + enalapril + LAMA, nebivolol + losartan + LAMA, nebivolol + losartan + LABA, nebivolol + losartan + LAMA/LABA, carvedilol + enalapril + LAMA, carvedilol + losartan + LAMA, carvedilol + losartan + LABA, carvedilol + losartan + LAMA/LABA. Patients of all groups received complex CHF treatment comprising diuretics, nitrates, cardiac glycosides (if necessary). Clinical examination, TTE, 6-minute walk test (6MWT), 24-hour electrocardiogram and blood pressure monitoring, respiratory function test were assessed at baseline and after 6 months of treatment. The quality of life was evaluated by MYHFQ, SGRQ and mMRC scale.

Results

After 6 months of therapy the improvement of clinical condition and quality of life were marked in all groups. At the end of observation period there was a significant improvement of patients clinical condition, quality of life, reduction of mean CHF FC and dyspnea severity, increase of exercise tolerance, slowing of progression of CHF and COPD, improvement of the parameters of intracardiac hemodynamics, structural and functional parameters of the left and right heart (a decrease in the size of the atria, LV volumes and internal dimension at end-diastole and end-systole, cardiac index, LVMMI, an increase of LVEF, a significant decrease in systemic vascular resistance and the pulmonary hypertension grade, significant improvement in systolic and diastolic function of the ventricles, regression of pathological remodeling of the heart, reduction of heart rate, duration and frequency of myocardial ischemia episodes (including its “silent” form). The best results were obtained in groups using a beta-blocker (nebivolol or carvedilol), a RAAS antagonist, and a combination of long-acting bronchodilators (indacaterol and tiotropium) – group 5 and 9. It is worth noting that beta-blockers, LABA and LAMA were well tolerated in all observation groups and serious adverse events were absent.

Conclusions

The appointment of 3-generation beta-blockers to patients with CHF on the background of CAD and COPD can significantly increase the effectiveness of treatment and does not cause a deterioration in spirometry in patients with such cardiopulmonary pathology. In our opinion, the most important point in the appointment of beta blockers to patients with moderate to severe COPD is low start dose and slow titration of the dose at the beginning of the therapy. It is advisable to include in the complex therapy of such patients a combination of LABA and LAMA as a basic bronchodilator support.

Funding Acknowledgement

Type of funding source: None

Attitudes and Beliefs of Eastern European Consumers Towards Animal Welfare

Simple Summary

A survey was conducted with 5508 consumers from 13 Eastern European countries. Three clusters of consumers were identified: one with consumers indifferent towards animal welfare; one with consumers concerned about animal welfare, but they believe it is difficult to achieve; and one with consumers concerned about animal welfare, and they believe it is possible to achieve it.

Abstract

The aim of this exploratory work, because of the existing bias on the size of the sample and some of the sociodemographic characteristics of the participants, was to investigate the Eastern European consumers’ beliefs and attitudes toward animal welfare, to perform a cross-country segmentation analysis and to observe possible differences with their Western European counterparts. For this purpose, a survey was conducted with 5508 consumers from 13 Eastern European countries (Bosnia and Herzegovina, Bulgaria, Czech Republic, Croatia, North Macedonia, Hungary, Moldova, Poland, Romania, Serbia, Slovakia, Slovenia, and Ukraine) using a questionnaire with nine statements about consumers beliefs regarding animal welfare (aspects of management, ethical issues about animals, and consequences of animal welfare on meat quality and price), one statement about the willingness to pay more for meat produced under better welfare conditions, and four statements regarding attitudes toward animal welfare. Differences between countries were detected for all the statements. Moreover, three clusters of consumers were identified: one with consumers indifferent towards animal welfare; one with consumers concerned about animal welfare, but they believe it is difficult to achieve; and one with consumers concerned about animal welfare, and they believe it is possible to achieve it.

Fat-Soluble Vitamins Affect Composition of Extracellular Matrix Deposited by Human Aortic Smooth Muscle and Endothelial Cells In Vitro

Atherosclerotic cardiovascular disease is accompanied by changes in arterial connective tissue. We evaluated the effects of fat-soluble vitamins A, D, and E individually and in combinations on the composition of extracellular matrix produced and deposited by arterial wall cells, human aortic smooth muscle cells, and endothelial cells. Individually, vitamins D and E stimulated collagen type I extracellular matrix deposition in human aortic smooth muscle cell cultures. However, vitamins A, D, and E reduced collagen type IV deposition by human aortic smooth muscle cell, counteracting the stimulatory effects of vitamin C. The extracellular matrix deposition of heparan sulfate by human aortic smooth muscle cells increased by vitamin C and its combination (C+D+E). β-carotene + D + C induced the extracellular matrix deposition of collagen I by endothelial cells. Vitamin E with other vitamins resulted in either induction (E+C+A) or inhibition (E+D). The extracellular matrix deposition of type IV collagen and elastin by human aortic endothelial cells was not affected by test vitamins, except the extracellular matrix type IV collagen decrease by combinations (A+E), (A+D+E), and (C+D+E). The extracellular matrix deposition of all tested glycosaminoglycans was reduced by vitamin A and its combination (A+C+D+E). Therefore, the fat-soluble vitamins applied individually or in combination—both with each other or with ascorbic acid—can affect extracellular matrix deposition of type I and IV collagens, and key glycosaminoglycans by cultured human aortic arterial wall cells.

P1477 Features of structural and functional parameters of the right and left heart and their relationship with the spirometry parameters in patients with CHF of ischemic genesis with COPD

Purpose

Сomparative analysis of structural and functional parameters of the heart, the state of external respiration in patients with CHF II-III FC of ischemic genesis in the absence and in combination with moderate to severe COPD.

Material and methods

The study included patients aged 65.6 ± 3.9 years with LVEF ≤ 45% (according to Simpson). The first group consisted of 87 patients with CHF of ischemic genesis, and the second group - 385 patients with CHF of ischemic genesis and coexisted COPD. All patients were evaluated for clinical condition, TTE, the study of respiratory function with bronchodilation test.

Results

Patients of both groups were comparable by sex, age, FC CHF (NYHA). In patients with COPD, linear and volumetric LV parameters exceeded the normal values and were significantly higher than in CHF patients without COPD. LVIMM, LV sphericity index were significantly higher in the group of patients with COPD, which is associated with more pronounced remodeling of the left heart.

Correlation analysis showed direct moderate and reliable relationships between the RVIDd (internal end-diastolic diameter) and MPAP (r = 0.68, p &lt; 0.01), RVIDd and LVSV (stroke volume) and FEV1 (r = 0.38, p &lt; 0.05), FEV1 and LVMMI (r = 0.33, p &lt; 0.05), FVC and LVMMI (r = 0.34, p &lt; 0.05), LVEF and FEV1 (r = 0.44, p &lt; 0.05) and VC (lung vital capacity) (r = 0.36, p &lt; 0.05). Negative correlations were found between low-level FEV1 and RVIDd (r=-0.29, p &lt; 0.05), FEV1 and SatO2 (r = 0.28, p &lt; 0.05), and a strong degree between MPAP and FEV1 (r=-0.55, p &lt; 0.05), moderate between MPAP and FEF75 (r=-0.57, p &lt; 0.05).

In patients with COPD more pronounced significant increases in RVIDd, MPAP, RA dimension were noted. In patients of this group (n = 385), the IVRT and time of deceleration during the early diastolic filling (DTE) of RV increased more significantly.

RV diastolic dysfunction in patients with CHF with COPD may be due to slower relaxation of the right ventricular hypertrophy and an increase in afterload (evidenced by the relationship between the velocity of early diastolic filling (E) of the RV and the thickness of the anterior wall of the RV; the velocity of late filling (A) of the RV and MPAP (r= 0.3, p &lt; 0.05)).

Conclusion

In patients with CHF of ischemic genesis with COPD, a more pronounced remodeling of the left and right parts of the heart was noted, reliable interrelationships of respiratory function indicators and structural and functional parameters of both the left and right ventricles of the heart were revealed.

Determination of Monensin, Narasin, and Salinomycin in Mineral Premixes, Supplements, and Animal Feeds by Liquid Chromatography and Post-Column Derivatization: Collaborative Study

A liquid chromatographic (LC) method for the analysis of monensin, narasin, and salinomycin in mineral premixes, supplements, and complete animal feeds at medicating and trace levels was collaboratively studied. The method uses methanolwater (90 + 10) extraction with mechanical shaking for 1 h, filtration, and dilution if necessary. Determination of the 3 ionophores is by reversed-phase LC using post-column derivatization with vanillin and detection at 520 nm. Suspect positive trace-level products and medicated feeds containing unexpected ionophores are confirmed by hexane extraction or post-column derivatization with dimethylaminobenzaldehyde (DMAB). Twenty-five test samples of medicated feeds, supplements, and mineral and drug premixes, and 9 test samples for trace-level analysis were sent to 11 collaborators in Bulgaria, Czech Republic, Portugal, France, The Netherlands, United States, and Canada. Acceptable results were received from 10 laboratories. For the medicated complete feeds, supplements, and mineral premixes, RSDr values (within-laboratory repeatability) ranged from 2.5 to 5.2%, RSDR values (among-laboratory reproducibility) ranged from 2.7 to 6.8%, and HorRat values ranged from 0.31 to 1.30. For the drug premixes, the result variability was excessive and HorRat values ranged from 2.27 to 14.1. For the trace-level test samples, all laboratories correctly identified the analytes and did not report any false positives. RSDr values ranged from 1.3 to 9.5%, RSDR values ranged from 5.2 to 13.1%, and HorRat values ranged from 0.4 to 0.97.

Attitudes and beliefs of Eastern European consumers towards piglet castration and meat from castrated pigs

Castration of male piglets is a common practice to avoid boar taint but is being questioned. The present work has an exploratory character and aims to investigate the beliefs and attitudes of Eastern European consumers regarding boar taint, surgical castration immunocastration and perception of meat from castrated pigs and to find out possible segments of consumers regarding these attitudes and beliefs. For this purpose, a consumer study was carried out involving 5508 consumers from 13 Eastern European countries (Bosnia and Herzegovina, Bulgaria, Czech Republic, Croatia, North Macedonia, Hungary, Moldova, Poland, Romania, Serbia, Slovakia, Slovenia and Ukraine). The questionnaire included statements related to beliefs about castration and perception of meat from castrated pigs, attitudes towards meat from castrated pigs. Results show that in general beliefs and attitudes of the consumers are not defined, probably because of the lack of knowledge (information was not provided to the consumers) towards these issues. Three different clusters of consumers were obtained with different beliefs towards castration.

Role of Coxiella burnetii in the development of fever of unknown origin: А mini review

Q fever is a widespread zoonosis throughout the world in the form of numerous natural and agricul-tural outbreaks. C. burnetii infects various hosts, including humans, ruminants and pets and in rare cases, reptiles, birds, and ticks. This bacterium is excreted in urine, milk, faeces, and birth products. In humans Q fever occurs as acute or chronic disease with diverse clinical presentation, as isolated cases and epidemics. It affects various organs and systems, and in pregnant women can cause miscar-riage or premature birth. Untreated Q fever can become chronic with adverse effects on patients. Diversity in the clinical picture in the absence of specific pathological syndrome often hinders accurate diagnosis and proper etiological significance. Therefore, improvement of diagnostic methods and in particular the development and introduction of new molecular diagnostic methods is the basis of effective therapeutic and prophylactic approach. Тhe purpose of the review is to renew the interest to Q fever – on one hand, because of its serious impact on human health and agricultural systems, and on the other, the ability for development and introduction of new molecular diagnostic methods.

Structural study of the X-ray-induced enzymatic reduction of molecular oxygen to water bySteccherinum murashkinskyilaccase: insights into the reaction mechanism

The laccase fromSteccherinum murashkinskyiis a member of the large family of multicopper oxidases that catalyze the oxidation of a wide range of organic and inorganic substrates, accompanied by the reduction of dioxygen to water. The reducing properties of X-ray radiation and the high quality of the laccase crystals allow the study of the catalytic reduction of dioxygen to water directly in a crystal. A series of diffraction data sets with increasing absorbed radiation dose were collected from a single crystal ofSteccherinum murashkinskyilaccase at 1.35 Å resolution. Changes in the active-site structure associated with the reduction of molecular oxygen to water on increasing the absorbed dose of ionizing radiation were detected. The structures in the series are mixtures of different states of the enzyme–substrate complex. Nevertheless, it was possible to interpret these structures as complexes of various oxygen ligands with copper ions in different oxidation states. The results allowed the mechanism of oxygen reduction catalyzed by laccases to be refined.

Combined use of EPR and 23Na MAS NMR spectroscopy for assessing the properties of the mixed cobalt–nickel–manganese layers of P3-NayCo1−2xNixMnxO2

EPR and ²³Na MAS NMR are used to gain insights into the structural peculiarities of the mixed cobalt–nickel–manganese layers of P3-Na_yCo_1−2xNi_xMn_xO₂.

Deep insight into Zr/Fe combination for successful Pt/CeO2/Al2O3 WGS catalyst doping

Efficient promotion of the Pt/CeO₂/Al₂O₃ catalytic system was achieved by the addition of two different ceria promoters, Zr and Fe.

Antipsychotic-induced tardive dyskinesia: The role of glutamatergic system

Tardive dyskinesia (TD) occurs in 20–25% of patients with long-term antipsychotic therapy. Abnormalities in glutamatergic transmission are considered one of the key components of the pathogenesis of drug-induced side effects. Glutamate acts as excitotoxin under certain conditions and in excessive concentrations.

Aim is to study the concentration of glutamate and analysis of single nucleotide polymorphisms (SNP) in genes coding the glutamate transporter and NMDA-receptors in schizophrenic patients with TD and without it.

The study group included 156 patients with schizophrenia receiving long-term antipsychotic treatment. Patients were divided into two groups: 63 patients with TD and 93 patients without it. Glutamate was determined in serum by spectrophotometric method. Determination of allelic variants of gene SLC1A2 (rs4354668) and GRIN2A (rs2650427, rs1969060) was performed by polymerase chain reaction in real-time.

We found a significant (P < 0.05) increase of the concentration of glutamate in patients with TD. Significant (P < 0.05) reduction in frequency of genotype GG of GRIN2A (rs1969060) and TT of SLC1A2 (rs4354668) were found in patients with TD in comparison to group without TD. In the study of glutamate concentration depending on the genotype GRIN2A (rs1969060) and genotype SLC1A2 (rs4354668) we observed a statistically significant change: elevated levels of glutamic acid identified with the heterozygous genotype in patients.

It is possible to suggest that reduction in frequency of these genotypes increases the risk of movement disorders due to the protective effect of these genotypes.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

[POLYHEXAMETHYLENE BIGUANID HYDROCHLORIDE (BIGUANELLE) THERAPY OF BACTERIAL VAGINOSIS]

The aim of our study was to determine the efficacy and tolerability of local therapy with polyhexamethylene biguanid hydrochloride (BIGUANELLE) in women with anaerobic vaginal infection.

MATERIAL AND METHODS

We include in our study 23 women (18-50) with established by AMSEL criteria bacterial vaginosis. In all of the women at the beginning and at the end of the survey was performed gynecological examination and microbiological research (AMSEL). The therapeutic scheme at all women is with a single vaginal application of gynecological solution BIGUANELLE. Effectiveness of the treatment was evaluated according to clinical complaints and microbiological research (Amsel criteria: Ph 4.5 >; KOH (+); "clue cells"; specific vaginal fluorine). Tolerability of patients to treatment was assessed by questionnaire.

RESULTS

Clinical complaints of patients after the therapy decreased as follows: vaginal fluorine with 73.9%; odor--75%; pruritus--50%; discomfort--90%. Microbiological research and their evaluation by AMSEL, showed the therapeutic efficacy of the therapy in 16 (69.6%) of all (n-23) patients. At 7 (30.4%) women, the treatment remained without effect. At questionnaire answers, 73.9% patients were satisfied with the application of BIGUANELLE, 95.6% of them have implemented it easily, 95.6% of women believe that BIGUANELLE is more convenient to use in comparison with similar products which have a daily application, and none of the patients (100%) have any complaints in applying this gynecological solution.

CONCLUSIONS

BIGUANELLE showed good clinical efficacy in the treatment of bacterial vaginosis. It is easily applied and well tolerated by the patients.

Patient doses from PET-CT procedures

Positron emission tomography (PET) was installed for the first time in Bulgaria in 2009, and nowadays two hybrid PET-computed tomography (CT) systems are in operation. The aim of this work is to estimate patient doses from PET-CT procedures and to explore potential for optimisation. Data were retrospectively collected for 50 patients examined with the system Philips Gemini TF and for 58 patients examined with the system GE Discovery 600. Whole-body examinations with radiopharmaceutical (18)F-2-fluoro-2-deoxy-D-glucose (FDG) were performed on all patients. Patient effective doses from the CT component of the examination were calculated with CT Expo software and compared with doses estimated applying the National Radiological Protection Board (NRPB) conversion coefficients. Effective doses from the PET component were calculated applying the ICRP 80 conversion coefficients. For the first system, average effective doses from CT component were 8.0 and 8.9 mSv, applying CT Expo and NRPB coefficients, respectively, and 4.9 mSv from PET component. For the second system, the corresponding values were 7.8, 8.7 and 5.9 mSv. These results for patient effective doses are relatively lower or comparable to other similar surveys. Reasons for the observed differences are analysed and presented.

MAGUKs, scaffolding proteins at cell junctions, are substrates of different proteases during apoptosis

A major feature of apoptotic cell death is gross structural changes, one of which is the loss of cell–cell contacts. The caspases, executioners of apoptosis, were shown to cleave several proteins involved in the formation of cell junctions. The membrane-associated guanylate kinases (MAGUKs), which are typically associated with cell junctions, have a major role in the organization of protein–protein complexes at plasma membranes and are therefore potentially important caspase targets during apoptosis. We report here that MAGUKs are cleaved and/or degraded by executioner caspases, granzyme B and several cysteine cathepsins in vitro. When apoptosis was induced by UV-irradiation and staurosporine in different epithelial cell lines, caspases were found to efficiently cleave MAGUKs in these cell models, as the cleavages could be prevented by a pan-caspase inhibitor N-benzyloxycarbonyl-Val-Ala-Asp(OMe)fluoromethylketone. Using a selective lysosomal disrupting agent -leucyl--leucine methyl ester, which induces apoptosis through the lysosomal pathway, it was further shown that MAGUKs are also cleaved by the cathepsins in HaCaT and CaCo-2 cells. Immunohistological data showed rapid loss of MAGUKs at the sites of cell–cell contacts, preceding actual cell detachment, suggesting that cleavage of MAGUKs is an important step in fast and efficient cell detachment.

Investigation of the spread of brucellosis among human and animal populations in southeastern Bulgaria, 2007

Three human cases of brucellosis were reported in summer 2007 in the region of Haskovo in southeastern Bulgaria. Subsequently, the regional veterinary and public health authorities carried out investigations to determine the spread of infection in domestic animals and in the human population. As a result, over 90,000 animals were tested, and 410 were found infected with brucellosis. The screening of 561 people believed to have been at risk of infection yielded 47 positive results. The majority of these persons had direct contact with domestic animals or had consumed unpasteurised dairy products. The investigations revealed evidence of disease among animals in the region and a considerable risk to humans, thus emphasising the need for effective prevention and control programmes.

Investigation of the spread of brucellosis among human and animal populations in southeastern Bulgaria, 2007

Three human cases of brucellosis were reported in summer 2007 in the region of Haskovo in southeastern Bulgaria. Subsequently, the regional veterinary and public health authorities carried out investigations to determine the spread of infection in domestic animals and in the human population. As a result, over 90,000 animals were tested, and 410 were found infected with brucellosis. The screening of 561 people believed to have been at risk of infection yielded 47 positive results. The majority of these persons had direct contact with domestic animals or had consumed unpasteurised dairy products. The investigations revealed evidence of disease among animals in the region and a considerable risk to humans, thus emphasising the need for effective prevention and control programmes.

Sings of Apoptosis of Immunocompetent Cells in Patients with Depression

Data have been obtained showing that programmed cell death - apoptosis - plays an important role in mediating the mechanisms of adaptation of the body to external influences. Studies were performed using 26 patients with depression (20 women and 6 men) with a mean age of 48,0±12,6 years. The control group consisted of 20 healthy subjects, identical in gender and age to patients in the experimental group. Measures of apoptosis of peripheral blood lymphocytes and serum cortisol concentrations were determined. A significant increase in lymphocyte apoptosis was found in patients with depression, resulting in an increase in the proportion of lymphocytes expressing the FAS receptor; cells with morphological signs characteristic of apoptosis (nuclear condensation, vacuolization) were also seen. The proportion of neutrophils with sings of spontaneous apoptosis in patients with depression prior to treatment was greater then that in healthy subjects, with values of 0,63±0,26% and 0,25±0,12 respectively (p< 0,05). The proportion of lymphocytes with fragmented nuclei was also greater, at 2,03±0,72% compared with 0,97±0,35 in healthy controls (p< 0,05). An increase in serum cortisol to 440,64±22,04 nM was found in patients with depression, while the mean in healthy subjects was 323,03±21,45 nM. A positive correlation between cortisol and CD95 cells was found, demonstrating the important role of corticosteroids in controlling expressing the apoptosis marker in immunocompetent cells. A high level of CD95+ lymphocytes and a high level of spontaneous apoptosis may result from the destructive influences of stress on the body of depressed patients.

Steroid and Thyreoid Hormones and Neurotic, Stress-related and Somatoform Disorders

Objective:

Study concentrations of steroid and thyreoid hormones in patients with neurotic, stress-related and somatoform disorders.

Methods:

35 patients with dissociative (conversion) disorders (ISD-10, F44), 29 patients with adjustment disorders (ISD-10, F43.2) and mentally healthy persons (27 persons) were investigated. Immunofermantal analysis for definition of concentration of steroid and thyreoid hormones were carried out.

Results:

We have observed statistically significant increased level of cortizol (p< 0,05) in patients with adjustment disorders (635,04±48,69 nmol/l) in comparison with control and patients with dissociative (conversion) disorders (444,97±24,53 nmol/l and 443,13±23,00 nmol/l accordingly). The statistically significant the lowered maintenance of dehydroepiandrosteronum is characteristic for patients with adjustment disorders in comparison with control and patients of another group (3,9±0,26; 6,35±0,62 and 6,69±0,50 mkmol/l accordingly, p< 0,05). For patients with dissociative (conversion) disorders is characteristic the statistically significant increased level of triiodthyronin (1,71±0,12 nmol/l), in patients with adjustment disorders and mentally healthy persons this metric composed 1,26±0,02 nmol/l and 1,34±0,04 nmol/l accordingly. The level of thyroxin for the persons with dissociative (conversion) disorders differ from values of control and patients with adjustment disorders (23,68±2,07 pkmol/l; 17,64±1,43 pkmol/l and 14,69±0,53 pkmol/l accordingly, p< 0,05).

Conclusion:

For patients with adjustment disorders is characteristic the statistically significant increased level of cortizol and the lowered maintenance of dehydroepiandrosteronum. Dissociative (conversion) disorders are formed in conditions of the raised maintenance thyreoid hormones and the physiological maintenance of steroid hormones.The investigation supported by project of RHSF №06-06-00691а, №07-06-95673и/М and №08-06-00284а.

Essential nutrients suppress inflammation by modulating key inflammatory gene expression

We investigated the effects of a nutrient mixture (NM) consisting of ascorbic acid, quercetin, naringenin, hesperetin, tea catechins, lysine, proline, arginine and N-acetylcysteine on experimental in vivo and in vitro inflammation triggered by bacterial lipopolysaccharide (LPS). BALB/c mice (n=36) were administered NM (200 mg/kg BW) or ibuprofen (20 mg/kg BW) for two weeks. Blood plasma, collected three hours after a single intraperitoneal injection with LPS (1 mg/kg BW), was analyzed with 14 cytokine microarray. LPS inflammatory effects were analyzed in human U937 macrophages by cytokine release, cyclooxygenase (COX) enzymatic activity, COX protein expression (Western blot analysis), specific mRNA levels (RT-PCR), and nuclear factor kappabeta (NFkappabeta) activation (phosphorylated p65 immunoassay). Nutrient supplementation in mice altered the LPS-induced cytokine response in a manner similar to ibuprofen (r=0.4157, p=0.139). Cytokine response to LPS in cultured macrophages was similar to the in vivo study (r=0.718, p=0.023). NM inhibited COX-2 enzymatic activity, and COX-2 and pro-inflammatory cytokine protein expression levels were downregulated by NM at the transcription level complementing a blockade in NFkappabeta activation. NM demonstrated strong beneficial effects on the experimental inflammation by targeting multiple responsible mechanisms in the complex process involved in the inflammatory reaction to pathogens.

Naturally produced extracellular matrix inhibits growth rate and invasiveness of human osteosarcoma cancer cells

Enhanced supplementation with certain naturally occurring nutrients and vitamins has been associated with a reduction in occurrence and progression of human cancer. The exact mechanisms of this action are still under investigation. Extracellular matrix (ECM) plays a key role in the development of cancer. Therefore, we studied whether nutrients could exert anticancer effects through alteration of ECM biological properties. Confluent cultures of normal human dermal fibroblasts were allowed to produce and deposit ECM during a 7 d incubation period in the presence of tested compounds. Subsequently, fibroblasts were removed and the growth rates of freshly placed cultures of human osteosarcoma cells (lines U2-OS, MMNG, or SK.ES1) on pre-formed ECM were assayed in plain cell growth medium. In addition, ECM was deposited by fibroblasts on the upper surface of a porous plastic membrane and the subsequent migration of osteosarcoma cells to the other side was assayed in non-supplemented medium. The results demonstrated that the ECM produced by normal fibroblasts treated with a mixture of ascorbic acid, lysine, proline, arginine, cysteine, and green tea polyphenols significantly reduced the growth rate and invasive activity of osteosarcoma cells in contrast to the non-supplemented control. The changes in ECM properties were accompanied by significant changes in ECM protein and glycosaminoglycan composition as assayed immunochemically. We conclude that anticancer effects of nutrients involve beneficial changes in ECM biological properties. The role of ECM components in ECM-dependent regulation of tumor cell activities is discussed.