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Background and Aim: The leptin (LEP) gene plays a role in the regulation of the activity required to obtain food, energy metabolism, and fat deposition and affects the body composition of animals. Lipogenesis is an ineffective process. A lot of energy from feed is expended on the synthesis of adipose tissue. This study aimed to determine the effect of LEP C528T and LEP C73T polymorphisms and pregnancy on adipose tissue formation and carcass grade in Aberdeen Angus heifers and first-calf cows. Materials and Methods: Heifers (n = 49) and first-calf cows (n = 30) were grouped according to their genotype for LEP C528T and LEP C73T polymorphisms at the age of 24 months. DNA samples were isolated from whole blood. Experimental animals were slaughtered at the age of 24 months, and a chemical analysis of samples of longissimus dorsi muscle and ground beef was performed. Results: The maximum internal fat weight, back-fat thickness, and fat content of the longissimus dorsi muscle and ground beef were determined in heifers heterozygous for both LEP C528T and LEP C73T polymorphisms. The ranking of genotypes in terms of adipose tissue formation did not change in first-calf cows compared to heifers carrying the same LEP gene variants. Pregnancy had a more significant (p < 0.05–0.001) effect on slaughter parameters and lipogenesis in animals of different genotypes than studied polymorphisms. Heterozygosity of the LEP gene was much more strongly expressed in the carcass grade of heifers. "Prime" grades were assigned to 66.7% of carcasses heterozygous for LEP C528T and "Top Choice" to 58.8% of carcasses with LEP C73T nucleotide substitutions. Conclusion: LEP C528T and LEP C73T polymorphisms were shown to affect the extent of fat formation in Aberdeen Angus heifers and first-calf cows. Animals with heterozygous genotypes exhibited the maximum development of internal fat, back-fat, and intramuscular fat. Pregnancy had a more significant effect on slaughter parameters and adipose tissue formation than studied polymorphisms. First-calf cows had a significantly lower fat content in carcasses than heifers. These results can aid in the production of efficient mature herds of Aberdeen Angus cattle.

Abstract Introduction: The present pilot study evaluates the quality of life of Bulgarian patients after a conventional hernia operation in which light or standard polypropylene hernia meshes were used. Materials and methods: Sixty-eight patients planned for recovery of primary or recurrent open hernia with implanted standard or lightweight polypropylene meshes were included in the study. Patients’ data were collected prospectively for a 5-month period (October 2017 - February 2018) on the basis of the case histories. The patients were interviewed using the EQ5D questionnaire and a visual analogue scale. Follow-up of each patient’s results was performed up to a year after surgery. Results: Three months after the operation, the patients reported only the presence of pain. On average, 24.5% of patients experienced mild pain and 20.3% - severe pain. In the standard mesh group, on average, the mild pain was 7.69%, swelling 3.84%, and foreign body sensation - 15.38% one year after the surgery. In the light mesh group the reported mild pain was 6.69%, pulling without pain - 13.33%, and foreign body sensation - 6.69%. There was no statistically significant difference in the pain level according to the used mesh, but in the group with implanted standard meshes, the reported problems prevailed. At the end of the survey period, the average score was 84.39±13.67. Conclusions: Hernia operation reduces pain 1 year after the procedure. The intensity of chronic pain one year after the surgery is relatively similar for both light and standard meshes in conventional inguinal hernia repair. The differences in the overall quality of life are insignificant in the long run. An individualized choice, based on the patients’ characteristics and safety of meshes, should be done by the healthcare specialists.

Central and Eastern European countries (CEEC) have among the highest rates of increase in healthcare expenditure. External reference pricing, generics and biologics price capping, regressive scale for price setting, health technology assessment (HTA), and positive drug lists for reimbursed medicines are among the variety of implemented cost-containment measures aimed at reducing and controlling the rising cost for pharmaceuticals. The aim of our study was to analyze the influence of a recently introduced measure in Bulgaria—budget capping in terms of overall budget expenditure. A secondary goal was to analyze current and extrapolate future trends in the healthcare and pharmaceutical budget based on data from 2016 to 2021. The study is a retrospective, observational and prognostic, macroeconomic analysis of the National Health Insurance Fund's (NHIF) budget before (2016–2018) and after (2019–2021) the introduction of the new budget cap model. Subgroups analysis for each of the three new budget groups of medicines (group A: medicines for outpatient treatment, prescribed after approval by a committee of 3 specialists; group B: all other medicines out of group A; and group C: oncology and life-saving medicines out of group A) was also performed, and the data were extrapolated for the next 3 years. The Kruskal–Wallis test was applied to establish statistically significant differences between the groups. During 2016–2021, healthcare services and pharmaceutical spending increased permanently, observing a growth of 82 and 80%, respectively. The overall healthcare budget increased from European €1.8 billion to 3.3 billion. The subgroup analysis showed a similar trend for all three groups, with similar growth between them. The highest spending was observed in group C, which outpaced the others mainly due to the particular antineoplastic (chemotherapy) medicines included in it. The rising overall healthcare cost in Bulgaria (from European €1.8 billion to 3.3 billion) reveals that implementation of a mechanism for budget predictability and sustainability is needed. The introduced budget cap is a relatively effective measure, but the high level of overspending and pay-back amount (from European €34 billion to 59 billion during 2019–2021) reveals that the market environmental risk factors are not well foreseen and practically implemented.