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Purpose: Recently, quantitative dermatoglyphic examinations have been intensively carried out for screening purposes in oncology. Material/Methods: The present study covered 82 women aged between 36 and 80 years with clinically, histologically and mammographically confirmed breast cancer and 60 healthy women aged between 31 and 79 years from the region of Varna, Bulgaria. Two dermatoglyphic methods were applied: i) dactyloscopy of finger ridge count and finger indexes and ii) palmoscopy - palmar ridge count, palmar maximal atd, adt and dat angles, and palmar main lines. Statistical data processing was performed by means of variation analysis, regression analysis, χ2 test and one-way ANOVA using the SPSS software package, version 19. Results: The results from the dactyloscopic and palmoscopic examinations revealed several statistically significant differences in these quantitative dermatoglyphic patterns between breast cancer females and healthy ones. Conclusion: We could conclude that the purposeful examinations of the quantitative dactyloscopic patterns such as total finger ridge count and finger indexes and quantitative palmoscopic traits such as palmar ridge count, maximal adt, atd and dat angles and main palmar lines play a promising role for the cost-effective and trustworthy breast cancer screening in Bulgaria.

Purpose: Wild edible mushrooms are used worldwide and in Bulgaria as well. This inquiry investigation aimed at evaluating some mushroom usage practices by inhabitants in towns and villages in the Region of Varna, Bulgaria. Material/Methods: We carried out a study of 200 adult individuals, 100 males and 100 females, on the territory of the Region of Varna using anonymous inquiry with a set of 12 concrete items about wild edible mushroom usage. Statistical data processing was performed using descriptive and correlation analysis. Results: There was a domination of the negative attitude towards the wild edible mushrooms among the respondents from the towns, the villages and all the respondents as a whole on the territory of the Region of Varna. The inhabitants in the villages used more commonly cooking than those in the towns, and the inhabitants in the towns dried more seldom fresh mushrooms than those in the villages. Freezing was very rarely made use among all the respondents. There were statistically significant correlations between main town residence, on the one hand, and wild edible mushroom traditional usage, including cooking, drying, preservation and freezing, on the other hand. Conclusion: This inquiry investigation revealed some peculiarities of the attitudes towards wild edible mushrooms among the urban and rural population in the Region of Varna and the extent of usage of common mushrooms in dependence on espondents’ main residence.

Quadruple-negative breast cancer (QNBC) presents with negative expression of estrogen, progesterone, and androgen receptors and of human epidermal growth factor receptor 2. This BC subtype has the worst prognosis. In QNBC, there is a greater paucity of prognostic biomarkers than in androgen receptors-positive triple negative BC (TNBC). Absent androgen receptor expression confers a more aggressive QNBC course and correlates with the expression of cancer stem cell phenotype, COX-2, and basal markers such as CK5 and nestin. Basal-like phenotype is significantly associated with adverse prognostic markers including high KI-67, COX-2 expression, and cancer stem cell phenotype. Engrailed-1 expression is associated with unfavorable overall survival in QNBC patients. Non-coding ribonucleic acids play a significant role in BC tumourigenesis by virtue of their oncogenic and tumour-suppressive properties. The identification of QNBC-specific circulating microribonucleic acids may improve tumour detection and prognosis. There is an obvious necessity to intensify the problem-oriented interdisciplinary research on the hot topic of prognostic biomarkers of QNBC.

Recently, breast cancer (BC) continuously ranks first in the incidence rate of malignant neoplasms in womenworldwide. Quadruple negative BC (QNBC) is a recently identified subtype of triple negative BC (TNBC) presenting with negative androgen receptor expression. QNBC characterization and treatment is fraught with many challenges.There is cumulative evidence suggestingthat QNBC ishighly proliferative and immunogenic, rendering it anideal candidate for cytotoxic chemotherapy and immunotherapy. Several chemotherapeutic agents such as imatinib, cabozantinib, dasatinib, lucitanib,sunitinib, docetaxel, doxorubicin, and cyclophosphamidein QNBCpatients are highlighted. Some subtypes and related pathway proteins are preferentially expressed in QNBC and may act as effective therapeutic targets such as acyl-CoA synthetase4, S-phase kinase associated protein 2, immune checkpoint inhibitors, kinesin family member C1,and epidermal growth factor receptor. Several recent investigations comparing the therapeutic approach to QNBC and TNBC are briefly reviewed. Further more intensive and problem-oriented research in this topic of rising socio-medical importance is needed.

Treatment of implant related infections after surgicalor dentalproceduresare challengingcomplicationsandmay have devastating results for patients.The ability of microorganisms to adhere and form biofilm on implant surface is one of the main reasons for treatment failure in infections. When used in human body implants provide a suitable surfacefor cell attachment and bacterial colonization. One of the most common bacteriathat is isolated in hospital-acquired infections is Staphylococcus aureus, methicillin-resistant subtype. When a biofilm is formed, bacteria acquire an arsenal of properties that allow them to survive in an adverse environment, increasing their resistance to antimicrobial agents. Recently, as treatment modalities bioactive glass is used in the treatment of infections with multiresistant bacteria types. Its mechanism of action is to stimulate osteogenesis by releasing biologically active ions and at the same time it has antibacterial functionon a number of antibiotic-resistant bacteria due to increasementin osmotic pressure and environmental pH without affecting host tissues. These properties make bioactive glass extremelly suitablefor the treatment of infectionin boneswith destruction and bone loss. The aim of the present study is to review the outcomesreported in the literature on the antimicrobial effectiveness of bioactive glass S53P4 on Staphyloccocus aureus(MRSA).

Purpose Numerous wild edible mushrooms are relatively well-known in Bulgaria and many countries all over the world. The objective of this inquiry study was to analyze some peculiarities of local knowledge of such mushrooms depending on inhabitants’ educational level in the Region of Varna, Bulgaria. Materials and methods We performed a study of 200 adult individuals, 100 males and 100 females, on the territory of the Region of Varna using anonymous inquiry with a set of 12 concrete items dealing with respondents’ knowledge of wild edible mushroom and focusing on the role of their educational level for this knowledge. Statistical data processing was carried out using descriptive, variation and correlation analysis. Statistical significance was considered at the level of p

Background and Objectives: Trichomonas tenax is a protozoan which participates in the human oral microflora. It is considered as a potential paradontopathogen. This microorganism is also reported in the respiratory tract. We aimed to analyze the available literature about the prevalence of Trichomonas tenax in the population affected by periodontal disease. Materials and Methods: Searching the Scopus, PubMed, and ScienceDirect databases with the keywords: “Trichomonas tenax” and “periodontal diseases” was able to identify several systematic reviews and original articles up until July 2023. All studies with patients suffering from periodontal disease, which mentioned the year of publication, the country, specified the detection methods, and included the total number of tested samples as well as the percentage of those infected with Trichomonas tenax were included. Irrelevant articles were excluded. Results: We found 137 studies, but only 64 studies about the distribution of Trichomonas tenax in patients with gum disease underwent qualitative analysis. The highest number of studies have been conducted in Iran, Poland and Iraq. Different methods have been used to detect the unicellular organism, each with a different specificity and sensitivity. Conclusions: Interest in Trichomonas tenax has grown considerably since 2000. Because of its association with periodontal disease, Trichomonas tenax’s role in the inflammatory process should not be overlooked.

This paper presents new records and noteworthy data on the following taxa in SE Europe and adjacent regions: red algae Lemanea fucina and Paralemanea annulata, parasitic fungus Anthracoidea pratensis, saprotrophic fungi Cyathus olla, Massaria campestris, and Xylaria sicula, stonewort Chara canescens, liverworts Gymnomitrion commutatum and Porella baueri, moss Acaulon triquetrum, monocots Anacamptis laxiflora, Cephalanthera damasonium, and Himantoglossum robertianum and dicot Jacobaea othonnae are given within SE Europe and adjacent regions.

Coronavirus disease 2019 represents a serious challenge for modern society worldwide because of the considerable and unfavourable consequences of the pandemic in terms of human health, economics and social life. In the present concise survey, some essential peculiarities of ozone as disinfecting and therapeutic means under the conditions of COVID-19 pandemic as reflected in the recent literature are described. Particularttention is paid to modern hospital disinfection means and methods. Ozone exerts antiviral activity through the inhibition of viral replication and direct inactivation of viruses by interfering with the virus replication phase and attacking capsid proteins. Ozone therapy is very inexpensive and may safely exploit the critical vulnerability in COVID-19.

Purpose: The objective of the present study is to analyze scientometrically some essential patterns of the dynamic science institutionalization on breast cancer immunohistochemistry and to outline the most significant scientists, journals, scientific institutions conference proceedings in this interdisciplinary field. Material/Methods: In December 2019, a retrospective problem-oriented, title-word based search was performed in Web of Science Core Collection (WoS), MEDLINE and BIOSIS Citation Index (BIOSIS) of Web of Knowledge as well as in Scopus for 2003-2018. The following parameters were comparatively assessed: annual dynamics of publications, author’s names, journal titles, scientific institutions, and scientific forums. Results: There were 1187 publications abstracted in WoS, 776 publications abstracted in BIOSIS, 711 publications abstracted in Scopus, and 616 publications abstracted in MEDLINE. There were journal articles in 288 journals abstracted in WoS, in 234 journals abstracted in MEDLINE, in 156 journals abstracted in Scopus, and in 140 journals abstracted in BIOSIS. The most productive authors were David G. Hicks, Rohit Bhargava and Ian O. Ellis. The ‘core’ journals were Modern Pathology, Laboratory Investigation and Cancer Research. The most influential scientific institutions were the University of Texas System (USA) and the University of Texas MD Anderson Cancer Center (USA). The annual meetings of the US and Canadian Academy of Pathology and the Annual San Antonio Breast Cancer symposia were most attractive to the investigators worldwide. Conclusion:Our comprehensive results could be of interest to breast cancer researchers and clinicians from smaller countries, institutional science managers, and journal editors.

Purpose: Wild edible mushrooms are collected and consumed for centuries worldwide and in Bulgaria as well. This questionnaire investigation aimed at assessing some common mushroom usage practices in a random sample from the population in Varna region, Bulgaria. Material/Methods: We performed a study of 200 adult individuals, 100 males and 100 females, from Varna region using anonymous questionnaire with 12 basic items about wild edible mushroom usage. Statistical data processing was performed using descriptive methods and correlation analysis. Results: There was a prevalence of male and female individuals with secondary and higher education. Most respondents preferred wild edible mushroom gathering in contrast to purchasing. The positive attitude towards wild edible mushroom usage as food is more common in males than in females. Most respondents consumed wild edible mushroom several times during any year. There were statistically significant correlations between urban main residence, on one hand, and wild edible mushroom non-nutritional usage, cooking, drying, preservation and freezing, on the other hand; between secondary educational level, on one hand, and positive attitude towards nutritional usage of wild edible mushrooms, wild edible mushroom cooking, preservation, freezing and drying and applications as therapeutic means; as well as between individual female sex belonging and wild edible mushroom applications as therapeutic means, on the other hand. Conclusion: This questionnaire investigation revealed several interesting peculiarities of the attitudes towards wild edible mushrooms among the population of Varna region and the extent of usage of common mushrooms depending on sex, educational level and main residence of respondents.

Purpose: The interest in evaluation of real knowledge of wild edible mushrooms at individual and population level increases mainly in developing countries. The purpose of our inquiry study was to assess the level of knowledge and awareness of the wild mushrooms in a random sample from the population of Varna region in Bulgaria. Material/Methods: We performed an anonymous questionnaire investigation of 200 adult individuals, 100 males and 100 females, from Varna region, including 17 potential opinions from their personal knowledge of wild edible mushroom usage. Statistical data processing was performed using descriptive methods, variation and correlation analyses. Results: Most respondents acquired their knowledge of wild edible mushrooms from their relatives. From all 200 persons investigated 78 respondents were not capable of recognizing at least one wild edible mushroom at all. More respondents trusted other people, who have very good experience with preparation of wild mushrooms, thus relying on differentiation of a mushroom poison. Their awareness was associated with their capacity to properly recognize wild mushrooms as well as their long-term practice to recognize toxic mushrooms. Just a minority of respondents shared that wild mushrooms in their vicinity could be a problem and had a slight idea of mycotherapy. Only two females had heard about training for wild mushroom recognition. There were statistically significant correlation dependences between respondent’s awareness of wild edible mushrooms, on one hand, and individual sex status, educational level and main residence, on the other hand. Conclusion: Our study identified two most recognized wild edible mushroom species in Varna region, edible boletus (Boletus edulis Bull) and parasol mushroom (Macrolepiota procera S. F. Gray). Most respondents acquired their knowledge of wild edible mushrooms from relatives. A problem-oriented training of the population on this topic should be performed to improve awareness of common mushroom features and avoid mushroom poisoning.

Purpose: To perform a retrospective analysis of mushroom poisonings in Varna region for 25 years (1991-2015). Mushroom poisonings account for 10.7% of hospitalizations associated with acute exogenous intoxication. Poisoning with Amanita phalloides, Amanita pantherina, Amanita muscaria and various fungi that cause only gastrointestinal symptoms are of greatest importance for the clinical toxicology in the Republic of Bulgaria. Material/Methods: Objects of the study were 1872 patients who received treatment at the Clinic for Intensive Treatment of Acute Intoxications and Toxicoallergies, Naval Hospital – Varna, Military Medical Academy, Bulgaria after eating mushrooms. Results: Patients with irritative gastroenteritis – 1703 (91%) were with the highest frequency, followed by those with Amanita phalloides intoxication - 147 (7.8%). Amanita phalloides poisonings are not common and have a low relative share to all mushroom intoxications, but they are characterized by severe course and high lethality. Poisonings with Amanita pantherina and Amanita muscaria are even less common – 22 (1.2%). Patients accepted for treatment were both male (50.5%) and female (49.5%). Patients in age between 25 and 60 years were prevalent – 1171 (62.6%). A fatal outcome was registered in only 25 patients with Amanita phalloides intoxications, which represents 17% of all patients with Amanita phalloides poisoning and 1.3% of all patients with mushroom intoxications. Conclusion: Mushroom poisonings causing irritant gastroenterocolitis and those with Amanita pantherina and Amanita muscaria have a good prognosis. Amanita phalloides intoxications are characterized by the development of life-threatening organ damages and high lethality.

Background Female breast cancer remains the most common malignant disease and a leading cause of death worldwide. We aim to follow up on the annual dynamics of its incidence, prevalence and mortality rates in the region of Varna, Bulgaria. Methods Data for the recent retrospective analyses was accessed through the information system of Marko Markov Specialized Hospital for Oncological Diseases of Varna for 2017-2021 and two most recent publications for 2013-2017, in accordance with the Medical University-Varna Ethical committee guidelines. Results The total number of newly registered cases of breast cancer in women aged between 24 and 95 years amounted to 1,341. Mean crude incidence rate in 2017-2021 was 108.83 per 100,000, ranging from 119.89 to 105.25 per 100,000 in 2017 and 2020, respectively. The age group of 61-70 years was most affected (26.55% of the cases). Mean crude prevalence rate during this period was 1496.32 per 100,000, varying from 1447.75 to 1549.71 per 100 000 in 2017 and 2020, respectively. The total number of deaths until the end of 2022 reached 310 with 2018 being the greatest in mortality rate (30.22% of the cases). In 2017-2021, bilateral breast cancer was diagnosed as synchronous in 15 women and metachronous in 9 women. Conclusions The regular regional epidemiological investigations could contribute to the enhancement of the effectiveness and quality of prevention, timely diagnosis and adequate complex treatment.