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The aim of the study was to evaluate capillaroscopic pattern in systemic sclerosis (SSc) patients and its association with disease duration as well as with presence of digital ulcers. Thirty six patients with SSc were included in the study. The severity of Raynaud's phenomenon (RP) at the hands was assessed with VAS (100mm), and the presence of digital ulcers at the hands was documented. Nailfold capillaroscopy was performed by a videocapillaroscope. RP was found as a clinical symptom in 100% (36/36) of the examined SSc patients. In SSc patients with a duration of the disease of less than 3 years, an early phase "scleroderma type" capillaroscopic pattern was found in 50% (5/10) of the cases. In the group of SSc patients with a duration of the disease of more than 3 years, late phase scleroderma type capillaroscopic pattern was found in 26.9% (7/26) of the cases, which was characterized by the presence of extensive, "desert-like" avascular areas and neoangiogenic capillaries. Scleroderma type capillaroscopic pattern was found in 97.2% (35/36) of the cases. Digital ulcers at the hands were found in 36.1% (13/36) of the patients. In 100% of those patients with digital ulcers (13/13), an active type scleroderma like pattern was observed, which is characterized by the presence of frequent giant capillaries, hemorrhages, and avascular areas. An active type scleroderma like pattern was found in 47.2% (17/36) of the patients without digital ulcers. The data show that the presence of digital ulcers at the hands of SSc patients is strongly associated with an active type scleroderma like capillaroscopic pattern. Observation of an active type scleroderma like pattern in patients without digital ulcers may therefore be used as a predictor for the development of trophic changes in the future, an indication for vasoactive medication for the prevention of the development of digital ulcers, and as an additional objective method for the evaluation of disease activity score in SSc.

Erectile dysfunction (ED) is the inability to develop and/or maintain an erection that is sufficient for satisfactory sexual intercourse. The prevalence of erectile dysfunction in diabetic men is 28-75%, this percentage rising with patient's age and duration of diabetes. The AIM of the present study was to investigate erectile dysfunction and quality of life in patients with type 2 diabetes mellitus (T2DM) after treating them with transdermal testosterone or with alpha-lipoic acid. The effect of a 12-week treatment with transdermal testosterone or alpha-lipoic acid on the erectile function and quality of life of 45 men with ED and T2DM was studied in a randomized, prospective, open clinical, comparative study. The parameters we measured in the patients were body weight and body mass index (BMI); the albumin, lipids, HbA1C, testosterone (T), sex hormone-binding globulin (SHBG), follicle stimulating hormone (FSH), luteinizing hormone (LH) and microalbuminuria levels; the International Index of Erectile Function (IIEF) and Health related quality of life (SF-36) questionnaires were completed to evaluate ED and quality of life before and after 12 weeks of treatment with alpha-lipoic acid (600 mg, parenterally, for 7 days, followed by 600 mg received per os) or with transdermal testosterone in a dose of 50 mg daily. Testosterone treatment decreased BMI significantly (p < 0.01), increased testosterone concentrations (p < 0.01) and raised the SHBG levels (p < 0.05), improved the glycemic control and lipid profile (total cholesterol, p < 0.05; HDL cholesterol, p < 0.05; triglycerides, p < 0.05). The patients treated with alpha-lipoic acid had their BMI (p < 0.01), HbA1C (p < 0.01), total cholesterol (p < 0.01), HDL-cholesterol (p < 0.01) and triglycerides (p < 0.01) significantly reduced. The indicators for ED in both groups were also statistically significantly improved. There was improvement for all patients' self-assessment score for "physical functioning" (p = 0.001), for "role limitations due to physical health" (p < 0.001) and for "general health perception" (p = 0.021). Transdermal testosterone and alpha-lipoic acid have a tangible beneficial effect on erectile dysfunction and on metabolic disorders in T2DM patients and can be used to treat such patients.

The aim of this study was to analyze the correlation between serum levels of inflammatory cytokines IL-1beta, IL-6, TNF-alpha and VEGF and the presence and severity of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (DM). In this prospective study we included 38 healthy volunteers (group 1) and 39 patients with type 2 DM (group 2). All participants underwent routine ophthalmological examination and laboratory analysis of the serum cytokines IL-1beta, IL-6, TNF-alpha and VEGF. Group 2 patients were additionally examined by colour fundus photography and fluorescein angiography to determine the DR stage. We studied the correlation of IL-1beta, IL-6, TNF-alpha and VEGF with the presence of DM, the presence and severity of DR, the duration of DM and DR, the serum levels of glycosylated haemoglobin, as well as with hyperlipidemia and the general indicators of inflammation - erythrocyte sedimentation rate (ESR) and fibrinogen. The group 2 patients had statistically significantly higher levels of IL-1beta (p = 0.01) and IL-6 (p = 0.029) and elevated TNF-alpha and VEGF levels in comparison with group 1 patients. Group 2 patients were divided into 5 subgroups depending on the severity of DR: patients without DR (n = 11), patients with mild non-proliferative DR (n = 10), patients with moderate non-proliferative DR (n = 5), and patients with severe non-proliferative DR (n = 2) (total number of non-proliferative DR (n = 17)) and patients with proliferative DR (n = 11). The comparative analysis showed statistically significant differences in the serum levels of IL-1beta (p = 0.003), TNF-alpha (p = 0.002) and VEGF (p = 0.005) between the different subgroups. Patients with proliferative DR showed significantly higher values of serum IL-1beta (p < 0.0001), IL-6 (p = 0.007), TNF-alpha (p = 0.002) and VEGF (p < 0.0001) compared with the patients with non-proliferative DR. The cytokine serum levels did not correlate with the duration of DM, the duration of DR (except for IL-1beta, p = 0.045), and hyperlipidemia (except for TNF-alpha, p = 0.05). TNF-alpha(p = 0.05) and VEGF (p = 0.047) serum levels correlated with the levels of glycosylated hemoglobin, and IL-1beta, TNF-alpha and VEGF correlated with the general indicators of inflammation (ESR and fibrinogen). Serum concentrations of IL-1beta, TNF-alpha and VEGF have an effect on the development and progression of DR. They correlate with the presence and severity of the disease. Whether serum cytokines can play the role of a prognostic factor or serve as a means to choose a proper therapeutic agent for the treatment of diabetic retinopathy should be analyzed by further more extensive prospective longitudinal studies in future.

Dzhambov A.M.,Medical university-Plovdiv
Noise and Health | Year: 2015

Diabetes mellitus is one of the leading causes for disability and mortality in modern societies. Apart from personal factors its incidence might be influenced by environmental risks such as air pollution and noise. This paper reports a systematic review and meta-analysis on the risk for type 2 diabetes due to long-term noise exposure. Electronic searches in MEDLINE, EMBASE and the Internet yielded 9 relevant studies (5 for residential and 4 for occupational exposure). They were checked against a predefined list of safeguards against bias producing individual quality scores, which were then fed to MetaXL to conduct a quality effects meta-analysis. People exposed at their homes to roughly Lden > 60 dB had 22% higher risk (95% confidence interval [CI]: 1.09-1.37) for type 2 diabetes in comparison to those exposed to Lden < 64 dB; when studies reporting contentious exposure categories were excluded, there was still 19% risk (95% CI: 1.05-1.35) for Lden = 60-70 dB versus Lden < 60 dB. In occupational environment there was not significant risk (relative risk [RR] = 0.91, 95% CI: 0.78-1.06) for < 85 dB versus >85 dB. There was no heterogeneity in the two groups (I2 = 0.00). The results should be interpreted with caution due to methodological discrepancies across the studies; however, they are indicative of the close links that noise pollution might have not only to cardiovascular diseases but to endocrine dysfunction as well. © 2015 Noise & Health.

To evaluate the effect of esculin, a plant coumarin glucoside, on free radicals and against epirubicin-induced toxicity on bone marrow cells. Antioxidant activity was assessed by a luminol-dependent chemiluminescence method or NBT test in a xanthine-xanthine oxidase system, and two iron-dependent lipid peroxidation systems. In vivo experiments were carried out in epirubicin-treated mice, alone or in a combination with esculin. Genotoxicity of the anthracycline drug was assessed by cytogenetic analysis and an autoradiographic assay. Esculin inactivated superoxide anion radicals in both systems we used. It exerted SOD-mimetic effect and reduced the level of superoxide radicals generated in a xanthine-xanthine oxidase system by 30%. Esculin also showed an antioxidant effect in a model of Fe2+-induced lipid peroxidation. Cytogenetic analysis showed that epirubicin had a marked influence on the structure of metaphase chromosomes of normal bone marrow cells. Inclusion of esculin in the treatment protocol failed to ameliorate the epirubicin-induced antiproliferative effects and genotoxicity in bone marrow cells. In this study the ability of the coumarin glucoside esculin to scavenge superoxide radicals and to decrease Fe-induced lipid peroxidation was documented. However, despite the registered antioxidant effects the tested compound failed to exert cytoprotection in models of anthracycline-induced genotoxicity in bone marrow cells. The results of this study warrant for more precise further evaluation of esculin, employing different test systems and end-points and a wider range of doses to more precisely appraise its potential role as a chemoprotective/resque agent.

Diabetes mellitus is a disease which carries a considerable social impact in Bulgaria and across the world because of its high prevalence. Research literature has recently included lots of studies investigating the effects of diabetes mellitus on the quality of life of diabetic patients and also many instruments to assess these effects. Quality of life is a concept that encompasses an individual's subjective perception of physical, emotional and social wellbeing, including both a cognitive component (satisfaction) and an emotional component (happiness). We review and analyse in the present article major determinants of disease-specific quality of life in patients with type 2 diabetes mellitus and the tools used for assessment. Fourteen instruments for measuring quality of life in type 2 diabetes mellitus (T2DM) met our search criteria. Their contents covered different quality-of-life domains or indicators-- typical diabetes symptoms, general health and quality of life, personality traits, physical functioning, mental and social well-being, treatment and quality of life. Most of the disease-specific tools had been field tested and data about their reliability and validity have been reported. Few tools had been subjected to formal assessment of their adaptability to changes. Of the instruments we assessed the most promising approaches for measuring the diabetes-specific quality of life are offered by ADDQoL, DCP and WBQ. Patients were involved in the development of these tools which have been shown by a number of studies to have good internal reliability, external and construct validity. Efforts are being continually made worldwide to develop a standard ensuring valid, reliable, easy to use tool for assessing quality of life in patients with type 2 diabetes mellitus in order to promote patients integration into society.

Agency: Cordis | Branch: FP7 | Program: CSA-SA | Phase: FP7-PEOPLE-2013-NIGHT | Award Amount: 94.22K | Year: 2013

The project sets as its main goal to enhance public recognition of researchers and their role in society and to encourage young people in Bulgaria to embark on scientific career. In the framework of the Europe 2020 strategy, the project focuses on the need for increasing the number of researchers and innovators in Europe and to foster the interest of the society and the youth, in particular, to research and innovation. For achieving the main goal, the following project objectives are defined: to disclose to the public the hidden sides of life and work of researchers, and show them as professionals and ordinary people; to highlight the EU emphasis on its researchers, the role of researchers in the Knowledge triangle and for building the Innovation Union; to involve citizens in debates on the contribution of researchers to European economy and society, as well as in ideas generation and open innovation; to foster active citizens position on the policy for growing research talents and making research and innovation attractive for young people. The project activities targeted at the younger participants will include within the Atelier of young talents: ideas competitions involving young people; cafes scientific Young talents under Spotlights where young talents will meet children and youth and discuss research topics with them. Most of the activities will be targeted at all age groups and will focus on making the public acquaint with the work and life of researchers: amusement programs of researchers Concert under the Stars; ideas fairs with stands of researchers groups presenting their research projects and new ideas and discussing them with citizens; lifestyle of researchers visits of research facilities guided by researchers; games between researchers and public Who, what, where show your knowledge; exhibitions of researchers; newspapers and dedicated web materials on researchers.

Agency: Cordis | Branch: FP7 | Program: CSA-SA | Phase: FP7-PEOPLE-2009-NIGHT | Award Amount: 155.41K | Year: 2009

The main objective of the project consists of enhancing researchers public recognition. Therefore, a varied programme of activities will take place in not less than 11 Bulgarian cities, i.e. Sofia, Varna, Plovdiv, Pleven, Rousse, Silistra, Shoumen, Stara Zagora, Yambol, Haskovo and Dimitrovgrad and will provide unique opportunities to the Bulgarian public to interact and have fun with researchers. Activities will include: Atelier of young talents targeted at the younger participants including: Youth Innovation Fair The challenge of new technologies, Youth essay competition Astronomy and challenges of new technologies, Youth Photo Competition Behind the stars, Demonstration Exhibition Our Future and the Space, and Other exhibitions and entertainment games. Activities targeted at all age groups: 9 amusement programs of researchers Astro party with researchers , Happening in the central square of Plovdiv, Scientific cafs, Demonstrations or scientific animations in Cabinets of curiosity, Demonstration in Street labs, Researchers exhibitions and publications of own works, poetry, paintings, pictures, models or photos on astronomy topics, Exhibitions: Bulgarian traces in science and 140 years of Prof. Marin Bachvarov, Short movies: Researchers night, and Astronomy observatories in Bulgaria, LAN parties, and Dedicated publications on Bulgarian researchers.

Agency: Cordis | Branch: FP7 | Program: CSA-SA | Phase: FP7-PEOPLE-2012-NIGHT | Award Amount: 101.27K | Year: 2012

Most of the IN-Close partners have had strong collaboration in supporting researchers career and mobility some of them as EURAXESS Service Centres, while others as partners in the six consecutive Researchers Nights (RN) organised in Bulgaria. During the last years RN activities drew positive attitude and interest among citizens on the role of researchers and science as a whole and established a base for regular meetings among scientists and the younger generation on leading topics of research and innovation. The European Year for Active Ageing and Solidarity between Generations was taken into account while designing the project concept. It was decided to focus public attention on innovations in medical sciences and topics such as reproductive health, e-health, robotics, active ageing, new materials and quality of life, however, underlining that a dedication to these specific research topics does not exclude scientists from other fields from participation in the events. In contrast, all project activities will be open to talented researchers willing to present their innovative products and to demonstrate their professional and personal achievements in front of a large audience. IN-Close sets as its main goal to enhance public recognition of researchers and their role in society and to encourage young people in Bulgaria to follow a scientific career. The target audience of the project will be, on first place, young people children, teenagers and students, and secondly, their parents and the public at large, including government, industrial and non-profit organisations. IN-Close will provide various opportunities to Bulgarians to interact and have fun together with the researchers. The project activities will take place in the 6 largest Bulgarian cities. The expected number of attendees is 5000 but through the integration of the location-based service (LBS), Facebook other media channels a target group of at least 10 000 people will be reached.

Agency: Cordis | Branch: FP7 | Program: CSA-SA | Phase: FP7-PEOPLE-2009-NIGHT | Award Amount: 27.89K | Year: 2010

.Bulgaria celebrates its researchers giving them the deserved recognition - this is the focus of the proposed action. The objective of the proposal is the valorization of the job researcher enhancing researchers integration in social fabric and reinforcing the links between research institutions and citizens. Special emphasis will be put on the involvement of young people revealing the enchantment of science and attracting them to research carrier. At the same time the proposal will promote the EU support for research and development and the opportunities for exchange, mobility and joint international teams. Typical Friday night activities in which main actors and animators will be famous scientists will be proposed to the large public designed and implemented by a broad consortium comprising researchers, public and business institutions. Six academic centers Sofia, Plovdiv, Varna, Burgas, Blagoevgrad, Shumen are the scenes of the entertainment activities gathering participants of all ages and social groups. Smaller towns will also be involved in the initiative by multiplication of part of activities in them.

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