A Rare Case of Extralobar Bronchopulmonary Sequestration.

Bronchopulmonary sequestration is a rare developmental abnormality of the pulmonary system. It is a pulmonary malformation and is defined as lung tissue without connection to the tracheobronchial tree with a systemic blood supply. We present a case of an eight-month-old infant with prenatally diagnosed bronchopulmonary sequestration.

Complicated Pneumonia in a Child: Hydropneumothorax Associated with MIS-C and GAS Superinfection.

A hydropneumothorax is an uncommon complication of pneumonia, particularly in pediatric patients, and typically arises secondary to conditions such as malignancies, esophageal-pleural fistula, thoracic trauma, or thoracocentesis. While pneumothorax is rarely reported in adults with COVID-19 and is even less common in children, isolated cases have been noted in those with Multisystem Inflammatory Syndrome in Children (MIS-C). A recent alert has also been issued about increased Group A Streptococcus (GAS) infections in Europe.

Ikaros Deletions among Bulgarian Patients with Acute Lymphoblastic Leukemia/Lymphoma.

The zinc finger factor 1 is a transcription factor with a well-known role in B- and T-cell development. The deletions of have an established significance in acute lymphoblastic leukemia, while reports on its prevalence and prognostic significance among ALL subtypes and regions vary. Breakpoint-specific qPCR is a practical method for testing of the most frequent types of deletions, considering there is clustering of the deletion events.

IGHV Mutational Status in a Cohort of Bulgarian CLL Patients: High Unmutated CLL Prevalence in North-East Bulgaria.

Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. One of the best established CLL prognostic markers is the somatic hypermutational status of the gene which is a part of the immunoglobulin heavy chain variable region. Technology for IGHV genotyping has been optimized and has been applied in routine diagnostics for the first time in Bulgaria.

Dementia and Alzheimer's Disease Prevalence in Bulgaria During 2018: Nationally Representative Study.

This paper presents data analysis of a large dataset of outpatient records for the purpose of establishing accurate prevalence rates of dementia and Alzheimer's disease in Bulgaria. The research is motivated by the lack of accurate prevalence data as well as statistics about the actual number of people affected by dementia at national level. Health data from pseudonymized outpatient records (1,378,355) of 642,013 unique patients (Male 39.

Oral Nirmatrelvir-Ritonavir as Postexposure Prophylaxis for Covid-19.

Background: Clinical trials of treatments for coronavirus disease 2019 (Covid-19) have not shown a significant benefit of postexposure prophylaxis.

Methods: We conducted a phase 2-3 double-blind trial to assess the efficacy and safety of nirmatrelvir-ritonavir in asymptomatic, rapid antigen test-negative adults who had been exposed to a household contact with Covid-19 within 96 hours before randomization. The participants were randomly assigned in a 1:1:1 ratio to receive nirmatrelvir-ritonavir (300 mg of nirmatrelvir and 100 mg of ritonavir) every 12 hours for 5 days or for 10 days or matching placebo for 5 or 10 days.

Defining Trimester-Specific Reference Intervals for Thyroid Hormones: Insights from a Bulgarian Monocenter Study.

: Pregnancy introduces various interfering factors that, alongside individual variations, impact the assessment of thyroid function tests. This underscores the necessity of defining trimester-specific reference intervals for thyroid-stimulating hormone (TSH) levels. Differences in population characteristics, including ethnicity, socio-economic factors, iodine prophylaxis, and obesity, emphasize the need to establish trimester-specific TSH ranges for women of reproductive age in the respective region or center.

Giant Ossifying Lipoma of the Hand: A Case Report and Review of Literature.

Lipomas are one of the most common benign tumors of the body, characterized by a slow-growing, painless mass that rarely causes symptoms. Bone metaplasia among the mature adipose cells, however, is a rare condition called osteolipoma. In this article, we present a case report of a 61-year-old lady with a giant osteolipoma of the hand.

Mapping the Bulgarian Diabetes Register to OMOP CDM: Application Results.

Background: The Bulgaria Diabetes Register (BDR) contains more than 380 millions of pseudonymized outpatient records with proprietary data structures and format.

Objectives: This paper presents the application results and experience acquired during the process of mapping such observational health data to OMOP CDM with the objective of publishing it in the European Health Data and Evidence Network (EHDEN) Portal.

Methods: The data mapping follows the activities of the well-structured Extract-Transform-Load process.

Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with Covid-19.

Background: Nirmatrelvir in combination with ritonavir is an antiviral treatment for mild-to-moderate coronavirus disease 2019 (Covid-19). The efficacy of this treatment in patients who are at standard risk for severe Covid-19 or who are fully vaccinated and have at least one risk factor for severe Covid-19 has not been established.

Methods: In this phase 2-3 trial, we randomly assigned adults who had confirmed Covid-19 with symptom onset within the past 5 days in a 1:1 ratio to receive nirmatrelvir-ritonavir or placebo every 12 hours for 5 days.

An Elevated mRNA Combined with Lower mRNA Level in Active Rheumatoid Arthritis Peripheral Blood.

We aimed to investigate the expression of pro-inflammatory cytokine genes , , , , and immunoregulatory genes , , and in the peripheral blood of patients with rheumatoid arthritis (RA) at messenger ribonucleic acid (mRNA) level. The total RNA was isolated from peripheral blood samples. Real-time quantitative PCR was used to perform TaqMan-based assays to quantify mRNAs from 8 target genes.

High Doses of Colchicine Act As "Silver Bullets" Against Severe COVID-19.

A 48-year-old patient with a weight of 120 kg with type 2 diabetes mellitus, hypertension, and gout was hospitalized on the third day of the COVID-19 diagnosis. His general condition is relatively good, oxygen saturation is 89%. Despite starting standard treatment, on the seventh day from the onset of symptoms, the patient deteriorated sharply (oxygen saturation dropped to 74%).

PORT: A Randomized, Cross-Over, Phase 2 Study of Melflufen Peripheral Versus Central Intravenous Administration in Patients With Relapsed/Refractory Multiple Myeloma.

Background: Melflufen, a first-in-class alkylating peptide-drug conjugate, rapidly enters tumor cells and metabolizes to melphalan. In previous studies, melflufen was administered via central venous catheter (CVC). However, administration by peripheral venous catheter (PVC) may be preferable.

Genetic Variant in a Patient with Epilepsy, Ophthalmological Anomalies, and Neurodevelopmental Delay.

We present the findings of a Whole Exome Sequencing in a 2-year-old boy, conceived via Fertilization with donor sperm, who suffers from an undiagnosed neurological syndrome. The following heterozygous variant in the gene was identified and classified as likely pathogenic: c.1655_1656, p.

Differences in integrated assessment and management of non-communicable diseases (NCDs) for people with HIV across the WHO European region.

Objectives: We aimed to assess the extent of integration of non-communicable disease (NCD) assessment and management in HIV clinics across Europe.

Methods: A structured electronic questionnaire with 41 multiple-choice and rating-scale questions assessing NCD assessment and management was sent to 88 HIV clinics across the WHO European Region during March-May 2023. One response per clinic was collected.

Secondary acute myeloid leukemia and de novo acute myeloid leukemia with myelodysplasia-related changes - close or complete strangers?

To compare the main features of patients with secondary acute myeloid leukemias (AMLs) after post-myelodysplastic syndrome (AML-post-MDS) or post-myeloproliferative neoplasms (AML-post-MPN) and myeloid blast crisis of chronic myeloid leukemia (CML-BC) vs. de novoAMLs with myelodysplastic characteristics (dn-AML-MDS).

von Willebrand factor/factor VIII concentrate (Wilate) prophylaxis in children and adults with von Willebrand disease.

Long-term prophylaxis with a von Willebrand factor (VWF) concentrate is recommended in patients with von Willebrand disease (VWD) who have a history of severe and frequent bleeds. However, data from prospective studies are scarce. WIL-31, a prospective, noncontrolled, international phase 3 trial, investigated the efficacy and safety of Wilate prophylaxis in severe patients with VWD.

Cardiovascular Manifestations of Multisystem Inflammatory Syndrome in Children: A Single-Center Bulgarian Study.

: Multisystem inflammatory syndrome in children (MIS-C) poses challenges to the healthcare system, especially with frequent heart involvement. The current retrospective observational study aims to summarize the type and degree of cardiovascular involvement in children with MISC and to find possible associations between laboratory, inflammatory, and imaging abnormalities and the predominant clinical phenotype using a cluster analysis. We present a retrospective observational single-center study including 51 children meeting the MIS-C criteria.

Molecular Analysis of Dihydropteroate Synthase Gene Mutations in Isolates among Bulgarian Patients with Pneumonia.

pneumonia (PCP) is a significant cause of morbidity and mortality in immunocompromised people. The widespread use of trimethoprim-sulfamethoxazole (TMP-SMZ) for the treatment and prophylaxis of opportunistic infections (including PCP) has led to an increased selection of TMP-SMZ-resistant microorganisms. Sulfa/sulfone resistance has been demonstrated to result from specific point mutations in the gene.

Therapeutic Results and Survival of Patients with Myelofibrosis Treated with Ruxolitinib-A Real-Life Longitudinal Study.

The aim of this study was to analyze the therapeutic results and survival of patients with myelofibrosis treated with ruxolitinib in comparison with a group on standard therapy. It is a cross-sectional, retrospective, non-interventional, real-life study that was performed between January 2000 and February 2023. Patients treated between 2000 and 2016, before the introduction of ruxolitinib, constituted the control group ( = 45), while those treated after May 2016, after ruxolitinib inclusion, constituted the active group ( = 66).

Меtformin-associated maternal and neonatal outcomes in women with gestational diabetes - a retrospective cohort study.

Objectives: To assess the maternal and neonatal outcomes in women with GDM treated with metformin, medical nutrition therapy (MNT) or insulin.

Material And Methods: The current retrospective cohort study includes data from 233 women diagnosed with GDM who gave birth between January 2017 and January 2019 at an obstetrics and gynecology hospital in Sofia, Bulgaria. Patients were assigned to three groups, according to the treatment approach - metformin group (n = 70), insulin group (n = 40), and MNT group (n = 123).