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Purpose: There is still no comprehensive analysis with Bulgarian patients investigating the association between perioperative clinical parameters and final outcome in the early phase of complicated intraabdominal infection. Methods: This single-center prospective study was conducted in the Clinic of Surgical Diseases at the University Hospital Stara-Zagora for the period November 2018 - August 2021. Before surgery and on the 3rd postoperative day (POD) we measured axillary temperature (t), systolic blood pressure (SBP), mean arterial pressure (MAP), respiratory rate (RR), heart rate (HR), mental status and systemic inflammatory response syndrome (SIRS) in 62 patients with complicated intra-abdominal infections (cIAIs). Results: Of the 62 patients, nine died (14.5%). Preoperatively, only MAP successfully discriminated survivors from non-survivors (p = 0.027), which was confirmed by the ROC Curve analysis (AUROC = 0.731). Postoperatively, almost all of the clinical parameters except axillary temperature (AUROC = 0.573) showed prognostic ability - SBP (AUROC = 0.779) and MAP (AUROC = 0.864) for prediction of favorable outcome, HR (AUROC = 0.916) and RR (AUROC = 0.935) for prediction of lethal outcome. Conclusion: All investigated clinical parameters, except for axillary temperature, demonstrated the ability to predict the final outcome on the 3rd POD in patients with cIAIs. [ABSTRACT FROM AUTHOR]

In the period 2018-2020, an experiment was carried out with tomato variety "Nikolina F1" on leached cinnamon forest soil. The influence of increasing irrigation and fertilizer rates delivered by fertigation on tomato yields was studied. The experiment contained 8 variants at two irrigation rates (1-4 variants - 100% MMC; 5-8 variants - 50% MMC) and increasing levels of fertigation (T1 and T5 - without fertilization; T2 and T6 - N15P8K15; T3 and T7 - N20P12K20; T4 and T8 - N25P16K25). The results show that the formed yields of tomatoes during the studied years are the result of the influence of climatic factors, applied fertilization and irrigation rates. The average yields of tomatoes from the three experimental years range between 2864.0 and 5601.3 kg.da-1 with an average yield of 4363.96 kg.da-1. With average yields for the three experimental years of 2145.3 kg.da-1 for 2018; 5513.63 kg.da-1 for 2019 and 5430.5 kg.da-1 for 2020, as the plants of variant T3 fertilizes with N20P12K20 and full irrigation rate - 100% MMC realized the highest yields, in 2018 with 23.1 %, in 2019 with 37.2% and in 2020 with 21.6% higher than the average yields for the respective years. The three-factor statistical analysis of the average yield data shows that the influence of the year is the strongest - 67.77% of the formed yields are dependent on the experimental year. The degree of influence of the applied fertigation is 19.5%, of the irrigation rate - 1.3%, of fertigation and the year is 7.48%, and the joint influence of fertilization and the irrigation rate is less than 1%. [ABSTRACT FROM AUTHOR]

This paper presents quantitative comparison of the effect of modified contemporary diesel blends under effective parameters of diesel engine. Comparative tests were made under bench conditions. The values of the power, economy and toxic performance of a diesel engine operating with standard fuel and modified diesel blends have been determined. It is concluded that the operation of a Volkswagen 1.9 diesel engine with a modified contemporary diesel blend results in a reduction in the exhaust gas temperature without altering its economic and environmental performance. [ABSTRACT FROM AUTHOR]

During the period 2018-2020, on leached Cinnamon forest soil at outdoor irrigation conditions, studies were conducted with determinant tomato variety Nikolina F1 -- medium early production. The influence of 50 and 100% irrigation rates and increasing fertilization by fertigation (N15P8K15; N20P12K20 и N25P16K25) on the quality of the formed production has been established. The results of the three-year study show higher quality indicators in tomatoes with reduced irrigation compared to 100% irrigation rate - 6.0% higher dry matter content, 12.3% more total sugars, 16.99% higher sugar-acid number, as well as an acid content reduced by 8.3%. In terms of dry matter, total sugars and sugar-acid number, the variant fertilized with N20P12K20 is optimal for both irrigation rates. In both irrigation rates, there is a trend for the acid content in the fruits to increase with the fertilizer rate, while in the case of ascorbic acid, there are no pronounced trends over the years. The regression dependences represented by polynomial equations between the quality indicators for tomatoes and the applied fertilization depending on the irrigation rate show high values of the coefficients of determination (R2 between 0.58 and 0.99), except for the dry matter and total sugars at full irrigation rate in 2020 [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the ability of World Society of Emergency Surgery Sepsis Severity Score (WSES SSS) to prognosticate the fatal outcome in our local setting and compare the findings with global data. METHODS: The retrospective study involved 110 patients with complicated intra-abdominal infections (cIAIs) admitted to Department of Surgical Diseases at a University hospital. All adult patients who required emergency surgery due to cIAIs from January 2017 to July 2019 were included. We assessed the prognostic performance of WSES SSS using area under receiver operating characteristics (AUROC) curves and analyzed the coordinates of the curves. RESULTS: The observed in-hospital mortality was 22.7%. WSES SSS was significantly higher in nonsurvivors compared to survivors - 7(5-8) points vs. 3(0-5) points, p < 0.0001. The established AUROC value of WSES SSS for outcome prediction was 0.825 (0.749-0.902). We have identified sensitivity of 92% and specificity of 68.2% for cut-off value > 4 points. CONCLUSION: The WSES SSS was shown as a practical and reliable mortality predictor in Bulgarian patients with cIAIs. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this study was to evaluate the highly elevated CRP levels at admission as a mortality predictor in patients with complicated intra-abdominal infections (cIAIs). METHODS: This retrospective study involved 78 adult patients with diagnosis cIAIs admitted to the Department of Surgical Diseases at a University Hospital Stara Zagora from January 2017 to October 2018. CRP concentrations, white blood cells (WBC) count, qSOFA score and SIRS criteria were determined at admission. We compared their prognostic performance using the area under receiver operating characteristics (AUROC) curves and analyzed the coordinates of the curves. RESULTS: Of the 78 enrolled patients twenty (25.6%) died during hospitalization. ROC Curve analysis revealed CRP as the best mortality predictor (AUROC = 0.787). The pairwise comparison of ROC curves showed prognostic superiority of CRP compared to WBC (AUROC = 0.787 vs. 0.511, p = 0.0194) and SIRS (AUROC = 0.787 vs. 0.579, p = 0.0315) in outcome prediction. The identified sensitivity and specificity for CRP cut-off value = 210 mg/L were 75.0% and 81.0%, respectively. CONCLUSION: We found highly elevated CRP levels at admission as a significant prognostic biomarker in patients with cIAIs. [ABSTRACT FROM AUTHOR]

Pollution intensities measure total emissions per dollar of output for the production sectors of the economy. This paper presents quantitative assessment of the effect of modified gasoil under effective parameters of diesel engine. Comparative tests were made under bench conditions. The values of the power, economy and toxic performance of a diesel engine operating with standard fuel and modified gas oil have been determined. It is concluded that the operation of a Volkswagen 1.9 diesel engine with a modified gas oil results in a reduction in the exhaust gas temperature without altering its economic and environmental performance. [ABSTRACT FROM AUTHOR]

Purpose: Acute pancreatitis (AP) often presents as complex diagnostic and management challenge to physicians, surgeons and radiologists caring for patients with the disease. Methods: In this article we present a case of a young woman with AP induced by hypertriglyceridemia (HTGP) that runs on the background of diabetic ketoacidosis with unusual clinical picture and normal amylase. Results and Conclusions: HTGP involves young people. Most of the cases can be presented with normal values of amylase and lipase, but the possibility of severe complications and the lack of specific therapies determine the need of early recognition. HTGP may need specific behaviour additional of generally accepted guidelines for the treatment of AP. [ABSTRACT FROM AUTHOR]

Abstract: Parathyroid hormone receptor 2 (PTH2R) and its ligand, tuberoinfundibular peptide of 39 residues (TIP39) constitute a neuromodulator system implicated in endocrine and nociceptive regulation. We now describe the presence and distribution of the PTH2R and TIP39 in the brain of primates using a range of tissues and ages from macaque and human brain. In situ hybridization histochemistry of TIP39 mRNA, studied in young macaque brain, due to its possible decline beyond late postnatal ages, was present only in the thalamic subparafascicular area and the pontine medial paralemniscal nucleus. In contrast, in situ hybridization histochemistry in macaque identified high levels of PTH2R expression in the central amygdaloid nucleus, medial preoptic area, hypothalamic paraventricular and periventricular nuclei, medial geniculate, and the pontine tegmentum. PTH2R mRNA was also detected in several human brain areas by RT-PCR. The distribution of PTH2R-immunoreactive fibers in human, determined by immunocytochemistry, was similar to that in rodents, including dense fiber networks in the medial preoptic area, hypothalamic paraventricular, periventricular and infundibular (arcuate) nuclei, lateral hypothalamic area, median eminence, thalamic paraventricular nucleus, periaqueductal gray, lateral parabrachial nucleus, nucleus of the solitary tract, sensory trigeminal nuclei, medullary dorsal reticular nucleus, and dorsal horn of the spinal cord. Co-localization suggested that PTH2R fibers are glutamatergic, and that TIP39 may directly influence hypophysiotropic somatostatin containing and indirectly influence corticotropin releasing-hormone containing neurons. The results demonstrate that TIP39 and the PTH2R are expressed in the brain of primates in locations that suggest involvement in regulation of fear, anxiety, reproductive behaviors, release of pituitary hormones, and nociception. [Copyright &y& Elsevier]

Purpose: The diagnosis of xanthogranulomatous pyelonephritis is primarily histological. The mandatory studies that have to be performed are: abdominal echography, excretory urography, CT, and renal angiography. Methods: The current report covers a period of 16 years (1992-2008) and presents clinical material from 9 patients with a long history of nephrolithiasis. In the past, six of them have undergone surgical or extracorporeal lithotripsy. Results and conclusion: The performed preoperative imaging studies showed kidney tumors, and the operative treatment method used was nephrectomy. The post-operative follow-up did not detect any complications in any of these patients. [ABSTRACT FROM AUTHOR]

Background: Intra-abdominal infections (IAIs) are a wide range of pathological conditions that affect all intra-abdominal tissues and organs. These include both inflammation of individual organs and any type of peritonitis (primary, secondary, tertiary), where the severity of the disease often depends on the spread of inflammation - local or diffuse peritonitis. Methods: In this article, we present a review and analysis of current definitions, classifications, and approaches in the diagnosis and treatment of intra-abdominal infections. Results and Conclusions: IAIs remain an important cause of morbidity and mortality in modern surgical practice worldwide. Early and accurate clinical diagnosis, adequate local control, appropriate antimicrobial therapy according to the patient's risk factors and infection, and prompt resuscitation in critically ill patients are the cornerstones of IAI management. The application of the principles of evidence-based medicine and the individual approach to patients is crucial for optimizing results. [ABSTRACT FROM AUTHOR]