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Purpose of the study: To investigate demographics, prevalence, risk factors and the different clinical forms and symptoms of syphilis in men who have sex with men (MSM). Material/Methods: 50 MSM with syphilis were registered at the Clinic of Dermatology and Venereology in the city of Pleven, Bulgaria, for the period 2008-2022. The diagnosis was confirmed by serological tests. Patients were distributed by their socio-demographic status. Risk factors and sexual behavior were studied, as well as clinical symptoms and co-morbidities of syphilis. Results: Of 50 MSM patients the most affected is the age between 20-29 years (54%). 34% of them are university graduates, 88% abused alcohol, nicotine and drugs in combination, 70% had sexual contacts with a casual partner, 26% of them had HIV co-infection. Secondary and early latent syphilis are the most common clinical forms of the disease (34%). The typical symptoms of primary and secondary syphilis were clinically manifested, 34% of them are localized in the genital. There is a significant correlation of the clinical form with the localization of the skin-mucosal lesions (p < 0.001). Antibiotic therapy is effective and leads to negative serological test results by the end of the second year of treatment. Conclusions: For 15 years (2008-2022), the number of registered MSM with syphilis in the Clinic of Dermatology and Venereology in Pleven increased after 2016 especialy in the time of the COVID-19 pandemic. Our results are close to the published data on the problem in the scientific literature for the last 10 years.

The COVID-19 pandemic had a major impact on the capacity of health systems to continue the delivery of essential health services. While health systems were being challenged by increasing demand for care of COVID-19 patients, it was critical to maintain preventive and curative services, especially for vulnerable populations. Materials and methods: A retrospective analysis was conducted on epidemiological and demographic characteristics of the COVID-19 pandemic in the Pleven region (March 2020 – March 29 2023). Data were obtained from annual reports of the National Statistical Institute and annual epidemiological analyses of Regional Health Inspectorate–Pleven and were analyzed using statistical software (IВМ SPSS Statistics 19.0). Results: There were 36,308 confirmed cases of COVID-19 (medical workers – 2,176 confirmed cases), with 1,895 deaths. The cases during the years were 5,646 (2020), 16,258 (2021), 15,225 (2022). The incidence of COVID-19 in the region was 2,389; 6,964, and 6,668 at 100,000 populations in 2020, 2021 and 2022, respectively. The prevalence of the disease was 93%, 98% and 94% of all registered respiratory transmitted cases (p

The aim of the study was to determine the spread of SARS-CoV-2 among students of Medical University-Pleven during the fourth wave of the COVID pandemic by PCR testing and to analyze epidemiological data. Material and methods: Cross-sectional epidemiological study was conducted for the period November-December 2022. A sociological method of data collection (interview) was used, and a questionnaire was developed for this purpose. Nasopharyngeal swab was taken from the students and RT-PCR analysis of SARS-CoV-2 was performed. Results: An interview was conducted with 200 students from various specialties at Medical University-Pleven. Clinical symptoms were reported by 24 (12%) of respondents, the leading ones being runny nose and cough; with comorbid conditions were 10 participants (5%) with predominant chronic lung diseases. Three students reported contact with coronavirus-positive patients. Six of the participants had travelled abroad in the past 14 days. Eighty-four students (42%) were immunized: 25 with one dose, 43 with two doses and 16 with three doses. Only two tested samples (1%) were positive for SARS-CoV-2. Both subjects reported complaints at the sampling time and were unvaccinated. Conclusion: The results of the study show a low percentage of infected, mostly non-immunized persons, which coincides with the trend in Bulgaria during the fourth wave of the COVID pandemic.

Eggs are a good source of balanced nutritional and biologically active substances - proteins, lipids, some irreplaceable nutritional components such as amino acids, polyunsaturated fatty acids, vitamins, macro- and microelements, etc. It is identified as the cheapest animal source of proteins, lipids, vitamins A, B12, riboflavin, choline, iron, zinc, phosphorus and calcium. At the same time, the dangers to human health that eggs can carry are also taken into account. Material/Methods: The literature used is based on databases PubMed, Embase and as well as data from own studies. Review Results: In the present review, we provide data on the importance of the composition of eggs in human nutrition are presented and the risk of their use is evaluated. Conclusions: The high biological and nutritional value of eggs are grounds for their use in the daily life of healthy people, without additional restrictions of cardiovascular diseases. There is a risk of food poisoning, which can be limited to acceptable levels by following good hygiene practices.

During recent four decades, the world has faced two horrific, deadly pandemics. In the background of the ongoing pandemic HIV/AIDS, the people were affected with the newly emerging Corona virus SARS-CoV-2, that rapidly turned into pandemic dimensions. There are data that, in various aspects, HIV infection was similar to SARS-CoV-2. The purpose of this review was to search for similarities and differences between both pandemics in view to use the experience of the past and knowledge we have acquired in order to better overcome current and future pandemics. Material/Methods: The iterature used is based on databases PubMed, Embase and random search on the Internet with the keywords COVID-19 and HIV, as well the Boolean operator "AND" to achieve a search of "COVID-19 and HIV". Review Results: In the present review summary, we provide data for similarities and differences regarding virological, immunologic, clinical and pharmacological aspects of HIV and SARS-CoV-2 infections and associated with them pandemics. Conclusion: SARS-CoV-2 was here and will remain here. COVID-19 is not the last pandemic, and people should be prepared for new encounters with agents of high virulence and pandemic potential.

Combined antiretroviral therapy (cART) provides HIV-infected people life expectancy comparable with HIV-uninfected people and turns the disease into a manageable chronic condition necessitating the need for innovative inflammatory markers. Our purpose was to determine the correlation between IL-6, D-dimer and high-sensitivity C-reactive protein (hsCRP) levels among HIV-infected and the presence of chronic inflammation during general and immunological aging and drug exposure. Material and methods: Comparative prospective study was conducted at 37 HIV-positive persons from the Center for Monitoring and Treatment of HIV-positive Patients at the Clinic for Infectious Diseases, UMBAL “Dr. G. Stranski” – Pleven (target group) and 18 HIV-negative individuals from outpatient practice (control group), aged ≥18 years. Results: The median age of seropositive persons was 40 years (24÷70 years), of the control group – 51 years (29÷72 years); 78% of the target group and 61% of the controls are men. The average duration of ART is 4 years (1÷9 years). The study of specified biomarkers in the target group found increased IL-6 in 8.11% of patients (mean 3.67±1.86 pg/mL; range 1.5÷8.62; 95% CI 3.11-5.02), increased D-dimer in 8.11% (mean 0.37±0.28 µg/mL; 0.21÷1.96; 95% CI 0.3691-0.37459) and increased hsCRP in 10.81% (mean 2.10±1.99 µg/mL; 0.19÷7.0; 95% CI 1.89-2.31). In the control group IL-6 was not increased (mean 2.75±1.67 pg/mL; 1.5÷6.91), D-dimer was increased in 16.67% (mean 0.37±0.17 µg/mL; 0.09÷0.8) and increased hsCRP – in 5.56% (mean 1.76±1.75 µg/mL; 0.19÷5.66). Il-6 was significantly higher in the target group. Conclusion: The implementation of sensitive biomarkers is crucial in the general diagnostic-therapeutic approach in aging with HIV.

Mumps is a vaccine preventable viral infection. Its typical clinical manifestations are characterized by pain and swelling of the salivary glands, fever, and fatigue. Often other organs are affected - testes in males after puberty (orchitis), ovaries in women (ooforitis), pancreas (pancreatitis), central nervous system (meningities). The use of specific immune prophylaxis led to a significant success in the fight against mumps, but there are still unresolved issues related to the immunological and epidemiological effectiveness of the vaccines. The disease continues to interest researchers today. The main issues being tackled are related to the conduct of virological, clinical and sero-epidemiological studies in different countries. Objectives of the study is to determine the frequency distribution of mumps-specific IgG antibodies in healthy populations in the region of Pleven, Bulgaria. Methods: a cross-sectional sero - epidemiological representative population - based survey in the area was made. Enzyme immunoassay method was used for an indirect proof of mumps - specific IgG serum antibodies. 410 people were examined at an average age of 25 (1 to 84). Of these, 250 (61 %) were women and 160 (39 %) - men. Results: Of all test results, the negative were 72 (19 %), the borderline were 12 (3 %), the positive were 182 (44 %), and highly positive were 144 (35 %). The vaccination status showed that 242 (69 %) of all surveyed were immunized with a vaccine against mumps. According to the immunization schedule in Bulgaria, 132 (33 %) people were immunized with monovaccine during the years - 1 intake, 80 (20 %) with trivaccine - 1 intake, and 64 (16 %) - 2 doses. Conclusion: We believe that despite the specific immunprophylaxis carried out against mumps decades on end, the necessary level of protection leading to its elimination has not yet been reached.