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To evaluate the association between asymptomatic hyperuricemia, renal damage and cardiovascular events and to investigate whether the presence of monosodium urate (MSU) deposits in the joints is related to more advanced renal changes and increased cardiovascular risk.

Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection of the central nervous system (CNS) caused by the reactivation of John Cunningham polyomavirus (JCV). Most often, this disease is observed in patients with severe immune suppression, such as those with AIDS. Cerebral toxoplasmosis results from the reactivation of a latent infection with Toxoplasma gondii, an intracellular parasite. This parasitosis is relatively rare in the United States, while in some regions of Europe the seropositive population is over 90%. Similarly, to PML, cerebral toxoplasmosis develops in stages of advanced immune deficiency. Both of these opportunistic infections of the central nervous system can cause severe neurological symptoms, and their simultaneous presentation can represent a diagnostic and therapeutic problem. We present a case of a 59-year-old patient with a newly diagnosed HIV infection with manifestations of epilepsy and progressive cognitive impairment. The patient was diagnosed initially with cerebral toxoplasmosis and subsequently with progressive multifocal leukoencephalopathy.

The aims of the present study are to investigate the relationship between the anthropometric indicators and peculiarities of the nutritional intake in people with overweight and obesity and the risk factors for the development of dental caries in adults.

In December 2019 a newly described single-stranded coronavirus, later named SARS-CoV-2, started its expansion around the world and subsequently caused a global pandemic, affecting the lives of millions of people worldwide. SARS-CoV-2 can bind multiple receptors on different cells and thus invade many target organs, including the respiratory and gastrointestinal mucous membranes, lungs, central nervous system, heart, etc. This virus can affect the kidney tissue both directly and as a consequence of other organ involvement or of the treatment administered, causing acute kidney injury and leaving long term squeals that worsen the prognosis. We describe three patients with acute kidney injury and subsequent acute renal failure at the background of coronaviral infection.

Aim: To investigate the association between cardiovascular burden and monosodium urate (MSU) deposits in the joints of patients with asymptomatic hyperuricemia and no evidence of arthritis and subjects with psoriatic arthritis and hyperuricemia.

Background: The diagnosis of chronic kidney disease (CKD) is usually delayed, when significant functional renal impairment has already occurred. The diagnosis is complex and clinical and laboratory investigations play a crucial role. There are well-established markers of CKD – serum creatinine and cystatin C. However, the search for new reliable biomarkers that aid in the assessment of kidney function and predict the evolution of the disease is still in progress.

Subacute thyroiditis is a relatively rare thyroid disease that develops after acute viral upper respiratory tract infection and manifests with neck pain, fever and transient hyperthyroidism. The diagnosis is often delayed due to the non-specific presentation and laboratory findings. It is misdiagnosed with upper respiratory tract infections, cervical lymph-adenitis, even with acute pyelonephritis. The authors present a series of 12 patients with subacute thyroiditis and discuss the main steps in the diagnosis, differential diagnosis and treatment of this disease.

Cocaine is a natural alkaloid extracted from the leaves of the South American plant Erythroxylum coca or synthesized chemically. After cannabis, it is the second most frequently abused recreational substance worldwide. Cocaine can affect every tissue and organ within the human body, including the kidneys, causing tissue ischemia due to vasoconstriction, endothelial dysfunction and damage, procoagulant activity and oxidative stress with subsequent ischemic infarctions and fibrosis. The renal changes in cocaine abuse and addiction are due to rhabdomyolysis, ischemic, hypertensive, and inflammatory changes with the development of cell proliferation and fibrosis. The authors present three patients with cocaine-associated renal damage and discuss the underlying mechanisms of cocaine-induces tissue changes.

Rhabdomyolysis (RM) is defined as striate muscle-cell damage with disintegration of skeletal muscles and release of intracellular constituents to the circulation, with or without subsequent kidney injury. RM is one of the leading causes of acute kidney injury and is associated with substantial morbidity. The major signs of acute kidney injury in rhabdomyolysis are: pain, weakness and swelling of the injured muscle or muscle groups and myoglobinuria with reddish discoloration of the urine and decrease in urine output to anuria. The authors describe three cases of rhabdomyolysis with acute renal injury and discuss the current knowledge on the etiopathogenesis, clinical manifestations, diagnosis and treatment of this condition.

Obesity has been linked with vitamin D deficiency in a number of cross-sectional studies, reviews and meta-analyses. The aim of the present study was to assess the correlations of plasma 25(OH) vitamin D levels with indices of body composition examined by DXA with an emphasis on lean and bone mass as well as on indices such as android/gynoid fat, appendicular lean mass, fat-mass indexes (FMI) and fat-free mass indexes (FFMI). 62 adult subjects consented to participate – 27 men (43.5%) and 35 women (56.5%). Their mean age was 45.3 ± 9.5 years. Fan-beam dual-energy X-ray (DXA) body composition analysis was performed on a Lunar Prodigy Pro bone densitometer with software version 12.30. Vitamin D was measured by electro-hemi-luminescent detection as 25(OH) D Total (ECLIA, Elecsys 2010 analyzer, Roche Diagnostics). Statistical analyses were done using the SPSS 23.0 statistical package. The serum 25(OH)D level was correlated significantly only to the whole body bone mineral content, the appendicular lean mass index (ALMI) and the ALM-to-BMI index, underlining a predominant role for lean and fat-free mass. Vitamin D showed a very weak correlation to % Body Fat and the Fat Mass Index (FMI) in men only. Moreover, the multiple regression equation including the associated parameters could explain only 7% of the variation in the serum 25(OH) D levels. Our conclusion was, that there are differences in the associations of the vitamin D levels with the different body composition indices, but these associations are generally very weak and therefore – negligible.

Cotinus coggygria Scop. leaf aqueous ethanolic extract was examined for its in vitro antiproliferative and antioxidant activity. Antiproliferative effect was assessed on four human gynecological cancer cell lines: breast (MCF7, T47D), cervical (HeLa) and ovarian (A2780) and compared to the cell growth inhibitory effect on non-cancerous breast epithelial cell line MCF10A using MTT cell proliferation assay. Radical scavenging assay with DPPH was applied to evaluate antioxidant potential of the extract. The obtained results showed that the herb inhibited cell growth of all of the tested cancer cell lines and the highest was the cytostatic effect on A2780 cells with a half maximal inhibitory concentration (IC50) value of 30.8 μg/ml. For the other cell lines the IC50 values were in the range of 55-122.7 μg/ml. Additionally, the extract exerted considerably weaker reduction in cell proliferation of the non-cancerous cell line MCF10A compared to cancer cells, which indicates for antiproliferative selectivity. C. coggygria extract showed high free radical scavenging activity with an IC50 value of 11.2 μg/ml. The obtained data provide evidence for pharmacological potential of the tested extract and future more detailed studies concerning the molecular mechanisms of the anticancer effect of the herb are needed.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease associated with different reproductive complications in the affected women. Inherited thrombophilias are genetic factors increasing the risk for thromboembolism and recurrent pregnancy loss, but their influence on other reproductive disturbances in SLE patients has not been completely clarified. Two hundred and twenty-three Caucasian women (112 with SLE and 111 controls) were included in the study. Complete reproductive history of all SLE patients was carefully obtained. Genotyping for the FVLeiden, FIIG20210A, and MTHFRC677T polymorphisms was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. No significant differences in the prevalence of the FVLeiden, FIIG20210A, and MTHFRC677T polymorphisms between patients and controls were established. Patients with FVLeiden had fewer pregnancies (0.57 ± 0.98 vs. 2.18 ± 1.58; p = 0.007) than the others, while no significant differences in the reproductive history of FIIG20210A carriers and non-carriers were observed (p >0.05). In the SLE group, 41.67% of women with the MTHFRC677T TT genotype had at least one miscarriage in comparison to only 14.00% of the other female patients (p = 0.030). While the prevalence of the investigated thrombophilias was similar in patients with SLE and healthy women, a substantial influence of the inherited prothrombotic factors on the reproductive history of patients was revealed. The investigations of the FVLeiden and MTHFRC677T polymorphisms in SLE patients could help to identify women at highest risk for reproductive failure and thus, further studies in other ethnic groups would be of strong clinical importance.

Diarrhea is the most common gastrointestinal symptom in HIV-infected patients. The incidence and severity of diarrhea increase with progression of the immune defi ciency. In the literature, 30-60% of the patients with diarrhea among HIV-infected individuals remain without specified etiological agent. The aim of this article is to present the incidence of enterocolitis among hospitalized HIV-infected patients over a 3-year period and the degree of etiological clarifi cation of the cause. The results of our analyses showed that 63% of the hospitalized HIV-infected patients for this period were with enterocolitis. Only in 30% of these patients etiological agent was isolated. The reasons for this are mainly financial constraints and, therefore, virological investigations and further endoscopic and histopathological examination of the patients with negative for bacteria and parasites stool samples, were not performed. In the cases with isolated pathogen, an etiological treatment was carried out in parallel with highly active antiretroviral therapy, while in unsubstantiated cases an empirical treatment was carried out. Advanced immune defi ciency was associated with more severe course and worse prognosis of the enterocolitis. The treatment with highly active antiretroviral therapy, which leads to improvement of the immune status of the patients, is essential for the output of enterocolitis in HIV-infected patients.

The aim of this paper is to present created scenarios for training crews on the VSTEP simulator and to analyze the results of a survey conducted on the effectiveness of the education in relation to the future realization of the trainees. Two scenarios developed on the VSTEP simulator are presented in this paper. The first scenario aims at the vessel reaching a certain point of the Burgas environment and dropping anchor there. The second scenario is about maneuvering two vessels in the Atlantic Ocean under ideal weather conditions. A survey was conducted with cadets and students related to the training of VSTEP navigation simulators at the Nikola Vaptsarov Naval Academy. Conclusions are drawn about the quality of training on the simulators, the level of teaching and the practical skills the trainees acquire at the Nikola Vaptsarov Naval Academy. [ABSTRACT FROM AUTHOR]

Lamination is the process of joining two or more distinct material layers together. Generally a resin is used to bind the different materials used in the laminate. This research presents a new method to create laminates without binders or resins using 3D printing. 3D printing offers a wide range of prospects, due to its distinct advantages across numerous industries. Changing the process parameters that affect mechanical qualities has been the subject of numerous studies. The goal of this work is to fabricate a bi-material laminate using fused deposition modelling and also investigate how the dimensional precision and surface roughness of a PLA-PMMA laminate affect its tensile strength. The specimens used in this study are made following ASTM D638 Type I standard. To investigate their impact on tensile qualities and quality attributes, three process parameters--layer height, infill density, and raster width--were chosen. To analyse the impact of the parameters taken into consideration on the component's dimensional accuracy, tensile strength, and surface quality, Taguchi's optimization is used. Layer height plays a prominent role on the specimen's thickness. Surface roughness is found to be most strongly influenced by layer height, while tensile strength is exponentially influenced by raster width. [ABSTRACT FROM AUTHOR]

In recent decades, natural products of plant origin have predominated among the sources of new therapeutic agents. Plants, which are intensively used in folk medicine, are the focus of particular interest, and being subjected to in-depth analyses for the assessment of their pharmacological properties. The objective of the present work was to evaluate the in vitro anticancer, antiviral, and antioxidant properties of a crude aqueous methanolic extract from the leaves of Rhus typhina L., which is a plant species with broad applications in traditional phytotherapy. The anticancer capacity of the extract was assessed on two human breast cancer cell lines (MCF7 and MDA-MB-231) using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) cell proliferation assay, and its cell growth inhibitory effect on cancer cells was compared with its action on a non-cancerous breast epithelial cell line (MCF10A). Moreover, the in vitro antiviral activity of the plant extract was studied against viral strains of three taxonomic groups: herpes simplex virus type 1 (HSV-1), coxsackievirus B1 (CVB1), and influenza A virus (IAV/H3N2) using a cytopathic effect inhibition test, extract cytotoxicity evaluation through the neutral red uptake assay, a virucidal assay, a viral attachment assay, and cell pre-treatment with the extract. In turn, a radical scavenging assay with 2,2-diphenyl-1-picrylhydrazyl (DPPH) was applied to explore the antioxidant potential of R. typhina leaf extract. Results indicated that the plant extract possessed antiproliferative activity against the tested cell lines which was stronger toward cancer cells. A modest inhibitory effect on IAV/H3N2 replication was detected; as well as on an effect on herpes virions and on the adsorption of the HSV-1 and IAV/H3N2 strains; and a protective effect on uninfected cells before HSV-1 contact. The leaf extract of R. typhina also exhibited a strong free radical scavenging activity. The results of the present work demonstrated the pharmacological potentials of the plant extract, which warrants further and more detailed study in the future. [ABSTRACT FROM AUTHOR]