Application of magnetic methods for assessment of soil restoration in the vicinity of metallurgical copper-processing plant in Bulgaria.

Copper ore mining and processing are among the most harmful anthropogenic influences for the environment and they are a subject of international and national law regulations. Recultivation of areas influenced by mining and processing industry is commonly applied and monitored in order to restore as much as possible the natural environment. In this study, environmental magnetic methods are applied in order to assess the degree of soil restoration in terms of soil development, after remediation of waste dump from Cu-processing plant. Soils developed under birch forest stands of different age (5, 15, and 25 years) as well as raw waste material were sampled along depth down to 20-30 cm. Variations in magnetic parameters and ratios obtained (magnetic susceptibility, frequency-dependent magnetic susceptibility, anhysteretic remanence (ARM), isothermal remanence (IRM), ARM/IRM100mT) suggest the presence of magnetic enhancement in the upper 0-15 cm, the thickness of this layer varying depending on the age of the forest stand. Magnetic mineral responsible for this enhancement is of magnetite type, while waste material contains a large amount of hematite, as evidenced by coercivity analysis of IRM acquisition curves and thermal demagnetization of composite IRM. Magnetic grain-sized proxy parameters suggest that magnetite particles are coarser, magnetically stable, while no or minor amount of superparamagnetic grains were detected at room temperature. A well-defined linear regression between the topsoil magnetic susceptibility and the approximate age of the forest stand provides an indication that the magnetic enhancement is of pedogenic origin. It is concluded that the observed magnetic enhancement of recultivated soils studied is linked to a combined effect of pedogenic contribution and possible additions of industrial ashes as a liming agent for soil restoration.

Cystic echinococcosis in Bulgaria 1996-2013, with emphasis on childhood infections.

The objective of this study was to determine some features of cystic echinococcosis among children and adolescents, such as epidemiology, diagnosis, organ localization, treatment, and social and environmental factors favoring transmission of the disease. The 18-year study period (1996-2013) includes officially registered primary cases treated surgically, and/or with drug therapy, and/or with the puncture, aspiration, injection, reaspiration technique. Organ localization of the cysts and the most common diagnostic procedures were studied from the patients' medical records. Groups of diseased and healthy children were surveyed to outline some of the environmental and social factors influencing morbidity. From 1996 to 2013, the average annual incidence of cystic echinococcosis in the country was 6.7 per 100,000, but with significant variations in the incidence between different age groups. The hydatid cysts in children aged 0 to 9 years may most frequently be found in the lungs, in contrast to patients from other age groups. Almost 90% of the affected children had sustained contact with dogs. At present, among the countries of the European Union, Bulgaria holds the highest incidence and prevalence of cystic echinococcosis. Childhood echinococcosis remains a serious health problem for the country. Therefore, the study of cystic echinococcosis in children has important epidemiological significance concerning the intensity of transmission.

[Identification the risk of preterm labor :the role of fetal fibronectin].

UNLABELLED: Fibronectins represent a group of glycoproteins, which form "molecular glue" and are necessary in the interaction between a cell and a cell. The existence of fetal fibronectin in pregnant woman's vagina up to 22 g.w. is normal. In a normally proceeding pregnancy between 22 g.w. and 35 g.w. there is not supposed to be found fetal fibronectin in cervico-vaginal secretion. Its presence is a highly informative biological marker for the risk of premature birth. AIM: The aim of this research was to determine the risk for premature birth through applying fetal fibronectin test as a specific marker to pregnant women with or withthout symptoms of threatened birth. METHODS: A prospective longitudinal study has been carried out. The tests have been applied to hospitalized patients in University hospital "Majchin dom", Clinic of Pathologic pregnancy and Delivery room. Tests have been applied on 116 patients in totally). The pregnant have been separated in two groups depending on the fact of presence or absence of premature birth symptoms. The screening methods used were: the fFN test and the cervical length measurement by transvaginal according to an established protocol. CONCLUSION: From the total of 116 patients, in 78 we have received positive tests for fetal fibronectin; in 38 - negative test. With asymptomatic patients, having higher risk of preterm birth, the percent of positive tests has been lower (14%). With asymptomatic patients with higher percent of risk factors have been: short cervix (38%), multiple pregnancy (29%), followed by patients with diagnosis of preterm birth in the past (25%) and bleeding in earlier terms. Estimating positive and negative predictive rate, we have achieved following results: The test for fetal fibronectin has excellent predictive rate - 97%, which coincides with the great deal of research until this moment in the world. Referring to the positive predictive rate--it is not sufficient--only 19%.

[Tocolysis with nifedipin; its use in current practice].

AIM: The aim of the study is to establish the safety and efficacy of calcium channel blocker- Nifedipin as tocolytic agents. A wide range of tocolytics have been utilized for the management of preterm labor Calcium channel blockers, namely nifedipine, gained popularity as tocolytics due to the oral route of administration, availability of immediate- and slow-release preparations, the low incidence of maternal adverse effects associated with their use, and the fact that they are inexpensive. METHODS: 88 pregnant women in preterm labor participated in a prospective longitudinal study Inclusion criteria were: gestational age between 24 and 34 weeks gestation; uterine contractions in 10-15 min interval; single pregnancy, lack of contraindications for tocolysis. In all cases the calcium antagonist Nifedipine was used in dosage 4 x 10 mg per os. The clinical response to tocolysis, gestational age at delivery and potential side effects were analyzed. RESULTS: 91 pregnant women participated in the study. Three were excluded because they refused to participate. 88 pregnancies were finally analyzed. In nine of them maternal contractions persisted despite of treatment. The other 79 pregnancies were delayed 48 hours to receive antenatal corticosteroids. From all these 79 pregancies 66 delayed 7 days. The most common adverse effects were tachycardia, hypotonia, headache, dizziness, but they escape soon after the first dose. CONCLUSION: Nifedipine is an effective oral tocolytic with few maternal side effects.

[Perinatal mortality of IUGR neonates].

This study was conducted to evaluate the role of intrauterine fetal growth restriction (IUGR) in the perinatale mortality. A prospective study was designed, including 329 consecutive singleton pregnancies between 24 to 40 weeks' gestation, whose body weight is under 10th percentile for the gestational week. The control group consist of 530 appropriate for the gestational week (AGA) in the same period of gestation. The fetuses are without inborn malformations. The results show grater stillbirth rate in the group of hypotrophic than in the eutrophic neonates. In the group under 27th week of gestation is 2.6% forAGA and 8.3% for IUGR, for the group between 28-31 w.g. is 9.6% and 21.1% respectively and for 32-35 wg. is 2.3% against 13.1%. Perinatal mortality rate (stillbirth and demised before discharged) for the group before 27th w.g. is 65.8% for AGA and 72.2% for IUGR (P > 0.05). Between 28-31 w.g. is 28.4% and 50.0%, for 32-35 is 6.9% and 27.8% respectively (P > 0.01). After 37th w.g. perinatal mortality rate is less in AGA than in SGA fetuses. In conclusion the stillbirth rate is more frequent in IUGR fetuses than in AGA and frequencies is more pronounce in late preterm pregnancy. The fetal hypotrophy has deleterious effect on neonatal survival rate.

[Identification of preterm labor: the role of fetal fibronectin in parents with symptoms].

AIM: To determine whether the presence of fetal fibronectin in vaginal secretions of patients with symptoms suggestive of preterm labor predicts preterm delivery. Fetal fibronectin, a large molecular weight glycoprotein produced in the chorion, is expressed in cervical and vaginal secretions in women with disruption of the choriodecidual junction by labor or by inflammation. METHODS: A prospective observational longitudinal study from January 2013 till December 2013 was performed on patients between 24 and 32 weeks of gestation with symptoms of preterm labor, intact membranes, and cervical dilation < 4 cm (total patients = 86). The endpoint was the delivery at 34 weeks or more. The screening methods used were: the fFN test and the cervical length measurement by transvaginal according to an established protocol. CONCLUSION: The presence of FFN in vaginal or cervical secretions before 35 weeks is a is a strong predictor that preterm delivery is unlikely within the next 7 to 14 days. The predictive power of FFN is stronger at earlier gestation ages (24-29 wks) than it is later in pregnancy and is stronger for short-term prediction (7-14 d).

[Pregnancy-induced haemolytic anaemia].

This is the clinical case of a primiparous eight month pregnant female, presenting with symptoms of pregnancy-induced acute haemolytic anaemia (haemolytic aneamia provoked by an immune mechanism, intra- and extra-erythrocyte defects, and HELLP syndrome were excluded). The anaemia progressed to become life-threatening for both the pregnant women and the foetus, which brought the following questions into consideration: diagnosis of anaemia during pregnancy; dosing of corticosteroid therapy; possibility of giving birth to a viable foetus and prognosis for next pregnancies. Owing to the inter-disciplinary efforts, the life and health of this pregnant woman were preserved, but the foetus was lost.

[Preterm birth--incidence and etiology].

Preterm birth is a major societal and economic problem. To him is accounting for 80 to 90% of neonatal morbidity and mortality worldwide. It is recognized as a complex multifactorial condition with different underlying etiologies. Paramount in the prevention of preterm birth is physician education regarding known risk factors, signs and symptoms of preterm labor and the role of close follow-up in the patients identified as high risk.

[HIV infection in pregnant women and risk of preterm birth].

According to estimates by WHO and UNAIDS, 34 million people were living with HIV at the end of 2011. Transmission of the human immunodeficiency virus (HIV) from mother to child can occur in utero, during labour or after delivery from breastfeeding. The majority of infants are infected during delivery. Clinical records have found more evidence of an increased rate of preterm delivery in HIV-positive women in low income countries.

Human trichinellosis in Bulgaria--epidemiological situation and trends.

Human trichinellosis is a major food-borne zoonosis in Bulgaria with a high health, social, and economic impact. Every year outbreaks and sporadic cases are registered in the country. Epidemiological data based on standard protocols for epidemiological surveillance and control of human trichinellosis for each region in the country were collected and analysed at the National Centre of Infectious and Parasitic Diseases, and the main epidemiological trends during the past 17 years (1990-2006) were determined. Since 1991 human trichinellosis has become a re-emerging zoonosis in Bulgaria. A total number of 145 trichinellosis outbreaks and 238 sporadic cases were registered. Altogether, 7544 persons have consumed meat or meat products harbouring Trichinella larvae, and of these, 4108 individuals (54.45%) contracted trichinellosis (with 2 deaths). The annual incidence of human trichinellosis varied from 0.27 to 7.40 per 100,000 population. Fifty-seven of the outbreaks were sourced to wild boar meat consumption, 67 were due to consumption of pork products, and in 21 outbreaks the source of infection was unidentified (4 of them were associated with consumption of mixed meat--pork and wild boar meat products). The peaks of outbreaks (12 per year) were registered in 1994, 1998, 2002, and 2003. In recent years some decrease in the numbers of outbreaks was observed (2004: 6, 2005: 3, and 2006: 7).