The nut-and-bolt motion of a bacteriophage sliding along a bacterial flagellum: a complete hydrodynamics model.

The 'nut-and-bolt' mechanism of a bacteriophage-bacteria flagellum translocation motion is modelled by numerically integrating the 3D Stokes equations using a Finite-Element Method (FEM). Following the works by Katsamba and Lauga (Phys Rev Fluids 4(1): 013101, 2019), two mechanical models of the flagellum-phage complex are considered. In the first model, the phage fiber wraps around the smooth flagellum surface separated by some distance. In the second model, the phage fiber is partly immersed in the flagellum volume via a helical groove imprinted in the flagellum and replicating the fiber shape. In both cases, the results of the Stokes solution for the translocation speed are compared with the Resistive Force Theory (RFT) solutions (obtained in Katsamba and Lauga Phys Rev Fluids 4(1): 013101, 2019) and the asymptotic theory in a limiting case. The previous RFT solutions of the same mechanical models of the flagellum-phage complex showed opposite trends for how the phage translocation speed depends on the phage tail length. The current work uses complete hydrodynamics solutions, which are free from the RFT assumptions to understand the divergence of the two mechanical models of the same biological system. A parametric investigation is performed by changing pertinent geometrical parameters of the flagellum-phage complex and computing the resulting phage translocation speed. The FEM solutions are compared with the RFT results using insights provided from the velocity field visualisation in the fluid domain.

Clinical Management of Women with Newly Diagnosed Osteoporosis: Data from Everyday Practice in Bulgaria.

INTRODUCTION: The real duration of osteoporosis treatment in clinical practice is still not well described. The primary objective is to estimate the proportion of patients who stayed on treatment during a 4-year follow-up, and the secondary objective is to estimate the proportion of patients who switched treatment and the reasons for switch or discontinuation. METHODS: This was a national retrospective chart review, based on routine clinical data. Data were collected electronically from medical records in 33 representative primary care physicians' sites. Inclusion criteria were women with postmenopausal osteoporosis that have received initial treatment prescription following diagnosis by DXA between January 1, 2012 and December 31, 2014, and at least a 12-month database history after the index date. Exclusion criteria were women receiving treatment for osteoporosis and follow-up at secondary care physicians' sites only. All statistical analyses were performed with the R statistical package. RESULTS: A total of 1206 female patients with newly diagnosed osteoporosis and treatment initiation were followed for 4 years. The majority (88.3%) had no history of previous fractures. Bone mineral density data were available in 70.1%. Endocrinology was the most common specialty among prescribing specialists (40.0%), followed by rheumatology (30.3%). Bisphosphonates (BPs) were the most common initial treatment (72.7%), followed by denosumab (20.1%). Ibandronate (70.2%) and alendronate (24.2%) constituted the majority of all prescribed BPs; 731 patients remained on treatment during the second year (60.6%), 524 during the third year (43.4%) and 403 (33.4%)-at study end (fourth year). In all groups, except that on denosumab, the most common reason for switching to another treatment was presumed lack of effect. The main reasons for treatment discontinuation were financial on the patient's part. CONCLUSIONS: The duration of osteoporosis treatment in real-world clinical practice is far from optimal: < 3-4 years irrespective of fracture risk. Factors other than medical considerations are at play, mainly limitations set by the Health Insurance Fund. The health authorities should be aware of this.

Bacteriostatic and Cytotoxic Properties of Composite Material Based on ZnO Nanoparticles in PLGA Obtained by Low Temperature Method.

A low-temperature technology was developed for producing a nanocomposite based on poly (lactic-co-glycolic acid) and zinc oxide nanoparticles (ZnO-NPs), synthesized by laser ablation. Nanocomposites were created containing 0.001, 0.01, and 0.1% of zinc oxide nanoparticles with rod-like morphology and a size of 40-70 nm. The surface of the films from the obtained nanomaterial was uniform, without significant defects. Clustering of ZnO-NPs in the PLGA matrix was noted, which increased with an increase in the concentration of the dopant in the polymer. The resulting nanomaterial was capable of generating reactive oxygen species (ROS), such as hydrogen peroxide and hydroxyl radicals. The rate of ROS generation increased with an increase in the concentration of the dopant. It was shown that the synthesized nanocomposite promotes the formation of long-lived reactive protein species, and is also the reason for the appearance of a key biomarker of oxidative stress, 8-oxoguanine, in DNA. The intensity of the process increased with an increase in the concentration of nanoparticles in the matrix. It was found that the nanocomposite exhibits significant bacteriostatic properties, the severity of which depends on the concentration of nanoparticles. In particular, on the surface of the PLGA-ZnO-NPs composite film containing 0.001% nanoparticles, the number of bacterial cells was 50% lower than that of pure PLGA. The surface of the composite is non-toxic to eukaryotic cells and does not interfere with their adhesion, growth, and division. Due to its low cytotoxicity and bacteriostatic properties, this nanocomposite can be used as coatings for packaging in the food industry, additives for textiles, and also as a material for biomedicine.

Magneto-Fluorescent Hybrid Sensor CaCO3-Fe3O4-AgInS2/ZnS for the Detection of Heavy Metal Ions in Aqueous Media.

Heavy metal ions are not subject to biodegradation and could cause the environmental pollution of natural resources and water. Many of the heavy metals are highly toxic and dangerous to human health, even at a minimum amount. This work considered an optical method for detecting heavy metal ions using colloidal luminescent semiconductor quantum dots (QDs). Over the past decade, QDs have been used in the development of sensitive fluorescence sensors for ions of heavy metal. In this work, we combined the fluorescent properties of AgInS2/ZnS ternary QDs and the magnetism of superparamagnetic Fe3O4 nanoparticles embedded in a matrix of porous calcium carbonate microspheres for the detection of toxic ions of heavy metal: Co2+, Ni2+, and Pb2+. We demonstrate a relationship between the level of quenching of the photoluminescence of sensors under exposure to the heavy metal ions and the concentration of these ions, allowing their detection in aqueous solutions at concentrations of Co2+, Ni2+, and Pb2+ as low as ≈0.01 ppm, ≈0.1 ppm, and ≈0.01 ppm, respectively. It also has importance for application of the ability to concentrate and extract the sensor with analytes from the solution using a magnetic field.

ß-Lytic Protease of Lysobacter capsici VKM B-2533T.

Bacteriolytic enzymes are promising antimicrobial agents for developing new-generation drugs. Recently, we have isolated a ß-lytic protease (BlpLc) from the culture liquid of Lysobacter capsici VKM B-2533T. This BlpLc possesses a valuable property, not described for ß-lytic proteases (Blps) earlier, of hydrolyzing living cells of Staphylococcus aureus 55 MRSA clinical isolate. This work phylogenetically characterized the BlpLc and investigated its properties. Analysis revealed a variability of pre-/pro-parts of Blp precursors. The mature BlpLc is the closest to the earlier annotated but not isolated Blp from Lysobacter sp. Root690. The biochemical characterization found conditions for the BlpLc general bacteriolytic activity relative to autoclaved S. aureus 209P cells to differ from that of earlier isolated Blp. Unexpected was the effect of serine (phenylmethylsulfonyl fluoride (PMSF)) and cysteine (p-chloromercuribenzoate (p-CMB)) protease inhibitors on BlpLc bacteriolytic and proteolytic activities. The specificity of BlpLc proteolytic action relative to hemoglobin, elastin, gelatin, collagen, azofibrin, myoglobin, ovalbumin, and ovamucoid was found. New types of peptide bonds-Gly-X, Ser-X, Lys-X, Ala-X, Val-X, Glu-X, and Phe-X-hydrolyzed by the enzyme in protein substrates were first revealed using MALDI-TOF. Turbidimetrically, the BlpLc was found to lyze living cells of S. aureus 209P, Micrococcus luteus B1819, and M. roseus B1236, which is important for expanding the enzyme's applied properties.

Trends in the epidemiology of thyroid diseases in Bulgaria since the year 2000-a review of the literature.

This review attempts to summarize data on the prevalence of thyroid pathology in the Bulgarian population over a period of 20 years. Thyroid dysfunction was studied in two population-based studies (2006 and 2012). In the first, hypothyroidism was found in 6.3% and hyperthyroidism in 3.7% of the participants. The second study found overt and subclinical hypothyroidism in 3.2% and 4.5%, respectively, of females, and in 1.1% and 2% of males. TPOAb levels were elevated in 23% of females and in 9.6% of males. Nodules were found using ultrasound (US) in 23.4% of the participants in the 2006 study (in 30.1% of females and 15.0% of males), while the 2012 study showed 24.4% (32.1% of females and 15.7% of males). Recent data regarding prevalence of thyroid carcinoma in the Bulgarian population are lacking. Between 4 and 6% of thyroid biopsies produce results which have markers for malignancy. Four studies were carried out to address urinary iodine excretion levels in schoolchildren and three for those in pregnant women. Although median urinary iodine was in the iodine-sufficient range, a rising proportion of women had low urinary excretion. In the studies involving schoolchildren, excessive iodine excretion was also observed. The major strength of this review is the combination of data from different publications to give an overall baseline of thyroid epidemiology in Bulgaria. Further work is needed to map the recent trends regarding thyroid pathology in Bulgaria and the complete epidemiological dataset.

Thyroglossal duct cyst carcinoma.

Not required for Clinical Vignette.

Hybrid Magnetic Nanostructures For Cancer Diagnosis And Therapy.

Cancer is the second disease in the world from the point of view of mortality. The conventional routes of treatment were found to be not sufficient and thus alternative ways are imposed. The use of hybrid, magnetic nanostructures is a promising way for simultaneous targeted diagnosis and treatment of various types of cancer. For this reason, the development of core@shell structures was found to be an efficient way to develop stable, biocompatible, non-toxic carriers with shell-dependent internalization capacity in cancer cells. So, the multicomponent approach can be the most suitable way to assure the multifunctionality of these nanostructures to achieve the desired/necessary properties. The in vivo stability is mostly assured by the coating of the magnetic core with various polymers (including polyethylene glycol, silica etc.), while the targeting capacity is mostly assured by the decoration of these nanostructures with folic acid. Unfortunately, there are also some limitations related to the multilayered approach. For instance, the increasing of the thickness of layers leads to a decrease the magnetic properties, (hyperthermia and guiding ability in the magnetic field, for instance), the outer shell should contain the targeting molecules (as well as the agents helping the internalization into the cancer cells), etc.

IncobotulinumtoxinA treatment of facial nerve palsy after neurosurgery.

BACKGROUND: This study evaluates the effect of incobotulinumtoxinA in the acute and chronic phases of facial nerve palsy after neurosurgical interventions. METHODS: Patients received incobotulinumtoxinA injections (active treatment group) or standard rehabilitation treatment (control group). Functional efficacy was assessed using House-Brackmann, Yanagihara System and Sunnybrook Facial Grading scales, and Facial Disability Index self-assessment. RESULTS: Significant improvements on all scales were seen after 1month of incobotulinumtoxinA treatment (active treatment group, р<0.05), but only after 3months of rehabilitation treatment (control group, р<0.05). At 1 and 2years post-surgery, the prevalence of synkinesis was significantly higher in patients in the control group compared with those receiving incobotulinumtoxinA treatment (р<0.05 and р<0.001, respectively). CONCLUSIONS: IncobotulinumtoxinA treatment resulted in significant improvements in facial symmetry in patients with facial nerve injury following neurosurgical interventions. Treatment was effective for the correction of the compensatory hyperactivity of mimic muscles on the unaffected side that develops in the acute period of facial nerve palsy, and for the correction of synkinesis in the affected side that develops in the long-term period. Appropriate dosing and patient education to perform exercises to restore mimic muscle function should be considered in multimodal treatment.

Reelin and its receptors, VLDLR and ApoER2, in melanocytic nevi.

Reelin is an extracellular signaling protein synthesized by Cajal-Retius cells in utero and early after birth, its presence being signaled in adult life too. Reelin acts on its receptors, VLDLR and ApoER2, acting on cytoskeleton, controlling migration and subsequently positioning and stabilizing the cortical neurons. We investigated the reelin presence and its receptors, VLDLR and ApoER2, in melanocytic nevi considering the neural crest origin of the nevus cells and their migration into skin during embrionary period. Melanocytic nevi present a strict cellular architecture and an increased malignant transforming capacity. We investigated reelin presence in 32 melanocytic nevi (5 junctional, 27 compound or 14 dysplastic nevi and 18 non dysplastic nevi). The assessment of reelin presence was performed by histological semiquantitative criteria. Results showed the presence of reelin in 29 cases (29/ 32). The presence of reelin was elevated in junctional areas as in dysplastic nevi. VLDLR presented positive values in 16 cases (16/ 32) and ApoER2 was weak positive in 7 cases. Reelin or its receptors was peritumorally absent. Our study showed the presence of reelin in nevus cells from cutaneous melanocytic nevi and, in these cells, only the VLDLR receptor was present in half of the cases. The significance of the reelin presence in cutaneous nevus cells may be hypothetically considered correlated with the position maintenance of the nevus cells or migration of these cells in malignant transforming situation. Abbreviations: ApoER2 = apolipoprotein receptor 2, VLDLR = very low density lipoprotein receptor, DAB-1 = DIABLO protein, HMB45 = gene HMB45.

One-year mortality after severe COPD exacerbation in Bulgaria.

INTRODUCTION: One-year mortality in COPD patients is reported to be between 4% and 43%, depending on the group examined. AIM: To examine the one-year mortality in COPD patients after severe exacerbation and the correlation between mortality and patients' characteristics and comorbidities. METHODS: A total of 152 COPD patients hospitalized for severe exacerbation were assessed for vitamin D status, diabetes mellitus (DM), arterial hypertension (AH), and metabolic syndrome (MS). Data were gathered about smoking status and number of exacerbations in previous year. CAT and mMRC questionnaires were completed by all patients. Pre- and post-bronchodilatory spirometry was performed. One-year mortality was established from national death register. RESULTS: One-year mortality is 7.2%. DM, MS, and VD are not predictors for one-year mortality. However there is a trend for increased mortality in patients with AH (9.5% vs. 2.1%, p = 0.107). There is increased mortality in patients with mMRC > 2 (11.1 vs. 0%, p = 0.013). The presence of severe exacerbation in the previous year is a risk factor for mortality (12.5% vs. 1.4%, p = 0.009). There is a trend for increased mortality in the group with FEV1 < 50% (11.5 vs. 4.4%, p = 0.094). Cox regression shows 3.7% increase in mortality rate for 1% decrease in FEV1, 5.2% for 1% decrease in PEF, 7.8% for one year age increase and 8.1% for 1 CAT point increase (all p < 0.05). CONCLUSIONS: This study finds relatively low one-year mortality in COPD patients after surviving severe exacerbation. Grade C and FEV1 > 80% may be factors for good prognosis. Risk factors for increased mortality are age, FEV1 value, severe exacerbation in previous year and reduced quality of life.

Diabetes Mellitus Type 2 in Hospitalized COPD Patients: Impact on Quality of Life and Lung Function.

INTRODUCTION: Diabetes mellitus (DM) is estimated to affect 2-37% of COPD patients, results varying widely between studies. DM may also correlate with quality of life and lung function. AIM: To examine correlations between DM and quality of life and lung function in COPD patients admitted to hospital with exacerbation of COPD. PATIENTS AND METHODS: A hundred and fifty-two patients were included in the study. They were all examined for diabetes mellitus. All patients completed CAT and mMRC questionnaires and underwent spirometry. RESULTS: 13.2% (20/152) of patients received medications for DM. 21.7% (33/152) had newly diagnosed DM and 30.9% (47/152) had prediabetes. DM is not associated with reduced quality of life and worse pulmonary function. However, untreated DM is associated with both reduced quality of life and worse pulmonary function. HbA1c is negatively correlated with FVC and positively correlated with CAT score. CONCLUSIONS: COPD patients hospitalized for exacerbation are at high risk for impaired glucose metabolism. Untreated DM is associated with worse lung function and lower quality of life, which stresses the importance of screening for the disease. The patients may benefit from optimizing blood glucose level.

Effect of dimerization on the field-induced birefringence in ferrofluids.

The magnetic-field-induced birefringence in a ferrofluid composed of spherical cobalt nanoparticles has been studied both experimentally and theoretically. The considerable induced birefringence determined experimentally has been attributed to the formation of chains of nanoparticles. The birefringence has been measured as a function of the external magnetic field and the volume fraction (f) of nanoparticles. It is quadratic in f as opposed to the Faraday effect, which is linear in f. Experimental results agree well with the theoretical model based on a simple density functional approach. For dilute solutions the experimental results can be explained by assuming that only dimers of nanoparticles are formed while the concentration of longer chains is negligible.

Polymorphisms of the human IL-1 receptor antagonist gene and forearm bone mineral density in postmenopausal women.

CONTEXT: Studies on the human interleukin 1 receptor antagonist (IL-1RA) gene polymorphism have provided conflicting data regarding the bone mass and quality. AIM AND DESIGN: The objective of this case-control study was to investigate the association between the forearm bone mineral density (BMD) and the IL1RA gene polymorphisms. MATERIALS AND METHODS: A total of 400 postmenopausal Bulgarian women participated in this study. BMD was measured at the forearm by X-ray absorptiometry on a DTX-100 device (Osteometer Meditech, USA). A PCR product was isolated. The alleles were scored according to their length: A1 - 410 bp - 4 repeats; A2 - 240 bp - 2 repeats; A3 - 500 bp - 5 repeats; A4 - 325 bp - 3 repeats; A5 - 595 bp - 6 repeats. All analyses were evaluated for statistical significance (χ(2)-test and T-test). RESULTS: Four alleles were observed - A1, A2, A3, and A4. The A1A1 genotype was more common in cases with low BMD than in controls with normal BMD (95% vs. 90%, χ(2)P < 0.01). The A2A2 genotype was equally distributed among cases and controls (both 5%). The other two genotypes (A3A3 and A4A4) as well as A1A3 were present only in controls with normal BMD. The A2A2 genotype was associated with higher BMD and the A1A1 - with lower BMD at both forearm sites. The odds ratio for low BMD in the presence of the A1A1 genotype was 2.11. The etiological factor reflecting the association between the polymorphism and the disease was 0.50. In our study sample the IL1RA genetic polymorphisms were associated with the forearm BMD. CONCLUSION: This genetic polymorphism may become a useful genetic marker for the study of osteoporosis.

Universal mechanism of dissipation in Fermi superfluids at ultralow temperatures.

We show that the vortex dynamics in Fermi superfluids at ultralow temperatures is governed by the local heating of the vortex cores creating the heat flux carried by nonequilibrium quasiparticles emitted by moving vortices. This mechanism provides a universal zero temperature limit of dissipation in Fermi superfluids. For the typical experimental conditions realized by the turbulent motion of ^{3}He-B, the temperature of the vortex cores is estimated to be of the order 0.2 T(c). The dispersion of Kelvin waves is derived, and the heat flow generated by Kelvin cascade is shown to have a value close to that experimentally observed.

Prevalence of low forearm bone mineral density in Bulgarian men: a pilot study.

OBJECTIVE: To determine the prevalence of osteoporosis at the distal forearm in a male cohort referred for bone density testing and to compare it to published data of Bulgarian women. DESIGN AND SUBJECTS: 315 consecutive Bulgarian men aged 20 to 84 years were included (mean age 53.74 +/- 14.67 years). 59% of them were self-referrals. The comparative female group consisted of 8869 Bulgarian women whose forearm bone mineral density (BMD) was measured in another study. MEASUREMENTS: BMD was measured by single X-ray absorptiometry at the distal forearm (distal and ultradistal sites) in all men. T-scores were calculated from manufacturer-provided Danish male reference data. RESULTS: The ratio of female to male patients was 28.2 (8869 to 315). Peak BMD was observed in men aged 30 to 39 years: 0.560 +/- 0.065 g/cm(2) (distal site) and 0.490 +/- 0.070 g/cm(2) (ultradistal site). A steady BMD decline followed reaching 0.492 +/- 0.064 g/cm(2) at the distal and 0.412 +/- 0.069 g/cm(2) at the ultradistal site in age group >70. Age had a rather weak negative impact on forearm BMD described by a linear model. In men aged over 50 years the prevalence of osteoporosis at the distal site was 21.19%, compared to 20.45% in women. Low bone mass was seen in 48.77% of men and 32.50% of women. Normal BMD was more frequent in women (47.05%) than in men (30.04%). CONCLUSIONS: We found a high prevalence of forearm osteoporosis in Bulgarian men which is comparable to that already known in women.

PvuII and XbaI polymorphisms of the estrogen receptor gene and bone mineral density in a Bulgarian population sample.

OBJECTIVE: The aim of this study was to search for a possible association of low bone mineral density (bMD) with the PvuII and XbaI polymorphisms of the estrogen receptor (Er) gene in bulgarian women. DESIGN: 400 bulgarian women participated in this study. bMD was measured at the lumbar spine, femoral neck and at the distal forearm. two groups were identified: women with normal bMD at both central sites (n=180) and women with low bMD at either site (n=220), designated as normal (NbMD) and low bMD (LbMD) groups, respectively. the genotype frequencies of PP, Pp, pp and XX, Xx, xx were investigated by Pcr and enzymatic digestion of the products by PvuII and XbaI. RESULTS: The genotype frequencies were 12% for the PP, 59% for the Pp and 29% for the pp genotypes in the NbMD, and 26%, 50% and 24% in the LbMD groups, respectively. the XX, Xx, xx genotype frequencies were 14%, 63% and 23% in the NbMD, and 33%, 50% and 17% in the LbMD groups, respectively. the various genotypes were significantly associated with bMD. the relative risk for low bMD was higher for the XbaI marker (rr=1.51) than for the PvuII marker (rr=1.35). the association between low bMD and the polymorphisms under study was described by an etiological factor of 0.28 for the XbaI marker and 0.20 for the PvuII marker. CONCLUSIONS: The specific XbaI and PvuII polymorphisms of the Er gene are associated with low bMD at all bMD measurement sites in the bulgarian female population. they might therefore become useful genetic markers in osteoporosis risk assessment in this specific population.

Prevalence of low central bone mineral density in a Bulgarian female referral population: a pilot study.

Osteoporosis is one of the most important health problems among elderly women. The prevalence of central osteoporosis in Bulgaria is still unknown. We tried to retrospectively determine the prevalence of osteopenia and osteoporosis at the spine and hip in a female referral population. Bulgarian women (2,600) aged group 25-87 years referred for bone densitometry screening were included. Information about known risk factors for low bone mass was recorded. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (Hologic QDR 4500 A) at the lumbar spine (2,547 participants, 1,954 of whom were postmenopausal) and left hip (723 participants, 605 of whom were postmenopausal). T-scores were calculated from Hologic-provided and own Bulgarian peak BMD data (the latter based on 122 healthy premenopausal 25- to 39-year-old women). Peak lumbar spine BMD was 0.994 g/cm2 (SD 0.095 g/cm2), and thus lower than the manufacturer-provided value of 1.047 g/cm2. The peak BMD of the total hip was 0.959 g/cm2 (SD 0.129 g/cm2) and thus higher than the manufacturer-provided BMD of 0.942. T-scores differed according to the database used. The osteoporosis threshold of -2.5 SD was reached at the spine in the age group 70-74 years. Left hip T-scores showed a much slower decline with age. In women aged 50 and older the prevalence of osteoporosis reached 37.31% at the spine, and 16.14% at the left hip. Osteopenia was found in 39.74% at the spine and in 65.57% at the total hip. This is the first Bulgarian study looking for the prevalence of central osteoporosis in a female referral population. It may become the starting point for future epidemiological work.

Prevalence of the metabolic syndrome in a Bulgarian female population referred for bone density testing.

OBJECTIVE: To investigate the prevalence of the metabolic syndrome in Bulgarian women referred for bone density screening. RESEARCH METHODS AND PROCEDURES: This was a cross-sectional clinical study. Subjects were 444 consecutive 30- to 75-year-old Bulgarian women recruited from the outpatients referred for bone density testing (mean age, 52.67 +/- 15.19 years; mean BMI, 26.10 +/- 5.71 kg/m2. Height (centimeters), weight (kilograms), and blood pressure were measured. BMI and waist-to-hip ratio were calculated. Fasting plasma glucose, blood lipids, and immunoreactive insulinemia (Bayer Corp.-Diagnostics Div., Tarrytown, NY) were determined. Body composition was analyzed by bioimpedance on a leg-to-leg analyser (Tanita TBF-215; Tanita Corporation, Tokyo, Japan). RESULTS: Of all women, 56.76% had a BMI > 25 kg/m2, 45.95% had a waist circumference > 88 cm, and 64.64% had a waist-to-hip ratio > 0.8; 59.90% had hypertension; 4.05% had fasting plasma glucose > 7.0 mM, and 42.79% had fasting morning immunoreactive insulinemia = 16 UI/liter; 23.65% had hypercholesterolemia; and 26.35% had hypertriglyceridemia. The prevalence of the metabolic syndrome in this sample, as defined by the National Cholesterol and Education Program-Adult Treatment Panel III, was 34.91%, and by the modified World Health Organization definition was 37.16%. DISCUSSION: We concluded that Bulgarian women 30 to 75 years old referred for bone density testing have a high prevalence of the metabolic syndrome. Therefore, large-scale prevention programs are needed in this field.