Trends in cardiovascular disease risk factor prevalence among male transport workers: Bulgaria, 1986 to 1997.

OBJECTIVES: This study investigated cardiovascular risk factors among male transport workers in Bulgaria. METHODS: Comparisons were made of data from independent surveys conducted among male transport workers aged 30 to 59 years in Sofia, Bulgaria, during 1986 (n = 1146) and 1996-1997 (n = 638). RESULTS: Smoking prevalence increased from 49% to 59% between 1986 and 1996-1997. Among current smokers, the percentage smoking 15 or more cigarettes per day decreased. The prevalence of elevated body mass index, hypertension, or angina pectoris did not change. CONCLUSIONS: Smoking prevalence rates increased during the study period; the prevalence of other risk factors remained high.

Prevalence, awareness, treatment and control of hypertension in a working Bulgarian population.

UNLABELLED: Arterial hypertension is a major risk factor for coronary heart disease and stroke mortality. Few data exist on prevalence, awareness, and management of hypertension in Bulgaria, precluding development of potentially beneficial risk reduction initiatives. Between September 1996 and July 1997, an age-sex stratified sample of 847 male and 771 female employees (age 18-64 y) of the national transport industry resident in Sofia was recruited during their annual physical examination. A structured interview was conducted and resting blood pressure (BP) measured. Prevalence: Elevated BP (mean of two consecutive readings SBP > or = 140 mmHg and/or DBP > or = 90 mmHg) was observed among 24% of women and 58% of men (p < 0.001). Prevalence increased with age in both men and women. Awareness: Among 722 employees with elevated BP, 49% of women and 33% of men (p < 0.001) reported history of hypertension. Awareness increased with age. MANAGEMENT: Among 345 employees with history of hypertension, 37% of women and 36% of men (p > 0.05) reported taking antihypertensive treatment. The proportion under management increased with age. CONTROL: Normal BP was measured in only 6% of men and 7% of women taking antihypertensive medication (p > 0.05; no consistent trends by age). Elevated BP is widespread and hypertension is underdiagnosed and poorly controlled in this urban working-age Bulgarian population, especially among those under 40 y. This may contribute to the high rates of coronary heart disease and stroke incidence and mortality in Bulgaria.

Endogenous production of tumor necrosis factor in normal mice orally treated with Deodan--a preparation from Lactobacillus bulgaricus "LB51".

The ability of orally administered Deodan, a product from the cell wall of Lactobacillus bulgaricus strain "I. Bogdanov patent strain tumoronecroticance B51" ATCC #21815, shortly called "LB51", to induce endogenous tumor necrosis factor-alpha (TNF alpha) production in normal mice was evaluated. The priming and triggering activities of the preparation were investigated in combination with lipopolysaccharide (LPS) and live BCG vaccine. Deodan was applied at a dose of 150 mg/kg and various treatment schedules were employed. The serum levels of TNF alpha in treated mice were quantified by ELISA. Oral administration of Deodan at a dose of 150 mg/kg for 1, 3, 10 or 20 consecutive days only enhanced serum TNF alpha levels in treated mice. Maximal TNF alpha levels were reached 6 h after the last application of Deodan. Deodan was effective in priming TNF alpha in mice triggered intravenously (i.v.) with LPS. Deodan triggered the production of TNF alpha in BCG-primed mice. The preparation, however, was not an effective trigger of mice primed intradermally (i.d.) with 1 microgram/mouse LPS. These findings suggest that Deodan is both a primer and trigger of endogenous TNF alpha. The advantages of treatment of neoplastic disease with agents which induce endogenous TNF alpha is discussed.

Determination of cytokine release after in vivo and in vitro administration of Deodan (a preparation from Lactobacillus bulgaricus "LB51") by the rabbit pyrogen test.

We investigated the in vivo and in vitro cytokine inducing effects of Deodan, an oral preparation from Lactobacillus bulgaricus "LB-51", using the rabbit pyrogen test. In the first experimental approach we administered Deodan, or its chromatographically purified fraction, via the i.m. or i.v. routes. Low doses of Deodan i.m. caused the formation of a single temperature peak, whereas large doses produced a biphasic temperature curve. Intravenous injection of Deodan produced a monophasic fever in all tested doses. Chromatographically purified Deodan injected i.v. to rabbits caused a febrile response with a dose-dependent pattern, strikingly similar to that of lipopolysaccharide. LAL-testing of Deodan, however, showed that the preparation does not contain endotoxin. In in vivo neutralization studies we demonstrated that IL-1, TNF alpha, and IL-6 mediate the rabbit febrile response to Deodan. Interestingly, the effects of Deodan on the production of TNF alpha and IL-6 were more pronounced than its IL-1 inducing activity. In the second approach, we injected supernatants from mononuclear cells incubated with nonpyrogenic doses of Deodan, intravenously to rabbits ("monocyte type" of pyrogen test). Rapid-onset monophasic fevers were observed, typical for the rabbit pyrogen reaction to i.v. administration of exogenous IL-1 and TNF. Finally, we demonstrated the presence of pyrogenic cytokines in the supernatants from macrophages of Deodan-treated mice. Together, these results indicate that Deodan induces the production of cytokines with endogenous pyrogenic activity.