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1.
Cytokine ; 170: 156315, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37544134

RESUMO

BACKGROUND: Bacterial meningitis is a life-threatening disease with high mortality and common long-term sequelae. The inflammatory response in the subarachnoid space, modulated by different cytokines, plays a major role in the pathogenesis of acute central nervous system infections. We aimed to examine correlations of interleukin (IL)-6, IL-8, IL-10, IL-12(p40), and tumor necrosis factor (TNF)-α levels with disease severity, complications, and outcome in patients with acute bacterial meningitis. METHODS: The study involved 30 patients with bacterial meningitis/meningoencephalitis admitted to the University Hospital St. George, Plovdiv over a period of 4 years. Patients were selected based on clinical presentation and laboratory abnormalities, consistent with a neuroinfection. Enzyme-linked immunosorbent assay was used to measure the studied cytokines in both cerebrospinal fluid (CSF) and serum in parallel. For microbiological diagnosis multiplex, polymerase chain reaction, and CSF culture were used. RESULTS: In patients with acute bacterial meningitis CSF levels of IL-6, IL-8, IL-10, and TNF-α are significantly increased than in serum. CSF TNF-α, CSF IL-8, and CSF IL-10 had a moderate negative correlation to CSF glucose. It was found that serum IL-8 is significantly elevated in patients who experienced neurological complications, have severe clinical course, and in deceased patients. CSF IL-10 is increased only in patients with severe acute bacterial meningitis. CONCLUSION: Among patients with acute bacterial meningitis serum IL-8 could delineate these with increased risk of neurological complications, severe clinical course, and fatal outcome. Serum IL-8 and CSF IL-10 could be used as indicators of disease severity.


Assuntos
Meningites Bacterianas , Doenças do Sistema Nervoso , Humanos , Interleucina-10 , Fator de Necrose Tumoral alfa , Interleucina-8/líquido cefalorraquidiano , Citocinas/líquido cefalorraquidiano , Interleucina-6/líquido cefalorraquidiano , Progressão da Doença
2.
Epidemiol Infect ; 147: e304, 2019 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-31736454

RESUMO

As Bulgaria transitions away from Global Fund grant, robust estimates of the comparative impact of the various response strategies under consideration are needed to ensure sustained effectiveness of the tuberculosis (TB) programme. We tailored an established mathematical model for TB control to the epidemic in Bulgaria to project the likely outcomes of seven intervention scenarios. Under existing programmatic conditions projected forward, the country's targets for achieving TB elimination in the coming decades will not be achieved. No interventions under consideration were predicted to accelerate the baseline projected reduction in epidemiological indicators significantly. Discontinuation of the 'Open Doors' program and activities of non-governmental organisations would result in a marked exacerbation of the epidemic (increasing incidence in 2035 by 6-8% relative to baseline conditions projected forward). Changing to a short course regimen for multidrug-resistant TB (MDR-TB) would substantially decrease MDR-TB mortality (by 21.6% in 2035 relative to baseline conditions projected forward). Changing to ambulatory care for eligible patients would not affect TB burden but would be markedly cost-saving. In conclusion, Bulgaria faces important challenges in transitioning to a primarily domestically-financed TB programme. The country should consider maintaining currently effective programs and shifting towards ambulatory care to ensure program sustainability.


Assuntos
Tuberculose/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bulgária/epidemiologia , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Planejamento em Saúde , Humanos , Incidência , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Modelos Biológicos , Avaliação de Processos e Resultados em Cuidados de Saúde , Avaliação de Programas e Projetos de Saúde , Tuberculose/economia , Tuberculose/epidemiologia , Adulto Jovem
3.
Int Arch Occup Environ Health ; 71 Suppl: S97-100, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9827892

RESUMO

The authors examined the influence of harmful factors of the working environment such as: microclimate, dust, noise, vibrations, and chemical noxes such as: ammonia, nitric oxides, hydrogen fluoride and gaseous fluorides, on the health status of workers involved in the production of fertilizers and ammonia in a nitrogen fertilizer plant. Various biochemical examinations of 158 workers were carried out. The morbidity rate for 1993-1995 was also studied. The biochemical monitoring indicated a statistically significant dependence of the abnormalities of the biochemical parameters on the professional exposure. The metabolic disturbances were proved by serum creatinine and urea elevations and rising urinary ammonia concentrations, by disturbances of the liver function consisting in an enhanced transaminase activity, and by disorders of the mineral metabolism presented with an increased urinary phosphorus excretion at a low serum phosphorus level as well as with increased serum and urinary fluorine concentrations. The temporarily registered morbidity rate showed a tendency towards an increase in diseases of the respiratory, gastrointestinal and cardiovascular system.


Assuntos
Fertilizantes , Exposição Ocupacional , Saúde Ocupacional , Humanos , Medição de Risco
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