On regime changes of COVID-19 outbreak.

The COVID-19 pandemic has had a very serious impact on societies and caused large-scale economic changes and death toll worldwide. The first cases were detected in China, but soon the virus spread quickly worldwide and the intensity of newly reported infections grew high during this initial period almost everywhere. Later, despite all imposed measures, the intensity shifted abruptly multiple times during the two-year period between 2020 and 2022 causing waves of too high infection rates in almost every part of the world. To target this problem, we assume the data heterogeneity as multiple consecutive regime changes. The research study includes the development of a model based on automatic regime change detection and their combination with the linear birth-death process for long-run data fits. The results are empirically verified on data for 38 countries and US states for the period from February 2020 to April 2022. Finally, the initial phase (conditions) properties of infection development are studied.

Recurrent meningitis caused by Salmonella enterica Paratyphi B var. Java in a 3-month-old infant complicated by dilation of subarachnoid spaces, subdural effusion and right-sided hemiparesis.

A 3-month-old female infant with meningo-encephalitis caused by Salmonella enterica Paratyphi B var. Java is described. The aetiological agent was confirmed in six CSF samples; however, none of the blood or faecal samples was positive for the same pathogen. The presence of the bacteria was confirmed in the CSF by culture, serology and Multiplex PCR assay. The infant developed dilated subarachnoid spaces and right-sided hemiparesis associated with the persistent bacterial meningo-encephalitis. She was re-admitted 2 weeks after recovery and initial discharge from hospital owing to recurrence of S. enterica Paratyphi B bacteria in the CSF and the development of large bilateral subdural effusions in the brain. Computed tomography and the clinical course confirmed dynamically progressive meningo-encephalitis. Following further parenteral antibiotics and symptomatic treatment, the child's condition improved. After a total of 24 days in the PICU, she was sufficiently improved to be discharged with a residual right-sided hemiparesis. However, sadly she died a week after discharge.Abbreviation: ALT: alanine aminotransferase; API: analytical profile index 20 E-test; AST: aspartate aminotransferase; CRP: C-reactive protein; CSF: cerebrospinal fluid; CT: computed tomography; EUCAST: European Committee on Antimicrobial Susceptibility Testing; MDCT: multi-detector computed tomography; PCR: polymerase chain reaction; PICU: paediatric intensive care unit; RBC: red blood cells; VITEK: automated instrument for identification/antimicrobial susceptibility testing; WBC: white blood cells.

A Case of Fasciolosis in a 11-Year-Old Syrian Immigrant Boy.

Fasciolosis is a chronic parasitic disease caused by two species of liver trematodes, Fasciola hepatica and Fasciola gigantica, which infest ruminants and rarely humans. The disease is spread all over the world, but more common in Asia in areas with extensive livestock farming and can be imported cases in Europe and America. In this case, we describe imported infection with F. hepatica in Bulgaria from 11-year-old Syrian immigrant boy.

Human Dirofilariasis in Bulgaria Between 2009 and 2018.

Autochthonous Dirofilaria repens infections have been found in dogs and other carnivores in most European countries. In the same countries, reports of human dirofilariasis are becoming increasingly prevalent. We present 18 cases of people infected with D. repens for a 10-year period traced in our hospital. The data was collected from the observations and tests of all 18 patients from the whole country treated at the Specialized Hospital for Infectious and Parasitic Diseases in Sofia in the period 2009 - 2018. We used a morphological method, serology test and Knott's method for microfilariae. The patients were 11 to 74 years of age, 12 female and 6 male. In most cases, patients have subcutaneous nodules or face, eyelid and eyes localization. The trend of increasing incidence in Bulgaria continues, with age and sex distribution and localization of the larva being similar to those in other European countries.

Inverse-Designed Broadband All-Dielectric Electromagnetic Metadevices.

This paper presents a platform combining an inverse electromagnetic design computational method with additive manufacturing to design and fabricate all-dielectric metadevices. As opposed to conventional flat metasurface-based devices that are composed of resonant building blocks resulting in narrow band operation, the proposed design approach creates non-resonant, broadband (Δλ/λ up to >50%) metadevices based on low-index dielectric materials. High-efficiency (transmission >60%), thin (≤2λ) metadevices capable of polarization splitting, beam bending, and focusing are proposed. Experimental demonstrations are performed at millimeter-wave frequencies using 3D-printed devices. The proposed platform can be readily applied to the design and fabrication of electromagnetic and photonic metadevices spanning microwave to optical frequencies.

Optimization of Eva Green real-time mPCR for differentiating C. jejuni/coli directly from feces.

OBJECTIVE: To develop and optimize a rapid molecular method for diagnosing campylobacteriosis directly from a clinical fecal sample and at the same time for determining the most common causing agents - C. jejuni/coli. MATERIALS AND METHODS: 38 clinical fecal samples from hospitalized patients with diarrheal syndrome were tested using a rapid immunochromatographic test. All positive samples were tested for confirmation by culturing in a microaerophilic atmosphere. The Eva Green real-time mPCR reaction of a direct fecal sample was conducted using the "IQ5TM Real-Time PCR System" apparatus. RESULTS: Out of 38 clinical fecal samples which were ICT positive, 18 strains were isolated by culture, namely, 17 of C. jejuni and 1 of C. coli. The Eva Green real-time mPCR reaction also reported 18 positive samples for Campylobacter, out of which 17 were of C. jejuni and only one of C.coli. CONCLUSION: We developed and optimized the Eva Green real-time mPCR for the detection and species differentiation of C. jejuni/coli directly from a clinical fecal sample. The molecular analysis we described has a 100% sensitivity and specificity when comparing the results obtained by it to those of the culture method, which is currently the "gold standard" in the diagnosis of campylobacteriosis (Tab. 2, Fig. 1, Ref. 6).

[ZIKA--VIRUS INFECTION].

This review summarizes the knowledge of the scientific community for Zika-virus infection. It became popular because of severe congenital damage causes of CNS in newborns whose mothers are infected during pregnancy, as well as the risk of pandemic distribution. Discusses the peculiarities of the biology and ecology of vectors--blood-sucking mosquitoes Aedes; stages in the spread of infection and practical problems which caused during pregnancy. Attention is paid to the recommendations that allow leading national and international medical organizations to deal with the threat Zika-virus infection.

[Molecular based targets and endometrial cancer].

In recent years, increasing attention has been paid to the rate of spread of endometrial carcinoma, especially in the postmenopausal period. Along with routine diagnostic methods, giving information on the location and progression of the disease, there are some morphological methods determining very accurately the correlations in the development of this type of cancer and his prognosis. Moreover--in recent years, the accumulated information about the molecular profile of this type of cancer made it possible to implement a number of new drugs against the so-called molecular therapy -'targets' in the neoplastic process. Significant proportion of cases show response rates, it is more hope in the development of more successful formulas and target -based therapy. In this review, we present and discuss the role of certain molecular markers as potential indicators of prognosis and development, as well as determining the target treatment of endometrial carcinoma.

[Endometrial cancer, turned out to be an endometroid ovarian cancer stage II].

43 years old female patients endometrial biopsy diagnosis shows highly differentiated adenocarcinoma. Because of this result she underwent total hysterectomy two weeks later, and the new hystology result is: highly differentiated endometroid ovarian carcinoma.

[Expression of human papilloma virus (HPV) and P16ink4a in cervical intraepithelial neoplasia (CIN) and papilloma].

UNLABELLED: p16ink4a Is a tumor-supressor gene and a key regulator of the cell cycle. The neoplastic cervical epithelium (squamous and cylindric) intensely expresses the cyclin-dependent kinase inhibitor p16ink4a. It was shown that the expression of p16ink4a in the squamous cervical cancer was induced by HPV. The aim of our study was to reveal the frequency of expression of p16ink4a and of HPV in the different grades of CIN and in the papilomatous cervical lesions. We used biopsy material (n=11) and cone biopsies (n=10), collected from women with different grades of CIN and with papillomatous lesions, having different grades of koilocytotic dysplasia. The biopsy material, collected from one woman with squamous cervical cancer was also studied. Using the immunohistochemical procedure we determined the expression of p16ink4a and HPV in the changed squamous cervical epithelium. RESULTS: We found that the neoplastic epithelium in CIN II and CIN III intensely expressed p16ink4a. We observed positive immune reaction for HPV in only 22.7% from the cases with papillomatous lesions, having koilocytic dysplasia. In conclusion we can state that p16ink4a could be used as a marker for the exact determination of CIN lesions in the cervix uteri. The koilocytic dysplasia, determined histologically was not always HPV-positive.

[Inborn laryngeal cysts - description of a case with fatal outcome]. / Vrodeno laringomukotsele - opisanie na edin sluchai s letalen krai.

The authors describe a case of a newborn baby with inborn laryngomucocaele, living 14 days after birth. The newborn baby was looked after with artifical lentilation. Because of the inability of self breathing the baby underwent tracheostomia. The autopsy revealed the presence of laryngomucocaele.

[Histopathological, electron microscopic and microbiological studies in patients with obstructive large-bowel ileus of tumor origin]. / Khistopatologichni, elektronnomikroskopski i mikrobiologichni prouchvaniia pri bolni s obturatsionen debelochreven ileus ot tumoren proizkhod.

We have studied the Liver and colon of 23 patients histologically, and 15-electron microscopically. In the course of light microscopic observation of the colon wall above the obstruction we found: degeneration and desquamation of epithelial lining, decrease of goblet cells, increase of acid glycoproteins, hypertrophy of myofibrils in the muscle layer and fibrogenesis in the interstitial tissue in between. In liver: there was slight to moderate fibrosis in portal tracts and somewhere in the sinusoids, and moderate inflammatory infiltrate in them. Electron microscopic observations showed: a. in colon above the carcinomatous obstruction we found hypertrophy of muscle cells and in between collagenoblasts I-II type; b. in liver without metastases the space of Disse was distended, with bundles of collagen somewhere. Ito cells showed signs of fibroblast transformation. Our hypothesis is that these chronic changes are a reaction to the protracted obstruction and to colon carcinoma.

[Clinico-anatomical studies of patients with sclerosis of the bladder neck]. / Kliniko-anatomichni prouchvaniia pri bolni sus skleroza na shiikata na pikochniia mekhur.

Clinico-anatomical studies were carried out in patients with sclerosis of the bladder neck. Specimens for histologic examination were obtained by transurethral resection or transvesical excision of the bladder neck. Histologic changes indicative of chronic nonspecific inflammatory process were found in the majority of cases. The most seldom finding was hypertrophy of the bladder neck muscular tissue.