ORTHODONTIC TREATMENT ALGORITHM OF PATIENTS WITH A BURDENED DRUG ANAMNESIS. DRUGS THAT REDUCE BONE MINERAL DENSITY.

The large number of drugs available today for the treatment of various general somatic conditions poses the challenge of studying both the positive and negative effects of drugs on orthodontic tooth movement. To improve the efficiency, safety and quality of treatment, an orthodontic care algorithm has been developed for patients taking glucocorticoids (GCS), drugs for the treatment of diabetes mellitus (thiazolidinediones and SGLT-2 inhibitors), L-thyroxine, immunosuppressors, antidepressants, anticonvulsants, proton pump inhibitors (PPIs), misoprostol (copyright database IREG deposit certificate No. 2089354). Out of 348 patients, who came for consultation and orthodontic treatment, 48 patients (13,8%), according to the algorithm, the active treatment and retention plans, appliance activation were adjusted taking into account the positive drug anamnesis. 9 patients were referred for consultations with doctors of other medical specialties to receive an information about general disease compensation degree, bone mineral density measurement and identification of possible contraindications for orthodontic treatment.

ALGORITHM OF ORTHODONTIC TREATMENT PATIENTS WITH A BURDENED DRUG ANAMNESIS. DRUGS THAT CAN INHIBIT TOOTH MOVEMENT.

According to the literature, more than 60% of orthodontic patients take certain medications and/or nutritional supplements on regular basis. To improve the efficiency and quality of treatment an orthodontic treatment algorithm has been developed for patients taking bisphosphonates, drugs for the treatment of diabetes (except thiazolidinediones and SGLT-2 inhibitors), hypotensive agents, antihistamines, statins, NSAIDs, estrogen-containing drugs, tetracycline, interferon-γ (copyright database IREG deposit certificate No. 2080699). The result of the study showed that 12,6% of patients, who came for consultation and orthodontic treatment, use different drugs on regular basis, with potential ability to slow down tooth movement. ; Algorithm helps orthodontist to make correct treatment plan, select appropriate orthodontic appliance activation regime, choose additional diagnostic procedures and consultations with doctors of other medical specialities according to patient's drug history.

[PRIMARY DIAGNOSTICS AND ORTHODONTIC TREATMENT PLANNING FOR PATIENTS ON MEDICINAL REGIMEN FOR CONCOMITANT PATHOLO-GIES].

In everyday practice orthodontists treat a lot of patients with different general diseases or taking some medications and nutritional supplements. Many farmacological agents and pathological conditions could influence bone metabolism and deteriorate the results of orthodontic therapy. Aim of the study was to analyze how many orthodontic patients have general diseases of taking any medications on regular basis. To work out diagnostic and treatment algorithms, based on general health status of the patient. 273 questionaries of orthodontic patients, treated by the same doctor in private clinic were analyzed. 97 patients (age 3,5-18 years) and 176 patients (age 19-64). 39,9% of patients have one or more chronic diseases (allergy, hypofunction of thyroid gland, artritis, hypertension, osteoporosis, diabetes II type). 60,4% of patients take on regular basis estrogen-containing medications, L-thyroxine, glucocorticoid therapy, NSAI medications, vitamin D3, Omega-3 and other nutritional supplements. Knowledge of clinical signs of the general disease, understanding of pathological process and it possible influence on the physiology of orthodontic tooth movement are of paramound importance for the orthodontist to work out correct treatment plan, choose type of appliance, schedule of activation and retention protocol.

Prevalence and prognosis of PIK3CA mutations in Bulgarian patients with metastatic breast cancer receiving endocrine therapy in first-line setting.

BACKGROUND AND AIMS: In approximately 40% of patients with HER2-negative/HR-positive breast cancer tumors, the PIK3CA gene is mutated. Despite this, clinical outcomes vary between studies in this cohort. We aimed to ascertain the prevalence of PIK3CA mutations in patients with metastatic HR+/HER2- breast in Bulgaria, as well the evaluation and comparison of progression free survival (PFS) between wild-type (WT) and mutation-positive groups in the real-world setting. METHODS: Three oncology centers in Bulgaria collected 250 tissue samples between 2016 and 2022 for this multicentric retrospective study. PIK3CA mutations were identified using Real-Time qPCR. The median follow-up period was 35 months. RESULTS: The mean age of the mutant cohort was 57.6 ± 11.6 years, compared to 56.5 ± 12.2 years for the WT cohort (p = .52). The percentage of patients with visceral metastasis was 58.8% (n = 147). Approximately 84.3% (n = 210) of the patients had reached postmenopause. 29.2% (n = 73) of the patients had PIK3CA mutations. The predominant mutation was present in exon 20, H1047R (46.5%). We found a significant correlation only between the presence of a mutation and the metastatic diseases at diagnosis (p = .002). As first-line therapy, 67.1% of patients received endocrine therapy (ET) plus cyclin dependent kinase (CDK4/6) inhibitor, while the remainder received ET alone. The median PFS of patients in the group with the mutation was 32 months (95%, CI: 22-40) compared to 24 months in the WT cohort ((95%, CI: 21-36) (p = .45)); HR = 0.86 (95%, CI: 0.5-1.3) (p = .46). We corroborated our conclusion using propensity matching score analysis, (36 months [95% CI: 20-40] vs. 26 months [95% CI: 21-38], [p = .69]). CONCLUSIONS: We found that the prevalence of PIK3CA mutations in our patients was comparable to what has been reported in other nations. Our results suggest that PIK3CA mutational status has no bearing to ET efficacy in first-line setting.

[Evaluating osteoporosis in occupations with vibration jeopardy in connection with climate and geographic features].

The article covers complex clinical and laboratory study in 140 workers with mining occupations in relation to climate and geographic location of the industrial enterprises. The examinees received ultrasound densitometry, X ray study of bone tissue, bone resorption and osteogenesis markers examination. All observations reliably demonstrated manifestations of osteopenic syndrome in workers engaged into the studied industrial branches.

[Search for new products of gene expression in human cardiac muscle. Microsequencing of proteins after two-dimensional electrophoresis]. / Poisk novykh produktov gennoi ékspressii v serdechnoi myshtse cheloveka. Mikrosekvenirovanie belkov posle dvumernogo élektroforeza.

Proteins of the human heart muscle were studied using modified two-dimensional electrophoresis. After separation, proteins were electroblotted onto Immobilon P membranes and several protein spots were used for microsequencing analysis. In most cases the proteins analyzed have blocked N-terminal amino acids. In order to study the primary structure of these proteins, hydrolysis in situ by trypsin followed by reversed-phase HPLC and microsequencing of the resulting peptides were performed. Four protein were identified in 8 analyzed fractions, specifically myosin light chain 1 (MLCl-V/sB), fatty-acid binding protein (heart isoform), alpha (B)-crystallin and alpha-tropomyosin. Amino acid sequences of two proteins were not found among human amino acid sequences collected in SWISSPROT bank (v. 21).

[The "major" proteins of the human myocardium in ontogeny]. / Izuchenie "mazhornykh" belkov miokarda cheloveka v ontogeneze.

Two-dimensional electrophoresis according to O'Farrell was used for studying changes in the content of major proteins of human myocardium at various stages of pre- and postnatal development. On the basis of the protein pattern specific of certain stages of myocardium differentiation the degree of development of the human cardiac muscle can be determined. The most pronounced changes in myocardium protein spectra are characteristic of the first half of pregnancy.

[Study of autolytic changes in human myocardial proteins by two-dimensional electrophoresis]. / Izuchenie autoliticheskikh izmenenii belkov miokarda cheloveka metodom dvukhmernogo élektroforeza.

Alterations of myocardial proteins were studied in the left ventricular tissue of adult persons and fetuses during natural autolysis. The most pronounced alterations were observed in proteins from regions of myosin light chains, region 119 and the region of muscle enzymes. When autolysis was studied in the myocardium and skeletal muscle, proteolytic alterations were observed in skeletal muscles later.

[The role of radio-inhalation scintigraphy in diagnosing tumors of the main bronchi]. / O roli radioingaliatsionnoi stsintigrafii v diagnostike opukholei krupnykh bronkhov.

The distribution of inhaled radio preparation has been studied in 7 cases of main bronchus neoplasms and 25 healthy subjects. Patterns of radio aerosols deposition have been followed versus regime of inhalation. Application of said procedure serves to improve the existing methods of radio inhalation scintigraphy as well as diagnostic procedures for tumors of main bronchi which X-ray examination and functional assessment of external respiration fail to detect.

[The effect of anti-glaucoma surgery on the visual function in patients with primary glaucoma]. / Vliianie antiglaukomatoznykh operatsii na zritel'nye funktsii bol'nykh pervichnoi glaukomoi.

Examinations of the visual field in 25 patients with Stages I and II primary open-angle glaucoma have shown that in the majority of cases surgery results in improvement of stabilization of the visual field status in respect of all its parameters (retinal sensitivity threshold, deficiency of the field and sensitivity). Increase of the number of defects and reduction of the retinal ability to discern light were observed in 5 patients: in 2 with postoperative hypotension and 3 with progressive cataracts.

[Use of a sclera-fortifying collagen plasty with trophic component in the treatment of high progressive myopia]. / Primenenie skleroukrepliaiushchei kollagenoplastiki s troficheskim komponentom v lechenii progressiruiushchei miopii vysokoi stepeni.

A modified scleroplastic operation is suggested, trophic collagenoplasty in which sclera-fortifying collagenoplasty is combined with subtenon implantation of a collagen infusion system. Using this system drugs stimulating trophic processes in the tissues of the posterior segment of the eyeball are infused within 7 to 9 days after surgery. Such operations were carried out in 42 eyes of 22 patients with high progressive myopia (8.0 to 27.0 diopters). The patients' ages varied from 30 to 57. Three months after surgery a manifest improvement of hydro- and hemodynamic parameters of the eyes, as well as of visual acuity with correction, of visual field, and of retinal light discriminating sensitivity were observed in the majority of patients (p < 0.05). The results of pre- and postoperative examinations demonstrate a high efficacy of such operations in patients with high progressive myopia combined with marked dystrophic changes in the tissues of the posterior segment of the eye.

[The comparative efficacy of nonsteroidal anti-inflammatory agents in the combined treatment of periodontal diseases]. / Sravnitel'naia éffektivnost' nesteroidnykh protivovospalitel'nykh sredstv v kompleksnom lechenii zabolevanii parodonta.

Nonsteroid anti-inflammatory drugs (NAID) are compared in 120 patients with periodontitis. The results confirmed clinical efficacy of modern NAID in this patient population. The best clinical results were achieved with voltaren. Local anti-inflammatory efficacy of dressings with acetylsalicylic and orthophene ointments and pyroxiphene was virtually the same.