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Genetic screening of liver cancer:State of the art

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World Journal of Hepatology 2024年第5期16卷 716-730页

作者： Milena Peruhova Sonya Banova-Chakarova dimitrina georgieva miteva Tsvetelina Velikova Department of Gastroenterology University Hospital"Heart and Brain"Burgas 8000Bulgaria Department of Genetics Faculty of BiologySofia University"St.Kliment OhridskiSofia 1164Bulgaria Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria

Liver cancer,primarily hepatocellular carcinoma,remains a global health challenge with rising incidence and limited therapeutic options.Genetic factors play a pivotal role in the development and progression of liver cancer.This state-of-the-art paper provides a comprehensive review of the current landscape of genetic screening strategies for liver cancer.We discuss the genetic underpinnings of liver cancer,emphasizing the critical role of risk-associated genetic variants,somatic mutations,and epigenetic alterations.We also explore the intricate interplay between environmental factors and genetics,highlighting how genetic screening can aid in risk stratification and early detection via using liquid biopsy,and advancements in high-throughput sequencing technologies.By synthesizing the latest research findings,we aim to provide a comprehensive overview of the state-of-the-art genetic screening methods for liver cancer,shedding light on their potential to revolutionize early detection,risk assessment,and targeted therapies in the fight against this devastating disease.

关键词： Hepatocellular carcinoma Liver cancer Genetic screening Risk-associated genetic variants Epigenetic alterations Genetic biomarkers Circulating tumor DNA Next-generation sequencing

Autoantibodies related to ataxia and other central nervous system manifestations of gluten enteropathy

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World Journal of Clinical Cases 2024年第12期12卷 2031-2039页

作者： Tsvetelina Velikova Georgi Vasilev Russka Shumnalieva Lyubomir Chervenkov dimitrina georgieva miteva Milena Gulinac Stamatios Priftis Snezhina Lazova Medical Faculty Sofia University"St.Kliment Ohridski"Sofia 1407Bulgaria Clinic of Neurology and Department of Emergency Medicine UMHAT"Sv.Georgi"Plovdiv 4000Bulgaria Department of Rheumatology Clinic of RheumatologyUniversity Hospital"St.Ivan Rilski"Medical University-SofiaSofia 1612Bulgaria Department of Diagnostic Imaging Medical University PlovdivPlovdiv 4000Bulgaria Department of Genetics Faculty of BiologySofia University"St.Kliment Ohridski"Sofia 1164Bulgaria Department of General and Clinical Pathology Medical University of PlovdivPlovdiv 4002Bulgaria Department of Healthcare Faculty of Public Health“Prof.Tsekomir VodenicharovMDDSc”Medical University of SofiaSofia 1407Bulgaria Department of Pediatric University Hospital"N.I.Pirogov"Sofia 1606Bulgaria

Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies.In this narrative review,we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease,immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following.We focused on the anti-gliadin antibodies,antibodies to different isoforms of tissue transglutaminase(TG)(anti-TG2,3,and 6 antibodies),anti-glycine receptor antibodies,anti-glutamine acid decarboxylase antibodies,anti-deamidated gliadin peptides antibodies,etc.Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological disorders.We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.

关键词： Gluten ataxia Celiac disease Gluten enteropathy Autoantibodies Anti-gliadin antibodies Anti-bodies to tissue transglutaminase Anti-tissue transglutaminase antibodies Anti-transglutaminase 6 antibodies Anti-glycine receptor antibodies Anti-glutamine acid decarboxylase antibodies

Applications of time series analysis in epidemiology: Literature review and our experience during COVID-19 pandemic

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World Journal of Clinical Cases 2023年第29期11卷 6974-6983页

作者： Latchezar Tomov Lyubomir Chervenkov dimitrina georgieva miteva Hristiana Batselova TsvetelinaVelikova Department of Informatics New Bulgarian UniversitySofia 1618Bulgaria Department of Diagnostic Imaging Medical University PlovdivPlovdiv 4000Bulgaria Department of Genetics Faculty of BiologySofia University"St.Kliment Ohridski"Sofia 1164Bulgaria Department of Epidemiology and Disaster Medicine Medical UniversityUniversity Hospital"St George"Plovdiv 4000Bulgaria Department of Medical Faculty Sofia UniversitySt.Kliment OhridskiSofia 1407Bulgaria

Time series analysis is a valuable tool in epidemiology that complements the classical epidemiological models in two different ways:Prediction and forecast.Prediction is related to explaining past and current data based on various internal and external influences that may or may not have a causative role.Forecasting is an exploration of the possible future values based on the predictive ability of the model and hypothesized future values of the external and/or internal influences.The time series analysis approach has the advantage of being easier to use(in the cases of more straightforward and linear models such as Auto-Regressive Integrated Moving Average).Still,it is limited in forecasting time,unlike the classical models such as Susceptible-Exposed-Infectious-Removed.Its applicability in forecasting comes from its better accuracy for short-term prediction.In its basic form,it does not assume much theoretical knowledge of the mechanisms of spreading and mutating pathogens or the reaction of people and regulatory structures(governments,companies,etc.).Instead,it estimates from the data directly.Its predictive ability allows testing hypotheses for different factors that positively or negatively contribute to the pandemic spread;be it school closures,emerging variants,etc.It can be used in mortality or hospital risk estimation from new cases,seroprevalence studies,assessing properties of emerging variants,and estimating excess mortality and its relationship with a pandemic.

关键词： Time series analysis Epidemiology COVID-19 Pandemic Auto-regressive integrated moving average Excess mortality Seroprevalence

Effectiveness and safety of COVID-19 vaccines in patients with oncological diseases:State-of-the-art

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世界临床肿瘤学杂志:英文版 2023年第9期14卷 343-356页

作者： Nedelcho Ivanov Boris Krastev dimitrina georgieva miteva Hristiana Batselova Radostina Alexandrova Tsvetelina Velikova Department of Clinical Immunology with Stem Cell Bank University Hospital AlexanrovskaSofia 1431Bulgaria Medical Center Nadezhda Medical Center NadezhdaSofia 1407Bulgaria Department of Genetics Faculty of BiologySofia University St.Kliment OhridskiSofia 1164Bulgaria Department of Epidemiology and Disaster Medicine Medical UniversityPlovdivUniversity Hospital St.GeorgePlovdiv 6000Bulgaria Department of Pathology Institute of Experimental MorphologyPathology and Anthropology with MuseumBulgarian Academy of SciencesSofia 1000Bulgaria Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria

Although the coronavirus disease 2019(COVID-19)pandemic was declared to be no longer“a public health emergency of international concern”with its wide range of clinical manifestations and late complications,severe acute respiratory syndrome coronavirus 2 infection proved to be a serious threat,especially to the elderly and patients with comorbidities.Patients with oncologic diseases are vulnerable to severe infection and death.Indeed,patients with oncohematological diseases have a higher risk of severe COVID-19 and impaired post-vaccination immunity.Unfortunately,cancer patients are usually excluded from vaccine trials and investigations of post-vaccinal immune responses and the effectiveness of the vaccines.We aimed to elucidate to what extent patients with cancer are at increased risk of developing severe COVID-19 and what is their overall case fatality rate.We also present the current concept and evidence on the effectiveness and safety of COVID-19 vaccines,including boosters,in oncology patients.In conclusion,despite the considerably higher mortality in the cancer patient group than the general population,countries with high vaccination rates have demonstrated trends toward improved survival of cancer patients early and late in the pandemic.

关键词： COVID-19 COVID-19 vaccines RNA vaccines Cancer Oncological Safety Efficacy Immunogenicity

Islet transplantation-immunological challenges and current perspectives

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World Journal of Transplantation 2023年第4期13卷 107-121页

作者： Plamena Kabakchieva Yavor Assyov Stavros Gerasoudis Georgi Vasilev Monika Peshevska-Sekulovska Metodija Sekulovski Snezhina Lazova dimitrina georgieva miteva Milena Gulinac Latchezar Tomov Tsvetelina Velikova Clinic of Internal Diseases Naval Hospital-VarnaMilitary Medical AcademyVarna 9010Bulgaria Clinic of Endocrinology Department of Internal DiseasesUniversity Hospital"Alexandrovska"Medical University-SofiaSofia 1434Bulgaria Faculty of Medicine Trakia UniversityStara Zagora 6000Bulgaria Department of Neurology Faculty of MedicineMedical University of PlovdivPlovdiv 4000Bulgaria Department of Gastroenterology University Hospital LozenetzSofia 1407Bulgaria Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria Department of Anesthesiology and Intensive Care University hospital LozenetzSofia 1407Bulgaria Department of Pediatric University Hospital"N.I.Pirogov"Sofia 1606Bulgaria Department of Healthcare Faculty of Public Health"Prof.Tsekomir VodenicharovMDDSc"Medical University of SofiaSofia 1527Bulgaria Department of Genetics Sofia University"St.Kliment Ohridski"Sofia 1164Bulgaria Department of General and Clinical Pathology Medical University of PlovdivPlovdiv 4000Bulgaria Department of Informatics New Bulgarian UniversitySofia 1618Bulgaria

Pancreatic islet transplantation is a minimally invasive procedure aiming to reverse the effects of insulin deficiency in patients with type 1 diabetes(T1D)by transplanting pancreatic beta cells.Overall,pancreatic islet transplantation has improved to a great extent,and cellular replacement will likely become the mainstay treatment.We review pancreatic islet transplantation as a treatment for T1D and the immunological challenges faced.Published data demonstrated that the time for islet cell transfusion varied between 2 and 10 h.Approximately 54%of the patients gained insulin independence at the end of the first year,while only 20%remained insulin-free at the end of the second year.Eventually,most transplanted patients return to using some form of exogenous insulin within a few years after the transplantation,which imposed the need to improve immunological factors before transplantation.We also discuss the immunosuppressive regimens,apoptotic donor lymphocytes,anti-TIM-1 antibodies,mixed chimerism-based tolerance induction,induction of antigen-specific tolerance utilizing ethylene carbodiimide-fixed splenocytes,pretransplant infusions of donor apoptotic cells,B cell depletion,preconditioning of isolated islets,inducing local immunotolerance,cell encapsulation and immunoisolation,using of biomaterials,immunomodulatory cells,etc.

关键词： Islet transplantation Type 1 diabetes Diabetes mellitus Immune tolerance Graft rejection T regulatory cells B regulatory cells

Long-term effectiveness,outcomes and complications of bariatric surgery

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World Journal of Clinical Cases 2023年第19期11卷 4504-4512页

作者： Milena Gulinac dimitrina georgieva miteva Monika Peshevska-Sekulovska Ivan P Novakov Svetozar Antovic Milena Peruhova Violeta Snegarova Plamena Kabakchieva Yavor Assyov Georgi Vasilev Metodija Sekulovski Snezhina Lazova Latchezar Tomov Tsvetelina Velikova Department of General and Clinical Pathology Medical University of PlovdivPlovdiv 4000Bulgaria Department of Genetics Sofia University"St.Kliment Ohridski"Faculty of BiologySofia 1164Bulgaria Department of Gastroenterology University Hospital LozenetzSofia 1407Bulgaria Department of Thoraco-abdominal Surgery Medical University PlovdivPlovdiv 6000Bulgaria University Clinic for Digestive Surgery Medical FacultySkopjeSkopje 1000North Macedonia Department of Gastroenterology Heart and Brain HospitalBurgasBurgas 1000Bulgaria Clinic of Internal Diseases Naval Hospital-VarnaMilitary Medical AcademyMedical FacultyMedical UniversityVarna 9000Bulgaria Clinic of Internal Diseases Naval Hospital-VarnaMilitary Medical AcademyVarna 9010Bulgaria Clinic of Endocrinology University Hospital AlexandrovskaSofia 1431Bulgaria Department of Internal Diseases Medical University–SofiaSofia 1431Bulgaria Clinic of Endocrinology and Metabolic Disorders UMHAT"Sv.Georgi"Plovdiv 4000Bulgaria Department of Anesthesiology and Intensive Care University Hospital LozenetzSofia 1407Bulgaria Medical Faculty Sofia UniversitySt.Kliment OhridskiSofia 1407Bulgaria Department of Pediatric University Hospital"N.I.Pirogov"Sofia 1606Bulgaria Department of Healthcare Faculty of Public Health"Prof.Tsekomir VodenicharovMDDSc"Sofia 1527Bulgaria Department of Informatics New Bulgarian UniversitySofia 1618Bulgaria Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria

Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.

关键词： Bariatric surgery Long-term outcomes Obesity Roux-en-Y gastric bypass sleeve gastrectomy Effectiveness Safety Quality of life

Studies on Feeding Habits and Parasitological Status of Red Fox, Golden Jackal, Wild Cat and Stone Marten in Sredna Gora, Bulgaria

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Journal of Life Sciences 2011年第4期5卷 264-270页

作者： Zvezdelina Kirkova Evgeniy Raychev dimitrina georgieva Department of Parasitology Trakia University Stara Zagora 6000 Bulgaria Department of Game Animals Trakia University Stara Zagora 6000 Bulgaria

In order to define the role of wild carnivores in the epidemiology of parasitoses with veterinary and medical importance their parasitological status and feeding habits were studied. In the period 2001-2006 the feeding habits of 167 foxes, 78 jackals, 40 wild cats and 23 stone martens from the area of Sredna Gora, Bulgaria were investigated. 113 of the foxes, 56 of the jackals, 22 of the wild cats and 21 of the martens were subjected to helminthological study. 147 wild boars and 26 badgers from the same area were subjected to trichinelloscopy. Rodents were the main food of the wild cats (82.7%), martens (52%) and foxes (50%). The main food of the jackals was carrion from domestic and wild animals (79.5%). 95.5% of the foxes, 100% of the jackals, 95.5% of the wild cats and 89% of the stone martens were infected with one or more helminth species. The prevalence of the most important helminths: Trichinella spp., Taenia spp. and Ancylostoma spp. was high in all carnivores examined. In the infected with Trichinella spp. animals only T. britovi was demonstrated. The wild boars and badgers were not infected with Trichinella spp. The correlation between the feeding habits and parasitological status is discussed.

关键词：寄生虫学保加利亚状态食性野生动物豺貂食肉动物