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World Journal of virology 2024年第3期13卷 82-88页

作者： Hristiana M Batselova tsvetelina v velikova Department of Epidemiology and Disaster Medicine Medical UniversityPlovdivUniversity Hospital“St George”Plovdiv 4000Bulgaria Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria

BACKGROUND varicella(chickenpox)and herpes zoster(shingles)are outcomes of varicella-zoster virus(vZv)infection,and understanding their incidence trends is vital for public health *** To conduct an ambispective epidemiological study by analyzing the main epidemiological characteristics of vZv infection during an 18 year-period(2000-2018).METHODS We used descriptive and epidemiological methods to characterize chickenpox in Bulgaria,the city of Plovdiv and the region for a period of 18 years(2000-2018).RESULTS The average incidence of varicella-zoster infection for the period 2000–2018 in the Plovdiv region was estimated at 449.58‰.The highest relative share of the infection was assessed in the month of January at 13.6%,and the lowest in the months of August and September at 2.9%(both months).The age group most affected by the infection was 1-4 years,followed by 5-9 *** corresponds to the so-called"pro-epidemic population"-a phenomenon typical for airborne infections,confirming their mass impact on the perpetuation of vZv *** Our findings reveal significant insights into vZv epidemiology,including age-specific incidence rates,clinical manifestations,and vaccination *** comprehensive analysis contributes to the broader understanding of vZv infec-tion dynamics and may inform evidence-based preventive measures.

关键词： varicella-zoster virus Epidemiology Incidence trends Chickenpox Shingles Public health Pro-epidemic population Age-specific incidence Clinical manifestations vaccination impact

Novel insights into autophagy in gastrointestinal pathologies,mechanisms in metabolic dysfunction-associated fatty liver disease and acute liver failure

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World Journal of Gastroenterology 2024年第27期30卷 3273-3277页

作者： tsvetelina velikova Milena Gulinac Medical Faculty Sofia University St Kliment OhridskiSofia 1407Bulgaria Department of General and Clinical Pathology Medical University of PlovdivPlovdiv 4002Bulgaria

In this editorial,we comment on three articles published in a recent issue of World Journal of *** is a pressing need for new research on autophagy's role in gastrointestinal(GI)disorders,and also novel insights into some liver conditions,such as metabolic dysfunction-associated fatty liver disease(MAFLD)and acute liver failure(ALF).Despite advancements,understanding autophagy's intricate mechanisms and implications in these diseases remains ***,MAFLD's pathogenesis,encompassing hepatic steatosis and metabolic dysregulation,require further ***,the mechanisms underlying ALF,a severe hepatic dysfunction,are poorly *** studies exploring the interplay between autophagy and GI disorders,as well as defined mechanisms of MAFLD and ALF,are crucial for identifying therapeutic targets and enhancing diagnostic and treatment strategies to mitigate the global burden of these diseases.

关键词： Gastrointestinal diseases Autophagy Metabolic dysfunction-associated fatty liver disease High-normal alanine aminotransferase level Silent information regulator sirtuin 1 Acute liver failure

Controversies regarding transplantation of mesenchymal stem cells

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World Journal of Transplantation 2024年第2期14卷 48-61页

作者： tsvetelina velikova Tereza Dekova Dimitrina Georgieva Miteva Department of Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria Department of Genetics Faculty of BiologySofia University St.Kliment OhridskiSofia 1164Bulgaria

Mesenchymal stem cells(MSCs)have tantalized regenerative medicine with their therapeutic potential,yet a cloud of controversies looms over their clinical *** comprehensive review navigates the intricate landscape of MSC controversies,drawing upon 15 years of clinical experience and *** delve into the fundamental properties of MSCs,exploring their unique immuno-modulatory capabilities and surface *** heart of our inquiry lies in the controversial applications of MSC transplantation,including the perennial debate between autologous and allogeneic sources,concerns about efficacy,and lingering safety ***,we unravel the enigmatic mechanisms surro-unding MSC transplantation,such as homing,integration,and the delicate balance between differentiation and paracrine *** also assess the current status of clinical trials and the ever-evolving regulatory *** we peer into the future,we examine emerging trends,envisioning personalized medicine and innovative delivery *** review provides a balanced and informed perspective on the controversies,offering readers a clear understanding of the complexities,challenges,and potential solutions in MSC transplantation.

关键词： Mesenchymal stem cells Transplantation controversies Regenerative medicine Autoimmune diseases Chronic inflammatory illnesses Tumor growth Metastasis Therapeutic potential Clinical use of mesenchymal stem cell

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 *** factors play a pivotal role in the development and progression of liver *** state-of-the-art paper provides a comprehensive review of the current landscape of genetic screening strategies for liver *** discuss the genetic underpinnings of liver cancer,emphasizing the critical role of risk-associated genetic variants,somatic mutations,and epigenetic *** 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 *** 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

New strategies in the diagnosis and treatment of immune-checkpoint inhibitor-mediated colitis

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World Journal of Clinical Cases 2024年第6期12卷 1050-1062页

作者： tsvetelina velikova Boris Krastev Milena Gulinac Miroslav Zashev vasko Graklanov Milena Peruhova Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria Medical Center Nadezhda Medical Center NadezhdaSofia 1407Bulgaria General and Clinical Pathology Medical University of PlovdivPlovdiv 4002Bulgaria Department of General Surgery University Hospital“Heart and Brain”Burgas 8000Bulgaria First Department of Internal Diseases Medical University of PlovdivPlovdiv 4000Bulgaria Department of Hematology University Hospital“St.George”Plovdiv 4000Bulgaria Division of Gastroenterology University Hospital“Heart and Brain”Burgas 1000Bulgaria

Immune-checkpoint inhibitor-mediated colitis(IMC)is an increasingly recognized adverse event in cancer immunotherapy,particularly associated with immune checkpoint inhibitors(ICIs)such as anti-cytotoxic T-lymphocyte antigen-4 and anti-programmed cell death protein-1 *** this revolutionary immunotherapy gains prominence in cancer treatment,understanding,diagnosing,and effectively managing IMC becomes *** represents a unique challenge due to its immune-mediated nature and potential for severe ***,a precise picture of IMC pathophysiology is currently ***,we aimed to summarize the existing data while acknowledging the need for further *** comprehensive review explores the mechanisms underlying ICIs,gastrointestinal adverse effects,and,in particular,IMC’s incidence,prevalence,and *** review also emphasizes the importance of recognizing IMC’s distinct clinical and histopathological features to differentiate it from other forms of ***,this paper highlights the urgentneed for evolving diagnostic methods,therapeutic strategies,and a multidisciplinary approach to effectively manage IMC.

关键词： Immune-checkpoint inhibitors Immune-checkpoint inhibitor-mediated colitis Inhibitor-mediated colitis management Immunotherapy-associated colitis Checkpoint inhibitor-induced colitis Gastrointestinal adverse effects Checkpoint inhibitor toxicity Inhibitor-mediated colitis therapy

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 *** 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 *** 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,*** studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction,presented as different neurological *** 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

Interferon-gamma release assays as a tool for differential diagnosis of gastrointestinal tuberculosis

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World Journal of Clinical Cases 2024年第27期12卷 6015-6019页

作者： tsvetelina velikova Anita Aleksandrova Medical Faculty Sofia University Street Kliment OhridskiSofia 1407Bulgaria Department of Immunology Medical-diagnostic laboratory RamusSimitli 6000Bulgaria

In this editorial,we comment on an article published in a recent issue of the World Journal of Clinical *** is a pressing need for reliable tools for diagnosing tuberculosis(TB)of the gastrointestinal *** advancements in the diagnosis and treatment,TB remains a global health *** et al demon-strated that TB may mimic gastrointestinal conditions,such as gastric outlet obstruction,causing a delay in the ***,the latter complication is frequently observed during infections,including Helicobacter pylori,and rarely is related to TB,as in the presented *** line with this,we think that laboratory tests based on interferon-gamma release assays can be a helpful tool for diagnosing latent TB paced in the gastrointestinal *** strategies and approaches for diagnosing latent/active extra pulmonary TB are crucial for establishing the diagnosis early and enhancing treatment strategies to mitigate the global burden of TB.

关键词： Tuberculosis Gastrointestinal tuberculosis Interferon-gamma release assay IGRA Primary gastroduodenal tuberculosis Gastric outlet obstruction Case report

vaccination for solid organ transplanted patients:Recommendations,efficacy,and safety

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World Journal of Transplantation 2024年第4期14卷 6-14页

作者： tsvetelina velikova Stavros Gerasoudis Hristiana Batselova Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria Faculty of Medicine Trakia UniversityStara Zagora 6000Bulgaria Department of Epidemiology and Disaster Medicine Medical UniversityUniversity Hospital“St George”Plovdiv 4000Bulgaria

Solid organ transplant recipients face unique challenges in managing their im-munosuppressed status,making vaccination a critical *** review aimed to comprehensively analyze current recommendations,evaluate the effi-cacy of vaccinations in this population,and assess safety *** explored the latest evidence on vaccine types,timing,and potential benefits for transplant patients,highlighting the importance of individualized approaches for routinely used vaccines as well as coronavirus disease 2019 *** synthesizing avai-lable data,this review underscored the pressing need to optimize vaccination strategies,ensuring that transplant recipients can obtain the full protection against many pathogens while minimizing risks associated with their post-transplant immunosuppression.

关键词： vaccination Solid organ transplant Immunosuppression Transplant reci-pients vaccine efficacy Safety COvID-19 vaccines Immunization strategies Post-transplant immunity Clinical recommendations

Method“Monte Carlo”in healthcare

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World Journal of Methodology 2024年第3期14卷 40-47页

作者： tsvetelina velikova Niya Mileva Emilia Naseva Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria Medical Faculty Medical University of SofiaSofia 1431Bulgaria Faculty of Public Health“Prof.Tsekomir vodenicharov MDDsc”Medical University of SofiaSofia 1431Bulgaria

In public health,simulation modeling stands as an invaluable asset,enabling the evaluation of new systems without their physical implementation,experimentation with existing systems without operational adjustments,and testing system limits without real-world *** simulation modeling,the Monte Carlo method emerges as a powerful yet underutilized *** the Monte Carlo method has not yet gained widespread prominence in healthcare,its technological capabilities hold promise for substantial cost reduction and risk *** this review article,we aimed to explore the transformative potential of the Monte Carlo method in healthcare *** underscore the significance of experiential insights derived from simulated experimentation,especially in resource-constrained scenarios where time,financial constraints,and limited resources necessitate innovative and efficient *** public health faces increasing challenges,incorporating the Monte Carlo method presents an opportunity for enhanced system construction,analysis,and evaluation.

关键词： Monte Carlo Simulation Healthcare Modeling Decision analysis Stochastic methods Statistical techniques Health economics

Artificial intelligence as a tool in drug discovery and development

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World Journal of Experimental Medicine 2024年第3期14卷 11-19页

作者： Maria Kokudeva Mincho vichev Emilia Naseva Dimitrina Georgieva Miteva tsvetelina velikova Department of Pharmacology and Toxicology Faculty of PharmacyMedical University of SofiaSofia 1000Bulgaria Healthcare Solutions Sofia 1404Bulgaria Faculty of Public Health Medical University of SofiaSofia 1431Bulgaria Department of Genetics Faculty of BiologySofia University St.Kliment OhridskiSofia 1164Bulgaria tsvetelina velikova Medical FacultySofia University St.Kliment OhridskiSofia 1407Bulgaria

The rapidly advancing field of artificial intelligence(AI)has garnered substantial attention for its potential application in drug discovery and *** opinion review critically examined the feasibility and prospects of integrating AI as a transformative tool in the pharmaceutical ***,encompassing machine learning algorithms,deep learning,and data analytics,offers unprecedented opportunities to streamline and enhance various stages of drug *** opinion review delved into the current landscape of AI-driven approaches,discussing their utilization in target identification,lead optimization,and predictive modeling of pharmacokinetics and *** aimed to scrutinize the integration of large-scale omics data,electronic health records,and chemical informatics,highlighting the power of AI in uncovering novel therapeutic targets and accelerating drug repurposing *** the considerable potential of AI,the review also addressed inherent challenges,including data privacy concerns,interpretability of AI models,and the need for robust validation in realworld clinical ***,we explored ethical considerations surrounding AI-driven decision-making in drug *** opinion review provided a nuanced perspective on the transformative role of AI in drug discovery by discussing the existing literature and emerging trends,presenting critical insights and addressing potential *** conclusion,this study aimed to stimulate discourse within the scientific community and guide future endeavors to harness the full potential of AI in drug development.

关键词： Artificial intelligence Drug discovery Drug development Decision-making AI-driven medicine Healthcare Public health