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Summary INTERNAL DISEASES PLENARY LECTURE Summary Abstracts from Jubilee Scientific Conference “45 years Medical University – Pleven”, 31 Oct - 2 Nov, 2019 1Institute of Metal Science, Equipment INTERNAL DISEASES and Technologies with Hydro- and Aerodynamics Centrе, PLENARY LECTURE Bulgarian Academy of Sciences, Sofia, Bulgaria CARDIAC SARCOIDOSIS – A NOT SO Corresponding Author: RARE TYPE OF CARDIOMYOPATHY Stefan Valkov Institute of Electronics, WITH RHYTHM DISTURBANCES Bulgarian Academy of Sciences 72, Tsarigradsko Chaussee Blvd. Borislav B. Dinov Sofia, 1784 Bulgaria Heart Center University of Leipzig, e-mail: [email protected] Germany Summary Corresponding Author: Due to the combination of attractive mechanical Borislav B. Dinov properties, biocompatibility and resistance to Heart Center University of Leipzig corrosion, the Co-Cr based alloys are widely Strümpellstraße 39 used for manufacturing of dental joints, implants 04289 Leipzig Germany and other medical devices. However, some e-mail: [email protected] drawbacks related to low hardness and wear resistance can be mentioned. These limitations Summary depend mostly on the surface properties and Cardiac involvement can occur in patients can be overcome by an appropriate technology with pulmonary or systemic sarcoidosis with for surface manufacturing. In recent years, the varying symptoms and severity. It can mimic deposition of coatings has been widely used for virtually every type of cardiomyopathy and is improving the properties of the materials. There therefore frequently misdiagnosed. Even more exist some technologies for depositing thin challenging are the cases of isolated cardiac films and coatings, including physical vapour sarcoidosis which are considered rare, often deposition (PVD), chemical vapour deposition remain unrecognized and have grave prognosis if (CVD), among others. The direct current (DC) left untreated with immunosuppressive therapy. magnetron sputtering (MS), which is a part of The key to the accurate diagnosis requires PVD, is among the most promising technologies alertness for the symptoms which, although not for the manufacturing of coatings. It provides specific, have typical clustering and evolution. good reproducibility and structure; thickness and The positive cardiac biopsy with noncaseating properties can be well controlled. The surface granuloma confirms the diagnosis but it has treatment of the materials employing a scanning low diagnostic yield and can be omitted in electron beam is another method of improving the many cases. Ultimately, the cardiac magnetic properties of the materials. The treated specimen resonance and positron-emission tomography is rapidly heated up to a specific temperature gained in importance and are increasingly used and cooled where the cooling rate reaches to corroborate the diagnosis and for follow-up of 106 K/s. This leads to phase transitions, grain the patients. The presentation tackles the protean size refinement and changes in the functional appearance, the difficulty of making the correct properties. This work aims to investigate the diagnosis and the challenges in the treatment of possibilities for improving the properties of Co- cardiac sarcoidosis. Cr based alloys by deposition of bilayer TiN/ Key words: systemic sarcoidosis, TiO coatings, electron beam treatment, as well 2 cardiomyopathy, cardiac sarcoidosis. as a combination of both methods. The obtained results are discussed concerning the materials’ requirements for implant manufacturing. 31 J Biomed Clin Res Volume 12, Number 1, Supplement 2, 2019 ORAL PRESENTATIONS PREVALENCE AND TYPE OF UNCOMMON EGFR MUTATIONS INDICATIONS AND TECHNICAL IN NSCLC IN THE BULGARIAN IMPLEMENTATION OF POPULATION VERTEBRAL ARTERIES CATHETER INTERVENTIONS Stoyan N. Bichev, Tereza B. Dineva1, Plamen Gatzov, Nataliya P. Chilingirova1, Nikolai Ivanov Savelina L. Popovska2 Medical University – Pleven, Bulgaria National Genetics Laboratory, Sofia, Corresponding Author: Bulgaria Plamen Gatzov, 1Science and Research Institute, Medical University – Pleven Medical University – Pleven, 1, St. Kliment Ohridski Str. Bulgaria Pleven, 5800 2Department of Pathology, Bulgaria e-mail: [email protected] Medical University – Pleven, Bulgaria Summary The vertebral arteries supply about 20% of Summary the human brain, including vital structures as Targeted therapies have changed the treatment the medulla oblongata, pons, cerebellum and paradigm in advanced and metastatic non-small medulla spinalis. The study aimed to evaluate cell lung cancer (NSCLC). Genetic testing for the technical aspects and the rate of success activating mutations in the EGFR gene has of vertebral arteries catheter interventions. become an essential part of routine clinical We evaluated 58 consecutive symptomatic practice. Frequent mutations in the EGFR gene patients for vertebral arteries abnormalities. such as del19 and L858R proved their clinical All of the patients had a history of ischemia in significance for the first-line treatment with that region. All patients underwent a Doppler tyrosine kinase inhibitors (TKIs). However, there ultrasound, selective carotid and vertebral are still other detected mutations in the EGFR arteries angiography. In 8 of the patients, we gene, which are generally defined as uncommon found significant atherosclerotic lesions. Two of or rare, where TKIs do not have such a priority them were in V2 and the rest – in V1 segments. in the treatment and are still a diagnostic and All of the lesions were stented using bare-metal treatment challenge. This study intended to detect stents. The direct stenting technic was used. the frequency and type of those rare mutations The stent size was 3.5 or 4.0 mm in diameter in the Bulgarian population. We used paraffin- and 12 to 18 mm in length. The procedural embedded tumours tissue samples from more success was 100%, and no complications were than 5000 patients in stage IIIB, and IV NSCLC recorded in the group. The in-hospital and up tested for EGFR mutations exons 18-21 in two to one-month follow-up of patients showed a reference labs in Sofia and Pleven. Two methods substantial improvement in their symptoms. The were used: DNA extraction based on real-time interventional vertebral arteries treatment, which PCR from formalin-fixed, paraffin-embedded uses direct stenting technology, is technically tumours tissue samples using Cobas® DNA feasible and leads to symptoms improvement in Sample Preparation Kit, Roche or DNA extraction patients with vertebrobasilar ischemia. from FFPE tumour tissue using QIAamp DNA Key words: vertebral arteries, angiography, FFPE Tissue Kit® (Qiagen). The quantity and intervention, stenting quality of extracted DNA were assessed by NanoDrop 1000 spectrophotometer (Thermo Scientific). Real-time PCR amplification by the Scorpions Amplification Refractory Mutation 32 Abstracts from Jubilee Scientific Conference “45 years Medical University – Pleven”, 31 Oct - 2 Nov, 2019 System (SARMS) method was used to detect Corresponding Author: mutations in the EGFR gene exons 18-21. From Petya Hr. Ilkova all tumour samples tested between November Department of Occupational Diseases and 2010 and April 2019 (72% former or current Clinical Allergy Activity, smokers, 2/3 male, 1/3 female with a median age St. Georgi University Hospital – Plovdiv 66, Peshtersko Shose at diagnosis 63years, 58% stage IV) we detected Plovdiv, 4000 36 cases of rare mutations. Subgroup analysis Bulgaria of those cases showed prevalence of males - 20 e-mail: [email protected] males, 16 females; 12 never-smokers, and 24 current or formal smokers. Detected uncommon Summary EGFR mutations were G719X (8 cases), ins The aim of this study was to compare the level exon 20 (7cases), L861Q (10 cases), S768I (6 of detection of occupational diseases in Bulgaria cases). In 4 cases, double mutations were found to other European countries, to present expertise - L858R/S768I; G719X/L861Q; S768I/L861Q; and healthcare activities of the Division of S768I/G719X. EGFR uncommon mutation is Occupational Diseases, Medical University rarely detected in genetic testings. Our study Plovdiv for the last 5 years, according to the revealed the prevalence of those mutations in the contract with Working Conditions Fund, and Bulgarian population and raised questions for better recognition for work-related problems the most appropriate therapeutic approach for to be accomplished. Statistical data from the such patients since not all mutations are reported International Labour Organization, National to benefit from first-line EGFR-TKIs. Statistical Institute and National Program for Safety and Work-related Health 2018-2020 were considered. A detailed overview and analysis TRENDS IN BULGARIA ON of all the reports about results of the diagnostic OCCUPATIONAL DISEASES and healthcare activities for the period 2014- DETECTION AND REAL SITUATION 2018, based on the contract between Working - HISTORY AND STATISTICS Conditions Fund and St Georgi University ON ACTIVITIES OF DIVISION Hospital - Plovdiv were conducted. A lower OF OCCUPATIONAL DISEASES level of detection of occupational diseases AND TOXICOLOGY, MEDICAL in Bulgaria in comparison to EU member UNIVERSITY – PLOVDIV countries was found. For the last five years, 824 patients were hospitalized, and occupational 1, 2 Svetlan M. Dermendzhiev , ethology was confirmed and reported in 49% 3 Petya Hr. Ilkova , of cases. Harmonization of the legal framework 1, 4 Zlatka B. Stoyneva , with European legislation and good practices 1 Iliya A. Arolski , implementation could significantly
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