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Alexandrovska Hospital

HealthcareSofia, Bulgaria
About: Alexandrovska Hospital is a healthcare organization based out in Sofia, Bulgaria. It is known for research contribution in the topics: Lens (anatomy) & Comparative genomic hybridization. The organization has 52 authors who have published 28 publications receiving 775 citations. The organization is also known as: Aleksandrovska University Hospital.

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Journal ArticleDOI
01 Apr 2011-Allergy
TL;DR: Viruses and bacteria in acute asthma exacerbations – A GA2LEN‐DARE systematic review 2011; 66: 458–468.
Abstract: A major part of the burden of asthma is caused by acute exacerbations. Exacerbations have been strongly and consistently associated with respiratory infections. Respiratory viruses and bacteria are therefore possible treatment targets. To have a reasonable estimate of the burden of disease induced by such infectious agents on asthmatic patients, it is necessary to understand their nature and be able to identify them in clinical samples by employing accurate and sensitive methodologies. This systematic review summarizes current knowledge and developments in infection epidemiology of acute asthma in children and adults, describing the known impact for each individual agent and highlighting knowledge gaps. Among infectious agents, human rhinoviruses are the most prevalent in regard to asthma exacerbations. The newly identified type-C rhinoviruses may prove to be particularly relevant. Respiratory syncytial virus and metapneumovirus are important in infants, while influenza viruses seem to induce severe exacerbations mostly in adults. Other agents are relatively less or not clearly associated. Mycoplasma and Chlamydophila pneumoniae seem to be involved more with asthma persistence rather than with disease exacerbations. Recent data suggest that common bacteria may also be involved, but this should be confirmed. Although current information is considerable, improvements in detection methodologies, as well as the wide variation in respect to location, time and populations, underline the need for additional studies that should also take into account interacting factors.

256 citations

Journal ArticleDOI
TL;DR: In this article, the authors defined threshold dose distributions for 5 major allergenic foods in the European population, including peanuts, hazelnut, celery, fish, and shrimp, using interval-censoring survival analysis with three parametric approaches.
Abstract: Background Precautionary labeling is used to warn consumers of the presence of unintended allergens, but the lack of agreed allergen thresholds can result in confusion and risk taking by patients with food allergy. The lack of data on threshold doses below which subjects are unlikely to react is preventing the development of evidence-based allergen management strategies that are understood by clinician and patient alike. Objective We sought to define threshold dose distributions for 5 major allergenic foods in the European population. Methods Patients with food allergy were drawn from the EuroPrevall birth cohort, community surveys, and outpatient clinic studies and invited to undergo a food challenge. Low-dose, double-blind, placebo-controlled food challenges were undertaken with commercially available food ingredients (peanut, hazelnut, celery, fish, and shrimp) blinded into common matrices. Dose distributions were modeled by using interval-censoring survival analysis with 3 parametric approaches. Results Of the 5 foods used for challenge, 4 produced similar dose distributions, with estimated doses eliciting reactions in 10% of the allergic population (ED 10 ), ranging from 1.6 to 10.1 mg of protein for hazelnut, peanut, and celery with overlapping 95% CIs. ED 10 values for fish were somewhat higher (27.3 mg of protein), although the CIs were wide and overlapping between fish and plant foods. Shrimp provided radically different dose distributions, with an ED 10 value of 2.5 g of protein. Conclusion This evidence base will contribute to the development of reference doses and action levels for allergens in foods below which only the most sensitive subjects might react.

150 citations

Journal ArticleDOI
TL;DR: Depressed patients’ performance was significantly worse than that of controls on almost all executive tasks and their score for logical memory was significantly correlated with that for several executive tasks, which may be useful in the differential diagnosis between depression and early Alzheimer’s disease.
Abstract: Several studies have evaluated executive function in depressed patients, and the results vary from significant impairment relative to controls to virtually intact performances. To better comprehend executive impairment in elderly patients with major unipolar depression, the performance of 21 elderly depressed patients was compared with that of 19 elderly normal controls on executive tasks. The relationships between memory deficits and depression severity and between memory deficits and executive dysfunction were also examined. Depressed patients' performance was significantly worse than that of controls on almost all executive tasks. Their score for logical memory was significantly correlated with that for several executive tasks. Executive performance was also correlated with depression severity. Unipolar depressed patients present executive deficits. Memory failure in these patients may reflect impairment in retrieval processes, which in turn depends on executive function. Executive deficits are associated with depression severity. These results may be useful in the differential diagnosis between depression and early Alzheimer's disease.

93 citations

Journal ArticleDOI
01 Oct 2009-Allergy
TL;DR: The EuroPrevall Integrated Project Euro-Health Survey in children and adults was designed to estimate the currently unknown prevalence of food allergy and exposure to known or suspected risk factors for food allergy across Europe.
Abstract: BACKGROUND: The epidemiological surveys in children and adults of the EU-funded multidisciplinary Integrated Project EuroPrevall, launched in June 2005, were designed to estimate the currently unknown prevalence of food allergy and exposure to known or suspected risk factors for food allergy across Europe. We describe the protocol for the epidemiological surveys in children and adults. This protocol provides specific instructions on the sampling strategy, the use of questionnaires, and collection of blood samples for immunological analyses. METHODS: The surveys were performed as multi-centre, cross-sectional studies in general populations. Case-control studies were nested within these surveys. The studies in children aged 7-10 years and adults aged 20-54 years were undertaken in eight centres representing different social and climatic regions in Europe. RESULTS: After a community-based survey collecting basic information on adverse reactions to foods, all those stating they had experienced such reactions, as well as of a random sample of those stating 'no reactions' to foods, completed a detailed questionnaire on potential risks and exposures. Also a blood sample was taken to allow serological analysis to establish patterns of food and aeroallergen sensitization. We also included a questionnaire to schools on their preparedness for dealing with food allergy amongst pupils. Subjects reporting adverse reactions to foods and sensitized to the same food(s) were called in for a full clinical evaluation that included a double blind placebo controlled food challenge (DBPCFC), following a protocol which is described in detail elsewhere. CONCLUSIONS: The outcome of these studies will help to improve our understanding of several important aspects of food allergies in the European Community, providing for more well-informed policies and effective measures of disease prevention, diagnosis and management.

79 citations

Journal ArticleDOI
TL;DR: The ensured delivery of medication with RLAI resulted in significant symptom improvement in this patient population, and might represent a novel option for patients in the early phases of psychosis.
Abstract: The efficacy and safety of risperidone long-acting injectable (RLAI) was investigated in patients in the early phases of schizophrenia and schizoaffective disorders (< or = 3 years). Patients who required a treatment change received RLAI (2-weekly gluteal injections of 25, 37.5 or 50 mg, per clinical judgement), without an oral risperidone run-in phase.A total of 382 patients were included in this 6-month open-label study; 73% of patients completed the study. A total of 84% had schizophrenia with a median duration of 1.0 year since diagnosis. Previous medications were mainly atypical antipsychotics (70%) and depot neuroleptics (24%). The main reasons for treatment change were non-compliance (42%) and insufficient efficacy (31%) of previous medication. The total Positive and Negative Syndrome Scale (PANSS) and all its subscale scores improved significantly (p < or = 0.0001), with 40% of patients showing a 20% improvement on total PANSS. Global Assessment of Functioning, quality of life, patient satisfaction and movement disorders also improved significantly. Tolerability of RLAI was generally good and no unexpected adverse events were reported. The ensured delivery of medication with RLAI resulted in significant symptom improvement in this patient population. Direct initiation of RLAI is well accepted by patients. RLAI might represent a novel option for patients in the early phases of psychosis.

61 citations


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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
20222
20213
20191
20181
20172
20153