Recent clinical studies and scientific literature increasingly support the use of essential oils (EOs) as adjuncts in enhancing sports performance and recovery. They have demonstrated potential in modulating mood, alleviating fatigue, facilitating muscle recovery, and contributing to the overall physiological and psychological well-being of athletes. Specifically, EOs such as peppermint and eucalyptus exhibit analgesic and anti-inflammatory properties, making them beneficial for managing exercise-induced muscle soreness and discomfort. Conversely, oils like lavender are recognized for their anxiolytic and sedative effects, which may improve sleep quality and promote relaxation. But both are essential for effective post-exercise recovery. As such, their strategic application may represent a valuable, complementary approach within the broader context of sports medicine and athletic training. Although EOs have been used for centuries in traditional medicine of various cultures to support physical performance, scientific research in the field of sports medicine remains still limited. Preliminary findings suggest promising effects on fatigue reduction, sleep, sympathetic activity, and endurance improvement. However, results are inconsistent, with some studies even showing no significant differences compared to placebo. Further rigorous research is needed to establish the efficacy and mechanisms of EOs in athletic settings.

Relapsing-remitting multiple sclerosis (RRMS) is defined by elevated IgG/IgA/IgM responses targeting Epstein-Barr Virus (EBV) nuclear antigen 1 (EBNA) and deoxyuridine-triphosphatases (dUTPases) of Human herpsesvirus-6 (HHV-6) and EBV. These responses suggest that the viruses are being replicated and reactivated. An increased prevalence of chronic fatigue syndrome, depression, and anxiety is associated with signs of immune activation in RRMS. Nevertheless, there is a lack of data regarding the association between viral reactivation and neuropsychiatric symptoms of RRMS. This study investigated the IgG/IgA/IgM responses to EBNA, and EBV and HHV-6-dUTPases, in 58 remitted RRMS patients and 63 normal controls. The McDonald criteria were employed to establish the diagnosis of MS. The Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Severity Score were employed to evaluate disabilities caused by RRMS. We evaluated the scores of the Hamilton Depression (HAMD) and Anxiety (HAMA) Rating Scales, and Fibro-Fatigue (FF) scale. One latent construct was extracted from the EDSS, MSSS, FF, HAMD, and HAMA scores. We discovered that the combined effects of IgG and IgM-HHV-6-dUTPAses accounted for 63.7% of the variance in this construct. Furthermore, the total FF, HAMA, and HAMD scores were substantially associated with the IgG and IgM-HHV-6-dUTPAses, accounting for approximately 38.7% to 51.0% of the variance. The three neuropsychiatric rating scale scores were also significantly correlated with IgA reactivity directed to both dUTPases and IgG/IgA/IgM to EBNA. In conclusion, the reactivation and replication of HHV-6 and EBV significantly contributes to chronic fatigue syndrome, as well as symptoms of depression and anxiety due to RRMS.

Introduction: Hydatidosis is one of the most critical parasitic zoonotic diseases worldwide. Lungs are the second most common site of the disease. Aim: This study aimed to evaluate the clinical presentation, diagnosis, radiological findings, surgical treatment and post-operative complications of pulmonary hydatid cyst in patients referred to the Second Surgery Clinic at St George University Hospital in Plovdiv, Bulgaria. Materials and methods: From January 2014 to December 2022, 69 patients were operated on due to pulmonary hydatidosis in the Clinic of Thoracic and Abdominal Surgery at St George University Hospital in Plovdiv, Bulgaria. Demographic data of the patients were collected including clinical symptoms, laboratory studies, radiological findings, location of the lung involvement, and surgical procedures and post-operative complications were recorded. Results: Pulmonary hydatidosis was confirmed for 69 (46 male and 23 female) patients. The average age of the study group was 31.59±19.49 years. In 29 of the tested patients, specific antibodies of the IgG class to Echinococcus granulosus were positive, and 23 patients showed negative results. The leading symptom was non-productive cough followed by shortness of breath, chest pain, fever, productive cough; rash was reported in one patient. 91.3% of the cases presented with a typical X-ray image and in 8.7% it was atypical. It turned out that 66.7% of patients with an atypical X-ray findings developed complications in the postoperative period. Right lung was affected in 50.7% of the cases. The average size of the echinococcal cyst was 7.43±3.23 cm. Statistical analysis revealed a correlation between the size of the hydatid cyst and the length of the postoperative period. Dissemination in other organs was found in 16 of the patients. No statistically significant differences were reported in the patients with dissemination, regarding the size of the primary hydatid cyst, complications and duration of the postoperative period. The preferred methods of approach were thoracotomy and VATS. The most commonly performed surgical technique was echinococcectomy and capitonnage a modo Delbet followed by two lobectomies and one wedge resection. The mean postoperative period was 7.00±2.81 days. In 12 of the analyzed patients, complications occurred in the postoperative period, and mortality was reported in one patient. Conclusion: Pulmonary echinococcosis remains a significant health issue in many countries worldwide including Bulgaria. With a prolonged silent period, it is usually diagnosed when clinical symptoms as cough, dyspnea, chest pain and fever start manifesting. Plain chest radiography remains the basic imaging method for initial diagnosis while ELISA test has limited diagnostic accuracy in cases of pulmonary hydatidosis. Irrelevant to surgical approach, Delbet’s capitonnage procedure is associated with good postoperative results and low complication rates.

Background: Thymus numidicus Poiret. (Lamiaceae) is an endemic plant with well-known antibacterial properties. It has been largely used in traditional Algerian medicine. This study aimed to compare the chemical composition of essential oils (EOs) extracted from leaves and flowers using the gas chromatography–mass spectrometry method, as well as to investigate its analgesic and anti-inflammatory activities. Results: The EOs were rich in monoterpenes and classified as a thymol chemotype. In vivo experiments revealed that acute treatment with T. numidicus EO (20 and 80 mg/kg) significantly increased the thermal threshold on the hot-plate at all tested hours compared to the control animals (p < 0.001, respectively), while only the higher dose had a similar effect to the metamizole group at 2 and 3 h. In the mechanical stimulus test, both doses of the EO led to a late analgesic effect presented with increased paw withdrawal threshold only during the third hour compared to the control group (p < 0.05, respectively). In the plethysmometer test both doses of the EO dose-dependently reduced paw volume with nearly 10% and 15% compared to the control animals at all tested hours (p < 0.001, respectively), with a more pronounced volume reduction in the higher dose. In a neuropathic pain model, the EO (20 mg/kg and 80 mg/kg) dose-dependently increased the withdrawal latency time towards thermal stimuli and enhanced the paw withdrawal threshold in response to mechanical pressure at all tested hours compared to the CCI-group (p < 0.001, respectively). These findings demonstrate the potent analgesic and anti-inflammatory effects of T. numidicus EO in models of acute and neuropathic pain.

Background/Objectives: The objective of our study was to quantify the annual costs, from a societal perspective, encompassing direct health care costs, direct non-health care costs, and labor productivity losses associated with spinal muscular atrophy (SMA) patients in Bulgaria and their caregivers. Methods: We applied a prevalence-based, bottom-up costing methodology to assess the socio-economic burden of SMA from a societal perspective. We evaluated and summed up all costs for health services (diagnosis, treatment, follow-up, and rehabilitation), educational and social services, and formal and informal care in the community, as well as indirect costs due to the loss of productivity and work capacity of the SMA patients’ caregivers. Results: Nine parents of SMA patients provided consent and completed the study’s questionnaire. Two children had SMA type III, and seven had SMA type II. The median annual socio-economic burden per SMA patient was EUR 254,968.80. The high direct costs, primarily driven by drug expenses, and the substantial indirect costs resulting from the loss of productivity among informal caregivers were the primary causes. We found no utilization of social care and educational services. Conclusions: We emphasize the need for careful consideration of long-term outcomes, real-world data collection, and performance-based reimbursement. An ideal scenario could achieve these objectives in synergy. A second layer of policy actions and measures must address the unmet needs of SMA patients and their families using a holistic approach. The indirect costs associated with SMA, particularly the productivity loss of informal caregivers, underscore the need for comprehensive support programs.