Summary The study is a statistical analysis of the dynamics and structure of forensic autopsies performed on dead bodies and body remains at University Hospital “Dr. Georgi Stranski” in Pleven. The study was based on forensic autopsy records database and forensic autopsy reports for the period 2009-2013. A total of 976 cases, including forensic autopsies, exhumations, examination of bone remains and inspection of dead bodies at the site of death (without following forensic autopsy), were analyzed. The studied data was coded and processed with Microsoft Excel software. A detailed data analysis of the number of autopsies, frequency of death by cause, distribution of death by gender, age, residence, place of death and its forensic category is presented. According to our results, the deaths due to diseases comprised 35% of all forensic autopsies. The most common cause of violent death was damage by mechanical factors (53%), followed by asphyxia (24.7%). The most common mechanical factor was vehicle crash trauma, followed by falling (22.5%). Accidents were the most common cause of death 62%, followed by suicides (31 %) and homicides 7%. Fifty-nine percent of the suicides were by hanging. The preliminary analyses of the studied data lead to several conclusions. The number of forensic autopsies was found to be progressively decreasing, but the road traffic death rate remained unchanged. Most of the forensic autopsies were performed in July. The highest death rates by age was observed in the age group between 51 and 60 years, with predominance of males over females (3.3 males: 1 females).

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Antibodies to elastin breakdown products are found in the serum of all human subjects and correlate with their respective serum peptide levels. The presence of these antielastin antibodies (AEAbs) and the corresponding antigens in circulation leads to the formation of circulating immune complexes (CICs). The aim of this study was to determine if the serum levels of free AEAbs (not bound in CICs) correlate with the development of vascular complications in diabetic children. To this end, we used a method for detecting immune complexes (complement inhibition factor [CIF]-enzyme-linked immunosorbent assay [ELISA]) in combination with an ELISA for detection of AEAbs. The levels of free immunoglobulin G (IgG) AEAbs were studied in the sera of 54 diabetic children (mean age 12.3+/-4 years; diabetes duration 5.2+/-3.7 years). Thirty-two of the children had vascular complications (group 1), and 22 were without vascular complications (group 2). Twenty healthy children (mean age 13.6+/-4.2 years) were used as controls. The diabetics showed statistically significant higher levels of free AEAbs (0.490 E492+/-0.244 E492 vs 0.307 E492+/-0.081 E492; p = .02) compared with the control group. In group 1, free AEAbs showed statistically significant higher levels than controls (0.523+/-0.269 vs 0.307+/-0.081; p = .016). Eighteen of 54 (33%) patients were positive for free AEAbs (13 of 32 [41%] in group 1 and 5 of 22 [22%] in group 2). Free AEAb levels in all diabetics showed a correlation with systolic blood pressure (r = .44; p = .01), diastolic blood pressure (r = .46; p = .009), total cholesterol (r = .33; p = .05), triglycerides (r= .38; p = .03), high-density lipoprotein (r= -.46; p = .009), serum fructose (r= .43; p = .001), and microalbuminuria (r= .41; p = .002). Patients who had vascular pathology showed a correlation of free AEAbs with microalbuminuria (r= .434; p= .026), serum fructose (r= .63; p = .0004), hemoglobin A1c (r= .392; p = .043), and triglycerides (r= .456; p = .025). These findings suggest that elevated levels of free IgG AEAbs are associated with the development of diabetic vascular complications in children.

Introduction: Suicide is a major public health problem but factors determining suicide risk are still unclear. Studies in this field in Bulgaria are limited, especially on a regional level.Methods: By a cross-sectional design, we accessed the medical records of all psychiatric patients committed suicide over a 10-year period (2009–2018) in one major administrative region of Bulgaria. A statistical analysis was performed of the association between age of suicide as an indirect yet measurable expression of the underlying suicidal diathesis and a number of socio-demographic and clinical characteristics.Results: Seventy-seven of 281 suicides (28%) had psychiatric records. Most common diagnoses were mood disorders (44%), followed by schizophrenia (27%), anxiety disorders (10%), substance use disorders (9%) and organic conditions (8%). Male gender, single/divorced marital status, early illness onset, co-occurring substance misuse and lower educational attainment (for patients aged below 70) were significantly associated with earlier age of suicide whereas past suicide attempts and psychiatric hospitalizations, comorbid somatic conditions and unemployment showed insignificant association. Substantial proportion of patients (60%) had contacted psychiatric service in the year preceding suicide, with nearly half of these encounters being within 30 days of the accident.Conclusion: Severe mental disorders are major suicide risk factor with additional contribution of certain socio-demographic and illness-related characteristics. Monitoring for suicidality must be constant in chronic psychiatric patients. Registration of suicide cases in Bulgaria needs improvement in terms of information concerning mental health. More studies with larger samples and longitudinal design are needed to further elucidate distal and proximal suicide risk factors.

Suicides are an important and current social and medical problem of the modern society. According to the National statistics for the period 2000-2010 in Bulgaria there have been 11646 suicides or death due to intentional self-harm. The objective of this study is to research the dynamics and structure of suicides in the county of Pleven for the past ten years, distributions based on gender, age, place of residence, chronobiology, cause of death, as well as other details. Subject of retrospective analysis is forensic medicine reports from the archives of the Department of Forensic Medicine at the Medical University-Pleven. 366 cases were investigated over a period of 2008 to 2017 years. The results show that men are 230 (62.8%) and women 136 (37.2%). The same ratio applies between residents in town and village. The highest is the number of suicides in the age interval between 61 and 70 years. According to the causes of death, the highest number is due to hanging-176 cases or 48%, followed by jumping from high buildings and poisoning. In 14% of cases presence of alcohol in the blood was found. Most suicides occur in March, followed by June and July, and according to days of the week-on Tuesdays and Fridays. The blood types of the suitcidants in the district of Pleven were compared to those in the district of Plovdiv, as well as the distribution for the whole Republic of Bulgaria. Finally, there is a comparison of similarities and differences with the results of other studies.