Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but severe drug reaction, most commonly to aromatic anticonvulsants with a delayed onset, variable clinical presentation and protracted course. The exact incidence of DRESS syndrome is not known because of the variability in clinical presentation, lack of strict diagnostic criteria and universally accepted nomenclature. We report four cases of DRESS syndrome associated with the use of carbamazepine. The clinical manifestation was similar: a maculopapular eruption progressing to exfoliative erythroderma, fever, and lymphadenopathy. Leukocytosis, atypical lymphocytes and liver injury (in 2 patients) were also observed. Assessment of causality using the Naranjo algorithm established a "probable" relationship with carbamazepine in three of the cases and a "possible" relationship in one case. Detection of DRESS syndrome is dependent on the exclusion of a variety of diseases with similar manifestations and may be delayed in time. DRESS syndrome is a potentially life-threatening multisystem adverse drug reaction, and accidental reexposure or drug provocation tests must be avoided.

Life-cycle, delimitation and redescription ofCatatropis verrucosa (Friilich, 1789) Odhner, 1905 (Trematoda: Notocotylidae) I. Kanev, I. Vassilev, V. Dimitrov and V. Radev Abstract The life-cycle of Catatropis verrucosa (Fr6lich, 1789) Odhner, 1905 has been completed experimentally starting from infected snails collected along the River Danube in Europe. Each stage of the life-cycle is redescribed. Taxonomic problems are discussed and the main features of the species are listed. Synonyms for C. verrucosa are Fasciola verrucosa Fr61ich,

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We present a case of nonspecific granulomatous prostatitis in combination with calculous ductal ectasia and extensive epithelial Paneth cell-like metaplasia in a TURP-specimen. Our report highlights the importance of calculous ductal obstruction and stasis of secretions in the etiopathogenesis of this type of prostatitis. The observed extensive Paneth cell-like metaplastic change in adjacent epithelial cells most likely represents a phenotypic adaptive mechanism directed against foreign antigens and nondegradable lipids in the stagnant intraluminal debris.

Some estimates of global climatic change in the next 100 years suggest a general warming and rainfall decrease on the Balkan Peninsula. Our studies suggest that in Bulgaria climatic changes have already started. Because water resources to a great extent depend upon climate dynamics, this paper develops the linkage of climatic fluctuations and water resources using time-series analysis of climatic parameters and some river runoff characteristics and their correlation. One of the main conclusions, based on the results, is that climatic change manifested in the last 15 years has significantly influenced river runoff. A study of the recent prolonged drought and the influence of changes on water resources and human activity begins with characterizing climate-hydrology linkages. The results of this study point to several problems of regional and local importance.