PubMed Health⌕ Search

Biomedical subjects

A Atanasov

Publications and source records attributed to A Atanasov.

At least 19 recordsLinked to original sources
PubMed1999

Ultrasound follow-up study of arthroscoped patients with gonitis.

UNLABELLED: The purpose of the present study was to evaluate by ultrasound methods and carry out a one-year follow-up study of synovial proliferation in the knee joint of patients with rheumatoid arthritis prior to and after arthroscopy and arthroscopic (AS) synovectomy. MATERIAL AND METHODS: 24 patients with a proven rheumatoid arthritis and affected knee joints were recruited for the study. Arthroscopic synovectomy of one of the affected joints was performed in all of them. The synovitis was evaluated clinically and ultrasonographically in 24 knee joints prior to the AS synovectomy and 7 days, and 3, 6 and 12 months after it. RESULTS: Either synovial thickening or villonodular proliferation in the knee joints were the findings in the examined patients using arthrosonography. All patient showed improvement of the disease activity index after the arthroscopic synovectomy and weakening of the baseline ultrasound evidence for synovial thickening and villonodular proliferation (p < 0.001). During the 12-month follow up study two patients were found at ultrasonography to have (without any clinical evidence for that) recurrence of the synovial thickening three months after arthroscopy. Ten patients had synovial thickening or villonodular proliferation recurrence during the 12 months of follow up with clinical evidence of gonitis; one case showed ultrasonographic evidence of hydrops. There was a complete consistency between the ultrasound and arthroscopic protocols with respect to the presence of synovial proliferation and intra-articular effusion. CONCLUSION: Arthosonography is an easy, safe, low-cost, non-invasive modality for diagnosis and follow-up of patients with rheumatoid arthritis prior to and after arthroscopic synovectomy and for assessment of the clinical prognosis in such patients.

Adult↗
PubMed1997

Postnatal follow-up of the oxygenation index, arterial to alveolar oxygen tension ratio and alveolar arterial oxygen tension difference values in neonates with the respiratory distress syndrome treated with conventional ventilatory support.

Recent development of sophisticated intensive care technique for use in newborn infants with the respiratory distress syndrome (RDS) has resulted in changes in the therapeutic strategies and moved the problem of neonatal survival into the realm of new therapeutic realities. At present, the mechanical ventilation methods form an integral part of the intensive care strategy of infants with RDS. They have come to the forefront of infant care because of their successful use in ventilatory support and children survival where other therapeutic modalities have failed. The present prospective observational longitudinal study was designed to assess the real-time convenience, reliability and accuracy of the changes in the oxygenation index (OI), arterial-to-alveolar oxygen tension ratio (a/A PO2) and alveolar-arterial oxygen gradient (A-a)DO2 in ventilator-dependent neonates with RDS, to analyze their feasibility and potential information yield in oxygen inhalation therapy as well as their prognostic implications and predictive value. Twenty neonates with RDS, heralded by respiratory failure which necessitated the initiation of oxygen inhalation therapy and ventilatory support within 24 hours of birth, were enrolled in the study. Ten of the infants survived and the remaining ten died. OI, (a/A PO2) and (A-a)DO2 were followed up sequentially and thoroughly analyzed as the primary outcome measures of the study. The indices were calculated on the basis of the complete monitoring of the ventilatory equipment parameters and acid-base status carried out on an hourly basis. Our results show that: 1. The combination of three indexes (OI, (a/A)PO2 and (A-a)DO2 we propose is a useful discriminating predictor of neonatal lung maturity reflecting arterial blood gas status in ventilator-dependent neonates with RDS. 2. The indices detect the efficacy of the modern conventional ventilatory support with real-time convenience and reliable accuracy forming the cornerstone of clinical decision-making in RDS neonatal intensive care and allowing timely corrections of the ventilatory equipment parameters. 3. The prospective follow-up of these indices improves the predictive value as compared to any single test of neonatal lung maturity and has important prognostic implications in the management of neonates with RDS.

Humans↗
PubMed1995

[Anaerobic nonclostridial soft-tissue infection].

Over the period 1985 through 1994, observations are conducted on forty-eight patients, 35 men and 13 women, with age ranging from 11 to 56 years, presenting anaerobic non-spore-forming infection of the soft tissues (necrotizing fasciitis (3), postinjection nonclostridial myositis (7), crepitant cellulitis in diabetic gangrene (21), neck phlegmon (5), perineal phlegmon (9), and progressive bacterial synergistic gangrene against the background of chronic osteomyelitis (3). Infection development is characterized by local necrotic processes, intoxication, crepitations, fetor, fever, and in part of the patients--septic shock and DIC syndrome. The microbiological study shows presence of anaerobes, as mono- and polyinfection, aerobic-anaerobic associations, and gram-negative aerobes--in one patient alone. Invariably, the general condition is rather serious. Lethality amounting to 12.5 percent is ascribed to the late detection and unspecified and inadequate treatment protocol in the initial period of observation. The treatment is complex: incisions with successive many-staged necrectomies, antibiotics, metronidazole, hyperbaric oxygenation and hemadsorption. If several (2-3) of the aforementioned symptoms are present, evidence of anaerobic flora should be mandatory and purposefully seeked.

Adolescent↗
PubMed1995

[Anaerobic surgical infection].

The study covers 125 patients with anaerobic surgical infection, aged 7 to 82 years. Of the total 27 cases are operated for acute cholecystitis, four--diffuse acute peritonitis, seventeen--acute appendicitis, and three--acute hematogenous osteomyelitis. In acute cholecystitis and acute appendicitis microbiological study is carried out of the content, organic wall and periorganic space. In acute cholecystitis patients anaerobic flora is found in 39.01 per cent, and gram-negative--in 44.9 per cent, and in those presenting acute appendicitis--in 28.3 per cent and 58 per cent, respectively. The clinical analysis results point to a severer clinical course in the patients presenting anaerobic flora. The letter becomes manifest as mono infection in 37.2 per cent. It is pointed out that in the presence of two or more signs, characteristic of anaerobic infection, namely: destructive early process, offensive odor and intoxication, anaerobic bacterial flora should be invariably considered. At each microbiological examination the results of staining according to Gram should be also demanded from the laboratory.

Acute Disease↗
PubMed1994

[Peritonitis of large-bowel origin--complicated colorectal carcinoma].

A total of 803 patients presenting colorectal carcinoma are operated on over a 14-year period (1979 through 1992). In 272 cases (33.8 per cent) the disease runs a complicated clinical course. Perforative peritonitis is recorded in 29 cases-10.6 per cent of the total number of patients with complicated course, and 3.6 per cent of the total number subjected to operation. Ileus peritonitis free of perforation is discovered in twenty-seven cases-9.5 per cent of 272, and 3.23 per cent of the total number-803. The microbiological study of abdominal cavity exudate from the patients with ileus peritonitis points to predomination of anaerobic micro-organisms, having an essential practical bearing on performing adequate perioperative and postoperative antibiotic treatment, and peritoneal cavity lavage during the operation. Radical two-staged operations with removal of the perforated neoplastic process in the first stage and preternatural anus formation are the method of choice. Palliative operations leaving the perforated carcinoma within the abdominal cavity account for 100 per cent lethality. A radical one-staged operation is indicated only in the event of localized peritonitis, young patients, preserved good general condition, usually following right hemicolectomy.

Adenocarcinoma↗
PubMed1993

[The treatment of stress incontinence by Burch's colposuspension].

By describing the stages of the colposuspensio according to Burch the authors emphasize the differences of this operation compared with the retro-pubic uteropexy a modo Marshal I-Marchetti-Krantz. Stress are the positive sides of the colposuspensio a modo Burch which make it a method of choice with the treatment of stress incontinentio in many countries and simultaneously special attention is paid to some of the stages of the operation which demand exact strictness. The colposuspensio a modo Burch guarantees high effective treatment (personal experience from 1989) that is why the authors propose this operation to be a method of choice concerning the treatment of stress incontinentio.

Female↗
PubMed1993

[The structure of colorectal carcinoma morbidity complicated by occlusive ileus].

A total of 232 patients with obturation neoplastic ileus of the colon are operated over a 12-year period (1979-1990). Colorectal carcinoma is the underlying cause of the development of obturation colonic impatency. Of the total of 654 patients with carcinoma of the colon and rectum operated on obturation colonic ileus is diagnosed in 232 cases (35.47 per cent). There is a tendency of the morbidity rate of obturation colonic ileus to increase during the observation period, rather markedly expressed in rectal carcinoma cases. In 160 patients (68.97 per cent) the neoplasm is located in the colon, and in seventy-two (31.03 per cent)--in the rectum. The morbidity rate recorded in men and among the urban population is higher. Obturation colonic impatency of a neoplastic origin is taken to be a pathological condition of advanced age. The mean age in men is 57.9 years, and in women--57.7 years.

Adult↗
PubMed1993

[Postoperative complications in occlusive colonic ileus of tumor origin].

Out of a total of 232 patients with obturation colonic ileus subjected to operation, in 79 cases (34.05 per cent) various types of complications are observed, distributed in four groups as follows: group one--on behalf of the organ operated on (colon and rectum), group two--peritoneal cavity and abdominal organs, group three--organs and systems outside the abdominal cavity, and group four--operative wound. In this respect bronchopulmonary complications, would infections and paralytic ileus play a major role.

Bulgaria↗
PubMed1992

[A new surgical treatment of stress incontinence in vaginal prolapse: urethrovesical suspension by a half-sheeted flap formed from the anterior vaginal wall].

The author described a new operative method concerning stress incontinentia with descensus of the vagina. The offered operative method belongs to the group of the urethrovesical suspensions and the elevating is done by a half-sheeted hammock formed by the anterior vagina wall. The stages of the operation are described and showed in details. This operative method has been approved and from two years practiced at the University Clinic.

Female↗
PubMed1991

[The risks for fetus and mother depending on the type of cesarean section].

The author points out the tendency to the increasing frequency of cesarean section (mainly) in the interest of the fetus and mother and emphasizes that in some cases the cesarean section itself represents a risk factor. This factor evolves from the direction and place of the uterine incision--transverse and longitudinal. The isthmic transverse incision of the uterine wall, proposed by Kehrer in 1981, is not always the most suitable, since in could not always assure sufficient space for elegant extraction of the fetus. This remark is referred especially to cases, when cesarean section is performed for a fetus under 32 weeks' gestation and then the lower uterine segment is not dilated enough and the transverse isthmic orifice is small for atraumatic extraction of the fetus. For these and some other states--twin pregnancy, transverse oblique presentation of the fetus, placenta previa varicose vessels of both sides of the uterus and very large fetus, the author proposes low isthmic longitudinal hysterectomy and emphasizes the motives for decision making. Except for advantages for the fetus and mother he points out more perfect adaptation of the edges--a guarantee for healthy and elastic edge, in which dehiscences are observed more rarely during the following deliveries according to foreign authors). The experience of the author in low isthmic longitudinal incision of the uterus is made on 62 cesarean sections, performed by 13 obstetricians, all convinced that this incision creates greater space possibilities--conditions for atraumatic extraction of the fetus.

Adult↗
PubMed1991

[Our experience with the suprasymphyseal cross-cut incision in Küstner's laparotomy].

The author describes the evolution of the suprasymphyseal cut according to Pfannenstiel since the time of its formation. He proposes and improved modification of this cut, in which all positive ideas till our days are integrated. The basic principle in this cut lies in the fact that the skin and subcutaneous tissue are separated from the fascia in the direction upward to the umbilical cord to a degree allowing to perform the desired transverse incision of the fascia. The positive sides of the suprasymphyseal cross cut are pointed out. The personal experience of the author are in support of this cut, who has used it in hundreds of women with various gynecological operations. This gives him foundation to recommend to the surgeons to include this method in their operative techniques during laparotomy for definite operations in the pelvis.

Abdominal Muscles↗
PubMed1990

[A modified technic of preoperative acute normovolemic hemodilution--the advantages and economic effect of its use in planned colorectal surgery].

In a prospective and comparative study were included 129 patients undergone planned operation for colorectal cancer. They were divided in two randomized groups: Group A consisted of 65 patients operated under conditions of preoperative acute normovolemic hemodilution (PANHD) by an own modified technique with Ringer-lactate and hemodex. Group B (control) included 64 patients operated with the use of homologous blood substitution. The results in the two groups were compared as to: intra- and postoperative blood transfusions; time (in days) of postoperative treatment; number of postoperative complications. Statistically significant differences (p less than 0.001) referrable to all three compared values were found. The modified PANHD technique in planned colorectal surgery is safer for the patients than the so far suggested techniques and may readily gain acceptance with the use of solutions of domestic produce. It leads to significant decrease in homologous blood transfusion, shortening the postoperative stay in hospital of patients subjected to hemodilution. The number of patients in whom postoperative complications developed was reduced.

Adult↗
PubMed1989

[Suprapubic uterovesical suspension via a hammock made from a flap formed from the vaginal wall--a new surgical method in stress incontinence].

The authors report on their own method, used in women with stress incontinence and included into the group of uterovesical suspensions. The idea of Pereyra and that of Goebell and Stoeckel was applied rationally as the suspension was achieved by a sling from a lambeau, formed from the vaginal wall. The stages of the operation were described in details as well as its advantages in comparison with other operations, used for the same purpose. The personal experience of the authors in this operation was based on 30 women, operated during 1986 and showed very high therapeutic efficiency.

Female↗