PubMed Health⌕ Search

Biomedical subjects

A Maleev

Publications and source records attributed to A Maleev.

At least 19 recordsLinked to original sources
PubMed1990

Cisapride and cimetidine in the treatment of erosive esophagitis.

The efficacy of cisapride, as compared with cimetidine, in the treatment of erosive esophagitis was studied in a double-blind trial. One hundred and twenty-nine patients were assigned to one of four dosage schedules: cisapride 10 mg b.i.d. (20 mg group) or q.i.d. (40 mg group), or cimetidine 400 mg b.i.d. (800 mg group) or q.i.d. (1600 mg group). Treatment lasted 8 to 12 weeks. The degree of esophagitis and the severity of diurnal and nocturnal heartburn and regurgitation were significantly (p less than 0.01) reduced in the four treatment groups. Endoscopy did not show any significant differences among the four groups, although cisapride tended to be more effective in moderate to severe esophagitis, in which cases mucosal healing (i.e. absence of erosions and ulcers) was observed in 69%, 64%, 55% and 55% of the patients treated with cisapride 40 mg, cisapride 20 mg, cimetidine 1600 mg and cimetidine 800 mg. Improvement in reflux symptoms in the two cisapride groups was not significantly different from that in the cimetidine 1600 mg group, but was better (p less than 0.05) than that in the cimetidine 800 mg patients. The severity score for all reflux symptoms had decreased by 79%, 74% (cisapride 40 mg and 20 mg), 69% and 57% (cimetidine 1600 mg and 800 mg) by the end of treatment. These results show that cisapride is at least as effective as acid-suppressing therapy in patients with reflux esophagitis, and is therefore a valuable alternative to it.

Cimetidine↗
PubMed1989

[Role of hepatitis B virus infection in chronic glomerulonephritis].

This study included 60 patients suffering from chronic glomerulonephritis (GN), confirmed by punch biopsy of the kidney. HBs antigen (Ag) was found in the sera of 5 patients, whereas anti-HBs and/or anti-HBc antibodies were found in 3 others. Of the 139 subjects carrying HBsAg or anti-HBc antibodies 117 suffered from chronic liver disease and 3 from chronic GN. Of the 11 patients afflicted with chronic GN and one with a hepatitis B virus (HBV) infection 9 had GN with IgA deposits and the other 2 had membranoproliferative GN. The renal tissue of these 11 patients was examined for the presence of HBs. HBc and HBe antigens using monoclonal antibodies. Virus particles were unsuccessfully sought by electron microscopy. It is possible that, in some patients infected with HBV and afflicted with chronic liver disease, the IgA deposits in the glomeruli result from the perturbed liver metabolism.

Adult↗
PubMed1989

[Hormonal aspects in the diagnosis of hirsutism].

Hormones of hypophyseal-adrenal axes were determined in 135 girls with hirsutism. On the basis of changes in the hormonal levels it was established that the syndrome of Stein-Leventhal in 62 girls (54% of the patients) was dependent on luteinizing hormone (LH) and was characterized by an increased index of LH/FSH over 3.0 as well as by an increased level of testosterone; hirsutism in 73 girls (67% of the patients) was dependent on adrenocorticotropic hormone (ACTH) and was characterized by an increased level of ACTH and cortisol secretion; in the remaining patients hirsutism was a combination of both forms of dependence on LH and ACTH and an increase of hormones of both axes was present or was idiopathic with normal hormonal plasma levels, but with increased skin conversion and metabolic testosterone clearance.

Adolescent↗
PubMed1989

[Chronopharmacokinetics of the preparation biomet400 in patients with duodenal ulcer].

Biomet400 is a selective H2-blocker produced by the firm "Pharmacia" of the Bulgarian Medical Academy. 11 patients were treated with the drug in a dose of 400 mg taken orally in the morning or in the evening. The pharmacokinetic analysis revealed a slower resorption of cimetidine in the patients who had taken the drug in the evening (Tmax = 2 h, resp. 1.67 h) and a lowered Cmax (1.96 micrograms/ml, resp. 2.79 micrograms/ml) in comparison with the patients who had taken the drug in the morning. In the patients who had taken the drug in the evening the apparent volume of distribution is statistically significantly higher (242 l, resp. 124 l by the morning administration) and a tendency toward a slower elimination than by the morning administration is found (t1/2 = 4.41 h, resp. 3.89 h). In the patients who had taken the drug in the morning the elimination is mainly by renal excretion (Clr = 405 ml/min, resp. 3.29 ml/min for the evening administration) while in the patients with evening administration the nonrenal clearance prevails (Clnr = 534 ml/min, resp. 339 ml/min). The results indicate the presence of chronopharmacokinetic differences in the cimetidine action and they can explain the better chronotherapeutic results of the treatment with biomet400 administered in the evening.

Administration, Oral↗
PubMed1987

Nabumetone (BRL 14777) presystemic elimination and disposition in patients with liver impairments.

The effect of presystemic elimination of nabumetone disposition was evaluated in 6 cirrhotic patients after oral administration of a single dose of 1000 mg of the drug. The data revealed the major role of hepatic metabolism in the removal of the drug from the body. The relatively high values of hepatic plasma excretion ratio (= 0.60 +/- 0.04) and of the total intrinsic clearance (= 90.74 +/- 15.87 l/h) places nabumetone between drugs with intermediate properties; clearance being partly dependent on plasma (blood) flow rate and on the hepatic metabolism whose systemic availability was 32% of the dose. Very good coincidence was obtained when ranging patients according to morphological evaluation of liver impairments was compared to the values of nabumetone disposition parameters. There was a statistically significant positive correlation (r = 0.831, p less than 0.05) between the fraction of the dose reaching the systemic circulation, f, and the gamma-GT "normalization index" (i.e., ratio between the observed decrease of serum gamma-glutamyl transpeptidase activity and the pretreatment difference from the upper normal value). A definite interpretation of the data cannot be provided until more knowledge about the effect of 6-mO-2-naphthylacetic acid on nabumetone metabolism is available.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1987

[Successful therapeutic effect on periodic disease with the intermittent use of colchicine].

The continuous application of colchicine reduces considerably the incidence of the paroxysms in patients with periodic disease. A patient is described, a Bulgarian, with periodic disease with a duration of 40 years (family Mediterranean fever), successfully treated with intermittent application of colchicine according to a schedule for the last 3 years. The evolution of the clinical manifestations was followed up as well as the absence of effect by the corticosteroid therapy applied before. The intermittent application of colchicine, in this case, prevents totally the paroxysms with high temperature and pain in abdomen, chest and joints with a considerable smaller amount of the drug applied. The intermittent application of colchicine should first be tried in the treatment of patients with periodic diseases.

Colchicine↗
PubMed1987

On the mechanism of the smooth-muscle action of rosanol.

In vivo and in vitro experiments were performed to clarify some aspects of the mechanism of the smooth-muscle action of rosanol prepared from rose oil. On dogs (in vivo) and on isolated segments from guinea-pig ileum (in vitro) rosanol at high doses exerted a slight inhibitory effect on the activated gastrointestinal motility. The cholinolytic rosanol action proved in in vitro experiments, was found to play an essential role in the mechanism of its gastrointestinal motility-inhibiting effect. The present studies showed a pronounced antagonistic effect of rosanol on the KCl-increased Ca2+ level in rabbit aorta. It might be suggested that this effect of rosanol is also involved in the inhibitory action of rosanol on the activated gastrointestinal motility.

Animals↗
PubMed1986

[Hepatocellular carcinoma--its echographic characteristics and diagnostic potentials].

Echography is an approved method for establishing focal processes in liver. Forty five patients, from Bulgaria and Kuwait, with confirmed hepatocellular cancer (HCC) were studied by echographies aiming at the elucidation of the possibilities of ultrasound examination in making the diagnosis of HCC in patients with and without cirrhosis of the liver. Five types of images have been established--hyperechogenic (29%), hypoechogenic (27%), mosaic (24%) mixed (11%) and type "bovine eye" (9%). The echographic characteristics that could suggest the character of the lesion are low-echogenic zone in the periphery and non-homogenous (mosaic) tissue structure. HCC, in 55.6 per cent of the patients, proved to be with multiple localization in liver. The comparison of the patients from Kuwait and Bulgaria revealed no differences in the mean age, carriership of HBsAg, but in the latter--the HCC was significantly more often combined with cirrhosis of the liver. Serum alpha-fetoprotein was increased in 15 out of 20 patients with HCC. The establishment of the tumour in part of the patients by ultrasound initially, suggests that echography is a useful method for the early diagnosis of HCC and for a systematic follow up of the patients with cirrhosis of the liver. Guided fine-needle biopsy was performed in 15 patients, and in 86.7 per cent of the cases--accurate cytologic diagnosis was obtained. Echography, combined with guided biopsy and determination of alpha-fetoprotein, guarantee in a considerable part of the cases, also the correct diagnosis of HCC in patients with and without cirrhosis of the liver.

Aged↗
PubMed1986

Infection with hepatitis delta virus in patients with fulminant hepatitis B and chronic HBsAg carriers in Bulgaria.

To evaluate the prevalence and clinical significance of delta infection in a Bulgarian population, 105 HBsAG positive patients with chronic liver diseases, and 42 patients who had died of fulminant hepatitis B were studied. Delta antigen was detected by direct immunofluorescence in the liver of 9 patients with chronic HBV infection (8.6%), and in 3 patients with fulminant hepatitis (7.14%). All chronic HBsAg carriers with delta superinfection had chronic active hepatitis or active liver cirrhosis. They were predominantly anti-HBe (+) in the serum. The mean age and the mean values of serum transaminase did not differ in delta antigen positive and negative patients with chronic liver diseases. A history of parenteral manipulations directly before the hepatitis was present in patients with delta antigen positive fulminant hepatitis. These results indicate a relatively low incidence of delta infection in our population, but it is invariably associated with severe liver disease.

Adult↗
PubMed1986

Liver insufficiency as a factor modifying the pharmacokinetic characteristic of the preparation nabumetone.

The effectiveness of the nonsteroidal anti-inflammatory agent nabumetone is related to the formation of an active metabolite: 6-methoxy-2-naphthylacetic acid. The plasma concentrations of nabumetone and its active metabolite, after administration of 1,000 mg single dose p.o., are followed at 0, 0.5, 1, 2, 4, 6, 8, 12, 24, 30 and 48 h in 6 patients with laboratory evidence for functional liver insufficiency caused by liver cirrhosis, confirmed by biopsy. In the patients with liver insufficiency the mean values of Cmax and AUC0-24 h for 6-methoxy-2-naphthylacetic acid were 26.75 +/- 8.45 mg/l and 623.64 +/- 161.8 mg X h/l respectively. They did not differ significantly from the values observed in healthy volunteers [v. Schrader et al. 1983]. The Tmax-value was prolonged to 8 h, compared to 4 h Tmax-value of the volunteers. There is a tendency towards a reduced bioavailability of 6-methoxy-2-naphthylacetic acid after nabumetone administration in patients with a more severely expressed pathologic impairment, compared to patients with slight morphologic changes of the liver parenchyma.

Aged↗
PubMed1983

[Significance of high titers of various autoantibodies in the diagnosis and monitoring of chronic liver diseases].

The diagnostic value of the high antibody titres are assessed in the work--namely antinuclear, antimitochondrial and antismooth-muscular, in chronic liver diseases. For that purpose 220 patients with morphologically confirmed chronic hepatitis and chronic liver cirrhosis were examined. Twenty three of them proved to have high titre antibodies. It was established that the females predominated in that group--20 out of 23. The high titre of autoantibodies correlated with the morphological data for the activity of the liver injury. No connection was established with the presence or absence of HB-virus markers in the cases with high titres of ASMA. HB-virus markers were found in none of the eight patients with high titres AMA. One of the six patients with high titres ANA had HBs-antigenemia. In the patients with high titres of autoantibodies, hyperimmunoglobulinemia, class IgG was most often established, whereas IgA and IgM were found almost with the same incidence in normal and elevated values. There were enzymologic data about hepatocytolysis and cholestasis in the majority of the cases. ASMA titre decreased in parallel with the decrease of the activity of the morbid process under the treatment effect.

Adolescent↗
PubMed1983

[Serum gastrin levels before and after short-term treatment of duodenal ulcer with cimetidine and pirenzepin].

Serum gastrin was studied before meals in 71 patients with duodenal ulcer, treated with various doses of simetidin and pyrensepin. Gastrin level was elevated after a treatment with 1 g simetidin daily and 125 mg pyrensepin, and remained unchanged with pyrensepin treatment (50 and 100 mg daily). A tendency to decreased gastrin level was observed after the treatment with simetidin 400 mg daily. Under those circumstances the attempt at duodenal ulcer treatment with lower simetidin doses, than the usual, is justified.

Adult↗