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Biomedical subjects

A Nachev

Publications and source records attributed to A Nachev.

11 recordsLinked to original sources

[Laparoscopic hysterectomy--the initial experience in Bulgaria].

The paper presents the first cases of laparoscopic-assisted vaginal hysterectomy and laparoscopic hysterectomy with removal of the uterus through the vagina performed in Bulgaria as well as the experience gained by the team from II gynaecology clinic at State University Hospital "Maĭchin dom" in Sofia from seven patients operated on by these techniques. The indications, the conditions and the implemented technique with its advantages and difficulties are described. The procedures are associated with less trauma and blood loss than abdominal surgery and are followed by a very smooth postoperative period which is very well tolerated by the patients. No intraoperative complications occurred. The postoperative period was free of any problems in 5 of the patients while in two there were minor complications. Marked shortening of the duration of the procedures is achieved with the initial experience.

Adult↗

[The use of cefotetan for the prevention of infectious postoperative complications in gynecology].

The study presents the results from the use of cefotetan for perioperative prophylaxis in 43 gynaecology patients compared with 29 controls without perioperative antibiotic prophylaxis with similar diseases and operations. Both groups show equal percentage of the cases with smooth postoperative period (70 and 72% respectively). 13 of the patients on cefotetan prophylaxis received additional antibiotic treatment (9 because of temperature up to 37.5 degrees and 4 because of temperature from 37.6 to 38.5 degrees). Mo major infections postoperative complications occurred among the patients on cefotetan prophylaxis. 8 of the non-prophylacted patients needed antibiotic treatment postoperatively including 4 with temperature above 38.5 degrees. Two infections of the operative wounds also occurred in the same group. The conclusion is that cefotetan effectively prevents the major infection postoperative complications in gynaecology. The administration of additional antibiotic treatment is most often not warranted.

Adolescent↗

[The CO2 laser treatment of extensive skin changes to the vulva caused by the human papillomavirus (HPV) and refractory to other types of therapy].

The authors describe three cases of large vulvar lesions caused by HPV. One patient has condylomata covering entirely the labia majora and minora, the clitoris, the perineum and the perianal area. The lesions made the structures of the vulva hard to distinguish. She was treated with podophyllin, Solcoderm and diathermy without effect. After 2 applications of Laser vaporisation 40 days apart she was completely cured. The other patient had two big squamous papillomata 3.5 by 3.5 cm and 0.5 cm thick situated on both sides of commissura posterior. She was also treated unsuccessfully with Podophyllin, Solcoderm and surgical excision. She was completely cured by a single-stage CO2-laser treatment. The third patient had condylomata acuminata of the labia minora and majora, fossa navicularis, the perineum and the perianal area. No other treatment had been attempted before. After two sessions of laser vaporisation she was cured, too.

Adolescent↗

[A case of mesenteric thrombosis occurring in a woman with a uterine myoma during her hospital stay].

The paper describes a case of a 40-year old woman who presented with complaints of crampy abdominal pain, weight loss, hypermenorrhea, anaemia, fever and peritoneal effusion which were attributed to a large solid pelvic tumour. During the preoperative investigations she had an attack of acute abdominal pain with bloody diarrhea assumed to be caused by gastrointestinal infection. The attack ceased quickly after intravenous infusions and antispasmodics were started. Several days later a second even stronger attack of abdominal pain with evidence of intestinal obstruction necessitated urgent laparotomy which revealed extensive necrosis of the small intestine with a coexistent large uterine myoma. A resection of the small intestine with a side-to-side anastomosis and hysterectomy with bilateral salpingo-oophorectomy were performed. The patient had an uncomplicated recovery gaining weight but still experienced mild discomfort after meals. The symptoms, the diagnostic difficulties as well as the therapeutic approaches in mesenteric ischaemia are discussed.

Acute Disease↗

[Gynecological operations in high-risk patients (a preliminary report)].

The incidence of post-operative complication has been studied in women with concurrent nor-gynaecological and gynecological diseases, such as: vascular diseases (varices, phlebothromboses, thrombophlebitis), hypertension, changes in cardiac status (age-associated. Angina pectoris, cardiac decompensations). ECG changes,valvular defects, increased blood sugar, pulmonary diseases, etc. The study was held retrospectively over 326 female patients who had undergone operations for the period 1992-1993.

Adult↗

[The treatment of urinary stress incontinence with the sling and Pereyra's suspension].

Patients with proven stress incontinence were subjected to surgical treatment which combined both sling and Stamey-Pereyra techniques. A 3-4 cm long and 1,5-2 cm wide sling of Bulgarian polyamide mesh was placed under the urethrovesical junction using a small vaginal incision. Two long polyamide sutures were tied to either end of the mesh and were retrieved from the vagina to the abdomen by Pereyra needle inserted through two small suprapubic incisions and guided by the vaginal forefinger. The technique of the procedure is described. A total number of 27 patients were operated on. Two of them has their suspending sutures cut postoperatively because of prolonged urinary retention. The remaining 25 were continent. The technique proposed combines the advantages of the sling procedures (high efficiency especially in cases of severe and recurrent incontinence) and the simplicity of Stamey-Pereyra suspension technique. On the other hand the Bulgarian polyamide mesh showed very good qualities. No infection, rejection or sling erosion were observed.

Adult↗

[The role of serum beta-HCG levels for the diagnosis of ectopic pregnancy].

The study includes 56 cases of women admitted at Second gynaecology clinic of the University Maternity Hospital Sofia with evidence or suspicion of having an ectopic pregnancy who had their serum beta-HCG levels determined quantitatively. 27 of them showed no beta-HCG in their sera and none turned out to have pregnancy, neither intrauterine nor ectopic. All cases of ectopic pregnancies (a total of 20) were associated with detectable beta-HCG levels in the serum. The great diagnostic value of serum beta-HCG is emphasized in the cases of old disturbed ectopic pregnancies accompanied by mild and uncommon symptoms and very low beta-HCG levels. In case of unruptured pregnancies or tubal rupture the diagnosis is verified before the result is available by the clinical and sonographic data. On the other hand the high sensitivity of the method leads to an increased number of cases with elevated beta-HCG in which the location of the pregnancy cannot be proven. The precise quantitative evaluation of serum beta-HCG enables us to follow the tendency of beta-HCG which may according to the clinical manifestations warrant invasive diagnostic procedures or just observation without active interference.

Abortion, Spontaneous↗