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Biomedical subjects

B Marinov

Publications and source records attributed to B Marinov.

At least 19 recordsLinked to original sources

[A case report of two incidents of acute abdomen in a woman during pregnancy and in the early puerperium].

The authors present a case of a 32 year old pregnant woman who is admitted to the Obstetric clinic in the 16th gestational week with a pain in the ileoceacal region of the abdomen and vomitting. The woman has clinical signs of acute abdomen. A clinical diagnosis of acute appendicitis was suggested. During the operation under general anesthesia was found a phlegmonous inflammation of a Mekel diverticulus with perforation as well as local peritonitis and a catharal inflammation of the appendix. The appendix and the Mekel diverticle were removed during the operation. No comlications were observed during the post operative period. No fetal distress was observed during and after the operation Three months later the same patient was admitted to the obstetric clinic in the 32nd gestational week with a diagnosis Threatened premature delivery in ml VIII status post resection of a Mekel diverticle and appendectomy. The patient had pain to the right of the umbilicus and vomiting. The labor was induced and a viable premature infant was born. Two days after delivery there was again a clinical symptoms and signs of an acute abdomen due to ileus. A strangulation of the terminal ileum was found due to adhesions A Debridman and a lavage were performed No complications were observed during the postoperative period. The authors discuss the difficulties which might ensue when the diagnosis acute abdomen is made in a pregnant woman

Abdomen, Acute↗

[The incidence of foetal macrosomia and method of delivery for a two-year period in the University Hospital of Obstetrics and Gynecology Maichin Dom--Sofia].

The authors carried out a retrospective study on the incidence of foetal macrosomia and the method of delivery on the 6157 consecutive births for a two-year period in the University Hospital of Obstetrics and Gynecology "Maichin Dom"- Sofia, Bulgaria. The incidence of foetal macrosomia (birth weight > 4000 g) among these births was 4,45% (274/6157 births). There was a coincidence between the admission diagnosis Macrosomia and the birth weight only in 8% of the cases. By Cesarean Section were delivered 117 macrosomic babies (42,7%): elective cesarean section had 89 patients - 32,48% (89/274) and emergency Cesarean section was done in 28 cases -10,2% Vaginal delivery had 157 patients - 57,3%. In this group 136 patients (86,33%) had normal vaginal delivery and 21 (13,37%) had operative vaginal delivery. (vacuum extractor, forceps, manual removal of the placenta). The authors found that the highest incidence of birth trauma was found in the cases where operative vaginal delivery was undertaken.

Bulgaria↗

[Pulmonary embolism and disseminated coagulopathy syndrome after first trimester termination of pregnancy--a case report].

We present a rare case report of first trimester termination of pregnancy by suction curettage because of missed abortion complicated by pulmonary thrombembolism and disseminated coagulopathy. The diagnosis was confirmed by clinical, sonographical and laboratory means. The relative risk of such complications after first trimester termination of pregnancy is discussed.

Abortion, Missed↗

[Three years experience of using mycosyst].

The aim of this study was to estimate therapeutical potentialities of the Mycosyst (Fluconazole) preparation, of the Gedeon-Richter company (Budapest, Hungary), in women with data for mycotic colpitis. 157 patients for three years period (April 2001-2004) were included in this study. Two groups of patients were formed. In 104 patients mycotic colpitis was diagnosed during curettage for feticide or missed abortion. Another 53 women were treated for mycotic colpitis unrelated to pregnancy. Complains of the patients disappear by the 48-th hour and in almost all women there were not complaints by the 4-th day. The most quickly were influenced itching, discomfort, erythema and dyspareunia and slowly and hardly discharge had been influenced. Mycosyst is a broad spectrum antimycotic agent of bistriazol type. It has good absorption and tissue saturation. 1-2 hours after oral administration maximal plasma concentration is achieved. Plasma half life is about 30 hours. This gave us opportunity for single or two doses Mycosyst for vaginal candidosis treatment. Use of two doses of 150 mg. was enough for acute forms treatment in almost 95% of cases. Mycosyst is sure, easy for use broad spectrum antimycotic from the azole group. This preparation is comparatively cheep and in the average Bulgarian income possibilities.

Abortion, Therapeutic↗

[Utrogestan and high risk pregnancy].

Utrogestan is a modern progesterone, which shows maximal effectiveness with minimal side effects. It is a natural progesterone in micronized form, which makes it suitable for oral administration and vaginal application with same effectiveness. The aim of our retrospective study was to evaluate the therapeutical effects of Utrogestan in women with threatened abortion in the first trimester. Our experience dated from about one year and a half. Sixty eight women were treated for threatened abortion with a daily dose of 400 mg Utrogestan. The treatment continued at least 14 days/average 21 days/. Utrogestan was administered orally twice daily. The main indications were first or consecutive threatened spontaneous abortion in first trimester. For the period of time no side effects and subjective complaints were established except particular cases of slight headache and dizziness after morning application. Sixty one of the sixty eight women were dehospitalised with healthy pregnancy with no side effects. In our experience we preferred to use the drug in women with lutein insufficiency before pregnancy. We conclude that Utrogestan can be widely applied in Obstetrics with the proper indications, such as threatened abortion in the first trimester. The prophylactic treatment in women with slighter complaints like dull pain and weight Utrogestan is applied one tablet twice daily. In graver cases the starting dosage is two tablets two or three times daily.

Abortion, Threatened↗

[Our experience in the application of local contraceptives].

The aim of this preliminarily study is to be assessed contraceptive action and possible side effects during application of spermicide Pharmatex, product of Laboratoire Innotech International (Paris, France). made for local contraception in form of globules and cream. 33 women between 21-38 years old were included in this study. The patients were in a period of one or more months after normal delivery (16 cases) or operative delivery(Caesarean section - 17 cases), most of them breastfeeding. The local contraceptive was preferred because of more rare sexual intercourse after delivery, influence of the oral contraception over breastfeeding and contraindication of IUDs in such cases. Pharmatex was applied for 6 and more months. It was not establish a case of pregnancy. In two of women at the beginning of the study was reported slight discomfort and dyspareunia, which gone further on. It was not necessity of stopping applications of the product. Discussed are mechanism of action, the way and indications for application of Pharmatex. Pharmatex is easy for use, with proven contraceptive action, insignificant side effects and antibacterial, antiviral and antimycotic properties. Specially appropriate in women with episodic sexual activity, in period after delivery and women, contraindicated for OC and IUDs.

Adult↗

University of Cincinnati Dyspnea Questionnaire for Evaluation of Dyspnoea during physical and speech activities in patients with chronic obstructive pulmonary disease: a validation analysis.

University of Cincinnati Dyspnea Questionnaire (UCDQ) was developed to measure the impact of dyspnoea during (1) physical activity (Phys), (2) speech activity (Speech) and (3) simultaneous speech and physical activity (Comb). The aim of this study was to evaluate the validity of UCDQ in COPD patients, comparing it to a large set of dyspnoeic indices and functional parameters. Fifty COPD patients (age 58.7 +/- 9.1 years, FEV1%pred = 39.3 +/- 17.0%, Baseline Dyspnoea Index (BDI) = 4.9 +/- 2.5, Six Minute Walk Distance (6MWD) = 373 +/- 128 m, Symptoms score = 9.4 +/- 2.5; mean +/- SD) participated in the study. We found the following mean scores for the three sections of the questionnaire: Phys = 3.5 +/- 0.9; Speech = 2.4 +/- 1.1; Comb = 4.2 +/- 1.0, meaning that patients report the most breathlessness during the combination of speaking and physical activity and the least breathlessness during speech activities. All three section of UCDQ had significant strong correlation with dyspnoea indices (BDI, Borg, MRC, OCD), 6MWD and symptoms score, which proves its concurrent and construct validity. Differentiation of patients by speech section (=3<) discriminated them significantly with respect to all dyspnoeic indices, symptoms score and 6MWD. All three dimensions of UCDQ had high test-retest reliability - ICC between 0.76 and 0.93. Factor analysis yielded three interpretable factors, as all dyspnoeic indices, three sections of UCDQ, symptoms score and 6MWD were loaded on the first factor. In conclusion, UCDQ provides valid and reliable information about the effect of dyspnoea on speech and daily activities.

Aged↗

[Some opportunities for the application of the drug mycosyst (preliminary communication)].

The colpitis is one of the most frequent gynaecological disease. The different methods of treatment of colpitis are a matter of discussion in many specialized studies. The aim of our retrospective study was to evaluate the therapeutic effects of Mycosyst (Fluconazol), produced by the pharmaceutical company Gedeon Richter (Budapest, Hungary), on women with acute fungal colpitis. The experience dated from about eight months (April--December 2002) with 27 patient with anamnestic, clinical, microscopic and microbiological data of fungal colpitis. Women were divided into two groups: 16 patients with diagnosed fungal colpitis at the time of interruption of pregnancy and 11 patients with this complaints not related to pregnancy. The therapeutic scheme is 150 mg Mycosyst as a single dose. The subjective complaints began to disappear 48 hours after the administration and were completely eliminated in almost all cases four days later. The medicine has a very fast effect on pruritus, erythema and urinary complaints, and a little bit slower influences the vaginal fluor. Some good pharmacodynamic and pharmacokinetic parameters of Mycosyst are: fast and complete absorption in gastrointestinal tract, long plasma life, elimination by the kidneys without being metabolized, doesn't affect the plasma concentration of steroids and testosterone, high and long terming concentration in each stratum of skin, nails, vaginal secretion and saliva. Our conclusion is that Mycosyst is reliable, easily applied broad-spectrum azol antifungal. The single dose of 150 mg is sufficient for treatment of acute fungal colpitis in almost 90%. The medicine is comparatively cheap and accessible.

Adult↗

Modified treadmill protocol for evaluation of physical fitness in pediatric age group--comparison with Bruce and Balke protocols.

The aim of this study was to compare classical Balke and Bruce protocols with our modification of Balke protocol in pediatric cardiorespiratory diagnostics. The modification of Balke consists of nine stages per 1 min at a constant velocity of 5.6 km x h(-1) and increasing elevation from 6% to 22% in 2% increments. Sixty healthy children (mean age = 13.3+/-0.2 years; BMI = 18.8+/-0.6 kg x m(-2); mean +/- 95% CI), divided into three groups of 20 children each, matched by age, height and BMI performed integrative cardiopulmonary exercise testing using one of the treadmill protocols mentioned. At the end of each exercise increment and throughout the recovery period the children were asked to rate the perceived exertion (RPE) using the Borg Category Ratio scale--CR-10. Exercise results showed that Balke protocol had the longest duration (21.7+/-0.6 min.) and the lowest values for VO2/kg (34.2+/-1.8 ml x min(-1) x kg(-1)) due to the minimal workload increments. Bruce protocol had intermediate duration (14.9+/-1.1 min.) and children achieved the highest VO2/kg (48.6+/-2.7 ml x min(-1) x kg(-1)) but the test is symptom-limited which is ethically unacceptable in childhood. Exercise data revealed that our modification of the classical Balke protocol had an optimal duration (11 min.) and yielded peak VO2/kg values (39.4+/-2.3 ml x min(-1) x kg(-1)) adequate for evaluation of children's exercise capacity. Children's ratings of perceived exertion were highest in Bruce protocol (6.5+/-0.4) and lowest in the original Balke protocol (4.5+/-0.8). In conclusion, the modification of Balke protocol is suitable and reliable for screening and clinical testing in pediatric age group.

Adolescent↗

Exercise performance and oxygen uptake efficiency slope in obese children performing standardized exercise.

Oxygen uptake efficiency slope (OUES) is an index meant to provide an objective measure of cardiopulmonary function at submaximal exercise. The aim was to study the exercise performance and OUES in obese children performing standardized exercise. Sixty children aged 6-17 years performed incremental treadmill exercise test. They were divided into two groups matched by age, sex and height: thirty obese subjects (15 girls/15 boys; BMI = 27.4+/-1.7 m x kg(-2)) and 30 controls (BMI = 18.8+/-1.0 m x kg(-2)). Perceived exertion was assessed by means of CR-10 Borg scale. The duration of the exercise for the obese children was significantly shorter than for controls (p = 0.010) but obese children had greater absolute values for oxygen uptake (VO2 peak mL x min(-1) = 1907+/-249 vs. 1495+/-208; p = 0.013) which, adjusted for body mass, decreased significantly (VO2/kg mL x min(-1) x kg(-1) = 29.2+/-1.4 vs. 33.6+/-1.3; p < 0.001). OUES correlated strongly with VO2 peak (r = 0.91) and oxygen pulse (r = 0.80), as well as with anthropometric variables height (r = 0.88) and age (r = 0.83). Extremely high correlation was found between OUES calculated for 100% of exercise duration and OUES at the anaerobic threshold (r = 0.979; p < 0.001). No significant differences were found between the studied groups concerning the absolute values of OUES. Obese children rated perceived exertion significantly higher than controls (Borg score 6.2+/-0.4 vs. 5.2+/-0.4; p = 0.001). In conclusion, the absolute metabolic cost of exercise and perceived exertion were higher in the obesity group. OUES is an objective measure of cardiopulmonary reserve that doesn't require a maximal effort but it is considerably dependent on anthropometric variables which impedes its interpretation as exercise index in childhood.

Adolescent↗

Ventilatory efficiency and rate of perceived exertion in obese and non-obese children performing standardized exercise.

Sixty children, in the age span 6-17 years originally divided into two groups, matched by age, sex and height--30 obese subjects [15 girls/15 boys; body mass index (BMI) = 27.4 +/- 4.5 m kg-2; ideal body weight (IBW) range = 122-185%] and 30 controls (BMI = 18.8 +/- 2.7 m kg-2) performed incremental treadmill exercise test. Perceived exertion was assessed by means of Category-Ratio Borg scale. The duration of the exercise for the children in the obesity group was significantly shorter than controls (P = 0.010) but obese children have greater absolute values for oxygen uptake (VO2peak ml min-1 = 1907 +/- 671 versus 1495 +/- 562; P = 0.013) and ventilatory variables (VE, VT), which adjusted for body mass decrease significantly (VO2/kg ml min-1 kg-1 = 29.2 +/- 3.8 versus 33.6 +/- 3.5; P < 0.001). Among the various methods for 'normalizing' absolute values of VO2peak for body size, dividing it by body surface area (BSA) yielded the best results (VO2/BSA ml min-1 m-2 = 43.5 +/- 4.6 versus 44.7 +/- 5.6; P = 0.335). The ventilatory efficiency determined either as a slope of VE versus VCO2 or as a simple ratio at anaerobic threshold did not differ between obese and non-obese children in the incremental and recovery periods of exercise. There was a negative correlation of VE/VCO2 slope with age and anthropometric parameters. Obese children rated perceived exertion significantly higher than controls despite the standard workload (Borg score = 6.2 +/- 1.2 versus 5.2 +/- 1.1; P = 0.001). In conclusion, the absolute metabolic cost of exercise is higher in the obesity group compared with the control subjects. Both groups have similar ventilatory efficiency but an increased awareness of fatigue that furthermore limits their physical capacity.

Adolescent↗

[Pregnancy complicated by ovarian cysts].

OBJECTIVE: To study outcome of pregnancy complicated by ovarian cysts, clinical behavior of functional cysts, efficiency of conservative and operative management during pregnancy and labor. MATERIAL AND METHODS: Twenty-three women with diagnosed ovarian cysts less than 5-6 cm in the early first trimester of pregnancy were followed by a two year period (1999-2000). Relationship between the sonographically change of cysts and pregnancy outcome was determinate. RESULTS: In a group of 23 women with ovarian cysts, 16 were successful pregnancies as followed: 12 ended in normal vaginal deliveries and 4 delivered by cesarean (1 obstetric indicated; 2 persisted cysts--serous and mucinous custadenoma; 1 after operated in 18 gest. Week border line cystadenoma). Of the last 7 pregnancies were operated and 3 electively terminated (1 blighted ovum and 2 missed abortions). CONCLUSION: Ovarian cyst in first trimester of pregnancy with maximum size 5-6 cm usually were reached until the 7-8 week, maybe followed by functional corpus luteal cysts, involuated until 14 gest. Week, rarely persisting and isn't expected to grow after 14 gest. Week or to cause complication in pregnancy and labor.

Abortion, Induced↗

[Complex effects of cavinton on climacteric symptoms].

The use of nonhormonal drugs in order to ameliorate climacteric symptoms makes it possible to treat also those women in whom there are some contraindications or lack of compliance for taking hormonal replacement therapy. The drugs with complex effects on the whole body functions are more widely used recently. The aim of the present study is to assess the therapeutic effect of Cavinton (vinpocetin) on the degree of climacteric symptoms and to verify its complex beneficial influence. The study comprises of three groups of women in early menopause--control group (n = 30), treatment groups with normolipidaemia (n = 32) and with hyperlipidaemia (n = 29). All women presented with moderately expressed climacteric symptoms as assessed by Kupperman menopausal index and Hamilton-Anxiety-Skala (HAMA). The women in the 2nd and 3rd groups have been taking Cavinton in an oral dose of 5 mg three times daily for 3 months. The following parameters of lipid metabolism were determined in the beginning and at the end of the study: total, HDL- and LDL-cholesterol, triglycerides, and two indexes of lipid atherogenic risk--total/HDL-cholesterol ratio and atherogenic index (AI) = total--HDL/LDL-cholesterol. The menopausal complaints were assessed by Kupperman index and HAMA. Blood vessels reactivity was determined by pulsation index (PI). Statistically significant decrease in total cholesterol and LDL-cholesterol levels as well as amelioration of atherogenic indexes was observed in the 3rd group. Kupperman index and HAMA decreased significantly on the 45th day and the 3rd month in the women under treatment. No significant changes in PI were observed but a tendency towards a decrease was seen in the 3rd group. Our data suggest that Cavinton possesses complex beneficial effects in climacteric women significantly ameliorating climacteric symptoms as well as some parameters of lipid metabolism in women with hyperlipidaemia.

Administration, Oral↗

[Possibilities for an individualized approach to the treatment of climacteric symptoms with phytoestrogens].

UNLABELLED: In climacteric women with contraindications and fear or lack of compliance for taking hormonal replacement therapy as well as in those cases where risks exceed benefits, the use of phytoestrogens is appropriate having in mind their especially good effect on neurovegetative symptoms. AIM: The present randomized prospective study is aimed at estimating the possibility for ameliorating climacteric symptoms with Melbrosia and at assessment of its effect on different symptoms in order to individualize the therapeutical approach. PATIENTS AND METHODS: Two groups of women with climacteric complaints were followed-up--control group (n = 32) and treatment group (n = 34). Climateric symptoms were assessed in the beginning and at the end of the study using Kupperman menopausal index. The levels of FSH, LH, oestradiol as well as some parameters of lipid metabolism were determined. RESULTS: A significant decrease of Kupperman index was observed in Melbrosia treatment group in contrast to the control group. No significant changes in gonadotropins, oestradiol and lipid parameters were found in both groups. CONCLUSION: The preparation Melbrosia, consisting of phytoestrogens and amino acids exerts a good therapeutic effect on climacteric symptoms mainly on the nervousness, anxiety, irritability, headache, and hot flashes.

Amino Acids↗

[The copper concentration in the blood serum of women with ovarian tumors (a preliminary report)].

The aim of the present study was to evaluate serum copper concentration changes in patients with benign cysts or carcinomas of ovary, and to compare these concentrations with the normal reference serum copper levels. Patients included in the study were as follows: benign ovarian cyst cases (n = 19), endometrial cyst cases (n = 5), ovarian carcinoma cases (n = 6), female patients with no ovarian disease (n = 161). Reference serum copper levels in apparently healthy subjects were 16.8 +/- 4.15 mumol/l (mean +/- SD). Serum copper concentration were significantly increased in ovarian carcinoma patients (22.98 +/- 3.90 mumol/l) in comparison with benign cyst patients (18.40 +/- 4.61 mumol/l) (p < 0.05), in with endometrial cyst patients (15.94 +/- 4.24 mumol/l) (p = 0.02), and in comparison with normal levels in controls (p < 0.001). Copper/zinc ratios were highest in ovarian carcinoma patients--1.68, intermediate in benign cyst patients--1.42, and lowest in endometrial cyst patients--1.08. The mechanisms underlying serum copper concentration variations in the different groups are briefly discussed with special emphasis on these in ovarian carcinoma patients.

Biomarkers, Tumor↗