[The diagnostic problems in duodenogastric reflux and reflux gastritis].
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Biomedical subjects
Publications and source records attributed to D Dimov.
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The model of a total duodenal-gastric reflux was developed in 20 dogs and morphological changes in the stomach were studied. 5 dogs served as control. Histologic changes occurred 3.5 months and 1 year after the operation were characterized by metachromasia, increased mucus formation, proliferation of epithelial and parietal cells, moderate inflammation. Process of the disease had fluctuations. 6 months after the operation 5 dogs were reoperated for the elimination of reflux and were observed for another 6 months. A complete reversibility of all changes was established. Bacteriological studies showed a considerable increase of bacteria population in the stomach and a pH increase. The authors suggest the term 'reflux gastropathy" to replace the term "alkaline reflux-gastritis".
The data available in the literature on the incidence of duodenogastric reflux and its relation with diseases of the stomach and duodenum are controversial. A study was performed based on the results of 4256 primary endoscopies of the stomach and duodenum: 3673 in nonoperated patients and 583 in patients having undergone vagotomy and resection. For duodenogastric reflux one judged from the yellow coloration of the gastric juice and regurgitation of bile at the moment of examination. Reflux had 428 patients (10.05 per cent)--330 in the nonoperated group (8.98 per cent) and 98 in the operated group (16.81 per cent). Inference is drawn that duodenogastric reflux does not coincide in incidence with reflux gastritis and that causal relation might be searched between gastritis, reflux esophagitis and duodenitis, on the one hand, and duodenogastric reflux, on the other.
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A vast literary review on Q-rickettsial endocarditis is presented--spread, frequency, predilection, clinical course, laboratory findings, diagnosis, treatment, prognosis. The first case of Q-rickettsial endocarditis in Bulgaria is reported. The case was proved by the high titre of the specific antibodies while the patient was still alive and post mortem by visualizing the causative agent in the aortic valve and by its isolation through inoculation of material from the aortic valve. The infection was not influenced by high doses of penicillin, gentamycin and brulamycin but was suppressed by vibramycin in combination with lincomycin and biseptol. The lethal outcome was due to severe heart failure. It is suggested that other cases of Q-rickettsial endocarditis should be expected since Q-fever is widely spread in Bulgaria and the characteristics of the disease, its diagnosis and treatment ought to be well known.
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Serum activity analyses of nine enzymes [CPK, HBDH, SDH, ALP, GPT, GOT, LDH, MDH, ALD] in patients with rheumaitc carditis revealed certain elevations of the mean values of LDH, GOT, HBDH, GPT, ALP and MDH. These changes have no particular diagnostic importance because similar findings were also obtained in patients with both rheumatic and nonrheumatic arthritis. The changes occurring during antirheumatic treatment are minimal and statistically not significant. Greater elevations of LDH, ALD, GOT, HBDH, GPT, MDH, and ALP are found in patients with decompensated rheumatic heart disease associated with active rheumatic carditis.