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Biomedical subjects

D Petrova

Publications and source records attributed to D Petrova.

At least 19 recordsLinked to original sources

[Early hemodynamic changes in chronic obstructive pulmonary disease with initial respiratory failure].

The chronic hypoxemia seems to play an important role in the pathogenesis of hemodynamic disorders in chronic obstructive pulmonary disease (COPD). The aim of the study was to follow-up the changes in pulmonary hemodynamics in COPD with mild respiratory failure. 78 COPD patients with Ist and IId degree of respiratory failure were investigated. The following investigations were carried out: two--dimensional echocardiography, spirometry, arterial blood gases and acid-base balance. In 18 of COPD patients a right heart catheterization was performed and the following indices were determined: mean pulmonary arterial (PA) pressure, pulmo-capillary resistance, teledyastolic right ventricular volume. The echocardiography showed significantly higher mean PA pressure values, an initial right ventricular dilatation and right ventricular wall hypertrophy. The indices of right heart catheterization were changed, too. The pulmo-capillary resistance was significantly increased. It was the most sensitive early parameter. The mean PA pressure was increased. There was no significant difference between the mean PA pressure determined by echocardiography and by right ventricular catheterization. A relationship between the degree of hypoxemia and the hemodynamic changes was found. The long development of COPD with mild respiratory failure leads to disorders in lung microcirculation and early changes in pulmonary hemodynamics. This process worsens the prognosis of COPD and the early prevention in the complex therapy of the disease is necessary.

Acid-Base Equilibrium↗

[Congestive heart failure--some current problems].

The congestive heart failure (CHF) has become one of the most common syndromes afflicting the population. The long-term prognosis of these patients is bad. The CHF shows a tendency toward fast progressive development. The aim of our study was a retrospective investigation on CHF patients, a determination of CHF functional class by NYHA and its type, a determination of the most important diseases leading to heart decompensation and of the reasons for dead in these patients. For a 6-year period we investigated 6428 patients. 1095 (17.03%) of them were with a different degree of CFH. More of them were with II and III functional class of CHF by NYHA. In the age decade from 61 to 70 years the frequency of CHF increased significantly. The most important diseases leading to CHF syndrome were chronic ischemic disease, arterial hypertension, COPD with chronic cor pulmonale and valve diseases. The average age of deceased CHF patients was 67.8 +/- 7.4 years. After the manifestation of the first group of symptoms the mean life duration of CHF patients was 13.2 +/- 4.1 years.

Age of Onset↗

[Cytokines and the liver in health and disease].

Cytokines are a group of proteins with autocrine, paracrine and endocrine activities which provide communication among hepatic cells and other cells and tissues of the man. Active in minute quantities, the cytokines activate and regulate homeostasis and cellular repair through effects on cell growth, differentiation and receptor expression and cell-mediated immunity. Cytokines--IL-1, IL-2, IL-6, IL-8 IL-10, IL-12, TNF-alfa, PDGF and others, modulate liver metabolism in health and disease, physiological and pathologic liver functions and the evolution of liver inflammation and injury to hepatic fibrosis and liver cirrhosis. Data concerning the use of a recombinant form of Interleukin-10 and Interleukin-12 in the treatment of chronic liver disease (chronic viral hepatitis, fibrosis, cirrhosis, alcoholic liver disease) and cell-mediated immunity regulation are widely discussed in the review.

Cytokines↗

[Sodium in clinics and complications of liver cirrhosis].

The changes in sodium homeostasis most frequently are expression of water-electrolyte balance disturbances in patients with liver cirrhosis. Hyponatremia of water excess is found in 35% of the patients with cirrhosis and ascites. This disturbance is most frequently connected with raised antidiuretic hormone (vasopressin) secretion and is realized by including of nonosmotic stimulating mechanisms. The vasopressin plays a leading role in pathogenesis of disturbed water metabolism in the liver cirrhosis. Some patients with hepatorenal syndrome are established with highest plasma vasopressin concentrations. Gene expression of the regulation of kidney vasopressin-sensitive water channels (aquaporin-2 proteins) is also raised in the liver cirrhosis. Using in practice vasopressin-type 2 (V-2) receptor antagonists gives hopeful results in medical treatment of water-electrolyte disturbances in patients with advanced liver cirrhosis.

Gene Expression↗

[The extrahepatic manifestations in hepatitis C virus (HCV) infection].

The hepatitis C virus (HCV) infection could affect not only the liver, but also other tissues, organs and systems. The number of the reported in the literature extrahepatic lesions by HCV incessantly increases. A reliable association between the infections by HCV and the mixed cryoglobulinaemias, membrano-proliferative glomerulonephritis and porphyria cutanea tarda is confirmed. The participation of HCV in the pathogenesis of some diseases of the thyroid gland, the lymphocytic sialadenitis, lichen planus, diabetes mellitus, thrombocytopenia, antiphospholipid syndrome, etc., is assumed. The extrahepatic lesions by HCV are probably connected with the participation of the immune system, but they may be as well due to the replicating virus in the affected tissues, organs and systems. The pathogenetic mechanisms of the extrahepatic and autoimmune manifestations of the infection with HCV are not elucidated, which poses difficult therapeutic problems regarding the choice of interferon and/or corticosteroid hormones.

Cryoglobulinemia↗

[The systemic and local immune responses in patients with alcoholic liver cirrhosis depending on hepatitis C viral infection (HCV)].

The systemic and local immune response was studied in patients with alcoholic liver cirrhosis and the significance of the combined infection with HCV. To investigation were submitted 23 patients (16 males and 7 females) aged between 29 and 61 years with alcoholic liver cirrhosis. Of them 14 were anti-HCV(+) and 9 anti-HCV(-). As controls were used 36 clinically healthy individuals, matched by sex and age to the patients. The flow cytometric analysis of the lymphocyte (Ly) populations from the peripheral venous blood and of cells from liver aspirate obtained by blind liver biopsy according to Menghini, was performed with FacsTAR (Becton Dickinson). In the anti-HCV(-) patients, as compared to the controls (patients/controls) the Ly subpopulations were increased: CD3+/mm3:2010 +/- 738/1440 +/- 388; CD4+/mm3:1350 +/- 441/991 +/- 442; IL-2R+/mm3:133 +/- 78.5/31 +/- 20. In the anti-HVC(+) patients we established increased IL-2R+/mm3: 170 +/- 126 as compared with the controls and anti-HCV(-) patients. The suppressor/cytotoxic (CD8+) Ly with their suppressor (CD8+CD11b+) and cytotoxic (CD8+CD11b-) subpopulations and natural killers (CD16+) had a tendency to diminution in the anti-HCV(+) patients. In both examined groups the B (CD19+) Ly were non-significantly increased. The flow cytometric analysis of the cells from the liver specimen in 9 patients of whom 3 anti-HCV(-) and 6 anti-HCV(+) revealed that CD3+ on the average were 32.8% +/- 20.4% (from 9.2% to 65.1%); CD4+ were 21.1% +/- 7.4% (from 12.0% to 34.5%); CD8+ 22.6% +/- 11.8% (from 4.7% to 39.8%) and their values were higher in the anti-HCV(+) patients; the correlation CD4+/CD8+ = 1/1.09 +/- 0.6; CD16+ were 12.9% +/- 10.1% (from 1.9% to 34.8%); CD19+ varied from 3.2% to 27.8%; monocytes (CD14+) were 7.69% +/- 5.65 (from 2.0% to 15.8%) from the cells of the aspirate and their percentage contents was higher in the anti-HCV(+) patients. The results of out study revealed that in patients with alcoholic liver cirrhosis changes in the cell immune response were also observed and that they were more marked in infection with HCV.

Adult↗

[The immunological changes and prognosis of cholestatic jaundice in choledocholithiasis].

Fifty-six patients presenting choledocholithiasis are covered by the study. They are distributed in groups according to total serum bilirubin values, as follows: with total serum bilirubin < 20 mumol/l--17; 20 to 50 mumol/l--13; 50 to 80 mumol/l--9; and > 80 mumol/l--17 cases. Sixty healthy, sex and age matched individuals serve as controls. The immunocompetent cells are determined flow cytometrically with FACS TAR (BECTON DICKINSON). A panel of monoclonal antibodies (Becton Dickinson) is used, including: Leu4 (anti-CD3+)--T-lymphocytes; Leu3a (anti-CD4+)--helper/inducer lymphocytes; Leu2a (anti-CD8+)--suppressor/cytotoxic cells; Leu11a (anti-CD16+)--cells with a natural killer activity; Leu12 (anti-CD19+)--B-lymphocytes. As shown by the obtained results there are no changes in cell-mediated immune response among choledocholithiasis patients with normal values of total serum bilirubin. Parallel to increasing the degree of cholestatic jaundice (ChJ) severity, the absolute values of lymphocytes and their subpopulations decrease. The deficit is most clearcut in patients presenting the highest degree cholestasis, as compared to healthy individuals ((Ly: 1690 +/- 174/2277 +/- 186; CD3+: 956 +/- 119/1793 +/- 67; CD4+: 607 +/- 83/988 +/- 80; CD8+: 239 +/- 52/639 +/- 85; CD16+: 146 +/- 38/367 +/- 55; CD19+: 181 +/- 33/200 +/- 13. In 11 cases with early restored biliary drainage (by the 21st day of ChJ), total serum bilirubin decreases within 10 days after the operation (choledochoduodenoanastomosis), whereas lymphocytes and their subpopulations show an increase in absolute values. Two months after choledochoduodenoanastomosis, the total serum bilirubin and the lymphocyte subpopulations being examined regain their normal values. In two instances with rather late biliary drainage recovery (30 days after ChJ) the total serum bilirubin and lymphocyte subpopulations under study show no tendency whatsoever towards normalization at 10 days postoperatively. The results of the study demonstrate that the poor prognosis among ChJ patients is also related to inhibition of the cell-mediated immune response. The early biliary drainage recovery (at 21 days of ChJ) exerts a more favourable effect on the immune system, and improves the prognosis of the clinical course run by the pathological process.

Aged↗

[Campylobacter (Helicobacter) pylori in chronic erosive gastritis, duodenitis and gastroduodenitis].

The presence and degree of manifestation of Campylobacter (Helicobacter) pylori in gastroduodenal mucosa were studied in 100 patients (56 men, mean age 51.4 years, and 44 women, mean age 46.5 years) with endoscopically proved chronic erosive gastritis (52 patients), erosive duodenitis (36 patients) and erosive gastroduodenitis (12 patients). The examinations revealed the presence of Campylobacter (Helicobacter) pylori in mean 77% of the patients with erosive gastritis, duodenitis and gastroduodenitis. Campylobacter (Helicobacter) pylori was found most often in patients with chronic erosive duodenitis--83.3%, whereas in the patients with erosive gastritis it was found in 73.07%. In 83.33% of the patients with chronic erosive gastritis, duodenitis and gastroduodenitis the campylobacter infection was well manifested--(++) according to Le Bodie et al (1987). The results allow the conclusion that one of the important pathogenetic factors of erosive gastritis, duodenitis and gastroduodenitis is the Campylobacter (Helicobacter) pylori infection of gastroduodenal mucosa.

Chronic Disease↗

[The cellular-humoral immune factors of patients with cholelithiasis uncomplicated and complicated by an inflammatory process].

82 patients-10 p. with uncomplicated cholelithiasis, 8 p. with chronic calculous cholecystitis, 34 p. with choledocholithiasis with stenosing papillo-odditis--and 30 healthy controls were examined, with monoclonal antibodies of the firm "Becton-Dickinson". The following immunocompetent cellular clones and subclones were examined: CD3+, CD16+, CD4+, CD8+, CD19+ CD4/CD8, HLA-DR+, CD3+. The results were read with analyzer for fluorescently marked activated cell clones "FACS-TAR". The serum IgA, IgM, IgG, C3-C4 complement fractions and circulating immune complexes were also examined. The analysis of the results shows that in the complicated cases of cholelithiasis with an inflammatory process in the biliary ducts several humoral and cellular immune factors take part.

Adult↗

[The chologon-sorbitol functional test under ultrasonic control in pathology of the gallbladder and biliary tract].

The degree of the filling up and the dilation of the gall bladder, its functional state as well as the passibility of d. cysticus are evaluated by ultrasound examination and computer determination of the surface and dimensions of the gall bladder. 546 patients, 20-78 years of age (484 women and 62 men) were examined by a pharmacodynamic functional test with chologon (acidum dehydrocholicum) in a dose of 10 mg/kg body mass and sorbitol (in 116 patients) in a dose of 20 g in 100 ml of water. The functional test is easily performed in the course of the ultrasound examination and side effects were registered. The test allows the assessment of the functional state of the gall bladder, the passibility of d. cysticus, the degree and mechanism of the filling up of the gall bladder and the bile ducts with bile. The better filling up of the gall bladder with bile after application of chologon (by passable d. cysticus) ensures better conditions for detecting microgallstones in the gall bladder as well as of diseases linked with its wall--cholesterosis, cancer and polypi of the bladder, etc.

Adult↗

[Campylobacter pylori in patients with chronic gastritis and gastric and duodenal peptic ulcer].

The presence of Campylobacter pylori was studied in biopsy material from gastric mucosa taken by guided biopsy during fiber gastroduodenoscopy from 101 patients with chronic gastritis (n = 50), peptic gastric ulcer (n = 28), peptic duodenal ulcer (n = 7), gastric cancer (n = 10) and gastric polyposis (n = 6). Campylobacter pylori was found in various quantity--moderate (++) and considerable ( )--in 64% of the patients with chronic gastritis, in 85.7% of the patients with peptic gastric ulcer and in 100% of the patients with peptic duodenal ulcer as well as in half of the patients with gastric cancer and polyposis. The quantity of Campylobacter pylori correlated with the severity of the inflammatory process and the degree of atrophy of the gastric antral mucosa. A tendency toward seasonal incidence of Campylobacter pylori infection of gastric mucosa was established: 78.69% of the patients examined during spring time (April-May) and 60.0% of the patients examined during winter time (January-February) had Campylobacter pylori infection. This explains to a certain extent the seasonal exacerbations of the pathological process in chronic gastritis and peptic ulcer. The development of a well expressed chronic atrophic gastritis is in direct relation with the greater quantity of Campylobacter pylori in the gastric mucosa. The study reveals the pathogenetic relations between the presence and quantity of Campylobacter pylori and the development and evolution of chronic gastritis and peptic gastric and duodenal ulcer.

Adolescent↗

[A case of large mixed thrombus in the left heart atrium].

A case is presented of a woman with a combined Rheumatic mitral valvular disease with a large mixed thrombus (65 mm) in the left atrium diagnosed post mortem. Such cases are very rare. In the course of the investigation of the patient many difficulties arose in spite of the use of modern instrumental methods. The precise and timely diagnosis of a thrombus in the left atrium allows an early radical treatment.

Female↗

[Dynamic changes in the functional respiratory indices in chronic obstructive lung disease].

The basic functional respiratory indices were followed up in 50 patients suffering from various forms of chronic obstructive pulmonary disease before and after treatment. A decrease of the dynamic indices followed up was found: inspiration indices--FEV 1% (forced expiratory volume), FVC% (forced vital capacity), FEV 1/FVC%, FEV 1/VC%; flow indices--MEF 25% (maximal expiratory flow), MEF 50% MEF 75%, PEF% (peak expiratory flow), MEF/FVC%, MMEF 25-70% (maximal mean expiratory flow). A decrease of vital capacity and of diffusion capacity was also found. The ratio RV/TLC% (residual volume/total lung capacity) was increased and a general hyperventilation was established. Moderate hypoxemia and lowered saturation by normocapnia and normal pH were also established. The control examinations after treatment showed improvement of all indices followed up.

Blood Gas Analysis↗

[Changes in the coagulation status of patients with chronic obstructive lung disease following the electrophoretic use of heparin].

49 patients with chronic obstructive pulmonary disease and 40 healthy persons were examined. The hemocoagulation state indices were followed up before and after treatment. The patients with chronic obstructive pulmonary disease were classified into two groups: I gr.--treated without drugs acting on the hemocoagulation factors, II gr.--treated with heparin applied by electrophoresis. Significant changes of some of the basic indices of hemostasis were found. Following electrophoretic application of heparin they were considerably improved compared with the control group of patients treated without heparin. This kind of treatment is well tolerated by the patients and does not lead to untoward reactions.

Adult↗

[The Dubin-Johnson syndrome].

Three cases of Dubin-Johnson syndrome in close relatives--brother, sister and a brother's son--are reported. The clinical characteristics, evolution, diagnostic and differential diagnostic problems as well as the treatment and prognosis of the disease are pointed out.

Biopsy, Needle↗

[Doxycycline esophagitis and esophageal ulcer].

Four cases of acute doxycycline injury of the esophageal mucosa--acute catarrhal doxycycline esophagitis and acute doxycycline ulcer are presented. The pathogenesis, clinical course, endoscopic pattern, prophylaxis and treatment of these complications of doxycycline treatment are discussed in detail. The gastroesophageal and duodenogastric reflux, which are most often the result of functional failure of the lower esophageal sphincter, are pointed out as the basic pathogenetic mechanism of the esophageal mucosa injury in oral doxycycline treatment.

Acute Disease↗