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Biomedical subjects

F Pandurski

Publications and source records attributed to F Pandurski.

18 recordsLinked to original sources

[Terminated pregnancy following prenatal diagnosis of congenital anomalies--a part of register of congenital anomalies].

UNLABELLED: The most of European registries of congenital anomalies (CA) collected information of CA in livebirths, stillbirths and terminated pregnancies following prenatal/ultrasound diagnosis. OBJECTIVES: to assess terminated pregnancies after prenatal/ ultrasound diagnosis of CA as a part of register of CA performed in University Hospital-Pleven. Among 21 202 births monitored during the study period (1996-2005), 679 CA were detected. The total prevalence of CA was 32/ 1000 births. The outcome of pregnancy for all cases of selected CA by register was 620 livebirths (91.3%), 36 stillbirths (5.3%), 23 terminated pregnancies (TP) (3.4%). The percentage of pregnancy termination was higher in the case of isolated anomalies, mainly lethal and CA associated with a low survival rate (61%), than with multiple ones. The most common CA detected after prenatal/ ultrasound diagnosis were neural tube defects (NTD) - the main reason for TP (52% of cases). The low proportion of these CA in TP (1/3) compared to their proportion in livebirths (50%) demonstrated an insufficiency of prenatal diagnosis of NTD as a part of register of CA performed in University Hospital-Pleven. Prenatal diagnosis of CA allows an early genetic counseling of mother presenting information on neonatal prognosis and recurrence risk for subsequent pregnancies. It helps family to take an adequate decision for termination of pregnancy with bad prognosis about heavy fetal CA.

Abortion, Induced↗

[Correlation between receptive wall analysis of benign ovarial cysts and their clinical conduct].

UNLABELLED: The biological behaviour (conduct) of benign ovarial cysts is interesting due to their comparatively high frequency of appearance and clinical manifestation. (During the last five years their frequency is between 62%-65% of the gynaecological surgical interventions). With this current survey the authors try to set up a target for research study of the wall receptive status of benign ovarial cysts. This study should be treated as a start up point rendering a prognosis for their eventual biological development. MATERIALS AND METHODS: An immunohistochemical survey was carried on with 50 patients who have already reached the surgical treatment in retrospective order for the period 2001-2003 (three years' period). The survey search is in direction receptive analysis of Estrogene /E2/ and Progesterone /P/ wall receptor in the ovarial cyst. A perspective observation was also carried on (control group of 50 cases) of hormonal-gestagene treatment of the benign ovarial cystogenesis. It appears to be the necessary prove material for hormonal receptors' participation in the cyst wall as an active factor for its development and involution. RESULTS: In the basic group /surgical treatment/ it was stated: In 39 patients--E2/-/, P/-/; in 4 patients--E2/+/, P/+/ In 5 patients--E2/+/, P/-/; in 2 patients--E2/-/, P/+/ CONCLUSION: The executed retrospective analysis demonstrates statistical importance in receptor competency lack in the wall of benign ovarial cysts as the probable grounds for them not being influenced during the conservative treatment method. This method led to the surgical elimination of the cyst. The statistical reliability, connected with the receptor E2 participation in the therapeutic behaviour of the benign ovarial cysts, is not stated. The final conclusions acquired from the executed research work would be a discussion issue after the correlative aspects in the prospective group are surveyed. The benign ovarial cysts' hormonal profile would be taken into consideration also.

Female↗

[Active screening for genetic pathology in newborns. I. Registration of congenital abnormalities].

Active screening for genetic pathology over a period of 12 years (1990-2001) involved examination of 29,629 newborns at the Clinic of Obstetrics and Gynaecology. Congenital anomalies were detected in 1244 cases (live-, stillbirths and terminated pregnancies) which gives an average incidence rate of 42.0 per 1000 among the studied population. Congenital cardiac anomalies and CA of the central nervous system were the most common types of isolated CA. They provided frequencies of 7.76 per 1000 and 6.85 per 1000 cases respectively. The incidence of the neural tube defects (NTD), particularly, varied throughout the years (t = 2.69; p < 0.01) but stated high--on average 2.12 per 1000 with the highest rate of 3.89 per 1000 in 1993. A reduction in the incidence of NTD is possible with a recommendation of periconceptional folic acid supplementation. Registration of CA is a strategy for identifying families at risk to give births of child with CA. This approach enabled us to provide more accurate genetic counselling and prenatal diagnosis for genetic pathology. Active screening of newborn population is likely to be an effective and necessary service.

Bulgaria↗

[Administration of activated recombinant factor VII (novo seven) for the control of massive bleeding in gynecology].

We report our clinical opinion for recombinant activated factor VII (NovoSeven, Novo Nordisk, Copenhagen, Denmark) administration in gynecology patients with massive haemorrhage. 3 women with gynecology deseases and severe bleeding in recieved NovoSeven in bolus IV. The blood loss and laboratory changes in hematology and haemostasis parameters are monitored. The bleeding was ceased in all cases. Decrease in values of Hb, Er and PTT was noted. The use of recombinant factor VIIA in gynecology patients with severe bleeding is effective and safe enough and could be an alternative to the extreme surgical procedures.

Adult↗

[Osteogenesis imperfecta - diagnostic challenges].

Osteogenesis imperfecta (OI) is one of the commonest skeletal disorders with an incidence about one in 10,000. It is characterized by clinical and genetic heterogeneity. Congenital lethal OI (OI type II) is the most severe from with a possibility of the early prenatal sonographic diagnosis. The authors present two clinical cases of antenatal diagnosis of OI in 26 and 24 weeks of gestation. The pregnancies were terminated. The accurate specific diagnosis was based on the clinical examination and radiographic features. In case N 2 additional findings were ascites and hydrothorax, that may occasionally be found in literature. The accurate prenatal sonographic diagnosis of lethal skeletal dysplasias and particularly of OI is possible and based on the specific sonographic findings during the second trimester of pregnancy. Ultrasound screening of all pregnant women in early second trimester is an efficient method for detection of many fetal malformations. It requires a participation of the both clinician sonographer and geneticist in a team in order to achieve a specific genetic diagnosis.

Abortion, Induced↗

[Ultrasonic biometry of the fetal kidney].

Renal biometry of the fetus was carried out on 1200 women when exogenous difference between renal and surrounding tissue became distinct. Three dimensions of the kidney were measured at two mutually performed perpendicular scans. In our study it was established that the ratio between the circumference of the kidney and the abdominal circumference was a constant, preserving itself during the whole pregnancy. Establishment of this process presented diagnostic criteria for fetal hypotrophy as well as for anomalies in the development of the kidney. The three parameters as well as the estimated by them volume of the kidney could be presented as dynamic curves, rather similar in their course with the curves of BPD and the abdominal circumference. Prognosis of the fetal weight was made on the basis of the volume of the kidney by the formula W = 125, 1689 + (0.2008 X V), as the exactness of the method was commensurable with the precision of the popular combined biometric formulas, although only one parameter was used. The ratio the pelvis:kidney was of interest as well, since it differed from that of the grown up persons and it was from 1:3 to 1:4 within the fetal norm. The transverse size of pelvis at least over 15 mm suggested obstructive uropathy and hydronephrosis. There was no statistically significant difference in the biometric parameters of the right and left kidney of the fetus in our study.

Biometry↗

[Electrolyte studies of the amniotic fluid].

The obstetrician does not pay attention to electrolytes in the amniotic fluid inspite of its great significance in the fetal homeostasis since its disturbance causes quick death of the fetus. In the presented article we aimed not only to describe reference values of sodium potassium, chloride and calcium but to examine their changes in prepathological and pathological states. 135 women with changes in the course of pregnancy of various character were investigated as well as 200 control women with normally progressing pregnancy. The results showed that there was steady state in the concentration of the indicated electrolytes during the whole pregnancy. There were no statistically significant changes in electrolyte concentrations neither in preterm or prolonged pregnancy, nor in acute or chronic fetal asphyxia, in meconial and hematinic mexures samples as well as in oxytocin infusions with a medium of saline. There was only highly significant lowering of the amount of calcium ions in the amniotic fluid of women with pre-eclampsia. Analysis of the results show that the kidney, finding itself in functional correlation with the placenta, is reliable regulator of the internal and external homeostasis of the fetus.

Amniotic Fluid↗

[The treatment of tubal pregnancy with methotrexate].

After a brief review on the possibilities for conservative treatment of tubal pregnancy the authors described a woman with left tubal pregnancy, in whom metotrexat was used successfully in a dose of 20 mg 4 times every other day administered intramuscularly. The right uterine tube of the woman was removed during the preceding ectopic pregnancy. The patency of the remaining tube was examined after a 2-month period, during which anti-inflammatory treatment was performed as well. An opinion is given that such conservative treatment should be used only in strictly diagnosed patients and with the single aim-preservation of reproductive capabilities of the woman, when there is no other way of treatment. When there are no reproductive aims, the operative method is recommended.

Adult↗

[Reconstruction of the uterine wall in cesarean section by a single-stage double-layer suture--our experience].

The authors described their own experience in usage of the figure-of-eight suture in the uterine wall after caesarean section. The method was used in 42 patients for the period of 1984-1987. In addition the corners of the uterine cut were strengthened by P-like sutures. An arch-like suture, turned with its concave part upwards, was used on the lower uterine segment for opening of the uterus since 1986. Polyamide antimicrobic threads were used for reconstruction. Very good results were found during the early puerperium, which supported the efficiency of the applied method.

Cesarean Section↗