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N Minkov

Publications and source records attributed to N Minkov.

At least 19 recordsLinked to original sources
PubMed1998

[Enterococci as uropathogens. Frequency of isolation and sensitivity to antibacterial agents].

221 clinically significant enterococcal strains (191: E. faecalis, 27: E. faecium, 3 others) were isolated from the urine of patients hospitalised with UTI over an 18-month period (1995-1996). The susceptibility of the isolates to 8 antimicrobial agents was determined by agar dilution method (NCCLS). All enterococci were sensitive to vancomycin and most of them (over 92%) to penicillin and ampicillin. Only 3.14% of E. faecalis and 3.70% of E. faecium were resistant to ciprofloxacin. A relatively high incidence of resistance of enterococci to aminoglycosides was observed: 46.07% and 51.85% to streptomycin, 42.41% and 44.44% to gentamicin, 70.68% and 77.78% to amikacin for E. faecalis and E. faecium, respectively. Among the resistant to penicillin and amino glycosides enterococci of the two species was found a great percent "high level" resistance. There were no beta-lactamase producers among our strains. The established multiresistance accompanied by "high level" resistance requires careful consideration of antimicrobial therapy of enterococcal UTI.

Adult↗
PubMed1997

[Late results of the complex treatment of primary kidney neoplasm in children].

88 children with primary renal tumours (85 with nephroblastoma and 3 with renal cell carcinoma) were treated between 1973 and 1990 in the paediatric urology department of Institute "Pirogov" and the paediatric haematological oncology department in Sofia. Combined therapy includes early surgery (nephrectomy + lymphadenectomy) and combination chemotherapy (Dactinomycin, Vincristine + Adriamycin, Endoxan). Stage II (with lymph node in involvement), III and IV disease was treated by radiotherapy. Chemotherapy and preoperative radiotherapy were administered in the case of very large tumours. In this series of 88 children, 64 (72.2%) are alive and 21 (23.8%) have died, while no information was available for 3 cases (3.5%). Survival was related to clinical stage, histological type and the child's age. One of the 2 cases with bilateral tumours survived for more than 2 years after the operation and combined therapy. One girl with liver and spleen metastases survived in remission for 11 years after the operation. Two children with pulmonary metastases, discovered one year after surgery for the primary tumour survived in remission for 4 and 14 years, respectively. The authors discuss the good results obtained with early combined therapy in this type of tumour.

Age Factors↗
PubMed1993

Problems in the treatment of urinary infections caused by Streptococcus agalactiae.

Authors have investigated the therapeutic problems in urinary infections caused by Streptococcus agalactiae in men and nonpregnant women. It is obvious from the literature that this problem has been considered mainly in pregnant women. On the basis of 86 patients (67 women and 19 men aged 14 to 81 years) it was established that the in vitro sensitivity of this Streptococcus was high (above 95%) to ampicillin, augmentin, cephalothin, lincomycin, chloramphenicol and erythromycin and 100% to rifampicin. For a successful treatment it is of great importance to establish the presence or lack of reservoirs of this infection (vagina, urethra, gastrointestinal tract). Mono- and combined antibiotic therapy was applied, as well as local treatment with vaginal lavages. Successful treatment is guaranteed by a thorough examination, identification of infection foci, including those outside the urinary system and choice of adequate individual approach to the patient. These variants are presented in detail.

Adolescent↗
PubMed1991

Streptococcus agalactiae as a urinary tract pathogen in males and non-pregnant females.

The role of Streptococcus agalactiae (group B streptococci, GBS) was investigated for a period of one year in different clinical forms of urinary tract infection in males and non-pregnant females over 14 years of age. The pathogen has been isolated in quantities of greater than or equal to 10(5) cfu/ml in midstream voided urine from 32 patients with clinical signs of urinary tract infection and pathologic urinary sediment. In every group of B isolates the antibiotic sensitivity to antimicrobial agents was determined by the single disk method of Kirby-Bauer. GBS with the same characteristics were established in urethral specimens of 4 males as well as in the vagina and faeces of 11 females. As a rule, peroral treatment with ampicillin proceeded successfully. In addition, women with streptococcal vaginitis were treated topically with 2% solution of chlorhexidine. Our results have demonstrated that GBS might cause urinary tract infection, but the evaluation of GBS isolated in urine specimens is complex.

Bacteriuria↗
PubMed1991

Acute changes of serum markers for tissue damage after ESWL of kidney stones.

Seventeen serum markers (including 9 enzyme activities) for eventual tissue damage were studied after ESWL in 40 patients with unilateral kidney calculosis. No changes were established in the 8 non-enzymic parameters and the activities of amylase, lipase, AST (GOT), ALT (GPT) and CK-MB. A statistically significant increase was found in LDH, alpha-HBDH, CK (twice) and glutamate dehydrogenase (3 times). The slight elevation of LDH and alpha-HBDH could be due to haemolysis caused by the shock waves. Increased activity of CK suggested myolysis and that of GlDH a hepatocellular damage.

Adult↗
PubMed1990

[Percutaneous nephrostomy in childhood].

Percutaneous nephrostomy has been performed in 18 children, in 7 of whom bilaterally. The indications for operation, the operative technique using combined echographic and X-ray method by own modification of cannulation, the postoperative complications and the results are analyzed. The advantages of the method and of the authors modification are pointed out. It is assumed that in the event of indications for temporary or lasting supravesical derivation of urine, as well as when emergency indication for unloading of urostasis arises, percutaneous nephrostomy may be considered first-order method of choice.

Child↗
PubMed1989

Possibilities of extending the indications for application of single antibacterial doses in urological practice.

The authors report very good results of the application of single antibacterial doses in the therapy of acute bacterial cystitis and asymptomatic bacteriuria and point out that in addition to these already established indications, single doses can be applied successfully in some other forms of urinary infection, too. They share the clinical results and on the basis of some experiments maintain the standpoint that postoperative urinary infections are also suitable for this therapy (if no evidence of pyelonephritis is available), as well as the infections of the upper urinary tract (if the isolated microorganisms are not charged with antibodies). A scheme of the so-called "long-term therapy with single dose once a week" is proposed instead of the systematic 3-6 months therapy. The results are compared to the routine 7-10 day course of treatment; as a matter of fact, they are the same. The advantages of the single-dose therapy are discussed.

Adolescent↗
PubMed1989

[Problems in the introduction of endourology].

The technical progress in medicine has produced a turn in the classical principles of the operative treatment of numerous diseases, including urological ones. Endourological methods are gaining increasing acceptance in such urologic diseases as renal calculosis, prostate adenoma, etc. They have considerable health and social effect. Their successful implication in every urologic unit requires planned and centralized supply with endourological equipment and training urologists for mastering endourological methods of diagnosis and treatment. Indicated are the factors, which may help for high-quality training of urologists and nurses and technicians. The role of health and other authorities in solving the problems of endourology are pointed out.

Endoscopes↗
PubMed1988

A new method for the management of ureteral colic after extracorporeal shock wave lithotripsy.

In ten patients, who underwent ESWL of renal calculi and had severe ureteral colic due to acute obturation of the ureteral lumen by larger stone fragments, i.v. glucagon injections combined with laevulose infusion were applied. All patients reported relief of pain and discomfort within 15-20 minutes after glucagon injection. Position of the stones in the ureter was regularly checked. No particular adverse effects of glucagon were noted. Glucagon increases GFR and diuresis and exhibits spasmolytic effect on the smooth muscle of the ureteral wall, thus facilitating the passage of stone fragments after ESWL. In certain cases and with certain indications we recommend the method as highly effective.

Adult↗
PubMed1988

[An acute recurrence of focal-segmental glomerulosclerosis in a kidney transplanted from mother to son with a rapid decline in kidney function].

A case is presented of a 19-year-old man suffering from focal-segmental glomerulosclerosis with terminal chronic renal failure to whom a kidney taken from his mother was transplanted. There was high blood-group and tissue compatibility between mother and son. The initial result was good, the transplanted kidney functioned well-diuresis of 3300 ml with high proteinuria. Gradually the diuresis fell to 100-200 ml. From the 29th day following the transplantation pulse urbason therapy was applied for 3 days but without effect. This led to the resumption of hemodialysis and removal of the transplanted kidney. The microscopic examination of the kidney revealed massive focal-segmental glomerulosclerosis which had led to terminal chronic renal failure. The rapid severe relapse of the disease in the transplanted kidney is explained with the malignancy of the disease and the very high compatibility between donor and recipient. It is recommended that renal transplantation in patients with focal-segmental glomerulosclerosis should not be performed with a kidney taken from a parent.

Acute Disease↗
PubMed1987

[Treatment of urinary infection with cephadroxyl (Pharmachem)--microbiological and clinical research].

The bacteria isolated from the urine of renal patients were tested for sensitivity towards cephadroxyl (Pharmachem) and other beta-lactam antibiotics--altogether 654 examinations were made. It was established that the gram-positive bacteria (excluding the Enterococcus) are sensitive towards cephadroxyl. From the Gram negative bacteria E. Coli, Klebsiella sp., Enterobacter sp., P. mirabilis, Citrobacter sp. showed the greatest sensitivity towards cephadroxyl, while the indole positive Proteus were with low sensitivity and P. aeruginosa, Acinetobacter sp., Serratia were resistant towards cephadroxyl. 30 patients with persistent mainly secondary urinary infection were treated with cephadroxyl. The clinical symptoms disappeared in 63.3% of the patients and another 26.7% of them showed considerable improvement. Bacteriological sterility of the urine was achieved in 61.29% of the patients. The side effects were mild and rare, only in single cases.

Adult↗
PubMed1986

Profuse haematuria.

Out of 1170 patients with macrohaematuria treated at the Clinic of Urology, "Pirogov" Institute, Sofia, 592 had profuse haematuria. With reference to the volume of blood loss the criteria for haematuria to be designated profuse are discussed. The most frequent diseases which led to profuse haematuria, as well as the methods for the etiological diagnosis of haematuria are reviewed. The authors present the experience they obtained from conservative and operative treatment of the syndrome, and stress that preference is given to the methods aiming at radical sanation of the basic disease.

Adenoma↗
PubMed1986

Our experience in the application of the biocompatible indwelling ureteral stents.

The need of indwelling ureteral stents for long-term use is established. The authors describe the indications for the indwelling ureteral stents and report their experience with the application of two types of endoprostheses: Gibbons stent and Double J ureteral catheters. The technique of the insertion of the stents is described and the complications are listed. It is concluded that the modern ureteral stents for long-term use have the place in the daily practice and are a real step forward in the fight against hospitalism and nosocomial infections.

Adult↗
PubMed1986

[Treatment of urologic infections with cefamandole (Pharmachim)--the microbiological and clinical results].

The authors study the possibilities of cephalosporin antibiotic cefamandol, new for our clinical practice, in the treatment of uroinfections. The microbiological study on a total of 2301 bacterial strains, isolated from patients with uroinfections, reveals that cefamandol excels in its action against gram-positive microorganisms, all beta-lactam antibiotics, used in our country. As regards E. coli, Citrobacter, Klebsiella, Enterobacter, P. mirabilis and indole positive pro cefamandol is better than ampicillin, carbencillin and cefalotin. A resistance to the preparation showed the majority of the isolates of Enterococcus, Serratia, Acinebacter and Pseudomonas aeruginosa. Excellent result was attained in 60% of all the 35 patients with uroinfections treated, manifested in "sterilization" of urine and in 5.71% bacteruiria became insignificant. In parallel, the clinical and laboratory symptoms of uroinfection were favourably influenced. The preparation has a good tolerance. Finally it should be underlined that this antibiotic must be introduced in the routine clinical practice for the treatment of adequate forms of uroinfections.

Bacteria↗
PubMed1985

[Acute papillary necrosis in transplanted kidney].

After a short literature survey, indicating the rarity of acute papillary necrosis in transplanted kidneys, the authors reported one of their patients, aged 32, with transplanted dead body kidney from a male, aged 30, with blood group compatibility and compatibility of two antigens in locus A. Two hemodialysis were necessiated because of acute tubular necrosis in the transplant. After the second one, performed 10 days after the transplantation, the patient felt very strong pains in the region of the transplant, edema around it and hypovolemic shock. The kidney was explanted and necrosis of the majority of the papillae in it--established, and around it--blood collection. After that incidence, the patients had three severe gastrointestinal hemorrhages with shocks, that necessitated profuse transfusion of blood. Their cause was a small erosion, about a lentil seed, at the pyloric opening, resulting from the cortico-therapy and periodic heparinization for dialysis. The patients was reanimated and returned to programmed chroniodialysis. The possible causes for papillary necrosis are discussed, most acceptable being two of them them--urostasis from 1200 ml urine in the urinary bladder, that required catheterization before the incidence and/or compression and ischemia of the transplanted kidney by the blood collection around it.

Acute Disease↗