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V Dimitrova

Publications and source records attributed to V Dimitrova.

At least 55 records · Page 3Linked to original sources
PubMed1998

Population pharmacokinetics of ciprofloxacin in patients with liver impairments analyzed by NPEM2 algorithm--a retrospective study.

In order to develop a population pharmacokinetic model for ciprofloxacin after single oral dosing in patients with liver impairments, a retrospective population analysis of already published data was undertaken. The purpose of the study was to compare the population model parameter estimates for ciprofloxacin obtained with the non-parametric expectation maximization (NPEM2) algorithm based on a full data set (NPEM2-FULL) with those based on a set of 3 randomly chosen time/concentrations data (NPEM2-3RPs). Parameter values generated by the standard two-stage (STS) approach using traditional data-rich situation were used as a "gold standard" for comparative purposes. There was no significant difference between parameter means at p < 0.05 for Gauss-Newton and maximum a posteriori Bayesian (MAPB) estimators. The values of k(s) (min/ml/h) as estimated by STS and NPEM2-FULL models, on the one hand, and by STS and NPEM2-3RPs population models on the other hand (0.001, 0.00095, and 0.001, respectively), were not significantly different (p = 0.1457, respectively p = 0.6276). The population models values of k(s) suggest that good approximation between ciprofloxacin renal clearance and creatinine clearance could be expected for most of the patients and support previous observations that creatinine clearance is a meaningful predictor for ciprofloxacin elimination from the body. The 3 population models estimated Vs/F (l/kg) without significant difference. The predictive performance of these population models was subsequently assessed using internal validation approach. The 3 population models demonstrated comparable accuracy and precision in Bayesian forecasting of drug plasma levels of validation group patients based on 1 random and 2 suboptimal prior drug concentrations. There was, however, a one-order of magnitude decrease in population models bias when 2 suboptimal data points were used as Bayesian priors.

Administration, Oral↗
PubMed1998

[Immune deficiency in the genesis of acute postoperative pancreatitis (initial studies)].

The issue of acute postoperative pancreatitis (APP) development is discussed against the background of the immune state of the organism. The problem in itself is by no means a new one. Attention is called to the major role of immunodeficiency as an underlying cause of APP. Proceeding from experience had with two observations, the early results of researches along this line are presented.

Acute Disease↗
PubMed1997

[The echographic diagnosis of a rare congenital uterine anomaly (uterus unicornis with a rudimentary noncommunicating horn)].

A correct diagnosis of a unicornuate uterus with rudimentary noncommunicating horn, complicated with haematometra in a 12-year-old patient, was established after a detailed sonographic examination. The diagnosis was confirmed by diagnostic laparoscopy and surgical excision the rudimentary horn was undertaken. The case is interesting with the fact that several months before the patient's referral to our hospital laparotomy was performed because of persistent and progressive abdominal pain and suspicion for acute appendicitis. The uterine anomaly present was described as uterus duplex. It may be concluded that: The diagnosis of uterine anomalies may be extremely difficult for the inexperienced operator even at laparotomy. This is important since the management of congenital uterine anomalies depends on their type and differs a lot. Any mistakes in this aspect may be fatal for the patient in her further life. The ultrasound examination performed by an experienced sonographer may give precise information about the nature of the defect thus making the task of the operator easier. The final diagnosis of the uterine anomalies is based on the combined interpretation of the data from the patient's history, the sonographic examination, the diagnostic laparoscopy and other methods of investigation if necessary.

Child↗
PubMed1997

[The effect of the duration of the dry period and of the use of antibiotics on the development of congenital infection in the newborn infant during premature rupture of the fetal membranes].

A retrospective study including 41 patients with preterm premature rupture of the membranes (PPROM) was carried out to investigate the influence of some factors (interval between PPROM and delivery, antibiotic administration) on the development of congenital infections of the newborn. When the PPROM--delivery interval exceeds 168 hours the infection rate is very high. The latter is lower when cephalosporin antibiotics instead of ampicillin are administered to the pregnant patient with PPROM.

Anti-Bacterial Agents↗
PubMed1997

[Unsuccessful contraception among patients seeking abortion on demand].

We have conducted a prospective study aimed to analyse contraceptive use among women seeking for legal abortion in the State University Hospital "Maĭchin dom"--Sofia. Our date demonstrate that the patients were well informed about the existing contraceptive methods. On the contrary the percentage of women-using contraception and especially those, using highly effective ones is relatively low. The patients claim the possible side effects of the high effective contraception as a reason against use.

Abortion, Legal↗
PubMed1996

[A variant of the authors' own method for transhepatic biliary drainage in high malignant obstruction of the bile ducts].

A modified technique for bilio-digestive anastomosis in high malignant obstruction of extrahepatic bile ducts, officially approved as an innovation (registration '29/1993), and a new variant of the technique with definite advantages, are described. The superiorities of the methods are discussed against the background of numerous procedures for bilio-digestive drainage in high biliary obstruction reported in the literature, with a special emphasis laid on liver parenchyma preservation, more reliable anastomosis application, no bile loss involved, and technically more readily and promptly executed.

Anastomosis, Surgical↗
PubMed1995

[Vascular exclusion of the liver].

Vascular exclusion of the liver (VEL) is a comparatively new and seldom used procedure. It is developed and practically implemented along with liver transplantation, and corresponds to the nonhepatic phase of the latter. VEL reduces considerably the risks of intraoperative hemorrhage, and is indicated in handling large and vascular tumors located in the vicinity of vessels. Its safe duration may reach up to 90 min, and is free of serious postoperative complications. VEL allows for broadening the scope of liver resection, and reduction of intra- and postoperative hemotransfusions.

Hemorrhage↗
PubMed1994

[The Echinococcus and complicated forms of hepatic echinococcosis--their surgical treatment].

A series of 137 patients presenting Echinococcus of which 132 (96.3 per cent) with hepatic location, operated in the clinic of hepatobiliary and pancreatic surgery over the period 1984 to 1994, are analyzed. Right-side location is documented in 59.1 per cent, left-side--in 26.5 per cent, and bilateral--in 14.4 per cent of the patients operated on. In 18.2 per cent it is a matter of a multiple process, and in 27.3 per cent--complicated course. Conservative operative procedures are used in 56.1 per cent, mixed--in 18.9 per cent, and radical--in 25 per cent. Overall mortality in the series amounts to 3.03 per cent; in patients subjected to radical operation--0 per cent, and in cases with serious postoperative complications requiring relaparotomy--similarly 3.03 per cent. Biliary fistulas as postoperative complications are noted in 4.5 per cent, and recurrences in the late postoperative period--in 1.5 per cent. The clinical relevance of the diagnostic methods used, and the indications for performing various operative procedures are discussed. The early and long-term postoperative results are assayed against the background of current literature reports on the issue.

Adolescent↗
PubMed1994

[Liver resections. Malignant diseases of the liver].

Proceeding from current literature data, personal experience had with resection surgery of the liver, carried out in a series of 64 patients, operated in the clinic of hepatobiliary and pancreatic surgery over the period 1984 through 1994, is analyzed. Thirty-four patients are operated on for benign, and 30--for malignant conditions, with five of the latter group presenting primary tumor of the liver. Seven partial resections, 33 segmentectomies and 24 lobectomies--7 typical and 17 atypical; 6 right and 18 left resections, are performed. Operative lethality in the total series amounts to 0 per cent. The early postoperative lethality in benign diseases is 0 per cent, and in complicated cases--2.9 per cent. In patients with malignant lesions--6.7 and 10 per cent, respectively. The indications for operative treatment, and the possibilities of other therapeutic approaches are discussed.

Adolescent↗
PubMed1993

[The surgical treatment of pancreatic carcinoma (a retrospective study)].

The authors report the data from the surgical treatment of 426 patients with pancreatic carcinoma, treated at the Academy of Medicine-General and Operative Surgery, within the period 1983-1992, as well as from their own material, consisting of 70 right-sided resectio of the pancreatis, done within the period 1978-1992. The patients with explorative laparatomies constituted 10.8% and had postoperative lethality 15.2%. Palliative operations were 73%, with postoperative lethality 13.2% and average survival 6.47 months. The radically operated patients constituted 16.19%, with postoperative lethality 14.28% in the general series and 7.14% in the personal series and postoperative survival 18.7 months. From the radically operated with a right-sided localization of the process 10.7% patients had 5 years survival. The early lethality of the left-sided resectio was 0% and the postoperative survival--5-10 months.

Adult↗
PubMed1993

[The surgical treatment of carcinoma of the extrahepatic bile ducts].

The authors have carried out a retrospective analysis of 157 patients with Ca in the extrahepatic biliary system, treated at the Clinic for Hepato-Biliary and Pancreatic Surgery within the period 1982-1992. From them 68 patients (43.31%) were with Ca in vesicule biliary and with Ca in the biliary tracts--89 patients (56.69%). The ratio men:women was respectively 1:4.67 and 1.12:1. The medium age of the patients was 63.08 years. In the group of the patients with Ca in biliary tracts the carcinoma was located in the upper third in 20.22% of the cases, in the middle third--in 24.72%, in the distal third--in 55.06%. Radical operations were made in 31.46% of the patients, with lethality 28.57%, whereas the postoperative lethality of the patients with duodeno-hemipancreatectomy was 6.67%, and the average postoperative survival was 32 months. The palliative operated patients constituted 65.17% in the general series, with lethality 15.52% and average postoperative survival 10.4 months. The explorative laparatomies constitute 3.37% from the operated patients. The total operative lethality was 19.1%. In the article the authors discussed the diagnostical methods, stated the preference for echography, computer axial tomography and retrograde cholangio-pancreatography in the mentioned sequence. The endoscopic procedures were discussed as and alternative for the non-resectable carcinomas of the biliary tracts.

Adult↗
PubMed1993

[Transduodenal papillosphincteroplasty in the treatment of choledocholithiasis and benign stenosis of the terminal choledochus and papilla Vateri].

The article contains data form the surgical treatment of 297 patients with choledocholithiasis and benign stenosis of choledochus terminal and papilla Vateri, treated in the Academy of Medicine-General and Operative Surgery within the period 1983-1992. The data relate to 59 patients with biliodigestive anastomosis, 114 patients with choledochotomy and T-drainage (Kehr drainage) and 124 patients with transduodenal papillosphincteroplastica. The postoperative lethality in the general series of patients was 3.03%, for the patients with transduodenal papillosphincteroplastica--0.8%. The serious complications in the postoperative period in the cases of papillosphincteroplastica represent 0%, while the excellent and very good results in the distant period--95.16%. The authors state the precise moments of the surgical techniques in the cases of transduodenal papillosphincteroplastica and their importance for the postoperative results. The authors specify the indications and the contraindications for carrying out the different surgical and endoscopic procedures.

Adult↗