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V Dimitrova

Publications and source records attributed to V Dimitrova.

At least 91 records · Page 5Linked to original sources
PubMed1990

[The remnant cystic duct in the syndromal complex of the postcholecystectomy syndrome].

Some modern aspects of the postcholecystectomy syndrome and the importance of d. cysticus remnant for its arising are discussed. Analysis is made of 13 patients with postcholecystectomy syndrome surgically treated at the Department of Propedeutics of Surgical Diseases, Research Institute of Surgery, over the period 1983-1989. Results are reported of a study of 180 operated patients (cholecystectomized), in in 7.8 of whom low-grade postcholecystectomy syndrome developed. Accent is laid on the importance of the intraoperative diagnosis and on some characteristics of technical nature, requiring precision in processing d. cysticus. Conclusion is drawn, aimed at reducing to a minimum the percentage of postcholecystectomy syndrome.

Adult↗
PubMed1990

[The current aspects of treating residual choledocholithiasis].

Taking into consideration the seriousness of the problem residual calculosis of the common bile duct, the authors analyse the noninvasive methods of treatment during the past 20-30 years. Available data in the literature are adduced pointing to the importance of endoscopic papillotomy and extraction of the calculi. Indications and contraindications for performing this procedure are defined. The different methods of treatment are evaluated on the basis of a follow up of three patients with residual calculosis of the common bile duct, treated by noninvasive method and the experience of treatment of nine patients with this disease for a period of nine years at the Department of Propedeutics of Surgical Diseases, Medical Academy in Sofia, on the one hand, and the experience with 984 patients in whom endoscopic papillotomy has been performed at the Workers Hospital "Dr. R. Angelov" in Sofia, on the other. Preference is given to endoscopic papillotomy with extraction of the calculi in residual common bile duct calculosis over operative treatment, with observance of definite indications. Excellent results of this therapeutic approach are reported: total percentage of early complications 1.52, late complications 1, ineffectiveness of the method 0.4 and case fatality rate 0.6. Another advantage is the limited contraindications and possibility for operative correction.

Adult↗
PubMed1990

[Our experience with nonanatomical liver resections].

The current status of the problem of nonanatomical liver resections is presented. Some characteristics of the technique applied in them are recorded and the indications for application of the operative technique are specified. Personal five-year experience (1983-1988) with 21 nonanatomical liver resections, applied in gall bladder cancer (4 patients), metastatic tumors (8 patients), high-grade biliary obstruction (7 patients), hemangioma (1 patient) and multiple echinococcosis (1 patient). The early postoperative results were very good, with early postoperative death of one patient. On the basis of these results, the authors advise extension of the indications for application of nonanatomical liver resections.

Adult↗
PubMed1990

[The survival of patients with mesangial immunoglobulin A glomerulonephritis].

68 patients with immunoglobulin A glomerulonephritis (IgA-GN) were studied. 67.4% of them were men. The most frequent clinical manifestation is the microscopical hematuria--in 39.7% of the patients. A single episode of macroscopic hematuria was found in 32.3% of the patients and recurrent macroscopic hematuria--in 25% of the patients. Proteinuria was found in all patients but nephrotic syndrome--only in one patient. At the time of the biopsy 35.5% of the patients were with hypertension, 13.2%--with initial chronic renal failure. The survival of the patients with IgA--GN, assessed according to the registration life tables, was 93% at the 5-th year, 88% at the 10-th year and 70.6% at the 20-th year. It was statistically higher in the patients without hypertension. Among the patients with proteinuria below 1.0/24 h no one reached terminal chronic renal failure. The male sex was a factor for a statistically shorter survival only at the 20-th year. The survival of the patients with insignificant histological changes was 100% for the period of the study, whereas it was significantly lower for the other histological variants. According to the data of the study, the presence of arterial hypertension, proteinuria above 1.0 g/24 h, a more severe histological variant (focal-segment, diffuse proliferative and particularly sclerotic), and to a certain degree the male sex play an unfavorable role in the survival and determine a poorer prognosis for the patients with IgA-GN.

Adolescent↗
PubMed1990

[The late results of treating membranous glomerulonephritis].

27 patients with membranous glomerulonephritis treated with corticosteroids, anticoagulants and some with immunosuppressors are discussed. Men prevailed. Nephrotic syndrome proved by renal biopsy was found in 88.9%, proteinuria under 3.5 g/24 h--in 11.1%, arterial hypertension--in 18.5%, renal failure--in 14.8% of the patients. At the end of the follow up 15 patients (55.6%) showed a complete remission and 4 patients a partial remission. In 8 patients (29.6%) there was chronic renal failure and three of them had gone through hemodialysis. Comparing the patients with and without chronic renal failure we found that only the presence of impaired renal function as found by renal biopsy and the greated duration of the disease are of statistically significant importance for the prognosis of membranous glomerulonephritis. A 5 year survival of the patients treated actively is 100% and a 10 year survival is 94.9% which allows the assumption that treatment of membranous glomerulonephritis can lead to a permanent remission and preservation of renal function.

Adrenal Cortex Hormones↗
PubMed1989

[Echographic morphometry of the fetal septum pellucidum in term pregnancy and in cases of congenital malformations].

The echographic morphometry of the fetal cerebral cranium includes a series of measurements and structural evaluation of the most important anatomical formation of the central nervous system (cns). Echographic anatomical relations of septum pellucidum were studied antenatally in 43 physiologically progressing pregnancies at term as well as in 13 pregnancies with congenital malformations of the fetus during the second and third trimester. It was established that at term pregnancy the transverse measurement of septum pellucidum reached values, forming 8.28-8.93% of the value of the fetal biparietal diameter. Its morphological examination proved that it has rectangular form during scanning of the fetal cranium at the level of "thalamus", interrupting the middle echo of the dividing line between the I and II thirds. In the group of pregnancies with malformations this structure was not discovered in neither case with congenital anomaly of cns as well as in cases with multiple malformative syndromes, involving intracranial content. The role of this parameter in early prenatal diagnosis of malformative fetopathies is discussed.

Congenital Abnormalities↗
PubMed1989

[Results of a clinical trial of the Dilapan hygroscopic cervical dilator].

The authors used Dilapan to dilate the cervical canal in women with induced abortion during the first trimester. Its effect was followed up in a group of pregnant women without preceding pregnancies (88 pregnant women). The dilator remained in the cervical canal from 90 to 210 min. The best results (dilation within 9--10 min) were achieved after its stay in the cervical canal for 3 to 3 1/2 h. In the group of nulliparas dilation of 10 sm was achieved in 49.5% of the cases after stay of dilator for a period of 120 to 180 min. The authors think that the usage of Dilapan is a method by which could be achieved lowering of the frequency of cases with isthmian-cervical incompetence. Application of Dilapan is of special value in women, who have not endured preceding abortions and deliveries and are pregnant for the first time.

Abortion, Legal↗
PubMed1989

[Fiber gastroscopy in the diagnosis of gastroduodenal diseases and of primary cancer of the gastric stump in particular].

Data available in the literature are adduced and personal experience recorded with 5930 fiber gastroscopies, leading to the conclusion that fiber gastroscopy is a valuable method for diagnosis of diseases of the upper part of the gastrointestinal tract. Some aspects of primary cancer of the gastric residue and its inevitable accompanying pathology--the gastroduodenal reflux--are discussed, analyzing 313 fiber gastroscopies of patients, who had undergone in the past gastric resection for benign diseases. The authors adduce motives for the need of periodic fiber gastroscopic control of operated patients, aimed at early prophylaxis of primary cancer of the gastric residue. The need of regular medical control on these patients is also emphasized.

Duodenal Diseases↗
PubMed1989

[Hormonal changes and cellular proliferation following partial resection of the pancreas].

This study is an attempt to elucidate the histomorphologic changes in the different portions of the gastrointestinal tract, occurring after partial resection of the pancreas with occlusion of the canal of the pancreas that remains. Experiments were carried out on dogs. A number of gastrointestinal hormones were determined by radioimmunoassay. Serious hormonal disturbances after operative intervention on the pancreas were found. The hormonal derangements following pancreatic surgery were attributed to histomorphologic changes in the digestive system.

Animals↗
PubMed1987

[Survival of patients with diffuse glomerulonephritis in disseminated lupus erythematosus treated with a combination of anticoagulants, corticosteroids and immunosuppressants].

The results are reported from the treatment of 17 patients with diffuse glomerulonephritis in lupus erythematodes disseminatus (16 females and I male, aged from 16 to 54, average age of 29.0), carried out during the period 1976-1982. All patients were treated with a combination of anticoagulants, corticosteroids and immunosuppressives in the course of II to 82 months (23.9 months on the average). By the end of 1978, corticosteroids were administered 3 times daily, whereafter--once in the morning or every second day. Complete clinical-laboratory remission was attained in 13 patients (76.4%). Any treatment to those patients was discontinued for 19 to 86 months (54.6 months on the average). Only in one patients recurrence was observed, coped with the respective treatment. Two of the patients died, after 43 and 82-month treatment respectively, of pulmonary pneumonia and another 2--of complications: associated with corticosteroids. With the combined treatment with anticoagulants: corticosteroids and immunosuppressives complete clinical-laboratory remission could be attained with a duration of over 4 1/2 years on the average in 3/4 of the treated. The combined treatment could preserve or restore the renal function, if renal insufficiency had not developed or developed but not very advanced. The maintenance of the complete clinical laboratory remission does not need a constant administration of corticosteroids or other pharmaceuticals. Lethality in the patients with diffuse lupus glomerulonephritis is still high. The single and alternative administration of corticosteroids reduces the risk of adverse effects.

Administration, Oral↗
PubMed1987

[Nifedipine in the treatment of arterial hypertension].

The results are reported from the administration of nifedipine to 39 patients with arterial hypertension. Thirty one of the patients suffered from hypertonic disease, and 8 had symptomatic hypertension. Light hypertension was established in 26 of the patients, moderate--10 and grave--3. In 22 of the patients (66.6%)--16 with light and 6 with moderate hypertension, the arterial pressure was normalized by the administration of nifedipine alone, 40 mg daily. In 16 patients the arterial hypertension was coped with the addition of beta-blockers, diuretic and clonidine. Only one patient failed to respond to the treatment. The effect advanced on 3rd--4th day on the average with the treatment with nifedipine alone and after 4-6 days after the inclusion of the double combination. Negligible and transitory adverse effects were observed in single patients. Nifedipine, administered alone or in combination with beta-blockers, diuretic and clonidine is an excellent agent in the treatment of light and moderate arterial hypertension.

Adult↗