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PubMed2000

[Laparoscopic hysterectomy--the initial experience in Bulgaria].

The paper presents the first cases of laparoscopic-assisted vaginal hysterectomy and laparoscopic hysterectomy with removal of the uterus through the vagina performed in Bulgaria as well as the experience gained by the team from II gynaecology clinic at State University Hospital "Maĭchin dom" in Sofia from seven patients operated on by these techniques. The indications, the conditions and the implemented technique with its advantages and difficulties are described. The procedures are associated with less trauma and blood loss than abdominal surgery and are followed by a very smooth postoperative period which is very well tolerated by the patients. No intraoperative complications occurred. The postoperative period was free of any problems in 5 of the patients while in two there were minor complications. Marked shortening of the duration of the procedures is achieved with the initial experience.

Adult↗

PubMed2000

Screening of amphetamine/methamphetamine and their derivatives in urine using FPIA and Triage 8 and the Scope and limits of a subsequent identification by means of the REMEDi HS system.

This study describes screening and identifying amphetamines, methamphetamines, and their derivatives in urine using immunochemical (Triage, FPIA) and chromatographic techniques (REMEDi HS). Amphetamines, methamphetamines, MDMA (3,4-methylenedioxymethamphetamine), MDA (3,4-methylenedioxyamphetamine), MDE (3,4-methylenedioxyethyl-amphetainine), MBDB (N-methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine), BDB (3,4-(methylenedioxyphenyl)-2-butanamine), PMA (4-methoxyamphetamine), DOM (2,5-dimethyloxy-4-methylamphetamine), DOB (4-bromo-2,5-dimethyloxyamphetamine), amphetaminil, pholedrine, fenfluramine, and amfepramone were subjected to a comparative study. For this, the substances were analyzed to determine their specific threshold concentration for a positive detection in the Triage test and their limit of detection and positive threshold concentration for the FPIA test and the results compared. Furthermore, the capabilities of a more detailed analysis with the REMEDi system were studied. This HPLC system was able to produce information on the single drugs and main metabolites found in the sample with the danger of false-positive or false-negative screening results greatly minimized.

Amphetamine↗

PubMed2001

[Modern treatment of vaginal mycosis in adolescence].

UNLABELLED: The aim of the study is to determine the effectiveness of the single per oral application of 200 mg Fungolon (Fluconazolum) in adolescent girls with proven Candida spp. Vaginal infection. MATERIAL AND METHODS: A prospective, case control study in 50 girls, aged 9 to 18 years, was performed. Patients were recruited in the outpatient Clinic of Paediatric and Adolescent Gynecology at the University Hospital "Majchin dom", Sofia, Bulgaria. They suffered from vaginal discharge and/or pruritus of the external genitalia. Candida spp. Was proven in all of the microbiological investigation performed. The treatment with Fungolon was performed per os, in single dose of 200 mg. RESULTS: The complaints and Candida in the vaginal smear (controlled 1 week after the treatment) disappeared in 43 of 50 patients (86%) treated. No effect was observed in 7 girls (14%). A reinfection with Candida was observed in 6 of the 38 patients (16%) at the second week after the treatment. The typisation of the resistant to Fungolon Candida shown predominance of Candida glabrata. There were no side effects registered during the Fungolon treatment. CONCLUSION: The treatment of Candida spp. Vaginal infection in adolescent girls by a single per oral application of 200 mg Fungolon (Fluconazolum) is very convenient and efficient. It gives a prompt effect (the complaints disappear in one or two days), high percentage of healed patients (86%), with absence of side effects. The usage of Fungolon should be highly recommended for treatment of vaginal mycoses in puberty and adolescence.

Administration, Oral↗

PubMed1975

Adaptive changes in behavior after repeated administration of various psychoactive drugs.

Evidence has been presented that d-amphetamine interacts with various types of behavior in the context of a conditioning paradigm. Rats exposed simultaneously to a locomotor activity measurement and three dose levels of d-amphetamine on repeated occasions gradually developed dose-related enhancement of drug-stimulated activity, which persisted after discontinuation of the drug. Rats trained in FR-operant chambers with food reinforcement showed a decrease in the rate of lever pressing after administration of d-amphetamine. Tolerance to this effect required varying numbers of daily drug injections, according to the subject's degree of prior drug experience. In both situations the drug administrations were coupled with the behavioral measure to allow for conditioning effects. In a continuous avoidance procedure the initial dose of d-amphetamine did not enhance response rate, although subsequent doses did produce significant stimulation. Even when the initial doses were administered out of temporal phase with the avoidance measurement, the simultaneous administration of the drug and the behavioral procedure on a subsequent day resulted in a significant drug-induced stimulation of response rate. Thus, in this particular instance, the conditioning influence of the earlier doses was apparent whether or not the drug effect occurred in contiguity with the avoidance measurement. Other reports in the literature (16) suggest that hallucinogenic drug action may be characterized by the peculiar "pause" in an FR pattern of responding for food reinforcement. This proposal was substantiated and extended to a number of representative hallucinogenic agents. d-Amphetamine or chlorpormazine reduced the rate of FR responding without provoking an obvious pause. Examination of tolerance and cross-tolerance to the hallucinogenic pause in the FR pattern after LSD, mescaline, psilocybin, DOM, and DMT generally indicated interactions between the drugs, although this was not entirely consistent. It follows that the mechanisms of action of these drugs probably have elements in common, though they are not necessarily identical. In doses as small as 10 mg/kg, cinanserin, a serotonergic receptor-blocking agent, completely reversed the pause in FR pattern induced by the various hallucinogenic drugs.

Adaptation, Psychological↗

PubMed2001

[Surgeons in Krakow between WWI and WWII].

During the war time when Polish borders had not been established yet, apart from having two surgical departments Jagiellonian University, Krakow had surgical departments in the Bonifratow, Izraelicki and Military Hospitals. More surgical departments were opened up in later years in pubic Health System Hospitals, among them were Narutowicz at near Pradnicka street and Sisters of Mercy at Lea street. Other well-known Krakow surgeons operated in smaller, private surgeries, such as: Dom Zdrowia (House of Health) or Zwiazkowy (Union) Clinic. At that time only 30 Surgeons worked in Kraków. They were outstanding specialists with a broad practice. Among them were Maksymilian Rutkowski, Jan Glatzel, Stanislaw Nowicki, Michal Hladij. Gradually, younger surgeons started to join them. they were: Jan Kowalczyk, Jerzy Jasienski, Stanislaw Kania, Wladyslaw Laszczak, Jozef Bugusz, Jozef Gasinski. Many of them who worked in the surgical hospitals in Krakow, left the city after obtaining a professorship (like Kornel Michejda, professor at the University of Wilno) or became heads of wards, like Zygmunt Drobniewicz, Alfons Mackowski and Tadeusz Guschlbauer. All of these surgeons were highly respected by the medical community as well as by the general public in their respective town and surrounding areas. A large income allowed that best of them to fund and supply their own wards. Occasionally, however, among the less successful surgeons, an uncompromising competition for patients developed. These events were disapproved and condemned by the medical establishment. Many surgeons led an active life outside of their profession. A surgeon with an exceptionally colorful personality was Jan Glatzel: witty, highly intelligent, a connoisseur of fine art, book lover with an active social life. Maksymilian Rutkowski was active in charitable organizations, helping to support Bratnia Pomoc Medykow. Michal Hladij, president of KS Cracovia, vice president of Krakowski Klub Automobilowy rendered his service to restore monumental cauldron in Rdzawka on the hillside of Obidowa. Others, like Dr Jozef Friszer, a former assistant in the Surgical Hospital, who also came from Krakow, later became and influential politician and the last prime Minister of the Second People's Republic.

Academic Medical Centers↗

PubMed2002

[Retinopathy of prematurity--frequency and risk factors].

UNLABELLED: Retinopathy of prematurity (ROP) is a significant problem in very low birth weight (VLBW) newborns, patients of the neonatal intensive care units (NICU). The aim of the present investigation is to report the results of our ROP-screening program: 1. Current frequency of ROP and the need for retinal surgery; 2. Main risk factors and the prophylactic possibilities for ROP. STUDY DESIGN: This is a retrospective study for 3 years period: 08.'98-07.01. 188 survived premature newborn patients of NICU, "Majchin dom", Sofia, met the criteria for ROP screening. The first eye exam was performed at 3 weeks of age, followed by exams every 2 weeks until complete vascularisation of the retina. RESULTS: The incidence of ROP any stage was 11.2% (21 of 188) and 4.2% (8) for stage > or = 3. The mean birth weight of the ROP (+) group was 982 g, the mean gestational age (g.a.)--27.9 g.w., comparing with 1258 g and 30.9 g.w. respectively of the ROP(-) group (p < 0.05). ROP stage > or = 3 was diagnosed as a rule among the newborns with birth weight < 1000 g 14.6% (7 of 48) and g.a. < 28 g.w. (6 of 41). Seven children have undergone successful retinal surgery. The children of ROP(+) group needed significantly longer mechanical ventilation and supplemental O2, they developed more often bronchopulmonary dysplasia and severe grade III-IV IVH, the percent of neonatal sepsis and the need of blood transfusions in the first month was greater too. CONCLUSION: The frequency and severity of ROP in our study is relatively low and that depends on the strict monitoring of the intensive cares. Main risk factors are extremely low birth weight and gestational age; severe RDS with longer duration of mechanical ventilation and supplemental oxygen. Grade III-IV IVH and neonatal sepsis are often a parallel finding with severe ROP. Other risk factors are the greater number of blood transfusions and the developing of chronic lung disease.

Bulgaria↗

PubMed2002

Effect of copper binding by suspended particulate matter on toxicity.

The kinetics of Cu(II) interactions with Susquehanna River (mid-Atlantic, USA) particle suspensions using the copper ion selective electrode (Cu-ISE) method indicated that the concentration of Cu2+ in both the suspension and filtrate was kinetically controlled; the reaction of Cu(II) in the suspension was faster than that in the filtrate. Bioassay tests were performed in continuous flow-through bioassay systems to examine the effect of kinetics of Cu(II) interactions with suspended solids on the toxicity of Cu to Ceriodaphnia dubia. The toxicity curves were displaced to higher total Cu concentration as the reaction time increased, indicating that such interaction of Cu with solids was time dependent. Further, the toxicity curves overlapped for reaction times of 6 and 24 h, indicating that the reaction was relatively rapid and that equilibrium was achieved within 6 h. The survival of organisms was related to the free Cu2+ concentration but deviated from the result for bioassays in which dissolved organic matter (DOM) rather than particles reacted with the added Cu(II) to affect the free Cu2+ concentration. It may be interpreted that, besides the toxic effect of Cu2+, particles exert adverse influences on the organisms.

Animals↗

PubMed1999

[Current treatment during life-threatening hemorrhages in obstetrics].

For the death of one third of the women in childbirth, the cause is a rich blooding after normal or surgical birthpermission. Blood loosing is especially dangerous when its quantity is more than 1000 ml. Typically for the clinical test is the expressed tahicardia and the sharply going down of the blood pressure. The facts, leading to this hard complicating are more than ten, as one of them is the surgical birth. There are cited authors, who define the contemporary treatment in this hard complicating. The tendency is to save the uterus, especially for young women and for these who have not alive children. For that purpore is used the linking of arterial blood vessels providing blood to the uterus and its lineal ways. It's described the treatment in these cases in state university hospital "Maichin dom". The author definitely concider that it is a high time that methods to find more application in the contemporary obstetrics in our country.

Adult↗

PubMedDate not supplied

The Marchetti-Vincenzi universal bundle nail for the treatment of tibial nonunion.

The authors report the results obtained in the treatment of 9 cases of uninfected hypertrophic or atrophic nonunion of the tibial diaphysis, using the Marchetti-Vicenzi Universal Bundle Nai. Lesions consisted in the sequelae of different types of diaphyseal fractures treated by means of several surgical procedures. Former fixation material was removed in all of the cases, the tibial medullary canal was reamed, and the Marchetti-Vicenzi Universal Bundle Nail was used for internal fixation. In some cases, additional procedures were used such as Osteomuscular Decortication (DOM) according to Judet, autologous bone grafting. All of the cases healed after a mean time of 22 weeks. The authors suggest that intramedullary nailing using the universal bundle nail is a reliable and safe procedure for the treatment of uninfected tibial nonunion.

Adult↗

PubMed2002

[Resuscitation in very low birth weight and extremely low birth weight newborns in the delivery room].

THE AIM: Of the study is to discuss the need of delivery room cardio-pulmonal resuscitation (DR-CPR) in VLBW and ELBW infants and intensity, to determine its prognostic significance for the neonatal outcomes, and the influence of some perinatal criteria. MATERIALS AND METHODS: A retrospective study is performed in University Maternity Hospital: Maichin Dom", for the years 1998-1999 including: 61 ELBW (500-999 g) and 122 VLBW (1000-1499 g). Excluded are infants with great malformations. RESULTS: There were 54% survivors in the ELBW and 86.1% in the VLBW group. 1-st min Apgar scores were significantly lower in the ELBW-group 3.5 +/- 1.9 in comparison to the VLBW: 4.9 +/- 1.9 = pH from umbilical artery were lower too: 7.19 +/- 0.16 and 7.24 +/- 0.14 respectively. From 12 ELBW babies with cord arterial pH < 7.1 survived only 3, but all 3 with pH < 7.0 died; 8 from 10 VLBW babies with pH < 7.1 survived. Intubation rates were as followed: ELBW group--82%, 70% in the first 5 min; VLBW group--57% and 34% respectively. Adrenalin and/or chest compression received 6 ELBW infants, 5 of who died and 4 had severe IVH. The same resuscitation received 8 VLBW babies, 4 of who died and 2 survivors had 3-4 grade IVH. Any grade of IVH occurred in 65% of ELBW and in 44% of VLBW infants. Severe IVH was seen in 37% and 16% respectively. Overall, survivors with grade 3-4 IVH were 15% among the ELBW group and 7.6% among the VLBW. CONCLUSIONS: Birth weight and gestational age are the most important factors, determining the intensity of DR-CPR and the prognosis in newborns of < 1500 g. Low Apgar scores, cord arterial pH < 7.10, the need of Adrenaline application and/or chest compression by DR-CPR are reliable prognostic criteria for death and poor nevrodevelopmental outcome.

Cardiopulmonary Resuscitation↗

PubMed2002

[Problems and outcome in extremely low birth weight newborns, depending on the mode of delivery].

THE AIM: Of this study is to determine the impact of the mode of delivery on survival, morbidity and prognosis of ELBW and extremely low gestational age (ELGA) newborns. METHODS: The retrospective review includes ELBW and ELGA infants born at the State maternity hospital "Maichin dom" Sofia from 1997 to 1999. These are 95 newborns divided into two groups: 31 born by Cesarean section (C. s.), and 64--per vias naturals (p. v. n.) with subgroups: 42--vertex, 22--breech delivery. Resuscitation is similar in all groups, according the routine practice. They are compared by the following indexes: rate of survival, Apgar scores at the 1-st and at the 5-th min, pH from the umbilical artery (u. a.), rate of the intraventricular hemorrhages (IVH) and periventricular leukomalacia (PVL), and early nevrodevelopmental outcome. RESULTS: The birth weight of all babies includes ranges from 500 to 999 g and the gestational age (g. a.) is > 24 weeks of gestation. There is no statistically significant difference (p < 0.05) according birth weight, pathology and treatment of the mother, between the two groups. In the C. s. group 17 babies survived (55%) while in p. v. n. 30 survived (47%), the worst was survival between the babies, delivered in breech presentation--7 (32%), p < 0.05. There is no significant difference between pH and BE from u. a., but Apgar scores are worse in the breech group, p < 0.05. The incidence of all grades IVH and PVL is almost the same, but there is a significant difference in the incidence of severe, grade 3 and 4 IVH and PVL (19% in C. s. group versus 48% p. v. n. group). The survivors with severe IVH are 57% among the breech delivered (p < 0.05) compared with respectively 33% and 26% among c. s. and vertex delivered groups. A CONCLUSION: Is made that C. s. provides better chances for a safe survival in ELBW and ELGA newborns and better prognosis for neurodevelopmental outcome. With the worst prognosis are the breech delivered ELBW babies.

Apgar Score↗

PubMed1975

Centrally active phenethylamines.

The two-carbon homologs of two potent psychotomimetic agents are described. Unlike the parent isopropylamine compounds (4-methyl-2,5-dimethoxyamphetamine, DOM, STP; and 4-bromo-2,5-dimethoxyamphetamine, PBR, 4-BR) these phenethylamines lead to an intoxication state which is, in normal subjects, of short duration and of greatly increased sensory enhancement, but which does not superimpose hallucinogenesis. These two phenethylamines, 4-methyl-2,5-dimethoxyphenethylamine (II) and 4-bromo-2,5-dimethoxyphenethylamine (III), are active in man at oral levels of 0.1 to 0.2 mg/Kg, approximately one tenth the potency of their three-carbon counterparts.

Adult↗

PubMedDate not supplied

[Hemangioblastomas of the central nervous system in Camagüey (Cuba)].

INTRODUCTION AND OBJECTIVE: Hemangioblastomas of the central nervous system are the most frequent vascular tumours. They are 1 2% of primary nervous system tumours and 8 12% of the posterior fossa neoplasms. The objective is to analize clinical behaviour and long term results of sporadic and Von Hippel Lindau linked hemangioblastomas. PATIENTS AND METHODS: It was searched the vacular Neurosurgical Data Bank at Manuel Ascunce Dom nech Hospital between January 1981 and January 2001 to select patients harvoring central nervous system hemangioblastomas histological confirmed. Melmo and Rosen criteria were utilized in Von Hippel Lindau syndrome. We performed a twenty years follow up of this patients. RESULTS: There were 12 patients with central nervous system hemangioblastomas. Average age of presentation was 41 years old. The first case had twenty years since the operation and the last, eight months. 83% were cystic and 17% were solids. There was not surgical mortality. One patient died of renal carcinoma 15 years after the operation on craneal fossa. CONCLUSION: Central nervous system hemangioblastomas are a cluster of challenge tumours. They are intraxial benign tumours with potential good outcome. We observed sporadic and Von Hippel Lindau linked hemangioblastomas. Patients with this syndrome need clinico imagenological screening to identify new associated lesions.

Adult↗

PubMed1975

Some cestodes and nematodes parasitizing gallinaceous and columbi-form birds in Nepal.

The birds from the valley of the Barun Khola River (Great Himalaya, Eastern Nepal), Tetraogallus tibetanus aquilonifer, Ithaginis cruentus cruentus, Lophophorus impejanus, Columba leuconota and Gallus gallus f. dom., were examined for helminths. Ten species of parasitic worms (3 of the class Cestoidea and 7 of the class Nematoda) were found in their digestive tract. One of them, Ascaridia nepalensis, is described as a new species.

Animals↗

PubMed2002

[Treatment of bacterial vaginosis with high dosage metronidazole and lactic acid].

INTRODUCTION: Bacterial vaginosis (BV) is one of the most frequent vaginal infections in women of reproductive age. This condition is a disbalance of vaginal flora that is expressed in a considerable displacement of normal lactobacilli flora by opportunistic and facultative microorganisms. Despite the moderate or missing clinical manifestation this dysbacteriosis is linked with many complications in obstetrics and gynecology. AIM: To evaluate the effect of treatment of bacterial vaginosis with the product Arilin rapid containing vaginal Metronidazole in high doses and a following vaginal application of lactic acid in a part of the patients. MATERIALS AND METHODS: For the period May 2001-August 2001, bacterial vaginosis was established in 45 patients of the Specialized hospital for active treatment in obstetrics and gynecology "Maichin Dom", Sofia and the Military medical academy-Sofia, gynecology ward. The diagnosis of bacterial vaginosis was established in accordance to Amsel's criteria and the results that were obtained from samples colored by Gram. For the treatment of BV were used local Metronidazole (Arilin rapid) and vaginal tablets containing lactic acid. The patients were divided into 3 groups. In the first group (18 women) vaginal suppositoria of 100 mg Metronidazole (Arilin rapid) were used for 2 days, in the second (20 women)--Arilin rapid x 1 glob./2 days and a following therapy with vaginal tablets containing lactic acid x 1 glob. for 7 days. The third group (7 women) was the control receiving placebo therapy--shampoo Dercome Femme containing lactic acid for external application. RESULTS: In the group receiving Arilin rapid we observed a normalization of vaginal flora in 71.43% (5/7), intermediate vaginal flora in 14.3% (1/7) and no change caused by therapy in 14.3% (1/7). In the second group, where lactic acid was included, cure was established in 94.1% (16/17) and in only one (5.9%) case was established intermediate vaginal flora. In the control group in 85.7% (6/7) of the cases was registered a lack of effect. CONCLUSION: Treatment with Arilin rapid showed good results in 71% of cases. Adding lactate to therapy improved the therapeutic effect and achieved cure in over 94%. The following application of vaginal lactate is an additional step helping the recolonisation of the vagina with lactobacilli and is a contribution to the struggle with recurrent forms.

Administration, Intravaginal↗

PubMed2003

[Correlation between the corneal arcus and dyslipoproteinemia].

Arcus corneae is the degeneration of the cornea, in which are depositing in its stroma, which is clinically manifested like cloudiness which is coincidental with edge of cornea, by the corneoscleral limb, looking like white ring. During 2002 in ophthalmology cabinet in Dom zdravlja Fojnica, 32 patients, aged 54-56, with diagnosis arcus corneae were treated, which means that findings of lipoprotein fractions in serum has been made. Those findings showed us positive correlation between degeneration of cornea and raising of serums lipoproteins level, especially LDL, cholesterol, thriglicerids, and that there isn't reverse relation, negative correlation between serum's HDL and certain ophthalmology's manifestation.

Arcus Senilis↗

PubMed1992

Dexamethasone iontophoresis: effect on delayed muscle soreness and muscle function.

The purpose of this study was to evaluate the pain alleviating effect of dexamethasone iontophoresis on delayed onset muscle soreness (DOMS) produced via an eccentric exercise bout, and to determine the effect on muscle function. Baseline data were collected on 18 female subjects for maximum isometric knee extension contraction (MVC), knee extension peak torque (PT), knee extension work (W), and muscle soreness perception (SP). All values were subsequently reassessed 24 and 48 hours after a 10-min bout of bench stepping. Immediately following the 24-hr reassessment, the experimental (E) (N = 6) and placebo (P) (N = 6) groups received iontophoresis treatment while the control (C) group (N = 6) received no treatment. Percent deviation from baseline of SP was significantly less at 48 hours (p less than 0.05) for the E group compared to P and C groups. However, MCV, PT, and W were no different between the three groups at 48 hours post muscle soreness bout.

Adult↗

PubMed1991

Discriminative stimulus properties of hallucinogens and related designer drugs.

Animals trained to discriminate classical hallucinogens from saline have been used in the past decade to examine other hallucinogenic agents. Time course (onset, duration of action) and locus of action have been studied, SARs have been formulated, and mechanism of action has been investigated in detail. On the basis of DD studies in animals, it was proposed that hallucinogenic agents may produce their actions in humans via a 5-HT2 agonist mechanism and that certain phenalkylamine hallucinogens such as DOM and DOB might constitute the first known examples of 5-HT2 agonists. This led to the development of [3]HDOB and [125I]DOI for use in radioligand binding and autoradiographic studies and to the use of hallucinogen-trained animals as a functional behavioral model of 5-HT2 receptor activation. Animals trained to classical hallucinogens are more recently being used to evaluate novel designer drugs. It can be seen, then, that this paradigm, using hallucinogenic agents as training drugs, has proven to be quite useful for the investigation of hallucinogens and nonhallucinogens alike.

Amphetamine↗