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Reviews 2012



Ya. Kornovski and E. Ismail
Gynecology Clinic, MHAT “Sv. Anna” − Varna
Summary: A review of the literature of commonly used mini-invasive surgical procedures in the treatment of cervical cancer has been made. These procedures are: laparoscopic surgical staging, sentinel lymph node identification, laparoscopic extraperitoneal paraaortic lymph node dissection, laparoscopic radical hysterectomy, laparoscopic parametrectomy, laparoscopic radical trachelectomy, laparoscopic-assisted exenteration and some procedures less commonly used as laparoscopic transposition of ovaries and laparoscopic ligation of hypogastric vessels. All these operations may be performed by robotic assistance as well. A comparison between laparoscopic, robotic and open surgery was made.
Key words: mini-invasive surgery, laparoscopy, cervical cancer
Address for correspondence: Assoc. Prof. Ya. Kornovski, Gynecology Clinic, MHAT “Sv. Anna”, 100 “Tsar Osvoboditel” blvd., Bg – 9000 Varna, tel: 052/821 209, e-mail: ykornovska@abv.bg

D. Gavrailova
Faculty of Public Health, Medical University – Sofia
Summary: Postpartum thyroid dysfunction (PPTD) is a common condition that causes significant morbidity. Its early detection can improve the quality of life and reduce morbidity in future pregnancies, as well as the long-term outcome. Despite its imperfections, measurement of TPOAb in early pregnancy (first trimester) seems to remain the most sensitive available and used by many researchers test for predicting PPTD. Whether screening for PPTD should be routinely performed to all pregnant women and whether a universal test could be applied is still a question under debate. Analyses of costs and benefits show certain benefits in terms of cost of screening.
Key words: pregnancy, рostpartum thyroid dysfunction, thyroid peroxidase (TPO) antibody, screening
Address for correspondence: Daniela Gavrailova, MD, Faculty of Public Health, Medical University, 8 Byalo more str., Bg – 1527 Sofia, tel. 02 9432-219, e-mail: ditcheli@abv.bg


D. Gavrailova
Faculty of Public Health, Medical University – Sofia

Summary: Hyperthyroidism in Graves`disease has an autoimmune genesis - it is due to the presence of antibodies that stimulate the TSH-receptors (TSH receptor antibody-TSHRAb) of the thyroid gland cells. The disease occurs in 0.5-1% of women in reproductive age, and about 2-10% of the patients have an active form of the disease during pregnancy. Overactive thyroid gland of the mother increases the probability of an adverse outcome of pregnancy and affects the growth and the development of the fetus.
Key words: hyperthyroidism (Graves’ disease), pregnancy, fetal thyroid dysfunction, neonatal thyroid dysfunction, antithyroid drugs
Address for correspondence: Daniela Gavrailova, MD, Faculty of Public Health, Medical University, 8 Byalo more str., Bg-1527 Sofia, tel.: 02 9432-219


M. Velizarova1, L. Mitev2, T. Boneva2 and E. Hadjiev³
1Central Clinical Laboratory, UMHAT “Alexandrovska”, Department of Clinical Laboratory
and Clinical Immunology, Faculty of Medicine
-- Sofia
2Department of Clinical Laboratory and Immunology, MMA
-- Sofia
3Clinic of Hematology, UMHAT “Alexandrovska”, Department of Internal Medicine
-- Sofia

Summary: Chronic myeloid leukemia (CML) is characterized with clonal proliferation of pluripotent bone marrow stem sells and the fusion Bcr-Abl gene with increased tyrosine kinase activity. The main pathogenetic mechanisms are associated with impaired cell adhesion, deregulation of cell growth and resistance to normal mechanisms of programmed cell death (apoptosis). The mechanisms that lead to the evolution of the disease and transformation into blast crisis are still insufficiently studied. A search is directed to genes that are associated with cell cycle control, differentiation and apoptosis and which are being affected in other malignant neoplasms. The aim of the review is to summarize the molecular-cytogenetic abnormalities in the evolution of CML, including the loss of tumour-suppressor functions ((р53, RB1, АТМ, CDKN2), activation of oncogenes other than Bcr-Abl (MYC, Jak2) and telomere shortening. Some evidence that progression is probably related to a wide range of alternating DNA damages and epigenetic changes is the presence of multiple molecular aberrations.
Key words: сhronic myeloid leukemia, Bcr-Abl, chronic phase, blast crisis, disease progression
Address for correspondence: Milena Velizarova, MD, Department of Clinical Laboratory and Clinical Immunology, Medical University – Sofia, 1 G. Sofiyski str., tel.: +359 2 92 30 928, e-mail: mvelizarova@abv.bg

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