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Case reports

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Volume 53, 2017

 

 

bullet 6'2017

Large tubulovillous adenomatous polyp of the rectum in a young patient – Medical Review (Medicinski pregled), 53, 2017, № 6, 47-52.
A. Kotzev(1) and M. Mirchev(2)
(1)Department of Propedeutics of Internal Diseases, Medical University -- Sofia,
(2)Clinic of Gastroenterology, University Hospital „Sv. Marina”, Medical University -- Varna
Abstract: Data from many studies showed that most of the colorectal cancers originate from adenomatous polyps. Adenomatous polyps are often detected in the population of industrialized countries with Western diet, especially in elder persons. However, chronic rectal bleeding in younger patients does not exclude the presence of adenomatous polyps and the necessity from colonoscopy and endoscopic polypectomy.
Key words: adenomatous polyp, colon, endoscopy, polypectomy
Address for correspondence: Andrey Kotzev, M. D., Gastroenterology Unit, University Hospital „Aleksandrovska”, 1, Sv. G. Sofiyski Blvd., Bg − 1431 Sofia, е-mail: dr_andrey_kotzev@abv.bg

 

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bullet 5'2017

Small bowel intussusception caused by metastatic melanoma: a case report report – Medical Review (Medicinski pregled), 53, 2017, № 5, 49-51.
Y. Georgiev(1), S. Garnenkova(2), P. Petrov(3) and A. Karashmalakov(1)
(1)Surgery Department, University Hospital -- Burgas, (2)General practitioner -- Burgas, (3)Radiology Department, University Hospital -- Burgas
Abstract: Small bowel intussusception is a rare clinical entity in adults, and in most of the cases it is caused by a malignant intraluminal tumor. We present a case of small bowel intussusception caused by a metastatic melanoma in a 43-year-old female patient. The patient had local excision and lymphadenectomy 2 years ago, and at the time of presentation of abdominal dissemination is on immuno­therapy. Surgical excision and precise chemotherapy has been associated with a better overall prognosis. Palliative surgery in acute bowel obstruction is the only treatment option available.
Key words: intussusception, melanoma, small bowel tumor
Address for correspondence: Yonko Georgiev, MD, Surgery Department, University Hospital Deva Maria, Al. Stamboliyski Blvd., Bg -- Burgas, tel.: +359 899 127 849, e-mail: yonko_georgiev@abv.bg

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bullet 4'2017

A female patient with systemic lupus erythematosus and breast cancer – Medical Review (Medicinski pregled), 53, 2017, №4, 31-33.
M. Baleva(1), M. Nikolova-Vlahova(2), S. Lesichkova(1) and Kr. Nikolov(1).
(1)Department of Clinical Immunology with Stem Cells Bank, University Hospital „Aleksandrovska”, (2)Department of Nephrology, Chair of Internal Diseases, University Hospital „Aleksandrovska”, Medical University -- Sofia
Abstract: A 55-year-old female patient with morning stiffness during 2-3 hours, arthralgia and arthritis of the small joints of arms in the last 5 years has been described. After that she had surgical intervention and chemotherapy for ductal breast cancer. Rheumatoid factor, anti-CCP and AST were negative. She was treated with Resochin and Diprophos with a good effect. Four months after operation she had clinical, laboratory and echographic data for pulmonary embolism with negative antiphospholipid antibodies, but with high ANA (1:1280) and positive DNA, RNP and Ro antibodies. At that time she had arthralgia and arthritis without morning stiffness. During the following 3 years she was without therapy. ANA titer was 1:320-1:640, but DNA, RNP and Ro were negative. The following associations between systemic lupus and neoplasm have been discussed: 1. SLE as a paraneoplastic syndrome that precedes the appearance of cancer. 2. Cytotoxic therapy and immunosuppressive therapy of SLE as a cause of malignancy. 3. Independent development of the diseases.
Key words: systemic lupus eythematosus, paraneoplastic process
Address for correspondence: Prof. Marta Baleva, MD, Department of Clinical Immunology with Stem Cells Bank, University Hospital „Aleksandrovska”, 1, Sv. G. Sofiyski St., Bg -- 1431 Sofia, e-mail: marta_baleva@yahoo.com

 

 

Distally based sural fasciocutaneous flap for reconstruction of soft tissue defect of the heel – Medical Review (Medicinski pregled), 53, 2017, №4, 34-37.
Y. P. Yordanov.
Department of Plastic Reconstructive and Aesthetic Surgery, Uni Hospital -- Panagyurishte
Abstract: The heel poses a unique reconstructive challenge to the plastic surgeon who must consider both reliable soft tissue coverage and function preservation when repairing defects in this location of the foot. There are many possible recon­struc­tive techniques, including local, distant, and free flaps. These flaps could be of muscular, myocutaneous or fasciocutaneous tissues. Among all the possibi­lities the distally based sural fasciocutaneous flap seems to be the one that offer good soft tissue restitution, providing functional restoration and being relatively easy for execution at the same time. In order to put a focus on it, the author of the present article briefly discusses some anatomical and surgical considerations for using this flap. A representative case report is presented and some practical tips are given.
Key words: reverse sural flap, fasciocutaneous flap, heel defect
Address for correspondence: Yordan P. Yordanov MD, PhD, Department of Plastic Reconstructive and Aesthetic Surgery, MHAT “Uni Hospital”, 100, Georgi Benkovsky St., Bg -- 4500 Panagyurishte, e-mail: yordanov_vma@abv.bg

 

 

CLINICAL IMAGE

Nasal dermoid sinus cyst – Medical Review (Medicinski pregled), 53, 2017, №4, 64-65.
A. Shef, Y. P. Yordanov and J. M. Lasso
(Full-text of the publication)

Giant congenital melanocytic nevi: А chance to be effective – Medical Review (Medicinski pregled), 53, 2017, №4, 66.

Р. Penev and G. Tchernev
(Full-text of the publication)

 

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bullet 3'2017

Anaplasma phagocytophilumamong Bulgarian patients: case reports – Medical Review (Medicinski pregled), 53, 2017, №3,  49-52.
M. Pishmisheva(1), M. Baymakova(2), I. Tsachev(3) and I. Christova(4)
(1)Department of Infectious Diseases, Hospital of Pazardzhik, (2)Department of Infectious Diseases, Military Medical Academy -- Sofia, (3)Faculty of Veterinary Medicine, Trakia University -- Stara Zagora, (4)Department of Microbiology, National Center of Infectious and Parasitic Diseases -- Sofia
Abstract: Anaplasmosis are diseases among animals and humans. These illnesses are presented with acute febrile syndrome, intoxication, and alteration in blood parameters. The pathological agents are microorganisms that infect granulocytes. The aim of this study is to present the clinical characteristics of three clinical cases of human granulocytic anaplasmosis. The patients are treated at the Department of Infectious Diseases, Hospital of Pazardzhik, Bulgaria.
Key words: human granulocytic anaplasmosis, thrombocytopenia, cytolytic syndrome, tick
Address for correspondence: Magdalena Baymakova, MD, PhD, Department of Infectious Diseases, Military Medical Academy, 3 St. Georgi Sofiyski Sr., Bg -- 1606 Sofia, e-mail: dr.baymakova@gmail.com

 

 

Case of infectious erythema with hepatic inflammation – Medical Review (Medicinski pregled), 53, 2017, №3, 49-52.
V. Velev
Pediatric Infectious Clinic, University Hospital “Prof. Iv. Kirov”, Medical University -- Sofia
Abstract: Infectious erythema ("fifth disease" or erythema infectiosum) is a poorly contagious, usually, with mild onset condition characterized by a symmetrical rash on the cheeks followed by a net-like erythema on the corps and extensor surfaces of the extremities preceded by flu-like symptoms. Infection with the erythema infectiosum virus is widespread around the world, especially in the less developed countries. The case we present is a 3-year-old child with severe flu-like symptoms and a characteristic rash. Hepatomegaly, elevated transaminases and serologically proven antibodies аgainst the causative agent of infectious erythema have been identified. In the differential diagnosis plan, infections with classical hepatotropic viruses have been rejected.
Key words: Infectious erythema, parvovirus B19, acute hepatitis
Address for correspondence: Valeri Velev, M.D., University Hospital “Prof. Iv. Kirov”, Pediatric Infectious Clinic, Medical University, 17, I. Geshov Blvd., Bg -- 1606 Sofia

 

 

CLINICAL IMAGE

Erysipelas and lymphedema – Medical Review (Medicinski pregled), 53, 2017, №3, 65-66.
U. Wollina, J. C. Cardoso and G. Tchernev

(Link to the full text publication)

 

Extensive sternum keloid scar scar – Medical Review (Medicinski pregled), 53, 2017, №3, 67-68.
Y. P. Yordanov, A. Shef and J. M. Lasso

(Link to the full text publication)

 

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bullet 2'2017

 

 

CLINICAL IMAGE

Cavernous Hemangioma of the Upper Lip – Medical Review (Medicinski pregled), 53, 2017, №2, 68 - 69.
U. Wollina, J. W. Patterson and G. Tchernev.
( Full text link - In Bulgarian)

 

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bullet 1'2017

A case of high survival after VATS talc pleurodesis for malignant pleural effusion of mammary carcinoma – Medical Review (Medicinski pregled), 53, 2017, №1, 49 -53.
D. Valchev, Z. Ilinov and E. Obretenov
Clinic of Thoracic Surgery, University Hospital „Prof. Dr. St. Kirkovich“ AD – St. Zagora
Abstract: Mammary gland carcinoma contributes for about 25% of all malignant pleural effusions (MPEs). Although malignant pleural effusion assumes an advanced stage of the main disease and places the patient in clinical stage IV, patients should not refuse palliative treatment of MPE because of the end stage of the disease. After a successful management of malignant pleural effusion, survival period can last from several months up to several years. Most authors report on post-operative survival in connection with malignant pleural effusion of mammary carcinoma of 13-14 up to 15.7 months within a range of 0-72 months. This article presents a case of survival of 97 months after performance of right-sided VATS talc pleurodesis in connection with malignant pleural effusion with pleural carcinomatosis of invasive ductal carcinoma (IDC) of the right mammary gland. Eight years after this procedure, the patient visited us again. There was a total control over the right-sided pleural effusion and a newly acquired, massive malignant pleural effusion in the left side having the same genesis, in connection with which the patient presented herself as a candidate for the same pleural palliative procedure.
Key words: VATS (video-assisted thoraciс surgery), malignant pleural effusion (MPE), talc pleurodesis, survival
Address for correspondence: dg_valchev@abv.bg

 

 

Epstein-Barr virus infection presenting as fever of unknown origin – Medical Review (Medicinski pregled), 53, 2017, №1, 54 - 58.
M. Baymakova1, G. Popov1, R. Andonova1, V. Kovaleva2 and K. Plochev1
1Department of Infectious Diseases, Military Medical Academy – Sofia
2Center of Military Epidemiology and Hygiene, Military Medical Academy – Sofia
Abstract: Three clinical cases of Epstein-Barr virus infection, presenting as Fever of Unknown Origin (FUO) were reported. Fever fulfilled the criteria for FUO by Durack and Street. The required laboratory and imaging investigations were done. Serological tests for Epstein- Barr virus (EBV) were found positive among the three presented patients. Antibodies of class IgM and IgG against EBV were detected by Anti-EBV-CA ELISA, Euroimmun, Lübeck, Germany. After thorough investigations and discussions, the diagnosis of acute viral hepatitis caused by Epstein-Barr virus was accepted for the three clinical cases. A specific supportive therapy was applied with a good outcome. Fever of unknown origin caused by Epstein-Barr virus is a serious challenge for both general practitioners and specialists from outpatient and inpatient healthcare. To deal with this challenge it is required a thorough knowledge of various diagnostic methods, to be „captured” timely and to start an adequate therapeutic regimen.
Key words: fever of unknown origin, Epstein-Barr virus, diagnostic
Address for correspondence: Magdalena Baymakova, MD, PhD, Department of Infectious Diseases, Military Medical Academy, 3 St. Georgi Sofiyski Str., Bg  1606 Sofia, e-mail: dr.baymakova@gmail.com

 

Last update of the page: 24.11.2017


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