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Volume 53, 2017

 

 

bullet 6'2017

Blunt colon injury -- the diagnostic challenge – Medical Review (Medicinski pregled), 53, 2017, № 4, 5-8.
K. Kostov and Yu. Vanev
3rd Surgical Clinic, UMHATEM “N. I. Pirogov” -- Sofia
Abstract: Due to the high risk of delay in diagnosis and the possibility of other potentially life-threatening injuries, blunt colon injuries are associated with high morbidity and mortality rates. Publications of research teams in the last 25 years have been analyzed in order to optimize the diagnostic algorithm in blunt colon injuries. Data were collected from patient groups for the diagnostic and preoperative approaches. Analyses of discussions and approaches in the diagnosis of blunt colon injury were summarized.
Key words: trauma, blunt colon injury, diagnosis
Address for correspondence: Konstantin Kostov, MD, 3rd Surgical Clinic, UMHATEM “N. I. Pirogov”, 21, Totleben Blvd., Bg -- 1606 Sofia, e-mail: dr.k.kostov@gmail.com

 

 

Cryptosporidiosis – Medical Review (Medicinski pregled), 53, 2017, № 4, 9-12.
V. Velev(1) and K. Georgieva(2)
(1)Department of Infectious Diseases, Parasitology and Tropical Medicine, MU -- Sofia,
(2)Trainee doctor, MU -- Sofia
Abstract: Cryptosporidiosis is a protozoan intestinal disease that is asymptomatic or acute gastroenteritis. It falls on opportunistic parasitoses indicative of HIV/AIDS and is caused by parasites Cryptosporidium spp. The most frequent infection is through contaminated water, food and contact with sick animals. Clinically, the disease develops unrecognizable from other acute intestinal infections and is diagnosed make only by appropriate laboratory methods. In most cases, it occurs as self-limiting diarrhea, but in immunocompromised patients, it can be a life-threatening condition.
Key words: Cryptosporidium, diarrhea, parasitology
Address for correspondence: Valeri Velev, MD, e-mail: velev_md@abv.bg

 

 

Contemporary aspects and eye symptoms of cat-eye syndrome – Medical Review (Medicinski pregled), 53, 2017, № 4, 13-17.
Kr. Koev
Department of Emergency Medicine, Medical University -- Sofia
Abstract: Contemporary aspects and eye symptoms of cat-eye syndrome (CES) are presented. CES-associated anomalies are related to the eyes, ears, anal area, heart and/or kidneys, but other organs may be affected, and some people have intellectual disabilities. Some affected individuals have additional ocular anomalies such as strabismus; and/or unilateral microphthalmia. Less common eye defects are observed, including irritation (aniridia); lack of tissue from eyelid parts (eyelid colloboma); loss of eye lens transparency (cataract) The iris' colloboma can give the iris an unusual appearance of "cat eye". The diagnosis of CES is based on the presence of additional chromosome material derived from chromosome 22. The CEC treatment requires the coordinated efforts of a team of medical professionals.
Key words: cat-eye syndrome, iris coloboma, eyelid coloboma, anal atresia, ear defects
Address for correspondence: Assoc. Prof. Krasimir Koev, MD, Department of Emergenci Medicine, Medical University, 8, Bialo more St., Bg -- 1527 Sofia, tel. +359 896291020, е-mail: k00007@abv.bg

 

 

Pharmacotherapeutic challenges in the treatment of severe asthma with biological drugs – Medical Review (Medicinski pregled), 53, 2017, № 4, 18-26.
E. Aron(1), Iv. Atanasova(2) and D. Terziivanov(2)
(1)Faculty of Chemistry and Pharmacy, Sofia University Sv. Kliment Ohridski -- Sofia,
(2)University Hospital Lozenetz, Medical Faculty, Sofia University Sv. Kliment Ohridski -- Sofia
Abstract: Current therapies based on inhaled corticosteroids and long-acting beta2-agonists remain effective in a large proportion of patients with asthma, but about 10% of them do not respond to these treatments even at high doses or with the use of oral corticosteroids. An eosinophilic inflammatory infiltration is a central event in asthma pathogenesis. IL-5 is the main cytokine responsible for eosinophil production, survival, maturation and activation at inflammation sites. Given the relationship of IL-5 to eosinophilia and asthma severity, monoclonal antibodies targeting IL-5 are promising in severe refractory asthma with persistent eosinophilia. The anti-IL-5 medications Mepolizumab, Reslizumab and Benralizumab, are therapeutically important for patients with severe eosinophilic asthma. The ability of these medications to reduce the production and survival of eosinophils improves the control of asthma exacerbations, increases FEV1, and improves patients’ quality of life.
Key words: severe asthma, biologic therapies, anti-IL-5 monoclonal antibodies
Address for correspondence: Erdal Aron, Faculty of Chemistry and Pharmacy, Sofia University Sv. Kl. Ohridski, 1, James Bourchier Blvd., Bg -- 1164 Sofia, e-mail: erdal.aron@gmail.com

 

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bullet 5'2017

Parvovirus B19 infection associated with anemic syndrome in patients with risk pregnancies – Medical Review (Medicinski pregled), 53, 2017, № 5, 5-10.
S. Voleva(1), S. Ivanova(1), V. Manolov(2), B. Marinov(3), S. Angelova(1), V. Vasilev(4) and S. Shishkov(5)
(1)National Center of Infectious and Parasitic Diseases -- Sofia, (2)Department of ClinicaL Laboratory and Clinical Immunology, Medical University -- Sofia, (3)”Maychin Dom” Specialized Hospital of Obstetrics and Gynecology, General Obstetirc Clinic, (4)ClinicaL Laboratory and Clinical Immunology, University Hospital “Alexandrovska”, (5)Department of Virology, Faculty of Biology, “Climent Ohridski” Sofia University
Abstract: Viral infections during pregnancy are a leading cause of severe complications of mother and fetus. To analyze their role during pregnancy becomes more important given the danger of the emergence of epidemic outbreaks of existing or new pathogens. There is substantial epidemiological evidence that pregnant women are at a higher risk of developing serious illnesses and mortality caused by viral infections. Data show that parvovirus B19 infection in women with pathological and risky pregnancies is associated with the development of severe anemic syndrome in addition to characteristic symptoms. Inflammation caused by viral infections leads to stimulation of cytokine synthesis (interleukin-6, TNF alpha, etc.), which in turn increases production of hepcidin from the liver. The peptide blocks iron in certain cells and tissues (hepatocytes, macrophages, PEC, placenta, cardiomyocytes, etc.). High serum hepcidin levels in patients with viral infection caused by parvovirus B19 could result in an excessive iron deposition in tissues and deficiency for erythropoiesis. Quantitative determination of serum hepcidin would prevent improper iron supplementation during anemic syndrome in the course of pregnancy and parvovirus B19 infection.
Key words: parvovirus B19, anemia, hepcidin, pregnancy
Address for correspondence: Silviya Emilova Voleva, National Center of Infectious and Parasitic Diseases, Virology Department, 44A Stoletov Blvd., Bg -- 1233 Sofia, tel.: +359 2 931 23 24, e-mail: svoleva@abv.bg

 

 

Modern Stickler syndrome diagnostics. Ocular signs and symptoms – Medical Review (Medicinski pregled), 53, 2017, № 5, 11-17.
Kr. Koev
Department of Emergency Medicine, Medical University -- Sofia
Abstract: Stickler syndrome (SS) is a hereditary progressive arthro-ophthalmopathy and belongs to the group of genetic disorders affecting connective tissue, in particular collagen. SS is a subtype of collagenopathy types II, IX and XI. It ias characterized by facial anomalies, eye problems, hearing loss and joint problems. SS is a predominantly inherited disorder of collagen connective tissue that affects the vitreous of the eye, with high degrees of myopia, risk of retinal detachment, cataracts and glaucoma. Early degenerative joint diseases are common. Other manifestations may include splitting of the palate, orthostatic anomalies and deafness. Recent molecular-level studies have shown that SS can be due to mutations in the COL2A1, COL11A1, COL11A2, COL9A1 or COL9A2 genes. There are many different types of collagen, which are indicated by Roman numerals. The COL2A1 gene encodes for collagen type II; the COL11A1 and COL11A2 genes encode for collagen type XI; the COL9A1, COL9A2 and COL9A3 genes encode collagen type IX. Additional phenotypic-genotypic studies can clarify the role of specific collagen fibers. It is necessary to continue the study of the relationship between SS and other collagen type II, type IХ and typе XI disorders.
Key words: Stickler syndrome, cleft palate; hearing loss, myopia, premature degenerative joint disease; retinal detachment, cataracts, glaucoma
Address for correspondence: Assoc. Prof. Krassimir Koev, PhD, Medical University of Sofia, 8, Bialo more St., Bg -- 1527 Sofia, tel. +359 896291020, e-mail: k00007@abv.bg

 

 

Osteonecrosis of jaw-bones – Medical Review (Medicinski pregled), 53, 2017, № 5, 18-23.
R. Kolarov
Executive Agency „Medical Audit“ -- Sofia
Abstract: In the paper different types of necroses of jaw-bones are reviewed. The bone of mandible is more often affected. Three types of necroses are known: aseptic necrosis, osteoradionecrosis and drug-induced necrosis. Aseptic necrosis of mandible is rarely observed and is characteristic of childhood. Osteoradionecroses result from performed radiotherapy in patients with oral cancer. Drug-induced necroses results from treatment with biphosphonates. During last years, cases of biphosphonate necrosis of jaw- bones increase. The etiology, pathogenesis and therapeutic approaches to the types of osteonecroses are presented.
Key words: jaw-bones, aseptic necrosis, osteoradionecrosis, drug-induced necrosis, etio­logy, pathogenesis, therapeutic approaches
Address for correspondence: Assoc. Prof. Rossen Kolarov, Executive Agency „Medical Audit“, 3, Sv. G. Sofiyski St., Bg -- 1606 Sofia, е-mail: rossen_kolarov@mail.bg

 

 

Stenotrophomonas malthophilia -- virulence factors and biofilm formation – Medical Review (Medicinski pregled), 53, 2017, № 5, 24-34.
A. Trifonova(1), E. Savov(1), I. Mitov(2) and T. Strateva(2)
(1)Laboratory of Microbiology, Department of Military Epidemiology and Hygiene, Military Medical Academy -- Sofia, (2)Department of Medical Microbiology, Faculty of Medicine, Medical University -- Sofia
Abstract: The role of Stenotrophomonas maltophilia as an opportunistic nosocomial pa­tho­gen, particularly among critically ill patients in Intensive care units, immunocom­promised individuals with haematological malignancies or solid tumors as well as persons suffering from the genetic disorder cystic fibrosis, is well known. In recent decades there’s been a noticeable increase in the frequency of isolation of this microorganism in hospitals and even reports of nosocomial outbreaks. Infections caused by S. maltophilia are often difficult to treat because of both the remarkable intrinsic resistance of the species and its ability to acquire fur­ther resistance to key antimicrobial agents such as trimethoprim/sulfame­tho­xa­zole. A variety of virulence factors contributes to the pathogenesis of infections, which is directly associated with the ability of bacterial cells to form biofilms on abiotic surfaces and host tissues. This review summarizes the existing literature data regarding virulence factors of S. maltophilia, divided into two groups -- extracellular and cell-associated, as well as its biofilm formation.
Key words: Stenotrophomonas maltophilia, virulence factors, biofilm
Address for correspondence: Assoc. Prof. Tanya Strateva, MD, PhD, Department of Medical Microbiology, Faculty of Medicine, Medical University, 2 Zdrave Str., Bg -- 1431 Sofia, tel. +359 2 9172750, e-mail: dr.strateva@abv.bg

 

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bullet 4'2017

Treatment of psoriatic arthritis with biological drugs – Medical Review (Medicinski pregled), 53, 2017, №4, 5-12.
A. Kopchev and S. Monov
Clinic of Rheumatology, Medical University -- Sofia
Abstract: Psoriatic arthritis (PsA) is a chronic autoimmune disease that belongs to the group of spondyloarthropathies. In the treatment of this disease non-pharmacological and pharmacological approaches are used. The main role in the pharmacotherapy is played by the biologic disease-modifiyng antirheumatic drugs (DMARDs). This review offers a classification of the DMARDs used to treat PsA, focusing on the biological agents that are the cornerstone in the treatment of all disease manifestations.
Key words: psoriatic arthritis, treatment, DMARD, biologicals, anti-TNF, anti-IL17, anti-IL12/23
Address for correspondence: Assoc. Prof. Simeon Monov, M.D., e-mail: doctor_monov@yahoo.com

 

 

Functional consequences in surgical treatment in patients with maxillofacial and neck malignancy – Medical Review (Medicinski pregled), 53, 2017, №4, 13-23.
E. Aleksiev
Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University -- Sofia, Department of Maxillofacial Surgery, University Hospital „Aleksandrovska” -- Sofia
Abstract: Maxillofacial and neck malignancies are characterized by two basic epidemiological signs -- an increase of disease spreading and а decrease of patients average age. Surgical treatment is a basic therapeutic method in head and neck malignancy. Ablative surgery removes body structures which causes functional impairment. Functional consequences in surgically treated patients include: mental functions, sensory functions and pain, speech functions, digestive systems, neuromusculoskeletal and movement-related functions as well as functions of the skin. No impairments have been observed with the cardiovascular, haematological, genitourinary and reproductive systems.
Key words: maxillofacial area, malignancy, surgical treatment, functional consequences
Address for correspondence: Evgeniy Aleksiev, MD, Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University, 1, Sv. G. Sofiyski St., Bg -- 1431 Sofia, e-mail: dr_aleksiev@yahoo.de

 

 

Clinical study of pharmacokinetics and efficacy of isotopically labelled long-chain phenylalkanoic acids as diagnostic means of cardiovascular diseases – Medical Review (Medicinski pregled), 53, 2017, №4, 24-30.
I. Manolov
Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University -- Sofia
Abstract: The isotopically labelled long chain omega-phenylalkanoic acids with straight and methyl branched carbon chain were tested on different patients with cardiac problems for the establishment of the pharmacological effects because of their application for the diagnosis and treatment of cardiovascular diseases. Structure-activity relationship was studied.
Key words: isotopically labelled phenylalcanoic acids, cardiomyopathy, myocardial resorption, structure-activity relationship
Address for correspondence: Ilia Manolov, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University, 2 Dunav St, Bg -- 1000 Sofia, tel.: +359 2 9236 519

 

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bullet 3'2017

Serum biomarkers in psoriatic arthritis – Medical Review (Medicinski pregled), 53, 2017, №3,  5-9.
A. Kopchev and S. Monov
Clinic of Rheumatology, Medical University -- Sofia
Abstract: Psoriatic arthritis is a chronic inflammatory autoimmune disease characterized by damage to the musculoskeletal system and many non-skeletal mani­fes­ta­tions. Up to one third of patients with psoriasis vulgaris are affected. Biomarkers are an important part of clinical practice as they allow an accurate assessment of the disease process and the effect of а therapeutic intervention. This review describes the potential serum biomarkers that could be used to distinguish between patients with skin disease from those with underlying musculoskeletal pathology, to track the disease activity and therapeutic response and to be used as surrogate markers of radiographic damage.
Key words: psoriatic arthritis, psoriasis, biomarkers, disease activity, therapeutic response
Address for correspondence: Assoc. Prof. Simeon Monov, M.D., e-mail: doctor_monov@yahoo.com

 

 

Role of IL-18 in inflammation - – Medical Review (Medicinski pregled), 53, 2017, №3, 10-15.
M. Pencheva(1), K. Kavaldzhieva(1), V. Lazarov(1), N. Trifonova(1), I. Sainova(2), E. Nikolova(2), Tz. Markovа(3) and D. Dimitrova-Dikanarova(1)
(1)Department of Biology, Medical University -- Sofia, (2)Institute of Experimental Morphology and Anthropology with Museum, Bulgarian Academy of Sciences -- Sofia, (3)Department of Pharmacology and Toxicology, Medical University -- Sofia
Abstract: This review focuses on the role of IL-18 in inflammation. The inflammation as a protective response of the body leads to the release of inflammatory mediators including cytokines. IL-18 is a member of the IL-1 family and most likely plays essential role during the inflammatory reactions. IL-18 acts on Th1 lymphocytes that are mainly producing IFN-γ in the presence of IL-2 or IL-12 to enhance their augmentation and also their survival. In addition, IL-18 induces production of cytokines and increases cytotoxic activity of lymphocytes. Typical of IL-18 and IL-1-beta is that they are activated by intracellular multi-molecular complexes, called inflammasomes. Inflammasomes control activity of caspase-1, which cleaves the inactive precursor pro-IL-1-beta and pro-IL-18, to produce the biologically active forms. In the literature there is a little bit of information on the exact mechanism underlying the efficacy of IL-18 on its target cells and the role of this interleukin in inflammation. Because of this, in this review we focus on the mechanisms underlying the effect of IL-18 on lymphocytes as well as on the biological and pathological role of IL-18 in comparison with other members of the IL-1 family.
Key words: inflammation, cytokines, IL-18, inflammasome, caspase-1, cell signaling
Address for correspondence: Magdalena Pencheva, Department of Biology, Medical University, 2, Zdrave St., Bg -- 1431 Sofia, e-mail: magdalena.91@abv.bg

 

 

Role of hepcidin in pathogenesis of atherosclerosis - – Medical Review (Medicinski pregled), 53, 2017, №3, 16-23.
V. Manolov(1), J. Petrova(2), V. Vasilev(3), M. Petrova(2), T. Kunchev(2), K. Tzatchev(1), Y. Jelev(2), P. Jeliazkov(4) and L. Traykov(2)
(1)Department of Clinical Laboratory and Clinical Immunology, MU -- Sofia, (2)Department of Neurology, MU -- Sofia, (3)Clinical Laboratory and Clinical Pharmacology, University Hospital ”Aleksandrovska”, (4)MU -- Sofia
Abstract: Carotid ultrasonography by determining intima-media thickness (IMT) is a well-proven diagnostic method for generalized atherosclerosis and is associated with cardiovascular disease factors. A few decades ago, the hypothesis that iron deficiency has a defensive role against heart disease is suggested. This explains the gender difference in the cardio-vascular diseases (CVD) frequency and the increase in incidence of female morbidity after menopause. At present, several studies focus on the relationship between iron levels in organisms and CVD. Some of them confirm the dependence on frequent blood donation and (sub) clinical development of atherosclerosis, but not CVD. Other authors have found reduced body ferritin levels, reduced oxidative stress, and improved vascular function, as measured by blood-borne vascular expansion in people who often donate blood, compared to the less common donors. In 2001 a peptide with an antimicrobial action called hepcidin was discovered. This small, 25-amino acid molecule has a key role in the systemic regulation of iron homeostasis. Hepcidin is synthesized from a number of cells, but hepatocytes are with major importance. The relationship between hepcidin levels and hepcidin/ferritin ratio with plaques and ABI, (the two most accurate NIMA markers for atherosclerosis), confirms hepcidin involvement in the development of atherosclerosis. The peptide has an established role in the progression of cardiovascular and metabolic diseases.
Key words: hepcidin, atherosclerosis, iron, demntion, IMT, CVD, ABI, NIMA
Address for correspondence: Victor Manolov, MD PhD, Department of Clinical Laboratory and Clinical Immunology, MU, 1, Sv. G. Sofiyski St., Bg -- 1431 Sofia, tel. +359 2 9230 928, e-mail: victhedoc4@abv.bg

 

 

Pharmacological investigation of isotopically labelled long chain phenylalcanoic acids on experimental animals – Medical Review (Medicinski pregled), 53, 2017, №3, 24-29.
I. Manolov
Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University -- Sofia
Abstract: The isotopically labelled long chain omega-phenylalkanoic acids with straight and methyl branched carbon chain were tested on different species of experimental animals for the establishment of the pharmacological effects because of their application for the diagnosis and treatment of cardiovascular diseases.
Key words: isotopically labelled phenylalcanoic acids, experimental animals, cardio­myo­pathy, myocardial resorption
Address for correspondence: Ilia Manolov, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University, 2 Dunav St, Bg -- 1000 Sofia, tel.: +359 2 9236 519

 

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bullet 2'2017

Role of the JAK-STAT signal pathway disturbances in the development of primary immune deficiencies – Medical Review (Medicinski pregled), 53, 2017, №2, 5 – 8.
N. Gesheva, S. Michaylova, S. Lesichkova, А. Michaylova and E. Naumova
Department of Clinical Immunology and Stem Cell Bank, University Hospital “Aleksandrovska”, Medical University -- Sofia
Abstract: This review describes the main disturbances in JAK-STAT signal pathway associated with primary immune deficiencies. The authors underline the significance of the determination of these changes in patients with common viral, bacterial and fungal infections. The knowledge on JAK-STAT signal pathway dysregulation is important for the prevention, early diagnosis and treatment. The authors also highlight how the impairments of these signal pathways contribute to the development of autoimmune diseases.
Key words: JAK-STAT signal pathways, primary immune deficiencies
Address for correspondence: Nevena Gesheva, MD, Department of Clinical Immunology, University Hospital “Aleksandrovska”, 1, Sv. G. Sofiyski St., Bg -- 1431 Sofia, e-mail: n_gesheva@hotmail.com

 

 

Serum hepcidin and oxidative stress in neurodegenerative diseases – Medical Review (Medicinski pregled), 53, 2017, №2, 9 – 15.
V. Manolov(1), S. Hadjidekova(2), Yu. Petrova(3), M. Petrova(3), V. Vasilev(4), L. Traykov(3) and K. Tzatchev(1)
(1)Department of Clinical Laboratory and Clinical Immunology, МU -- Sofia, (2)Department of Medical Genetics, МU -- Sofia, (3) Clinic of Neurology, University Hospital ”Aleksandrovska”, Department of Neurology, МU -- Sofia, (4)Clinical Laboratory and Clinical Pharmacology, University Hospital “Aleksandrovska” -- Sofia
Abstract: Oxygen is needed for energy metabolism and normal functioning of most eukaryotic organisms. It is partially reduced in the respiratory chain to low superoxide free basic radical which can be converted into other forms of reactive oxygen species. Free radicals can pass freely through the cell and nuclear membranes and oxidize bio-macromolecules. Lipid peroxidation caused by them leads to a change in permeability of the membrane. The most striking effect of aging due to oxidative stress can be described in neurodegenerative diseases associated with disturbed metabolism of microelements. Upon aging in the brain accumulation of redox metals (copper, iron and zinc) was observed. This makes the brain more likely to develop neurodegeneration. Neurodegenerative diseases are conditions, in which the nervous system progressively and irreversibly deteriorates. Neurodegenerative diseases are often late manifestation of disorders typified by Alzheimer’s disease, Parkinson’s disease, Huntington’s disease and amyotrophic lateral sclerosis. Hepcidin is a key regulatory protein that controls the intestinal iron absorption and its distribution in the body. Oxidative stress plays an important role in neuronal damage caused by cerebral ischemia. Free iron is significantly increased during ischemia and is responsible for the oxidative damage of the brain. Iron, the most brain damaging metal, plays a critical role in neuronal damage caused by oxidative stress.
Key words: oxidative stress, neurodegenerative diseases, hepcidin, trace elements, Alzhei­mer’s disease, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis
Address for correspondence: Victor Manolov, MD, PhD, Department of Clinical Laboratory and Clinical Immunology, MU, 1, Sv. G. Sofiyski Str., Bg -- 1431 Sofia, tel. +359 2 9230 928, e-mail: victhedoc2@yahoo.com

 

 

The place of endoscopic retrograde cholangiopancreatography in the complex treatment of cholelithiasis – Medical Review (Medicinski pregled), 53, 2017, №2, 16 – 20.
P. Getsov(1), S. Dineva(2), B. Vladimirov(3)
(1)Department of Diagnostic Imaging at University Hospital "Tsaritsa Ioanna“ -- Sofia, (2)Department of Diagnostic Imaging, Medical Institute of Ministry of Interior -- Sofia, (3)Clinical Center of Gastroenterology, University Hospital "Tsaritsa Ioanna“ -- Sofia
Abstract: The treatment of cholelithiasis requires cholecystectomy, as it aims the removal of the gall bladder along with all the concretion, including those in the biliary tract. In patients with cholelithiasis, stones in the common bile duct are found in 10-25% of cases, and the frequency increases in parallel with the age. The introduction of the laparoscopic technique changed the approach to patients with biliary pathology. The introduction of the minimally invasive surgery of the biliary system is impossible without co-administration of interventional endoscopic procedures -- endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, lithotripsy, extraction, and stenting. The indications for preoperative ERCP include proven common bile duct stones, jaundice, recent pancreatitis, and cholangitis, and extended common bile duct visible in other imaging studies. The success of ERCP with sphincterotomy and extraction in such cases is up to 95%. The clinical practice continues to be a dynamic process to choose between different diagnostic and therapeutic alternatives. ERHPG remain one of the techniques in the complex treatment of cholelithiasis.
Key words: ERCP, laparoscopic cholecystectomy, common bile duct stones, cholelithiasis
Address for correspondence: Stoyanka Dineva, MD, Department of Diagnostic Imaging, Medical Institute of Ministry of Interior, 79, Skobelev Str., Bg -- 1606 Sofia, e-mail: victhedoc2@yahoo.com

 

 

Synthesis of isotopically labelled long chain fatty acids for the diagnosis of cardiovascular diseases – Medical Review (Medicinski pregled), 53, 2017, №2, 21 – 36.
I. Manolov

Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University of Sofia
Abstract: Methods for the synthesis of long chain omega-phenylalkanoic acids with straight and methyl branched carbon chain are presented in the paper. The possibilities for isotope labelling procedure of phenylalcanoic acids by means of 131I are discussed. These compounds are of interest because of their application for the diagnosis and treatment of cardiovascular diseases.
Key words: 15-phenylpentadecanoic acid, 3-methyl-15-phenylpentadecanoic acid, isotope labeling
Address for correspondence: Ilia Manolov, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University, 2 Dunav St, Bg -- 1000 Sofia, +359 2 9236 519.

 

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bullet 1'2017

Trichinosis in childhood – current aspects – Medical Review (Medicinski pregled), 53, 2017, №1, 5-12.
М. Panayotova1, M. Muchtarov2, D. Popov3 and V. Boeva-Bangyozova4
1Department of Pediatrics, Trakia University, Stara Zagora
2Department of Gastroenterology, Multi-Profile Hospital for Active Treatment “Kardzhali”, Kardzhali
3Department of Physiology, Medical University, Plovdiv
4Medical University, Sofia
Abstract: Trichinosis is an acute or chronic helminthic disease caused by ingestion of raw or undercooked meat and meat products infected with viable Trichinella larvae. It presents with fever, myalgia, periorbital or facial edema, high eosinophilia, skin rash and allergic syndrome. In humans the disease most commonly occurs in family groups during autumn and winter. This correlates with the active hunting season, poaching and the traditional slaughter of domestic animals without veterinarian control around the winter holidays by people with low health culture. It is not uncommon for children to acquire the disease when their family is affected. Unfortunately, there is a lack of official summarized data on the incidence of pediatric trichinosis in Bulgaria, as well as worldwide. The aim of our current work is to provide a literature review of pediatric trichinosis based on the existing publications, as well as our own practice. In contrast with adults, most infections in children are asymptomatic or subclinical. This might be due to the rarer consumption of raw meat in early childhood. Fever, myalgia and facial edema are milder in young children in comparison with adolescents. Young children usually present with lymphadenopathy, splenomegaly and exanthema. In conclusion, we emphasize on the importance of preventative measures and strict veterinarian control on meat products, avoidance of under-cooked meat, and health education, particularly among children of school age, about the potential danger of eating raw meat products.
Key words: Trichinella, trichinosis, incidence, helminthic zoonosis
Address for correspondence: Marlena Panayotova, MD, Department of Pediatrics, Trakia University, 11 Armeiska Str., Bg – 6000 Stara Zagora. E-mail: marlenapanayotova@gmail.com

 

 

Oxidative stress in chronic dialysis patients – Medical Review (Medicinski pregled), 53, 2017, №1, 13-18.
V. Manolov1, D. Yonova2, E. Vazelov2, V. Vasilev1, I. Georgieva2, I. Trendafilov2, V. Papazov2 and K. Tzatchev1
1Department of Clinical Laboratory and Clinical Immunology, Мedical University – Sofia
2Clinical Center of Dialysis, Мedical University – Sofia
Abstract: Chronic kidney disease (CKD) is characterised by the complex of cell metabolism changes, leading to oxydative stress (OS). In recent years it is well known that OS plays a major role in pathophysiology in diseases as atherosclerosis, CKD, diabetes mellitus, malignancies and even in aging. Trace elements selenium (Se), copper (Cu) and zinc (Zn) play a significant role in antioxidant defending system of organism. Their antioxidative function is expressed through proteins, in which they are included. Main antioxidant enzymes are superoxide dismutase (SOD), catalases (CAT) and glutathione peroxidase (GSH-Px). In healthy population, kidneys are involved into hemostasis of few trace elements, including Se. Zn is essential for human body and is involved into more than 300 metaloproteins. Zn is the second important trace element after iron. Cu is essential for organism, too. It has different content in soil and water in different regions of the globe. Gastrointestinal tract and kidneys are basic units in the metabolism of magnesium (Mg) in human body. In the gastrointestinal tract it is absorbed from food. Hepcidin is a key regulatory protein of iron intestinal absorption. It is a peptide that is synthesized in liver. It acts through connection to the only known iron intracellular exporter – ferroportin. Anemia and oxidative stress are conditions that always accompany chronic kidney diseases, especially in their terminal phases (patients on chronic dialysis). In these cases abnormal levels of some important trace elements – Zn, Se, Cu, and Mg, are observed. Hepcidin concentrations are also elevated in CKD. Reciprocal links and influences are found between all these conditions.
Key words: oxidative stress, anemia, hepcidin, trace elements, hemodialysis
Address for correspondence: Victor Manolov, MD, PhD, Dept. of Clinical Laboratory and Clinical Immunology MU, 1 “Sv.
Georgi Sofiyski” Str. Bg – 1431 Sofia, tel.: +3592 9230 928, e-mail: victhedoc2@yahoo.com

 

 

Indices for measurement of disease activity and therapeutic response in psoriatic arthritis. Part II: composite indices, quality of life and global assessment of patient and physician – Medical Review (Medicinski pregled), 53, 2017, №1, 19-22.
A. Kopchev and S. Monov
Clinic of Rheumatology, Medical University - Sofia
Abstract: Psoriatic arthritis has many and various manifestations as it affects the musculoskeletal system and other organs and systems. For global analysis of the condition every aspect should be accounted for – peripheral arthritis, axial skeleton, dactylitis, enthesitis, skin and nail involvement. Some other aspects such as patient’s quality of life and assessment of the disease and also the disease activity from the physician’s point of view, are also important. Finally, a single composite index that includes all aforementioned points will allow assessment the whole disease spectrum with only one tool.
Key words: psoriatic arthritis, composite indices, quality of life, activity, systemic involvement
Address for correspondence: A. Kopchev, Clinic of Rheumatology, Medical University, 13 Urvich St. 1612 Sofia


 

Last update: 23.11.2017

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