RESUMEN
AIM: Our aim was to evaluate our experience in diagnosis and treatment of preeclampsia in the clinic of Pathological pregnancy--Varna Medical University. We compared our results with the results of prominent western clinics. MATERIAL AND METHODS: We evaluated 140 patients with preeclampsia for the period of 2010 to 2013. A special file was fulfilled. It included: age, parity, gestational age, value of arterial blood pressure, urea, creatinine, common protein in blood, duration of treatment, oedema, urine protein. RESULTS: The mean age of the patients was 30 years. The urea and creatinine were normal. The mean hospital stay was 5,71 days. The blood protein was 61 g/l, only 4.17% of the patients were with protein lower than 58 g/l. In 87.5% of the patients the systolic blood pressure was between 135 and 160 mmHg, in 12.5% the systolic blood pressure was over 160mm Hg. In 58.34% there was a proteinuria. The mean gestational age was 33 gestational weeks. The delivery was performed in the most suitable for the preeclampsia gestational age. CONCLUSIONS: According to our research work the patients with preeclampsia have a very high risk for cardio-vessel diseases and again of preeclampsia in their future pregnancies from 30%-40%. High prenatal care can prevent most of the complications connected with this disease.
Asunto(s)
Preeclampsia/diagnóstico , Adulto , Presión Sanguínea , Parto Obstétrico , Femenino , Humanos , Recién Nacido , Preeclampsia/sangre , Embarazo , Proteinuria/diagnóstico , Adulto JovenRESUMEN
AIM: Our aim was to demonstrate the diagnostic difficulties as well as the atypical clinical development of ovarian tumours in combination with pregnancy. MATERIAL AND METHODS: We present a rare case of large mucinous cystadenoma in 32-year old patient, who is 20 gestational weeks pregnant. Ultrasound examination and MRI were performed, which visualized a huge multilocular ovarian tumour formation with a small amount of ascites. RESULTS: We performed laparatomy adnexectomy which included the ovarian cyst, partial omentectomy and we took 4 samples of smears from the whole abdominal cavity, as well as ascites samples for cytology. The pregnancy was preserved. The histological examinations reported: mucinous cystadenoma without morphological data for malignant transformation. CONCLUSIONS: In our rare case the organ preserving operation was a completely sufficient surgical staging procedure.
Asunto(s)
Cistoadenoma Mucinoso/cirugía , Quistes Ováricos/cirugía , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/cirugía , Ovario/cirugía , Complicaciones Neoplásicas del Embarazo/cirugía , Adulto , Cistoadenoma Mucinoso/diagnóstico por imagen , Cistoadenoma Mucinoso/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Quistes Ováricos/diagnóstico por imagen , Quistes Ováricos/patología , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias Ováricas/patología , Ovario/diagnóstico por imagen , Ovario/patología , Embarazo , Complicaciones Neoplásicas del Embarazo/diagnóstico por imagen , Complicaciones Neoplásicas del Embarazo/patología , UltrasonografíaRESUMEN
UNLABELLED: The currently available treatment for uncomplicated urinary tract infections includes only antibiotics and chemotherapeutic agents. Experience in the management of acute uncomplicated infections using non-antibiotic products is very limited. The aim of this observation was to study to what extent the response to Cystostop Rapid would be more rapid and more effective compared to antibiotic therapy in patients with acute uncomplicated urinary bladder infections. The secondary objective was to determine the time to improvement of cystitis symptoms following the start of treatment, as well as the duration of patients' disablement. A total of 158 female subjects were included, assessed microbiologically, and evaluated for incidence and severity of symptoms, before the start of treatment and after completion of treatment. A visual analogue scale was used for patient self-assessment of the severity of symptoms, the improvement of symptoms, as well as the time to improvement of symptoms. RESULTS: 158 females, eligible according to the inclusion criteria of the study, were allocated to one of the two groups according to time of enrollment: Group A included 86 subjects: assigned to Cystostop Rapid for 3 days and administered according to the manufacturer's recommended regimen; and Group B included 72 women: assigned to ciprofloxacin 500 mg twice daily for 3 days according to the Product Registration File with the BDA. The clinical and microbiological effectiveness of Cystostop Rapid was comparable to that of ciprofloxacin, providing a two-fold more rapid improvement of cystitis symptoms, at a mean time to improvement of 24 hours (p < 0.02) versus 46 hours for ciprofloxacin. Clinical improvement within 48 hours of Cystostop Rapid regimen occurred in 97% (p < 0.02) of patients, vs. 65.3% of patients on ciprofloxacin. Improvement of symptoms within 12 hours was reported in 36% of patients on Cystostop Rapid vs. 5.5% of patients in the ciprofloxacin group (p < 0.02). No adverse events or intolerability to the therapy were reported throughout the course of the study.
Asunto(s)
Antibacterianos/uso terapéutico , Ciprofloxacina/uso terapéutico , Cistitis/tratamiento farmacológico , Manosa/uso terapéutico , Preparaciones de Plantas/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Adolescente , Adulto , Betula/química , Cistitis/microbiología , Femenino , Humanos , Manosa/efectos adversos , Fitoterapia/métodos , Preparaciones de Plantas/efectos adversos , Resultado del Tratamiento , Vejiga Urinaria/efectos de los fármacos , Vejiga Urinaria/microbiología , Infecciones Urinarias/microbiología , Vaccinium macrocarpon/química , Adulto JovenRESUMEN
Plasma levels and urinary amino acid excretions were estimated by high-performance liquid chromatography in 15 control subjects and 36 stone formers (SFs) classified according to the stone type: (1) 22 cases with calcium oxalate stones; (2) four cases with pure uric acid stones; (3) 10 cases with magnesium-ammonium phosphate stones, either pure or mixed with apatite. Some types of stones (namely oxalate and uric acid calculi) are mainly formed as a result of a metabolic deficiency that may affect the amino acid metabolism, and thus may be reflected in the urinary amino acid pattern. Data demonstrated clearly that there is a general tendency towards decreased amino acid excretions in all SFs with all types of stones. As a whole, one can observe a higher percentage of patients with calcium oxalate and phosphate calculosis, who have low urine excretions of amino acids; about 50% are the SFs with lower urine excretion of serine, glycine, taurine and i-leucine; the high percentage of patients with CaOX calculi shows lower urine excretions of tyrosine and ornithine.
Asunto(s)
Aminoácidos/metabolismo , Cálculos Renales/metabolismo , Adulto , Aminoácidos/sangre , Aminoácidos/orina , Apatitas/metabolismo , Oxalato de Calcio/metabolismo , Cromatografía Líquida de Alta Presión , Femenino , Humanos , Cálculos Renales/sangre , Cálculos Renales/orina , Compuestos de Magnesio/metabolismo , Masculino , Persona de Mediana Edad , Fosfatos/metabolismo , Estruvita , Ácido Úrico/metabolismoRESUMEN
PURPOSE: To share our experience about partial resection (nephron sparing) in localized (T1aN0M0) renal hypernephroid cancer as organ preserved operation. Opportunities and longterm results. MATERIAL AND METHOD: For last 10 years we have done 89 partial resections in patients with localized renal hypernehroid cancer. In all cases we have done lymphatic dissection of relevant lymph region of the affected side. RESULTS AND DISCUSSING: All operated patients had five years of survival. We observed developing contralateral hypernefroid carcinoma in one patient that necessary performing a partial resection in this place. In two patients we performed a partial resection of a solitarykidney. The results of surgery are very good when we stage properly cancer process that allows organ preservation.
Asunto(s)
Carcinoma de Células Renales/cirugía , Neoplasias Renales/cirugía , Riñón/cirugía , Nefrectomía/métodos , Carcinoma de Células Renales/patología , Humanos , Riñón/patología , Neoplasias Renales/patología , Nefronas/patología , Nefronas/cirugía , Análisis de SupervivenciaRESUMEN
Retroperitoneoscopic approach is gradually becoming the method of choice in many urologic diseases. In this article we analyse and present the first cases of urological retroperitoneoscopic operations performed in the Department of Urology of the University Hospital "Akeksandrovska". For the period from May 2006 to March 2009 35 extra- and retroperitoneoscopic operations were performed. A 26 retroperitoneoscopic decortications (unroofing) of renal cysts with different localization were performed. 5 pieloplasties without interruption of pieloureteral segment (3 by Fenger method. 2 cases with Y-V pyeloplasty), 2 ureterolithotomies, 1 pyelolithotomy and one radical extraperitoneoscopic prostatectomy. The mean operative time in retro-peritoneoscopscopic decortications of renal cysts was 49.62 minutes (15 to 95 minutes), and in pyeloplasties, ureterolithotomies and pyelolithotomies, mean operative time was 88.00 minutes (65 to 150 minutes). The average pararenal drainage secretion was 138 ml for 24 hours (from 50 ml to 150 ml. The average blood loss was 86 ml (from 50 ml to 120 ml). In one case conversion was required because of technical problems and little experience of the team. Postoperatively in 5 cases (13.51%) we observed subcutaneous emphysema. The benefits of retro-extraperitoneoscopic urological operations are associated with lower morbidity, short stay in hospital, shorter recovery period and less pronounced pain syndrome.
Asunto(s)
Enfermedades Urológicas/cirugía , Humanos , Enfermedades Renales Quísticas/cirugía , Prostatectomía , Espacio Retroperitoneal/cirugía , Uréter/cirugíaRESUMEN
The local recurrence of the renal cell carcinoma in renal fossa after complete radical nephrectomy is uncommon. According to the latest articles related to this issue it ranges between 2% and 4%. For the period of 1999-2005 we evaluated 11 patients who underwent surgery for isolated renal cell carcinoma recurrence, all of them without clinical presence of distal metastases. 9 of the patients were operated for their first time in our department, and only two in other hospitals. These 9 patients represent 1.41% of the whole number of radical nephrectomies for RCC (637) which took place in our department for the same period of time. The tumor stage of the primary tumor varied from T1 to T3a. In addition lymph node dissection was performed on 7 of the patients. The average time for developing clinically significant fossa recurrence was 18 months. The current article has the purpose to present newer the data for the factors, which may be directly related to the risk of developing local recurrence in the renal fossa after complete radical nephrectomy--the initial tumor stage of the RCC, the relationship between the primary tumor and the histological type of the recurrent masses.
Asunto(s)
Carcinoma de Células Renales/cirugía , Neoplasias Renales/cirugía , Recurrencia Local de Neoplasia/cirugía , Nefrectomía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Renales/epidemiología , Carcinoma de Células Renales/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Neoplasias Renales/epidemiología , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/epidemiología , Recurrencia Local de Neoplasia/etiología , Recurrencia Local de Neoplasia/patología , Factores de RiesgoRESUMEN
Since 1989, when Hodge and al. demonstrated transrectal ultrasound guided prostate biopsy, it has become a "gold standard" for the diagnosis of prostate cancer. According to the experience gained in the period 1999-2003 in the Department of Urology-Medical University, Sofia, in a prospective follow-up of 20 prostate cancer patients, we found relationship between the positive tru-cut biopsy cores and the rate of positive lymph nodes.
Asunto(s)
Biopsia con Aguja , Ganglios Linfáticos/patología , Neoplasias de la Próstata/patología , Ultrasonido Enfocado Transrectal de Alta Intensidad , Anciano , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Neoplasias de la Próstata/diagnóstico por imagen , UltrasonografíaRESUMEN
The method of echography is one of the basic diagnostic methods used in medicine. It's application is of a great importance for the clinical estimation of the cases of kidney stone disease. The authors put a stress on the use of the echography as a method of a brand-new conception aiming to get a vision of the kidney stone as a geometric figure, based on a mathematical principle.
Asunto(s)
Cálculos Renales/diagnóstico por imagen , Adulto , Anciano , Femenino , Humanos , Cálculos Renales/terapia , Litotricia , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , UltrasonografíaRESUMEN
The medicine science is in a progressive mode. One of the ever discussed problems is the stone kidney disease and the optimizing methods of its treatment. In this article the authors announced a new method of applying jelly, thus improving the efficiency of the Extracorporeal Shockwave Lithotripsy (ESWL).
Asunto(s)
Cálculos Renales/terapia , Litotricia/métodos , Cálculos Ureterales/terapia , Anestesia , Femenino , Humanos , Cálculos Renales/etiología , Masculino , Resultado del Tratamiento , Cálculos Ureterales/etiologíaRESUMEN
The classic operative methods are still topical. Applying some new operative techniques makes the medical science more complete and thus help better treatment of the variety of diseases encountered in medical practice. In this article the authors present brand - new operative method of pieloplasty, named by them X-pieloplasty.
Asunto(s)
Hidronefrosis/cirugía , Procedimientos Quirúrgicos Urológicos/métodos , Femenino , Humanos , Hidronefrosis/epidemiología , Hidronefrosis/etiología , Riñón/cirugía , Masculino , Resultado del Tratamiento , Uréter/cirugíaRESUMEN
The development of the medicine itself, meets the current question of the common, interdisciplinary method of approach in the treatment of a series of diseases, such as biliurolithiasis. The attempt to make a classification is basic for making an optimal method of treatment of the biliurolithiasis. The biliurolithiasis is a disease influencing some new strategies of treatment in the combined efforts of the urologist and the surgeons both.
Asunto(s)
Colelitiasis , Urolitiasis , Colelitiasis/clasificación , Colelitiasis/complicaciones , Colelitiasis/diagnóstico , Colelitiasis/epidemiología , Humanos , Incidencia , Persona de Mediana Edad , Urolitiasis/clasificación , Urolitiasis/complicaciones , Urolitiasis/diagnóstico , Urolitiasis/epidemiologíaRESUMEN
Acute urinary retention is a problem a high medico-social importance. Many risk factors modify its incidence. Having un adequate information of the ethiology and the pathogenesis of the disease itself gives new opportunities for future therapeutic methods.
Asunto(s)
Retención Urinaria , Enfermedad Aguda , Humanos , Retención Urinaria/etiología , Retención Urinaria/terapiaRESUMEN
UNLABELLED: The common occurrence, of inflammatory diseases in the urinary tract and the genitals in men, is quite a reason for identification of the agents and looking for some new chances of therapeutic treatment. MATERIALS AND METHODS: For a period of two years (2002-2003) we accomplished 4810 microbiological tests of urine and prostate secretion on patients with uroinfections. The cultures are completed on standard nutrition medium, as the biochemical identification of the strains is accomplished by the systems mini API and "bio Merieux" BBL Crystal, "Becton Dickinson". Meanwhile for a period of one year, 113 patients with different uroinfections are treated and studied. In 16 (14.1%) Levofloxacin (Tavanic-R) is applied i.v. 500mg/daily as in the rest cases 97 (85.9%) Tavanic are applied per oral in different therapeutic doses. RESULTS AND DISCUSSIONS: The most common agent in our study was the E. Coli, as for the year 2003 we read an increase of the infections caused by E.Coli with 3.4% comparing to the previous one (38.5% to 35.1%). The differentiation of patients treated with Levofloxacin in groups is completed as follows: with acute uncomplicated cystitis--pyelonephritis after ESWL--15.9%; with postoperative uroinfections--20.3%; with chronic post-tuberculosis pyelonephritis--4.4%; and with inflammatory diseases of the male genitals--37.2%.
Asunto(s)
Antiinfecciosos Urinarios/uso terapéutico , Levofloxacino , Ofloxacino/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Orina/microbiología , Antiinfecciosos Urinarios/administración & dosificación , Esquema de Medicación , Enfermedades de los Genitales Masculinos/tratamiento farmacológico , Enfermedades de los Genitales Masculinos/microbiología , Humanos , Masculino , Ofloxacino/administración & dosificación , Resultado del Tratamiento , Infecciones Urinarias/microbiologíaRESUMEN
The increasing number of renal transplantations in Bulgaria and the increased survival rate of renal transplantation patients lead to an increase of the number of complications (vascular, urological, liquid collections) requiring surgical intervention. One hundred and ninety renal transplantation patients have been treated in the Department of Renal Transplantation for the period 1997-2003. Of these 12 were admitted to the Clinic of Vascular Surgery. We observed 36 surgical complications: arterial thrombosis--7, venous thrombosis--1, arterial stenosis--7, lymphocoele--4, hematoma--4, ureteral fistula--6, ureteral stricture--6, ureterolithiasis--1. We undertook following surgical interventions: vascular reconstruction, thrombectomy, lymphocoele punction, fenestration towards peritoneal cavity, reimplantation techniques (a modo Gregoari, Boeminghausi, Boari), termino-terminal anastomosis with native ureter, uretero-enteric anastomosis, ESWL of ureteral stone. Renal transplantation complications requiring surgical interventions are serious urological problem. The severity, the type (vascular, liquid collection, urological), and the diagnosis of these complications determine patients' prognosis. Urgent surgical interventions lead to rapid recovery of graft function, eradication of the infection, amelioration of blood flow, and improved graft survival.
Asunto(s)
Trasplante de Riñón/efectos adversos , Linfocele/cirugía , Complicaciones Posoperatorias , Procedimientos Quirúrgicos Operativos/métodos , Trombosis/cirugía , Enfermedades Urológicas/cirugía , Constricción Patológica/etiología , Constricción Patológica/cirugía , Hematoma/etiología , Hematoma/cirugía , Humanos , Linfocele/etiología , Trombosis/etiología , Enfermedades Urológicas/etiologíaRESUMEN
Aim of the embolization of the renal artery is to provoke ischemia or shut out from blood supply of the kidney tissue including pathologically changed area. As a result of this procedure the affected kidney becomes suitable for surgical removal without significant loss of blood. In this study there are included 116 nephrectomies due to kidney carcinoma. Clinical diagnosis and treatment of the patients are held at the Clinic of Urology of the Alexandrovska Hospital for the period 1990-1995. Embolization of the renal artery is accomplished in 52 subjects (63.41%). The procedure was contraindicated in 10 subjects (8.62%). It was established intraoperatively that the affected kidney had good embolization in 46 subjects (88.46%), in 4 subjects (3.44%) it had excellent embolization, and in 2 subjects (1.72%) there was just peripheral embolization. Authors conclude that: 1) Nevertheless this method is invasive it still has a place in urologists' practice. 2) Preoperative embolization of the renal artery is a devise for surgical removal of the kidney as well as achieving maximum effect.
Asunto(s)
Pérdida de Sangre Quirúrgica/prevención & control , Embolización Terapéutica , Neoplasias Renales/cirugía , Riñón/cirugía , Arteria Renal/cirugía , Humanos , Riñón/irrigación sanguínea , Nefrectomía/métodos , Resultado del TratamientoRESUMEN
Severe uro-genital infections frequently complicate a wide range of urological conditions. The favorable outcome of these infections depends mainly on the choice of appropriate antimicrobial treatment. Cefrom is bactericidal beta-lactamase-resistant IV generation cephalosporine antibiotic. In 2003 we treated 20 patients with severe urinary tract infections with Cefrom. We achieved excellent therapeutic results--urinary tract infections were eradicated in all patients, as shown by the microbiological investigations of urine specimen after the antibacterial course of treatment. The wide antimicrobial spectrum, the good tissue permeability in the organs of the genito-urinary tract and the good tolerability of Cefrom make this antibiotic a drug of choice in patients with acute and complicated urological infections.
Asunto(s)
Antibacterianos/uso terapéutico , Cefalosporinas/uso terapéutico , Infecciones Urinarias/tratamiento farmacológico , Orina/microbiología , Adolescente , Adulto , Antibacterianos/administración & dosificación , Cefalosporinas/administración & dosificación , Esquema de Medicación , Humanos , Persona de Mediana Edad , Resultado del Tratamiento , Infecciones Urinarias/microbiología , CefpiromaRESUMEN
UNLABELLED: The successes in the kidney transplantation are closely connected with the successes of the immunology and the advance of the immunosuppressive therapy. The main task of the modern immunosuppressive therapy is the insurance of medicines with a minimum nephro-toxicity, and the optimum protection regarding the adoptive body against an early reaction of rejection. The polycomponent anti-T-limphocitic antibodies (ATG) give us the opportunity of that. The polycomponent anti-T-limphocitic antibodies or the antilimphocitic serum (ALS) are xenogenetic polycomponent antibodies, that are directed to the human T-limphocites, i.e. antitimocitic globuline (ATG). They are received by immunization of rabbits or horses with human thymus limphoid cells. They are received for the first time by horses, and later on by rabbits. The last patent medicines have more powerful effect. In spite of the side effects of the polycomponent ATG, the patent medicine is used for inductive treatment after transplantation of organs and for a treatment of acutely rejection of the graft. We have treated 15 patients after kidney transplantation with ATG for a period of an year in the ward of kidney transplantation in The Clinic of Urology. The patients with transplantation are at the age of 21 to 50 years old, and by sex--11 male and 4 female patients. 9 of them are transplanted from alive donor and 6--from a dead body. We have applied the patent medicine of ATG Timoglobuline in a phial of 5 mg\ml intravenally in a bank of 500 ml physiological solution according to the weight and the blood test of the patients. We have applied a fourfold immunosuppressive therapy: Urbazon, Imuran, CyA(Neoral) +ATG. CONCLUSIONS: ATG is a mixture of monocomponent polyspecific antibodies, which, in spite of its side effects, has been applied successfully in transplantation for more than 30 years. In the course of many years anti-CD3 patent medicine OKT3 has been the only one monocomponent antibody for the treatment of an acute rejection of the graft for inductive therapy in transplanted patients.A chimerical (baziliksimab) and humanized (daklizumab) monocomponent antibodies of the alpha-chain of the receptor for IL-2 (CD25) are used for the prophylaxis of the episodes of acutely rejection of the transplanted kidney during the last 10 years. ATG does not consists of anti-CD25 antibodies. That is why the simultaneously application of ATG with baziliksimab or daklizumab is expected to have an additional effect with a complementary mechanism of efficacy.
Asunto(s)
Suero Antilinfocítico/uso terapéutico , Rechazo de Injerto/prevención & control , Inmunosupresores/uso terapéutico , Trasplante de Riñón/inmunología , Linfocitos T/inmunología , Adulto , Suero Antilinfocítico/administración & dosificación , Femenino , Rechazo de Injerto/inmunología , Humanos , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana EdadRESUMEN
The review of literature offerred discusses the opinions of different authors about indications and contraindications for radical oncological procedures in cases of renal and ureteral diseases.
Asunto(s)
Neoplasias Renales/cirugía , Uréter/cirugía , Procedimientos Quirúrgicos Urológicos , Urología , Humanos , Nefrectomía/métodos , Vejiga Urinaria/cirugía , Procedimientos Quirúrgicos Urológicos/métodosRESUMEN
Basically no one has ever introduced into practice any better procedure in cases of hydrocele than those of Winkelmann and Bergman. We recommend always a resection of the covering sheets of the testis as a profilactic measure against recurrency. Our study included 192 patients with hydrocele who were operated during the period 2000-2001 in the Clinic of Urology, Medical University of Sofia. The surgical procedures included: Winkelmann's procedure--in 118 cases (61,45%); Bergman's procedure--in 63 cases (32,81%);Orchiectomy--in 3 cases (1.56%) of total testicular atrophy; Combination of hydrocele and co-existing groin hernia was found in 4 cases (2,08%); Orchiectomy--in 1 case (0.52%) of bleeding which lead to hematoma on the 4th postoperative day; Reoperation--in 1 case (0.52%) of compression of the testicular blood vessels (after Winkelmann's procedure); Suppuration of the operative wound-- in 2 cases (1.02%) after Winkelmann's procedures. The authors consider that: 1. Winkelmann's and Bergman's procedures prooved to be quite satifactory as surgical treatment of patients with hydrocele. 2. Diagnosis and surgical treatment are easy to be performed. Postoperative complications are possible in cases of poor surgical technics, damaged local status and shortened time for hemostasis. 3. The well-known method of Lord was not used in our practice, but we do not deny it.