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A Nikolov

Publications and source records attributed to A Nikolov.

At least 19 recordsLinked to original sources
PubMed2006

Detection of free elastin-derived peptides among diabetic children.

Elastin breakdown products are found in the serum of all human subjects. The presence of these elastin-derived peptides (EDP) and the corresponding antibodies in circulation leads to formation of circulating immune complexes (CIC). The aim of this study was to determine if serum level of free-EDP (unbound in CIC) correlate with the development of microvascular complications in children with Type 1 (insulin-dependent) diabetes mellitus. To this end we used a method for detecting immune complexes (CIF-ELISA) in combination with an ELISA for detection of EDP. The levels of free EDP were studied in sera of 81 diabetic children (mean age 13.46+/-3.51 years, diabetes duration 5.17+/-4.21 years). Forty-two of the children had vascular complications (group 1) and 39 were without vascular complications (group 2). Twenty-one healthy children (mean age 12.6+/-2.47 years) were used as controls. Diabetics showed significantly higher levels of free EDP (68.1+/-25 ng/ml versus 51+/-12.5 ng/ml; p=0.003) compared to the control group. In group 1, free EDP showed significantly higher levels than controls (78.9+/-25.6 ng/ml versus 51+/-12.5 ng/ml; p=0.0001). About 38 of 81 (47%) patients were positive for free EDP (30/42--71% in group 1 and 8/39--21% in group 2). Free EDP levels in all diabetics showed a correlation with insulin dose (r=0.23; p=0.041), and microalbuminuria (r=0.57; p=0.0001). Patients who had vascular pathology showed a correlation of free EDP with microalbuminuria (r=0.41; p=0.0081), retinopathy (r=0.32; p=0.041), insulin dose (r=0.37; p=0.02), HbA1c (r=0.35; p=0.03), systolic blood pressure (r=0.30; p=0.045) and total cholesterol (r=0.36; p=0.02). These findings suggest that elevated levels of free EDP are associated with the development of diabetic vascular complications in children.

Adolescent↗
PubMed2006

[Assessment of Bishop's pelvic score in induction of labor prognosis].

Aim of the present mixed prospective and retrospective study is to determine the prognostic significance of the 5 parameters of the pelvic score of Bishop for the continuity and the final outlet of induction of labor. Based on the given results the authors conclude that the dilatation of the cervix is a good prognostic factor for the nulliparous and bad prognostic factor for multiparous. The effacement of the cervix is significant for the outlet of the induction regardless of parity. The level of the presenting part is a valuable criterion for the nulliparous when the pelvic is well assessed but for the multiparous it has no prognostic value. The firmness of the cervix has a bad prognostic value regardless of parity. The position of the is a good prognostic factor for the outlet of the induction but has no value prognosis of the continuity of the induction.

Cervix Uteri↗
PubMed2006

[Phlebothrombosis and thrombophlebitis during the second half of pregnancy and puerperium].

Fhlebothrombosis and thrombophlebitis of the cerebral veins and sinuses develop relatively rare, but they affect young people and have poor prognosis. Pregnancy and puerperium are et risk due to hormonal and homeostatic changes in the organism. This report exhibits the most frequent etiologic factor, early symptoms, clinical manifestation, diagnostic value of the different methods, treatment principals and the factors that determine the outcome of thrombofphlebitis and phlebothrombosis during pregnancy and puerperium. In the acute phase a treatment with direct anticoagulants (intravenous heparin or low molecular mass heparins) and symptomatic treatment with anticonvulsants and drugs against oedema. After the acute phase the treatment continues with oral indirect anticoagulant as long as the severity of the disease requires.

Female↗
PubMed2006

[Magnetic resonance imaging--diagnosis and differential diagnosis of tumor formations (cyst) in the abdomen cavity during pregnancy].

The existence of tumor formations with unidentified origin in the abdomen cavity of the pregnant can cause serious problems during the operative intervention. It is critical to find the organ origin of the existing formation and it's relations with the neighboring organs. In the following article we present some of the capabilities of the magnetic resonance tomography as a complementally to the existing in the clinical practice classical and special methods for diagnosis and differential diagnosis of tumor formations in the abdomen cavity during pregnancy. MRI locates precisely the organ origin, the type and the size of the cyst formation, furthermore it helps to determine in detail the access point, the type and size of the operative intervention. The technique is harmless concerning the pregnancy and the development of a normal, healthy fetus.

Abdominal Cavity↗
PubMed2006

[Hysteroresection of submucous myomas after treatment with zoladex].

UNLABELLED: The early and heavy clinical symptoms of the submucous myomas demand early surgical intervention. The new alternative to the classical abdominal operation is the transcervical hysteroresection which is miniinvasive and organ-preserving procedure. OBJECTIVE: to assess the effect of the preoperative treatment of the patients with Goserelin acetate (Zoladex) on the intraoperative measures (operation time, intraoperative complications, difficulty of the procedure). STUDY DESIGN: prospective. PATIENT(S) AND METHODS: Total of 50 women with submucous myomas underwent hysteroresection. Ten of them were treated with Zoladex for two months preoperatively. RESULTS: In the treated group a mean decrease of 10.16 mm of the myoma diameter was achieved. This is especially important for myomas above 30 mm in diameter because 10 mm decrease in diameter leads to significant reduction of the tissue volume which has to be resected. In the treated group the mean operation time was decreased by 17.08 min. and the operation was assessed as "easier" in 90% of the cases. The authors assessed that the positive effect of Zoladex consists not only of the decreasing of the myoma diameter but also of achieving an endometrial atrophy which significantly improves the conditions for performing the intrauterine operation. CONCLUSION: Hysteroscopic resection of submucous myomas after pretreatment with Zoladex is faster, easier and with less intraoperative complications.

Adult↗
PubMed2006

[Pregnancy after treatment of primary sterility with zoladex in patient with essential thrombocytopenia].

We have a patient with essential /idiopathic/ thrombocitopeny and primary sterility, who becomes pregnant after medical and operative treatment. With the beginning of the menarche her menstrual cycle goes irregular with menstrual bleeding duration from 8 to 20 days, cystic ovaries, non-ovulation cycles, trombocytopeny and anemia. A laparotomy was performed twice, because of the existence of hemoperitoneum, caused by a rupture of the corpus luteum. After achieving a amenorrhoea with Zoladex treatment, a splenectomia was performed. As a result we observe a physiological recovery of the menstrual cycle, the ovulation cycle and the pregnancy. The patient's hematology and hemostaseology statuses went back to normal.

Amenorrhea↗
PubMed2006

[The efficacy of the misoprostol in cases of abnormal and pathologic hypotonic hemorrhage in the early puerperium].

UNLABELLED: The aim of this study is to determine the efficacy of the Misoprostol (Cytotec) in cases of abnormal and pathologic hypotonic hemorrhage in the early puerperium as a result of hypotonia of the uterus. MATERIAL AND METHODS: A group of 50 women with vaginal or abdominal labor developing hypotonic abnormal/pathologic bleeding after the placental delivery were given Misoprostol (Cytotec 200-400 microgr per rectum and/or per oral every 15 min). We compared this group with a control group without having postpartum bleeding. RESULTS: The application of Misoprostol resulted in uterine contraction and discontinuing the abnormal bleedings in both vaginal and Caesarian deliveries. The main blood lost in the next two hours period after vaginal labor didn't differ with the blood lost of the normal labors (66 ml vs. 75 ml). In the Caesarian deliveries the blood lost after application of the Misoprostol also didn't differ with the blood lost after normal caesarian section (78 ml vs. 80 ml). CONCLUSIONS: Misoprostol decreases the hypotonic uterine bleedings in the placental and early puerperal period. The significance of the Misoprostol in the group of therapeutic events is determined by its fast therapeutic effect, its convenient application and its good tolerance.

Administration, Oral↗
PubMed2006

[Using GnRH-agonists (Zoladex) in the treatment of genital endometriosis].

METHODS AND MATERIALS: The study is prospective and involves 112 patients suffering from pelvic endometriosis aging from 19-38 years. (28.6 average age). The disease was diagnosed via laparoscopy and the stage was determined using the revised AFS classification. Zoladex (Goserelin depot--3.6 mg) is being applied every 28 days for 6 months in the hypodermic tissue of the front abdomen wall. All patients are being examined monthly after every Zoladex application (for subjective complaints--dysmenorrheal, dyspareunea, pelvic pain; serum estradyol-E2; amenorrhea; side effects) and every 24 months (recuperation of the menstrual cycle, pregnancy). RESULTS: In 88% of the patients amenohrea is obsereved in the first eight weeks of therapy. The menstrual cycle takes an avarege of 68 (31-139) after the last Zoladex application to reappear. At the end of the first month after the first application the serum level of estradyol E2 is lowered to a menopause level (from 750-800 to 120-130 Pmol/L) and it remains as low till the end of the treatment. Eight weeks after the completion of the therapy it goes back to its normal values. During the course of the first month of amenorrhea condition a 38% fall in the level of complaints (dysmenorrheal, dyspareunea, pelvic pain) is observed. After the 6th month 88% of the patients have no complaints. Side effects observed during the course of treatment include warm waves, sweating, vaginal dehydration (60-80%) which do not in any way disturb the patients to the point of quitting the therapy and do disappear with its end. The focus group contains 54 infertile patients with endometrioses willing to get pregnant. In 12 months after the completion of the treatment 16 of the patients become pregnant, followed by 12 more in the next one year. CONCLUSION: Zoladex causes amenorrhea, which lasts till the end of the treatement. It causes a rapid drop of the serum consentration to a menopause level. Causes a strong and durable treatment of the symptoms of endometriosis. The side effects disappear with the end of the therapy. The treatment is easy to go through and there no cases of a quitting patient. The treatment has a curable effect over the endometriosys and in cases of infertility provides a possibility for pregnancy.

Adult↗
PubMed2006

[Vaginal candida infection in the third trimester of pregnancy].

The aim of this study is the determination of the frequency of vaginal Candida colonization in pregnant women in the third trimester, the status of the vaginal ecosystem, the grade and the subspecies of the candidal colonization, clinical manifestations and the therapeutic effect of the local antimycotic treatment. In this study it has been followed 172 pregnant women with a normal pregnancy at the end of the third trimester. It has been estimated that about 28.4% of all women get a vaginal yeast colonization - Candida spp. In 89.7% (44 women) of the cases, the colonization was caused by an overgrowth of the yeast Candida albicans. The remaining cases are caused by other subspecies of Candida - 5 cases (10.3%) - C. tropicalis /2/, C. parapsilosis /2/, C. glabrata/1/. The women in the first group were with symptoms of active candidosis (25.6%) and 88.3% of the cases were confirmed by microscopy, and 90.6% after a bacterial growth in a culture. In 7.7% of the cases was specified a mild to moderate colonization without a clinical signs of infection (II group). The local treatment with antimycotic vaginal globules and crème for 5 to 7 days alleviates the clinical symptoms. It was not observed a case of maternal - fetal transmission of this infection not a clinical manifestation in the early postpartal period.

Candida↗
PubMed2006

[Torsion of a nongravid leiomyomatous uterus].

The torsion of a nongravid uterus is not of frequent occurence. The leading reasons are a presence of an adnexial formation or leiomyomas. In this case report it has been presented a 65-year old patient with a hard abdominal pain. After the gynecologic and ultrasound examination it has been found an uterus myomatosus with three intramural-subseros leiomyomas. By the following laparotomy was confirmed the ultrasound results - the uterus with big intramural-subserous leiomyoma 8-9 cm in a diameter, and two more leiomyomas - 5 cm, a torsion of the body uterus at 180 degree above the vaginal part of the cervix. The adnexes were rotated around the supravaginal (isthmic) part of the uterus, the uterine tubes were hyperemic, swollen, with livid color, and the ovarian were atrophic. Total hysterectomy with bilateral adnexectomy was performed. We suggested that the main reason for this torsion of the uterus was the presence of leiomyomas and the genital descensus played a role as a predisposition.

Aged↗
PubMed2005

Serum AGE-elastin derived peptides among diabetic children.

The purpose of the study was to measure advanced glycated end products (AGE) of elastin in human serum. In the present study, we adapted an ELISA technique for the determination of AGE-elastin-derived peptides (AGE-EDP) in human sera of healthy and diabetic subjects. This test makes use of human aortic elastin hydrolyzed by a chemical procedure (alpha-elastin) and AGE-Hemocyanin. Polyclonal sera from rabbit against AGE-Hemocyanin and from sheep against alpha-elastin were obtained and their specificity was tested via direct and competitive ELISA. Sera of 60 Type 1 (insulin-dependent) diabetic children and 28 healthy subjects were tested. The patients with vascular complications showed significant higher levels of age, diabetes duration, systolic blood pressure (SBP), diastolic blood pressure (DBP), dose, EDP and AGE-EDP than those without vascular complications. AGE-EDP concentrations of all diabetics correlated with triglycerides (r=0.19; p=0.04). The correlation was found between AGE-EDP and DBP in the subgroup of patients with microalbuminuria+retinopathy (r=0.94; p=0.0006). The subgroup of patients with microalbuminuria (n=19) showed correlation with age (r=0.24; p=0.008), AGE-EDP (r=0.65; p=0.0001), EDP (r=0.51; p=0.0001) and SBP (r=0.33; p=0.0003). Further studies are necessary to elucidate the relationship between the serum level of AGE-elastin degradation products and diabetic vascular complications. The measurement of non-invasive markers of elastin synthesis and degradation may be useful in monitoring development and therapeutic intervention in diabetic vascular complications.

Adolescent↗
PubMed2005

Serum fibrillin-antifibrillin immune complexes among diabetic children.

The fibrillins are large glycoproteins components of 10-nm microfibrils found in the extracellular matrix of most tissues. Microfibrils play a role in elastic fiber assembly and serve to link cells to elastic fibers in the extracellular matrix. Fibrillin-1 (FBN-1) and -2 (FBN-2) are large, secreted glycoproteins known to be components of extracellular matrix microfibrils located in the vasculature, basement membrane, and various connective tissues and are often associated with a superstructure known as the elastic fiber. Anti-fibrillin antibodies found in some autoimmune diseases could form circulating immune complexes (CIC) with corresponding antigens. Type 1 (insulin-dependent) diabetes mellitus is an autoimmune disease leading to formation of different types of autoantibodies. To determine the possible presence of FBN-anti-FBN CIC (IgG and IgM) were studied by modified version of ELISA 35 children with Type 1 diabetes mellitus (mean age--12.37+/-3.77 years, diabetes duration 4+/-3.5 years). Eight of the diabetics had vascular complications. Twenty healthy children (mean age--11.58+/-2.89 years) were used as controls. Diabetics showed statistically significant higher levels of FBN-anti-FBN-2 CIC - IgG (0.303+/-0.076 vs. 0.252+/-0.029; p=0.029) and IgM (0.415+/-0.085 vs. 0.348+/-0.069; p=0.018) compared to the control group. FBN-anti-FBN-1 CIC IgM correlate with diabetes duration (r=0.52; p=0.0015) and BMI (r=0.33, p=0.053) while FBN-anti-FBN-1 CIC IgG correlate with serum Zinc (r=0.49, p=0.006). FBN-anti-FBN-2 CIC IgG correlate with microalbuminuria (r=0.65, p=0.0046) and retinopathy (r=0.61, p=0.0001). This study suggests that there may be a relationship of levels of FBN-anti-FBN-2 CIC IgG with the development of diabetic microangiopathy. Of course the number of the tested patients is limited for definitive conclusions. Although the meaning of these results is still being determined, the measurement of FBN-anti-FBN CIC may represent immunologic markers of FBN metabolism.

Antigen-Antibody Complex↗
PubMed2005

[Reference values range of the fetal oxygen saturation and its dispersal during labor without cardiotocographic evidence for fetal distress].

UNLABELLED: The objective of this study is to establish the reference values range of the fetal oxygen saturation during the first and the second period of labor and their dispersal according to the extent of cervical dillatation in cases with normal FHR--absence of fetal hypoxia and asphyxia of the newborn. MATERIAL AND METHODS: This is a prospective study which involves 94 women with normal FHR. All of the newborns are with umbilical artery pH values greater than 7.15 and 5 min Apgar score greater than 7; there was no necessity for any reanimation procedures, assisted ventilation or intensive care treatment. The fetal oxygen saturation (SpO2) is monitored by fetal pulseoxymeter Nellcor N 400, fetal sensors FS - 14. Cardiotocographic monitoring is carried out simultaneously. Blood is obtained from the fetal scalp during labor for blood gas and pH analysis, and umbilical artery pH as well as the Apgar score of the newborn are determined. RESULTS: The average monitoring time during the first period of labor is 107.19+/-29.49 min. with reliability of the recordings 86.54+/-6.10%. The average monitoring time for the second period of labor is 36.72+/-8.31 min. with reliability of the recordings 75.42 +/-9.61%. The mean SpO2 values are 48.71+/-5.52% during the first period and 47.30+/-4.62% during the second period of labor. The reference SpO2 values ranging between the 25-th and 75-th percentile in fetuses with normal FHR are 46-52 % for the first and 44-50 % for the second period. The results for fetal SpO2 during the different stages of cervical dillatation are as follows: for 4-5 cm - 49.49+/-5.12%, for 6-7 cm - 48.76+/-5.42%, for 8-9 cm - 48.39+/-5.49%. CONCLUSIONS: The fetal SpO2 dispersal during cervical dillatation of 4-5, 6-7 and 8-9cm accordingly demonstrates a nonsignificant decrease of SpO2 for the different groups (p>0.05). The fetal SpO2 dispersal between the first and the second period of labor also demonstrates decrease of SpO2 values and shows a minor statistically significant difference (p < 0.05 - Repeated measures ANOVA), which is considered to be within the normal range and does not reflect on the newborn's well-being.

Apgar Score↗
PubMed2005

[Link between the state of vaginal flora and the development of uroinfection during pregnancy].

One hundred and forty urines and vaginal secretions from pregnant women were investigated. Significant account of microorganisms in urine was found in 12 cases/8.5%/. In the group I/N normal vaginal flora/ in 3.2%, in the group II/I intermediate vaginal flora/ in 8.1%, in the group III/BV/ in 20% of the cases. The high-degree vaginal colonization with uropathogens endangers the women with development of ascendant uroinfection during pregnancy.

Female↗
PubMed2005

[Amyloid-producing leiomyoma of the womb--a complete morphological study and possible etiology].

Case study of a 41 year old woman with tumor-related amyloidosis in a singular intramural leiomyoma of the uterine corpus. The tumor has been thoroughly revised with electron microscopy and underwent a histological, histochemical, and imunohistochemical studies. A hypothesis of its origin has been suggested. To our knowledge, this is the first documented case of amyloid-producing leiomyoma.

Adult↗
PubMed2005

[Prognostic significance of Bishop's pelvic score for the continuity and the final outlet of induction of labor].

Aim of the present mixed prospective and retrospective study is to determine the prognostic significance of the pelvic score of Bishop for the continuity and the final outlet of induction of labor and to determine the optimal score in the beginning of the induction related with a successful outlet. Based on the given results the authors conclude that the pelvic score of Bishop has a good prognostic value for the continuity and the final outlet of induction of labor with a various values of the separate parameters. Pelvic score > or = 5 is related with a shorter and more successful inductions of labor.

Delivery, Obstetric↗