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Biomedical subjects

B Vladimirov

Publications and source records attributed to B Vladimirov.

34 records · Page 2Linked to original sources
PubMed1989

[Comparative studies of peptic ulcer in the active stage with and without hemorrhage].

100 patients with gastric peptic ulcer and 100 patients with duodenal peptic ulcer in an active with well expressed pain syndrome were studied clinically and gastroscopically. These two groups of patients were compared by several indices with a group of 81 patients with gastric peptic ulcer and 243 patients with duodenal peptic ulcer admitted to hospital because of acute bleeding from the ulcer. All patients were examined endoscopically with a fibroscope "Olimpus--GIF--Q 10". The results were processed by the semiquantitative statistical method--U criterion. It was established that the peptic ulcer patients over 60 years of age bleed more often than the younger ones. The incidences of bleeding increase with the duration of the ulcer. Comparatively more often bleed the ulcers on the posterior wall of the duodenal bulb and the larger ulcers. Preceding drug induced lesions are found more often in the bleeding ulcer patients than in the non-bleeding ones with an expressed pain syndrome only. The results lead to the conclusion that advanced age, use of ulcerogenic drugs and greater size of the ulcer are unfavourable risk factors for bleeding in the patients with peptic ulcer.

Adult↗
PubMed1989

[Endoscopic treatment of cholangitis via an external nasobiliary drain].

The acute suppurative cholangitis is an acute emergency condition requiring quick decompression of the obstructed bile pathways. The authors present their experience in the treatment of 51 patients by endoscopic sphincterotomy with or without mechanical lithotripsy and extraction of the stones and a nasobiliary drainage for 5 up to 15 days. Technically the manipulation was 100% successful and its therapeutic efficacy was 94.2% including II patients to whom it was performed as a preoperative procedure. In 6 patients (11.8%) a transitory amylase elevation was registered and one patient (2%) developed acute pancreatitis. The treatment was unsuccessful in 6% of the patients--these were patients with severe liver impairment (biliary cirrhosis) and long term cholangitis. The authors recommend the biliary drainage as an emergency and temporary treatment of the acute suppurative cholangitis.

Acute Disease↗
PubMed1989

[Treatment of peptic ulcer using proglumide (Milid)].

20 patients with peptic gastric ulcer and 30 patients with peptic duodenal ulcer were treated with Milid (Proglumid). The following results were achieved: in 85% of the patients with peptic gastric ulcer and in 93% of the patients with duodenal ulcer the pain was relieved on the 4th day on the average. In 95-96% of the patients treated the dyspeptic complaints disappeared on the 2-3 day. The endoscopic examination performed on the 20th day revealed full epithelization of the ulcer in 30% of the patients with gastric ulcer and in 43.3% of the patients with duodenal ulcer. Following the treatment course the basic secretion and acid production fell statistically significantly in the patients with gastric ulcer while in the patients with duodenal ulcer the basic and stimulated secretion and acid production were suppressed. The drug Milid does not change the serum gastrin level but suppresses the gastrin secretion in the gastric juice. The Milid treatment leads to an increase of the quantity of the N-acetylneuraminic acid in the gastric juice which partly reflects the cytoprotective action of Milid. The drug can be used in the everyday practice for the treatment of peptic ulcer.

Adult↗
PubMed1989

[1-step endoscopic laser papillosphincterotomy with endoscopic biliary drainage].

Two patients with obstructive jaundice are presented. They had cancer of the large duodenal papilla and choledocholithiasis with edema and deformity of the papilla. Endoscopic laser papillosphincterotomy with "Nd-YAG" laser and one-step endoscopic biliary drainage--endoprosthesis of the common bile duct and naso-labial drainage, respectively--were performed. The importance of laser papillotomy in patients, in whom electropapillotomy can not be accomplished or will not give satisfactory results, is emphasized. Analysis is made of the periodic medical literature on this problem. Report is made for the first time on combining two endoscopic methods--laser photocoagulation and endoprosthesis in benign and in malignant stenoses of the papilla, realized in one act.

Aged↗
PubMed1989

[Transendoscopic mechanical lithotripsy in choledocholithiasis].

When there are large stones in the common bile duct or constrictions of the bile ducts the stones very often cannot pas spontaneously or after an endoscopically performed sphincterotomy. In 54 patients after an unsuccessful attempt to extract the stone with the Dormia-basket endoscopic mechanical lithotripsy was performed followed by balloon extraction of the fragments, balloon dilatation of the constricted sectors of the bile duct and securing a bilionasal drainage for prophylaxis of cholangitis. The mechanical lithotripsy was successful in 50 of the patients (92.4%). The jaundice and the cholestasis decreased up to the 10-th day and the cytolytic enzymes became normal. Complications occurred in 2 patients (4%)--hemorrhage up to the 12-th hour after the manipulation. The author recommends, in cases of unsuccessful stone extraction by endoscopic sphincterotomy, the mechanical lithotripsy in combination with balloon extraction of the fragments, balloon dilatation of the constricted sectors of the bile duct and nasobiliary drainage for washing the bile ducts, prevention of bile duct occlusion and treatment of cholangitis in cases of unsuccessful extraction by endoscopic sphincterotomy.

Adult↗
PubMedDate not supplied

Quantitative assessment of severity of biliary tract infection.

BACKGROUND/AIMS: It is very important for physicians to evaluate the severity of the biliary infection. At the moment, there is no useful quantitative system. In this study, we propose a scoring system for assessing the severity of biliary infections and evaluation of the efficacy of antibacterial and endoscopic treatments. MATERIALS AND METHODS: We created a biliary tract infection score (BTIS) including local physical and ultrasound findings, signs of inflammation and hepatobiliary involvement. The BTIS was calculated in 317 patients: group I-155 pts with cholecystitis and cholangitis, treated only by antibiotics and group II-162 pts with acute cholangitis treated by endoscopic procedures. RESULTS: The BTIS allowed the differentiation of the severity of biliary infections: 15.50 +/- 0.52 in acute cholangitis group and 5.77 +/- 2.79 in group I (p < 0.001). The BTIS significantly decreased after antibacterial therapy (excluding only the cefotiam subgroup) and in endoscopicaly treated patients. CONCLUSIONS: The BTIS is a combination of simple, reliable, acceptable and low cost parameters, reflecting the principal pathological processes and degree of abnormalities. A BTIS facilitated the assessment of severity of biliary infection and comparison of the results of various methods of treatment.

Aged↗