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Biomedical subjects

D Karadimov

Publications and source records attributed to D Karadimov.

17 recordsLinked to original sources
PubMed1999

[Orthotopic liver transplantation - recipient selection criteria].

In a great number of patients with progressive liver diseases whose terminal phases are cirrhosis and hepatic insufficiency, liver transplantation is the only feasible therapeutic alternative. However, the undertaking of liver transplantation is largely dependent on the availability of donor organs. Hence, the process of selecting the most adequate recipient is of critical importance from both medicolegal view-point, and in terms of the likelihood of a successful outcome of transplantation. The study is designed to asses the problems faced with a special reference to indications, contraindications and timing of liver transplantation.

Ethics, Medical↗
PubMed1998

[Hemodynamic changes and nitric oxide production in an experimental model of sepsis].

Nitric [correction of Nitrous] oxide is most likely a queer "end mediator" giving rise to vasoplegia in septic shock patients. The study is aimed at comparative assessment of kinetic changes in the synthesis of nitric [correction of nitrous] oxide in experimentally induced sepsis model with the corresponding hemodynamic parameters. The laboratory animals--pigs--are divided up in two groups, and exposed to general narcosis induction, orotracheal intubation and mechanical ventilation under controlled regimen. The hemodynamic parameters studied include: MAP, CO and SVR. Additional endotoxin (1 mg/50 ml) in the form of infusion is given to the animals in the sepsis group. Nitrate production mirrors NO synthesis, insofar as there are no other relevant mechanisms of nitrate synthesis. The kinetic parameters of nitrate production are estimated using stable nitrate isotopes--N15. The theory of compartment models and appropriate computerized simulation are used to calculate the respective constants. In the endotoxin treated group (n = 5) a significantly higher level of synthesis of induced NO production is documented--26 +/- 9 mumol/h, as compared to production in the control group--6 +/- 7 mumol/h, as well as a significant increase in cardiac output and systemic vascular resistance reduction. The good correlation between enhanced NO production and hemodynamic response (increase in cardiac output and decrease in systemic vascular resistance) corroborates the validity of the method.

Animals↗
PubMed1996

[The pathophysiological and intensive care-resuscitation aspects of septic shock].

Sepsis and septic shock continue to be the most common causes of death and multiple organ failure among patients in intensive care units. The standard therapeutic regimens include surgical removal of the source of sepsis, antimicrobial therapy, optimizing oxygenation, volume resuscitation, and treatment with catecholamines. The ever extending knowledge of the pathophysiological role played by cytokines and nitrous oxide in septic shock promote the efforts to control their synthesis and pharmacologic action in clinical situations. New therapeutic approaches have become available, including the administration of high doses immunoglobulins, monoclonal antibodies against endotoxin, pentoxilfyline and nitrous oxide inhibitors. Based on the encouraging findings, controlled clinical studies are undertaken to assay with precision their clinical efficacy.

Critical Care↗
PubMed1996

[Nitric oxide--a basic mediator of vasodilation and septic shock].

Nitric oxide is synthesized from the amino acid I-arginine by a family of enzymes, the nitric oxide synthases. The synthesis of nitric oxide by vascular endothelium is responsible for the vasodilatator tone that is essential for the regulation of blood pressure. NO also contributes to the control of platelet aggregation and the regulation of cardiac contractility. These actions are all mediated by the activation of soluble guanylate cyclase and the consequent increase in the concentration of cGMP in target cells. Several studies suggests that some diseases are related to defects in the generation or action of nitric oxide. Some of the features of septic shock, including hypotension, vascular hyporeactivity, myocardial depression and tissue damage appears to result from excess production of NO. Controlled clinical trials to assess the effects of nitric oxide synthase inhibitors on mortality and morbidity in septic shock seem justified and are already planned.

Animals↗
PubMed1996

[The multiple organ failure syndrome--its pathophysiology and treatment].

Polyorganic deficiency syndrome (PODS) is a generalized response to the effect of a variety of agents hardly lending itself to control, becoming manifest with rapid proliferation within the body. The issues discussed include: epidemiology with a special reference to panendothelial trauma to pulmonary and other systems with impairment of oxygen utilization by the cells, microcirculation disorders, mediators, ARDS development, disturbed barrier function of the intestinal mucosa, enhanced glutamine consumption with ensuing villous atrophy. Symptoms presented by various organs, treatment consisting in block of stimulation and block of mediators, as well as selective decontamination and adequate diet are also dealt with. Against the background outlined above the prognostic point rating system (the so-called score rating) of PODS with simultaneous application of the APACHE III rating system are evaluated. Age-related factors and number of organs involved are likewise considered.

Humans↗
PubMed1995

[Controlled hypotension against a background of nimodipine during an operation on neurosurgical patients with hypertension].

Operative interventions in subarachnoid hemorrhages caused by brain vessel aneurysm require meticulous dissection of the latter. Regardless of the preoperative preparation of hypertensives, hypertension is a factor predisposing to intraoperative blood pressure fluctuation which, in turn, is extremely unfavourable and interferes with the operation proper on the aneurysm. What is more, it augments the spasm of cerebral vessels and brain edema. Any increase in blood pressure may result in a rupture of the aneurysm. As shown by a parallel study on two groups of patients with hypertension, following intraoperative administration of calcium antagonists having a preventive effect on brain, the stabilization of blood pressure attained is persistent, with the spasm of cerebral vessels and brain edema lending themselves more readily to control. The application of controlled hypotension is more easily effected, and administration of ganglioblocking agents is unnecessary.

Adolescent↗
PubMed1995

[Glutamate antagonists--a new stage in the development of cerebral protection?].

This is a survey of 35 papers, published in medical journals worldwide over the past 5 years, in an attempt to disclose the current level of understanding the fine biochemical mechanism underlying neuronal lesions, as well as to outline the possible trends of cerebroprotective therapy evolution, as put forward by the authors of the cited works. A number of researches demonstrate the role of glutamate and other excitatory amino acids in neuronal lesions' development during hypoxia, hypoglycemia, cranio-cerebral trauma and the like. It is logical to presume that the antagonists of glutamate receptors and their relationship to ionic canals may be considered as having an essential bearing on the build-up of a complex cerebroprotective strategy, corroborated in turn by a number of studies on cell cultures in vitro, and in numerous animal models as well. The already known and clinically used phencyclidine compounds, and first and foremost, the general anesthetic ketamine, spark a great surge of interest along these lines.

Animals↗
PubMed1994

[A case of an impossible cannulation of the v. jugularis and v. subclavia in a female patient with longstanding myasthenia gravis and immunosuppressive therapy].

The report deals with a female patient presenting myasthenia gravis of 8-year duration, maintained on continuous APV, repeatedly cannulated central veins, and immunosuppressive therapy with corticosteroids--Imuran and Sandimmun. Repeated CT examination of the mediastinum fails to detect any process. The consecutive scanning is necessitated because of the impossibility to cannulate v. jugularis and v. subclavia at the last attempt. Cytological evidence of a thymosarcoma is established during examination.

Adult↗
PubMed1994

[A case of generalized convulsion during induction with Diprivan].

The case report concerns a male patient presenting oligophrenia and epilepsy of long duration, adequately prepared for anesthesia with anticonvulsants, sustaining generalized convulsion during anesthesia induction with Diprivan. On deepening Diprivan anesthesia, the convulsion subsides. The patient runs an uneventful postoperative course, free of convulsions. The issue of small doses Diprivan giving rise to convulsions is comprehensively discussed.

Adult↗
PubMed1994

[Morphine and benzodiazepine derivatives in cerebral angiographies].

This is a report on thirty-two patients undergoing cerebral angiography, performed under combined local analgesia in conjunction with morphine and benzodiazepine derivatives. Emphasis is laid on the lack of serious life-endangering complications. The risks of general anesthesia are avoided, and the patient's psyche is conserved. Investigations are performed during both planned and emergency angiographies. A pregnant female patient is also examined by the method described. There are no complications worth noting. The method is proposed as a procedure intermediate between general anesthesia and local analgesia.

Adult↗
PubMedDate not supplied

Hypoxia reduces the conduction velocity of the excitation along the striated muscles in man.

The conduction velocity of the excitation along the striated muscles in man, hereafter refered to as muscle fiber conduction velocity (MFCV) was used to estimate the muscle functional state under hypoxaemic hypoxia. The averaged MFCV was counted by the method based on the surface measurements (using bipolar "branched" multielectrodes) of the electrically elicited compound action potentials of the brachial biceps muscle. The arterial and venous blood-gas and acid-base parameters were simultaneously measured and the body temperature was controlled intramuscularly. With afebrile patients under normoxaemia or hypoxaemia following brain stroke, MFCV decreased proportionnally to the arterial partial oxygen pressure (PaO2) rate; a strong positive correlation (r = 0.882) between MFCV and PaO2 was found up to PaO2 of 12.0 kPa and MFCV 3.5 m/s. In the case of over PaO2 = 12.0 kPa, the relationship entered into saturation; the further increase PaO2 was not followed by concomitant changes in MFCV. The results show that MFCV-testing is a valuable tool to evaluate the functional state of the striated muscle under hypoxia.

Action Potentials↗