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Biomedical subjects

I Gruev

Publications and source records attributed to I Gruev.

At least 19 recordsLinked to original sources
PubMed1990

[Comparative echographic and computed tomographic studies of acute focal bacterial nephritis].

The diagnostic potentialities of ultrasound and computed tomography for the early diagnosis of acute focal bacterial nephritis were studied in 12 patients. The echographic findings in all patients are similar: insular tumor-like zone, unclearly defined from the neighbouring parenchyma, hypo-, hyper- or isoechogenic, without liquefaction and lack of distant amplification. The computed tomographic image of 4 from 5 patients studied is as follows: perihilar defect with wedge-shaped form, hypodense structure, radially striated areas from the cavity system toward the parenchyma after applying of a contrast medium. The conclusion is that an early diagnosis of the acute focal bacterial nephritis could be achieved by ultrasound examination which is of high informativeness, harmless, with no radiation and should be basic diagnostic method for this kind of nephritis. The early diagnosis allows a more precise treatment.

Acute Disease↗
PubMed1990

[Endoperoxides and the immunological indices of patients with chronic pyelonephritis].

In 31 patients with chronic active pyelonephritis and 10 clinically healthy controls the following indices were followed up: the serum level of the endoperoxides and several parameters of humoral and cell immunity (T-lymphocytes, active T-lymphocytes, T-helpers, T-suppressors, B-lymphocytes, NK-cells, immunoglobulins G, A and (M), as well as the lysing activity of the natural killers towards the cell line K-562. The patients with chronic pyelonephritis were classified into two groups: I group--patients examined for serum peroxides in the acute phase of the inflammatory process and II group--patients examined in the subacute phase. A statistically significant differences was found for the serum endoperoxides between the patients form the I group (in the acute phase of the disease) and the healthy controls (respectively) 52.0 +/- 17.3 nmol MDA and 9.0 +/- 6.9 nmol MDA, p less than 0.001). The difference between the patients in the subacute phase and the healthy controls was insignificant (p less than 0.1). No significant deviations were found in the immunologic indices studied. The findings show that the immunologic mechanisms probably do not play a leading role in the pathogenesis of chronic pyelonephritis. The endoperoxides level is an index of the activity of inflammatory process in this disease.

Adult↗
PubMed1990

[The serum concentration of trace elements in chronic kidney failure].

The serum copper, zinc, selenium and magnesium levels were studied in 37 patients with chronic renal failure of various degree. The examination of the oligoelements and magnesium was performed on flame and electrothermal atomic absorption spectrophotometry. Reference values from 345 clinically healthy persons were used in the interpretation of the results. The serum, zinc, selenium and magnesium concentrations are lowered and the differences are statistically significant (for zinc p less than 0.01, selenium--p less than 0.001, magnesium--p less than 0.05). These changes are not directly related to the degree of impairment of the excretory renal function. The serum copper concentrations are statistically significantly elevated and this correlates with the degree of impairment of the excretory renal function. The possible pathogenetic mechanisms of these changes are discussed.

Adult↗
PubMed1989

[Multiple bilateral parapelvic kidney cysts].

8 patients, 2 men and 6 women, 42 to 67 years of age, with bilateral multiple cysts of the renal sinus are described. 3/6 patients had macroscopic hematuria, pyelonephritis, 5/8 patients were with arterial hypertension and 4/8 patients were with renal failure. All patients were examine by ultrasound once more after a greater diuresis was achieved in order to differentiate from hydronephrosis. The isotopic nephrographic curves were normal in 2/8 patients and were disturbed in the remaining 6 patients. Hydronephrotic type curves were not found. Urography was performed to 4 of the patients and in 2 of them the diagnosis was polycystosis and in the other 2 patients it was bilateral parapelvic cysts. Possible mistakes in the diagnosis of bilateral parapelvic cysts are discussed. The reported cases with superimposed pyelonephritis and renal failure point to the need of prophylactic medical examinations of such patients.

Adult↗
PubMed1989

[Changes in the level of urinary secretory immunoglobulin A in patients with recurrent pyelonephritis].

The urine concentration of secretory immunoglobulin A was studied in 58 healthy persons (26 women and 32 men) and in 55 patients (44 women and 11 men) with chronic recurrent pyelonephritis before the beginning of the antibacterial treatment. An immunoenzyme method on a solid phase was used (ELISA). In 21 patients a lowered urine secretory immunoglobulin A level (IgA) was found, in 19 patients it was elevated and in 15 patients it was in normal ranges. In the group of patients with an elevated secretory IgA level the antibacterial treatment was successful in 89.5% of the patients while in the group of patients with a lowered secretory IgA level the treatment was successful only in 61.9% of the patients. In 12 patients the secretory IgA level was examined after the treatment and in 72.7% of them it was changed--in 38.2% of the patients the level was lowered and in 34.5% of the patients it was elevated. The local immune response of the organism against infections is discussed.

Adult↗
PubMed1988

[Beta 2-microglobulin in chronic exacerbated pyelonephritis].

The serum and urine beta 2-microglobulin levels were determined in patients with chronic recurrent pyelonephritis and in healthy controls. The urine beta 2-microglobulin level was considerably increased in the patients with chronic recurrent pyelonephritis which is linked with the activity of the disease.

Adult↗
PubMed1988

[Parathyroid function in recurrent calcium nephrolithiasis and chronic kidney failure before and after oral calcium loading].

A case is presented of a female patient with recurrent calcium renal calculosis, chronic calculous pyelonephritis and chronic renal failure II degree to whom an oral calcium tolerance test was performed. The data of the test are characteristic for parathyroid hyperfunction. The possible cause of these changed is discussed. The conclusion is reached that the oral calcium tolerance test is of differential diagnostic value in patients with initial renal failure, too.

Administration, Oral↗
PubMed1986

[Multiple endocrine adenomatosis manifested chiefly by hyperparathyroidism].

A case with multiple endocrine neoplasia was reported, including parathyroid adenoma, of the main cells of the gland, multiple small adenomas in the tail of pancreas, (cytologically and electron-microscopically determined as A cellular) and light-cellular adenoma of adrenal. The hyperfunction of parathyroid adenoma was manifested with hypercalcemia (3.75 mmol/l), and morphologically--with the multiple calcium metastases in lungs, kidneys and heart, established at necropsy. The cause for the death was the acutely advanced ischemic disease of myocardium, on the background of chronic pyelonephritis and renal insufficiency. The timely diagnosis of such morbid states is concluded to be important for the clinical practice and could lead to the saving of the patients by operative removal of the tumour.

Adenoma↗
PubMed1986

[Immunoglobulins in the serum of chronic pyelonephritis patients].

The authors studied the serum levels of immunoglobulins G, A and M in 72 patients with chronic pyelonephritis and 77 clinically healthy subjects. In spite of the high biological variability of the indices studied, high serum levels of IgG and IgA were established in the patients with active urologic infection and with advanced renal insufficiency. Significantly higher values of IgG were established in active pyelonephritis, caused by E. coli and Proteus and of all immunoglobulins--in infection with Enterococcus. The serum level of immunoglobulins in chronic pyelonephritis should be complexly interpreted, together with the other clinical and laboratory data.

Adult↗
PubMed1986

Liver insufficiency as a factor modifying the pharmacokinetic characteristic of the preparation nabumetone.

The effectiveness of the nonsteroidal anti-inflammatory agent nabumetone is related to the formation of an active metabolite: 6-methoxy-2-naphthylacetic acid. The plasma concentrations of nabumetone and its active metabolite, after administration of 1,000 mg single dose p.o., are followed at 0, 0.5, 1, 2, 4, 6, 8, 12, 24, 30 and 48 h in 6 patients with laboratory evidence for functional liver insufficiency caused by liver cirrhosis, confirmed by biopsy. In the patients with liver insufficiency the mean values of Cmax and AUC0-24 h for 6-methoxy-2-naphthylacetic acid were 26.75 +/- 8.45 mg/l and 623.64 +/- 161.8 mg X h/l respectively. They did not differ significantly from the values observed in healthy volunteers [v. Schrader et al. 1983]. The Tmax-value was prolonged to 8 h, compared to 4 h Tmax-value of the volunteers. There is a tendency towards a reduced bioavailability of 6-methoxy-2-naphthylacetic acid after nabumetone administration in patients with a more severely expressed pathologic impairment, compared to patients with slight morphologic changes of the liver parenchyma.

Aged↗
PubMed1986

[Drug sensitivity of urinary microflora and the effect of treatment in exacerbated chronic pyelonephritis].

A total of 226 patients with exacerbated chronic pyelonephritis were studied and the effect of 10-day antibacterial course--followed up. In 178 cases the treatment was consistent with the drug susceptibility of urine microflora and in 48, it was carried out in the absence of such susceptibility. The susceptible strains were affected in a considerably higher percentage (64.60) than the nonsusceptible (41.67). The chronic renal insufficiency (ChRI) has been a factor restricting the effectiveness of the antibacterial agents. Out of III affected patients 24 (21.62%) were with ChRI, whereas they were 38 (46.34%) from not-affected ones. It has been concluded that the treatment of chronic exacerbated pyelonephritis should individually be carried out with a dynamic microbiological control.

Adolescent↗
PubMed1985

[Comparative clinical x-ray, radioisotope nephrographic and ultrasonic studies of chronic pyelonephritis patients].

The authors compare the incidence of the changes established by X-ray, radioisotope-nephrographic and ultrasound studies on 115 patients with chronic pyelonephritis. Most frequent and most characteristic are the changes with venous urography. Though not specific, the changes in the isotope-nephrogram and ultrasound contribute to the establishment of functional and structural disturbances in chronic pyelonephritis. They have no contraindications for application, hence they are of high value in the presence of chronic renal insufficiency, where venous urographic is not effective. The ultrasound study has indisputable advantages in establishing the X-ray negative calculi, renal cysts and a functioning kidney.

Adult↗
PubMed1985

[Scintigraphic study of the kidneys with a 99m Tc-ascorbic complex in chronic pyelonephritis patients].

A scintigraphic study of the kidneys was carried out in 1780 patients with chronic pyelonephritis: 1308 with calculous and 472 with acalculous pyelonephritis. The scintigraphic finding was interpreted for each kidney separately. Diffuse damages of renal parenchyma was most often observed (47,6%), being, in the majority of the cases--bilateral. Disturbed drainage was established in 13,2%, dysfunction of one of the kidneys--in 18,8% and focal disturbed structure--in 5,4% of the kidneys studied. The results from the scintigraphic study were juxtaposed to the clinic of the disease and the data from laboratory and X-ray investigations. The scintigraphic study of the kidneys with 99m Tc-ascorbic complex is easy to perform, well tolerated by the patients, non-invasive method with no special risks, with minimal irradiation loading. Scintigraphy provides valuable information to the clinicians about the functional, structural and drainage disorders in the kidneys of patients with chronic pyelonephritis, allowing the control of the evolution of the disease and the effect of the treatment.

Ascorbic Acid↗
PubMed1985

[Microbial spectrum in chronic pyelonephritis and the drug sensitivity of the microorganisms].

The authors studied the etiological spectrum of 226 patients with chronic pyelonephritis, with 926 microbic strains isolated from the urocultures. The most frequent microbic causative agents were E. coli (40,82%), Proteus (a total of 17,82%), Enterobacter (8,86%), Klebsiella (8,64%), Pseudomonas (6,16%), Enterococcus (5,94%). The drug susceptibility of the majority of the isolated gram-negative microorganisms versus ampicillin and chloramphenicol, widely used in out-patient department practice, is relatively low. An important condition for the effectiveness of the treatment is the consideration given to the susceptibility of the microbic strains, isolated from the uroculture.

Anti-Bacterial Agents↗