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Biomedical subjects

I Popov

Publications and source records attributed to I Popov.

At least 37 records · Page 2Linked to original sources
PubMed2004

Histopathology of residual rectal carcinoma following preoperative radiochemotherapy.

Preoperative radiotherapy with (CRT) or without chemotherapy (RT) in the management of patients with locally advanced rectal carcinoma is increasingly accepted as therapeutic modality to reduce local recurrence and improve survival, decrease tumor size and/or stage, has less toxicity compared to postoperative therapy, improves sphincter preservation and the ability to perform a curative resection. In a brief review of literature we discussed the possible prognostic role of most important pathologic parameters and their clinical implications. At present, predictive value of tumor response to neoadjuvant therapy remains uncertain, whether evaluated as five-point histological tumor regression grade (TRG) or recently proposed three-point rectal cancer regression grade (RCRG). However, most reports emphasize reduced local reccurence rates and disease-free survival advantage in patients with complete tumour regression or tumour down-staging, occuring in up to 20% and 60% of cases, respectively. Patients with advanced post-treatment tumour stage (ypT3/4), positive lymph nodes (ypN1/2), vascular invasion, positive circumferential resection margin, clearance < 2mm, or absence of tumor regression are shown to have poor clinical outcome. Among CRT-induced morphological features, only "fibrotic-type" stromal response with minimal inflammatory infiltrates and absence of surface ulceration are correlated to recurrence-free survival. Preliminary unpublished results of a pilot study from our multidisciplinary prospective trial relate to correlation of histopathologic parameters and morphologic changes to rectal cancer regression grade (RCRG). Therefore, we studied 22 consecutive patients, mean age 56 (range 23-69) years, with transmural cT3/4 stage and were subgrouped as follows: RCRG-1 (7 patients, 31.8%), RCRG-2 (9 patients, 40.,9%) and RCRG-3 (6 patients, 27,2%). In addition, 14 patients (63%) showed tumour downstaging and only 1 patient (4.5%) nodal down-staging after ypTNM restaging. There was the predominance of fibrotic-type stroma (16 patients, 72.8%) versus fibro-inflammatory response (6 patients, 27.2%), frequent tumoral necrosis (13 patients, 59%) but infrequent surface ulceration (5 patients, 22.7%) and peritumoural eosinophylic infiltration as well as endocrine cell differentiation (4 patients, 18%). The second aim of our study was to investigate determinants of radiosensitivity, i.e. the relationship between proliferative activity indices (Ki-67 and PCNA) as well as the induction of apoptosis (p53) and the tumour regression (RCRG) after neoadjuvant CRT. The interaction between Ki-67 and PCNA immunoexpression levels and the benefit of CRT was significant for Ki-67 (p = 0.03), but not for PCNA (p = 0.08) and p53 levels (p = 0.4). In a conclusion, high percentage of Ki-67-positive tumor cells in the preoperative biopsy predicts an decreased treatment response after preoperative CRT of rectal cancer. However, long-term follow-up and large studies are necessary to establish the value of regression grade and the need for its prediction by reliable biological markers.

Adult↗
PubMed2004

Systemic treatment of colorectal cancer in Serbia: what have we done and what can we offer in the new century?

The treatment of patients with metastatic colorectal cancer (mCRC) has changed dramatically over recent years in Serbia. The more optimal use of 5-fluorouracil (5-FU) in association with leucovorin (LV), the development of new drugs such as oxaliplatin and irinotecan and of the oral fluoropyrimidines, such as capecitabine, have increased therapeutic options and to the improved outcome of patients with mCRC. Throughout our 10-years published papers in international journals, we presented development of chemotherapy for mCRC and improvement in treatment outcome in Serbia. It is shown that combination therapy with 5-FU/LV and oxaliplatin or irinotecan is more active than 5-FU/LV in first line treatment of mCRC. Sequential therapy with FOLFIRI+FOLFOX was the most efficacious combination in comparison to any other 2 drugs combinations. The combination protocols in second line were superior to mono irinotecan and equal to LV5FU2 in terms of time to progression. The oral fluoropyrimidines seems to have an activity comparable to that of i.v. 5-FU/LV. New agents acting on novel targets are under development. Angiogenesis inhibitors, epidermal growth factor inhibitors, COX-2 inhibitors and farnesyl transferase inhibitors might play a role in the future in the treatment of CRC. We will present our first experience with bevacizumab, vascular endothelial growth factor inhibitor.

Antineoplastic Agents↗
PubMed2004

[Effect of intravenous gamma-globulin therapy on lymphocyte population in pregnant women with antiphospholipid antibodies].

UNLABELLED: The aim of the study was to establish the distribution of the lymphocyte populations in peripheral blood in pregnant women with antiphospholipid antibodies (aPL) and a history of recurrent pregnancy loss as well as to make a study on the influence of the intravenous IgG-treatment (IVIg) on the levels of antibodies and peripheral lymphocytes. MATERIALS AND METHODS: 14 pregnant women were investigated. The latter had two or more recurrent abortions and positive aPL--anticardiolipin (aCL) and/or anti-beta 2-Glycoprotein I (anti-beta 2-GPI). The lymphocyte populations were examined, using a flowcytometric method in peripheral blood before 6-7th gestational week and on the 10-14 day after the second IVIg infusion. 10 pregnant women wer used as controls who had no aPL antibodies and no pregnancy loss. RESULTS: 13 out of 14 pregnancies were successful Lymphocyte populations of the examined patients before the first infusion compared to the controls showed statistically significant differences for: T-lymphocyted Th(reduced) and CD3-CD56 + NK (increased) Significant increase after therapy was noticed for the levels of T-lymphocytes, and Th while the NK-cell populations were significantly reduced. CONCLUSIONS: aPL-positive pregnancies most probably were associated with elevated and activated peripheral NK-cell subpopulations. The low doses of IVIg successfully reduce the levels of aPL, as well as peripheral CD3-CD56 + NK cells.

Abortion, Habitual↗
PubMed2004

[Profenid or veral for the postoperative analgesia in gynaecology].

We present our results for study and assessment of efficacy in accordance with postoperative analgesia with single dose Profenid (ketoprofen) or Veral (diclofenac) administrated per rectum. We studied 60 patients divided in two groups--group 1 (analgesia with Profenid) and group 2 (analgesia with Veral). All patients received standard endotracheal anesthesia for elective gynaecologic operations. We have assessed quality of the postoperative analgesia by: Ta--time of analgesia (time for first want of analgesics by patient), VRS (verbal rating score), VAS (visual analogue score), PONV (postoperative nausea and vomiting) and sedation rate.

Administration, Rectal↗
PubMed2004

[Iron-deficiency anaemia in everyday gynaecological practice].

INTRODUCTION: Iron-deficiency anaemia /IDA/ is of utmost significance to clinical practice. Chronic haemorrhages from the genital tract are the major etiological factor for its appearance in 60-70% of the patients. Abnormal genital bleeding for the specialist in Obstetrics and gynaecology and IDA for the haematologist are frequently met problems in their everyday practice, which require detailed examination, good colaboration and synchronization between the work of both specialists. PURPOSE: Diagnosing and etiological treatment of IDA of gynaecologic origin by mutual timely and adequate co-operation of gynaecologist and haematologist. MATERIALS AND METHODS: Clinical survey based on the algorithm worked out. Its everyday application started in July-August 2001 and till today /30.04.2003/ 253 cases with IDA in the Department of Gynaecology are taken in. A record of proceedings was made for every patient and that helped the further diagnostic and therapeutic activity and respective data processing. RESULTS AND DISCUSSION: The data and results obtained verify the achievement of final diagnostic specification of IDA, the role of the algorithm as a stepping-stone to its etiological treatment, complete and durable correction of iron deficiency.

Adolescent↗
PubMed2004

[Fetal macrosomia: mode of delivery].

This study was provided among 1847 deliveries from January, 1 to December, 31, 2003. The aim of the study was to examine the correlation between antenatal diagnosis "fetal macrosomia" and the mode of delivery. We found that among the cases with birth weight > or = 4000 g and antenatal diagnosis "fetal macrosomia" the rate of cesarean section was fourfold higher than among the cases without such a diagnosis. There weren't statistically significant correlation between the cases with antenatal diagnosis "fetal macrosomia " and the cases with estimated birth weight < or = 3999g in reference to the mother's age and weight, parity, fundal height and abdominal circumference. There are insignificant differences between both of groups in reference to gestacional age and birth.

Adult↗
PubMed2004

[Gynecological laparoscopy and Mayer-Rokitansky-Kuster-Hauser syndrome (report of three cases)].

The syndrome is described in 1838 and it is named after the four authors. It includes combined agenesis of uterus, cervix and the upper 2/3 of the vagina, but the fallopiantubes and ovaries are normally presented. Expect abnormalities of the female reproductive system there are abnormality of the kidneys, vertebral bodies and loss of hearing. The authors of the present publication describe in details etiology, pathogenesis, clinical presentation, differential diagnosis and therapeutic methods for syndrome's treatment. There are presented three clinical cases, which are by laparoscopy proved. In conclusion it is indicated the importance of the gynecological laparoscopy like a modern method for diagnosis of the congenital anomalies of the female genital tract leading to primary amenorrhea.

Abnormalities, Multiple↗
PubMed2004

[Indications for third and more than three cesarean sections--analysis and pattern of practice].

PURPOSE OF THE STUDY: Authors aimed to analyse indications for third and more than three times cesarean sections (c. s.), as well as, to make an assessment of the adequacy of the taken decisions. METHODS AND MATERIALS: It was conducted a retrospective study for third and more than three times cesarean, including period 1991-2003 in the Department of Obstetrics and Gynaecology, Medical University, Pleven. During that time 28645 births has taken place, 2971 of which are by cesarean section. 2,5% from the last, has been third and more than three times cesarean. Using expert judging, indications for the last were divided into three groups-right, disputable and wrong. RESULTS: In the cases with only one mentioned indication "Re-re c.s." 37,8% (28 patients), ratio between right, disputable and wrong was 2:1:1 and the same ratio in the cases with indication "Re-re c.s.+ other indications" 58,1% (43 patients), was 5:1:1. In 4,3% of the cases (3 patients) no indication "Re-re c.s." was mentioned. CONCLUSION: Reduction of third and more than three times cesarean can be achieved by more careful judgement of indications in second, "disputable", group and erradication of the "wrong", which most commonly are jatrogenic reasons. This will result in diminishing the increasing frequency of abdominal births, as well as, preventing possible complications for mother, connected with operation.

Bulgaria↗
PubMed2004

[Antibiotic prophylaxis on treatment outcome after gynecologic surgery].

The aim of our study is to estimate advantages and disadvantages of some antibacterial drugs which were used for prevention from infections in the early postoperative period. Our study is retrospective and involved all women which were undergoing different operations in department of gynaecology for the period January 2000 until June 2004. Due to a large number of patients and long period of time which were evaluated our study shows assume data for efficacy of different antibacterial drugs and drug combination when we using them for prevention. It is very interesting for the authors result about relationship between price-efficacy-durance ot hospital being.

Anti-Bacterial Agents↗
PubMed2004

[Leiomyomatosis and chronic pelvic pain].

UNLABELLED: Leiomyomatosis is one of the major gynaecological diseases, which cause the onset of chronic pelvic pain /CPP/. PURPOSE OF THE STUDY: To build up a pain profile of patients with leiomyoma by the use of quantitative and qualitative characteristics. METHODS AND MATERIALS: The study was conducted through the period of 01.01.2004-01.07.2004 in the Clinic of Gynaecology of the Department of Obstetrics and Gynaecology, Medical University-Pleven. During that period 94 patients with leiomyomatosis were admitted in the clinic, and they filled in an inquiry form, containing also a pain calendar and pain map. Clinical and pathohistological data, verifying type, localization and clinical manifestation were used too. RESULTS AND DISCUSSION: Forty-eight /51.1%/ of 94 patients with leiomyomatosis admitted in the clinic had been experiencing CPP. CPP had been the reason for diagnosing leiomyomas. A dependency was determined between quantitative value of CPP and: localization of leiomyomas, presence of another accompanying myoma gynaecological pathology, body mass index, histological changes, time of the onset of CPP, chronological appearance according to day and menstrual cycle. Pain qualitative characteristics were mainly defined by localization of leiomyomas, histological changes in them and eventually a presence of another accompanying myoma gynaecological pathology. CONCLUSION: Building up a specific for leiomyomatosis pain profile helps to provide a faster and more accurate diagnostic assessment and therapeutic management.

Bulgaria↗
PubMed2004

[Gynecologic laparoscopy and Swyer syndrome (two additional cases)].

The syndrome belongs to the group of the congenital abnormalities and is also known as syndrome of the pure gonadal dysgenesis with the presence of medullar elements. The girls with the Swyer syndrome are characterized by the presence of the male karyotype--46,XY and they are sex-chromatin negative. The authors of this publication describe in details etiology, pathogenesis, clinical presentation, differential diagnosis and therapeutic methods for syndrome's treatment. There are presented and two clinical cases, proved by chromosome analysis and verified by laparoscopy. It is about the significance of gynecologic laparoscopy for precise diagnostics in congenital anomalies of the genital system.

Adolescent↗
PubMed2003

Acute spinal cord injury in pregnancy: an illustrative case and literature review.

Acute trauma is not all that uncommon in pregnancy. It accounts for 15% of non-obstetric maternal deaths. Moreover, about 15% of acute spinal cord injuries involve young women of childbearing age (Gilson et al., 1995). Most of the existing literature on spinal cord injury in pregnancy is concerned with the management of patients with pre-existing lesions; very few articles deal with acute injuries. We report the management of a case of acute spinal cord injury in the third trimester of pregnancy and review the major clinical issues associated with such cases.

Adult↗
PubMed2003

Choriocarcinoma presenting with upper gastrointestinal bleeding and intussusception.

Choriocarcinomas are rare genital tract tumours, which can present with extragenital symptoms and signs. We report on an 18-year-old nulliparous woman presenting with jejunal choriocarcinoma. An outline of the diagnostic difficulties and different manifestations of extragenital choriocarcinoma is given. A high index of suspicion should be maintained and a multi-disciplinary approach is mandatory.

Adolescent↗
PubMed2002

Comparison of the efficacy of two different dosage dacarbazine-based regimens and two regimens without dacarbazine in metastatic melanoma: a single-centre randomized four-arm study.

The aim of this randomized four-arm phase III study was to evaluate whether there is a difference in activity between regimens containing dacarbazine and regimens without dacarbazine in metastatic melanoma, whether there is a dose-effect relationship for dacarbazine, and whether non-dacarbazine-containing aggressive regimens are in any way superior to non-aggressive ones. A total of 219 patients with metastatic cutaneous melanoma were included in this study; 196 of them were evaluable for activity. The patients were randomized into four treatment arms: arm A (standard dose dacarbazine arm), vincristine 1.4 mg/m2 on day 1, carmustine (BCNU) 60 mg/m2 on day 1, and dacarbazine 300 mg/m2 per 24 h on days 2-5; arm B (high-dose dacarbazine arm), vincristine and BCNU as in arm A and dacarbazine 600 mg/m2 per 24 h on days 2-5; arm C ('aggressive' regimen without dacarbazine), vindesine 3 mg/m2 on day 1, bleomycin 7 mg/m2 per 24 h on days 1-4, and cisplatin 30 mg/m2 per 24 h on days 5-8; arm D ('non-aggressive' regimen without dacarbazine), BCNU 100 mg/m2 on day 1 and procarbazine 90 mg/m2 per 24 h on days 1-10. The four arms were well balanced with regard to patient- and disease-related characteristics. On an intend-to-treat basis, the response rate was 11 out of 49 (22%) in arm A, nine out of 47 (19%) in arm B, 16 out of 63 (25%) in arm C and nine out of 60 (15%) in arm D. There was a large overlap between the 95% confidence intervals and no significant differences in the response rates between the four arms. Median survival in the four treatment arms was 4, 5, 6 and 4 months, respectively, again with no significant differences. Median survival for responders (8, 11, 10 and 13 months, respectively) in all four arms was significantly longer than in non-responders (4, 3, 5 and 4 months, respectively). Arms A, B and C were significantly more toxic compared with arm D, which was for all practical purposes devoid of toxicities. The efficacy of all four regimens thus appeared comparable both in terms of response rate and survival. Responders in all four arms achieved a survival benefit. There does not seem to be a dose-effect relationship for dacarbazine in metastatic melanoma. Chemotherapy from arm D, might be well suited for 'fragile' or elderly patients due to the lack of toxicity.

Adult↗
PubMed2002

Preterm labour--is bacterial vaginosis involved?

OBJECTIVE: To assess the efficacy of treatment of bacterial vaginosis (BV) using metronidazole to reduce preterm labour in primigravidae and multigravidae with previous midtrimester abortion or preterm labour. DESIGN: Randomised controlled trial. SETTING: Tertiary academic hospital. METHOD: Two different groups of patients were screened for BV at the first antenatal visit, namely primigravidae and high-risk multigravidae who had had a previous midtrimester abortion or preterm delivery. Patients where BV was diagnosed clinically or on Gram's stain of a smear taken from the posterior vaginal fornix, received either 400 mg metronidazole, or 100 mg vitamin C orally twice daily for 2 days. The Gram's stain was repeated after 4 weeks. If BV was found again, treatment with the same drug was repeated. OUTCOME MEASURES: Preterm delivery, birth weight and perinatal deaths. RESULTS: One thousand and five patients entered the study, but 40 were excluded for various reasons and 10 were lost to follow-up. There were 464 primigravidae, of whom 150 (32%) had BV. Except for the 5-minute Apgar score, no significant differences were found between primigravidae negative for BV and those who received either metronidazole or vitamin C. There were 491 high-risk multigravidae, of whom 127 (26%) had BV. The mean gestational age in the BV-negative group was 37 weeks, in contrast to 37.4 weeks in the vitamin C group and 35.6 weeks in the metronidazole group. Birth weights in these three groups were 2,752 g, 2,759 g and 2,475 g respectively, significantly less (P = 0.0109) in the metronidazole group in comparison with the BV-negative group. Delivery before 37 weeks occurred in 29% of high-risk multigravidae with no BV but in 24% of those who took vitamin C and in 43% who took metronidazole. Differences were significant between the BV-negative and metronidazole groups (P = 0.0231) and also between the metronidazole and vitamin C groups (P = 0.0274). Delivery before 28 weeks occurred in 4% of the high-risk multigravidae with no BV but in 10% of those with BV who took metronidazole. The difference was significant (P = 0.0430). Analysis for maximum likelihood estimates for preterm labour identified only previous preterm labour or midtrimester abortion as risk factors. CONCLUSION: Metronidazole does not seem to reduce the prevalence of preterm labour when given for BV before 26 weeks' gestation.

Adult↗
PubMed2002

Preterm labour--is Mycoplasma hominis involved?

OBJECTIVE: To assess whether Mycoplasma hominis is associated with preterm labour in primigravidae and multigravidae with previous midtrimester abortion or preterm labour. DESIGN: Cohort analytical study. SETTING: Tygerberg Hospital, a tertiary academic hospital in the Western Cape. METHODS: Gram's stains were done on smears taken from the posterior vaginal fornix, at the first antenatal visit, between 16 and 26 weeks' gestation, in primigravidae and multigravidae at risk for preterm labour. Cultures for M. hominis and other commonly occurring organisms were done from endocervical swabs taken at the same visit. The outcome of pregnancy in mothers with positive cultures for M. hominis was then compared with outcome in women with negative cultures. OUTCOME MEASURES: Prevalence of Chlamydia trachomatis, Ureaplasma urealyticum, bacterial vaginosis and preterm delivery, birth weight and perinatal deaths. RESULTS: Cultures for M. hominis were positive in 83 patients (21%) and negative in 312 (79%). Significantly more mothers in the positive group (40%) delivered before 37 weeks' gestation than in the negative group (28%, P = 0.0313). Their babies weighed significantly less (2,669 g v. 2,864 g, P = 0.0141). The positive group was also associated with more alcohol use in pregnancy and fewer of them were married. C. trachomatis was found in 18% of mothers in the positive group but in 8% of the negative group (P = 0.0082). U. urealyticum was cultured in 96% of mothers in the positive group in contrast to 81% in the negative group (P = 0.001). Bacterial vaginosis was observed on 75% of mothers with positive cultures for M. hominis but in 22% with negative cultures (P = 0.00001, odds ratio 10.21, 95% confidence interval: 5.63-18.65). CONCLUSION: Positive culture for M. hominis was associated with more preterm deliveries and also with a higher frequency of C. trachomatis, U. urealyticum and bacterial vaginosis.

Adult↗
PubMed2002

Chemoembolization for liver metastases from colorectal carcinoma: risk or a benefit.

Results from clinical trials do not allow definitive conclusions about the role of chemoembolization (ChE) in the treatment of colorectal cancer (CRC) liver metastases. The aim of present phase II study was to investigate toxicity and efficacy of ChE for patients, with unresectable colorectal liver metastases after failure of 5-FU based chemotherapy. Secondary endpoint was clinical benefit measurement. Eleven patients were enrolled in first stage (two-stage Simon design), 2 males/9 females, median age 60 (46-71). Performance status was I in 8 patients and II in 3 patients. All patients had radical surgery, 7 of them adjuvant chemotherapy and 4 systemic chemotherapy. The ChE regimen consisted of an injection of iodinated oil Lipiodol with mitomycin C (3 mg/ml). Repeated treatments were performed at 9- to 12-week intervals. We applied 17 ChE (median 1/pts.). Clinical benefit was a composite of measurements of pain, ECOG performance status, weight and tumor fever. Study was stopped after first stage because non of the patients (pts) achieved objective response (RECIST). Stable disease occurred in 5 pts (45%). Median time to progression was 3 months (range 3-9 months). Median survival was 9 months (range 4-16 months). A decrease of the baseline carcinoembryonic antigen level occurred in 0% of the cases. Clinical benefit was recorded in one patient. Common toxicity included a "postembolization syndrome," which consisted of fever, pain in the right upper quadrant, nausea, and vomiting. Grades 3-4 toxicity (NCI-CTC) followed transaminases 6/11, LDH 4/11. In addition, a drop in F V levels was noted in 5 pts, F VII in 9, F IX in 2 and F X in 10 pts. Decrease in At III levels occurred in 6 pts and FDP appeared in one. Thus, The ChE as performed in the present study did not appear to bring any benefit; furthermore, significant liver toxicity compromises the safety of such procedure.

Aged↗