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Biomedical subjects

M Minkov

Publications and source records attributed to M Minkov.

At least 19 recordsLinked to original sources
PubMed2002

[Associated trauma with urinary tract injuries].

The authors analyze the peculiarities in the diagnostic and curative behavior in cases of associated traumatic injuries with participation of the urinary system in adults and children. A trauma is defined as associated when one kind of traumatic agent affects more then one organ or system. The authors do not discuss the combined trauma where we observed different damaging agents as for example mechanical trauma plus radiation or burn. The experience of the treatment of 64 children and 109 adults suffering from associated traumatic injuries for the period 1981-1997 has been summarized. In cases of associated traumatic injuries the kidneys are the most common participants on the part of the urinary system (70.3% of the children and 51.4% of the adults). On the second place we witness bladder damages in adults and urethra damages in children. The data concerning the combination between urological trauma and other organs traumas are available in details--the most common are: bone fractures, lesions of intraabdominal organs, skull and brain traumas, etc. The three basic problems caused by such kind of trauma are also discussed--organizational, diagnostic and curative. At the end the authors present the most typical characteristics of associated traumatic injuries in children compared to those in adults.

Accidents, Home↗
PubMed2001

Pattern and course of single-system disease in Langerhans cell histiocytosis data from the DAL-HX 83- and 90-study.

BACKGROUND: Single-system (SS) disease is the most common presentation in Langerhans cell histiocytosis (LCH) with a heterogenous clinical picture and course. Mostly bone and rarely skin or lymph nodes are involved. PROCEDURE: One hundred and seventy patients with SS-LCH were registered in the DAL-HX 83/90 studies. They were diagnosed according to uniform diagnostic criteria and followed by a standardised schedule. RESULTS: Single bone lesions were most common (68%), followed by multiple bone lesions (19%), isolated skin disease (11%), and isolated lymph node involvement (4 patients). In the detection of bone lesions radiographic skeletal survey proved to be superior to bone scan (97% vs. 82%). Treatment comprised surgery, irradiation and local instillation of steroids, and standardised chemotherapy for multifocal bone disease. After initial therapy 81% of the patients remained disease free. Reactivations restricted to the skeleton occurred in 18% of both unifocal and multifocal bone disease. Two skin patients had a chronic course. Fatality occurred only in one infant with skin disease who progressed to multi-system disease. Twenty-five percent of all patients developed permanent consequences, which were already present at diagnosis in about half of these patients and comprised mainly orthopedic problems related to lesional sites. Diabetes insipidus occurred in 3% and anterior pituitary dysfunction in 2% of the patients. CONCLUSIONS: The course in SS%LCH was benign. In bone disease reactivations remained restricted to the skeleton and did not influence survival. However, reactivations had an impact on morbidity, as permanent consequences were mostly related to the site of disease activity. Med Pediatr Oncol 2001;37:108-114.

Adolescent↗
PubMed2000

Statement of current majority practices in graft-versus-host disease prophylaxis and treatment in children.

Great variations exist in the prophylaxis and treatment of GVHD in children undergoing allogeneic stem cell transplantation (SCT). The EBMT Working Party Paediatric Diseases (EBMT-WP PD) and the International BFM Study Group--Subcommittee Bone Marrow Transplantation (IBFM-SG), aimed at evaluating current local standards in the prevention and treatment of GVHD and steps which can be taken to achieve a uniform policy for the individual methods. Several conferences with their members assessed practices which are mainly applied or under investigation in children and identified where additional information is needed. For prevention of GVHD, the majority of the paediatric centres prefer CsA +/- MTX. Addition of folinic acid to MTX was considered for reduction of side-effects. During treatment of acute GVHD most centres administer prednisolone and whole blood level-adjusted CsA as medications of first choice. In cases of poor or no response to this therapy, additional immunosuppressive agents such as ATG, mycophenolate-mofetile and tacrolimus are being increasingly used. The treatment of chronic GVHD usually consists of various combinations of prednisolone and CsA. In severe cases, extracorporeal photopheresis, psoralene-UVA (PUVA) and thalidomide are administered.

Adolescent↗
PubMed1999

Cyclosporine A therapy for multisystem langerhans cell histiocytosis.

BACKGROUND: Treatment of multisystem Langerhans cell histiocytosis (LCH) remains difficult. Various regimens of single and multiagent chemotherapy have been used, but a significant proportion of patients fail to respond to treatment. PROCEDURE: We have evaluated the use of cyclosporine A (CSA) in a controlled group of patients, who had received a systematic primary therapy (LCH-I). Patients received CSA either as a single agent (10 patients) or in combination with vinblastine, etoposide, prednisolone, and/or antithymocyte globulin (16 patients). RESULTS: Among the total of 26 patients treated, a single patient developed a complete response and three a partial response, whereas 85% (22 patients) had no response to CSA. CONCLUSIONS: CSA is at best of limited value in the treatment of patients with multisystem LCH, particularly those who had progressive disease while receiving chemotherapy.

Adolescent↗
PubMed1999

Leucocyte transfusions from rhG-CSF or prednisolone stimulated donors for treatment of severe infections in immunocompromised neutropenic patients.

Sepsis in profound neutropenia after chemotherapy is associated with high mortality despite appropriate antibacterial or antifungal treatment. In a prospective phase I/II study we evaluated the feasability and efficacy of leucocyte transfusions (LT) in patients with malignancies or haematological disorders who were suffering from severe bacterial or fungal infection during therapy-related bone marrow aplasia. 30 patients with severe neutropenia and clinical signs of life-threatening sepsis not responding to adequate treatment, received LT from rhG-CSF-stimulated family donors or from prednisolone-primed volunteers. A total of 301 LT were administered. The median number of LT per patient was seven (range three to 65), the median duration of LT treatment was 8 d (range 2-35). The white cell count (WBC), absolute neutrophil count (ANC) and lymphocyte count of the concentrates from rhG-CSF-stimulated donors were significantly higher than those from prednisolone-primed volunteers (P = 0.0001). Despite the critical condition of the patients, LT were generally well tolerated. Only 39 (12.9%) LT were associated with adverse reactions. The transfusion of leucocytes collected by continuous flow leukapheresis from both rhG-CSF and prednisolone stimulated donors resulted in a measurable increment of the peripheral leucocyte and ANC counts in our patients. On day 100 after the first LT, 20/30 patients were alive with complete clearance of the infection.

Adolescent↗
PubMed1998

Transplantation activities and treatment strategies in paediatric stem cell transplantation centres: a report from the EBMT Working Party on Paediatric Diseases. European Group for Blood and Marrow Transplantation.

To determine the current approach to stem cell transplantation (SCT) in centres which treat predominantly paediatric patients, a questionnaire was sent to 67 centres known by the EBMT registry to perform SCT mainly in children. Fifty-five centres from 19 countries responded. Forty centres (75%) started their transplantation activities between 1980 and 1992. Median number of transplants/centre was 95 (range 8-400). Median number of transplants/centre/year was 18 (range 5-85). On average, there was one physician responsible for seven SCT/year while one nurse was involved for a median of 1.7 SCT/year. Median four rooms/centre (range 1-17) were available for paediatric SCT. The most common isolation facilities were rooms with high efficiency particulate air filtration (HEPA). Eighty-two percent (45/55) of the centres performed allogeneic as well as autologous SCT, while 5% (three centres) offered exclusively allogeneic SCT and 13% (seven centres) used only autologous stem cell rescue. Stem cell source for allogeneic SCT was bone marrow in 87%, peripheral blood (PB) in 10% and umbilical cord blood in 3%. Donors were HLA matched related in 57%, mismatched related in 13%, and matched unrelated in 30% of allogeneic SCT. PB was the most commonly used stem cell source for autologous SCT (48%), followed by BM (41%) and the two together (11%). Data analysis revealed substantial differences in protective care, stem cell processing and transplantation procedures within the centres, irrespective of the country, centre size and transplant type.

Adolescent↗
PubMed1998

Proposal for standard recommendations for prophylaxis of graft-versus-host disease in children. European Group for Blood and Marrow Transplantation (EBMT) Working Party Paediatric Diseases and the International Study Committee of the BFM family-subcommittee Bone Marrow Transplantation (IBFM-STG).

Great variations exist in the practices of graft-versus-host disease prophylaxis for children undergoing allogeneic stem cell transplantation. It was the aim of the EBMT Working Party on Paediatric Diseases and the International Study Group of the BFM-Family, subcommittee bone marrow transplantation (IBFM-SG) to define standard recommendation for prevention of GVHD. Thus a survey was carried out among the local representatives of the EBMT WP and IBFM-SG members to define standards for GVHD prophylaxis basing on available literature data, discussion with colleagues and their own experience. Presently the majority of regimen for GVHD prophylaxis are centred on CsA and a short course of MTX with addition of some other immunosuppression (eg ATG or ALG) in patients with high risk for severe GVHD. The proposal defined different category of patients: patients with malignant disease who are either transplanted from HLA matched sibling donors or HLA mismatched family donors (or volunteer unrelated donors) and patients with non malignant disease who might not benefit from graft-versus-leukaemia effect having either an HLA matched sibling donor or an HLA mismatched family donor (or volunteer unrelated donor). Homogeneous GVHD prophylaxis for defined patient groups should provide better information to optimise strategies in reducing treatment related toxicity and incidence of relapse by increasing GVL effect.

Adolescent↗
PubMed1991

[Integrating demographic and socioeconomic policies].

"The article offers a theoretical model of integration between demographic and socioeconomic policy [in Bulgaria].... The author examines the changes in the population's demographic structures: changes in the sex ratio; ageing; [and] family nuclearisation.... The conclusion is drawn that in order to boost the effectiveness of the demographic policy, social practice and its scientific back-up should be even more fully integrated." (SUMMARY IN ENG)

Bulgaria↗
PubMed1989

[Migration and migratory behavior].

"The article considers theoretical and methodological peculiarities in studying...migration and migratory behaviour.... The author makes use of the information obtained from [censuses and current demographic statistics for Bulgaria as well as] information from representative sociological studies.... The author uses [a] mathematical model in modelling migration and migratory behaviour, emphasizing the need for a profound sociological study of the main stimuli which influence the migratory processes and the extent of their impact on individuals." (SUMMARY IN ENG AND RUS)

Bulgaria↗
PubMed1989

[Marriage rate, divorce rate, and the development of the Bulgarian family].

The author examines the new forms of consensual union that are becoming increasingly prevalent in Europe and their detrimental effects on the reproduction of generations and socialization. "Using data from the sociological study conducted by the Institute of Sociology of the Bulgarian Academy of Sciences in 1977 and the data obtained in the latest population census in 1985, the development of the Bulgarian family and influence of [these] new social relations under socialism are investigated." Particular attention is given to trends in marriage and divorce rates. (SUMMARY IN ENG AND RUS)

Bulgaria↗
PubMed1989

[Main conclusions and practical tasks in the socio-demographic sphere].

Demographic considerations are explored in relation to developing a social policy for Bulgaria. "Special attention is devoted to those areas of the social sphere, which are connected with the reproduction and realization of human resources, with raising the potential and abilities of the nation, and attaining a high degree of readiness for labour and social activities." (SUMMARY IN ENG AND RUS)

Bulgaria↗