Akusherstvo i ginekologii͡a
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Akush Ginekol (Sofiia) · Jan 2010
[Treatment of anaemia of prematurity with SS-R-Hu-erythropoietin and significance of hypoxia-inducible factor].
The main cause of anaemia of prematurity is low erythropoietin levels. A few years ago hypoxia-inducible factor/HIF/gene transcriptor was established, regulating not only the synthesis of erythropoietin /EPO/, but also other growth factors as well as enzymes of anaerobic glycolysis, activated by hypoxia. ⋯ The presence of hypoxia at low levels of Hb and Ht leads to more rapid activation of erythropoiesis. Nevertheless, these babies need more red blood cell transfusions due to clinical symptoms of hypoxia. Normoxia after red blood cell transfusion leads to decrease of reticulocytes count by 30% and platelets by 35% in spite of treatment. The presence of relative hypoxia with Hb 110-120 g/l u Ht 31-32% is optimal for starting treatment with EPO--levels, low enough for activation of HIF and high enough to avoid blood transfusions.
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Akush Ginekol (Sofiia) · Jan 2010
[Doppler velocimetry for timing of delivery in intrauterine growth-restricted (IUGR) fetuses].
The aim of this study was to find a relationships between umbilical artery (UA) and MCA Doppler, ductus venosus (DV) Doppler and perinatal outcome in preterm, intrauterine growth-restricted (IUGR) fetuses. UA Doppler is a placental function test that provides important diagnostic and prognostic information in preterm IUGR. DV Doppler effectively identifies those preterm IUGR fetuses that are at high risk for adverse outcome (particularly stillbirth) at least 1 week before delivery, independent of the UA waveform. Relationships between perinatal outcome, arterial and venous Doppler status and gestational age require ongoing observational research effort.
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Akush Ginekol (Sofiia) · Jan 2009
[Effect of small-doses ketamine on postoperative pain management with combinations morphine/ketoprofen or lidol/ketoprofen after major gynecological surgery] [corrected].
We examine the potential beneficial effect of small-doses ketamine on postoperative pain management with combinations morphine/ketoprofen or lidol/ketoprofen after major gynecological surgery. After patient written consent, 50 healthy women, which were scheduled for abdominal gynecological surgery were randomly allocated into two groups depending of postoperative analgesic technique--morphine/ ketoprofen or lidol/ketoprofen. ⋯ Using ketamine during the anesthesia improve quality of postoperative analgesia in accordance with less opioid consumption for the combination morphine/ ketoprofen, but not for the combination lidol/ketoprofen. Adding small doses ketamine to combination morphine/ketoprofen improve postoperative analgesia; reduce morphine consumption and incidences of morphine-related side effects after major gynecological surgery.
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Akush Ginekol (Sofiia) · Jan 2009
[Survival, prognostic factors and modern tendencies in adjuvant treatment of diagnosed endometrial cancer patients with or without lymph node dissection].
Our aim was to research and evaluate very big clinical material for 22 years period (1987-2009) at the National Cancer Center, Gynaecological clinic and Medical University--Departement of Obstetrics and Gynaecology-Varna. We studied some of the most important prognostic factors in patients with endometrial cancer, radically operated with or without lymph node dissection. We compared our results with the results of other authors working in this field. Our aim was by examining the prognostic factors and the survival rate to define and help the choice of the most suitable radical surgical treatment, as well as the application of most suitable adjuvant therapy. ⋯ The radical surgical treatment with lymph node dissection (pelvic and/or paraaortal) gives a better survival rate in intermediate and high risky groups. The extent of the lymph node dissection is an independent prognostic factor. In stage IA and IB, grade 1 and 2, a simple total hysterctomy has the same significance for the survival of patients as the radical hysterectomy with lymph node dissection. In stage IIB endometrial cancers the most suitable treatment is radical hysterctomy with lymph node dissection. The lymph node dissection is of benefit for endometrial cancers grade 3, stage IC, stage II, serous and clear cell carcinomas.
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Akush Ginekol (Sofiia) · Jan 2008
Review[Application of activated recombinant factor VII (rFVIIa, NovoSeven) in neonatology].
Recombinant activated factor VII is vitamin K dependent glycoprotein, similar as the same in the human blood plasma. First has been described in application for hemophilia, where are presented inhibitors of factors VIII and IX, later was proved that it has effectiveness in hemorrhage with different etiology. ⋯ The data shows that there is low risk of side effects of the recombinant activated factor VII in neonatal period. But still has been described as a experimental treatment.