[Efficiency and safety of the intravenous application of esomeprazole (nexium - Astra Zeneca) in high risk patients subjected to mechanic ventilation].

INTRODUCTION: The aim of the research was to determine the effectivity and the safety of the intravenous application of Esomeprazole (Nexium - Astra Zeneca) like prevention of the development of stress-ulcers of the gastric mucous with high risk patients at ICU with mechanic ventilation. PATIENTS AND METHODS: 47 patients subjected to mechanic ventilation over 48 hours with availability of just one more risk factor for development of stress-ulcers of gastric musous were included in the study. Samples of gastric juice for determination of the acidity and presence of fresh erythrocytes and microbiological cultures from gastric contents, wash away of the mouth cavity and tracheal aspiration were tested on the 1st, the 3rd and the 5th day from the start of the treatment. At the end of the therapy there has been determinated the outcome - survivor or died and total quantity of the haemotransfusions. RESULTS: The acidity of the gastric juice changed in the range over pH 5 during the 24 hours by the application of esomeprazole. Fibrogastroscopic examinations were performed of patients who were found to have fresh erythrocytes in the gastric contents. No one was registered with bleeding of the gastric mucous. The isolated microorganisms of the gastric juice and wash away of mouth cavity were identical with those of tracheobronchial aspiration in about 13 %. CONCLUSIONS: In our study the application of esomeprazole i.v. was effective and safe approach for profilaxy of the stress-ulcers and the bleeding of the gastric mucous. Comparative studies with H2-blockers and sucralfat are necessary for clarifying and objectifying the significance of the microbiologic isolates of the gastric contents and wash away from mouth cavity and their relation to the development of nosocomial pneumonia.

[Clinico-morphologic parallels in malignant lymphoma]. / Kliniko-morfologichni paraleli pri maligneni limfomi.

Concurrent clinicomorphological studies were carried out in patients with malignant Hodgkin's and non-Hodgkin lymphomas treated in the Hematologic Clinic of the High Medical Institute in Pleven. The frequency of the different clinicomorphological variants and their classification in accordance with their initial localization, clinical stage and histological variant were studied. Some clinicomorphological features of the patients studied are analyzed.

[2,3-diphosphoglycerate level during the active and maintenance treatment of iron-deficiency anemia patients]. / Nivo na 2,3-difosfoglitserata po vreme na aktivno i poddurzhashto lechenie na bolni ot zheliazodefitsitna anemiia.

The objective of the present study was to obtain information about the duration of tissue hypoxia in patients with iron deficiency anemia. That fact is of importance for the determination of the duration of maintenance iron therapy. The level of 2,3-diphosphoglycerate was studied during the treatment, after the correction of anemic syndrome and after 60-day out-patient department treatment. The data obtained revealed that the level of 2,3-diphosphoglycerate was considerably elevated, as compared with the norm, before the treatment. After the active treatment and correction of anemic syndrome it was decreased, but remaining above the norm. By the 60th day of the out-patient department treatment the decrease continued and the level of 2,3-diphosphoglycerate approached the norm.