[A clinical case of young, oral combined contraceptive using women, heterozygous carrier of the Factor V (Leiden) which revealed thrombosis of the left internal jugular vein and brain ischemia with cerebral infarction and ischemic stroke].

Thrombophilia is associated with increased risks of venous thrombosis in women taking oral contraceptive preparations. Universal thrombophilia screening in women prior to prescribing oral contraceptive preparations is not supported by current evidence. The case is presented of a 23 year-old women with a personal history of interruption and on the same day started with oral contraceptive (0.03 microg ethynil estradiol - 0.075 microg gestodene), which due on a 18 pill/day to acute headache, increasing vomiting and speaking defects. Physical/neurologic/gynecologic examinations observed a normal status. The MRI and CT revealed thrombosis of the left internal jugular vein and brain ischemia with cerebral infarction and ischemic stroke. The acute therapy of thrombotic findings was accompanied with many tests. The thrombophilia PCR-Real time - test finds heterozygous carrier of the Factor V (Leiden). This case shows the need of large prospective studies that should be undertaken to refine the risks and establish the associations of thrombophilias with venous thrombosis among contraceptive users. The key to a prompt diagnosis is to know the risk factors. The relative value of a thrombophilia screening programme before contraceptive using needs to be established.

[Comparative analysis of blood and urinary electrolytes in normotensive and hypertensive normal, overweight and obese subjects aged 50-54 in the Bulgarian army]. / Sravnitelen analiz na elektrolitite v kruvta i urinata pri normotonitsi i khipertonitsi (s normalno teglo, sus svrukhteglo i zatlusteli) ot Bulgarskata armiia na vuzrast 50-54 godini.

Objective of the study is to investigate the hypotheses regarding the correlation of serum levels and urinary excretion of electrolytes with arterial hypertension. 211 subjects aged 50-54 from Bulgarian Army were studied. Evaluated were following parameters: SBP, DBP, BMI, Na+, K+ in blood serum; Na+, K+, NaCl, KCL, Na/K ratio, Ca++, Mg++ in 24-h urine excretion. Statistical analysis of variance, dispersion and correlation analysis (using 6D program from statistical pack BMDP) were applied. In the blood, no correlation was found between Na+ and both SBP and DBP. A significant positive correlation between SBP and K+ was found only in non-obese hypertensive females (R = 0.59, p < 0.05). Correlation between K+ and DBP was negative in separate groups with normal BMI (R = -0.84, R = -0.65, p < 0.05). In the 24-h urine excretion, no correlation was found between K+, NaCl, KCL and SBP, as well as between Na+ and SBP and DBP. Significant positive correlation was found between K+ and DBP in obese hypertensive subjects (R = 0.56, p < 0.05) and between NaCl and DBP (R = 0.47 up to R = 0.66 in separate groups, p < 0.05). Significant positive correlation between Ca++ and DBR (R = 0.47) was found in obese hypertensives. Mg++ correlates positively with DBP (R = 0.62 in some groups). Urine levels of Ca++ and Mg++ were significantly higher in normatensives. Electrolytes in blood and urine were closely related to DPB rather than to SBP. K+ levels in blood affect only DBP. Our data do not confirm the hypothesis for the positive correlation between urinary Na(+)-excretion and BP (except in obese subjects). The hypothesis about the inverse relation of K(+)-intake to BP, especially to DBP is confirmed by our data. The data regarding the Ca++ and Mg++ urinary excretion and their correlation with DBP and SBP are very discordant and do not give an opportunity to make definite conclusions. Our data confirmed the hypothesis about the natriuretic effect of Mg++, which possibly is of a protective value for development of AH in some obese persons.

[The cellular immunity indices of patients with a rheumatic heart defect]. / Izsledvane na niakoi pokazateli ot kletuchniia imunitet pri bolni s revmatichen porok na surtseto.

In 29 patients with clinical diagnosis of rheumatic valvular disease the quantitative values of active rosettes and the specific sensitization to human heart myosin were examined. The specific sensitization to human heart myosin was examined by two methods concurrently: method of inhibiting leucocyte migration in agarose and method for direct specific lymphocytolysis with myosin. The results were compared with those of 44 clinically healthy controls. In the patients with rheumatic valvular disease (RVD) the values of the active rosettes are significantly lower (p less than 0.01) than in the healthy controls. With the method of direct specific lymphocytolysis with myosin statistically significant sensibilization of the lymphocytes to myosin was found in the patients with RVD (p less than 0.001). In 5 patients examined before and after operation it was established that 2-4 weeks after a successful correction of the hemodynamics the specific sensibilization of the lymphocytes to myosin was no more present.