[HEAD INJURY DURING PREGNANCY].

No matter how severe is head injury during pregnancy, it can threaten both- the maternal and (or) the fetal life. The risk derives from systemic and cerebral consequences of high intracranial pressure, hypotension, anemia or expanding mass lessions in the cranial cavity. The specific hormonal background of the mother may contribute the better outcome after traumatic brain injury (TBI). Pregnancy and trauma push the doctors to create different and specific management than the usual case. Investigating literature data we figure out the initial assessment, management priorities for resuscitation of the head injured pregnant patient, concidering the specific anatomic and physiologic changes during pregnancy. We accept the principal: first save the mother, then the child, if possible, proposing algorithm for severe head injured pregnant patient management.

Percentile reference values of arterial blood pressure for individuals aged 20 to 60 years from Plovdiv region.

In the course of an epidemiological screening of a Plovdiv region contingent we determined the percentiles of arterial blood pressure of 1458 men and 1146 women (aged 20 to 60 years) selected at random using the SPSS/PC+ program. The derived values for the 75th percentile of the systolic arterial blood pressure for men over 30 years of age and for women aged over 35 years form a group of high-normal systolic arterial blood pressure; for men over 35 years and women over 40 years a first class arterial hypertension is formed at the 75th percentile (USA, 1995). The reference values of the 75th and 90th percentiles of the systolic and diastolic arterial blood pressure rise step-like in men and steeply in women. After 50 years of age the reference values of systolic arterial blood pressure displayed a prevalence in women whereas those of the diastolic arterial blood pressure prevailed in men.

Percentile reference values of lipid risk factors of ischaemic heart disease: cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides in individuals aged 20 to 60 years in Plovdiv region.

1408 men and 1069 women aged 20 to 60 years selected at random from the Plovdiv region were studied during an epidemiological screening. Statistical analysis of the data was carried out using a SPSS/PC+ program. The percentiles (reference values and intervals) of the lipid risk factors were determined. The reference intervals and values at the 75th and 90th percentile for both sexes showed a prevalence of cholesterol, HDL-cholesterol and LDL-cholesterol for women, and of HDL-cholesterol at the 90th percentile for men below the age of 45 years. The derived percentile reference values for cholesterol, LDL-cholesterol and triglycerides are higher than the respective values for some European and American populations. A moderate and high lipid risk was identified for women over the age of 40-45 and in men in the age range 20-60 from all age groups. The established reference values for individuals of both sexes aged 20 to 60 years make it possible to diagnose and monitor dyslipidemias. They can be used for the purposes of the educational lipid program of the Plovdiv region population.

[Splenectomies for Hodgkin's disease--a study of the period 1984-1994]. / Splenektomii po povod na bolestta na Khodzhkin--prouchvane za perioda 1984--1994 g.

Explorative laparotomy with ensuing splenectomy in Hodgkin's disease is applied for the first time in the Stanford University in the late 60-ies. Opinions on the pros and cons of the method in terms of number of cases, complications and the like are largely dissenting. The analysis covers 153 patients with Hodgkin's disease subjected to splenectomy. Primary diagnosis is made on the ground of lymph node biopsy. Wide spreading of the disease, coincidence of diagnoses in different locations and complications are briefly discussed, with recommendations made concerning improvement of the organization of sample handling and correlation with the clinical findings.

[Case report of Gaucher's disease]. / Bolestta na Gaucher s prinos na edin sluchai.

The case of a 42 years old man suffering from Gaucher's disease is reported. The primary diagnosis was liver cirrhosis based on echographic and scintigraphic examinations. The following signs were found: thrombocytopenia, slight hemolysis, shortened life of the erythrocytes with considerable sequestration in the spleen, abnormal flocculation tests, increased acid phosphatase. The X-ray examination revealed irregularly oval light spots with different size and form and well cut outlines in the skull and a zone of bone resorption in the right shoulder joint. The liver needle biopsy showed parenchymal infiltration with Gaucher's cells. The above mentioned deviations and the family heredity of the patients suggested the diagnosis of an adult form of Gaucher's disease. The fibroplastic changes in the liver including formation of septa led to the suggestion of a link between Gaucher's disease and liver cirrhosis.

[So-called immunoglobulin-producing lymphoma with a case presentation and the production of monoclonal immunoglobulin M]. / Vurkhu t. nar. imunoglobulini produtsirashti limfomi s predstaviane na sluchai s proizvodstvo na monoklonalen imunoglobulin M.

The authors discuss the B-cellular lymphomas, producing various kinds of monoclonal paraproteins as well as parts of them--light or heavy chains. A case of a patient with lymphoplasmocytic malignant lymphoma, producing monoclonal IgM in pentamer form mainly, as well as in Valdenström disease but without the symptoms characteristic for it--hyperviscosity and hemorrhagic diathesis, is described. The disease has been histologically, cytologically and electron microscopically diagnosed. Attention is paid to the long-term relatively benign course and subsequent malignant course with manifested laboratory changes as well as change in the objective state, requiring the monotherapy to be substituted for active complex treatment, though the effect was unsatisfactory, with a fatal outcome of the inflammatory complications and progressive anemia. The place of the case in Kiel classification of malignant lymphomas is discussed.