[Oral contraceptives increase deep venous thrombosis in smoking women].

There is consistent evidence that the use of oral contraceptives and is associated with increased risk of deep vein thrombosis. The study objective was to assess age specific incidence of deep venous thrombosis and pulmonary embolism in women 20 to 50 years of age associated with the use of oral contraceptives, and smoking habit. A case-control study of vein thrombosis was conducted in National Heart Hospital in Sofia. The study consists of studies for vascular events (peripheral vascular disease) during hormonal therapy. We found that cigarette smoking aggravates venous thromboembolism and pulmonary embolism the in women using oral contraceptives, v. The effect of smoking alone on venous tromboembolism was not found significant. Most probably different factors that increase the incidence of vascular narrowing or occlusion might explain the association between deep venous thrombosis, complicated pulmonary thromboembolism oral contraceptives use and smoking in women in pre-menopausal age.

[Breast-feeding and drugs of abuse].

Drugs of abuse in breast-feeding women and the risk for the baby represent a problem of great concern both from a medical as well as of ethical point of view. Possibilities for the determination of the levels of exposure are discussed. Analysis of the risk for the infant exposure to drugs of abuse excreted in the breast milk is done. The effects of the most important drugs of abuse on breast-fed babies are reviewed.

[Drugs in pregnancy].

The use of drugs in pregnancy is being discussed. The influence of different factors, both physiological and drug related (physicochemical characteristics, dose, duration of pharmacotherapy) on the processes of absorption, distribution, protein binding, metabolism and excretion are reviewed. The up-to-date classification of the drugs in relation to their effects on the fetus is presented. Special emphasize is given to drugs (antibiotics, cardio-vascular, psychotropic etc.) used for the treatment of acute and chronic conditions in the course of pregnancy. Drugs used for symptoms like pain, high temperature and constipation are also reviewed. Recommendations for the use of safer drugs in pregnancy are given. Drugs with proven teratogenic effects are presented.

Effects of some beta-adrenoceptor blockers on avoidance learning in rats.

In experiments on male Wistar rats, we studied the effects of some beta-adrenoceptor blockers: nonselective-propranolol, pindolol and 3b (a new aminotetraline derivative); and cardioselective (beta 1)-acebutolol and talinolol, on avoidance learning. The nonselective beta-adrenoceptor blockers failed to deteriorate and in some cases even facilitated learning, estimated by the number of avoidance responses and their latencies, while the cardioselective blockers significantly impaired learning process. A significant learning-impairing effect was shown by the beta 2-adrenoceptor agonist salbutamol. Similar was the effect of the mixed alpha- and beta-adrenoceptor blocker labetalol. The results are interpreted in connection with the functional role of beta 1- and beta 2- adrenoceptors in the CNS and with the importance of their balance for learning process.

[Clinico-therapeutic and microbiologic studies of the Bulgarian antibiotic cephalothin in patients with active pyelonephritis]. / Kliniko-terapevtichni i mikrobiologichni prouchvaniia na bulgarskiia antibiotik tsefalotin pri bolni s aktiven pielonefrit.

A total of 38 patients with active pyelonephritis and significant bacteriuria were treated with the Bulgarian antibiotic cephalotin, the bacteria isolated from their urine manifesting susceptibility to the Bulgarian broad-spectrum antibiotic cephalotin. Twenty six from the patients were with preserved renal function, and 12 with various stages of renal insufficiency. The subjective complaints, febrility, leukocyturia and bacteriuria were best affected. The highest anti-bacterial effect was observed in the patients with uroinfections caused by E. coli, Proteus mirabilis, Klebsiella and staphylococci. Cephalotin has a good tolerance and has no adverse effects. Painful infiltrations were established in some of the patients in the region of the site of intramuscular application, with a transitory character. Cephalotin was assessed, on the base of the study, to be a good and prospective broad-scpectrum antibiotic, deserving to be widely applied in the therapeutic practice.

[Fibrin fibrinogen degradation products in the urine and blood in patients with diabetes mellitus and renal complications]. / Fibrin/fibrinogen razgradni produkti v urinata i kruvniia serum na diabetno bolni s niakoi bubrechni uslozhneniia.

Making use of immunoelectrophoretic method for semiquantitative determination, the fibrin/fibrinogen degradation products (FDP) were determined in urine and blood serum of 63 patients with diabetes mellitus with various vascular-degenerative and inflammatory complications in the kidneys as well as of 23 clinically healthy subjects. FDP presence in urine was found mainly in patients with diabetic nephropathy (in 32.6%). FDP in blood serum was found with significantly increased values in diabetic nephropathies (mean 14.9 mg/ml) and particularly in their advanced forms (mean 16.4 mg/ml), whereas in diabetics with chronic pyelonephritis, their content was increased in single cases (mean 1.9 mg/ml). A moderately manifested correlation of FDP in urine and serum with blood urea, serum creatinine and creatinine clearance was established as well as partly with protein quantity in urine and diastolic arterial pressure. The determination of FDP in urine and blood serum could serve as an additional sign in the differentiation of diabetic nephropathy and chronic pyelonephritis in diabetic patients.

[Diagnostic significance of lysozymuria in chronic pyelonephritis]. / Diagnostichno znachenie na lizozimuriiata pri khronichniia pielonefrit.

Lysozymuria was studied in 70 patients with chronic pyelonephritis with preserved renal function and two groups of 18 patients each with pyelonephritis, with chronic renal insufficiency (CRI) and glomerulonephritis without CRI. Elevated value of lysozyme in urine was obtained in 40% of the patients with chronic pyelonephritis with preserved renal function and in 66.6% of those with chronic pyelonephritis in the stage of a chronic renal insufficiency. Lysozyme level in urine is in a correlation dependence on serum creatinine level. Lysozymuria is more frequent among patients with pyelonephritis with significant bacteriuria as well as among patients not treated with uroantiseptics. Lysozymuris is present in two patients with nephrotic syndrome from the patient group with glomerulonephritis and in two with probable not complicated chronic pyelonephritis.

[Pharmacokinetics of the pressor substance, 5,8-dimethoxy-trans-2-(2-hydroxyethyl)-amino-3-hydroxy-1,2,3,4-tetrahydronaphthalene hydrochloride (1b), after intravenous use]. / Farmakokinetika na presornoto veshtestvo 5,8-dimetoksi-trans-2-(2-khidroksietil)-amino-3-khidroksi-1,2,3,4-tetrakhidronaftalin khidrokhlorid (1b) sled intravenozno prilagane.

The authors investigated the pharmacokinetics of the pressor substance 5,8-dimetoxy-trans-2-/2-hydroxyethyl/-amino-3-hydroxy-1,2,3,4-tetrahydronaphthaline hydrochloride (1b), which possessed strong pressor action. Blood concentrations after venous administration in a dose of 1 mg/kg of body weight were determined by means of exctration spectrofluorometric method. The data complied with the biexponential equation, meeting the requirements of an open two-compartment model. There was a quick elimination of the substance from the central compartment, which correlated also with the data for quick disappearances of the effect on the arterial pressure.

[Characteristics of the proteinuria in diabetic nephropathy]. / Kharakteristika na proteinuriiata pri diabetnata nefropatiia.

Considerable deviations, qualitative and quantitative, in patients with nephropathy were found with the examination 38 patients with various stages of diabetic nephropathy and 14 other diabetic patients as well as 37 healthy subjects. The urine of those patients is characterized by high content of albumin, transferrin and immunoglobulins G, A and M and to lesser degree--of alpha 2-macroglobulin. The selectivity of proteinuria is most frequently decreased, especially in the advanced stages of diabetic nephropathy. Tubular components (light chains, alpha 2- and beta-microglobulins) were also found in the urine of the same patients.

[Urine specific gravity and osmolarity in hypertension patients with dehydration]. / Spetsifichno teglo i osmolalnost na urinata pri khipertonichno bolni v usloviia na dekhidratatsiia

Results are reported from the comparative investigations of kidney concentration function by urine specific gravity and its osmolatity of 58 patients with arterial hypertension. Significant differences were found in more of the half of the patients. On the base of certain theoretical prerequisites and possibilities of technical errors was concluded that the determination of the maximal urine osmolality is a more reliable and more accurate index for the actual renal concentration ability. Urine specific gravity can be used in the everyday clinical practice due to the more convenient and easier determination. Urine osmolality must be used predominantly in scientific-clinical studies.

Acid-base equilibria in ethylene glycol--II: autoprotolysis constants and acid-base properties of ethylene glycol and its mixtures.

The acid-base behaviour of ethylene glycol and its mixtures with water (1, 5 and 10%), methanol, ethanol, isopropanol, nitromethane (each 10%) and ethyl methyl ketone-chloroform (5 + 5%) have been investigated by potentiometric titration, in a cell without liquid junction, equipped with a glass and a silver-silver chloride electrode. The autoprotolysis as well the protolysis constants of phthalic acid were determined for each mixture. The added solvents improve the properties of ethylene glycol, decreasing the viscosity without changing the acid-base behaviour of the ethylene glycol itself, which is favourable for the titration of weak bases. Water increases the basic, and nitromethane the acidic, properties of the mixture. Small quantities of water (ca. 1%) do not impair the titration conditions.

[131-I-hippuran clearance and isotopic nephrography in patients with endemic nephropath]. / 131J-khipuranov kliruns i izotopna nefrografiia pri bolni s endemichna nefropatiia

The authors carried out investigations on renal function with isotope nephrogram and 131J-hippuran clearance in 30 patients with endemic nephropathy - three with and 27 without nitrogen retention. In all patients, especially in advanced stages, a considerable decrease of the effective renal plasma flow was established. The radioisotope nephropathy also provides evidence for diffuse bilateral and symetric alterations in the complete renal function. The statement was confirmed that in the course of endemic nephropathy, all renal structures are gradually involved, but the functions of tubules and interstitial tissues are especially severly disturbed.

[Changes in blood coagulation in diabetic nephropathy]. / Promeni v susirvaemostta na kruvta pri bolni ot diabetna nefropatiia

Investigations on certain hemocoagulation indices are carried out of 52 diabetics, 32 of them with diabetic nephropathy. The following indices were determined: thrombocyte numer, thrombocyte adhesion and aggregation, recalcification and heparinrecalcification time, partial thromboplastin time (PTT) and prothrombin time, coagulation retraction and thrombelastography. Data for increased blood coagulation are established in diabetics and especially in the presence of nephropathy. Most manifested are the changes in thrombocyte adhesion, in PTT, recalcification and heparin-recalcification time. Changes in thrombelastogram and the rest of the indices are less manifested. In patients with more advanced forms of nephropathy--the increased hemocoagulation is more pronounced. The changes described are considered non diabetes specific and are associated with the accompanying atherosclerosis. Those changes might indicate inclusion of anticoagulants and antiaggregating medicines in the therapeutic program of patients with diabetic nephropathy with the respective indications.

[Morphological study of the parathyroid glands in diabetes mellitus and its renal complications]. / Morfologichni prouchvaniia na paratireoidnite zhelezi pri zakharniia diabet i b"brechnite mu uslozhneniia

The parathyroid glands of 14 deceased diabetics were investigated as well as nine control non-diabetics. Various in character and degree histological alterations were observed during the morphological investigations of those glands: mild or better manifested hyperplastic alterations (six cases), microadenoma (one case), focal vasculary determined atrophia (two cases, total atrophia of involutive type (two cases), close to the control alterations (three cases). Hyperplastic alterations are established most frequently in the presence of diabetic nephropathia and azotemia. They could be explained with the development of a secondary hyperparathyroidism, associated with chronic renal insufficiency. In single cases, an effect of the disturbance of the calcium-phosphorus metabolism in diabetes is admitted. Changes in the parathyroid glands, from the type of generalized diabetic microangiopathy, is suspected in one of the deceased patients. Two microadenomas were found in another case, predominantly with dark basic cells. No dependence was established between the morphological alterations and the severity, diabetes form, nor with the presence of pyelonephritis. Certain dependence was established between the age of the deceased and the stage of the azotemia.

[Hereditary nephritis with bearing loss of the receiver type (Alport's syndrome) with a description of 2 cases]. / Vurkhu nasledstveniia nefrit s namalenie na slukha ot priemen tip (sindrom na Alport) s opisanie na dva sluchaia

A familial predisposed diffuse nephropathy is described in three adult patients--brothers, combined with hearing abatement--receiver type--in two of them. Typical gout was also found in them, that is difficult to associate with the azotemia. It was admitted that it concerns the Alport syndrome in adults, developing with certain peculiarities, advanced patient age, disturbances of purine metabolism, moderately selective proteinuria of glomercultubular type and chromosome aberration--thresomia of F chromosome.

[I-131-hippuran clearance and isotope nephrography in chronic pyelonephritis]. / 131-J-hipuranov kliruns i izotopna nefrografiia pri khronichen pielonefrit

The results from the complex radioisotope and clinical examination of 105 patients with chronic pyelonephritis are presented. 131J-hippuran clearance was performed according to the single injection method. The obtained average value 583--166 ml/min 1,73 m2 for the patients in renal compensated stage is lower than the normal. The average value for renal plasma flow is 229.58--127 ml/min/1,73 m2 for patients in renal decompensated stage. The filtration fraction--FF showed decreased values both in renal compensated (0,14) and in decompensated patients (0,09). That gives us sufficient grounds to assume some changes in the glomerular function even in the compensated stage of chronic pyelonephritis and during the decompensated stage it considerably decreases due to manifested morphological changes, addecting also the glomerular apparatus. Isotope nephrogram was made to 71 of the patients, which proved normal in those in the compensated stage or with slight alteration, predominatly unilaterally, while in the cases with decompensated stage--the changes were strongly manifested, most frequently in the three segments, bilaterally.