I. Teodorova - Academia.edu (original) (raw)

Papers by I. Teodorova

European Urology Supplements, 2013

ABSTRACT Introduction & Objectives: The aim of this study was to analyze our initial expe... more ABSTRACT Introduction & Objectives: The aim of this study was to analyze our initial experience with living donor kidney transplantation, and to interpret the results from the urological point of view. Material & Methods: Within a 5-year period (June 2008 - June 2013), a total of 39 couples had been initially screened and subjected to profound medical examinations at the preliminary phase of our living donor kidney transplantation program. Of these, 16 couples finally underwent kidney transplantation, 12 of which were realized in our hospital. The mean age of the donors was 50.3 years (range, 20 - 68 years), and the mean age of the recipients was 35.0 years (range, 23 - 54 years). Kidney donation was performed from parent to child (7 cases), or between brothers and sisters (5 cases). Results: In spite of the significant co-morbidity, causing deteriorated common condition in the majority of the recipients, and the multiple vascular anomalies, found in most of the donors, all surgical procedures ran successfully and without major peri-operative complications. The most common post-transplantation complications were the inflammatory ones. Acute pyelonephritis of the transplanted kidney and urosepsis developed in 6 patients, four of whom were subjected to repeated surgery: 1 open mini-incisional nephrectomy of a native kidney, due to active vesicoureteral reflux; 1 ureterolithotomy, due to a stone, obstructing the ureter of the transplanted kidney; 1 re-implantation of the ureter, following excision of the necrotic distal part, and 1 liberation of the distal ureter from postoperative adhesions. There was 1 hemorrhagic complication (huge pararenal hematoma) that was managed conservatively. One of the transplanted kidneys had to be removed on the 4th year after the transplantation, due to immunosuppressant nephrotoxicity and chronic kidney rejection. None of the rest had been rejected, or removed. Conclusions: Most of the postoperative complications, observed in our initial series of patients, were urological in nature, which emphasizes the leading role of the urologists and the impact of their experience and qualification during the kidney transplantation itself, and during the follow-up period.

Известия на Съюза на учените – Варна Серия „Медицина и екология”, Dec 28, 2018

Malignant plasmacytoma (MP) (multiple myeloma) is a clonal B cell disease affecting slow-release ... more Malignant plasmacytoma (MP) (multiple myeloma) is a clonal B cell disease affecting slow-release plasmatic cells accompanied by monoclonal paraprotein production followed by lytic bone lesions. Nearly 50% of the newly diagnosed patients have a reduced glomerular filtration rate and about 9% require dialysis treatment due to severe renal impairment. The aim of this study is to direct nephrologists' attention to seeking and diagnosing patients with unclear fast progression of CKD and to highly sensitive methods of proving especially light chains in urine. Early diagnosis and treatment, rapid and effective reduction in the number and removal of light paraprotein chains by aggressive chemotherapy and/or apheresis may reduce the risk of renal impairment and prevent end-stage renal failure. Rapid and timely diagnosis as well as effective treatment of renal failure combined with conservative and interventional therapy reduces severe complications and significantly prolonged survival in patients with malignant plasmacytoma, delaying the progression of renal involvement.

Известия на Съюза на учените – Варна Серия „Медицина и екология”

Scripta Scientifica Medica, 2007

European Urology Supplements, 2013

ABSTRACT Introduction & Objectives: The aim of this study was to analyze our initial expe... more ABSTRACT Introduction & Objectives: The aim of this study was to analyze our initial experience with living donor kidney transplantation, and to interpret the results from the urological point of view. Material & Methods: Within a 5-year period (June 2008 - June 2013), a total of 39 couples had been initially screened and subjected to profound medical examinations at the preliminary phase of our living donor kidney transplantation program. Of these, 16 couples finally underwent kidney transplantation, 12 of which were realized in our hospital. The mean age of the donors was 50.3 years (range, 20 - 68 years), and the mean age of the recipients was 35.0 years (range, 23 - 54 years). Kidney donation was performed from parent to child (7 cases), or between brothers and sisters (5 cases). Results: In spite of the significant co-morbidity, causing deteriorated common condition in the majority of the recipients, and the multiple vascular anomalies, found in most of the donors, all surgical procedures ran successfully and without major peri-operative complications. The most common post-transplantation complications were the inflammatory ones. Acute pyelonephritis of the transplanted kidney and urosepsis developed in 6 patients, four of whom were subjected to repeated surgery: 1 open mini-incisional nephrectomy of a native kidney, due to active vesicoureteral reflux; 1 ureterolithotomy, due to a stone, obstructing the ureter of the transplanted kidney; 1 re-implantation of the ureter, following excision of the necrotic distal part, and 1 liberation of the distal ureter from postoperative adhesions. There was 1 hemorrhagic complication (huge pararenal hematoma) that was managed conservatively. One of the transplanted kidneys had to be removed on the 4th year after the transplantation, due to immunosuppressant nephrotoxicity and chronic kidney rejection. None of the rest had been rejected, or removed. Conclusions: Most of the postoperative complications, observed in our initial series of patients, were urological in nature, which emphasizes the leading role of the urologists and the impact of their experience and qualification during the kidney transplantation itself, and during the follow-up period.

European Urology Supplements, 2013

ABSTRACT Introduction & Objectives: The aim of this study was to analyze our initial expe... more ABSTRACT Introduction & Objectives: The aim of this study was to analyze our initial experience with living donor kidney transplantation, and to interpret the results from the urological point of view. Material & Methods: Within a 5-year period (June 2008 - June 2013), a total of 39 couples had been initially screened and subjected to profound medical examinations at the preliminary phase of our living donor kidney transplantation program. Of these, 16 couples finally underwent kidney transplantation, 12 of which were realized in our hospital. The mean age of the donors was 50.3 years (range, 20 - 68 years), and the mean age of the recipients was 35.0 years (range, 23 - 54 years). Kidney donation was performed from parent to child (7 cases), or between brothers and sisters (5 cases). Results: In spite of the significant co-morbidity, causing deteriorated common condition in the majority of the recipients, and the multiple vascular anomalies, found in most of the donors, all surgical procedures ran successfully and without major peri-operative complications. The most common post-transplantation complications were the inflammatory ones. Acute pyelonephritis of the transplanted kidney and urosepsis developed in 6 patients, four of whom were subjected to repeated surgery: 1 open mini-incisional nephrectomy of a native kidney, due to active vesicoureteral reflux; 1 ureterolithotomy, due to a stone, obstructing the ureter of the transplanted kidney; 1 re-implantation of the ureter, following excision of the necrotic distal part, and 1 liberation of the distal ureter from postoperative adhesions. There was 1 hemorrhagic complication (huge pararenal hematoma) that was managed conservatively. One of the transplanted kidneys had to be removed on the 4th year after the transplantation, due to immunosuppressant nephrotoxicity and chronic kidney rejection. None of the rest had been rejected, or removed. Conclusions: Most of the postoperative complications, observed in our initial series of patients, were urological in nature, which emphasizes the leading role of the urologists and the impact of their experience and qualification during the kidney transplantation itself, and during the follow-up period.

Известия на Съюза на учените – Варна Серия „Медицина и екология”, Dec 28, 2018

Malignant plasmacytoma (MP) (multiple myeloma) is a clonal B cell disease affecting slow-release ... more Malignant plasmacytoma (MP) (multiple myeloma) is a clonal B cell disease affecting slow-release plasmatic cells accompanied by monoclonal paraprotein production followed by lytic bone lesions. Nearly 50% of the newly diagnosed patients have a reduced glomerular filtration rate and about 9% require dialysis treatment due to severe renal impairment. The aim of this study is to direct nephrologists' attention to seeking and diagnosing patients with unclear fast progression of CKD and to highly sensitive methods of proving especially light chains in urine. Early diagnosis and treatment, rapid and effective reduction in the number and removal of light paraprotein chains by aggressive chemotherapy and/or apheresis may reduce the risk of renal impairment and prevent end-stage renal failure. Rapid and timely diagnosis as well as effective treatment of renal failure combined with conservative and interventional therapy reduces severe complications and significantly prolonged survival in patients with malignant plasmacytoma, delaying the progression of renal involvement.

Известия на Съюза на учените – Варна Серия „Медицина и екология”

Scripta Scientifica Medica, 2007

European Urology Supplements, 2013

ABSTRACT Introduction & Objectives: The aim of this study was to analyze our initial expe... more ABSTRACT Introduction & Objectives: The aim of this study was to analyze our initial experience with living donor kidney transplantation, and to interpret the results from the urological point of view. Material & Methods: Within a 5-year period (June 2008 - June 2013), a total of 39 couples had been initially screened and subjected to profound medical examinations at the preliminary phase of our living donor kidney transplantation program. Of these, 16 couples finally underwent kidney transplantation, 12 of which were realized in our hospital. The mean age of the donors was 50.3 years (range, 20 - 68 years), and the mean age of the recipients was 35.0 years (range, 23 - 54 years). Kidney donation was performed from parent to child (7 cases), or between brothers and sisters (5 cases). Results: In spite of the significant co-morbidity, causing deteriorated common condition in the majority of the recipients, and the multiple vascular anomalies, found in most of the donors, all surgical procedures ran successfully and without major peri-operative complications. The most common post-transplantation complications were the inflammatory ones. Acute pyelonephritis of the transplanted kidney and urosepsis developed in 6 patients, four of whom were subjected to repeated surgery: 1 open mini-incisional nephrectomy of a native kidney, due to active vesicoureteral reflux; 1 ureterolithotomy, due to a stone, obstructing the ureter of the transplanted kidney; 1 re-implantation of the ureter, following excision of the necrotic distal part, and 1 liberation of the distal ureter from postoperative adhesions. There was 1 hemorrhagic complication (huge pararenal hematoma) that was managed conservatively. One of the transplanted kidneys had to be removed on the 4th year after the transplantation, due to immunosuppressant nephrotoxicity and chronic kidney rejection. None of the rest had been rejected, or removed. Conclusions: Most of the postoperative complications, observed in our initial series of patients, were urological in nature, which emphasizes the leading role of the urologists and the impact of their experience and qualification during the kidney transplantation itself, and during the follow-up period.