Nikolay Atanasov Yanev

Medical University of Sofia · Department of Pulmonary Diseases

The aim of the research is to perform microbiological analysis of respiratory tract samples in patients with cystic fibrosis and to verify the aetiology, prevalence and antibiotic sensitivity of the isolated pathogens. Sixteen patients with cystic fibrosis aged from 3 months to 30 years were included. Twenty-nine respiratory and one digestive tract...

Background: Sarcoidosis is a chronic inflammatory disease that can affect multiple organs. The aetiology of sarcoidosis is not fully understood, but there is increasing evidence that the microbiome may play a role. The blood microbiome is a collection of microorganisms that live in the bloodstream. It is a complex and dynamic community that is infl...

Paraganglioma is a neuroendocrine tumor that originates from extraadrenal chromaffin cells. Primary thyroid paraganglioma is an extremely rare neoplasm. In this study, an exceptionally uncommon case of recurrent mediastinal malignant paraganglioma with primary origin from thyroid gland is presented. Median resternotomy, resection of left brachiocep...

Introduction Single microbial pathogens or host-microbiome dysbiosis are the causes of lung diseases with suspected infectious etiology. Metagenome sequencing provides an overview of the microbiome content. Due to the rarity of most granulomatous lung diseases collecting large systematic datasets is challenging. Thus, single-patient data often can...

ЦЕЛ: да се проучи разпространението на пневмоцистозата при различни групи имунокомпрометирани и имунокомпетентни лица, да се установят нивата на колонизация от патогена сред рискови групи на населението и да се изясни тяхната роля като възможен резервоар за разпространение на инфекцията с P. jirovecii. МАТЕРИАЛИ И МЕТОДИ: Приложeни са микроскопски...

The Pneumocystis jirovecii (P. jirovecii) and protozoan of the genera Acanthamoeba, Cryptosporidium, and Toxoplasma gondii are opportunistic pathogens that can cause life-threatening infections in immunocompromised patients. Aim of the study was to evaluate the coinfection rate with opportunistic protozoal agents among Bulgarian patients diagnosed...

Background: Pneumocystis pneumonia (PCP) commonly affects immunocompromised individuals, whereas in immunocompetent persons, it occurs relatively rarely, and in most cases, the Pneumocystis infection is detected as an asymptomatic colonization. The present study aimed to establish the prevalence of Pneumocystis jirovecii infection in human hosts w...

Introduction: Cardiac disorders are common in patients with chronic obstructive pulmonary disease (COPD). They worsen shortness of breath and physical capacity and reduce the quality of life. Ultrasound assessment of cardiac function could contribute to assessing the severity of the disease. This study aimed to assess the prognostic significance of...

Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality, and healthcare costs worldwide. Lung cancer is the second most common cancer and is the leading cause of cancer mortality, accounting for almost 25% of all cancer deaths. This study aims to investigate the prevalence of COPD in patients with lung...

Only a small percent of all intubated SARS-CoV-2-positive patients survive because of the development of severe respiratory and multiorgan failure. The development of tracheal stenosis after orotracheal intubation or tracheostomy is a dangerous complication with gross consequences for the patient and medical staff. Endoscopic interventional procedu...

(1) Background: A number of studies have demonstrated the connection between develop- ing or exacerbating chronic respiratory diseases in adults and children. However, still, few studies focus on reducing exacerbations via immunomodulation. (2) Methods: In this pilot study, a total of 25 pediatric and adult patients with bronchial asthma (BA) and c...

The lung microbiome dysbiosis contributes to lung carcinogenesis. Of particular interest would be to compare the blood and lung tissue microbiomes in patients with lung carcinoma. The aim of our study was to compare blood and lung biopsy microbiomes in patients with lung carcinoma. Blood and lung biopsy samples were collected from three patients w...

Isoniazid (H; INH) is an important first-line drug for the treatment of active tuberculosis (TB) and latent TB infection because of its potent early bactericidal activity against Мycobacterium tuberculosis. Currently, TB resistant to INH, alone or in combination with other drugs, is the most common type of drug-resistant TB. Epidemiology of INH-re...

The Pneumocystis jirovecii (P. jirovecii) and protozoan of the genera Acanthamoeba, Cryptosporidium, and Toxoplasma gondii are opportunistic pathogens that can cause life-threatening infections in immunocompromised patients. Aim of the study was to evaluate the co-infection rate with opportunistic protozoal agents among the Bulgarian patients diagn...

Background: Each year, approximately two million adolescents and young adults in the world become infected with tuberculosis (TB). The problem is that the classification of the disease includes children in the age group 0-14 years and young adults aged 15 and over. The present study aims to analyze and compare the epidemiology and clinical present...

Introduction: Diaphragmatic dysfunction is common in patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess the prognostic significance of impaired diaphragmatic movement at rest and after exercise. Methods: This was a prospective study of patients with stable COPD. Diaphragmatic movements were examined at rest an...

Sarcoidosis is a systemic granulomatous disease of unknown etiology and pathogenesis, in which there is an increased risk of pulmonary thromboembolism (PE). This manuscript presents two clinical cases of PE in patients with sarcoidosis. Patients with sarcoidosis are at risk of developing PE. All patients with sarcoidosis and impaired respiratory fu...

Introduction The Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy report provides guidance on effective management of chronic obstructive pulmonary disease (COPD) according to local healthcare systems. However, COPD is a heterogenous disease and certain aspects, including prevalence, disease–time course and phenotype distribut...

Introduction and importance Thyroid cancer is the most common endocrine malignancy, while primary paraganglioma of the thyroid gland (TP) is an unusual tumour and in rare cases, this disease tends to mimic thyroid cancer. They are rare extra-adrenal neuroendocrine tumours originating from the neural crest, and are found almost exclusively in the he...

Immunoglobulin G4-related disease (IgG4-RD) is a lymphoproliferative disease which is described almost exclusively in adults. There are only a few pediatric patients who have been observed with this disorder. Here, we describe a rare case of IgG4-RD in a 17-year-old girl with a single manifestation—tracheal stenosis without previous intubation or o...

Background In recent years, there has been a revolution in the genomic profiling and molecular typing of lung cancer. A key oncogene is the epidermal growth factor receptor (EGFR). The gold standard for determining EGFR mutation status is tissue biopsy, where a histological specimen is taken by a bronchoscopic or surgical method (transbronchial bio...

Background In recent years, there has been a revolution in the genomic profiling and molecular typing of lung cancer. A key oncogene is the epidermal growth factor receptor (EGFR). The gold standard for determining EGFR mutation status is tissue biopsy, where a histological specimen is taken by a bronchoscopic or surgical method (transbronchial bio...

Objectives: Obtaining qualitative, sufficient material for the diagnosis of malignancies in cases with normal endoscopic findings in patients with suspected lung cancer and hilar and mediastinal lymphadenopathy is challenging. Materials and methods: Endobronchial ultrasound (EBUS) was used to control a transbronchial needle biopsy (ТBNA) for the fi...

Background Understanding the risk factors for exacerbations of COPD may help provide a more personalised approach to exacerbation prevention. Method Observational, prospective, international, multicentre study aimed at identifying risk factors for exacerbations of COPD. Clinical variables, lung function and CAT scores were collected at baseline. I...

Surgical interventions for corrosive stricture of the esophagus are extremely difficult and technically challenging. In this manuscript, we present a patient with esophagectomy due to perforation of a corrosive stricture of the esophagus that underwent malignant transformation and subsequent perforation of a giant duodenal stress ulcus, which occur...

Introduction Chronic obstructive pulmonary disease (COPD) is associated with increased lung and systemic inflammation. We aimed to identify associations between easy-to-obtain blood biomarkers and the frequency and severity of exacerbations. Methods Cross-sectional, multicentre study performed in four centres in Spain, Italy, Bulgaria, and Sloveni...

Aspergillus is a fungus which could cause a number of infectious and allergic diseases especially in immunocompromised patients. We report a case of 15-year-old boy with a small post- pneumonic cavity formation in the 3rd segment of the right lung. After conventional intravenous antibiotic treatment the X-ray changes were still persisting. The boy...

Introduction Granulomatosis with polyangiitis is rare but severe necrotizing vasculitis. Disseminated and limited forms are distinguished. The latter are characterized by only upper respiratory tract and/or lung and/ or glomerulonephritis. The lung involvement is confirmed with fibrobronchoscopy. Aim The aim of the study is to present the bronchos...

Introduction Present medical care for the children with cystic fibrosis (CF) improves the quality and the duration of life, although digestive and respiratory dysfunction, chronic infections, progressive lung destruction and growth retardation leads to premature death. Our aim is to review the morbidity and mortality in patients with CF in Central...

Background: At present, there is little information in Bulgaria regarding the rate and stability of frequent-exacerbation phenotype in COPD patients. Aim: To study the rate and stability of frequent-exacerbation phenotype in COPD patients. Materials and methods: We followed up 465 COPD patients for exacerbations over a 3-year period. Exacerbations...

In recent years, there has been a revolution in genomic profiling and molecular typing of lung carcinoma. Full genomic profiling is recommended forassessment of optimal personalized therapy. The epidermal growth factor receptor (EGFR) is a key oncogene for targeted therapy. A gold standard for determining EGFR mutation status is histological specim...

Background: Autofluorescence bronchoscopy (AFB) allows a more sensitive approach to the diagnosis of premalignant and malignant endobronchial lesions than white light bronchoscopy (WLB) can do. Aim: To assess the autofluorescence bronchoscopy and white light bronchoscopy in diagnosing malignant endobronchial lesions. Materials and methods: The desi...

As part of a retrospective study on bronchoscopies performed at the Clinic of Pneumonology and Phthisiatry of the University Hospital - Pleven by autofluorescence bronchoscopy we found 3 cases diagnosed with carcinoma in situ. They were treated in different ways - endobronchial electrocoagulation, extraction by forceps biopsy and open surgery, but...

Background: Environmental pollution can be one of the main risk factors for acute exacerbations of chronic obstructive pulmonary disease (COPD). Aim: To study the relationship between air pollution, outdoor temperature and exacerbations of COPD. Materials and methods: COPD patients (n=1432) were followed up for one year. The levels of particul...

The study aimed to assess the inhalation technique of patients with bronchial asthma/chronic obstructive pulmonary disease (COPD) via an objective method and to evaluate the effect of training in patients with incorrect technique. Тhe inhalation technique of 120 patients with obstructive pulmonary disease was tested. The patients were divided into...

Background: Studies showed good correlation between CAT score and mortality in COPD patients. Aim: To study the relationship between CAT score, mortality and exacerbations in COPD patients who require LTOT. Methods: Patients with severe hypoxemia with indications for LTOT were followed up for three years with assessment of symptoms, hospitalization...

Topic: There is not enough data in Bulgaria about the influence of air pollution and outdoor temperature on the frequency of acute exacerbations of COPD (AECOPD). Aim: To study the relationship between the levels of air pollutants and outdoor temperature and frequency of AECOPD. Methods: To observe the frequency of AECOPD we followed 477 hospitaliz...

Introduction Correct inhalation technique is essential part of obstructive pulmonary diseases treatment. Aims To test patients' inhalation technique, to determine most common mistakes during inhalation and to find out factors, which affect the inhalation technique. Methods The inhalation technique of 94 patients with obstructive pulmonary disease (...

Background: Indications for LTOT in patients with moderate hypoxemia (MH) are controversial. Aim: To characterize and compare patients with MH versus patients with severe hypoxemia (SH) with or without access to LTOT. Methods: Patients were added to a registry and were followed up for three years. Main aspects of follow up were mortality, rate of h...

Introduction: GOLD 2014 recommendations categorise COPD patients in four groups, which differ significantly in clinical characteristics and outcomes. Aim: This follow-up study attempted to determine the distribution and stability of GOLD 2014 revision groups in three consecutive years 2012, 2013 and 2014. Methods: A total of 262 (210 male and 52 fe...

Background: The control of asthma is important to maintain normal activity. One of the key points in good asthma control is the management of exacerbations. Aim: To characterize asthmatic patients with and without exacerbations (E). Methods: Specially designed questionnaire was used to evaluate asthma patients from around 37 medical practices acros...

There are COPD patients who are rehospitalised due to recurring COPD exacerbations. Aim: To characterize COPD patients who were rehospitalised due to acute exacerbations of COPD(AECOPD). Methods: We followed retrospectively 544 patients for hospitalization for AECOPD for one year. Information about age, FEV1, CRP, WBC, fibrinogen, comorbidities and...

Introduction: Some of the patients with long-term bronchial asthma present with irreversible airflow limitation (FEO1/FVC< 0.7) on their routine pulmonary function tests. Aims: To analyse outpatients with asthma and FEO1/FVC< 0.7 looking for characteristics that could be easily applied in clinical practice. Methods: Four hundred and forty nine pati...

Introduction: The GOLD 2014 assessment predicts future exacerbations and mortality risk, separating patients into high symptom groups (B, D) and high risk groups (C, D). Aim: Our aim was to investigate hospitalisations, exacerbations and mortality in a 3 year prospective study in outpatients with COPD. Material and Methods: A total of 262 (210 male...

Background: Many studies examine the cost effectiveness of care provided for COPD patients receiving long-term oxygen treatment (LTOT). Aim: The aim of our study was to evaluate the costs for hospital treatment of exacerbations in COPD patients requiring LTOT which is not reimbursed in Bulgaria. Methods: Patients with COPD and indications for LTOT...

Background: The revision of GOLD in 2011 and its updates suggested a more complex approach for the COPD severity evaluation and management. Objectives: To evaluate COPD severity and management in Bulgaria using data from pulmonary specialists (PS) from all over the country. Methods and Material: We applied a specially designed questionnaire to eval...

Objectives To investigate serum zinc concentrations in pediatric patients with cystic fibrosis (CF). Methods 33 children with CF were included in the patient group of the study. They were divided into two sub-groups according to the severity of the clinical manifestation of the malabsorption syndrome. The control group of the study consisted of 28...

Purpose: The clinical aspects of antibiotic resistance (ABR) of patients in ambulatory practice with chronic obstructive pulmonary disease (COPD) are not investigated thoroughly. The aim of the present study is to find the most frequent respiratory pathogens of ambulatory COPD patients and to evaluate the resistance of their isolates to tested anti...

Data concerning the prevalence of AAT deficiency in general population or respiratory patients in CEE countries are limited or non-existent. The overwhelming majority of individuals with AAT deficiency remains undiagnosed. We present data from the CEE A1AT Network established in 2013. DBS samples were collected in 2013 from 866 COPD patients in Po...

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Introduction The latest GOLD 2011 recommendations provide an opportunity for a more patient oriented therapeutic approach. Aim This prospective 1-year, follow-up study attempted to determine the direct cost and the cost of associated comorbidities derived from the management of COPD patients hospitalized for an exacerbation. Methods A total of...