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Biomedical subjects

D Trejbal

Publications and source records attributed to D Trejbal.

At least 37 records · Page 2Linked to original sources
PubMed1998

[The Groningen Activity Restriction Scale (GARS) in the evaluation of severity of rheumatoid arthritis].

BACKGROUND: The functional ability of the patient in chronic diseases reflects the severity of the pathological process and the success of treatment. OBJECTIVE: Evaluation of the functional ability of patients with RA and assessment of the influence of the pathological process on the performance of simple everyday tasks. METHODS: Physical capacity and functional ability were examined using the Groningen activity restriction scale (GARS) and Health Assessment Quesionnaire (HAQ). RESULTS: The authors examined 160 patients with RA (135 women and 25 men), mean age 48.3 +/- 12.13 years and a duration of the disease of 21.32 +/- 15.61 months. The mean value of the functional ability according to GARS was 32.67 +/- 11.61. Women had a poorer score (33.36 +/- 11.91) than men (28.96 +/- 9.44), the difference was however not statistically significant. The mean value of functional ability according to HAQ/FDI of the patients was 1.079 +/- 0.65. Women had a poorer score (1.156 +/- 0.625) than men (0.722 +/- 0.936), the difference being significant (P < 0.01). The authors found a significant correlation (P < 0.001) between HAQ and GARS as well as a significant relationship with parameters assessing the inflammatory activity. In GARS a relationship with the duration of the disease was found (P < 0.05), but not with HAQ. There was no significant relationship between GARS or HAQ with the patients age. In investigations of the restriction of functional ability during common everyday activities it was revealed that the greatest problem of patients is care of feet and nails, climbing stairs and personal hygiene. As to household activities the highest score was recorded for "strenuous house work" (scrubbing floors, cleaning windows and vacuum cleaning), shopping ironing and bedmaking. CONCLUSION: GARS is a reliable practical and simple scale of functional ability of patients with RA which can be used for the accurate description of the severity and for evaluation of the degree of functional ability.

Activities of Daily Living↗
PubMed1997

[Present trends in the pathogenesis, diagnosis and therapy of vasovagal syncope].

Vasovagal syncope is the most frequent cause of syncopal conditions. In its pathogenesis autonomic nervous, neurohumoral, cerebrovascular and other mechanisms participate. The gold standard in the diagnosis of vasovagal syncope is in recent years the head up tilt test. In treatment pharmacotherapy, cardiac pacing or their combination can be used.

Humans↗
PubMed1996

[The clinical picture of latent hypothyroidism in women].

The authors investigated the most frequent clinical symptoms in a group of 132 women with latent hypothyroidism (mean age 40.2 years, incl. 102 women younger than 45 years). They assessed the diagnosis on the basis of an excessive TSH response after administration of 0.2 mg thyreoliberin by the i.v. route (TRH test), while the thyroxine values were normal (TSH 0 min.: 4.93 +/- 3.55, TSH after 20 min. following TRH: 39.27 +/- 18.28 mIU/ml, T4: 102.0 +/- 25.02 nmol/l). Forty-one patients (31%) had goitrectomy in the case-history. USG examination of 70 patients revealed goitre in 13 (18.6%) reduced echogenity of the thyroid gland in 20 (28.6%) and microcysts in 31 (44.2%) of the patients. Analysis of the clinical symptoms revealed manifestations of a depressive symptomatology in 56 patients (40.3%), benign mammary dysplasia in 39 patients (29%). In the subgroup of women younger than 45 years an impaired menstrual cycle was recorded in 49 (48%) and galactorrhoea in 10 patients (9.8%). After thyroid substitution (L-thyroxine 50 micrograms/day) they observed in the majority normalization of the menstrual cycle and partial improvement of depressive manifestations.

Adolescent↗
PubMed1996

[Treatment of autonomous thyroid gland nodules using percutaneous injections of ethanol under ultrasonography control--initial experience].

The authors treated nine women with autonomous adenomas of the thyroid gland by repeated ethanol injections under ultrasonographic control. In all patients clinical and laboratory characteristics of hyperthyroidism were present. After treatment is seven patients euthyroidism was induced, in two patients subclinical hypothyroidism which persisted also during the 6-month follow-up period. In all patients ultrasonographic changes in the nodes were recorded: a reduced echogenity the development of "halo"--hypoechogenic outlines--a change of the shape and on average a 37% reduction of the volume. Treatment was feasible also under out-patient conditions: it was well tolerated by the patients, undesirable effects were not serious and only transient and receded spontaneously.

Adenoma↗
PubMed1996

[Interferon in the treatment of Loeffler's endocarditis].

The authors describe their own experience with the administration of recombinant alpha 2c interferon in the treatment of Loefller's endocarditis. Based on their analysis (as well as in keeping with the spares data in the literature-as a rare disease is involved), the authors consider this procedure as a qualitative advance of treatment. They consider their account as preliminary because of the short period of time, and therefore in future strict dispensary care of the patient is essential.

Female↗
PubMed1995

[Diagnostic sensitivity of 24-hour electrocardiographic Holter monitoring in indications for coronarography].

The authors evaluated 24-hour ECG monitoring (Holter monitoring) in 70 patients indicated for coronarography. They assessed the sensitivity, specificity, positive and negative predictive value of Holter monitoring. They compared the findings with data reported in the literature and with the sensitivity of the ergometric test for indication of patients for coronarographic examination. Although the sensitivity and specificity of Holter monitoring does not exceed generally reported values of sensitivity and specificity of bicycle ergometry, in the discussion the authors mention conditions where Holter monitoring is an asset for indication of patients for coronarographic examination.

Adult↗
PubMed1995

[Latent hypothyroidism--a minor laboratory variation or a disease?].

Latent hypothyreosis is a state which is characteristic by normal values of thyroid hormones (T3, T4) and moderately increased values of thyroid-stimulating hormone (TSH), or extensive response of TSH after stimulation with thyrotrophin-releasing hormone (TRH-test). The characteristic symptoms include goitre, symptoms of mammary glands (galactorrhea, benign mammary dysplasia), impairment of menstruation cycle and fertility and psychic disturbances (depressive symptomatology, deterioration of memory). The characteristic laboratory alterations include increased basal or stimulated values of prolactin and impairment of lipoprotein metabolism (significant decrease of HDL, increase of LDL). This aspect often makes the indication of substitution therapy justified in spite of normal concentrations of peripheral hormones. (Ref. 26).

Humans↗
PubMed1995

[Neurohumoral activity in liver cirrhosis].

The authors assessed in 40 patients with cirrhosis of the liver and in 33 controls the plasma renin activity (PRA), aldosterone (PA), the atrial natriuretic factor (ANF) and the digoxin like activity (DLA) in plasma under basal conditions. In patients with cirrhosis of the liver they found significantly lower levels of PRA, PA and DLA, as compared with the control group, the ANF levels were not significantly altered. In the group with cirrhosis the highest neuroendocrine activity was recorded, in particular of PRA and PA in decompensated cirrhotics receiving diuretic treatment. Therefore it is useful to combine diuretics with preparations or measures which reduce the activity of the renin-angiotensin-aldosterone system and/or promote the activity of natriuretic substances. The authors found a negative correlation between PRA and SNa, PRA and UNaV, while ANF did not correlate with natriuresis. The main determinant of Na excretion in decompensated cirrhosis is the activity of the renin-angiotensin-aldosterone system. DLA plasma levels also correlated inversely with SNa values and Na excretion and thus also reflect the severity of fluid retention.

Adult↗
PubMed1994

[Transesophageal atrial stimulation in routine clinical practice].

The authors examined 90 patients by the method of transoesophageal atrial stimulation with different indications. They consider transoesophageal atrial stimulation a suitable method for basic examination of an impaired functional status of the sinoatrial node and atrioventricular conductivity. It is suitable for assessment of predisposition to supraventricular disorders of the rhythm and for testing the effectiveness of treatment of impaired supraventricular rhythm. The authors use it also for a modified loading test in patients with coronary heart disease. They evaluate transoesophagel al atrial stimulation as a simple, safe, non-invasive method, practically without contraindications, which extends our diagnostic and therapeutic possibilities, is not demanding from the technical and economic aspect and can be used in any hospital.

Adult↗
PubMed1994

[The effect of water immersion on humoral and urinary parameters in healthy persons and in patients with liver cirrhosis].

The authors subjected 10 healthy subjects and 13 patients inflicted by liver cirrhosis in the stage of vascular decompensation (ascites and/or oedemas) to water immersion (WI). The group of healthy subjects responded during WI by a significant increase of diuresis and sodium diuresis at its maximum in the third hour, which was accompanied by a decrease of plasma aldosterone (PA) and a decrease of atrial natriuretic factor (ANF) and digoxin-like activity (DLA). The decrease of plasma vasopressin (PAVP) was not statistically significant. In patients with liver cirrhosis a significant increase of diuresis and sodium diuresis took place, whilst the response was significant already in the first hour of WI. Only 3 non-respondents were among the ill patients. In the group of liver cirrhotics also a significant decrease of AVP, PA, and an increase of ANF and DLA were recorded, the response of humoral factors was not significant due to great variability. A long term administration of diuretics (Spirolakton+Furosemid) did not decrease the serum K in ill patients. Hence, WI by means of supervention of volume expansion evokes an increase of diuresis and natriuresis in both healthy and ill subjects, the latter with decompensated liver cirrhosis which is associated with a controversial reaction of sodium diuresis and sodium retention factors. It is possible to use it as a supplementary method in the therapy of oedemas due to liver cirrhosis besides diuretic therapy. (Tab. 2, Fig. 3, Ref. 22.)

Adult↗
PubMed1994

Central hypothyroidism--various types of TSH responses to TRH stimulation.

Thyrotropin (TSH) levels in serum before and 20 and 60 min after the administration of 0.2 mg TRH i.v. as well as thyroid hormone (T3, T4) levels were studied in 39 patients with organic diencephalo-pituitary lesions and 27 healthy subjects. All participants gave their informed consent with the study. By the type of TSH response to TRH stimulation all patients were divided into 4 groups: 1. Normal response (n = 10): basal TSH 2.31 +/- 1.51, peak TSH 20 min after TRH 12.17 +/- 6.53, TSH 60 min after TRH 8.43 +/- 4.65 microU/ml; T3 2.02 +/- 0.48 and T4 95.9 +/- 27.73 nmol/l; 2. Blunted or absent TSH response (n = 8): basal TSH 0.82 +/- 0.42, peak TSH 20 min after TRH 1.51 +/- 0.66, TSH 60 min after TRH 1.35 +/- 0.51 microU/ml; T3 1.6 +/- 0.49 and T4 86.63 +/- 16.49 nmol/l; 3. Delayed ("diencephalic") TSH response (n = 16): basal TSH 2.69 +/- 1.27, peak TSH 20 min after TRH 7.96 +/- 3.35, TSH 60 min after TRH 10.0 +/- 3.97 microU/ml; T3 1.30 +/- 0.63 and T4 65.85 +/- 21.13 nmol/l; 4. Higher basal or stimulated TSH (n = 10): basal TSH > 10 mU/ml or stimulated values above 25 mU/ml. Mean T3 and T4 values in patients with normal or blunted TSH response did not differ significantly from the controls. Mean T3 and T4 in the group with delayed TSH response were significantly lower (P < 0.01). High TSH and low T3 and T4 levels were found in the patient with large meningioma sellae.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

The role of endogenous digitalis-like factor in blood pressure regulation in essential hypertension.

We examined plasma renin activity (PRA), plasma aldosterone (PA), atrial natriuretic factor (ANF) and endogenous digitalis-like factor (DLF) in 15 healthy subjects and 15 patients with essential hypertension (EH) to obtain basal values and values after extracellular fluid volume (ECFV) expansion caused by infusion of isotonic saline solution over a period of 2 hours (20 mg/kg). A significant increase in diuresis and natriuresis accompanied by a decrease in PRA and PA and an increase in ANF was observed in both groups. No significant differences were observed in ANF levels between normotensive subjects and hypertensive patients. Hypertensive patients showed significantly higher basal values of DLF than normotensive subjects. However, an increase in plasma DLF following ECFV expansion was observed only in the group of healthy subjects. There was a positive correlation between ANF and natriuresis and a negative correlation between ANF and systolic and diastolic blood pressure (BP). Changes in DLF correlated positively with changes in diastolic BP in both groups, while in healthy subjects a negative correlation was recorded between PRA and DLF. We conclude that the increased diuresis and natriuresis in ECFV expansion is presumably accounted for not only by suppression of PRA and PA, but also by stimulated ANF secretion, while in healthy subjects stimulation of DLF may be involved as well. The insufficient DLF response to saline infusion may indicate an exhausted DLF reserve in hypertensive patients. As a vasoactive substance, DLF can participate in the regulation of blood pressure and play a role in the pathogenesis of arterial hypertension.

Adult↗
PubMed1993

[Atrial natriuretic factor as a marker of clinical severity in cardiac failure].

The authors examined plasma levels of the atrial natriuretic factor (ANF) in 26 patients with manifestations of cardiac failure. The ANF levels were high as compared with reference values (21 +/- 16.7 fmol/ml vs. 4.9 +/- 2.1 fmol/ml) and different in relation to individual functional NYHA classes, i.e. the lowest ones were in the second and the highest ones in the fourth class. Concurrently the authors revealed a statistically significant negative exponential correlation between plasma ANF levels and the left ventricular ejection fraction (r = 0.550, p < 0.01) and a bordeline correlation between ANF and the stroke volume (r = -0.45, p = 0.05). The results indicate that the plasma ANF level is a good indicator of severity of cardiac weakness and can be used in clinical work as a prognostic indicator in patients with heart failure.

Adult↗
PubMed1992

[Patients after thyroid gland surgery from the aspect of the endocrinologist].

The authors examined 85 patients after a mean interval of 2.5 years following thyroidectomy. They focused attention on evaluation of the functional state using as criteria the TSH and TRH test. Simultaneously they examined by ultrasonography the volume of the remainder of the thyroid gland. In 8 patients operated on account of carcinoma the average volume of the thyroid gland was 1.3 ml. Five patients were hypothyroid despite permanent substitution. Of 77 patients operated on account of benign goitre evident hypothyroidism was found in 29 (37.7%) and latent hypothyroidism in 14 (18.2%). The volume of the remainder of the thyroid gland in these patients was on average smaller than 4 ml, while in patients who were euthyroid after thyroidectomy the mean volume of the remaining thyroid was more than 4.5 ml.

Adult↗
PubMed1991

Plasma cortisol and prolactin response to insulin-induced hypoglycemia in neurosis.

Prolactin (PRL) and plasma cortisol response to insulin induced hypoglycemia were studied in 14 patients with various somatic and vegetative complaints of neurotic character and in 12 controls. In all examined subjects glucose level fell below 50% of basal values and below 2.2 mmol/l. Significant PRL and plasma cortisol response were present in all controls. Plasma cortisol increase in control group was at least 1.5 fold higher than basal values and the difference between basal concentrations and highest values after stimulation was at least 0.25 mumol. Individual peak of PRL values in group of controls was 1.8-10 fold greater than basal levels. In the group of 14 patients in 11 cases no PRL response to challenge was found and in 4 cases also plasma cortisol response was blunted. In two patients extremely exaggerated PRL reaction was found. Different PRL responses to insulin-induced hypoglycemia are probably a manifestation of different types of neurotransmitter metabolism breakdown.

Adolescent↗
PubMed1990

[The prolactin and TSH response to stimulation in patients with hypophyseal tumors].

The authors examined the prolactin (PRL) and thyrotropin (TSH) response to stimulation with chloropromazine and thyreoliberin in 10 patients with pituitary tumours. They observed a hypothalamic response instead of the expected pituitary response. These findings may be of importance for the understanding of the aetiopathogenesis of pituitary tumours. As we are able to influence nowadays some expansive pituitary processes by conservative treatment, these findings may in the near future be important in clinical practice.

Adenoma, Chromophobe↗