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E Nartowicz

Publications and source records attributed to E Nartowicz.

At least 37 records · Page 2Linked to original sources

[Evaluation of prophylaxis and actual prevalence of HBV infection in twelve hemodialysis centers of Northern Poland].

The aim of the study was to estimate the HBV infection preventive measures used in the twelve dialysis centres in north Poland. In all of the centres hepatitis B vaccination and segregation of HBV infected patients (dedicated machines or separate rooms), which are the two basic HBV infection control methods, were introduced. Our results point out that in some of the centres certain modification of these methods would be possible, including universal predialysis vaccination programme, changes in hepatitis B vaccination schedules with most effective routes of vaccination only and dedication for HBV infected patients not only separate rooms but separate dialysis staff as well.

Adolescent↗

Lack of effect of amiodarone on survival after extensive infarction. Polish Amiodarone Trial.

BACKGROUND: The purpose of this study was to elucidate whether the reduction of mortality with amiodarone after myocardial infarction depended on ejection fraction. METHODS: The data from the Polish Amiodarone Trial were analysed retrospectively. Patients with acute myocardial infarction and contraindications to beta-blockers were randomized on days 5-7 after admission to receive amiodarone (n = 305) or placebo (n = 308). Short and long-term (46 months) mortality were analysed comparing the groups with impaired (ejection fraction < 40%) and preserved (ejection fraction > or = 40%) left ventricular function. A subset of patients (n = 523) with available echocardiograms were subjected to this analysis. RESULTS: Long-term and sudden cardiac mortality were significantly reduced with amiodarone in the group of patients with ejection fraction > or = 40% (amiodarone versus placebo, respectively: 9.1 versus 16.5%, P < 0.05; 3.4 versus 8.2, P < 0.05). No beneficial effect of amiodarone was observed in the group with low ejection fraction (cardiac and sudden cardiac mortality: amiodarone versus placebo, 20.8 versus 19.3% and 7.8 versus 5.7% respectively). One-year mortality also revealed a favourable trend only in amiodarone-allocated patients with ejection fraction > or = 40%. CONCLUSION: Amiodarone decreased long-term and sudden cardiac mortality after myocardial infarction only in patients with preserved left ventricular function. No benefit was observed in patients with decreased ejection fraction.

Amiodarone↗

[Assessment of outcome in treatment of cardiac shock after myocardial infarction with intravenous streptokinase].

In 1986 a prospective randomized study coordinated by the Institute of Cardiology in Warsaw was started in 10 teaching cardiology hospitals in Poland for assessment of the results of treatment with intravenous streptokinase infusion in acute myocardial infarction. The studied population comprised 927 patients admitted to intensive treatment units within 6 hours after the onset of infarction pain. For the groups treated with streptokinase or heparin 752 patients were selected at random. In 175 cases the administration of streptokinase was contraindicated. These patients received conventional treatment and served as controls. The age of the patients was from 38 to 70 years, mean age 57.6 +/- 9.3 years. In 105 out of 927 cases cardiac shock was diagnosed. In the groups of early shock during hospitalization the death rate was 82%. No statistically significant difference was found in the death rates between patients with cardiac shock treated with heparin or with streptokinase.

Adult↗

[Congestive heart failure and ventricular arrhythmia in relation to magnesium, potassium and sodium in serum and erythrocytes].

The aim of this study was to determine magnesium, potassium and sodium in plasma and erythrocytes in patients (14 male, 12 female; the average age 60.3) with congestive heart failure (CHF) (NYHA class II/III, III, IV) who were treated with digitalis, diuretics and vasodilators. All patients were subjected to 24 h ECG monitoring and ventricular arrhythmias classified according to LOWN, were analyzed in relation to electrolyte contents in erythrocytes and serum. Control group consisted of 20 persons (17 male; 3 female: the average age 58.7 years). Plasma and erythrocyte K and Na were determined by flame spectrophotometer; Mg was assayed by atomic absorption spectrophotometer. Statistical analysis was made by t-Student test. Results obtained suggest that patients with CHF require supplementation K+ with Mg2+ (tab. I). Our study has not revealed expected interrelationships between ventricular arrhythmias and electrolyte disturbances in patients with CHF. It should be stressed, however, that the small numbers of patients in the subgroups in our study might have blurred the possible relationship.

Adult↗

[Magnesium, potassium and sodium in serum and erythrocytes in acute myocardial infarction].

Serum concentration and erythrocyte contents of Mg++, K+ and Na+ was measured on day 1, 3 and 14 in patients with transmural myocardial infarction. The study group consisted of 72 patients (15 females and 57 males) with the diagnosis of myocardial infarction based on WHO criteria. The control group consisted of 52 healthy subjects (11 females and 41 males). Measurements of sodium and potassium were made using flame photometer, magnesium was measured with atom adsorption spectrophotometry. Lowest magnesium and potassium concentrations (in serum and in erythrocytes) were found on day 1 and day 3 with almost full normalization on day 14. Sodium serum concentration and erythrocyte contents varied; lowest serum concentration appeared on day 1 and day 3, erythrocyte contents was highest on day 1.

Adult↗

Effect of amiodarone on mortality after myocardial infarction: a double-blind, placebo-controlled, pilot study.

OBJECTIVES: The goal of this study was to evaluate the effect of amiodarone on mortality, ventricular arrhythmias and clinical complications in high risk postinfarction patients. BACKGROUND: No therapy has been shown to reduce sudden death in patients ineligible to receive beta-adrenergic blocking agents after myocardial infarction. METHODS: Patients who were not eligible to receive beta-blockers were randomized to receive amiodarone (n = 305) or placebo (n = 308) for 1 year. RESULTS: There were 21 deaths in the amiodarone group compared with 33 in the placebo group (odds ratio 0.62, 95% confidence interval [CI] 0.35 to 1.08, p = 0.095). There were two noncardiac deaths in the amiodarone group and none in the placebo group; thus, the difference in cardiac mortality (19 vs. 33, respectively) was statistically significant (odds ratio 0.55, 95% CI 0.32 to 0.99, p = 0.048). There was a significant decrease in Lown class 4 ventricular arrhythmias (7.5% vs. 19.7%, respectively, p < 0.001). Adverse effects developed in 30% of amiodarone-treated patients and 10% of placebo-treated patients. Pulmonary toxicity, which was mild and reversible, occurred in only one patient in the amiodarone group but in no patient in the placebo group. CONCLUSIONS: This trial demonstrated a significant reduction in cardiac mortality and ventricular arrhythmias with amiodarone treatment. However, given the wide confidence intervals and borderline statistical significance of our trial, larger trials are needed to confirm or refute this view.

Amiodarone↗

[The heart in arterial hypertension].

The data is presented on the pathogenesis of myocardial changes in arterial hypertension. The non-haemodynamic causes are discussed of myocardial hypertrophy, as well as the participation of collagen in its early phase and the haemodynamic consequences of hypertrophy and its regression. Hypotensive drugs and their ability ot prevent myocardial hypertrophy and (or) inducing of its regression were compared.

Cardiomegaly↗

[Stellectomy in the treatment of patients with long QT syndrome].

The authors present the surgical technique of stellate ganglion excision as a therapeutic method in patients with the long QT syndrome. The operations were performed through an anterior supraclavicular approach. Discussing the anatomic considerations, the possibilities of complications and side effects, both temporary and permanent, including Horner's syndrome are reviewed. On the base of the review of present literature and the postoperative results in patients treated in the Otolaryngological Department of the Medical Academy in Bydgoszcz, the authors confirm that the results of stellate ganglion excision in patients with the long QT syndrome are encouraging, but the possibilities of complications, including sudden death after stellectomy, must be taken into consideration.

Adult↗

[False results of measuring digoxin levels in patients with renal failure. Comparison of the RIA--FPIA methods].

During last few years were reports concerning a new endogenous digoxin -like immunologic factor (DLIF) in patients not receiving digitalis. DLIF was stated in pregnant women's blood umbilical and neonatal blood as well as in patients with renal failure or hepatopathy. This phenomenon could be related to hormones changes (pregnancy) as well as alterations of cholesterol, triglycerides, free fatty acids, albumins or total protein level (nephropathy, hepatopathy). DLIF overstated determination of serum digoxin concentration, which in the case of exceptional narrow digoxin therapeutic spectrum as well as its concentration-dependent toxicity became a significant clinical problem. Effect extent of DLIF on serum digoxin level could be also related to applied analytic technics. The aim of the study was to compare two routinely applying analytic methods: polarized immunofluorescence (FPIA-TDx Abbott) with radioimmunological assay (RIA). The study was performed in patients with renal failure to estimate DLIF effect on real serum digoxin concentration as well as on extent and DLIF elimination velocity during dialysis. DLIF occurrence in patients with renal failure not receiving digitalis was experimentally stated using both RIA and FPIA methods. However, RIA revealed DLIF in all cases: before and after dialysis as well as in not dialyzed patients with a concentration above 0.3 ng/ml, when FPIA values were respectively: 0.087; 0.043; 0.078 ng/ml, which was less than 10% of digoxine therapeutic range (0.9-2.0 ng/ml). DLIF lowered in a course of dialysis to FPIA advantage, which was proved by FPIA/RIA ratio decrease nearly of a half of its predialysis value. Pre- and postdialysis values of FPIA/RIA ratio were 0,204 and 0,134 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnostic Errors↗

[Comparative evaluation of biological availability and anti-arrhythmia effectiveness of Mexicard (mexiletine Polfa)].

In 16 healthy males bioavailability of Mexicord (Polfa) was studied, in comparison with mexiletine of foreign made. Bioavailability extent (EBA) of Mexicord was over 99% in comparison with a standard drug. Comparative study of antiarrhythmic activity and side effects was performed in 32 patients with frequent ventricular premalure beats and nearly in a half of them resistant to antiarrhythmic agents. Mexicord was effective in 47% of treated patients, and side effects (most often nausea) were observed in 28% of patients, but only in 1 case therapy withdrawal was necessary. Statistical study proved a lack of significant differences in antiarrhythmic effectiveness and side effects between Mexicord (Polfa) and a drug of foreign made.

Adult↗

ST 567 compared with propranolol in stable angina.

UNLABELLED: The aim of this study was to investigate the effectiveness of ST 567 in patients suffering from ischaemic heart disease and to compare the effects of this drug with those of propranolol. The study group consisted of 48 male patients, mean age 53, with stable, exercise-induced angina pectoris. After a two-week run-in-placebo period, the patients were randomized to treatment with ST 567 3 X 30 mg (N = 24) and propranolol, 3 X 40 mg (N = 24). The drugs were administered in a double blind fashion during four weeks. Heart rate at rest was decreased by ST 567 from 76 to 65 (P less than 0.005) by propranolol from 76 to 62 (P less than 0.001). Systolic blood pressure was lowered by ST 567 from 131 to 121 (NS) and by propranolol from 133 to 118 (P less than 0.05). Exercise tolerance was increased by ST 567 from 20 X 10(3) to 34 X 10(3) J (P less than 0.05), by propranolol from 26 X 10(3) to 32 X 10(3) J (P less than 0.01) (mean values). Anginal attacks (no. per week) were reduced by ST 567 from 14 to 7 (P less than 0.05) and by propranolol from 14 to 5 (P less than 0.01). Nitroglycerin consumption in no. of tablets per week decreased in ST 567 from 12 to 7 (P less than 0.01), in propranolol from 11 to 4 (P less than 0.0). There were 7 drop outs during treatment with ST 567:2 cases of myocardial infarction, exacerbation of angina in 2 patients, visual disturbances in 2 patients, vertigo in 1 patient. With propranolol we observed worsening of angina in 1 patient, with disturbances in sexual potency in 1. IN CONCLUSION: ST 567 is an effective agent in chronic angina but slightly less effective than propranolol in the dosages studied.

Angina Pectoris↗