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Biomedical subjects

J Bastecký

Publications and source records attributed to J Bastecký.

At least 19 recordsLinked to original sources
PubMed1995

[Arrhythmogenic right ventricle].

A 26-year-old patient with an irrelevant personal and family-history was treated on account of attacks of relapsing ventricular tachycardia and cardiac failure, mostly dextrolateral. After ruling out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, Ebstein's anomaly, the diagnosis of an arrhythmogenic right ventricle was established. This disease is suggested by negative T waves in the thoracic leads V1-V3 during sinus rhythm and by the shape of the QRS complex which was the type found in block of the Tawara branch with an axis of + 100 degrees during attacks of ventricular tachycardia. Moreover, ventricular tachycardia of the same type was produced during electrocardiographic examination. On angiographic examination ARVD is suggested by marked trabeculization and impaired kinetics of the outflow tract of the right ventricle. In the prevention of relapses of ventricular tachycardia beta-blockers and Cordarone were successful when used simultaneously with cardiac stimulation type AAI applied on account of a confirmed sinoatrial block.

Adult↗
PubMed1995

[Problems of admission and detention of citizens in health care institutions in the Czech Republic].

The author explains in detail new legal regulations on admission to and detention in health institutions of citizens of the Czech Republic, as applied to people with mental disorders. The author describes three stages of implementation as regards admission of a person to a psychiatric in-patient department, i.e. prerequisites for involuntary psychiatric hospitalization, the stage of the intervention and the stage of admission to and detention in a psychiatric in-patient department. Attention is drawn to the fact that in the legal regulations are some inaccuracies and that practical implementation of involuntary hospitalization of the mentally sick is associated with some difficulties. It is recommended that after evaluation of experience with the implementation of the new regulations which are valid since Jan. 1, 1992 some of the regulations should be amended.

Commitment of Persons with Psychiatric Disorders↗
PubMed1994

[Actilyse (a recombinant tissue-type plasminogen activator] in the treatment of acute myocardial infarct. Comparison of the effects of Actilyse and streptokinase].

The preparation Actilyse--a tissue plasminogen activator prepared by recombination--is an effective fibrinolytic drug. The authors recorded in a group of 33 patients reperfusion in 91%, evaluated on the basis of indirect criteria. In a group of 18 patients treated with streptokinase reperfusion was achieved in 74%. Based on changes of CK and CK-MB values--an earlier rise of values following Actilyse administration and conversely their more marked increase during subsequent sampling after streptokinase administration--it may be assumed that earlier dissolution of the thrombus in the coronary artery occurs after Actilyse administration, as compared with streptokinase. It may be thus assumed that there is also a smaller necrotic focus after Actilyse treatment, as compared with streptokinase. Early re-occlusion--according to indirect indicators--occurred in 8.6% in the Actilyse treated groups, as compared with 5.9% in the streptokinase treated group. The fibrinogen values decline in the Actilyse group to 40% and in the streptokinase group to 28%. Later enhanced new formation of fibrinogen occurs and the fibrinogen values rise to 160% in the Actilyse treated group and to 250% of the initial value in the streptokinase treated group. The elevated fibrinogen value, as compared with the baseline value, persists for the 12 days of the follow-up. No severe spontaneous haemorrhage was recorded, haemorrhagic manifestations were associated with blood sampling and i.v. administration of drugs only. The necessity to administer blood was due to a complication during puncture of the subclavian vein in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

[Tumor microembolization in the lungs--a cause of marked dyspnea, syncope, hemolytic syndrome and disorders of hemocoagulation].

The authors describe the course of the disease in a 28-year-old woman who suffered two years following surgery of breast cancer from rapidly deteriorating dyspnoea, syncopes and laboratory manifestations of global respiratory insufficiency. The finding on auscultation of the lungs was normal, pulmonary angiography did not reveal signs of serious pulmonary embolization. The patient died after ten days in hospital despite comprehensive therapy and artificial ventilation. Necropsy revealed multiple microembolizations of tumourous cells into the pulmonary vessels as the main causes of the disease. Concurrently infiltration of the bone marrow by tumourous cells was revealed. The course of the disease was complicated by impaired haemocoagulation as a result of microangiopathic haemolytic anaemia and disseminated intravascular coagulation during the passage of erythrocytes through the pathologically altered pulmonary capillaries and impaired liver function.

Adult↗
PubMed1992

[15 years' activity of the Psychosomatic Disorders Section within the Psychiatric Association in the Czech Medical Society].

The author describes in detail the activities of the psychosomatic section of the Psychiatric Society of the Czech Medical Society since its foundation in 1975 from the theoretical, organizational, research and teaching aspects. The aim of this section is above all to enforce the psychosomatic approach and bio-psychosocial model of disease in the Czechoslovak health services. The society developed its activities according to interdisciplinary principles. The perspectives of development of psychosomatic care in Czechoslovakia in the next future are in particular: 1. further enforcement of the psychosomatic approach to patients and the bio-psychosocial model of disease in clinical practice and theory; 2. development of so-called consultation-liaison psychiatry according to the concept of Z. J. Lipowski on the basis of nonpsychiatric disciplines and creation of further psychosomatic in- and out-patient units and departments, in particularly at the primary health care level; 3. further development of postgraduate and initiation of undergraduate teaching of psychosomatic and behavioural medicine; 4. development of research, in particular by the method of controlled clinical trials and prospective studies; 5. extension of possibilities to publish work and of international collaboration.

Czechoslovakia↗
PubMed1990

[Severe antihistamine poisoning complicated by ventricular tachycardia].

A 26-year-old female clerk without previous heart disease ingested with suicidal intensions antihistaminic drugs--H1 blockers, astemizole (a total of 700 mg) and terfenadine (a total of 900-1200 mg). The main sign of intoxication was repeated polymorphous ventricular tachycardia type torsade de pointes, which at the onset of hospitalization changed into ventricular fibrillation. Therapeutically the impaired rhythm was controlled by electric cardioversion and atrial stimulation with a frequency of 120/min. On the third day it was possible to discontinue atrial stimulation and later the patient was discharged without any permanent sequelae.

Adult↗
PubMed1990

[News in psychopharmacotherapy].

The author deals with new findings in research and clinical application of atypical neuroleptic drugs, MAO inhibitors, in particular and second generation, and non-diazepine anxiolytics, in particular serotonergic ones. He summarizes the possibilities of psychopharmacotherapy of clinical units which will be included in the 10th revision of the International statistical classification of diseases, injuries and causes of death, i.e. panic anxiety, obsessive compulsive disorder, agoraphobia with panic attacks and generalized disorder of anxiety.

Anti-Anxiety Agents↗
PubMed1990

[Sulpiride (Eglonyl Alkaloid) in the treatment of functional disorders of the digestive tract].

Sulpirid was administered in an open clinical trial--150 mg/day for 4 weeks--to 31 patients (15 man and 16 women, mean age 31.5 years, mean duration of complaints 1 month to 6 years) suffering from functional disorders of the digestive system. Their health status was evaluated by a specialist in internal medicine, by a psychiatrist and a self-administered SCL-90 questionnaire before the onset of treatment and after four weeks. In 29 patients the complaints disappeared or improved markedly and this improvement persisted also after discontinuation of the drugs. In the entire group a significant drop of the mean initial intensity of psychopathological feature in all dimensions of the questionnaire occurred; the improvement was more marked in men where the mean baseline values of psychopathology were higher. There was also a significant decline of the mean numbers of positively evaluated items in 9 of 10 dimensions of the questionnaire. The drug was well tolerated by the patients with the exception of one transient allergic skin reaction. So far the exact ratio of improvement of psychopathology as a therapeutic response to sulpirid administration and the placebo effect on the patient's complaints cannot be exactly evaluated. Sulpirid has some advantages, as compared with other psychopharmaceutic preparations used in this indication (e.g. amitriptyline, dosulepine).

Adolescent↗
PubMed1990

[Suicidal ingestion of thioridazine as a cause of severe impairment of heart rhythm--polymorphic ventricular tachycardia].

A 35-year-old female alcohol addicted ingested with suicidal intentions a single dose of 500 mg thioridazine. The course of intoxication was complicated by the development of polymorphous ventricular tachycardia of the torsade de pointes type, about six hours after ingestion. The dysrhythmia was immediately suppressed by stimulation from the right atrium. After 36 hours the stimulation could be abolished. Because of delirium tremens the patient with a normal ECG tracing was returned to the psychiatric clinic.

Adult↗
PubMed1990

[Successful treatment of the superior vena cava syndrome caused by thrombosis and a fibrous septum in a patient with a permanent cardiac pacemaker].

A patient with a ten-year permanent implantation of a pacemaker was admitted on account of a clinically serious syndrome of the vena cava superior. The cause of the syndrome was an angiographically confirmed extensive thrombosis and after its dissolution a fibrous septum in the area of the orifice of the vena cava superior into the right atrium. The septum caused by a fibrous strip at the orifice of the vena cava superior into the right atrium was removed by surgical operation during thoracotomy by dilatation of the original opening in the fibrous septum by a Broca dilator and digitally. The authors recommend, based on their own experience and data in the literature, to use fibrinolytic therapy in clinically severe thrombosis in the area of the vena cava superior or the right atrium caused by an electrode--during temporary or permanent pacing--or by a catheter used for parenteral nutrition.

Aged↗
PubMed1990

[Hospitalization of the mentally ill without their consent in the USSR].

The author gives a detailed account of recent Soviet instruction of urgent hospitalization which is an important step in this area of psychiatric institutionalism. The new Soviet set-up is compared with analogous Czechoslovak regulations and the practice of admitting a patient without his consent. The author assumes that consequential adherence to the new Soviet instructions in practice should contribute to a reduction of the possible risk of abuse of psychiatry.

Commitment of Persons with Psychiatric Disorders↗
PubMed1989

[Psychological symptoms in patients with hearing and equilibrium disorders and possibilities of treatment with psychopharmacologic agents].

The aim of the investigation was to find out in a group of 130 hospitalized men and women, suffering from impaired hearing and equilibrium, the prevalence of psychic symptoms and psychopathological syndromes and symptoms suitable for psychopharmacological intervention. The method of interview and questionnaire SCL-90 was used which makes it possible to extract from quantifiable answers to 90 questions 10 symptoms constructions (dimensions) which roughly correspond with psychopathological syndromes. Psychopathological syndromes which are associated with the basic disease and are suitable for psychopharmacological intervention are in both sexes the following: somatization, depression, anxiety, phobic anxiety, impaired sleep and appetite. The assessed symptoms corresponding to a varying extent to the items of the questionnaire in both sexes are within the mentioned dimensions. In the subsequent stage the authors differentiate psychopathological syndromes and symptoms in acute and chronic ENT disease of the investigated groups. The authors maintain that psychopharmacological drugs influence in a favourable way not only the present mental symptoms in the framework of secondary psychopathology but also the psychosomatic component of the basic disease and thus have a favourable effect on its course. The author recommend some antidepressants, anxiolytics and neuroleptics to be used in small doses.

Adult↗
PubMed1989

[Cardiac tamponade as a complication of acute myocardial infarct. (Clinical and pathologico-anatomic analysis of patients with acute myocardial infarct and cardiac tamponade)].

Cardiac tamponade is a frequent cause of death in acute myocardial infarction--in as many 23%. It is encountered in particular in the 7th and 8th decade, in patients with a first infarction which is frequently situated in the anterior wall of the left ventricle. 93% of the patients have obvious ECG manifestations of Q infarction. The diagnosis of cardiac tamponade is easy when during an acute terminal attack slow activity on the ECG tracing is found without a haemodynamic response and the pulse on the great arteries is not palpable even after external cardiac massage. In 80% the onset of cardiac tamponade is very sudden. The presence of shock or cardiac failure makes the diagnosis of cardiac tamponade more difficult. As to investigated indicators, in the development of cardiac tamponade the systemic pressure--systolic as well as diastolic--on admission or during hospitalization, may play a part. The patients have a less marked coronary sclerosis, fibrosis of the cardiac muscle is less frequently present. Previous necroses of the heart muscle may have probably a certain protective effect on the development of cardiac tamponade. Anticoagulants obviously do not influence the development of cardiac tamponade.

Aged↗