Biomedical subjects

J Bulas

Publications and source records attributed to J Bulas.

At least 19 recordsLinked to original sources

PubMed1998

[Significance of left ventricular hypertrophy in hypertension].

Left ventricular hypertrophy (LVH) is supposed to be a useful marker of cardiovascular (CV) complications during the course of hypertension (HT). To evaluate it, authors compared the clinical findings in hypertensive patients (pts) with and without LVH defined by echocardiography (echo). Hospital records of hypertensives treated in the 1st Medical Department during the year 1995 were analysed. LVH was defined by echo (Penn convention) as left ventricular mass index (LVMI) > 125 g/m2 in men and > 115 g/m2 in women. Presence of LVH was found in 72 pts (mean age 66 y), absence of LVH in 38 pts (mean age 56 y). There were statistically significant more CV complications in LVH-positive pts (incidence of myocardial infarction, arrhythmias, heart failure, ischemia (ECG), mitral regurgitation) as in LVH-negative. Tendency for other complications in LVH-positive pts (incidence of renal failure, stroke, LV diastolic dysfunction and aortic regurgitation) was also present. LVH-positive pts were about ten years older than the LVH-negative. In other risk factors (LVH and age not included) the both groups of pts were matched. LVH in pts with HT brings usually a complicated course of the disease. Age is an important contributing factor. Authors recommend to look after LVH presence in hypertensives as it carries much more complicated course of the disease.

Adult↗

PubMed1998

[In Process Citation]

The therapy of AMI is aimed at the prevention of death, minimalization of discomfort caused by the disease and the reduction of the infarction focus (as soon and as markedly as possible) since the success of this step links with the later short-term as well as the long-term prognoses of the patient. (Tab. 2, Ref. 15.)

Journal Article↗

PubMed1996

[Diurnal changes in blood pressure, albuminuria and urinary excretion of retinol-binding protein in type I diabetics].

We studied 24-h ambulatory systolic and diastolic blood pressure (SBP, DBP), 16-h daytime and 8-h nighttime urinary excretion of albumin (UAE) and retinol-binding protein (URBP) in 20 type 1 diabetic patients (group 1) with normoalbuminuria (UAE < 20 micrograms/min) and 20 type 1 diabetic patients (group 2) with microalbuminuria and low proteinuria (UAE 20-500 micrograms/min). The groups were comparable in age, diabetes duration and actual glycaemic control. Daytime and nighttime SBP and DBP were higher in group 2 compared to group 1 (p < 0.01). Nighttime decrease in SBP and DBP correlated with nighttime decrease in UAE in group 2 (p < 0.05, p < 0.001). There was no correlation between BP and actual glycemic control in either group. Daytime UAE was found in group 2 by 20% higher than nighttime UAE. We found higher daytime and nighttime URBP in group 2 compared to group 1 (p < 0.05). We conclude, that microalbuminuric and low-proteinuric patients had elevated BP and nighttime decrease in BP correlated with nighttime decrease in UAE but not with actual glycemic control. Increased URBP in these patients suggests impaired proximal renal tubular function in early stages of diabetic nephropathy.

Adult↗

PubMed1996

[Long-term electrocardiographic monitoring of patients after acute myocardial infarct].

The authors present an account on detailed electrocardiographic follow-up of a patient for 12 months after an inferior myocardial infarction. The patient died 14 months after the IM due to arrhythmia after previous remodelling of the left ventricle. The results assembled by means of superstandard methods of signal averaging electrocardiography (method of cumulative amplitudes, RMS signal and frequency analysis) and electrocardiographie body surface mapping (isointegral maps) are confronted with detailed clinical examinations and repeated echocardiographic investigations. The assembled results indicate that the applied superstandard methods make it possible to extract electrocardiographic parameters (presence of pathological high frequency peaks, raised values of partial cumulative amplitudes at the end of the QRS complex at higher frequencies, negative correlation coefficients from comparisons of integral maps with controls) which are a signal that the patient's life is threatened.

Aged↗

PubMed1994

Remodeling in myocardial infarction and body surface potential maps.

This study deals with the capabilities of body surface integral and departure maps to evaluate the chronic stage of myocardial infarction based on dividing the left ventricle into 12 segments. The effects of ventricular remodeling on electrocardiographic potential distributions are considered. A 61-year-old male patient was examined five times by body surface potential mapping during a period of 9 months after acute myocardial infarction. Integral maps were calculated for 60 ms after QRS onset and compared with mean data from a control group using departure maps. Integral maps showed a continual reduction of negative potentials in the lower half of the torso with time. The negative area covered the lower torso in the departure maps during the whole study, but its form and value changed. According to the location of the departure area, the surface projection of the scar moved from a position corresponding to inferior segments to a position corresponding to posterior segments. Its size also decreased. Echocardiographic examinations showed progressive enlargement of both ventricles with time. Therefore, the authors postulate that the changing pattern of body surface potential maps was mainly influenced by ventricular remodeling after myocardial infarction.

Electrocardiography↗

PubMed1993

[Thrombolytic therapy of acute myocardial infarct].

In the period of two years the authors treated at the coronary care unit 146 patients inflicted by the acute myocardial infarction (AMI). In 15 of them (13 men, 2 women, 13 times Q and twice non-Q, 5 times anterior, 10 times inferior) they performed intravenous thrombolytic treatment by use of streptokinase. The success rate of the thrombolytic therapy was evaluated by noninvasive markers: 1.) rapid withdrawal of chest pain, 2.) rapid (in 6 hours) and essential improvement of ST segment elevation and 3.) presence of reperfusion arrhythmias (in 6 hours). The authors detected insufficient medicinal conciousness among their health district population as regard to their response after the AMI origin (absolute majority of patients delayed their arrival). Minor complications due to therapy (allergy and minor local hemorrhage) occurred in 4 patients. Nobody died. Only those cases were considered as being successful, in which all three success rate markers were present. This condition was fulfilled in 8 patients (i.e. in 53% of cases) and with minor insufficiencies in further two patients (which would increase the percentage of the success rate to 67%). This success rate of the thrombolytic therapy ranges within the limits given by literature. In five patients the authors evaluated the behaviour of the left ventricular asynergy (its range and index) prior to and following the thrombolytic therapy and this examination they consider to be appropriate for observance of the thrombolytic therapy success rate in patients with AMI. (Tab. 3, Ref. 20.).

Adult↗

PubMed1993

[Hypereosinophilia syndrome].

The authors of the submitted paper describe the diagnosis, course and treatment of hypereosinophilic syndrome in a 36-year-old female patient with marked affection of the right ventricle: endomyocardial fibrosis with parietal thrombi obliterating the cavity of the right ventricle. The clinical picture was dominated by rapid progression of severe cardiac decompensation with a fatal outcome.

Adult↗

PubMed1993

[Time delay in acute myocardial infarct].

The authors present their experience concerning the time-delay in 357 patients with acute myocardial infarction admitted to the coronary unit over the years 1988-1991. This time indicator was evaluated by using two approaches, i.e. the global time-delay (the time between the onset of the patient's complaints and his/her admission to the coronary unit) and patient's time-delay (the time between the onset of the patient's complaints and his/her decision to notify the health care service). Arbitrary criteria were set up: 10 hours for the former and 5 hours for the latter parameter. The established criteria were met by 40% of the patients. Only 24% of the patients presented at the coronary unit within 6 hours, and these could receive thrombolytic treatment. The decision time (patient's time-delay) amounted that the education level of our population has to be enhanced so as to increase the number of patients with acute myocardial infarction presenting at the coronary unit at an early stage. (Tab. 1, Ref. 9.)

Coronary Care Units↗

PubMed1990

A study of the inhibition of adrenaline-induced vasoconstriction in the isolated perfused liver of rabbit.

We have studied the action of a series of vasoactive and antispasmodic agents on the intrahepatic vasoconstriction induced by adrenaline in the isolated perfused liver of rabbits. The arterial and portal venous resistance, oxygen consumption, liver weight and bile flow were investigated. The drugs used were as follows: nonspecific alpha-adrenergic antagonists (DH-ergocristine, dibenamine, phenoxybenzamine), vasodilators with a direct miscellaneous action (theophylline, papaverine, dipyridamole, glucagon, Aiu-cor by Instituto Gentilli, Italy [inosine, ATP, IPI, UTP]) and antispasmodics (piperylone, tropenziline, noraminophenazone). Adrenaline increased arterial and portal venous resistance followed by a diminution of oxygen consumption, liver weight and bile flow. alpha-Adrenergic antagonists inhibited the effects of adrenaline on portal venous resistance and oxygen consumption and especially the effects on hepatic arterial resistance. The most potent agent was phenoxybenzamine. In contrast to alpha-adrenoceptor blockade, the effects of other vasoactive agents were without a sustained influence on hepatic arterial resistance (excepting those of glucagon and dipyridamole). Some of them were effective as antagonists on responses in the portal venous bed (papaverine, Aiu-cor). Moreover, there were drugs exerting an enhancement of the vasoconstrictor responses of hepatic artery to low concentrations of adrenaline with no effect on the portal venous bed (piperylone, tropenziline). Theophylline and noraminophenazone exerted no effect either on the arterial or portal venous bed. No vasodilator agent antagonized the changes of the bile flow after adrenaline administration.

Animals↗

PubMed1990

[Does early echocardiography contribute to the prediction of complications in acute myocardial infarct?].

The authors give an account of their experience with early echocardiography (two-dimensional examination, division of left ventricle into 20 segments) during stratification of patients with acute myocardial infarction (a group of patients with a first infarction). They evaluated the presence or absence of serious asynergy (akinesia or dyskinesia) of the left ventricle and its relationship to the incidence of complications (serious dysrhythmia, decompensation, cardiogenic shock and death). The relations between asynergy and different complications were tested by means of multidimensional contingency tables. A statistically significant partial correlation (p less than 0.01) was recorded between the most serious asynergy and the presence of decompensation and also cardiogenic shock. The detection of serious asynergy of the left ventricle is a useful stratification indicator of the risk of the acute infarction, as no patient without asynergy died or overcame cardiogenic shock.

Adult↗

PubMed1989

[The development of myocardial infarct in a patient treated with 5-fluorouracil].

The authors describe the first case of myocardial infarction in their department which occurred during 5-fluorouracil treatment. In a 37 year-old patient two years before the infarction an epidermoid carcinoma of the lower lip was found. The patient was subjected to operation and radiotherapy. Because of a relapse of the process after one year the patient was re-operated with subsequent chemotherapy (vincristine, methotrexate, cis-platinum). Because the effect was not satisfactory, after another year 5-fluorouracil treatment was started (i.v. infusion of 3000 mg in two days). In the course of the infusion the patient developed the clinical picture of a non-transmural infarction of the anterior wall. The course was uncomplicated. The ECG returned to normal on the 9th day after discontinuation of 5-fluorouracil treatment. The effect of 5-fluorouracil on the heart is explained by a coronary vascular spasm. The authors recommend therefore administration of calcium blockers.

Adult↗

PubMed1986

Venous plasma adrenaline response to orthostatic syncope during tilting in healthy men.

The effect of transient cerebral ischaemia connected with acute orthostatic hypotension on plasma adrenaline and noradrenaline levels was studied in seven healthy male volunteers during tilt. Sublingual administration of 1 mg nitroglycerin was used to block peripheral vascular reflexes and thus to provoke orthostatic intolerance. A consistent increase in plasma adrenaline concentrations (from 19.2 to 104.3 pg/ml on average, P less than 0.01) was found in six subjects who developed clinical signs of collapse after tilting. Plasma adrenaline never changed after tilting without collapse. Posturally stimulated plasma noradrenaline increases were similar yet irrespective of the presence of collapse.

Adolescent↗

PubMed1985