We studied 24-h ambulatory blood pressure (SBP, DBP), actual glycemic control assessed from seven blood glucose measurements, 16-h daytime and 8-h nighttime urinary excretion of albumin (UAE) and retinol-binding protein (URBP) in 20 normoalbuminuric (group A, nighttime UAE < 20 micrograms/min) and 20 microalbuminuric and low-proteinuric type I diabetic patients (group B, nighttime UAE 20-500 micrograms/min) matched for age and diabetes duration. Glycemic control was similar in the two groups. Daytime and nighttime SBP and DBP were higher in group B compared to group A (p < 0.01). Nighttime decrease in SBP and DBP correlated with nighttime decrease in UAE in group B (p < 0.05, p < 0.001), but not in group A. There was no correlation between BP and actual glycemic control in either group. We found higher daytime and nighttime URBP in group B compared to group A (p < 0.05). We conclude that, in microalbuminuric and low-proteinuric patients, daytime and nighttime BP was elevated but still in the normal or borderline range, and nighttime decrease in BP correlated with nighttime decrease in UAE but not with actual glycemic control. Increased URBP in these patients suggests slightly impaired proximal tubular function in early stages of diabetic nephropathy.

Adult↗

PubMedDate not supplied

[Echocardiographic evaluation of asynergy of the left ventricle in the early stages of acute myocardial infarct and its value in predicting infarct complications].

The authors report on their experience with the semiquantitative echocardiographic evaluation of left ventricular asynergy (group of 36 patients examined by two-dimensional echocardiography, dividing the left ventricle into 20 segments) in the early stage of myocardial infarction and its application in the prediction of complications of infarction. The authors evaluated asynegry using two parameters: RA (range of asynergy and IA (asynergy index) which characterizes the grade of ventricular affection. They describe the calculation of these parameters. The authors revealed a significant correlation (p less than 0.005) between RA or IA and the incidence of decompensation or cardiogenic shock. RA and IA values (median values and scatter) in three groups of patients (non-complicated infarction, complicated infarction and infarction with cardiogenic shock and death) give the opportunity of early stratification of patients with acute infarction. RA above 50% and IA above 20 indicate that the patients is at high risk. On the other hand, RA lower than 25% and IA lower than 5 suggest a minor infarction and probably an uncomplicated course of the disease. In the investigated group anterior infarctions affected a greater mass of the left ventricle than diaphragmatic ones and the higher death rate in this group (20% vs. 14%) was consistent with this.

Adult↗

PubMedDate not supplied

[The pre-hospitalization period in acute myocardial infarct].

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.)

Emergency Medical Services↗