Biomedical subjects

J Kvasnicka

Publications and source records attributed to J Kvasnicka.

At least 145 records · Page 8Linked to original sources

PubMed1990

Changes in haemostasis and proteins of the acute phase following cardiac surgery.

After cardiac surgery performed with extracorporeal circulation (ECC) involving heart valve prostheses (PHVS, n 12) and after a bypass of the coronary arteries by a venous graft (CABG, n 19), the authors investigated the dynamics of changes of haemostasis on the 1st, 3rd, 6th, 10th and 21st day after operation. As anti-thrombotic treatment after PHVS anticoagulants were used, after CABG thrombocyte inhibitors. On the 1st day after operation in both groups thrombocytes decline, while after the 10th day their numbers increase. From the 6th day there is in both groups a rise of fibrinogen and other proteins of the acute phase (alpha-1-antitrypsin, orosomucoid and ceruloplasmin, while there was a drop of transferrin. On the 3rd and 6th day after operation fibrinolysis activators decline (euglobulin fibrinolysis). These findings suggest an increased risk of thrombophilia during the postoperative period and are probably associated with the release of interleukin-1 after Ecc and the stress of cardiac surgery. In patients with CABG on the 1st day a major drop of thrombocytes occurs, on the 6th day an elevated fibrinogen value was recorded and on the 10th day a reduced fibrinolytic activity, as compared with patients with PHVS. These changes will be, however, associated rather with a greater development of general atherosclerosis in patients with CABG, which leads to a further alteration of haemostasis, rather than with the applied antithrombotic treatment.

Acute-Phase Proteins↗

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

[Aortic stenoses and pulmonary hypertension].

Authors have been catheterized a total of 36 patients with isolated aortal stenosis. In 14 from them (38%), the mean pression value in pulmonar artery was ranged as over 25 torrs (3.33 kPa). It was proved on the statistical evaluation of hemodynamic data that the pulmonar hypertension is correlated with the pression on the end of diastola of the left ventricle (correlation coefficient r = 0.89), being irrelated of the extent of aortal gradient, bed surface, heart index, age, pulmonar vascular resistence and functional classification. The pression value in pulmonar artery is correlated negatively with the ejection fraction of left ventricle (r = -0.76). Pulmonar hypertension in isolated aortal stenoses is inflicted with functional disorder of left ventricle. The significance of pression value in pulmonar artery is discussed from the scope of indicatory strategy as to provide an urgent surgery, i.e. the exchange of the aortal valve.

Aortic Valve Stenosis↗

PubMed1990

[Atherosclerosis risk factors in patients examined by coronarography. I. Selection and evaluation of risk factors].

The significance of individual risk-factors associated with the ischaemic heart disease is known to be estimated differently in various stages. In this account, still more screening and evaluation of mentioned factors is continuously needed in facing different social, economical, demographical and geographical conditions. The analysis has been made of such risk-factors which are generally precluded as decisive ones (age, sex, blood lipid levels, cigarette smoking, higher blood pressure, obesity, diabetes mellitus). The majority of these factors and their interrelations may be influenced. Of special author's concern were different dependencies between the selective groups of coronarographied patients and the groups defined with mainly clinical symptomatology. Authors suggest that the analysis of proper group may be supportive in order to formulate such a complicated topic and outline the appropriate trends of secondary prevention also in their conditions.

Coronary Angiography↗

PubMed1990

[Atherosclerosis risk factors in patients examined by coronarography. II. Results and evaluation in the group of men].

The attherosclerosis risk-factors occurrence is studied in the present paper and compared with that of abnormal coronarogram in 376 male subjects. As an abnormal coronarogram is estimated this with at least one of coronaries having more than 50% of lumen obstructed. The abnormal coronarogram occurred significantly with more frequently in male patients with hyperlipoproteinemia an in smokers (p less than 0.001). In a total of male subjects with positive coronarographic findings, the significantly higher averaged levels of total cholesterol (p less than 0.01) have been stated. Authors detected the levels of total cholesterol higher than 6.72 mmol/l and those of triglycerides higher than 1.80 mmol/l are significantly exerting the influence on the value of coronarographic score. Of particular interest is a fact that no significant relation of abnormal coronarogram to the occurrence of systemic hypertension has been detected as well as to the disorders of glycide metabolism and obesity. However, mathematically significant relation has been determined between the smoking and hyperlipoproteinemia (p less than 0.001). The cigarette smoking was stated to enhance hyperlipoproteinemia as 4 %. Smokers have been found to represent pathologically increased both triglyceride and total cholesterol levels. It is to be said that the group of smokers has values of body mass index (BMI) lower ones than the group of non-smokers. Authors also revealed the disorders of glycide metabolism were related with higher occurrence of hyperlipoproteinemia in men as 1-2%. Although no significantly frequent occurrence of glycide metabolic disorders has been proved in men with abnormal coronarogram, the more detailed analysis showed those with glycide metabolic disorders were significantly higher in coronarographic score (p less than 0.05) in contrast with the group compared, and showed significantly higher occurrence of hemodynamically important stenoses than the controls. The results of the present work are believed to enlarge the knowledge about the relations between the atherosclerotic changes, their clinical manifestations and risk-factors estimated in conditions which are completely different from those of routine epidemiological studies. The necessity of primary prevention is confirmed and possible secondary measures are indicated.

Adult↗

PubMed1990

[Atherosclerosis risk factors in patients examined by coronarography. III. Results and evaluation of the group of women].

The occurrence of atherosclerosis risk-factors has been studied in comparison with the rate of abnormal coronarogram in 63 female subjects. As an abnormal coronarographic finding the obstruction of more than 50% lumen of at least one of coronaries was estimated. Female subjects with hyperlipoproteinemia (p less than 0.001) and hypertension (p less than 0.05) showed significantly more frequent abnormal coronarographic findings. Coronarographically positive women revealed significantly higher levels of total cholesterol (p less than 0.05). No relationship was detected between the pathological coronarogram and glycide metabolic disorders. Of particular interest is a fact that the disorders of glycide metabolism are conditioning the occurrence of hyperlipoproteinemia in women of our group as far as 15-16% (p less than 0.001), whereas in men only as 1-2 % (p less than 0.05). These results are supporting the opinion of those authors who point on the interaction between the disorders of glycide metabolism and hyperlipidemia estimating disorders of glycide metabolism in women to be more significant risk-factor of coronary atherosclerosis than in men. Our findings are confirming specificity of profile of atherosclerotic risk-factors in women. In accord with them, the importance of hyperlipidemia and hypertension is estimated to be the most significant risk of atherogenesis. The implementation of principles of primary and secondary prevention of ischemic heart disease is carried through the common approaches in both men and women.

Adult↗

PubMed1990

[Atherosclerosis risk factors in patients examined by coronarography. IV. Relation of atherosclerosis risk factors and clinical manifestations of ischemic heart disease (myocardial infarct, angina pectoris)].

The total of 376 male and 63 female subjects is concerned. As an abnormal coronarogram, such a finding is estimated where at least one of coronaries showed more than 50% lumen obstruction. The occurrence rates of atherosclerotic risk-factors, angina pectoris and myocardial infarction have been studied with regard to the abnormal coronarograms. A special concern in male group is almost simultaneous occurrence of angina pectoris along with positive coronarogram. The occurrence of both studied factors shows an increase with more age. The percentage of IM occurrence is practically the same in all age groups studied regardless to the value of coronarographic score. However, the male subjects with both clear and suspected IM (especially in the age group up to 40 years) are stated to show higher occurrence of normal coronarographic findings (32 %). This is in agreement with the suggestion that also other factors are involved than the atherosclerotic affection of coronary bed, what demonstrates the complexness of pathophysiological mechanisms of IM genesis.

Adult↗

PubMed1990

[Experience with implantation of a permanent electrode for cardiac pacing directly through the subclavian vein in 2,309 patients].

Since April 1975 to the end of 1988 permanent cardiac stimulation was employed in 2,309 patients. The stimulating electrode was placed in the right ventricle in 2,258 patients and in the right atrium in 29 patients. Two electrodes were introduced in 22 patients one in the right ventricle and the other in the right atrium. All electrodes were introduced directly through the subclavian vein. No other approach was used. Serious complications appeared in 4 patients (i. e. in 0.17%). Pneumothorax on the side of the introduced electrode occurred in 3 patients. One woman of 80 died in connection with this complication. Another woman, who was overdosed with Pelentan, experienced hemothorax on the side of electrode insertion. After drug discontinuation and thoracic puncture the patient was doing well. In our opinion the subclavian approach for permanent electrode introduction is much more convenient than the introduction via either the cephalic or the jugular vein respectively. The former approach is considerably quicker and less traumatic in use. This method may be used in practically all patients. The repetitive introduction of the electrode through the same subclavian vein is much appreciated in patients in whom a new electrode has to be introduced. This method may be used for right atrium stimulation and for sequential pacing as well.

Cardiac Pacing, Artificial↗

PubMed1990

[Percutaneous recanalization of the femoral artery using a laser].

The authors performed, in the period from February to May 1989 seven recanalization interventions on occlusions of femoral artery with a laser angioplasty. In six cases the dilatation of the formed primary canal was made by subsequent balloon angioplasty. In all patients the intervention was followed by a significant clinical improvement and increased doppler index. No significant clinical complications occurred during the interventions.

Adult↗

PubMed1990

[Systolic and diastolic intervals in patients with hypertrophic obstructive cardiomyopathy before and after withdrawal of verapamil].

Mechanocardiographic investigations were carried out in a group of eight patients with hypertrophic obstructive cardiomyopathy (HOCM) who had been implanted a DDD pacemaker which allowed efficient therapy to be administered in the combination of metoprolol in the dose of 300 mg/day and verapamil in doses of 240-480 mg/day. The investigation was repeated one week after temporary withdrawal of verapamil. The control group consisted of six patients with idiopathic third-degree-complete AV block with implanted DDD pacemakers. Over the period of 24 hours before investigation, these patients received 300 mg of metoprolol. All the patients had the same heart rate (70 bpm) and a constant PQ interval (0.18 s). Statistical analysis of the obtained data revealed the following findings: 1. There was no difference between the control group and the group of HOCM patients treated with verapamil. 2. Withdrawal of verapamil in HOCM patients resulted in a significant prolongation of the 2-0 interval and shortening of the O-c interval recorded on apexcardiogram compared to the control group. In conclusion, verapamil affects LV diastolic parameters in patients with HOCM and the changes are compatible with the beneficial effects of verapamil. These changes may however result partly from increased left atrial pressure due to atrial poisoning with verapamil.

Cardiomyopathy, Hypertrophic↗

PubMed1990

[Is the argon laser suitable for angioplasty procedures?].

Laser angioplasty is a perspective method for the treatment of complications of atherosclerosis of peripheral and coronary arteries. The present study deals with the effects of an argon laser on cadaverous coronary arteries with atherosclerotic plaques. Radiation of the argon laser created in the plaque a circular defect with a singed margin. The energy of radiation being equal, the size of the defect depended on the position of the optic fibre -- it was greatest when the optic fibre was in contact with the plaque. The defect thus formed had uneven margins with adjacent layers of thermal damage which were larger in calcified plaques than in fibrous and fibrolipomatous plaques. Penetration of radiation into the plaque depended on its composition -- being least in calcified plaques. When the arteries were rinsed with saline during irradiation, the effect of radiation on the tissue was reduced as the tissue was cooled. The argon laser causes greater thermal damage of the arteries than pulsed lasers and therefore its clinical application will be restricted.

Angioplasty, Laser↗

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

Human recombinant erythropoietin in the treatment of anaemia in chronic haemodialysis patients.

Five women aged 50-64 years with chronic renal failure caused by interstitial nephritis, maintained by chronic haemodialysis, were treated for three months with human recombinant erythropoietin. The blood haemoglobin level roce from 78.0 +/- 6.9 g/l to 108.4 +/- 15.5 g/l, haematocrit from 21.8 +/- 1.8% to 33.6 +/- 4.8%, and the rate of reticulocytes 1.8% to 4.9%. Serum ferritin concentration declined from 2213 +/- 1982 micrograms/l to 850 +/- 953 micrograms/l. Unlike the pre-treatment period, no blood transfusion had to be given during the administration of erythropoietin. The patients' general condition improved. There were no serious complications. The action of erythropoietin persisted for two months. Human recombinant erythropoietin is a significant help in the treatment of patients with chronic renal failure.

Anemia↗

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↗

PubMed1989

[Treatment of anemia in patients on a regular dialysis program using human recombinant erythropoietin].

Five women aged 50-64 years with chronic renal failure, due to interstitial nephritis, enlisted in a regular dialyzation programme were treated for three months with human recombinant erythropoietin. The blood haemoglobin level rose from 78.0 +/- 6.9 g/l to 108.4 +/- 15.5 g/l, the haematocrit from 21.8 +/- 1.8% to 33.6 +/- 4.9%. The serum ferritin concentration declined from 2213 +/- 1892 micrograms/l to 850 +/- 953 micrograms/l. Contrary to the period before treatment, during erythropoietin administration no blood transfusion had to be administered. The general condition of the patients improved. There were no serious complications. The action of erythropoietin persisted for two months. Human recombinant erythropoietin is significant help in the treatment of patients with chronic renal failure.

Anemia↗

PubMed1989

[Treatment of hairy-cell leukemia using interferon alfa].

The paper gives a brief account of alpha interferon (IFN) production employed for clinical use in oncology. In onco-haematology, in particular, the alpha IFN effect in hairy-cell leukaemia and chronic myeloid leukaemia is surprisingly favorable. This study analyzes the IFN therapeutical results in 11 patients with hairy-cell leukaemia during the first six months of treatment. For various reasons, four patients were not treated with IFN long enough to attain a therapeutic effect. One female patient with splenomegaly failed to respond to the treatment. In six patients the treatment was successful. Satisfactory partial remission was induced in five of these patients, in one--a complete remission. The paper briefly discusses the present knowledge of how IFN works. The effect is three-fold: anti-viral, immunomodulatory, and anti-proliferative. In hairy-cell leukaemia, the IFN anti-proliferative effect on the leukaemic cell population was observed in most cases. In conclusion, the authors, drawing on their own experience and literary data, propose indications, dosage, length of IFN therapy and describe side-effects in hairy-cell leukaemia, treated with alpha IFN. In natural and recombination forms, the alpha IFN can be considered important addition to the limited therapeutical options of hairy-cell leukaemia treatment.

Adult↗

PubMed1989

[40 years of the Czechoslovak transfusion service].

The authors analyze the development and creation of the concept of a uniformly organized blood transfusion service in the CSSR from its beginning to the present time. For the needs of the Czechoslovak socialist health services it proved expedient to integrate haemotherapeutic care in a common department of haematology and transfusiology, in a network of common sections of haematology and blood transfusion and to focus the transfusion service on clinical work. On average there is one common department for a population of 135,000 which ensures blood transfusions as well as haematological work and there is one doctor specialized in haematology and transfusiology per 48,000 population. Blood donorship in the CSSR for basic needs of the transfusion service is not paid; it is organized by the Czechoslovak Red Cross. On average 35,000 units of blood per 1 million inhabitants are collected per year. Component haemotherapy predominates; only 20-25% of the production is used for transfusions of whole blood. The ratio of whole blood transfusions to erythrocytes is 35:65%. The annual number of blood transfusions per hospital bed is 5 on average. The incidence of undesirable posttransfusion reactions, mainly febrile and allergic, is low, it varies between 0.2 and 0.4%. Serious haemolytic reactions are rare and occur in recent years in one patient per 100,000 transfusions. The achievement of the standard of the Czechoslovak blood transfusion service is due to the care of the two national ministries of health, the good training of workers and the clinical orientation of the performed work.

Blood Transfusion↗

PubMed1989

[Further development of the transfusion service in Czechoslovakia].

The blood transfusion service in the CSSR must react in its future activities not only to recent advances in the discipline but also to the present adverse position as regards the spread of AIDS and other virus diseases. Therefore the further development in the CSSR is focused above all on the prevention of transmission of virus infections, incl. organized development of autologous transfusions. To this end the training of new specialists in the discipline must be focused, i. e. on training of clinical transfusiologists. As the basis the concept is used that haematology and blood transfusion in Czechoslovakia is a specialization of internal medicine or paediatrics. In the development of laboratory diagnosis attention is focused on the use of micromethods with the possibility of automation of examinations as well as economy of diagnostic procedures and staff.

Blood Transfusion↗