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Biomedical subjects

J Slany

Publications and source records attributed to J Slany.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Heparin in deep venous thrombosis of the leg--effectiveness and safety].

The aim of this retrospective study was to evaluate the adequacy of heparin treatment in deep venous thrombosis and the rate of symptomatic complications under the everyday conditions of a hospital. The investigation was carried out in 200 consecutive patients, 117 women and 83 men (mean age 61 +/- 17 years) with verified deep venous thrombosis. Na-heparin was given over 12 +/- 7 days; the initial daily dosage amounting to 31700 IU followed by a maintenance dosage of 36150 IU. 153 patients were treated exclusively or predominantly by the subcutaneous route (3 times daily) and 47 by continuous i.v. infusion. In the i.v. group 47% of thrombin times (TT) were prolonged to values exceeding 48 seconds in comparison with only 39% in the subcutaneous group (p less than 0.001). 34 patients developed thromboembolic complications (pulmonary embolism in 33), causing death in 13 cases. Patients with thromboembolic complications differed from those without in respect to the rate of a therapeutically prolonged TT (10% vs 44%, p less than 0.001) and signs of pulmonary embolism on admission (44% vs 8%, p less than 0.001), but not with respect to heparin dosage. Thromboembolic complications appeared in only 3 patients receiving i.v. therapy. Patients with thrombosis of the iliac or femoral veins appeared twice as likely to develop pulmonary embolism than patients with calf vein thrombosis (n.s.). Bleeding was registered in 11 patients. One patient died from retroperitoneal haemorrhage. At the time of bleeding 10 patients were on subcutaneous heparin and in 9 patients the TT was prolonged to over 2 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Delayed-Action Preparations↗
PubMed1988

Effects of naftidrofuryl in patients with intermittent claudication.

In a randomized, double-blind, placebo-controlled study in patients with peripheral arterial occlusive disease stage IIb of Fontaine's classification, the efficacy of naftidrofuryl, a vasoactive substance, was investigated. Forty patients--31 men and 9 women with an average age of 62.98 +/- 10.65 years--were admitted to the study. All had a history of claudication for at least six months. The duration of the trial was eighteen weeks. After a washout period of two weeks the patients received either two times 400 mg naftidrofuryl or two identical placebo tablets daily for eight weeks. Subsequently a crossover from verum to placebo and vice versa was carried out and the alternative medication was administered for another eight weeks. Clinical results were evaluated by measuring painfree and maximal walking distance by treadmill test at a speed of 3.2 km/h and an inclination of 12 degrees. Systolic ankle pressure and brachial pressure were measured by Doppler ultrasound, and ankle/arm pressure ratio was calculated. Treadmill test, Doppler ultrasound examination, and laboratory data analysis were performed at the beginning of every study period, every four weeks during and at the end of the study. Results. The patients in both groups showed an initial homogeneity of age, risk factors, concomitant diseases, walking distance, and Doppler indices. After eight weeks naftidrofuryl resulted in a statistically significant increase in painfree (p less than 0.02) and maximal walking distance (p less than 0.05). The placebo-treated group showed only a slight, statistically nonsignificant increase in both painfree and maximal walking distance.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1987

[Do vasodilators help in chronic heart failure?].

The value of vasodilator drugs in the treatment of patients with chronic congestive heart failure is reviewed on the basis of the randomized double-blind, placebo-controlled trials so far published. Apparently, venous, or combined venous and arteriolar dilation in addition to cardiac glycosides and diuretics may produce long-term improvement in advanced stages of heart failure. Vasodilators with isolated afterload reducing properties seem to be of limited value. Long-term improvement with nitrates and alpha-receptor blocking agents is often modest, probably due to development of tolerance. The most striking results were observed with converting enzyme inhibitors: they evoke virtually no tolerance, improve haemodynamics at rest and during exercise, relieve symptoms of heart failure and are even suggested to reduce mortality.

Adrenergic alpha-Antagonists↗
PubMed1987

Cerebral ischemia in children and young adults.

Cerebral ischemia is very rare in children and young adults. There can be a multitude of causes; in many cases etiology remains undetermined. We report here on 7 cases, 11 to 25 years of age. Pathogenetic factors (lupus erythematodes, endocarditis, fibromuscular dysplasia) and risk factors (cigarette smoking, oral contraceptives) were found in 5 patients whereas in 2 cases the etiology was not determinable. Three patients were treated with low weight dextrans, two patients received prostaglandin E1, and in 2 cases regional thrombolysis was performed. Three female patients died, two with occlusions of the rostral part of the basilar artery and one with an occlusion of the carotid artery and lupus erythematodes as the primary disease. Long-term observations of the surviving patients showed good recovery from neurological deficits. Prognosis quoad sanationem seems better in this age group than in elderly patients.

Adolescent↗
PubMed1987

Postprandial increase of cardiac output in patients with acute myocardial infarction.

The influence on the hemodynamics of oral and intravenous nourishment containing the same amount of calories in comparison to isotonic solution of sodium chloride was studied in 14 patients with acute myocardial infarction. Forty minutes after administration of nourishment, a 34% increase in cardiac index, rising from 2.61 +/- 0.43 to 3.49 +/- 0.68 l/min/m2 was measured in the oral group, P less than 0.001. The increase was 22% (from 2.75 +/- 0.54 to 3.36 +/- 0.83 l/min/m2) in the intravenous group, P less than 0.025. Stroke index rose by 26% (from 33.4 +/- 7.8 to 42.1 +/- 10.6 ml/m2) in the oral group, P less than 0.025; and by 13% (from 32.7 +/- 8.3 to 37.0 +/- 9.7 ml/m2) in the intravenous group, P less than 0.05. No increases were seen in heart rate, mean blood pressure and pulmonary arterial diastolic pressure. The systemic vascular resistance decreased significantly in both groups. Thus, changes that mimic those seen during treatment with positive inotropic or vasodilating drugs were found. These effects have to be taken into account when assessing hemodynamic changes following cardiovascular medication.

Adult↗
PubMed1987

Different effects of beta-1-adrenergic blocking agents with ISA or without ISA on peripheral blood flow.

Until recently beta-adrenergic blocking agents were considered contraindicated in peripheral arterial occlusive disease (PAOD). However, in recent years several studies have failed to show negative effects on peripheral blood flow. It was the aim of this study to compare the effects of celiprolol, a beta-1-adrenergic blocking agent with intrinsic sympathomimetic activity (ISA), and of metoprolol, a beta-1-adrenergic blocking agent without ISA, on peripheral blood flow of patients with and without PAOD. In an acute trial 24 patients (group I: 12 patients with PAOD stage I and II; group II: 12 patients without PAOD received a single dose of 200 mg celiprolol or 200 mg metoprolol in a double-blind crossover design. Celiprolol induced no significant changes in calf and skin blood flow at rest or during reactive hyperemia. Basal vascular resistance (BVR) and minimal vascular resistance (MVR) were not affected. Metoprolol, however, significantly reduced muscle blood flow and increased BVR in both groups. Subsequently the patients were treated in a randomized double-blind design with a daily dose of 200 mg celiprolol or metoprolol for three weeks. In long-term treatment skin and muscle blood flow at rest and during reactive hyperemia, BVR, and MVR were not affected by celiprolol. Metoprolol significantly lowered calf blood flow at rest in patients with PAOD; other parameters remained unchanged. In patients without PAOD, metoprolol caused a significant decrease of calf blood flow at rest and an increase of BVR. Calf blood flow during reactive hyperemia, as well as skin blood flow at rest and during reactive hyperemia, showed no significant changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1987

Validity of continuous-wave Doppler sonography of the vertebrobasilar system.

To assess the value of continuous-wave Doppler sonography for detection and exclusion of lesions in the vertebrobasilar system, the ultrasonic and angiographic findings were compared in a prospective study. Altogether, 200 vertebral arteries in 176 patients were evaluated by both methods. Insonation of the vertebral arteries was performed at the mastoid slope and at the origin of the vessel. Of 62 angiographically proven lesions, 45 were detected by ultrasound. Of 138 normal vertebral arteries, 129 were correctly diagnosed. Sensitivity for all lesions was 72.5%, and for hemodynamically relevant lesions it was 91%. Overall specificity was 93.5%. A positive predictive value of 83.3% and a negative predictive value of 88.4% for all lesions shown by angiography demonstrate the high reliability and accuracy of doppler ultrasound of the vertebrobasilar system.

Arterial Occlusive Diseases↗
PubMed1987

Intracoronary streptokinase versus intravenous anisoylated plasminogen streptokinase activator complex in the treatment of acute myocardial infarction.

As part of a randomised multicentre study, 16 patients with acute myocardial infarction were treated with either anisoylated plasminogen streptokinase activator complex (APSAC) administered as an intravenous bolus of 30U or 250,000U of streptokinase by the intracoronary route. The reperfusion was documented angiographically during a 90-minute period and possible reocclusion was assessed at 90 minutes and 24 hours after the start of therapy. The percentage of reperfusion obtained in the APSAC group was 83% versus 63% in the streptokinase group. One reocclusion was seen after 24 hours in the APSAC group. Fibrinolytic activity was more pronounced in the APSAC group but there were no major bleeding problems in either group. The administration of 30U of APSAC by an intravenous bolus injection produced results at least as good as those obtained with intracoronary streptokinase and in addition offered the advantage of a simpler and quicker administration.

Adult↗