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Biomedical subjects

J Spinar

Publications and source records attributed to J Spinar.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Beta blockers in the treatment of chronic cardiac failure].

The authors present contemporary findings on the treatment with beta-blockers in patients with chronic heart failure. It is important to differentiate acute and chronic administration. The authors discuss theoretical prerequisites for the administration of beta-blockers in chronic heart failure. They give an account of indications, contraindications and mode of treatment. The dosage pattern for different preparations is given. The authors summarize the results of major studies with beta-blockers: MDC, CIBIS, ANZ, US Carvedilol Trials and they outline the trends of future research and indications for treatment with beta-blockers.

Adrenergic beta-Antagonists↗
PubMed1998

[Ramipril in the treatment of moderate to moderately severe hypertension. A multicenter open study].

A twelve-week open trial investigating the effect and tolerance of ramipril in 685 patients with mild to moderate hypertension in 88 clinics mostly of general practitioners (list with the author). The antihypertensive effect was investigated after 4, 8 and 12 weeks. The trial was terminated consistent with the protocol by 501 (73.1%) patients, 36 (5.3%) were eliminated early and in 148 (21.6%) the prescribed protocol was not respected. 413 patients (82.4%) terminated the trial on monotherapy, the remaining 88 (17.6%) had combined treatment from the 8th week onwards. When the trial with monotherapy was terminated the drop of blood pressure was more marked already during the 4th week and this trend proceeded during the 8th and 12th week, while in patients who had combined treatment from the 8th week the authors did not observe a drop of the blood pressure between the 4th and 8th week. The investigated laboratory indicators displayed insignificant changes within the range of normal values. The preparation was well tolerated, the total number of undesirable effects was 11% (three patients discontinued because of a cough). The effectiveness was evaluated by the attending physician as very good in 88%, the tolerance in 97%.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1998

[The effect of ramipril on metabolic, renal and cardiac function in hypertension and type II diabetes mellitus].

OBJECTIVE: To assess the effect of ramipril on indicators of glucose metabolism, incl. insulin resistance, on renal function with microalbuminuria, changes of some echocardiographic signs of hypertrophy and compliance of the left ventricle in patients with hypertension and type II diabetes mellitus. MATERIAL AND METHODS: The authors examined 32 patients with hypertension grade I and II and with diabetes type II, who had ramipril, 2.5-10 mg/day, for a period of six months. The examination before and after long-term treatment comprised basic biochemical sampling incl. concentrations of immunoreactive insulin, C-peptide and glycated haemoglobin and also complete functional examination of the kidneys, incl. microalbuminuria. Echocardiographic examination was focused on assessment of signs of hypertrophy and compliance of the left ventricle. Treatment of diabetes was not changed in the course of 6 months. RESULTS: In addition to the anticipated drop of blood pressure a declining trend of insulin resistance was recorded, there was a significant decline of microalbuminuria and a rise of natriuresis, the left ventricle mass declined and its compliance improved. CONCLUSION: Ramipril one of the inhibitors of angiotensin converting enzyme is an effective and useful medication for type II diabetics suffering from hypertension.

Adult↗
PubMed1996

Non-invasive prognostic factors in chronic heart failure. One-year survival of 300 patients with a diagnosis of chronic heart failure due to ischemic heart disease or dilated cardiomyopathy.

The prognosis and clinical findings related to prognosis were examined in 300 patients with congestive heart failure in a prospective study. The diagnosis was based on case history data (NYHA class II or III), depressed ejection fraction (< or = 40%) and/or increased cardiothoracic ratio (> or = 50%). Forty-eight (16%) patients died within 1 year after the entry examination. Non-invasive baseline parameters of survivors and non-survivors were compared. All necessary medication was allowed. At the entry of the study three parameters independently predicted an increased mortality on a high significance level (P < 0.01): cardiothoracic ratio, signs of lung congestion on the chest X-ray (four grade classification), and plasma urea level; other three parameters did so on a lower significance level (P < 0.05): plasma natrium, creatinine value and endsystolic volume. Other parameters such as age, ejection fraction, NYHA class or exercise tolerance duration were not statistically different in survivors and non-survivors. Our modification (a four grade classification) of the signs of lung changes on the chest X-ray enables a more accurate determination of the prognosis in patients with chronic heart failure.

Cardiomyopathy, Dilated↗
PubMed1996

[Non-invasive prognostic parameters in chronic heart failure].

The relationship between baseline clinical, laboratory and auxiliary indicators on the one-year mortality was investigated in 125 patients with chronic heart failure caused by ischaemic heart disease or cardiomyopathy associated with dilatation. During the baseline examination all patients had cardiac symptoms-functional class NYHA II-IV- and their ejection fraction assessed by echocardiography was < 40% and/or their cardiothoracic index was > 50%. Within twelve months after the baseline examination 19 (15.2%) patients died. Signs of pulmonary congestion and the cardiothoracic index were the most significant prognostic indicator of the one-year mortality (p < 0.001). As to other indicators, the following were statistically significant: sodium level, urea level, the duration of the ergometric test and the patients' body weight. Statistical significance was not recorded in echocardiographic indicators and the NYHA classification. These data, in particular the newly introduced four-grade classification of pulmonary congestion, make it possible to assess a more accurate prognosis of high risk patients with chronic heart failure.

Female↗
PubMed1995

[Hemocoagulation and hemorheology in heart failure and the possible effects of glycosaminoglycans].

Chronic congestive heart failure is one of the risk groups of acquired hypercoagulant and hyperviscous state. In a group of patients with medium and severe cardiac failure the administration of sulodexide led to an increased activation of the fibrinolytic potential--a drop of PAI-1 and fibrinogen, to an increased activation of anticoagulatory potential--an increase of AT III and reduced plasma viscosity. Global coagulation and biochemical screening parameters were not affected by treatment. Administration of the preparation did not exert important undesirable effects and was well tolerated.

Aged↗
PubMed1995

[Stress tests in chronic heart failure].

The authors compared two types of spiroergometric tests in 14 patients with chronic heart failure (NYHA II-III, ejection fraction < 40%). Test A: 0.25 W/kg 3 minutes, 1 minute break, increase by 0.25 W/kg á 3 minutes. Test B: 25 W 2 minutes without break, increase by 10 W á 2 minutes. The two tests did not differ as to the achieved heart rate, blood pressure reading, oxygen consumption and biochemical parameters at the end of the load, even at the level of the anaerobic threshold. There was a significant statistical difference in the duration of the load: test A lasted 16.4 minutes, test B 9.7 minutes (p < 0.001). The length of the test B correlated with the peak oxygen consumption per 1 kg body weight (p < 0.001, r 0.9866). The authors recommend for common practice test B with a defined period of the load as sufficient.

Anaerobic Threshold↗
PubMed1994

[The patient after myocardial infarct--what next? Diagnostic and examination methods].

The authors present a review of possible examination methods for the assessment of post-infarction ischaemia and estimation of the prognosis in patients after myocardial infarction. Criteria of the positivity of tests are given, as well as their sensitivity and specificity. The tests are listed according to their availability in different departments and with regard economic aspects, i.e. from the cheapest to the most expensive ones. The outcome of this examination pattern should be indication of coronarography which is the only examination to provide accurate information on the blood supply of the heart muscle and the results of coronarography are the basis of further decisions on the strategy of treatment.

Humans↗
PubMed1994

Comparison of two protocols used in exercise testing in chronic heart failure patients.

UNLABELLED: Spiroergometrical testing with the load graded upto symptom-limited maximum with the determination of anaerobic threshold begins to be a routine method in exercise testing of cardiac patients. Functional parameters according to available data depend on the source of load and may be influenced by the protocol of testing, too. That is why we decided to compare two protocols used in chronic heart failure patients exercise testing. 11 male and 3 female patients (NYHA II, III) suffering from chronic heart failure were subjected to the symptom-limited tests (protocol A-0.25 W.kg (-1/3 minutes with one minute breaks; protocol B-25 W + 10 W/2 minutes). There was no statistically significant differences in the symptom-limited values of main functional parameters. The AT level parameters did not differ significantly, as well. Anaerobic threshold could be determined in all patients using the protocol A and in 11 cases using the protocol B. The difference in rates was not statistically significant. The workload duration using the protocol B was significantly shorter (9.7 +/- 3.8 minutes vs. 16.4 +/- 3.6 minutes). CONCLUSIONS: Protocol B is less time demanding and therefore it is more suitable for determination of the symptom-limited parameters in the clinical routine. Anaerobic threshold can be determined by protocol A more often than by protocol B. Therefore, protocol A appears to be more suitable for the individual prescription of the appropriate physical activity and for scientific purposes, too.

Anaerobic Threshold↗
PubMed1993

[Bisoprolol in the treatment of hypertension].

Bisoprolol is an effective antihypertensive drug which reduces significantly the systolic, and diastolic blood pressure, the pulse rate in a recumbent, sitting and standing position. Recommended dosage is 10-15 mg once a day. Bisoprolol is suitable for use in hypertensive patients with associated diseases, in particular angina pectoris and impaired rhythm.

Bisoprolol↗
PubMed1992

Radiologic changes in chronic heart failure.

The relationship between chest X-ray findings and NYHA classification or haemodynamic parameters (ejection fraction, end-diastolic and end-systolic volumes by echocardiography, right atrial pressure--RAP, pulmonary artery pressure--PAP and pulmonary wedge pressure--PAWP by right heart catheterization) was evaluated in 44 and 22 patients with chronic congestive heart failure, respectively. In chest X-ray, the cardiothoracic index (CTI) and authors' own classification of pulmonary congestion (PCG) of classes 0, 1 and 2 were used. A significant correlation was found between CTI and NYHA classification or haemodynamic parameters, and between PCG (classes 0 and 2) and echocardiographic parameters or right heart pressures (EDV, ESV, RAP, PAP, PAWP), but there was no significant relationship between X-ray and left ventricular ejection fraction. For a PAWP higher than 18 mmHg and PCG class 2, the sensitivity of X-ray was 86% and specificity 80%. The authors conclude that chest X-ray provides reliable information about the haemodynamic parametres, comparable to echocardiographic and catheterization data.

Cardiomegaly↗
PubMed1990

[Is accurate dosing possible using infusion sets?].

The authors discuss factors which influence the dispensing of infusion solutions by means of infusion sets regulated by a button. They draw attention to the fact that by means of infusion sets IS 103 and TS 203 accurate dispensing is not possible as the rate of flow changes markedly with the time of administration of the infusion. On the other hand, in the EXADROP dispenser marked slowing down of the infusion in relation of time does not occur and the authors recommend it therefore for common use in standard departments.

Humans↗
PubMed1990

[Practical use of infusion pumps].

The authors present a brief characteristic of infusion pumps on the drop principle and factors which influence the size of the drop. They also pay attention to the knowledge of drop size for nutritional needs and accurate dosage of drugs.

Infusion Pumps↗