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Biomedical subjects

Z Rumboldt

Publications and source records attributed to Z Rumboldt.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

[Diagnostic characteristics of myxoma of the left atrium].

Three middle-aged patients (38, 40 and 41 years old; two women and one man) with left atrial myxoma diagnosed by echocardiography and successfully operated on are presented. Two patients had tumor embolus as the dominant presenting symptom. The time span between the first symptoms and the echocardiographic diagnosis was 6 months, 12 months, and 12 days, respectively. From that moment to surgery the average lag was 6.3 days only, including the complex transportation to distant surgical centres. All the patients are now alive, all with normal findings more than 2 years after the operation.

Adult↗
PubMedDate not supplied

[Familial cardiovascular risk factors].

In a 16 per cent systematic sample of the fifth grade elementary school pupils from Split, Yugoslavia (198 boys and 250 girls, aged 11.3 +/- 0.4 years; mean +/- SD), 116 children (25,9% of the sample; 61 girls and 55 boys) were found at risk for cardiovascular diseases, having the values of one or more of the recognized risk factors above the 90th percentile of distribution for age and sex, e.g. serum cholesterol greater than 5.6 mmol/l. After the 3-year follow-up period the parents and the available relatives of these children were checked for the same risk factors in order to evaluate the magnitude of family aggregation. The prevalence of cardiovascular risk factors was 3-5 times higher for the parents of the children at risk than for the control parents (e.g. 57.1 vs 11.8 per cent in boys; p less than 0.001). The observed parent-child agreement was highest for serum cholesterol and triglycerides (range 30.0-37.5%; p less than 0.01). The family clustering of risk factors was prominent in the second generation (e.g. grandparents, p less than 0.01) as well, and even among the other relatives (p less than 0.05). It is concluded that the probability of adverse cardiovascular outcome increases not only with the individual level of aberration and with the mutual enhancement of risk factors, but with positive history and family aggregation as well: these phenomena have important influence on the process of physicians' decision making, with obvious practical implications.

Cardiovascular Diseases↗
PubMedDate not supplied

[Changes in left ventricular function and structure in hypertensive patients treated with methyldopa and urapidil].

In a randomized cross-over and double-blind trial twenty mild-to-moderate hypertensives (11 males, 9 females, mean age 48.4 +/- 7.6 years) were receiving methyldopa (250 mg b.i.d.) or urapidil (30 mg b.i.d.) for 7 weeks and then treated with alternative drug for additional 7 weeks, separated by one week of wash-out period. Both antihypertensives induced significant reduction (P less than 0.01) in systolic and diastolic arterial pressure, while no significant changes (P greater than 0.20) in the body weight and the heart rate were observed. The echocardiographic features of left ventricular hypertrophy (LVH) did not decrease significantly (P greater than 0.05) on either drug, except for the left ventricular posterior wall thickness (LVPWd), which decreased on methyldopa from 10.4 +/- 1.3 to 9.8 +/- 1.4 mm (P less than 0.05). The drugs under study did not change significantly the echocardiographic indices of left ventricular function. Echocardiography resulted to be more sensitive in detecting LVH than electrocardiography. It is concluded that methyldopa might successfully reduce LVH, while direct and indirect vasodilators (such as urapidil) are less effective.

Adult↗
PubMedDate not supplied

[The role of the diagonal ear lobe crease in the clinical evaluation of coronary risk].

Two hundred and forty-three prospective patients (143 with proved coronary heart disease and 100 without coronary disease) were analysed for the presence or absence of ear lobe crease, a possible aural sign of coronary artery disease. The crease was present in 72.7% of the coronary and 48% of the noncoronary examinees (p less than 0.001). The crease was more prevalent in older (greater than 50) than in the younger patients. The positive predictive value of this sign averages 70% and the negative one 60%.

Coronary Disease↗
PubMedDate not supplied

[The time interval from the onset of myocardial infarct to arrival in the coronary unit in the area of Split].

The time interval from the initial symptoms of myocardial infarction to the coronary care unit admission in patients treated at the Department of Internal Medicine, University Hospital "Firule", Split, and Military Hospital, Split, between 1 January 1981 and 31 December 1987, vas analysed. The average duration of this delay was 14.8 +/- 11.6 hours (range 2-72 hours). It is concluded that this interval should be substantially reduced in order to decrease the actual coronary heart disease death rate.

Coronary Care Units↗
PubMedDate not supplied

[The role of science in medical practice].

Reviewed are the subtle differences between the scientific method, which is one of the foundations of current medical practice, and the scientific discovery including all the activities aimed at evidence and verification, which is not a part of daily routine and belongs to elite. Underscored is the fact that modern medicine, besides the scientific (deterministic) should repose on the ethical (humanistic) cornerstone.

Ethics, Medical↗
PubMedDate not supplied

[Comparison of single and double doses of hydrochlorothiazide in the treatment of arterial hypertension with special emphasis on changes in vascular reactivity].

The hypotensive effects of 100 and 50 mg hydrochlorothiazide (HTZ) were evaluated in 30 mild-to-moderate hypertensives, divided into two groups, with diastolic pressure between 95 and 110 mmHg. In both groups, the average MAP reduction was 15% (P less than 0.05). There were no significant differences in antihypertensive effects between single (50 or 100 mg o.d.) and double (25 or 50 mg b.i.d.) doses of the same drug. Blood pressure control was better after two than after one month on each of the various dosing schedules. Side-effects were mild and well tolerated: observed was a significant increase in triglyceride level from 3.0 +/- 1.8 to 4.8 +/- 2.4 mmol/L under the treatment with 100 mg HTZ o.d. and a statistically significant decrease in potassium level from 4.4 +/- 0.3 mmol/L to 4.1 +/- 0.3 mmol/L after two months treatment with 50 mg HTZ o.d. Unexpectedly, these changes were not dose-related. The venous reflexes showed atenuated response to norepinephrine after HTZ treatment, while arterial inflow, venous capacity and venous outflow increased significantly (P less than 0.05). It is concluded that HTZ exhibits some direct vasodilator activity and that the pharmacokinetic features of this drug do not correlate with the pharmacodynamic ones. At least in the management of mild-to-moderate arterial hypertension single daily dosage is quite adequate.

Adult↗
PubMedDate not supplied

[Characteristics of diurnal rhythm in the development of myocardial infarct: risk in the morning hours].

The onset of precordial pain was assessed in all the patients admitted to the Clinical Hospital "Firule" and the Military Hospital, Split, during a six-year period (1981-1986) with acute myocardial infarction (n = 1304). According to the time of onset, all the subjects were stratified in three-hour intervals. The large majority of initial symptoms was registered between 7 and 10 a.m. (372 or 28.53% of all; chi 2 = 317, P less than 0.001). The results of this and other studies of circadian rhythm in coronary events points out to the high risk of morning hours, suggesting specific preventive measures, including pharmacological and life-style interventions.

Circadian Rhythm↗
PubMedDate not supplied

[The vasodilating effect of chlorthalidone in mild hypertension evaluated by impedance venous plethysmography].

Thirty hypertensive outpatients of both sexes having diastolic blood pressure below 110 mmHg were included in a randomized trial. Their mean age was 50.4 +/- 8.6 years. After a two-week placebo period, the patients were treated with chlorthalidone in a single daily dose of 25 or 12.5 mg over the one-month period, and the next month the alternative dose (i.e. 12.5 or 25 mg) was administered. Changes in vascular reactivity were measured by occlusive plethysmography (mercury strain-gauge) at the end of the placebo period, and then post the first and second month of therapy. All the observed parameters, i.e. rest flow (RF), peak flow (PF), venous capacity (VC), and maximal venous outflow (MVO) increased with 25 mg of chlorthalidone, and similar findings were registered when a dose of 12.5 mg was given. There was a significant increase in venous capacity of both groups (from 2.6 to 3.2 and from 3.0 to 3.4 ml/100/min) and in peak flow of the group that was on 25 mg of chlorthalidone as the first dose (from 18.6 to 23.9 ml/100ml/min). Both doses had similar antihypertensive effect. It is concluded that antihypertensive effect of chlorthalidone is partly due to changes in vascular reactivity in the sense of vasodilation which is more prominent at the venous side of the blood flow, Low-dosed chlorthalidone is equipotent in antihypertensive efficiency, its side effects are rare, and the cost of therapy is by far the lowest.

Chlorthalidone↗
PubMedDate not supplied

[Primary actinomycosis of the liver--case report].

The liver is a rare site of actinomycotic abscess localization. A 36-year-old man admitted to the hospital because of pain under the right costal margin with skin hyperemia and edema in that region is presented. Clinical and laboratory examinations disclosed liver actinomycotic abscess. Surgical drainage was done followed by 8 months of antibiotic (penicillin) therapy. Discussed are the difficulties in diagnostic procedure and the lack of consensus in the therapeutic approach.

Actinomycosis↗
PubMedDate not supplied

[Characteristics of patients with acute myocardial infarction treated in Split 1982-1992].

Three thousand three hundred and fifty-two patients (70% males and 28% females) were hospitalized and treated in Split for acute myocardial infarction (hospital mortality 20%) between 1982-1992. The number of these admissions has been constantly rising from 226 in 1982 to 397 in 1992. Over 45 years of age were 3043 (90.8%) of the patients (70% males and 30% females), while 309 of them (9.2%) were under 45 (93% males, 7% females). The lethality rate was 21% in the first and 8% in the second subgroup. In patients over 45 inferior myocardial infarction was found in 35%, and in patients under 45 in 49%. In the older group there were 40% smokers, 42% hypertensives and 39% hypercholesterolemics, while there were 75% smokers, 35% hypertensives and 33% hypercholesterolemic patients in the younger age group. The results show that the number of patients treated for acute myocardial infarction in the Split region is constantly increasing (p < 0.001). In patients under 45 years of age there is significantly higher inferior infarction prevalence (p < 0.001); a larger percentage of males (p < 0.001) and smokers (p < 0.001), and lower percentage of hypertensives (p < 0.001) and hypercholesterolemic patients (p < 0.05) was observed, as well as lower hospital mortality rate (p < 0.001).

Croatia↗