[Chronobiology in medical practice].
This review is intended to present some practical applications of the knowledge of biorhythms for both diagnostic and therapeutic purposes.
Biomedical subjects
Publications and source records attributed to A Markiewicz.
This review is intended to present some practical applications of the knowledge of biorhythms for both diagnostic and therapeutic purposes.
The aim of the study was to ascertain whether the seasons of the year influence the course of mild or moderate bronchial asthma, and to assess the effectiveness of respiratory kinesitherapy. In outpatients one month cycles of respiratory kinesitherapy were performed (twice a week for 45 min.) and were still repeated three times in the next seasons of the year. Spirometric and psychological examinations and also the self-evaluation of dyspnea were performed before and after each cycle. Additionally PEF was self-measured by the patients every day. It has been shown that seasons of the year influence neither the values of spirometric parameters of lung ventilation, the circadian rhythm of PEF, nor the effectiveness of respiratory kinesitherapy. However, the repeated cycles of effective breathing favourably influenced the psychic condition and reduced the subjective feeling of dyspnea, as well as improved the quality of asthmatics' life.
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The aspects of acute purulent mediastinitis (APM) have been reported on the basis of the analysis of 14 cases treated in the last 5 years. The most frequent causes of APM were the complications after surgery on esophagus ad trachea (10 cases). The other group included patients operated on by sternotomy. Three patients survived. In both of them diagnosis was established within 12 hours from the beginning of APM and early re-thoracotomy was performed. The rest of the patients died because of sepsis and multiply organ failure (MOF). The conclusion is that only early diagnosis as well as aggressive surgical treatment give a chance to save life in such a dangerous severe complication.
18 patients have been treated in our department for mediastinal emphysema (ME) during last 15 years. Small degree ME was found in 5 cases medium degree ME in 6 cases and in 5 patients tension emphysema was noted. Small degree ME was caused by abdominal and thyroid gland surgery, middle degree ME was recognized after surgical treatment of the mediastinal tumors or after mediastinal traumas. Tension emphysema of the mediastinum was observed in patients artificially ventilated, after blunt chest injuries or in the course of pneumonia. Sometimes it was impossible to establish the cause of ME. Tension emphysema of the mediastinum was usually life-threatening and required decompression.
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Calcium heparin in a dose of 13,200-15,300 U was administered in 8 healthy men, aged 26-54, by inhalation at 8:00 or 20:00, where each study was separated by a minimum of three weeks interval. Serum coagulation variables, lipids, electrolytes and enzymes were measured before inhalation, 2 h later and after 48 h. Following heparin inhalation changes both in coagulation variables and less distinct in lipids variables were noted at both test times, but no morning-evening differences were observed, with the exception of cholesterol and HDL.
A case is presented of anaemia which was caused by decubitus ulcer and fistula of the duodenum developed as a result of pressure exerted by aortofemoral vascular prosthesis.
The absorption of vitamin B12 in selected pathological states of the gastrointestinal tract was studied. Schilling test was performed with 37 kBq (1 microCi) of 57Co-labelled vitamin B12 as an analysis of urinary radioactivity. No increase in cobalamin absorption was present after exogenous IF had been administrated to patients after resection of the upper part the stomach and total gastrectomy. This suggests that there is another factor likely to affect vitamin B12 absorption.
Basing on results of first screening of the Pol-MONICA Project in 1984 in two centres that is the Tarnobrzeg province and two districts of Polish capital Warsaw (Praga South and Praga North) the level of 11 main coronary disease risk factors was compared in 2469 men and 2729 women. The following 5 risk factors were statistically significant for both men and women: the Durnin index of body fat content, the total cholesterol concentration in the plasma, triglyceride level, numbers of daily meals. The mean level of two factors that is the HDL-cholesterol concentration and the HDL-cholesterol/total cholesterol ratio was lower in the Warsaw sample what speaks in favor of concept that the ischemic heart disease threat is greater in that population. Among men the Warsaw population exhibited moreover the significantly higher value of diastolic blood pressure as well as of Quetelet body mass index; age and numbers of cigarettes smoked daily has also been higher in that population. In women from the Tarnobrzeg province ++ the diastolic blood pressure was higher than that in the Warsaw population. The two populations studied showed also highly significant differences so far as the complex of all 11 features is concerned what enabled the qualification of 72.3% of men, and 68.4% of women as belonging to the big city population or to the agricultural-industrial population using the discriminant Fisher function.
According to the Pol-MONICA program the random selected population samples were studied in inhabitants of Warsaw or the Tarnobrzeg province . After excluding from analysis the subjects treated with the hypotensive++ or hypolipemic drugs the differences between populations studies with regard to range of mean pressure value, except systolic pressure (RRs) in women, appeared significant ones. In populations studied the arterial blood pressure (CTK) was influenced by: age, sex, education, family history with regard to the circulatory system, the alcohol intake, smoking, heart action frequency the Quetelet coefficient value, triglyceride concentration and daily sodium intake. After analysis of inter-population differences in values of above factors the mean RRs values in populations studied did not differed significantly whereas differences in mean values of diastolic pressure (RRr) were highly statistically significant.
According to the POL-MONICA program basing on screening studies of random population samples of two Warsaw districts and the Tarnobrzeg provinceip the detectability of arterial hypertension (AH), the AH treatment fact, the effectiveness+ of AH treatment and the populational control of AH has been evaluated. The AH control was better in Warsaw (men 55%, women 73%) than in the Tarnobrzeg province (men 44%, women 65%). In both populations the control was better among women than among men and increased with the age of subjects investigated. In both populations the treatment was introduced only in half of detected AH and increased also with the age of subjects studied. Only 20% men and 25% of women in Warsaw and 35% of men and 42% of women in the Tarnobrzeg province was effectively treated. The AH control in the Warsaw population was twice a lower than in the Tarnobrzeg province (Warsaw: men 5%, women 10%, Tarnobrzeg: men 7%, women 16%). Exceptionally bad control of HT has been stated in the youngest and the middle age men group in Warsaw (2.9%). The patterns studied with the use of MLF functions in both population studied have significant influence on the detectability and the AH treatment fact and remain without the influence of effectivity of treatment.
Ten healthy men were tested at 0600, 1200, 1800 and 2400 hours on different days at rest in a laboratory at room temperature followed by 1 h of heat exposure in a climatic chamber at 42 degrees C, 60% rh (50 min rest and 10 min exercise on a cycle ergometer at 50% VO2max). Heart rate, blood pressure, rectal temperature Tre, metabolic rate, number connection test, visual and auditory reaction time, flicker test and catecholamine excretion were measured. Heat exposure and exercise caused lower heart rate acceleration at 2400 hours than at 0600 and 1200 hours, the smallest increase of Tre at 1800 hours, and an increase in metabolic rate greater at 1200 than at 1800 hours. In the afternoon, when, according to the circadian rhythm, the body temperature is highest, the additional heat load produced the smallest physiological effects. Performance efficiency, after heat exposure combined with physical exercise, improved slightly, but diurnal variations did not show significant circadian rhythm.
The aim of the present study was to investigate the possible existence of rhythmicity of some morphological structures of the duodenum [correction of jejunum] in man. The height of intestinal villi was found to vary significantly during the 24 h time span, being higher during the day than during the night, when the proportion between small and medium size villi changed (p less than 0.05). The highest mitotic activity was found at 200 and at 600, and the lowest at 1000 and 1400 (p less than 0.01). Both height and width of microvilli did not change during the 24 h span, while thickness of the glycocalyx was slightly higher during the day when compared to the night. There were no significant circadian changes of Paneth cell granularity. We conclude that circadian rhythmicity of duodenum [correction of jejunum] morphology in man is less distinct than in animals, but that significant circadian changes in some parameters do exist.
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