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Biomedical subjects

A Spring

Publications and source records attributed to A Spring.

At least 19 recordsLinked to original sources
PubMed2005

[Analysis of quality of life in patients with a facial prosthesis].

OBJECTIVE: This clinical study examined the quality of life of face-disabled patients who had received a facial prosthesis. PATIENTS AND METHODS: The examination of the 58 patients was performed using different questionnaires. For the evaluation of the subjective health-related quality of life an instrument constructed by the WHO was used (WHOQOQL-Bref). The Frankfurter Scales of Body Concepts (FKKS) was chosen to measure the self-assessment of the patient's own body perception. For the assessment of the present general quality of life a visual analogue scale was used (Anamnestic Comparative Self-Assessment, ACSA). Additionally an ad hoc questionnaire was used, which registers the post-therapeutic epithetic rehabilitation. The health-related quality of life of this sample was compared to a healthy one of the normal population. RESULTS: The examinations showed that the quality of life of the patients is reduced in contrast to the healthy group when the acquired defects were located in the region of the eye and the nose. The evaluation of the scales of body concepts showed that the patient's own body image was significantly altered. Body contact with other persons and their own sexual attraction was perceived as remarkably diminished. The patients believed that they spread an unpleasant odor. It is surprising that the wearers of a facial prosthesis indicated that they did not notice a restriction in the acceptance of their body by others. The influence of the application of camouflage did not have an impact on the quality of life. CONCLUSION: To improve the restricted quality of life, to the raise the reduced well-being and to strengthen the altered body experience, psychological care should be provided besides further optimization of the surgical-epithetic therapy and the camouflage technique.

Adaptation, Psychological↗
PubMed2004

[Unilateral decompressive craniectomy in left transverse and sigmoid sinus thrombosis].

Cerebral venous and dural sinus thrombosis is a rare cause of stroke. We explore the controversial issue of anticoagulation therapy and indication for decompressive craniectomy in association with severe sinus thrombosis. The 62-year-old female patient was admitted to hospital, because of first generalized seizure. A computed tomographic (CT) scan of the brain revealed a left occipital hemorrhage. Digital subtraction angiogram showing thrombosis of the left transverse and sigmoid sinus. An intravenously administered regimen of heparin was begun, because of a protein S deficiency. On the 6th day the patients level of consciousness deteriorated, necessitating intubation, hyperventilation, and mannitol. Repeat CT scan revealed increasing edema with midline shift and obliteration of the basal cisterns, although the hemorrhagic lesion was unchanged. The patient developed signs of diencephalic dysfunction. A large left temporoparietooccipital craniectomy was performed and the dura was opened. The multiloculated intraparenchymatous hemorrhage portion of the brain was not removed. In addition, the patient was treated postoperatively with heparin therapy for three months, than a regimen of phenprocoumon was begun. Twelve months later the hemianopsia had not improved and she had an incomplete Wernicke's dysphasia. When, despite adequate anticoagulation therapy and intensive care, neurological deterioration occurs in sigmoideus and/or transversus dural sinus thrombosis with unilateral edema, a decompressive craniectomy should be considered especially in young patients.

Anticoagulants↗
PubMed2003

Concomitant renal cell carcinoma with pituitary adenoma.

Renal cell carcinoma has a complex and variable natural history. We report a case underlining this who presented concomitant renal cell carcinoma metastasis with pituitary and adrenocortical adenomas. A 62-year-old woman presented with visual loss. Imaging revealed a large sellar mass with suprasellar extension. Four years before, nephrectomy and adrenalectomy had been performed for a renal cell carcinoma with metastasis in a coexistent adrenocortical adenoma. Faced with progressive visual loss and the questionable pituitary pathology, the patient underwent trans-sphenoidal surgery. Due to profuse tumor bleeding, only a biopsy was possible. In a second operation, the patient underwent craniotomy with subtotal resection of the tumor. Histological examination of the specimen revealed a metastasis of the renal cell carcinoma and a pituitary adenoma. The case presented here and a review of the reports suggest that there are some differences between the clinical features and outcomes of metastases of renal cell carcinoma and those of pituitary gland metastases from other primary sites.

Adrenal Cortex Neoplasms↗
PubMed2002

[Parasagittal meningioma in a skull dated 32500 years before present from southwestern Germany].

Summary. During excavation in 1931 by Riek in the cave of Vogelherd close to Stetten in the Lone Valley in southwestern Germany there was found an anatomically modern human skull (called: "Stetten 2") dated 32500 years before present. The skull was excavated without postcranial skeleton in the cave and showed no signs of burial. Paleopathological examinations of the calvarium reveals skeletal abnormalities that indicate parasagittal meningioma next to the bregma. Paracentral Meningiomas cause seizures and focal weakness, followed by headache. These observations are discussed in the context of modern medical knowledge. Our theory integrated archaeological, anthropological and paleopathological knowledge and helped to create the understanding of Paleolithic and earliest modern man knew regarding the "brain" and illness.

Germany↗
PubMed2001

[Spontaneous intraspinal epidural hematoma secondary to use of platelet aggregation inhibitors].

HISTORY AND ADMISSION FINDINGS: A 64-year-old woman previously in good health experienced an acute onset of severe neck pain and weakness of the left arm that had developed within minutes. Neurological examination revealed paresis of the left arm. There was a previous history of cardiovascular disease and she had been treated with 100 mg of aspirin per day. INVESTIGATIONS: MRI revealed a left posterolateral intraspinal mass extending from C3 to C7. The hemostatic evaluation showed no abnormalities (platelet count, prothrombin time, partial thromboplastin time). TREATMENT AND COURSE: A laminectomy with evacuation of the epidural hematoma was performed. The postoperative course was uneventful, with complete disappearance of the neurological deficit. CONCLUSION: We report a rare condition of spontaneous spinal epidural hematoma that was associated with aspirin intake. A short time interval from onset of symptoms to diagnosis (MRI) and surgery is crucial for the outcome.

Angina Pectoris↗
PubMed2001

[Is application of electrocardiographic exercise test always usefull in the diagnosis of coronary artery disease? Advantages and limitations of this method].

UNLABELLED: To determine the diagnostic value of the electrocardiographic exercise testing (EET) in 551 patients with chest pain regarded as definite or probable stable angina pectoris (CAD), results of performed EET were compared with coronary angiography. All patients underwent exercise testing according to the Bruce protocol. The criterion for a positive exercise ST-segment response was > or = 1 mm of horizontal or down sloping depression 80 msec after J-point. The indications for cardiac catheterization in each patient were determined at the discretion of the attending physician. Clinically important coronary artery disease was defined as > 50 per cent narrowing of the diameter of at least one major vessel or > or = 50 per cent of the left main coronary artery. RESULTS: The sensitivity and specificity of EET for detection of CAD were for the entire group, in women and men respectively: 93%, 91%, 94% and 21%, 16%, 27%. CONCLUSION: 1. Indications for EET should be based on prior probability of coronary artery disease. 2. Application of higher than conventional ST depression criteria (> or = 2 mm) lowers sensitivity but increases specificity of EET. 3. Variables determining false positive results are as follows: age, sex (female), low probability of CAD, ST-segment depression in leads: II, III, aVF and mitral valve prolapse. 4. Variables determining false negative results are as follows: high probability of CAD, sex (male) and one vessel disease.

Adult↗
PubMed2001

[Effects of thrombolysis on left and right ventricular diastolic function in patients after myocardial infraction. One-year follow-up].

UNLABELLED: It has been shown, that successful reperfusion of the infarctrelated artery by thrombolysis can prevent left ventricular (LV) dilatation and dysfunction. To date no study has shown the impact of thrombolytic therapy on LV and RV diastolic filling. The aim of the study was to assess the effects of thrombolysis on LV and RV diastolic inflow and systolic function of LV in patients (pts) after anterior myocardial infarction MI. METHODS: Echocardiographic and Doppler-derived measurements of LV systolic function, RV and LV diameters and diastolic function at rest and after treadmill exercise test (TET) were assessed prospectively in 21 patients (pts) after MI treated with streptokinase and 10 pts treated without thrombolysis during one-year follow-up. They were compared with 31 age-matched controls. RESULTS: LV and RV filling indices in both groups of pts after MI were impaired compared to controls but in pts without thrombolysis were more abnormal compared to pts treated with thrombolysis. Among several echocardiographic variables most consistent alteration was shortening of E-deceleration time of mitral as well as RV inflow, more abnormal in pts without thrombolysis. There was strong inverse relation between degree of impairment of diastolic variables and exercise capacity. CONCLUSIONS: These data indicates beneficial effect of thrombolysis on RV and LV diastolic function in patients after AMI. E-deceleration was the most sensitive marker of diastolic dysfunction.

Blood Pressure↗
PubMed2001

[Taking history in diagnosing coronary artery disease in the 21st century--wasting time or a valuable diagnostic tool?].

UNLABELLED: The relation of chest pain characteristics and other features of the history of disease to coronary angiograms was assessed in 551 patients with chest pain regarded as definite or probable stable angina pectoris. A standardised questionnaire was used to record demographic details and chest pain characteristics of interviewed patients. The differentiation between typical, atypical or nonanginal pain was based on classification proposed by Diamond. The indications for catheterization in each patient were determined at the discretion of the attending physician. All patients underwent diagnostic coronary angiography (clinically important coronary artery disease was defined as > 50 per cent narrowing of the diameter of at least one major vessel or > or = 50 per cent of the left main coronary artery). CONCLUSION: Chest pain characteristics remains an effective tool for estimating probability of coronary artery disease.

Adult↗
PubMed2000

[Density of beta-adrenergic receptors and left ventricular mass in patients with primary essential hypertension].

UNLABELLED: Left ventricular hypertrophy (LVH) is one of the more important risk factors for sudden death. There are multiple factors for development of LVH in patients with hypertension. Sympathetic nervous system may play a key role causing afterload increase and neurohumoral mechanisms activation. The aim of the study was to determine beta-adrenergic receptors density and its relations to left ventricular mass in hypertensive subjects. The study was carried out in 63 patients (23 women and 40 men), mean age 43.3 +/- 11.6 yrs with primary hypertension: stage I--42 pts and stage II--21 pts. The control group consisted of 26 healthy persons matched for age and sex. We evaluated the density of beta-adrenergic receptors using 125I-cyanopindolol radioligand labeling method. Left ventricular dimensions were assessed by echocardiography (Hewlett-Packard 77010 CF) and left ventricular mass index (LVMI) was calculated. Systolic and diastolic blood pressure and LVMI was significantly higher in hypertension group 156.7 +/- 12.5 vs. 119.8 +/- 8.8 mmHg, p < 0.0001, 95.9/5.5 vs. 78.8 +/- 6.5 mmHg, p < 0.0001, 126.5 +/- 41.9 vs. 93.1 +/- 19.9 g/m2, p < 0.001 respectively. Beta-adrenergic receptors density was 40.7 +/- 29.9 fmol/ml in the hypertensive vs. 37.2 +/- 17.8 fmol/ml in control group (p = NS). There was no correlation between beta-adrenergic receptors density and LVMI. There was a statistically significant positive correlation between LVMI and systolic and diastolic blood pressure (r = 0.44, p < 0.05; r = 0.60, p < 0.01 respectively). CONCLUSIONS: 1. Beta-adrenergic receptors density was unchanged in patients with hypertension and did not correlate with LVMI. 2. A high positive correlation between blood pressure values and LVMI, but only in stage II hypertension was revealed.

Adult↗
PubMed1999

[Influence of treatment with metoprolol or enalapril on recovery of contractile function of the left ventricle in patients after acute myocardial infarction treated by thrombolytics].

Regional left ventricular contractility caused by myocardial stunning as a result of transient ischemia and postreperfusion injury is a reversible state it can however persist even for several month. It seems reasonable to shorten this period as much as possible. The aim of the study was to estimate the influence of treatment with metoprolol or enalapril on the recovery of contractile function of left ventricle in patients after acute myocardial infarction treated thrombolytically. Investigations were carried out in 127 patients (mean age 62.3 +/- 11.9 years). Metoprolol was used in 37 patients in dose 0.02-0.05 g b.i.d., enalapril in 48 patients 0.0025-0.01 g b.i.d. 42 patients were not treated with any beta-blocker or ACE inhibitor. In all patients echocardiographic study was performed 3 times: on 2-3rd day following acute myocardial infarction immediately before introducing the treatment with metoprolol or enalapril, after 1 month and after 3 months. Echocardiographic study wall motion index (WMI) was calculated basing on. Significant decrease in WMI was observed after 1 month compared to its value on 2-3rd day acute myocardial infarction and after 3 months compared to 1 month after myocardial infarction in each of 3 subgroups of patients. No statistically significant differences in WMI were found out between studied subgroups. Neither metoprolol nor enalapril started on 2-3rd after thrombolytic treatment of acute myocardial infarction do not affect the recovery of contractile function of stunned myocardium.

Acute Disease↗
PubMed1999

[The diagnostic value of resting electrocardiography in stable coronary artery disease].

The relation of resting electrocardiographic (ECG) patterns to angiographic features was assessed in 566 patients with chest pain regarded as definite or probable stable angina pectoris. The indications for catheterization in each patient were determined at the discretion of the attending physician. All patients underwent diagnostic coronary angiography (clinically important coronary artery disease was defined as > or = 70 per cent narrowing of the diameter of at least one major vessel or > or = 50 per cent of the left main coronary artery) and standard 12 lead electrocardiography which was interpreted by 2 cardiologists independently in coordinating centre. The signs of impaired coronary blood flow were assessed by abnormalities of repolarization (among others S-T segment, the T wave), depolarization and presence of disturbances of cardiac rythm. The resting routine electrocardiogram was assigned to one of three categories: normal, nonspecific abnormalities or typical for coronary insufficiency. The typical pattern for ischemia was present in 104 patients (18%), nonspecific abnormalities were present in 185 patients (33%) and electrocardiogram was normal in 277 patients (49%). Sensitivity and specificity of the typical for coronary insufficiency resting ECG was calculated: 23% and 87% respectively for the entire group, 33% and 81% in women, 20% and 93% in men. In the group with normal resting electrocardiographic pattern 55% of patients have significant stenosis in at least one major coronary artery.

Cardiac Catheterization↗
PubMed1998

[Use of beta-adrenoreceptor antagonists in treatment of patients with chronic heart failure].

Chronic heart failure (CHF) is present in 1-10% of the whole population. From the drugs used in CHF so far only angiotensin converting enzyme inhibitors and nitrate with hydralazine improved the survival which was caused by beneficial influence of these drugs on neurohormonal factors. There is growing interest in beta-blockers which are believed to stop the progress of CHF. Although the first attempts of using beta-blockers in the treatment of CHF took place in 70-ties, only recent years brought better understanding of mechanisms of their action. The beneficial effect of beta-blockers in CHF is related to their protective influence on myocardium and to hampering of apoptosis--programmed cell death--the phenomenon which is exaggerated in CHF. The investigations carried out in last years proved that carvedilol which is beta 1-, beta 2- and alpha 1-blocker and has antioxidant properties improved clinical status and reduced mortality in the cohorts of patients with all-cause CHF. At present great trials estimating various beta-blockers and comparing these drug among themselves are being conducted.

Adrenergic beta-Antagonists↗
PubMed1998

[The influence of 3-month treatment with molsidomine on structure, function and some neurohormonal parameters in patients with chronic heart failure treated with digoxin, diuretic and angiotensin converting enzyme inhibitors].

The aim of the study was to estimate the influence of long-term treatment with molsidomine on structure, systolic function and neurohormonal parameters in patients with chronic heart failure (CHF). Investigations were carried out in 30 patients (mean age 63.0 +/- 10.9) in NYHA class III and IV. The cause of CHF was: coronary artery disease in 60% of patients, hypertension in 20% and dilated cardiomyopathy in 20% of patients. Molsidomine was administrated in dose of 2 mg tid for 3 months. During the study the previous treatment with ACEI, diuretics and digitalis was maintained. Using echocardiographic method left atrial dimension (LA), left ventricular end diastolic (LVEDD) and end systolic diameter (LVESD), interventricular septum (IVSDD) and posterior wall end diastolic diameter (LVPWDD), ejection fraction (LVEF) and fraction of shortening (LVFS) were measured. Plasma level of atrial natriuretic peptide, endotelin, neuropeptide Y and aldosterone and plasma renin activity were estimated radioimmunologically. All echocardiographic and neurohormonal measures were performed 4 times: before therapy, after 3 days, 2 weeks and 3 months of treatment with molsidomine. We observed significant increase in LVEF, which at baseline was 33.8% and after 3 months 44.8% (p < 0.05). None of the other echocardiographic parameters nor any of neurohormonal factors changed significantly during the 3-months treatment with molsidomine.

Aged↗
PubMed1997

The detection of simulated malingering using a computerized category classification test.

A category classification test was used to differentiate between normal student control participants, students instructed to malinger a memory deficit, and amnesic patients. Controls (N = 44) and amnesic patients (N = 10) were instructed to do their best, while simulators of malingering (N = 43) were instructed to fake a memory deficit for credit and possible financial compensation. Participants studied a list of high distortions of a prototype dot pattern and were then asked to choose whether or not a new set of dot patterns (random patterns, high distortions, low distortions, and the prototype) belonged to the same category of dot patterns as studied. Malingerers performed significantly worse than normal controls and amnesic patients. A discriminant function analysis showed that the classification test can be used to correctly classify participants as simulated malingerers, controls, or amnesic patients significantly higher than chance. These results indicate that a category classification test can be used in the detection of simulated malingering and that some tests of implicit memory provide a potential supplement to standard forced choice tests in the detection of malingering.

Journal Article↗
PubMed1997

[Right ventricular diastolic disfunction and its relation to left ventricular performance in patients with hypertension].

Abnormalities in left ventricular (LV) diastolic function may be the earliest indications of hypertensive heart disease. Because the two ventricles influence each other's performance this study was designed to investigate the impact of chronic LV pressure overload in essential hypertension (HT) on diastolic function of right ventricle (RV). RV and LV diastolic function was evaluated in 74 patients with mild-to-moderate essential HT using pulsed wave Doppler echocardiography. Fifty-five normotensive patients without heart disease acted as control subjects. In studied group, 17 patients (23%) had normal mitral (MV) and tricuspid (TV) flow parameters, 28 (38%) had impaired LV filling parameters [MV early (E) to late (A) peak flow velocity ratio (MV E/A) 0.81 +/- 0.12 vs control 1.19 +/- 0.18, p < 0.001] while 29 patients (39%) had abnormal both mitral [MV E/A) 0.72 +/- 0.15 vs control 1.19 +/- 0.18, p < 0.001] and tricuspid flow parameters (TV E/A) 0.8 +/- 0.19 vs control 1.23 +/- 0.1, p < 0.001). In group with impaired diastolic filling of both ventricles indices of mitral flow were significantly more abnormal compared to group with normal TV flow parameters (MV E/A 0.72 +/- 0.15 vs control 0.81 +/- 0.12, p < 0.05). RV filling parameters correlated with filling parameters. There was good correlation between TV A and MV E (r = -0.56, p < 0.01), the time velocity integral of early mitral inflow (MV E-VTI) (r = -0.64, p < 0.001) and positive correlation with MV A (r = 0.78, p < 0.0001). Also there was good correlation between LV mass and TV E (r = -0.56, p < 0.01) and the time velocity integral of early tricuspid inflow (r = -0.72, p < 0.001). Data indicate that RV diastolic function is abnormal in essential hypertension and these abnormalities are closely related to those of LV diastolic function and LV mass.

Adult↗
PubMed1997

[The effect of amlodipine on structure and function of the heart and exercise tolerance in patients with hypertension].

UNLABELLED: The aim of the study was to assess whether the hypotensive activity of amlodipine is associated with regression of left ventricular hypertrophy and improvement of impaired LV or right ventricular (RV) diastolic function or increasing of tolerance of physical activity in hypertensive patients. Assessment of left ventricular structure, systolic and diastolic function as well as RV diastolic dimension and diastolic function were performed in 24 patients with mild-to-moderate hypertension before administration of amlodipine and 3, 6 and 9 months of the treatment. In order to assess the tolerance of physical activity, incremental treadmill exercise testing was performed at baseline and after 6 and 9 months of the therapy with amlodipine. RESULTS: During 9 months of the therapy with amlodipine no significant change in indexes of LV mass or in LVM was observed. Similarly amlodipine did not influence the parameters of LV or RV diastolic function in studied patients. However, amlodipine treatment resulted in significant increase in total exercise time (p < 0.05), total workload (p < 0.01) measured in METs and decrease in diastolic blood pressure during exercise test. CONCLUSION: The nine months of the therapy with amlodipine resulted in significant improvement in exercise tolerance. Total exercise duration and total workload measured in METs significantly increased. During this time of the therapy no significant changes in LV structure or LV and RV diastolic function were observed. One can make an assumption that amlodipine inhibits progression of structural and functional derangement in hypertensive patients.

Adult↗