Biomedical subjects

F Sefrna

Publications and source records attributed to F Sefrna.

At least 19 recordsLinked to original sources

PubMed1995

[Effectiveness of conservative and surgical treatment of lumboischiadic syndrome].

BACKGROUND: Hitherto performed retrospective studies of conservative and surgical treatment of compressive radicular lumboischiadic syndrome did not provide a clear answer to the question which procedure cures the disease more effectively. The reason is that severe types of the disease treated by surgery were compared with therapeutic results of milder forms treated conservatively. The authors compared therefore the effectiveness of both therapeutic procedures in a prospective study with a random selection of patients as regards the therapeutic procedure. METHODS AND RESULTS: In two groups--first group comprising 100 patients with the global syndrome and second group comprising 64 patients with the pure syndrome--the authors enlisted the patients by random selection for conservative or surgical treatment. Early results were assessed three months after treatment. Satisfactory results (cure) were achieved in 50% of the operated patients with the global syndrome, compared with 23.81% treated conservatively (p < 0.01), and improvement was recorded in 77.77% operated patients as compared with 58.69% conservatively treated patients (p < 0.05). In the group with the pure syndrome satisfactory results were achieved in 68.75% operated patients as compared with 21.87% conservatively treated patients (p < 0.001) and improvement in 81.25% patients as compared with 53.12% conservatively treated patients (p < 0.01). CONCLUSIONS: The investigation proved a statistically significantly greater effectiveness of the surgical method of treatment of compressive radicular lumboischiadic syndrome as compared with conservative treatment. The second finding was that both methods have a relatively low effectiveness as regards, complete recovery. It is necessary to seek methods to increase the effectiveness of both therapeutic procedures, in particular clearly more effective surgical treatment.

Humans↗

PubMed1995

Hemocompatibility in hemodialysis and erythropoietin therapy.

Two studies designed to investigate the effect of recombinant human erythropoietin (rHuEPO) treatment of anemia in chronic dialysis patients on hemocompatibility were conducted. Study 1, whose main aim was to establish whether treatment with rHuEPO enhances coagulation activation during dialysis, included 15 patients before rHuEPO therapy at a mean hematocrit (HCT) of 22.3% and then during therapy at a HCT of 29.3%. The plasma concentrations of the thrombin-antithrombin III complex were not higher during rHuEPO therapy than before it when performing hemodialysis with a Cuprophan membrane. No significant difference was demonstrated either in the values of activated clotting times (Hemochron), thrombocyte or white blood cell counts (Coulter S+II), or in plasma C5a concentrations (ELISA) established during dialysis sessions before and during rHuEPO therapy. In Study 2, which focused primarily on the question of whether or not rHuEPO therapy increases thrombocyte activation during hemodialysis, 8 patients on chronic dialysis were examined both before therapy at a mean HCT value of 22.1% and during rHuEPO therapy at a HCT of 31.5%, invariably during dialysis with either a Cuprophan or polyacrylonitrile (AN69HF) membrane. The plasma concentrations of beta-thromboglobulin (ELISA) did not differ between the examinations made during rHuEPO and before rHuEPO therapy; however, statistically significant differences were found between dialysis sessions involving Cuprophan and AN69HF membranes. No significant difference between examination before and during rHuEPO was demonstrated in activated clotting time nor thrombocyte and white blood cell counts in this study either. The authors conclude that rHuEPO therapy does not enhance coagulation activation during hemodialysis, does not have an effect on thrombocyte activation, and does not influence complement activation and changes in white blood cell counts.

Acrylic Resins↗

PubMed1994

Impact of cardiovascular risk factors on morbidity and mortality in Czech middle-aged men: Pilsen Longitudinal Study.

The impact of biological and life-style characteristics measured during baseline examination on 12-year morbidity and mortality of coronary heart disease (CHD), stroke (STR), and malignancies was investigated in an urban population of 3,540 middle-aged men initially free of clinical disease. The following factors enhanced significantly (at the 5% level) the adjusted relative risk ratios: for total mortality age, smoking, and elevated systolic blood pressure; for CHD age, smoking, elevated systolic blood pressure, serum cholesterol levels, and body mass index, and family history (father or mother). Myocardial infarction was positively associated with age, smoking and elevated serum cholesterol levels. For STR age and elevation of both systolic and diastolic blood pressure were risk factors. The relative risk for all malignancies was enhanced by age and smoking. Regular alcohol consumption was associated with a significantly lower risk for all CHD; however, with only marginal significance for myocardial infarction. Higher education was associated with a significantly lower risk of total mortality, all CHD, and myocardial infarction and a marginally lower risk of STR. A high leisure physical activity was negatively (but not significantly) associated with the risk of all end points.

Adult↗

PubMed1994

[Continuous ambulatory peritoneal dialysis--an effective method of treatment in chronic renal failure].

The authors evaluate the results of treatment of continuous ambulatory peritoneal dialysis (CAPD) in seven patient with chronic renal failure during a 12-month period. The baseline examination was made one month before CAPD was started, one day before insertion of a Tenckhoff catheter and then after 1, 3, 6 and 12 months of treatment. The highest assessed mean serum urea concentrations during treatment were 19.8 +/- 2.3 mmol/l (arithmetic mean +/- SE of the mean), creatinine 815.1 +/- 43.1 mmol/l. The haematocrit improved significantly due to CAPD. From the mean value of 22.5 +/- 1.7% recorded one month before treatment it increased to 32.8 +/- 2.5% after 12 months of therapy. In five patients CAPD made it possible to discontinue and in two to reduce antihypertensive medication. During the investigation period the authors did not detect a drop of total protein and albumin in serum. Serum cholesterol increased significantly during treatment. Peritonitis was recorded four times during the total period of 70 months of treatment, i.e. on average one episode during 17.5 months of treatment. Based on their results the authors conclude that CAPD is at present one of the very effective methods of treatment of chronic renal failure. The incidence of peritonitis was already during the first year when treatment was initiated comparable with the results in departments where it is commonly used and after further experience it declined to one episode per 38.8 months of treatment. The method deserves wider application than hitherto.

Adult↗

PubMed1993

[Carcinoma of the lung in patients with pneumoconiosis].

From 614 patients with notified pneumoconiosis who died in 1964-1992 on necropsy carcinoma of the lungs was found in 87, i.e. 14.1% (in 48 it was the cause of death). The incidence in individual years did not differ significantly; on evaluation in relation to the diagnosis of pneumoconiosis an insignificantly more frequent incidence was found in complicated pneumoconiosis of miners. On evaluation by work places miners in black coal mines and workers in quarries were affected more frequently, the difference being at the borderline of statistical significance. As to the histological aspect, most frequently squamous cell carcinoma was involved, the site was most frequently in both upper lobes. The carcinoma was seven times associated with silicotic lesions, with anthracofibrotic lesions six times (a total of 14.9%). In lifetime carcinoma was detected in 55 of the patients who died, i.e. in 63.2%. As to aetiopathogenetic influences, the relationship with smoking is significant. The aetiopathogenesis of carcinoma of the lungs in patients with pneumoconiosis is most probably not uniform-the influence of smoking is beyond doubt, the carcinogenic effect of silica should be considered in patients with carcinoma in the scar. With regard to the repeatedly proved more frequent incidence of carcinoma of the lungs in patients with pneumoconiosis, frequent check-ups of patients with pneumoconiosis focused on possible detection of lung cancer are essential.

Adult↗

PubMed1992

[Clinical study of biocompatibility of dialysis membranes made from non-modified and modified cellulose].

Basic biocompatibility parameters of dialysis membranes made of non-substituted regenerated cellulose (NRC) and cellulose membranes with hydroxyl groups substituted, to a higher (H) or lower (L) degree, by dl-ethyl-amino-ethyl groups (DEAE), or by acetate (CA) were investigated in a 16-week clinical study, involving 10 long-term haemodialysis patients. In the 15th minute of dialysis, the decrease in blood leukocyte count, while using NRC (0.24 +/- 0.03 of baseline value, arithmetic mean +/- SEM) was deeper compared with that seen in DEAE-L (0.88 +/- 0.10, p < 0.001), in DEAE-H (0.79 +/- 0.10, p < 0.01), and in CA (0.73 +/- 0.05. p < 0.05). In the 15th minute of the procedure, C5a concentrations, reflecting complement activation, were higher in NRC (4.4 +/- 0.51 micrograms/L) than in DEAE-L (1.41 +/- 0.22, p < 0.001), in DEAE-H (1.68 +/- 0.47, p < 0.01), and in CA (1.68 +/- 0.22, p < 0.01). Activated clotting times were, in the 10th minute of the procedure, significantly longer in NRC (2.94 +/- 0.37 of baseline value) than in DEAE-H (1.74 +/- 0.10, p < 0.05) and, by the end of dialysis, the difference between these membranes (NRC: 1.47 +/- 0.21, DEAE-H: 0.85 +/- 0.08, p = 0.07) was close to the level of statistical significance. The authors conclude: 1. Substitution of the hydroxyl groups of regenerated cellulose reduces the decrease in leukocyte count and complement activation in the initial phase of haemodialysis. 2. At the same time, substitution by DEAE groups may raise thrombogenicity, as indicated by the shorter activated clotting times.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

[Results of studies of indicators of hemostasis in hemodialyzed patients during administration of 1-deamino-8-D-arginine vasopressin].

The fibrinolytic activity (FA) evaluated according to the euglobulin clot lysis time was in haemodialyzed patients (3.0 +/- 0.2 arb. u.) lower than in patients with chronic renal failure treated by conservative methods (4.7 +/- 0.6, p less than 0.05) and than in healthy subjects (4.2 +/- 0.4, p less than 0.05). After stimulation by intravenous administration of 1-deamino-8-D-arginine vasopressin the FA in haemodialyzed patients rose to (4.5 +/- 1.6), less than in conservatively treated (14.1 +/- 2.1, p = 0.06) and than in healthy subjects (18.2 +/- 3.9, p less than 0.001). By using specific methods it was proved that the inadequate rise of FA in haemodialyzed patients after stimulation is conditioned by a defect of the release of the plasminogen tissue activator from the vascular wall. Contrary to healthy subjects (7.0 +/- 1.3 vs. 16.7 +/- 2.3 ng/ml, p less than 0.01) is plasma concentration in haemodialyzed subjects (5.3 +/- 0.5 vs. 7.9 +/- 0.8, NS) did not increase significantly. Repeated examinations of some of the haemodialyzed patients revealed that almost 20 months of regular haemodialysis do not lead to further changes of basal (2.9 +/- 0.3 vs. 2.8 +/- 0.2) nor stimulated (4.2 +/- 0.5 vs. 4.8 +/- 0.9) FA. Basal plasma concentrations of the von Willebrand factor were in the dialyzed patients (89.1 +/- 8.8%) higher than in healthy subjects (67.2 +/- 4.4, p less than 0.05). After stimulation the concentration of the von Willebrand factor increased significantly in healthy subjects (99.1 +/- 4.3, p less than 0.01), but not in dialyzed patients (82.9 +/- 3.1, NS), obviously due to the pathological reactivity of their vascular wall. The above findings may be associated with thromboses and atherosclerosis in patients on long-term dialysis.

Adult↗

PubMed1991

What are the causes of unsatisfactory control of arterial hypertension in the population?

A cross-sectional epidemiological study was conducted in the late 1980's in 660 men and 440 women, aged 35-60 years to assess the level of control of arterial hypertension (AH) in an industrial population. A relatively high rate of blood pressure (BP) assessment was found; only 2% of those screened had never their BP measured. Despite this, 44% of men and 40% of women with a high BP were unaware of their AH and conversely 15% of women and 12% of men with a positive history of AH were found to have BP less than 140/90 mmHg. Sufficient AH control was provided only in one fifth of the total amount of 300 hypertensive subjects. The paper evaluates the detection rate of our epidemiological study designed to assess the current status of control of AH and the causes of the unsatisfactory level of detection and control of a high BP are discussed.

Adult↗

PubMed1991

Serum cholesterol increase in a middle-aged male industrial population during ten years (1976-1986) and general food consumption changes in Czechoslovakia.

The authors evaluate the coronary risk factor changes in middle-aged men from the point of view of changed nutritional habits of the whole population (yearly per capita consumption of different food). They compared 3,754 men aged 40-50 years when screened in 1976-77 (Skoda I Study) and 568 men aged 40-50 years when screened in 1986-88 (Skoda II Study). During the 10-year period, a significant decrease of smoking habits was observed, hypertension prevalence remained unchanged and hypercholesterolaemia prevalence increased significantly. The estimated yearly per capita consumption of meat and fat remained unchanged in the years 1975-1985, however, the structure of consumption revealed a gradual change towards food containing high amounts of animal fat. Education efforts during the 10-year period (1976-1986) led to a decrease in smoking habits in middle-aged men leaving hypertension control unchanged. The observed increase of cholesterol levels may be attributed to inappropriate nutritional habits gradually worsening in the whole population probably due to a socio-economic depression.

Adult↗

PubMed1990

[Improvement in the detection and control of hypertension in the industrial population of the Skoda Plzen factory 1976-1986].

The authors investigated the effect of the ten-year intervention programme on the standard of detection, control and effectiveness of treatment of arterial hypertension in an industrial population. The prevalence of hypertension did not change during the investigation period (about 24%). In group B (1986) a decline of the blood pressure was recorded in all age groups on average by 10/0 mmHg (1.3/0 kPa) in men and by 15/9 mmHg (2/1.2 kPa) in women. In men detection improved and the ratio of treated hypertonics increased (p less than 0.05); in women the trend of improvement was not significant. The number of untreated subjects with hypertension did not change in the course of 10 years (15-16% of all hypertensive subjects). 50% hypertensive men and women were treated effectively in group A and 59% men with high blood pressure in group B; the ratio of effectively treated hypertonic women in group B did not change. There was no difference in the level of control of hypertension between men and women in either group. The differences in the prevalence and treatment of severe hypertonics (i.e. DPB greater than or equal to 110 mm Hg = 14.7 kPa) were not significant when comparing groups A and B (2.4% of group A and 4.1% of group B).

Adult↗

PubMed1990

[Adjuvant therapy of lung cancer].

The authors evaluated in a retrospective investigation the effectiveness of adjuvant postoperative chemotherapy (ChT) and radiotherapy (RT), as compared with surgery alone, according to morphological types and stages of cancer lung (CaP). In a group of 321 patients 143 were treated by operation alone, 36 by operation and RT and 53 by operation and ChT. ChT involved administration of Cyclophosphamide, 30 mg/kg, at three-week intervals, some of the patients were also given vincaalkaloids. Therapy was repeated after 6-month intervals. According to the gross mortality data the probability of survival (PP) was compared by Kaplan-Meier's method. Improved PP was proved in patients with small cell lung cancer (MbCa) treated by operation and ChT and in third-stage disease treated by adjuvant ChT. In stage I of CaP adjuvant ChT and RT cause deterioration of the perspective of survival, as compared with operation alone and in stage II adjuvant ChT and RT are no advantage. The authors recommend adjuvant ChT in patients with surgically treated small-cell carcinoma and in stage III of operated CaP. They draw attention to the different response of tumours to adjuvant ChT and RT according to types and stages of CaP, to the fact that RT does not prolong the survival and to the possibility of preoperative ChT and RT in some types and stages of CaP.

Combined Modality Therapy↗

PubMed1990

[Relation of morbidity from gastric and duodenal ulcers with work disability and dispensarization].

A retrospective investigation of the morbidity from peptic ulceration of the stomach and duodenum associated with work incapacity in 1985-1987 in workers of a large engineering factory provided evidence that personal data on this morbidity processed on a computer are along with the medical documentation of individuals a useful source of information for the selection and enlistment of patients into dispensary care and for its evaluation. The investigation revealed at the same time some methodological aspects of dispensarization.

Adolescent↗

PubMed1990

[Effectiveness and reliability of preoperative studies in patients with lung cancer].

The data of documentation of 267 operatively treated patients with lung cancer are shown in a retrospective study. The patients were treated in the clinic for tuberculosis and respiratory diseases of the faculty hospital Plzen. In 50% of the cases the results of histological and cytological examinations correspond with the surgical observations. Results of the pneumomediastinography and the computed tomography of the lung and mediastinum correspond with findings through the operation in 71% and 73% respectively. Through out the last three years the reliability of the cytological diagnosis was increased significantly (p less than 0.01).

Biopsy↗

PubMed1989

[Plasma proteins and other substances in membrane plasmapheresis. Relation to possibilities and limitations of this therapeutic method].

The authors investigated the effectiveness of therapeutic membrane plasmapheresis and its influence on plasma concentrations of 17 proteins, cholesterol, triacylglycerols, urea, creatinine and uric acid. To this end they made 30 operations on monitors A 2008 PF with filters Plasmaflux P 2, where they exchanged one volume of plasma and replaced it with isooncotic albumin. They assessed the plasma concentrations of the investigated substances before, in the course of and after the operation, estimated sieving coefficients during the 15th and 90th minute and the clearance. Under conditions in vivo they confirmed that the sieving coefficients of the investigated substances approach the value of "1" and the clearance of the filtration rate, i.e. that the investigated substances pass easily through the plasmafilter and that plasmapheresis removes the substances non-selectively. They demonstrated that the assessment of plasma concentrations alone can lead to underestimation of the effectiveness of the operation. Assessment of sieving coefficients and clearance makes more adequate evaluation of the effectiveness of the procedure possible. Assessment of sieving coefficients and clearance made it obvious that plasma concentrations do not depend only on the amount of substance removed by plasmapheresis but also on other factors which must be investigated. The authors' findings support efforts to introduce methods for the selective removal of pathogenetic substances.

Blood Proteins↗

PubMed1988