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Biomedical subjects

I Balazovjech

Publications and source records attributed to I Balazovjech.

At least 37 records · Page 2Linked to original sources
PubMed1996

A 5-year follow-up of preventive approach to patients with essential hypertension.

We examined the effect of a 4-5 week spa programme consisting of hypertension control education, physical education and smoking cessation on a long-term risk factor control. Two hundred and twenty hypertensive males underwent a 1 month training programme. At the end of the month, improvement had occurred in blood pressure (BP), heart rate (HR) exercise capacity, degree of obesity and serum cholesterol and triglycerides. At 5-year follow-up several parameters still showed improvement. The mean resting, exercise and recovery BP was lower than initial values as was the double product. The subjective and objective load tolerance during exercise had also improved. Half of the patients required less medication than initially to control their BP and in 80% of cases the BP was either the same or lower than initially. The mean heart size did not change from control values; 84% of patients felt that their general health improved. The mean triglyceride level was lower than at the start and the number of smokers had fallen from 33 to 21%. On the other hand several parameters showed disappointing results. The weight and serum cholesterol and risk factor score remained unchanged and mean resting HR actually increased. Only 10% were exercising regularly and 20% had a worsening of their BP. Thus intensive short term intervention studies may help reduce some cardiovascular risk factors temporarily but the long effect of this intervention in the control of risk factors is still limited.

Adult↗
PubMed1996

[Therapeutic approach in patients in hypertensive crisis].

The clinical picture of a hypertensive crisis is not determined only by the blood pressure reading but mainly by the associated symptoms of acute organ damage: neurological, cardiovascular and renal symptoms. The approach to the patient depends on the fact whether an emergency or urgent condition is involved. The authors review at first general principles of treatment of hypertensive crises. The analyze the therapeutic approach to different clinical conditions.

Acute Disease↗
PubMed1995

[25 years' experience with diagnosis of pheochromocytoma].

The author submits his 25-year experience with the diagnosis of pheochromocytoma in 36 patients. He evaluates the clinical picture by discrimination analysis of subjective symptoms and objective signs of the disease. Hypertension--by 24-hour monitoring of the blood pressure. In case of slight elevation of catecholamines he uses the Estulice test. In liminal cases patients are dispensarised. Due to a higher frequency of CT examinations in hypertonic patients findings of adenomas of the adrenals cumulate which are hormonally inactive. Gammagraphy can in that case confirm a functionally active pheochromocytoma, it can however produce also a falsely positive finding with an extraadrenal localization. Non-invasive detection of the site of a pheochromocytoma (computed tomography, ultrasonography, metaiodobenzyl guanidine gammagraphy, the finding of an increased catecholamine production) suffices for indication of surgical treatment. The author tries to avoid invasive examinations (angiography), as well as pharmacological provocation tests. Symptoms of catecholamine heart muscle disease can simulate the electrocardiographic finding of acute myocardial infarction which makes decision taking on the therapeutic procedure more difficult. After alpha-blockers and in particular after a successful operation the electrocardiographic changes are restored to normal. After early assessment of the diagnosis and surgery the disease has at present a favourable prognosis.

Adrenal Gland Neoplasms↗
PubMed1994

HPLC-ED determination of catecholamines and their metabolites in urine.

High performance liquid chromatography (HPLC) with electrochemical detection (ED) was applied for the monitoring of catecholamines (epinephrine - E, norepinephrine - NE, dopamine - DA) and their main metabolites (homovanillic acid - HVA, vanillylmandelic acid - VMA) in urine samples of patients with the pheochromocytoma diagnosis. Both amperometric and colorimetric detectors were tested for the clinical applications and the results were compared. The optimization of separation conditions was worked out, especially the effects of mobile phase compositions (pH, ionic strength, organic modifier and ion-pair agent concentrations). Dependences of capacity ratio values k' on all optimized components of the mobile phases were evaluated. Chromatographic conditions were optimized for the suitable chromatographic resolution (Rij > 1.25). Extraction recoveries for liquid-liquid and solid-phase extractions have been worked-out. Detection limits for catecholamines in urine were in the range of 0.3-0.6 ng/ml and 10-20 ng/ml for HVA, VMA using coulometric detector.

Catecholamines↗
PubMed1993

The effect of short-term celiprolol therapy on platelet function in essential hypertension.

The reduction of increased platelet aggregation in essential hypertension is one of the aims of modern antihypertensive therapy. Twenty-one hospitalized patients with non-treated essential hypertension were examined. The platelet function measurements were made before the therapy and after 1 week of celiprolol administration (300 mg/day). Fifteen essentially hypertensive patients were investigated before and after 1 week of placebo administration. Plasma beta-thromboglobulin was assayed, and the whole blood platelet aggregation (initial and total-induced by adrenaline and ADP) was measured. A significant decrease in adrenaline-induced (from 19 to 13%, p < 0.02) and ADP-induced aggregation (from 15 to 13%, p < 0.05) was observed after celiprolol administration. This reduction of adrenaline-induced platelet aggregation may be explained by the stimulation effect of celiprolol on platelet beta 2-receptors. Thus, some inhibitory effect of celiprolol on platelet aggregation is one of the further advantages of this drug in the therapy of essential hypertension.

Adult↗
PubMed1993

Compliance with antihypertensive treatment in consultation rooms for hypertensive patients.

Compliance with antihypertensive therapy was examined by a questionnaire in 124 essential hypertension patients in an outpatient hypertension clinic. It was found that antihypertensive drugs were used regularly by only 62% of patients, with forgetting and feeling of well-being without therapy the principal reasons given for irregular drug taking. Treatment of hypertension is reported to have a deleterious effect on physical and mental activity, routine activities, sexual activity, memory, athletics and family life in only 2% of patients. Patients who were aware that increased BP reduces life span used the prescribed drugs more regularly and came regularly for checkups compared with patients lacking the relevant information. Patients over 60 years of age and smokers exhibited the worst compliance. No significant differences were found for sex or duration of treatment. With regard to nonpharmacological measures, most patients were willing to begin a programme of regular physical exercise, reduce weight, learn relaxation techniques and reduce alcohol intake: smokers, however were unable to stop the habit.

Antihypertensive Agents↗
PubMed1993

[Regression of hypertrophy of the left ventricle in patients with hypertension after 6-month treatment with Fludex].

Indapamide (Fludex) administered in daily doses of 2.5 mg resulted in optimal improvement of the blood pressure in patients with mild or moderate hypertension. During the period of 6 months treatment that was tolerated well by the patients, no influence of indapamide on the levels of glucose, cholesterol, triglycerides, and creatinine in blood was observed. A mild decrease of serum potassium in blood was clinically not relevant. Using echocardiography and electrocardiography a regression of the hypertrophy of the left ventricle of the heart was observed.

Blood Pressure↗
PubMed1993

[Celiprolol increases the microcirculation in subcutaneous tissue and calf muscles in essential hypertension].

The microcirculation of the subcutaneous tissue and muscles of the extremities is changed already in the early stage of essential hypertension. Insight into the effect of celiprolol, a beta blocker of the third generation, on tissue microcirculation is of both pathogenetic and therapeutic value. On using the method of Na131I tissue clearance, the effect of celiprolol on the microcirculation of subcutaneous tissue and muscles of the extremities was studied in 21 patients with essential hypertension. Celiprolol was administered orally in the daily dose of 300 mg. After one-week administration celiprolol significantly reduced mean arterial pressure and significantly increased the microcirculation in the subcutaneous tissue of the hand and crus as well as in the calf muscle. Celiprolol was thus found to increase the microcirculation in those tissues of the extremities in which its decrease was recorded before onset of the treatment. The obtained results may be of therapeutic value particularly in patients suffering from ischemia of the lower extremities. (Fig. 2, Ref. 19.).

Adult↗
PubMed1992

Follow-up of outpatients with essential hypertension. A comparison of three methods of blood pressure measurement.

Compared with conventional, routine blood pressure measurement in the outpatient department of a hospital, 24-hour blood pressure monitoring provides more comprehensive information about blood pressure values in day-to-day life of the hypertensive patient. The hospital setting with all its stimuli affects the hypertensive patients so that their values will be statistically significantly higher compared with normal ones. Recent years have seen the introduction into clinical practice of self-monitoring by the patients themselves. Comparison of these three methods for blood pressure measurements revealed that self-monitoring may provide fairly accurate values comparable with those obtained by the "standard method", i.e., 24-hour monitoring. In view of the low variability of the mean value of blood pressure over a period of several days, self-monitoring can be employed in groups of selected outpatients on long-term follow-up.

Blood Pressure↗
PubMed1992

[Multicenter study of isradipine in the treatment of hypertension].

MIS is a one-year Multicentre Isradipine Study of the treatment of essential hypertension, in which participated seven centres in Czechoslovakia. The study comprised 144 patients with mild or medium severe hypertension. Isradipine belongs into the group of dihydropyridine derivatives with a high specific and low non-specific affinity to dihydropyridine binding sites of the L-type of calcium channels. After a four-week placebo period isradipine treatment (2.5 mg (1/2 tablet twice a day/was started. This dose increased to 5 mg (1 tablet twice a day) unless normalization of the diastolic pressure was achieved by a smaller dose. Monotherapy with isradipine normalized the diastolic pressure (less than 90 mmHg) in 44% of the hypertonic patients. 56% hypertonics where monotherapy with isradipine did not reduce the diastolic pressure below 90 mmHg were treated by a combination of isradipine and bopindolol. This group of patients had a significantly higher systolic and diastolic pressure, a higher number of erythrocytes and thrombocytes at the onset of the investigation. Addition of bopindolol to isradipine proved very effective. At the end of the one-year study 87% of the patients had a normal diastolic pressure. Isradipine as monotherapy and combined with bopindolol did not influence the metabolic risk factors of IHD and drug tolerance was very good.

Adrenergic beta-Antagonists↗
PubMed1992

MIS (Multicentric Isradipine Study of antihypertensive therapy).

One-year open Multicentric Isradipine Study (MIS) performed in 7 centres in Czechoslovakia included 144 patients with mild and moderate hypertension. Isradipine was given at a dose of 2.5 mg daily. If normalization of diastolic blood pressure (BP) had not been reached, the dosage was increased to 5 mg. Monotherapy with isradipine normalized diastolic BP in 44% of patients. Isradipine (5 mg daily) was combined with bopindolol in patients in whom isradipine alone failed to normalize diastolic BP. These had higher mean systolic and diastolic BP, body weight, erythrocyte and platelet counts at the beginning of the study. The combination of isradipine with bopindolol normalized diastolic BP in 87% of the group at the end of 48 weeks' treatment. Tolerance was excellent in 82% of patients. Treatment was discontinued in 8% patients, undesirable effects being the reason in 2%, ineffective therapy in 2% and poor adherence to therapy in 4%. Isradipine in monotherapy or in combination with bopindolol did not exert an adverse effect on the metabolic risk factors of ischaemic heart disease (cholesterol, glycaemia).

Adrenergic beta-Antagonists↗
PubMed1992

[Psychosomatic aspects of arterial hypertension].

In patients with labile hypertension aged 18-25 years the authors observed an increased sympathicoadrenal reactivity to mental strain caused by solution of a numerical square, parallel with a rise of diastolic blood pressure. Despite the fact that we do not know so far to what extent prolonged mental strain participates in the genesis and development of essential hypertension, the findings of the influence of some types of short-term strain on an acute rise of the blood pressure in hypertonic subjects should be used to modify the non-medicamentous procedure in treatment of the disease.

Adolescent↗
PubMed1992

[Wilson's disease and pregnancy].

The authors describe the case of a 27-year-old female patient with Wilson's disease who during penicillinamine treatment became pregnant and was delivered of a healthy infant. The diagnosis of Wilson's disease was confirmed by the finding of a Kayser-Fleischer ring in the cornea and a concurrent serum ceruloplasmin concentration lower than 0.20 g/l. Unrecognized and untreated, the disease is associated with the development of organ complications which in the end prove fatal. On the other hand, early diagnosis and effective treatment throughout life can prevent liver and brain damage and thus enable the patient to live a normal life and women can have a healthy child.

Adult↗
PubMed1991

Modulation of serotonergic and adrenergic systems by long-term antihypertensive treatment with enalapril.

Enalapril (Renitec, Merck-Sharp-Dohne, Rahway, USA) administered alone (Group I), or in combination (Group II) in a dosage normalizing blood pressure (BP) was investigated for its ability to inhibit adrenergic and serotonergic systems in a one-year study. BP normalization was achieved. Serotonin (5-hydroxytryptamine, 5HT) levels in platelet rich and poor plasma, urinary excretion of 5HT, adrenaline and noradrenaline decreased. Correlations between the changes in BP and the inhibition of serotonergic and adrenergic systems were found in the acute phase in Group I. In chronic effect the reduction of BP correlated with inhibition of the serotonergic system in both groups. Changes in adrenergic and serotonergic systems correlated in the acute phase in both groups; during chronic treatment only in Group II. It is concluded that a concurrent antihypertensive effect and the inhibition of sympathetic activity and 5HT amplifying mechanism (antiatherogenic effect) are of clinical importance for hypertension treatment and prevention of its complications.

Blood Pressure↗
PubMed1989

Catecholamine heart muscle disease in pheochromocytoma.

Many clinical symptoms and signs in patients with pheochromocytoma are evoked by the influence of catecholamines on the heart muscle and on the coronary circulation. In our work besides clinical features the ECG pictures of the patients were studied where the elevation of the ST segment with a negative coronary T wave but without a Q wave were observed. In the echocardiographic picture our patients showed a rather hyperkinetic heart action in the florid phase of the illness. For several years after surgery a nonhomogenous structure of the interventricular septum persisted. Hypertrophy of the septum was a less frequent finding. In patients with pheochromocytoma we suppose the signs mentioned above to be the manifestation of the catecholamine heart muscle disease (CHMD).

Adolescent↗
PubMed1989

[Gammagraphic imaging of pheochromocytoma using 131I-metaiodobenzylguanidine].

The authors present their first experiences with scintigraphic examination of pheochromocytoma by means of 131I-metaiodobenzylguanidine (MIBG). In two of the eight patients examined, the already established diagnosis of pheochromocytoma and paraganglioma was confirmed, in two the examination yielded confirmation of the presumed diagnosis, and in the remaining four patients presence of the tumor was excluded. In conformity with literary data, the authors found the given examination to be suitable for: 1. confirming the diagnosis of pheochromocytoma in cases with unequivocal CT findings, 2. excluding extraadrenal activity, 3. detecting relapses or the occurrence of an extraadrenal tumor, 4. detecting not suspect manifold endocrine neoplasias, 5. establishing the diagnosis of malignant pheochromocytoma, and 6. for examining patients presenting with a family history of pheochromocytoma.

3-Iodobenzylguanidine↗
PubMed1987

The effect of small doses of guanfacine (Estulic Sandoz) on the lipid levels and catecholamine excretion in patients with essential hypertension.

During three-month therapy with small doses of guanfacine (Estulic Sandoz) that were sufficient to control blood pressure in patients with stage II essential hypertension and led to a decrease in excretion of noradrenaline and vanillylmandelic acid, the authors found a decrease in the level of blood cholesterol in patients with hyperlipidaemia. There was no adverse effect on the levels of triglycerides, beta, pre-beta and alpha lipoproteins. The authors conclude that Estulic therapy is indicated in patients who, in addition to essential hypertension, have hyperlipidaemia.

Adult↗