PubMed Health⌕ Search

Biomedical subjects

J Masopust

Publications and source records attributed to J Masopust.

At least 19 recordsLinked to original sources

[Prevention of venous thromboembolism in psychiatry].

The hospitalized patients of the psychiatric wards represent a risk group for the development of venous thromboembolism. Apart from sedative administration, total movement reduction, bad life style and daily routine and increased body weight, there is negative impact of dehydration, prolonged hospitalization and sometimes immobilisation in consequence of mechanical restraints. A large amount of patients are treated with antipsychotics that have a series of adverse effects. Depending of the drug used, the most frequent of them are somnolence, fatigue, extrapyramidal syndrome, hypotension, hepatotoxicity, increased body weight, prolongation of the QT interval of the ECG with a risk of ventricular arrhythmias, hematopoietic disorders, lipid or glycide metabolism disorders or hyperprolactinemia. Another potential adverse effect of these drugs is the heightened risk of venous thromboembolism development (deep vein thrombosis and/or pulmonary embolism). There is the risk of a pathological blood clotting event in psychiatric patients, especially those treated with antipsychotics. Although it is not high, it can have fatal consequences when combined with a relatively frequent pulmonary embolism and difficult diagnostics of thromboembolism. An algorithm for thromboembolism prevention has been developed. It involves important general risk factors of venous thrombosis (VTE history, immobilisation, malignancy, age over 75 years etc.) and also markers (physical restraints, dehydration, obesity, antipsychotics use) that can participate in the pathogenesis of venous thrombosis in the hospitalized psychiatric patients with limited motility. The authors believe that this prophylaxis is indicated, safe, effective and that it improves the quality of life at relatively low costs.

Anticoagulants↗

[Monitoring parameters of energy metabolism in patients with acute abdomen--possible prognostic factors?].

UNLABELLED: The prognosis of patients treated on account of serious surgical abdominal attacks is influenced apart from the severity of the condition also by failure of the energy metabolism. Some disorders of the milieu intérieur are the result of a deficient energy situation, energy failure participates in the development of organ disorders, failure and death. The cellular energy metabolism can be expressed as the so-called "redox-state" which can be assessed directly by estimating the ratio of ketone substances in arterial blood--AKBR--Arterial Ketone Body Ratio. The objective of the study was to test whether assessment of the AKBR index is possible, what is its importance in clinical practice and to compare its validity in particular with the commonly used scorin system APACHE II and MPI. The authors evaluated 24 patients operated on account of obstruction of the large intestine and 8 patients operated on account of peritonitis of intestinal origin. While evaluation by means of the MPI score helped to assess the prognosis, evaluation by the APACHE II score did not contribute to prediction of the development of the disease. Assessment of AKBR was of prognostic value only in patients who died during treatment. CONCLUSION: For practical use it is necessary to improve and simplify biochemical examination and scoring systems and learn how to utilize them better.

APACHE↗

[Use of radiopharmaceuticals, radiation burden and radiation risks in examination procedures in nuclear medicine].

Consistent with the worldwide development of nuclear medicine, in the Czech Republic in 1987 to 1996 partly the spectrum of used radiopharmaceutical preparations and their ratio changed. In the majority of radiopharmaceutical preparations the mean administered activity increased by 20 to 80% and the range of activities administered in different departments diminished somewhat. Adherence to principles of radiation protection of patients is assisted by guidelines of administered activities of radiopharmaceutical preparations laid down in new regulations on radiation protection valid in the CR from the middle of 1997. The radiation burden associated with the majority of examinations in nuclear medicine expressed as the effective dose is comparable with the radiation burden of radiodiagnostic examinations, only after administration of preparations with 131I, 201Tl, 67Ga and 111In it is markedly higher. Based on knowledge of the effective dose it may be concluded that the lifetime extra risk of a fatal tumour due to administration of radiopharmaceutical preparations is by two to three orders lower than the lifetime risk of spontaneous development of fatal tumours. A special feature of radiation risk is its hypothetical character--it is frequently projected into the distant future of human life, contrary to immediate non-radiation risks of some medical procedures and risks in the living environment which frequently are higher. Any examination using ionising radiation can be made only if the expected health benefit for the patient is significantly greater than the radiation risk. Excessive fear of radiation risk should not lead to refusal of justified examinations with possible subsequent serious health damage for the patient.

Czech Republic↗

[Treatment of retinal venous occlusion with hemodilution and laser coagulation. Prevention of secondary glaucoma].

BACKGROUND: Neovascular glaucoma is similarly as other ocular neovascularizations, a complication of retinal venous occlusions. The objective of the present work was to assess whether it is possible to prevent this complication by isovolaemic haemodilution and laser coagulation of the retina. METHODS AND RESULTS: Between 1991 and 1996 we used in 10 patients with occlusion of the central retinal vein and in 25 patients with occlusion of the branch of the central retinal vein repeated haemodilution with reduction of the haematocrit to 0.36. In case of soft retinal exudates the retina was treated by laser coagulation. The whole group comprised 28 men and 7 women. The patients' age was 42 to 76 years, 14% of the patients were under 50 years. The mean follow-up period was 29.5 months. During the investigation period so far none of the patients developed neovascular glaucoma. After treatment venous collaterals developed in the retina in 48.5%, in the disc of the optic nerve in 16% of the patients. Improved visual acuity was recorded in 90% of the patients after occlusion of the trunk and in 44% patients after occlusion of the branch of the central retinal vein. CONCLUSIONS: Adjustment of rheological conditions by haemodilution improved for three months the haemodynamic conditions in the affected retina, promote recanalization of the occluded vessels and the development of a collateral circulation and prevented neovascularization. Based on their experience the authors assume that haemodilution combined with laser coagulation has a positive impact on the visual prognosis, but in particular on prevention of neovascular glaucoma, which so far did not develop in the thus treated patients.

Adult↗

[Computer-assisted interpretation of laboratory results].

The clinician-the patient-the laboratory are parts of one communication system. Computer based communication between laboratory and clinician is fast, highly reliable, and accurate. Computer assisted interpretative reports are a natural consequence of the requirements of problem solving strategies in clinical and laboratory medicine.

Clinical Laboratory Techniques↗

[Clinical biochemistry and laboratory medicine in the 21st century].

The author gives an outline of the assumed development of clinical biochemical examinations in future decades based on the development during the past 40 years. The development of biochemical analyzers will probably mean more perfect robotization; the increase in capacity (number of tests performed per hour) probably will not result from more rapid individual analyses (the rate of 900 tests/hour is probably optimal) but the capacity will be increased by doubling and trebling of critical elements (photometry or technique of measurements, pipetting etc.). Probably the volume of blood samples will not be reduces (to less than 1-2 microliters); however, amplification techniques will be used far more (as at present the polymerase chain reaction and others (for replication of cellular substances such as DNA). There will be a shift and greater use of "in vivo" techniques such as magnetic resonance spectroscopy and examinations using biosensors (because of the possibility and in particular expedience of examining some analytes continuously). The examined spectrum will be extended by further substances (in particular those with a short-term existence such as e.g. cytokines, selectins, adhesive molecules etc.; manifestations of circadian dynamics will be followed up much more e.g. in tumours, or chronopharmacokinetics of some drugs. A great development may be foreseen in the sphere of the use of computer technique for evaluation and communication of laboratory data and other data on the patient. For consultations global (or at least regional) computer networks will be much more widely used.

Chemistry, Clinical↗

Midodrine, a new therapeutic agent: recent experience.

Midodrine, marketed as Gutron by Hafslund Nycomed, was given at a dose of 2.5 mg three times daily always half an hour after the main meal for a period of 84 days to 8 women in the age of 25.42 years--average 34.5 yrs--and BMI of 19.8. These women with a blood pressure value below 100/60 mmHg most of the time displayed signs of neuroticism but had no organic and neurologic lesion. Clinical internal examination, Jarmatz-de Marée test, ECG-supine, standing, Holter dynamic ECG, ergometry, arterial and venous plethysmography, Doppler distal pressures-supine, standing, clinical neurological examination, EEG, perfusion brain tomography-supine, standing, urine examination--chemically and microscopically--, blood count, Na, K, Cl, glucose, urea, creatinine, uric acid, bilirubin, gamma-GT, alk. phosphatase, LDH, ALT, AST, thrombocyte index and the count of desquamated endothelia in blood before and after the end of 84-days Gutron therapy were carried out. It was ascertained that: (1) Gutron had no side effects; the marked subjective improvement reported by all patients persisted for months after the end of therapy. (2) No changes in biochemical parameters, ECG, Holter ECG monitoring, pulse rate, Doppler index and EEG were found. (3) Gutron did not raise the tendency to platelet aggregation and had no toxic effect on the vascular endothelium as demonstrated by unchanged thrombocyte index and endothelaemia. (4) Gutron administration was associated with a significant rise in upright diastolic pressure, especially when standing for prolonged periods--Jarmatz-de Marée test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Neurohumoral relations in neurological and psychiatric patients.

Sixteen patients-epileptics, alcoholics, psychotics and post-contusion cases-were subjected to neurological, psychiatric, psychological, morphological (X-ray, CT, NMR), physiological (EEG, polysomnography, evoked potentials), immunological and SPECT examination. Most had CT and SPECT signs of focal brain damage. The results were but exceptionally due to injury, most were of unknown etiology. This tallied with EEG focal abnormalities, mainly sleep disorders, sometimes subjective ones, but invariably detectable objectively. In each case there was REM, in some also NONREM sleep deficiency. Half of the cases were tested immunologically, each time with positive results: increased levels of acute-phase protein and stress-reaction proteins. As copious literature and our experience show, the above pathological condition, rather than being accidental, constitute regardless of etiology, an integrated entity which could be called "programme cerebropathy". The primary role is played there by the epileptic focus and its properties, in particular, the speed of discharge and localization and brain stem humoroergic systems, i.e., their performance and mutual balance. There is a program sequence of events, first, and epileptic focus acting on the neighborhood, the rise of secondary and tertiary foci, and influence over the thalamocortical system. Soon afterwards, epileptic activity begins to act on brain-stem structures. This results in changes in sleep, mood, psychic output, immunity, endosecretion, and in paroxysms.

Adult↗

[Detection of cerebropathy in neurologic and psychiatric diseases].

The authors made a comprehensive examination of 16 patients--epileptics, alcoholics, psychotic subjects and patients after cerebral contusion. The patients were subjected to a neurological, psychiatric, psychological examination as well as to a morphological examination (X-ray, CT, NMR), physiological examination (EEG, polysomnography, evoked potentials), immunological examination and SPECT. The majority of patients had positive CT and SPECT findings suggesting focal brain damage. These results could be explained only in exceptional cases by injury, the majority was of unknown aetiology. With this corresponded focal EEG abnormalities and in particular sleep disorders, sometimes subjective but always detectable by objective methods. There was always a shortage of REM, sometimes also NONREM sleep. Half the patients were subjected to an immunological examination which was always positive and comprised elevated acute stage proteins and proteins associated with the stress reaction. Numerous data in the literature and the authors' experience indicate that the mentioned pathological findings are not incidental and form, independently on the aetiology, an integrated unit for which the term cerebropathy can be used. A primary role is played by the epileptic focus and its quality, i.e. above all the rate of discharge and site and humoroergic systems of the brain stem, in particular their efficiency and mutual balance. The events have a programmed sequence. At the beginning an epileptic focus develops which influences the surrounding area, secondary and tertiary foci are formed and the thalamo-cortical system is affected. Soon this is followed by an apparent influence of the epileptic activity on structures of the brain-stem. The consequence are changes affecting sleep, mood, mental performance, immunity, endosecretion and paroxysms. Subsequently individual symptoms are already prepared but have a different latency of manifestation and the latter depends also on external provoking influences. The thalamo-cortical reaction is characterized by the manifestation of epileptic paroxysms and sets in after a different interindividual incubation following injury. The same applies to the hippocampal reaction manifested by the organic psychosyndrome. Some symptoms such as changes of immunity, sleep or endosecretory function are not necessarily manifested if the influence of the focus on structures of the brain-stem is not sufficiently intense. Conversely if the effect on the brain-stem and limbic structures is greater and the effect on the thalamo-cortical system smaller, psychotiform behaviour develops. Then there are marked changes of phoria, dynamogeny, rate, affectivity, sleep and hormonal secretion and its equilibrium.

Adult↗

A comparison of coronary risk factors in groups of trained and untrained adolescents.

Fifty-five experimental (29 male, 25 female) and 38 control (20 male, 18 female) adolescent subjects participated in this study to investigate the differences in coronary heart disease (CHD) risk factors in groups of trained and untrained adolescents. As expected the trained group (both sexes) had higher maximal aerobic power (VO2max) and lower systolic blood pressure at rest. The level of total cholesterol was the same in both groups, but the levels of high-density lipoprotein and its lipoprotein subfractions apolipoprotein (Apo-A) and Apo-A1 were higher, and low-density lipoprotein, Apo-B and triglycerides were significantly lower in the experimental group. The value of risk factors from the family history was the same in both groups, but the behavioural and physical risk factors such as smoking and percentage of body fat were lower in the trained group. It would appear that the group of adolescents, trained for several years in athletics and swimming, had a more beneficial lipoprotein profile and a lower level of behavioural and physical risk factors than the control group. For methodological reasons it remains an open question whether these profile differences are the consequences of self-selection procedures or the effects of training.

Adolescent↗

Favourable levels of cardio-vascular health and risk indicators during childhood and adolescence.

This paper is concerned with favourable levels of constitutional cardio-vascular health indicators during childhood and adolescence. A cross-sectional randomised sample of healthy Czechoslovakian children was investigated, because this population is habituated to a favourable life style. Twenty girls and 20 boys at ages 8, 12 and 16 years were recruited to the study. Statistical data for means and standard deviations are presented with regard to maximal aerobic power, haemodynamic variables such as arterial blood pressure, heart rate at submaximal and maximal muscular exercise, body fat content, blood lipids including total cholesterol and its fractions, high- and low-density lipo-proteins, fasting triglycerides and the apo-lipo-protein profile. The maximal oxygen uptake in absolute values increased with age in both sexes and the boys appeared to average higher than the girls at each age. When maximal aerobic power was expressed on a total body weight basis, boys appeared to average higher at age 16 years (56 ml X min-1 X kg-1) than girls (45.8 ml X min-1 X kg-1). The highest recorded heart rate for ergometric work averaged close to 200 min-1 in both sexes with no significant age differences. The diastolic blood pressure at rest did not change significantly with age or sex. Serum cholesterol levels were found to decrease significantly after puberty in boys (post-pubertal dip), but in the girls there was found no systematic change in mean values with age. When HDL was expressed as a percentage of total cholesterol there appeared to be no differences related to age and sex.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗