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Biomedical subjects

K Donat

Publications and source records attributed to K Donat.

At least 19 recordsLinked to original sources
PubMed1988

[How many patients with acute myocardial infarction can be treated by thrombolysis?].

Thrombolytic treatment of acute myocardial infarction (MI) is limited by the time elapsed since onset, accuracy of the diagnosis and the presence of contra-indications. These factors were prospectively investigated in 173 consecutive patients with proven acute MI, admitted to a city hospital between July and December 1986. Fifty-eight patients (35%) were admitted within three hours of onset of symptoms. Delay in calling a doctor or ambulance was significant: 50% of patients waited for more than two hours after onset of symptoms, 40% more than three hours. Duration of transport to hospital averaged 30 min. Infarct-typical angina of at least 30 min had been present in 143 patients (83%). Atypical symptoms and silent MI was more frequent in the older patients. Diagnostic ST segment elevation of 2 to 3 mm on admission was present in 59 (34%) patients. After consideration of contraindications, present in 120 patients with altogether 165 potential factors, thrombolytic treatment was possible in only seven (4%) of those with the greater ST elevations within three hours after onset of symptoms and 13 (7.5%) within six hours. The most frequent contraindications were age (over 75 years), hypotension, re-infarction at the same site, intramuscular injections (unspecified drugs) within the preceding seven days, or resuscitation with cardiac massage before admission.

Age Factors↗
PubMed1986

Community phase of cardiac rehabilitation.

Although their effects cannot be shown to statistically alter coronary heart disease mortality or morbidity, voluntary health organizations throughout the world clearly play an important role in bringing about favorable changes in the natural history of this disease and in the community phase of its management. In particular, voluntary organizations are able to conduct research surveys and field trials and by so doing favorably influence state health administration. They are able to correct temporary deficiencies in health services, particularly in the form of psychosocial support and cardiac health education. Observers note that the major change in community phase management has occurred with the wider use of coronary bypass surgery since 1975. More objective data, especially relating to psychosocial factors, can be expected when further research (especially the MONICA Study) is completed. Throughout the world, however, existing voluntary health organizations could be more active in the community phase of cardiac rehabilitation. It would seem an area where such organizations could well do more. A challenging question that should be constantly reviewed is 'Can we do more to reduce the effects of invalidism in cardiac patients?'

Australia↗
PubMed1985

[Acute myocardial infarct in a metropolitan area].

In a retrospective study the course of acute myocardial infarction was investigated in 1840 patients treated in 1980 in eleven Hamburg hospitals (90% of hospitals admitting emergencies). 71% of patients were over 60 years of age, infarction frequency reached its peak in the eighth decade. Compared to prior investigations the percentage of women was higher both as a whole and in patients over 70 years of age (ratio men to women = 1.8 : 1). In comparison with the overall population of Hamburg, infarction rate was not increased in certain social classes. Frequency of "silent" infarctions was 4 to 5 times higher in patients of 70 years of age than in younger ones. Left ventricular failure and conduction disturbances increased with age, while extrasystoles occurred at all ages without difference. Hospital mortality of acute infarction was 29% for men and 37% for women. Striking results are the higher mortality of younger women and the considerable increase of mortality in patients over 70 years of age, probably due to change of age structure, the large number of acute reinfarctions (29%), and the short admission time. 40% of patients of all age-groups were admitted within 3 hours after onset of infarction.

Adult↗
PubMed1982

[Depletion of normal and denervated brown fat in the gerbil (meriones unguiculatus M.-E. 1867)].

Our investigations have shown that depletion of brown fat is prevented by its complete denervation. The cutting off either the spinal nerves or the perivascular nerves only leads to a partial depletion. From this we conclude that the brown fat is innervated via these two nerve paths. The depletion of brown fat is accompanied by the development of different cell types that are described as different stages of this process. The investigations eliminate the possibility that brown fat may change into white fat.

Adipose Tissue↗
PubMed1981

[Therapy of coronary insufficiency with diuretics].

Saluretic drugs like thiazide and benzothiadiazine (chloruretic sulfonamides), potassium-sparing diuretics (amiloride, triamterene and spironolactone) and diuretics with an effect on the loop of Henle (furosemide, ethacrynic acid, bumetadine and etozoline) support the efficiency of digitalis preparations in such cases, in which the load of the heart may be diminished by hemodynamic disburdening of the myocardium through reduction of preload. Here, reduced venous filling pressure is the result of increased elimination of sodium and of dehydration. These drugs are efficacious, but can endanger the patient even if prescribed under right indication and by right dosage. Therefore they should be taken only if necessary and only under continuous medical supervision. The therapeutic breadth of the different diuretics is more favourable than that of the digitalis glycosides. Thus the careful prescription of diuretic drugs can enhance digitalization significantly, especially for patients of higher age with increased sensitiveness on heart glycosides or with supposedly "refractory" heart failure. A rapid intravenous injection of furosemide is the best method for the emergency treatment of an acute pulmonary edema in consequence of left heart failure. This is efficacious in a shorter time and in a better manner than an initial injection of heart glycosides. The favourable effect of diuretic drugs in myocardial failure may be explained by improving the force-velocity curve of the heart with reduction of preload of the myocardium and with diminished venous congestion.

Diuretics↗
PubMed1980

[Results with outpatient coronary groups. Five years of the Hamburg model (author's transl)].

Three and six months after joining the outpatient coronary groups in their area, follow-up studies became possible in 543 patients after their myocardial infarction. The subjective complaints had fallen in this six months, the physical performance measured ergometrically, had distinctly increased. Patients who had joined the coronary group were able to work again significantly earlier. At the time of the.follow-up 5% were pensioners, 76.2% were able to work, 51% fully active at their old workplace.

Antihypertensive Agents↗