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Biomedical subjects

K Kozlíková

Publications and source records attributed to K Kozlíková.

16 recordsLinked to original sources

[Pharmacoeconomic profile of antibiotics used in the treatment of lower respiratory tract infections in geriatric patients].

The paper aims to evaluate the pharmacoeconomic profile of antibiotics (ATB) used in the treatment of lower respiratory tract (LRT) infections and thus contribute to rationalization of therapeutic procedures. Of 2870 patients hospitalized at the Geriatric Clinic of the Medical Faculty of Comenius University from 1 January 1999 to 31 December 2001, 189 patients with acute infections of the LRT were included in the retrospective study. For pharmacoeconomic evaluation, cost effectiveness analysis was employed, the principal parameter of which, cost effectiveness coefficient, was the ratio of the price of ATB treatment in Slovak crowns (SK) and the criterion of effectiveness (E), the number of asymptomatic days in a month. The authors separately evaluated ATBs administered perorally (p.o.); intravenously (i.v.), and sequentially, and they also compared i.v. and the corresponding sequentially administered ATBs. Statistical comparison revealed significant differences in the prices and cost effectiveness coefficients of individual alternatives of ATB treatment. Employed ATBs did not significantly differ in the criteria of effectiveness. According to the cost effectiveness coefficient (SK/asymptomatic day), fluoroquinolones were less expensive (median price/E: pefloxacin: p.o. 19.3; i.v. 29.1; sequentially administered 26.0, and ciprofloxacin: p.o., 14.7, i.v., 54.1, sequentially administered, 31.7). Sequential administration of ATBs (ampicillin-sulbactam, cefuroxime, amoxicillin-klavulanate, ciprofloxacin) was significantly cheaper in comparison with i.v. administration. With therapeutic equivalence, the total pharmacoeconomic profile of ATB treatment depended on the price parameter. In the selection of ATB it is also necessary to consider the price of the drug.

Acute Disease↗

[Reduction of astigmatism after perforating keratoplasty by adjustment of single running sutures and its influence on visual acuity].

The authors assess the outcomes of postkeratoplasty single running suture adjustment in 14 eyes (16 adjustments) of 14 patients (4 women, 10 men). The average age of patients was 39.68 year (ranging from 19 to 70 years). The suture adjustment was done in time span 2 to 39 weeks following after perforating keratoplasty (PKP), average 7.5 weeks. Follow up time was from 1 to 12 months, average 10.8 months. The value of keratometric and topographic astigmatism before suture adjustment were compared to the value of keratometric and topographic astigmatism 1, 6 and 12 months after suture adjustment. The changes of corneal refractive power and changes of uncorrected and best-corrected visual acuity were noticed as well. The mean value of keratometric astigmatism 7.47 +/- 2.69 D and mean topographic astigmatism 7.75 +/- 3.25 D before suture adjustment was decreased to 4.92 +/- 2.41 D and 4.83 +/- 1.46 D respectively one month after suture adjustment. These reductions of keratometric and topographic astigmatism (2.55 D and 2.92 D respectively) were statistically significant (p = 0.0416, and p = 0.0211 respectively). The mean keratometric astigmatism was still significantly lower (p < 0.05) after 6 and 12 months after suture adjustment in comparison to status before suture adjustment. In assessment of topographic changes we noticed small continuous increasing of astigmatism (1.27 D after 6 months and 0.2 D after 12 months after suture adjustment). These changes of topographic astigmatism were not statistically significant. The changes of mean corneal refractive power were not statistically significant as well. The mean uncorrected visual acuity increased significantly (from 0.13 to 0.34, p < 0.05) 1 month after suture adjustment. This improvement of uncorrected visual acuity was not significant after 6 and 12 months after suture adjustment. The best-corrected visual acuity improved from 0.37 to 0.61 after one month after suture adjustment but was not statistically significant and stayed still at the same level with minimal changes during follow up time.

Adult↗

[Effect of chronic Chlamydia infection with non-specific inflammation on cardiovascular complications in acute myocardial infarct].

It is known that local and systemic inflammatory processes play an important role in the genesis and development of atheroclerotic lesions and in the pathophysiology of acute coronary syndromes. This hypothesis is supported by findings of elevated parameters of the "inflammatory" reaction in the affected blood vessels but also in the blood of atherosclerotic patients. Known risk factors do not explain quite satisfactorily epidemiological cardiovascular phenomena and different manifestations of coronary heart disease. It is very probable that also Chlamydia pneumoniae is a risk factor. This assumption is based on evaluation of seroepidemiological data, examination of atherosclerotic plaques not only in humans but also in animal models with chlamydial infection. Based on retrospective and prospective evaluation of case-records the authors analyzed the incidence of cardiovascular complications in 83 patients with acute myocardial infarction (AIM), incl. 51 patients (31 men and 20 women, mean age 64.4 +/- 3.4 years who had a non-specific inflammation and chlamydial infection, and 32 patients (24 men and 8 women, mean age 64.7 +/- 3.6 years) who had chlamydial infections but no non-specific inflammation (in the blood). These patients were selected from all patients hospitalized during 1998-2001. When diagnosing acute myocardial infarction we applied WHO criteria, and the presence of at least two of three criteria was necessary: a history of prolonged (more than 20 min). stenocardia, electrocardiographic changes typical for ischaemia and/or necrosis and elevation of myocardial enzymes in serum, Non-specific inflammatory activity was present in patients (i.e. positive) if the following laboratory parameters were recorded: C-reactive protein > 5 mg/l assessed by the radial immunodiffusion method; fibrinogen > 4 mg/l assessed by the coagulation method according to Claus; leukocytes > 9.6 x 10(3)/microliter, leukocytes were counted automatically in a Coulter chamber; lymphocytes > 3.4 x 10(3)/microliter. Red cell sedimentation rate > 20 mm/hour. The activity was evaluated as positive when all parameters were elevated. The presence of chronic infection with Chlamydia pneumoniae was assessed qualitatively by antibody positivity (IgG) in serum using the microimmunoflurescent method (using a set from Labsystems Co.). The incidence of associated risk factors (obesity, smoking, diabetes, hyperlipidaemia and hypertension) is higher in the sub-group of patients with Chlamydia infections without inflammation, however, the difference is not statistically significant. The incidence of cardiovascular attacks was higher in the sub-group of patients with chlamydial infection and concurrent inflammation as compared with the sub-group of patients with chlamydial infection without inflammation. In case of re-infarction of the myocardium, a sudden cerebrovascular attack, death and arrhythmia the difference was statistically significant, while in case of cardiac failure and cardiogenic shock the difference was not significant. Patients with acute myocardial infarction with chlamydial infection and a concurrent non-specific inflammation had to be treated more often by combined (i.e. more intense) treatment, thrombolytic treatment, PTCA and surgery (bypass) of the coronary vessels as compared with patients with Chlamydia infections but without inflammation. The authors assume therefore that not only different risk factors but also the effect of non-specific inflammation and Chlamydia infection contribute towards the increased number of cardiovascular postinfarction complications. Therefore a therapeutic approach involving eradication of infection and suppression of the inflammatory reaction should be considered.

Arteriosclerosis↗

[Heart failure in hypertensive patients with left ventricular hypertrophy].

Left ventricular hypertrophy (LVH) is supposed to be a useful marker of cardiovascular complications during the course of hypertension. Authors compared the presence of heart failure, left ventricular diastolic dysfunction and chronic atrial fibrillation in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Hospital records of 192 hypertensives treated in our medical department during years 1996-1999 were analysed. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. Presence of LVH was found in 128 patients (mean age 65.9 years), absence of LVH in 64 patients (mean age 64.8 years). Both groups of hypertensives were matched by demographic parameters, by the presence of hyperlipidemia, by smoking habits. Hypertensive patients with left ventricular hypertrophy were more often treated by ACE inhibitors. There were statistically significant more patients with heart failure, left ventricular diastolic dysfunction and chronic atrial fibrillation in LVH-positive patients than in LVH-negative once. There was also statistically significant lower ejection fraction (50.3 +/- 11.4% vs 56.5 +/- 7.4%) in LVH-positive patients than in LVH-negative once. Left ventricular hypertrophy in patients with hypertension brings usually a complicated course of the disease with a high contribution to the development of chronic heart failure.

Adult↗

[Modern technical aids in the teaching of medical physics and biophysics].

The set of analogous electric and electronic models of physical and biological processes tested in the teaching process of Medical Physics and Biophysics is discussed. Measuring arrangement of model, digital storage oscilloscope and personal computer allows to display, record, save and process any electric signal. This proposed arrangement offers new possibilities for more detailed description of selected types of signals generally not only in the teaching process.

Biophysics↗

[Mapping electrocardiographic fields in heart hypertrophy].

The paper deals with chosen parameters that can be used for heart hypertrophy diagnosis and are obtained from body surface electrocardiographic maps. Parameters are analysed in repeated measurements of a patient with left ventricular hypertrophy that regressed due to treatment with verapamil.

Body Surface Potential Mapping↗

[Teaching of informatics at the Medical School of Comenius University in Bratislava and its evaluation by students].

In this study we analyzed meanings of students about teaching of informatics at our faculty with aim to improve it. They were asked to complete a questionnaire, which contained questions about organization of teaching, programmes and technical equipment. They had also possibility to suggest their improvements. We sorted the students into two groups according to their previous knowledge and experience in working with computers and then analyzed their answers. The results will be taken into account in further teaching of informatics.

Attitude↗

[Long-term electrocardiographic monitoring of patients after acute myocardial infarct].

The authors present an account on detailed electrocardiographic follow-up of a patient for 12 months after an inferior myocardial infarction. The patient died 14 months after the IM due to arrhythmia after previous remodelling of the left ventricle. The results assembled by means of superstandard methods of signal averaging electrocardiography (method of cumulative amplitudes, RMS signal and frequency analysis) and electrocardiographie body surface mapping (isointegral maps) are confronted with detailed clinical examinations and repeated echocardiographic investigations. The assembled results indicate that the applied superstandard methods make it possible to extract electrocardiographic parameters (presence of pathological high frequency peaks, raised values of partial cumulative amplitudes at the end of the QRS complex at higher frequencies, negative correlation coefficients from comparisons of integral maps with controls) which are a signal that the patient's life is threatened.

Aged↗

Electric instability after myocardial infarction displayed in body surface potential maps.

A longitudinal study during the first year after myocardial infarction (MI) was performed in 12 patients (pts) to evaluate the reversibility of the electric heart field changes occurring during the acute phase by means of body surface potential mapping (BSPM). Using correlation coefficients we showed that the inversion of electric processes in myocardial depolarization and/or repolarization during acute phase of MI displays irreversible damage of the myocardium that means high risk for the pt and that the healing of infarcted heart is not completed within 6 months after MI at least from the electrical point of view.

Body Surface Potential Mapping↗

Body surface isochrone maps of peak R in normal adolescent girls.

The aim of our study was to evaluate the adequacy of a new mapping device for obtaining a reliable set of normal maps characteristic for this approach. We studied body surface isochrone maps of peak R in four healthy adolescent girls using the mapping system CARDIAG 128.1 with 80 unipolar leads placed in a regular grid. The constructed maps were compared with published data using 10 criteria. None of the maps obtained could be regarded as normal. After evaluating the reasons for the "abnormality", we assume that they could be caused mostly by the processing of signals. This fact can be eliminated by improving the existing software.

Adolescent↗

[Surface integral maps, their characteristics and methods of quantitative analysis].

Integral maps (IM) enable considerable reduction of measured data with preservation of all characteristics of electric field of the heart with exception of the time sequence of activation. Review article offers a definition of the term IM and explains the mode of their construction, depiction and analysis as well as the principles of derivation and variation maps. A review of qualitative and quantitative parameters used in analysis of IM in humans is given. There are also mentioned modes of comparison of IM from simple, directly readable parameters to complicated mathematical and statistical methods of processing.

Electrocardiography↗