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Biomedical subjects

M Kozák

Publications and source records attributed to M Kozák.

11 recordsLinked to original sources
PubMed1999

[Electric programmed ventricular stimulation using a permanent cardiac pacing system--a noninvasive method in arrhythmia].

BACKGROUND: Complex forms of ventricular arrhythmias often occur in patients with an implanted permanent cardiac pacing system. Some of the pacemakers are provided with software which allows electrophysiological testing of the cardiac conduction system by coupling with an external diagnostic pacemaker via their programmer. This method is non-invasive. METHODS AND RESULTS: In a group of 26 patients (19 males, 7 females) with an implanted pacemaker (Paragon III, Synchrony III, Sensorithm--all Pacesetter) complex ventricular arrhythmias were observed (class Lown IVa and higher). In these patients the electrical stability of the myocardium was tested by the described method (protocol: incremental pacing 90-220 bpm, pacing drives 110 bpm and 140 bpm with 1-3 extrastimuli). Complex ventricular arrhythmias were induced in 42% patients (n = 11), in this subgroup 55% (n = 6) was non-sustained ventricular tachycardia, 36% (n = 4) sustained ventricular flutter, 9% (n = 1) sustained ventricular tachycardia. Patients with non-sustained ventricular tachycardia were treated with beta-blockers, in the others the effective therapy was selected according to electrophysiological testing (amiodarone in 4 patients, ICD in 1 patient). During a 24-month follow-up the overall mortality was 7.7% (n = 2), sudden death mortality was 3.8% (n = 1). CONCLUSIONS: Programmed ventricular stimulation performed by a permanent cardiac pacing system is a simple and above all non-invasive method with no need for fluoroscopy. It can be repeated several times. It is not possible to pace from the right ventricle outflow tract. This is the main disadvantage. Nevertheless, by using non-invasive risk stratification methods (echocardiography, signal averaged ECG, heart rate variability, baroreflex sensitivity, dispersion of QT interval) the patients in need of an invasive study can be identified. This method can be considered an alternative screening method and a standard part of the investigation of the algorithm in patients with a previously implanted pacemaker.

Arrhythmias, Cardiac↗
PubMed1998

[Optimalization of rate adaptation using Holter functions in DDD/R pacemakers].

Introduction of the pacing rate adaptation according to the momentary metabolic needs added other programmable parametres which demand physician's attention during the initial postimplantation programmation and also in follow-up of pacemaker patients. The parametres setting is strictly individual with a need of feedback control. In some devices it is enabled by Holter functions as a part of pacemaker software. These methods were used to set the rate adaptive parametres in the group of 23 patients with implanted DDD/R pacemaker. The walking stress test was used. Model follow-up situations are presented in 3 case reports. Using Holter functions enables the physician to put patient's subjective complains in relation with actual heart rate--this is used to optimize the parametres of rate adaptation. The authors consider the Holter functions a necessary part of rate adaptive pacemaker software.

Aged↗
PubMed1997

[Selection and long-term effect of treatment in vasovagal neurocardiogenic syncope].

BACKGROUND: Syncope state performed by transient loss of consciousness connected with a postural tone decrease present still an important therapeutical problem. The authors use HUT testing for discovering of vasovagal etiology of a syncope. The aim of the study was to find out the optimal medication in treatment and prevention of VVS by repeated HUT drug testing in a group of positive patients. METHODS AND RESULTS: We examined a group of 300 patients (172 female and 128 male) age 35.26 +/- 13.47 years with an anamnesis of recurrent syncopes by HUT test. In 83 patients (27%) we set up a diagnosis of VVS. Thirteen patients (15.66%) were only followed without medication. The rest of the group (70 patients, 84.34%) started with a therapy. Testing was performed by repeated HUT according to the "Westminster protocol". HF and BP were measured by FINAPRESS 2,300 made by Ohmeda. The effective therapy was found in 64 patients (91.43%) of the group. For various reasons the therapy was changed and retested in 9 patients (14.06%). Beta1 selective beta-blockers were used in 51 patients (80.96%) theophyllin in 5 patients (7.94%), etilephrin in 6 patients (9.52%) and clonidine in 1 patient (1.59%). CONCLUSIONS: The therapy of VVS should be set-on according to the effective drug selection by serial drug testing in repeated HUT tests. The article shows a high predictive value of negative HUT test for a long term effect of tested therapy.

Adult↗
PubMed1996

[Head-upright tilt table test: a new method for diagnosis of vasovagal neurocardiogenic syncope].

The head upright tilt table test (HUT) has been unambiguously included into the screening algorithm of syncopes. The HUT is based on exposing patients to orthostatic stress. This easy, cheap and safe test makes it possible to diagnose neurally-mediated vasovagal syncope (NMS). The pathophysiology of the NMS is based on the hypercontractility of the myocardium, when with the body being orthostatic, the venous return to the heart is lower and then followed by protecting mechanism--vasodilatation and bradycardia--both controlled by the CNS. Nowadays there is a tendency to integrate examination schedules of the HUT and all possible types of responses have been defined.

Humans↗
PubMed1995

[Seasonal effect on serum levels of thyroid hormones in German shepherds and dachshunds and their health status].

A relatively frequent prevalence of dermatoses in summer has drawn our attention. Dermatoses of endocrine origin occur very often. We have noticed the deterioration of skin changes in animals with hypothyroidism. Bubeník et al. (1983), Webster et al. (1991), Reiter et al. (1988) reported that changes in concentrations of thyroid hormones were found in fallow-deer, sheep and hamsters due to the effect of temperature and season. Based upon this knowledge we have decided to observe the health status and function of the thyroid gland in two randomly selected groups of various size dogs--German shepherd and dachshund during four seasons. We observed following parameters: concentration of triiodothyronine (T3), thyroxine (T4), cholesterol (Chol) and total lipids (TL) in the blood serum, average temperatures in individual seasons. Blood was always withdrawn fasting in the morning from vena antebrachii. Concentrations of T3 and T4 were determined by the commercial kits RIA-test-T4 and RIA-test-T3 (Human-Lab, Kosice, Slovak Republic). The levels of cholesterol and total lipids were determined by the BIO-LA-tests (Lachema, Brno, Czech Republic). March, April, May were included into spring season; June, July, August into summer; September, October, November into autumn; and December, January, February into winter. The Slovak Hydrometeorologic Institute in Kosice provided the values of average temperatures in observed seasons. The average temperatures in individual seasons were the following: spring +9.8 degrees C, summer +18.4 degrees C, autumn +8.5 degrees C, winter -1.2 degrees C. During the observed period concentrations of cholesterol and total lipids ranged within the reference values in both breeds.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

[Neural syncope--a current therapeutic problem].

Syncope, a state performed by transient loss of consciousness connected with postural tone decrease present still an important therapeutical problem. It can vary from a benign physiological body reaction to a life-limiting situation. The authors of the article present HUT-testing to be a simple, useful and safe method for discovering vasovagal mechanism of the syncope. They notice the experiences with treatment according to the HUT results. The most frequent types of therapy are the pharmacological and the pacing ones, when the former is appropriate for I and III class of VVS the latter then for the II. class. There are some big studies in progress now which should bring more information about this clinical problem.

Humans↗
PubMed1994

[The role of the HUT test (head upright tilt table test) in patients with syncope of uncertain etiology].

UNLABELLED: The authors have examined 73 patients at the mean age of 36.8 +/- 15.3 (M:34, F:39). All the pts have suffered from recurrent presyncopes or syncopes the etiology of which has not been diagnosed by previous internal, neurological or psychiatric examination. Before the HUT the patients have undergone a complete cardiological examination. The HUT has been carried out according to the modificated Westminster protocol, the blood pressure and the heart rate have been monitored continuously. The end-point of the HUT has been a presyncope or a syncope, viewed as positive. The positive pts have been divided into 4 groups according to the changes of their blood pressure and heart rate during a presyncope or a syncope-mixed, cardioinhibitory A, cardioinhibitory B and vasodepressor responses. Out of 73 pts there have been 27 pts (37%) with positive responses and 46 (63%) with negative responses. The mixed type has been achieved in 12 pts, cardioinhibitory A-in 5 pts, cardioinhibitory B-in 2 pts, vasodepressoric in 8 pts. The mean time needed for positive response during the native HUT has been 17.7 +/- 11 min, after activating with isoproterenol for 2.6 +/- 1 min. The achieved results correlate with data in medical literature. The test activated with isoproterenol increases its sensitivity. There have not been any complications marked within the examined group. CONCLUSION: The HUT has been unambiguously included into screening algorithms of syncopes as an easy, cheap, safe examination with good sensitivity and specificity.

Adult↗
PubMed1991

[Late complications of unrecognized post-traumatic diaphragmatic hernias].

The authors reflect, based on two case-histories, on problems of diagnosis and operation of undiagnosed post-traumatic diaphragmatic hernias. In one instance a perforation of the diaphragm was missed during operation of a piercing heart injury and in the second case the operation was made only after incarceration of the stomach and spleen one year after a blunt chest injury.

Adult↗
PubMed1991

[Surgical treatment of necrotizing hemorrhagic pancreatitis with a prolonged course].

The authors describe the course of acute haemorrhagic necrotizing pancreatitis complicated by prolonged septicaemia, the formation of abscesses, acute haemorrhage and a intestinal fistula--"Critically ill patient". Early surgical elimination of necrotic septic foci is the prerequisite of effective treatment and cure. In the diagnosis CT and magnetic resonance prove most useful. With the latter so far little experience as been assembled. Ultrasonographic visualization technique is insufficient for the diagnosis of focal changes in the area of the pancreas.

Acute Disease↗