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Biomedical subjects

M Mydlík

Publications and source records attributed to M Mydlík.

At least 37 records · Page 2Linked to original sources

[Urinary oxalic acid excretion in chronic kidney failure and after kidney transplantation].

Urinary oxalic acid excretion was examined in 61 patients with chronic nephropathies and in 21 patients after renal transplantation with a varying mean glomerular filtration. In both groups of patients a correlation was found between the plasma oxalic acid and serum creatinine and by a hyperbolic correlation between plasma oxalic acid and creatinine clearance. Moreover the authors found a direct correlation between oxalic acid and FEoxalic acid and FE(Na)+, FEH20 and FE1-ascorbic acid in both patient groups. Various chronic nephropathies and treatment in both groups did not affect the revealed correlations. In 13 healthy subjects during the period of maximum water diuresis urinary Na+ excretion did not increase but there was a significant increase of the l-ascorbic acid and oxalic acid excretion. In a group of 8 patients in the polyuric stage of chronic renal failure without dialysis treatment under conditions of increased dietary NaCl intake (15 g/24 h) a significant increase of the urinary Na+ excretion was recorded while the l-ascorbic acid and oxalic acid excretion was unaltered. From the assembled values of the examined biochemical indicators ensues that urinary oxalic acid excretion, similarly as ascorbic acid excretion, depended on water excretion.

Adult↗

[Pharmacotherapy of silent myocardial ischemia in patients on hemodialysis].

Cardiovascular complications are the main causes of morbidity and mortality of patients on regular dialysis treatment. Myocardial ischaemia in those patients may be promoted apart from accelerated atherosclerosis also by many extracoronary and extracardial factors. In a group of 60 haemodialyzed patients followed up on a long-term basis silent myocardial ischaemia is encountered during 24-hour Holter monitoring in 30-40% of the examined patients. Its occurrence at the end of haemodialysis and during the early posthemodialytic period and its long persistence are typical. The authors examined 20 regularly dialyzed patients with transient depressions of the ST segment in whom they tested retarded nitroglycerin, metoprolol and verapamil. All three drugs had a significant effect on the myocardial ischaemia (intensity and duration of depressions of the ST segment). In addition to correction of the modifying factors of silent myocardial ischaemia the authors prefer verapamil in order to influence the negative sequelae of secondary hyperparathyroidism. If pharmacotherapy of myocardial ischaemia is ineffective, in patients on regular dialysis treatment stress radionuclide scintigraphy or echocardiography and selective coronarography are indicated, which decide on a possible revascularization operation in these risk patients already during the pretransplantation period.

Adrenergic beta-Agonists↗

[Hemoperfusion with Amberlite XAD-4 in acute theophylline poisoning].

Haemoperfusion through Amberlite XAD-4 was used in a female patient who took with suicidal intention 29 tablets of Syntophylline. During 5 hours of haemoperfusion the theophylline plasma concentration declined significantly to the lower limit of the therapeutic range. Early application of haemoperfusion, using Amberlite XAD-4, led to rapid regression of symptoms of acute intoxication and recovery of the patient.

Acute Disease↗

[Cardiologic management in patients on a long-term dialysis program].

Cardiovascular complications are the main cause of mortality in patients with chronic renal failure. Hypertension and lipid abnormalities which often lead to left ventricular hypertrophy and accelerated atherosclerosis as well as coronary artery disease are a common cause of death. On the other hand uremia often causes pericarditis and thereby may lead to cardiac tamponade and constrictive pericarditis. Renal failure can also cause secondary hyperparathyroidism, amyloidosis, hemosiderosis and oxalosis which can produce visceral infiltrations and lead to a variety of disturbances of cardiovascular functions. Life-threatening arrhythmias are one of the major cardiovascular complications during maintenance dialysis as their occurrence might result in sudden death. The aim of cardiologic management which includes the complex of preventive and therapeutic measures is to reduce the morbidity and mortality and to improve the quality of life.

Cardiovascular Diseases↗

[Hemoperfusion in mushroom poisoning. Clinical analysis of 58 patients].

Fifty-eight patients with acute mushroom poisoning--Amanita phalloides were treated. Among them were 28 children and 2 adolescents. From all the patients mean age was 30.5 years, 31 patients were in hepatic coma. All patients undergone conservative treatment and haemoperfusion. The mean time from beginning of acute poisoning to the first haemoperfusion was 61 hours. Ninety-eight haemoperfusions were performed, from this number 26 using Amberlite XAD-2. Seventeen simultaneous or subsequent haemodialyses and 12 plasmaphereses were performed. Mortality occurred in 20 patients (34.5%). Survival of patients depended on the amount of ingested mushroom, on the early admission of patients to dialysis centre and on the beginning of extracorporeal treatment until the period of 24 hours after acute poisoning.

Acute Disease↗

[Sorbitol-negative E. coli 016 in a 10-year-old child diagnosed with hemolytic-uremic syndrome and in his asymptomatic father].

In Escherichia coli strains isolated from faeces and smears from the rectum in haemolytic-uraemic syndrome of a child and healthy relatives the authors assessed the biochemical activity, antigenic characteristic, sensitivity to twelve antimicrobial substances and factors of virulence. Sorbitol negative strains were isolated from the ill child and his father. The strains belonged into serogroup 016. The remaining strains were sorbitol positive. They belonged into serogroups 02, 012 and 019. Nineteen sorbitol negative strains of E. coli from the sick child caused mannose sensitive agglutination of chicken and guinea pig erythrocytes, they produced colicin V and aerobactin. Except for one strain they were serum resistant. Fourteen strains induced the oedema on the foot of mice and eleven produced a lethal effect in mice. Except for three ampicillin resistant strains the remaining were sensitive to the examined antibacterial substances. Two sorbitol negative strains of E. coli isolated from the asymptomatic father produced aerobactin and one strain was serum resistant.

Adult↗

Vitamin B6 requirements in chronic renal failure.

According to our results the long-term daily oral supplementation of 6 mg vitamin B6 was sufficient for prevention of vitamin B6 deficiency in chronic renal failure, regular dialysis treatment and CAPD groups of patients. Haemodialysis and charcoal haemoperfusion have led to non-significant decrease of erythrocyte vitamin B6. A favourable effect was found of daily oral administration of 50 mg pyridoxine on electrophoretic mobility of peripheral blood lymphocytes and cellular immunity.

Adult↗

[ECG Holter monitoring in patients with chronic renal failure in a long-term dialysis program].

Using the Holter method, the authors monitored for 24-hours 30 patients included in a long-term dialyzation programme during and after haemodialysis. A group of 15 patients who had during examination frequent or complex supraventricular or ventricular ectopia was compared with a group of 15 patients with sporadic ectopia. In the arrhythmic group paroxysmal supraventricular tachycardia was recorded in 33% and paroxysmal atrial fibrillation in 13%, polytopic or repetitive ventricular extrasystoles in 14%, couplets in 20% and volleys of ventricular extrasystoles or non-persisting ventricular tachycardia in 20%. Comparison of clinical laboratory and echocardiographic characteristics revealed in the arrhythmic group significantly higher mean ages of patients, higher levels of ionized serum calcium before haemodialysis, C terminal parathormone, the breadth of the interventricular septum, and the authors observed also a higher incidence of hyperechogenity of cardiac structures. On analysis of repolarization ECG changes significant asymptomatic depressions of the ST segment were found which were transient and dominated during the early posthaemodialyzation period in 11 patients of the whole group (37%).

Adult↗

[Vitamin B12 and folic acid in chronic kidney failure and after kidney transplantation].

Vitamin B12 in plasma, folic acid in plasma and erythrocytes were examined in 11 patients in the polyuric stage of chronic renal failure without dialyzation treatment, in 38 patients included in a long-term dialyzation programme before and after 3 months' oral administration of folic acid--(2 X 5 mg week)--and in 23 patients after transplantation of the kidneys. In none of the examined groups vitamin B12) and folic acid deficiency in plasma was detected. A reduced folic acid level in erythrocytes, but still in the reference range, was found in patients in the long-term dialyzation programme without supplementation. Supplementation with folic acid increased its concentration in plasma 4.5 times and in red cells 5.5 times. Haemodialysis did not influence the concentration of the examined indicators in plasma and red cells. According to the recorded results it is not necessary to supplement patients in long-term dialyzation programme and after renal transplantation with vitamin B12 and folic acid, if their dietary protein intake is not restricted.

Female↗

[Hemoperfusion of theophylline. An in vitro study].

The authors made 30 haemoperfusions of theophylline in vitro in a closed system, using capsules Hemasorb 800 C, Hemasorb 800 A-2 and 800 A-4. As perfusion solution they used 4 litres of aqueous solution with an osmolality of 286 mmol/kg. The theophylline concentration in solution was 282.8 +/- 5.2 mumol/l. Individual haemoperfusions lasted 5 hours. After the theophylline solution has passed across Hemasorb A-4 the concentration of the substance could be assessed at all time intervals and during the 180th minute the theophylline concentration could be detected also before entering the haemoperfusion capsule. When using Hemasorb 800 A-2, the adsorption capacity of the haemoperfusion capsule was exhausted already during the 180th minute. The assembled results suggested that the most effective theophylline haemoperfusion in vitro was obtained with Hemasorb 800 A-4 and the least effective one with Hemasorb 800 A-2. The authors recommend to use in acute intoxication with theophylline in humans haemoperfusion via Hemasorb 800 A-4.

Hemoperfusion↗

Serum vitamin A, retinyl esters and vitamin E in nephrotic syndrome.

Serum vitamin A, retinyl esters and vitamin E were increased in a group of 33 patients with chronic glomerulonephritis and nephrotic syndrome without reduction of mean glomerular filtration rate. Despite hypoproteinaemia and reduced values of serum proteins with a different molecular weight, increased values of vitamin A protein carriers were found. Serum total cholesterol, LDL cholesterol, triglyceride, prebeta und beta lipoproteins were increased, HDL cholesterol was within the reference range. Direct relationships were found between serum retinyl esters and vitamin A, and between serum retinyl esters and prealbumin. Indirect relationships were detected between serum total cholesterol and total proteins, serum total cholesterol and albumin, and serum vitamin E and albumin. The increased values of vitamin A, retinyl esters as well as its protein carriers and of vitamin E were probably a manifestation of enhanced protein and lipid synthesis in the liver as a result of albumin depletion. These results show true A and E hypervitaminosis in patients with nephrotic syndrome.

Blood Proteins↗

[Vitamin A and metabolic disorders of calcium and phosphorus in patients on a long-term dialysis program].

The aim of the present work was to reveal the relationship between vitamin A serum levels and some indicators of metabolic calcium and phosphorus disorders in patients in a long-term dialyzation programme. Thirty-six patients in a long-term dialyzation programme were divided into three groups. Group A comprised 11 patients who were treated for 3-9 months but without specific treatment, group B was formed by 10 patients treated for 2-5 years who were given calcium carbonate, 3 g/24 h, by the oral route for a period of six months and group C which comprised 15 patients treated for 3-10 years who were given 1 alpha, 25-dihydroxycholecalciferol (Rocaltrol), 0.25 micrograms/24 h for a period of six months. At the end of the investigation a significant rise of total calcium and serum Ca2+ occurred in all three groups of patients an a significant decrease of increased value of phosphorus, C-PTH and vitamin A in serum in groups B and C. In group A which was without treatment there was a significant increase of serum C-PTH and vitamin A after six months. The concentration of retinyl esters in serum was within the reference range of there were undetectable values throughout the investigation in all patients. A direct relationship was found between total calcium and vitamin A, alkaline phosphatase and C-PTH in serum in all 36 patients at the onset of the dialyzation programme. Moreover there was a direct relationship between C-PTH and vitamin A in groups, A, B and C at the onset of the investigation and in groups and vitamin C at the end of the investigation.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcitriol↗

[Vitamin B1, B2 and B6 in erythrocytes in the nephrotic syndrome].

In 19 patients with nephrotic syndrome in different diseases not associated with reduction of the glomerular filtration surface vitamin B1 was within the reference range, vitamin B2 was insignificantly and vitamin B6 significantly reduced. The concentrations of vitamins B1, B2 and B6 in red blood cells were assessed by indirect enzymatic methods and were expressed as vitamin action. Long-term six-month riboflavin supplementation (2 mg/24 h) and pyridoxine (50 mg/24 h) in seven patients improved vitamin B2 and B6 levels in erythrocytes independently on the regression of the clinical and laboratory activity of the basic disease.

Adult↗

[Use of a computer for obtaining optimal serum sodium values at the end of hemodialysis].

The authors made 41 haemodialyses in 21 patients in the course of a long-term dialyzation programme, using a dialyzation monitor connected with a computer. The aim of the investigation was to achieve at the end of the six-hour haemodialysis the optimal serum sodium value of 142 mmol/l, using different ultrafiltrations (1000, 2000 and 3000 ml/6 hours). It was revealed that to obtain the optimal serum sodium level it was necessary to use in the dialyzation solution a sodium concentration of 144.9 +/- 0.2 mmol/l. The water transport from the intracellular to the extracellular fluid was typical for the distribution of total body water, regardless of the volume of ultrafiltration. The amount of removed sodium during haemodialysis depended on the sodium concentration in the dialyzation fluid and on the ultrafiltration volume. The values of the volume and clearance of sodium-free water depended on the amount of sodium eliminated into the dialyzation solution.

Female↗

[The effect of sodium levels in dialysis solutions on the distribution of total body water during hemodialysis].

Thirty-seven haemodialyses with ultrafiltration were performed (3000 ml/6 hours). using three sodium concentrations (140, 145 and 150 mmol/l) in the dialysate solution in 16 hyperhydrated patients during a long-term dialysis program. The amount of eliminated sodium during haemodialysis depended on the sodium concentration in the dialysate solution. The reduction of the volume of total body water corresponded to ultrafiltration. When a sodium concentration of 150 mmol/l in the dialysate solution was used, the smallest diminution of extracellular fluid and greatest diminution of intracellular fluid was observed. At the same time the greatest transport of water from the intracellular into the extracellular fluid was recorded. A sodium concentration of 145 and 150 mmol/l in the dialysate solution gave rise to positive values of sodium-free water and of sodium-free water clearance. Sodium-free water and of sodium-free water clearance correlated directly with the sodium concentration in the dialysate solution and inversely with the amount of eliminated sodium. The patients were free from complaints during haemodialyses and no significant blood pressure changes were found. The dialysate solution with the sodium concentrations used is suitable for a long-term dialysis programme; the authors recommend, however, to use individual sodium concentrations, depending on the patient's clinical condition.

Adult↗