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Biomedical subjects

W Pluta

Publications and source records attributed to W Pluta.

17 recordsLinked to original sources
PubMed1993

[Acute myocardial infarction with shock. Intracoronary thrombolysis].

UNLABELLED: Of 932 pts with acute myocardial infarction (AMI) who underwent reperfusion therapy (RT) by intracoronary streptokinase (IC.STK), 32 pts had cardiogenic shock (CS). Shock was defined as systolic blood pressure (BP) < or = 80 mmHg without inotropic support or BP < or = 90 mmHg with inotropic or balloon counterpulsation support and left ventricular end diastolic pressure < 18 mmHg and clinical symptoms of hypoperfusion. Time from onset of symptoms to initiation of therapy was less than 6 hours. Reperfusion was defined as reestablishment of antegrade TIMI-2 or 3 flow in occluded artery. Comparison revealed no significant differences in sex, age, time after onset of symptoms, artery involved, history of previous AMI, left ventricular ejection fraction and in extent of coronary disease between pts with successful and failed thrombolysis. IC.STK was successful in 12 pts with CS (37.5%) and in 67.2% of pts without CS (p < or = 0.001). Mortality rate in pts with CS was 25% in reperfused and 81.8% among nonreperfused (p = 0.0095). CONCLUSIONS: 1. IC.STK gives a considerably lower rate of reperfusion in pts with AMI complicated by CS. 2. No influence on the frequency of effective reperfusion with respect to the analyzed clinical and angiographical data was found. 3. The high mortality in the group with unsuccessful reperfusion as well as the low effectiveness of the IC STK indicates the necessity to apply more effective methods of reperfusion in pts with AMI complicated by CS.

Aged↗
PubMed1993

[Cardiogenic shock. Coronary angioplasty after failed intravenous thrombolysis].

Rescue coronary angioplasty (PTCA) was employed as reperfusion strategy after unsuccessful intracoronary infusion of streptokinase in 13 patients with AMI complicated by cardiogenic shock (CS). Reperfusion defined as reestablishment of TIMI 3 degree flow in the infarct related artery and reduction in luminal narrowing to less than 50% was achieved in 8 patients (61.5%). The failure of PTCA was caused by: inability to cross occlusion in 2 patients and recurrent thrombosis despite repeated dilatations resulting in hemodynamic instability requiring cardiopulmonary resuscitations during the procedure in 3 patients. There was no significant differences in mean age, sex, time from onset of symptoms, LVEF, artery involved, extent of coronary disease and incidence of cardiopulmonary resuscitations during the procedures. There where 4 in-hospital deaths among patients with failed PTCA (80%) compared to 25% mortality in reperfused group. We conclude that PTCA is an effective method of achieving reperfusion in patients with CS complicating AMI after failed thrombolysis with intracoronary streptokinase and that it improves in-hospital survival.

Angioplasty, Balloon, Coronary↗
PubMed1993

[Changes in osmolarity during inhalation with various IPPB and ultrasound devices].

Inhalation of slightly hyperosmolar solutions may result in asthma attacks. "Evaporation" and hence increase of the concentration of the aerosol in continuous atomisation by ultrasound has been known for a long time. The present study aimed at finding out to what extent an osmolarity increase can be detected even with commercial home inhalation devices with an inhalation period of between 3 and 5 minutes. We examined the following instruments: Heyer Sekundant, Bird-Mark 7, Respirator IPPB (supplier: Stephan) Pari-Inahalierboy, Heyer-Prodomo and the compressed-air driven inhalators FT 51 (Heyer) and the ultrasound device US-77 supplied by Heyer. Osmolality was measured with the osmometer Osmomat-030 supplied by Gonoteck. We atomised a mixture of 5 drops Berodual with physiological saline solution and isotonic brine (salt water) from the German spa Bad Ems. All inhalation devices showed after a short time an increase in osmolarity that was lowest with the Inhalierboy and Heyer Prodomo. The Heyer Sekundant and Bird-Mark 7 models showed increases that were a cause for concern. It is recommended on the basis of the results obtained that suppliers should state on their inhalation equipment not only the droplet size and aerosol density but also the increase in osmolarity on atomisation of a reference substance after 3 or 5 minutes, respectively. It would be desirable, in the interests of safe therapy, that the data given for an inhalation equipment should include over and above the usual characteristics the increase in osmolarity per unit of time under defined environmental conditions (see above) on atomisation of a reference solution.

Aerosols↗
PubMed1989

Coronary artery stenosis in patients with valvular heart disease.

144 patients with valvular heart disease (VHD) underwent selective coronary angiography. Significant coronary artery stenosis was found in 26% of the examined patients. Diagnostic accuracy of some clinical indexes was analysed in this group. Most useful in predicting the presence of significant coronary narrowing in patients with VHD were increased cholesterol level and the presence of arteriosclerosis in lower limbs. Patients over 40 years who have both these indicators should have coronary angiography performed prior to surgical treatment.

Adult↗