PubMed Health⌕ Search

Biomedical subjects

Z Fejfar

Publications and source records attributed to Z Fejfar.

At least 19 recordsLinked to original sources
PubMed1993

Dogs at high or low risk of ventricular fibrillation. An experimental study of acute myocardial ischaemia.

In the last 15 years, measurement of the ventricular fibrillation threshold (VFT) after ligation of the coronary artery in anaesthetised dogs has become our standard method for the evaluation of the stabilizing effect of antifibrillation drugs. Analysis of a group of 143 dogs revealed that in 75 animals the VFT 8 minutes after the ligation of the coronary artery dropped to less than 1 mA (high risk group), while in the remaining 68 dogs the decrease was smaller and not below 1 mA (low risk animals). The difference between the groups could be seen already before the ligation of the coronary artery. The high risk animals had a lower VFT and a higher heart rate. The groups also differed in the response to drugs administered 15 minutes after the ligation of the coronary artery. Metipranolol, a liposoluble beta blocker of the beta 1 and 2 cardiac receptors (Trimepranol Spofa 0.3 mg.kg-1 b.w.), increased greatly the VFT in both groups already 8 minutes after the injection of the drug and eliminated the difference between the groups. Flunitrazepam (Rohypnol Hoffmann-La Roche 0.25 mg.kg-1 b.w.) increased the VFT less than metipranolol and the difference between the groups disappeared only 30 minutes after its injection. Celiprolol (Selectol Linz Chemie 3.0 mg.kg-1 b.w.) blocking beta 1 and stimulating beta 2 receptors as well as trimecaine (sodium channel blocker, Mesocain Spofa 3.0 mg.kg-1 b.w.) led only to a small insignificant increase in the VFT and the difference between the groups of dogs remained.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1992

[The importance of the Czech Medical Society yesterday and today].

Fourteen physicians headed by Jan Evangelista Purkynĕ signed the proposed by-laws of the Czech medical society in october 1861. Emperor's approval was received 26th june 1862 and in july Purkynĕ was elected the first president. The same illuminated personalities were the founders of the Casopis lékarů ceských--the Czech medical Journal which has remained the most important Czech periodical until the present time. The aims of the Society were to cultivate medical science and promote Czech language in medicine. Weekly scientific sessions, medical periodical and publication of monographs related to medicine were the means how to achieve the aims. The Czech Medical Society became soon the centre of medical science in Bohemia. Its members were among the foremost fighters for the use of Czech language in Charles university and their relentless effort helped much to the establishment of the Czech Univerzity in 1882 and Czech medical faculty a year later. In subsequent years the Society was also involved in professional problems related to social health insurance, medical fees, ethical problems and other relevant questions such as the establishment of medical chambers. The activity of the Czech medical Society was never interrupted during its 130 years of existence, although there were several difficult periods in its life, mainly during the first and second world war and also in the past 40 years. In spite of the atomization of medicine the Czech medical Society has been continuing its eminent mission to create communication and establish close links between the medical science and practical medicine by systematically bringing new knowledge in medicine and biology to general physicians and by putting together physicians, surgeons and basic scientists. The task for the future is seen in optimal transfer of new knowledge and ideas from scientists to practicians and vice versa; and to take care of the highest possible moral and ethical standard required for humane medicine. Tradition and achievements of our teachers is binding and we are looking forward to better future in united Europe.

Czechoslovakia↗
PubMed1992

Analgosedation raises baroreflex sensitivity in acute myocardial ischaemia.

Acute local myocardial ischaemia is associated with a decrease in baroreflex sensitivity while electrical instability (vulnerability) of ventricles increases. Co-administration of a benzodiazepine and a potent analgesic (analgosedation) has been found to raise both baroreflex sensitivity and ventricular fibrillation threshold. Pharmacological modulation of neurovegetative ionization of the heart in the early phase of ischaemia is a promising method for preventing sudden coronary death.

Animals↗
PubMed1992

[Self-care in the prevention of sudden cardiac death].

In acute myocardial infarction a third up to half of death registered within the first month occur in the first hour of the onset of attack most frequently because of ventricular fibrillation. Immediate self administration of drugs stabilizing electrically the heart may prevent it. On the basis of experiments in dogs and in rats flunitrazepam (Rohypnol tabl. 1 mg), tramadol (Tramal caps. 50 mg) and the beta blocker metipranolol (Trimepranol tabl. 10 mg) were selected for clinical trial on high risk patients. As the chosen combinations of drugs were not yet tested in view of possible interactions, we studied their effect on circulation and cardiovascular reflexes in eight healthy volunteers. When the drugs were absorbed from the mouth mucosa, the decrease in the heart rate during deep breathing was observed already 15 minutes after the intake of drugs. The subjects started to feel relaxed; later on they had pleasant feelings and felt sleepy. There were no undesirable changes in the heart rate or blood pressure. In the three drug combination with metripranolol, the decrease in the heart rate was more marked. The tests in volunteers were without any undesirable effects and both combinations may, therefore, be given to selected high risk subjects, e g. convalescents from myocardial infarction. Randomized trial to prove the preventive effect already started.

Adult↗
PubMed1992

[Disorders of circulation regulation and heart disease].

Functional disorders of the circulation imply an inadequate circulatory response to repeated, in particular mental strain, associated with typical complaints and manifestations. Instead of the formerly used term of neurocirculatory asthenia nowadays neurotic conditions with manifestations in the circulation are described more frequently as hyperventilation syndrome, syndrome of chronic fatigue or panic anxiety syndrome. The paper deals with the pathogenesis, diagnosis, prognosis and therapy where a talk with the patient, elucidating the relationship between the stressing situation and circulatory manifestations is most important.

Humans↗
PubMed1991

Prevention of sudden coronary death.

The following results were obtained in an experimental study in the dogs in general pentobarbital anaesthesia: Lidocaine type antiarrhythmics (lidocaine, Xylocaine ASTRA, Ethmozin USSR) administered shortly before artery ligation have a pro-fibrillation effect. This effect is indirectly proportional to the ischaemic focus development. A 3rd-generation beta blocker with intrinsic sympathetic activity (celiprolol, Selectol Chemie-Linz) had the same electrostabilizing effect on the ventricles in the acute phase of ischaemia as a 1st-generation beta blocker (metipranolol, Trimepranol SPOFA). The 3rd-generation blocker, however, stopped short of provoking a drop in the heart rate invariably associated with the 1st-generation beta blocker. The analgesic fentanyl (G. Richter) in combination with benzodiazepine (m,idazolam, Dormicum Hoffmann-La Roche) inducs analgosedation. In this way the dose of the analgetic can be reduced and yet the analgesia and electrostability of the heart remain the same. Due to the lower dose of the analgesic there is a lesser decrease in the heart rate and blood pressure. Analgosedation can be discontinued by administering an antagonist-agonist of benzodiazepines (flumazenil, Anexate Hoffmann-La Roche) or an antagonist of potent analgesics (butorphanol, Beforal SPOFA) without the risk of eliminating, at the same time, the electrostabilizing effect of analgosedation on the ischaemically damaged ventricles of the heart. For the prevention of sudden coronary death due to ventricular fibrillation in the acute phase of local myocardial ischaemia we can, on the basis of our experimental results, recommend analgosedation and the use of beta blockers with intristic sympathetic action. The use of lidocaine antiarrhythmics may lead to a reduction in the electric stability of the heart ventricles the ischaemic focus is developing under a certain "critical" blood level of the antiarrhythmics.

Adrenergic beta-Antagonists↗
PubMed1991

Analgosedation-enhanced baroreflex sensitivity in acute local myocardial ischaemia.

In acute local myocardial ischaemia produced in mongrel dogs, the sensitivity of baroreflex decreased as electrical instability (vulnerability) of cardiac ventricles increased. Simultaneous administration of a benzodiazepine and a powerful analgesic (analgosedation) augmented both baroreflex sensitivity and ventricular fibrillation threshold. Modulation of neurovegetative activation of the heart by drugs in the early stage of ischaemia holds promise as a potential technique of sudden coronary death prevention.

Animals↗
PubMed1989

The antifibrillatory effect of fentanyl, sufentanil and carfentanil in the acute phase of local myocardial ischaemia in the dog.

To determine the effect of strong analgesics on electrical instability (vulnerability to ventricular fibrillation), we examined the action of fentanyl (60 micrograms/kg), sufentanil (10 micrograms/kg) and carfentanil (3 micrograms/kg) on the ventricular fibrillation threshold (VFT) in a dog model of coronary artery occlusion. The effect of strong analgesics was compared with that of the first-generation beta-blocker propranolol (1.2 mg/kg) and the third-generation beta-blocker celiprolol (3 mg/kg). In the 5th minute of ischaemia, VFT declines in all groups of dogs. VFT values rise significantly from the 23rd to the 60th minute of ischaemia after opiate analgesic administration. The mean increase in VFT after opiate analgesics is less pronounced than after beta-blockers. Administration of opioid analgesics is followed by strong prevalence of vagal drive to the heart. Sympathetic drive to the heart after propranolol administration disappears and is depressed after the administration of celiprolol only. Blockers of the beta-receptors apparently intervene directly in the ischaemic focus and affect the "substrate" of electrical instability. The opioid analgesics probably exert their effect through a change in "substrate" modulation. There is an ongoing search for drugs that would stabilize the heart electrically in acute myocardial infarction, thus preventing sudden death. Our experimental results favour a combination of strong analgesics with other electrostabilizing drugs.

Adrenergic beta-Antagonists↗
PubMed1989

The electrostabilizing effect of a combination of midazolam and fentanyl: an experimental study in the dog.

Using a model of local myocardial ischaemia in the dog, the authors studied the electrostabilizing effect of a combination of the benzodiazepine midazolam (Dormicum Hoffman--La Roche) and the strong narcotic analgesic drug Fentanyl (Richter). The electrostabilizing effect was assessed using the method of ventricular fibrillation threshold (VFT) measurement. The same increase in the fibrillation threshold as that induced by the administration of midazolam or fentanyl alone was achieved by a combination of both drugs given, however, in reduced doses. The electrostabilizing effect of benzodiazepines and potent analgesics is enhanced by their simultaneous administration. At the same time, the adverse side effects observed on the administration of fentanyl alone (bradycardias, hypotension, cardiac blockade) due to the prevalence of parasympathetic drive, are reduced. Simultaneous administration of a benzodiazepine and an analgesic has become a modern technique, in anaesthesiology, so-called analgosedation. Experiments have shown the technique, in addition to the generally recognized analgesia, sedation and anxiolysis, exerts electrostabilizing effects on the myocardium damaged by ischaemia. The authors therefore recommend analgosedation in the drug treatment of acute myocardial infarction.

Animals↗
PubMed1987

A comparison of the antifibrillatory effect of midazolam and flunitrazepam in acute myocardial ischaemia in the dog.

A study was carried out using a model of myocardial ischaemia in the dog after ligation of the left coronary artery to determine the effects of the benzodiazepines, flunitrazepam and midazolam, on the ventricular fibrillation threshold. The fibrillation threshold was measured twice within 15 min and 8 min after ligation. Fifteen minutes after the onset of ischaemic heart attack, 1.2 mg midazolam/kg or 0.25 mg of ischaemia. Their effects on haemodynamics were negligible. It is suggested that both benzodiazepines can be used for increasing electrical stability of the heart in patients with acute myocardial infarction and to inhibit the psychic stress response. Because of its short biological half-life and water solubility, allowing painless intravenous administration, midazolam offers a more flexible approach to pharmacotherapy immediately after acute heart attack according to the patient's current clinical status.

Animals↗
PubMed1987

An experimental contribution to the treatment of acute myocardial infarction.

1. Benzodiazepines and strong analgesics raise considerably the ventricular fibrillation threshold and thus electrically stabilize the heart in the early stage of myocardial ischaemia. 2. Benzodiazepines markedly potentiate the electrostabilizing effect of the beta-blocker metipranolol. 3. Trimecaine per se does not electrically stabilize the heart in the first hour of ischaemia. When combined with a benzodiazepine, trimecaine stabilizes the heart also in this early stage of myocardial ischaemia. 4. Infusion of a benzodiazepine (midazolam) combined with fractionated administration of a potent analgesic (fentanyl) does not produce pronounced changes in the haemodynamics and ventilation of healthy subjects. 5. Benzodiazepines and strong analgesics exert a favourable effect on the neurovegetative stress response in the early stage of acute myocardial ischaemia. They can be therefore recommended as a component in the treatment of patients with acute myocardial infarction.

Adult↗