Vnitr̆ní lékar̆ství
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Vnitr̆ní lékar̆ství · Sep 2006
Review[Diuretics in therapy of "diuretic resistance" by patients with congestive heart failure].
Loop diuretics are integral part of overall therapy of severe congestive heart failure. Approximately 10-20 % of patients with congestive heart failure (NYHA class III-IV) do not respond satisfactorily to diuretic treatment. Despite its frequency, the term "diuretic resistance" remains inadequately defined. ⋯ The combination of diuretics, particularly of loop diuretic with thiazide agents, is recommended for prevention as well as treatment of this complication. Effective management is also continuous infusion of loop diuretic. If it is impossible to achieve adequate response by combination of diuretics, increasing of its dosage or/and frequency or continuous infusion, then dialysis methods may be employed (however it is not intended to discuss this option in this article).
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Vnitr̆ní lékar̆ství · Sep 2006
Comparative Study[Monitoring of glucose concentration in critical patients, comparing arterial blood glucose concentrations and interstitial glucose concentration measured by microdialysis technique].
Recent studies have shown that normalization of blood glucose in critically ill patients by intensive insulin therapy significantly decreases their mortality and morbidity. The aim of our study was to compare interstitial glucose concentrations in subcutaneous adipose tissue (measured by microdialysis technique) and arterial blood glucose concentrations to test the suitability of subcutaneous adipose tissue for long-term placement of biosensors for glucose measurement in critically ill patients. ⋯ Our study demonstrated good correlation between interstitial glucose concentrations in subcutaneous adipose tissue and arterial blood glucose concentrations in post-cardiac surgery patients. Further studies are needed to evaluate this relationship in patients with more severely disturbed perfusion of subcutaneous adipose tissue.
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Traumatic tricuspid regurgitation is a rare disease owing to penetrating or nonpenetrating thoracic trauma. In the last 40 years, since motorism is increasing, this disease can be seen more frequently. ⋯ Later on, the patient might have no symptoms; however, symtoms of right heart failure indicating an operation appear. This case-study is concerned with a patient with traumatic tricuspid regurgitation.
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Vnitr̆ní lékar̆ství · Sep 2006
Editorial Comment[Monitoring of glucose concentration in critical patients].