Vnitr̆ní lékar̆ství
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Vnitr̆ní lékar̆ství · Jun 1996
[Phthalic acid esters in the peritoneal cavity of patients treated with continuous ambulatory peritoneal dialysis].
A solution for peritoneal dialysis stored in bags made from material which does not contain diethylhexyl phthalate is significantly less contaminated with this plasticizer, as compared with a solution stored in bags made from PVC with diethylhexyl phthalate. The afferent tube which contains diethylhexyl phthalate in all sets investigated by the authors is not an important source of this plasticizer for the peritoneal solution. Contamination of the peritoneal solution with dibutyl phthalate added to colours used for print on the bags (inscription on the outside of the bag) was found in both types of bags (no significant differences were found). ⋯ This applies only, provided that the peritoneal solution is not contaminated with dibutyl phthatate during preparation, before it is filled into bags. After six hours instillation in the peritoneal cavity diethylhexyl phthalate and dibutyl phthalate was not detectable in the peritoneal solution (detection limit 0.5 microgram/l). They are completely retained and metabolized resp. in the patient's peritoneal cavity.
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In part 2 author pays attention to new findings on treatment of sepsis and septic shock. He emphasizes facts which are of immediate importance for clinical practice and therapy. Possibilities of immunomodulating therapy (monoclonal antibodies, immunoglobulins) are described in detail.
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Vnitr̆ní lékar̆ství · Apr 1994
[Success of pharmacologic cardioversion and electric cardioversion in patients with atrial fibrillation or flutter in a 5-year retrospective study].
The authors evaluated in a five-year retrospective study the success of pharmacological and electric cardioversion in general in 353 patients with atrial fibrillation and in 117 patients with atrial flutter. The success of electric cardioversion in the group with fibrillation arrhythmia was 72%, in the group with atrial flutter 92%. The success of pharmacological cardioversion in the group with fibrillation arrhythmia was 96.2%, in the group with atrial flutter 79.8%. In pharmacological cardioversion in both groups the combination quinidine-isoptin was best.
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The author discusses the problem of aluminium osteopathy as one of the clinical manifestations of aluminium intoxication in dialyzed patients. She describes the case-histories of three patients treated on account of aluminium intoxication with desferrioxamine. The disease was manifested by pain in the bones and joints and muscular weakness, in two patients also with symptoms of encephalopathy. ⋯ Therefore cases of aluminium intoxication are rare. Nevertheless it is important to pay attention to the problem of aluminium accumulation as its early diagnosis facilitates treatment. In the author's opinion the method of choice for elimination of aluminium from the organism is one-line haemofiltration combined with desferrioxamine.
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The authors present their own experience with percutaneous alcohol block of the coeliac plexus. Between April 1988 and December 1991 they used it in 22 patients. Except one patient the others suffered from severe pain of abdominal organs associated with carcinoma of the pancreas. ⋯ The intervention was repeated in four patients. The authors emphasize that the procedure is relatively simple and safe, and if successful, makes it possible to reduce or even eliminate opiates. It improves the quality of the remaining life of the patient.