Materia medica Polona. Polish journal of medicine and pharmacy
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Profound periodic sleep hypoxemia (as low as 9-10% saturation) was observed in 41 morbidly obese patients with obstructive sleep apnea (OSA). Group 1 consisted of 14 patients with awake hypercapnia (mean PaCO2 54 +/- 8 torr, s.d.) and group 2 were 27 with eucapnia (PaCO2 38.6 +/- 2.9). ⋯ We conclude that daytime hypercapnia predicts more severe sleep desaturation in NREM in obese patients with OSA. The combination of morbid obesity and hypercapnia with OSA is associated with the most profound and repeated hypoxemia ever reported as occurring without evident brain damage or death.
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Comparative Study Clinical Trial
Long-term antiarrhythmic pharmaco-therapy guided by Holter monitoring in patients with malignant ventricular arrhythmias and ischemic heart disease.
In 126 patients with clinical ventricular tachycardia and/or fibrillation, ischemic heart disease and repetitive and/or frequent ventricular ectopic beats long-term therapy guided by Holter ecg was assessed. Criteria for efficacy of antiarrhythmic drugs were following: 1) > 75% decrease in ectopic beats, 2) elimination of salvos, 3) > 90% reduction of couples and R/T and 4) reduction of multiformity up to 2 forms. ⋯ During follow-up 1-49 months, mean 20, rate of sudden death was lower in responders as compared with nonresponders (p < 0.05). However, suppression of ventricular ectopic beats was not predictive for a favorable outcome, because the incidence of arrhythmic events and total cardiac death was similar in the two groups.
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Comparative Study
Effect of mannitol on intracranial pressure in focal cerebral ischemia. An experimental study in a rat.
The authors studied the effects of mannitol on intracranial pressure (ICP) in experimental focal ischemia in a rat. Stroke was produced by occlusion of middle cerebral artery (MCA). The study revealed that mannitol decreases ICP in ischemic stroke much less then in healthy animals and also a significant rebound effect was seen, especially in the 5th and 7th day after MCA occlusion. The authors suggest a very limited use of mannitol in clinical treatment of elevated ICP after cerebral ischemic stroke.
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Angiotensin-converting enzyme (ACE) was determined in blood serum of 110 patients with sarcoidosis and 80 healthy persons. Taking into account the advancement of pulmonary changes as well as disease activity the behaviour of this enzyme was estimated. It was found that ACE activity is significantly higher in patients with sarcoidosis than in control group. The rise of ACE activity took place in 90% of patients with active sarcoidosis and almost in 50% with inactive sarcoidosis.
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Guideline
Diagnosis of chronic pancreatitis and pancreatic cancer at the centre of gastroenterology.
The installment of 4-step diagnostic system led to an improvement of the final diagnosis of chronic pancreatitis and pancreatic cancer. The average time during which pancreatic cancer proceeds from the onset of symptoms to computed tomography or laparotomy shortened considerably due to the application of the system screening procedures as well as of modern imaging techniques.