Application of Inspiratory Muscle Training to Improve Physical Tolerance in Older Patients with Ischemic Heart Failure.

Regardless of the management regime for heart failure (HF), there is strong evidence supporting the early implementation of exercise-based cardiac rehabilitation (CR). Respiratory therapy is considered to be an integral part of such secondary prevention protocols. The aim of the study was to evaluate the effect of inspiratory muscle training (IMT) on exercise tolerance and the functional parameters of the respiratory system in patients with heart failure involved in cardiac rehabilitation.

Influence of Inspiratory Muscle Training of Various Intensities on the Physical Performance of Long-Distance Runners.

The aim of this study was to assess the efficacy of inspiratory muscle training (IMT) at different intensities on the pulmonary function and physiological adaptations of long-distance runners undergoing sports training. This study involved 25 long-distance runners. The subjects were randomly divided into three groups depending on the type of IMT applied: POWERbreathe device (group 1), Threshold IMT device (group 2), and a control group.

Prevalence of bifid mandibular canals in panoramic radiographs: a maxillofacial surgical scope.

Purpose: The present study aims to estimate the prevalence of bifid mandibular canals in patients treated at the Dental Clinic of the Federal University of Paraná, Brazil.

Methods: The sample consisted of 3,024 panoramic radiographs from male (n = 1,155) and female (n = 1,869) patients (mean age 30 years). An experienced radiologist analyzed the panoramic radiographs according to the study of Langlais et al.

Pheochromocytoma of the adrenal gland selectively secreting dopamine -- a case report.

Pheochromocytoma of the adrenal gland secreting catecholamines is a relatively rare endocrinological cause of secondary arterial hypertension, usually developing in people aged between 40 and 50, more often in women than in men. Each accidentally diagnosed lesion in adrenal glands is an incidentalom0a. Incidentalomas are most commonly benign tumours: adenomas, adipomas and angiomas; less often they are of a malignant or metastatic character.

Surface roughness enhances the osseointegration of titanium headposts in non-human primates.

It is well recognized that micrometer and nanometer sized surface features enhance the skeletal attachment of implants within bone. However, little is known regarding the integration of implants placed outside the bone but in contact with the surface. Loosening of chronic skull anchored headposts in non-human primate based experiments can be a factor.

Comparison of left ventricular function by tissue Doppler imaging in patients with diabetes mellitus without systemic hypertension versus diabetes mellitus with systemic hypertension.

Because diabetes mellitus substantially increases the risk of development of heart failure, we sought to establish early alterations in left ventricular systolic and diastolic function in patients with diabetes mellitus with and without coexisting systemic hypertension. We studied 134 subjects using echocardiography comprising standard 2-dimensional and conventional Doppler as well as tissue Doppler imaging. Our study demonstrated the early appearance of both left ventricular systolic and diastolic dysfunction in diabetic patients at rest and the contributory effects of diabetes to myocardial impairment produced by hypertension, as well as the high usefulness of tissue Doppler imaging in detection and quantitation of myocardial dysfunction in diabetics.

[Renal artery aneurysm as a cause of resistant hypertension in a young female--case report].

A case of a 19-year-old woman suffering for 5 years from pharmacologically resistant hypertension, is presented. During invasive diagnostic procedures left renal artery aneurysm was found. Surgical resection with vessel prosthesis implantation was successfully performed.

Relation between heavy metals and left ventricular diastolic function in patients with coronary artery disease.

One of the earliest detectable abnormalities in patients with coronary artery disease is left ventricular diastolic dysfunction. Its main cause is myocardial ischaemia, but still many of other mechanisms are possible. The aim of this study was to investigate the relation of cadmium, lead, copper, zinc, and selenium with left ventricular diastolic function indices in patients with coronary artery disease.

[Thrombocytopenia and disseminated intravascular coagulation in a patient with left atrial myxoma--a case report].

A case of a 47-year-old man, a Jehovah's Witness, with left atrial myxoma is presented. Clinical presentation included several months of thrombocytopenia and disseminated intravascular coagulation. Deterioration of heart failure was complicated by pneumonia and worsening of disseminated intravascular coagulation.

Analysis of hepatitis G virus infection markers in blood donors and patients with hepatitis.

The incidence and clinical significance of hepatitis G virus (HGV) is still not fully known. The aim of our study was to assess the frequency of HGV RNA and antibody to HGV E2 protein (anti-E2) in Polish blood donors and patients with hepatitis, and to compare the sequence of HGV clones with those reported by others. Two-hundred and nineteen blood donors and 83 patients with hepatitis were studied.

[Cytostatic drugs: occupational hazard to health care workers].

Cytostatic anticancer drugs are known as carcinogenic, mutagenic, and teratogenic risk factors for health care workers who are occupationally exposed during preparation and management of such drugs. Risk assessment for occupational exposure to antiblastic chemotherapeutic drugs is carried out by means of environmental and biological monitoring. During last twenty years, several researchers have developed and validated methods for monitoring occupational exposure to such agents.

[The course of acute hepatic porphyria].

Acute hepatic porphyrias are the diseases dependent on the congenital metabolic defects of the hem biosynthesis. The diagnosis of porphyria only on the grounds of clinical picture is extremely difficult as it is presented by the variety of symptoms, often imitating other diseases. In each case the diagnosis must be confirmed by the biochemical and enzymatic investigations.

[Factor VIII inhibitor appearing in women during delivery].

Factor VIII inhibitor is rare, but very serious postpartum complication. Bleeding diathesis caused by this inhibitor is called acquired haemophilia. Three women with postpartum inhibitor to factor VIII and life threatening bleeding were described.

Surgery in hemophilia A patients with factor VIII inhibitor: 10-year experience.

Patients with hemophilia A and circulating anticoagulant (factor VIII inhibitor) present a difficult, even unsolvable problem, particularly if they require surgical treatment and the inhibitor titer is high. During the 1986-1995 period 29 surgical procedures on inhibitor hemophilia A patients were performed in our center. Each of the cases had an individual character, and all demanded special clinical treatment.

Immune tolerance induction in haemophiliacs with inhibitor to FVIII: high- or low-dose programme.

In 1993-94, 15 high responders were treated in our centre according to the Malmo protocol which was modified as follows: serial plasmapheresis was performed instead of extracorporeal adsorbtion to protein A for reducing inhibitor levels and, after the bolus dose to neutralize the inhibitor, factor VIII concentrate was administered by a continuous infusion. Thus, this regimen included continuous infusion of factor VIII(FVIII) for 1-4 weeks, iv cyclophosphamide for 2 days and orally for 8-10 days, and intravenous immunoglobulin (IVIG) from the fourth day for 5 days. All patients had been qualified for the treatment when the antibody level was < 15 BU mL(-1) .

[Influence of magnesium on rate of sodium transport through lymphocyte membranes in patients with hypertension].

Clinical and experimental investigations indicate that one of the causes of primary hypertension may be diminished membrane sodium efflux. Magnesium is thought to be one of necessary factors that influence normal sodium membrane efflux and thereby maintains correct membrane gradient and potential. The aim of the study was to determinate the influence of intravenous 25% magnesium sulphate infusion on arterial pressure and sodium leukocyte membrane efflux in subjects suffering from primary arterial hypertension.

[Propafenone, flecainide, procainamide in the treatment of a fresh attack of atrial fibrillation].

The purpose of the present work was an assessment of the effectiveness of intravenously administered propafenone, flecainide and procainamide in restoration of sinus rhythm in patients with atrial fibrillation attack lasting not more than 48 hours, The studies were carried out in 95 patients, including 30 treated with propafenone, 27 with flecainide, and 38 with procainamide. Propafenone turned out to be effective in 23 patients (76.7%), flecainide in 19 patients (70.

[Multiorgan trauma].

A case is presented of a patient with multiorgan trauma. The main diagnostic problem was coexisting haemorrhage. Curable skin defects were healed after several covering them with intermediate thickness mesh grafts.

[Splenectomy in adult patients with idiopathic thrombocytopenic purpura after intravenous immunoglobulin treatment].

Eight patients with idiopathic thrombocytopenic purpura (ITP) and no response to steroids therapy were prepared for splenectomy, for 5 consecutive days, with intravenous immunoglobulin (IVIG, 0.4 g/kg body weight). Increase of platelet counts and/or remission of haemorrhagic diathesis were observed in 7 patients, in one case IVIG proved ineffective.

[Tests concerning the usefulness of serum myoglobin levels for the diagnosis of reperfusion in patients with imminent myocardial infarction].

Blood myoglobin, CPK and CK-MB activities were assayed in 32 patients with the acute myocardial infarction up to 360 minutes following the start of thrombolytic therapy. Plasma myoglobin, CPK and CK-MB activities increased significantly less in 18 patients in whom reperfusion of the coronary artery has been noted. Maximum increase in myoglobin levels preceded an increase in CPK and CK-MB activities and it may be an early marker of reperfusion.

A study on financial viability of clinics and physician practices in under-served areas of Wisconsin: summary of results with recommendations.

A survey of 21 physicians and clinic managers located in Health Professional Shortage Areas (HPSAs) and other under-served areas in Wisconsin found that to combat increasing costs, low reimbursement rates, and increasing charity care demands, several practices rely on outside sources of funding to remain financially viable. Also, the financial viability of physician practices in under-served areas of Wisconsin is threatened more by the low reimbursement rates of Medicaid and Medicare than by the provision of charity care. Though few are limiting the number of Medicare and uninsured patients they will treat, many have begun implementing cost containment measures, including more strict collection policies.

The effects of Medicare and Medicaid reimbursement on the financial viability of clinics and physician practices in medically under-served areas of Wisconsin.

A survey of 21 physicians and clinic managers located in Health Professional Shortage Areas (HPSAs) and other under-served areas in Wisconsin found that to combat increasing costs, Medicare and Medicaid discounts, charity care demands and physician recruitment difficulty, several practices rely on outside sources of funding to remain financially viable. Also, the financial viability of physician practices in under-served areas of Wisconsin is threatened more by the reimbursement rates of Medicaid and Medicare than by the provision of charity care. Though few are limiting the number of Medicare and uninsured patients they will treat, many practices have begun implementing cost-containment measures, including more strict collection policies.

A study on financial viability of clinics and physician practices in under-served areas of Wisconsin: the primary care physician shortage problem and collection issues.

A survey of 21 physicians and clinic managers in Health Professional Shortage Areas (HPSAs) and other under-served areas in Wisconsin found that to combat increasing costs, low reimbursement rates and increasing charity care demands, several practices rely on outside sources of funding. Also, the financial viability of physician practices in underserved areas of Wisconsin is threatened more by the low reimbursement rates of Medicaid and Medicare than by the provision of charity care. Though few are limiting the number of Medicare and uninsured patients they will treat, many have begun implementing cost containment measures, including more strict collection policies.