Publications by authors named "Zdenek Stach"
Article Synopsis
- Acute supraventricular arrhythmias can worsen hemodynamic stability in patients with septic shock, and a study compared the effects of intravenous propafenone and amiodarone on arrhythmias in this population.
- In a trial with 209 patients, those receiving propafenone had a quicker return to sinus rhythm (3.7 hours) compared to those on amiodarone (7.3 hours), although the overall 24-hour sinus rhythm rates were similar.
- Propafenone led to fewer cases of arrhythmia recurrence than amiodarone, especially in patients without a dilated left atrium, indicating it may be a more effective option for short-term management.
Article Synopsis
- A prospective study was conducted on Covid-19 ARDS patients to investigate how the location of chest drains affects the detection of pneumothorax through bedside imaging methods like chest ultrasound (CUS) and X-ray.
- Out of 106 pneumothorax cases, the study found that chest drains were more accurately located with CUS in patients who experienced full lung expansion, while a significant percentage had residual pneumothorax post-drainage.
- Key indicators of a likely residual pneumothorax included an invisible chest drain on CUS, a low chest drain index (CDI) on X-ray, and observable continuous air leaks from the drain.
Envenomations that are caused by snakebites are mostly accompanied by venom-induced consumption coagulopathy (VICC) with defibrination. The clinical course of VICC is well described; however, reports about its detailed effects in the hemocoagulation systems of patients are sparse. In this pilot study, we prospectively analyzed the changes in plasma fibrinogen that were caused by the envenomation of six patients by five non-European snakes.
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- Coagulopathy with defibrination is a serious symptom of snakebite envenoming, leading to dangerous issues like severe bleeding and organ damage.
- A case is reported involving a bite from the African Great Lakes bush viper (Atheris nitschei), which resulted in a failure of blood coagulation due to a lack of specific treatment options like antivenom.
- The bite caused a rare and critical complication: atraumatic splenic rupture with significant internal bleeding, requiring immediate surgical intervention to remove the spleen (splenectomy).
Article Synopsis
- Supraventricular arrhythmias can worsen blood flow issues in patients with septic shock, leading researchers to hypothesize that propafenone might be more effective than amiodarone for restoring normal heart rhythm.
- The study will involve septic shock patients experiencing new arrhythmias but with stable left ventricular function, randomly assigning them to receive either drug and measuring their rhythm control after 24 hours.
- Results will also analyze the need for rescue treatments, mortality rates, and factors predicting successful rhythm control and recurrent arrhythmias, with a target enrollment of 200 patients to validate the findings.
Background: Inflammatory biomarkers may aid to distinguish between systemic inflammatory response syndrome (SIRS) vs. sepsis. We tested the hypotheses that (1) presepsin, a novel biomarker, can distinguish between SIRS and sepsis, and (2) higher presepsin levels will be associated with increased severity of illness and (3) with 28-day mortality, outperforming traditional biomarkers.
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- Snakebites from exotic venomous snakes can lead to serious health issues, with most incidents occurring among snake breeders in Europe and North America or from rattlesnakes in the wild.
- Victims may experience a range of severe symptoms including organ failure, muscle paralysis, respiratory distress, and severe coagulation issues.
- Effective management of these cases requires collaboration between clinical toxicologists and intensive care physicians, as many healthcare providers may not be experienced with the complexities of severe envenoming treatment.
A snake breeder, 47-years-old man, was bitten by the saw-scaled viper (Echis carinatus sochureki). After admission to Toxinology Centre, within 1.5 h, laboratory evaluation showed clotting times prolonged to non-measurable values, afibrinogenaemia, significantly elevated D-dimers, haemolysis and myoglobin elevation.
View Article and Find Full Text PDFAlthough the bites caused by snakes from former Agkistrodon family in the areas of occurrence are not rare and even have certain epidemiologic importance, in case of envenoming by Deinagkistrodon acutus the clinical studies and case reports are very sporadic. This case report describes the envenoming of a private snake breeder bitten by young Chinese moccasin Deinagkistrodon acutus to the thumb of his left hand. He sought for a medical help immediately after snakebite.
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- The study analyzed snakebite cases from the common European viper (Vipera berus) in the Czech Republic over 15 years, collecting data from a Toxinology Centre database.
- Out of 191 recorded snakebites, 25.7% resulted in systemic envenoming, while 47.6% had local symptoms without systemic effects, and 26.7% were dry bites with no symptoms.
- No fatalities occurred, but the research emphasized the need for antivenom treatment in cases with systemic symptoms and advised caution for children even in less severe cases, highlighting the importance of specialized hospital care for envenomed patients.
Article Synopsis
- The study focuses on the analysis of 87 cases of exotic snakebites in the Czech Republic over 15 years, highlighting that most cases involved venomous species with serious envenoming effects.
- Out of these cases, 33.3% resulted in systemic envenoming, and 19.5% required antivenom treatment, although there were no fatalities reported.
- The findings emphasize the importance of timely medical intervention, including antivenom administration and organ support, to improve outcomes for patients suffering from exotic snakebites.
Purpose: To determine bioenergetic gain of 2 different citrate anticoagulated continuous hemodiafiltration (CVVHDF) modalities and a heparin modality.
Materials And Methods: We compared the bio-energetic gain of citrate, glucose and lactate between 29 patients receiving 2.2% acid-citrate-dextrose with calcium-containing lactate-buffered solutions (ACD/Ca(plus)/lactate), 34 on 4% trisodium citrate with calcium-free low-bicarbonate buffered fluids (TSC/Ca(min)/bicarbonate), and 18 on heparin with lactate buffering (Hep/lactate).
Protobothrops mangshanensis bite: first clinical report of envenoming and its treatment.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub
June 2012
Aim: This case report presents envenoming by the Chinese pit viper Protobothrops mangshanensis (formerly Zhaoermia) and its treatment.
Methods: A 38 year old snake breeder suffered two-fang bites to elbow by a Chinese pit viper Protobothrops mangshanensis resulting in local edema of the affected arm. No other signs of envenoming appeared.
Article Synopsis
- The study investigates how citrate anticoagulation affects the delivery of metabolic substrates in patients, comparing those using acid-citrate-dextrose (ACD) with those on unfractionated heparin.
- Results show that citrate levels were similar between different dialysis techniques, and the systemic loads of lactate and glucose were also comparable across groups.
- The findings suggest that ACD may provide a notable amount of metabolic substrates, and that the measurement of unmeasured anions can help predict citrate delivery during treatment.
Article Synopsis
- A case study details the rare envenoming from a bite by a viperid snake, Proatheris superciliaris, involving a 57-year-old Czech herpetologist.
- The patient experienced severe symptoms including pain, nausea, hematuria, and various organ issues such as acute renal failure and lung lesions.
- Treatment was supportive, involving haemodialysis and plasma/platelet replacement, ultimately leading to complete recovery within a month.