[Patient adherence in respiratory tract infections: ceftibuten versus other antibiotics (PARTICULAR study)]. / Przestrzeganie zalecen lekarskich w zakazeniach dróg oddechowych: ceftibuten a inne antybiotyki (badanie PARTICULAR).

The study was conducted to evaluate patient compliance to antibiotic therapy in respiratory tract infections. The main aim of the study was to establish whether dosing frequency (1 vs 2 or 3 times daily) and other factors influence compliance. Patients aged 18 and over attending selected primary health facilities in Lódz region were enrolled. Patients were randomly assigned to receive ceftibuten, 400 mg once daily or other antibiotic on physician's choice with 2 or 3 times daily dosing. On the 5th day during the home visit the questionnaire study was performed and the compliance was measured by a pill count. Four hundred and six patients (205 in ceftibuten and 201 in other antibiotics group, respectively) were fully evaluable. Overall compliance was 76.6% with 97.6% for ceftibuten, 66.0% for antibiotics with b.i.d. dosing and 23.5% for antibiotics with t.i.d. dosing. Using a logistic regression analysis with a stepwise variable selection, dosing frequency was found to be a major variable associated with patient compliance (p = 0.00000, odds ratio 0.09, 95% confidence interval 0.057-0.165). Non-compliance with antibiotics is a common phenomenon in respiratory tract infections therapy. Once-daily antibiotic dosing leads to the best possible compliance in such circumstances. Due to its once-daily dosing and rare side effects, ceftibuten ensures nearly perfect compliance in respiratory tract infections therapy.

Angioarchitectonics of the venous vessels and morphological changes in coronary heart disease.

For an understanding of the effects of myocardial protection via the coronary sinus and other cardiac veins, study of the angioarchitectonic of these veins in ischemic hearts is of special interest. Venous vessels were filled with radiological contrast material (hearts of decreased patients who died from coronary disease and also normal hearts) and were then studied using the microhistoangiographic technique. It was noted that necrotic zones of the histologic preparations were similar to the corresponding microangiograms. It was found that with myocardial infarction in the process of organization, the venous vessels around the necrotic zone appear and infiltrate from the border toward the "vessel-less" space lying in the necrotic center. This points to a participation and to the importance of venous vessels in the renovation of microcirculation in the necrotic zone after myocardial infarction.

Angioarchitectonics of the venous vessels in the normal human myocardium.

The studies have been conducted on normal hearts using microhistoangiographical method. Angioarchitectonics of venous vascularization of the left and right ventricular walls have been described. The so-called "perforating veins", venous vessels of type I (intramuscular venous plexuses), venous vessels of type II and the Thebesian veins have been distinguished.

Microangioarchitectonics of the myocardial venous vessels in coronary heart disease.

The studies have been conducted on human hearts in the course of acute and chronic coronary insufficiency using microhistoangiographical method. Changes in the angioarchitectonics of the venous vessels in the course of myocardial infarction and also in chronic coronary insufficiency have been described. It was noted that the renovation of the vessels in the organizing infarcts begins from the venous pole with the participation of the intramuscular venous plexuses.

Termination of the coronary sinus in the left atrium.

The authors described abnormal outlet of the coronary sinus into the left atrium. This rare malformation was found during autopsy of the heart in 39 years old woman. In order to show other malformations histopathological studies and postmortem coronarography have been performed.

Effect of venous retroperfusion on experimental myocardial ischemia in the open-chest pig.

Venous retroperfusion, by arterialization of the coronary sinus or the vein accompanying an ischemic artery, has been suggested as an alternative method of myocardial revascularization in patients with severe coronary disease in whom direct revascularization would be an unacceptable risk or technically impossible. This study was carried out to assess whether or not venous retroperfusion can increase myocardial blood flow in the area of ischemia after sudden occlusion of a normal coronary artery in an animal, the pig, with a coronary vasculature similar to that of humans. It was found that net flow measured with an electromagnetic flowmeter through either an aorta-to-coronary sinus shunt or an aorta-to-left anterior descending coronary vein shunt after occlusion of the left anterior descending artery was at first high but rapidly decreased toward zero flow within 1 hr. Blood flow in the ischemic region measured by the microsphere method 20 min after coronary occlusion did not increase. This disparity between electromagnetic flow and regional flow suggests that there are venous-to-thebesian or venous-to-venous shunts into the systemic and pulmonary circulation through vessels greater than 14 micron. It is unlikely that effective oxygen or metabolite exchange would occur in vessels this size.

Arterialization of the coronary veins in diffuse coronary arteriosclerosis.

Since the coronary veins and capillaries are not involved with arteriosclerotic disease the authors performed experimental, and afterwards, clinical total and selective coronary vein arterialization. Acute myocardial ischaemia created for instance by ligation of the anterior descending branch, was treated by an internal mammary artery to regional coronary vein anastomosis. In 21 patients the selective arterialization of the "Vena cordis magna" or of "Vena cordis media", and total arterialization of the coronary sinus was performed. The clinical improvement and follow-up studies seem to be promising in the treatment of patients with advanced diffuse heavy coronary arteriosclerosis. In acute myocardial ischaemia with coronarographically localized coronary occlusion, the aim of regional vein arterialization is to minimize the area of infarction.