[The complications after lung transplantation]. / Komplikace po transplantaci plic.

Lung transplantation (LuTx) is an important treatment for a selected group of patients in the terminal stage of a number of lung diseases, which can bring them a significant improvement in quality of life and long-term survival. Nowadays a perioperative period is not significant limitation for patient survival due to the development of transplant surgery, but the period of months to years after LuTx is crucial for survival. The post-transplant period is very complicated for LuTx patients due to a special treatment regimen, special medication, especially immunosuppressive drugs and the possibility of many complications, whether early or late or acute or chronic. These complications can be divided into several groups. These are rejections, infections, tumors, non-infectious pulmonary complications, and extrapulmonary complications. This is a very wide range of diverse states and to cope with them, it is necessary, apart from good patient co-operation, to team together with specialists in many fields of medicine. But the reward is the satisfaction, good quality of life and long-term survival of transplanted patients.Key words: infection - lung transplantation - rejection - tumours.

Effect of sertraline in paroxysmal hypertension.

OBJECTIVE: Paroxysmal hypertension or pseudopheochromocytoma is quite a common problem in clinical practice. The optimal treatment for this condition has not been established. This study sought to investigate whether sertraline (a selective serotonin reuptake inhibitor) reduces the symptoms. METHODS: We enrolled 64 patients referred to our department between April 2008 and October 2014 for symptomatic paroxysmal hypertension. Patients received sertraline, 50 mg once daily, in addition to their current medication. The effect of the treatment was assessed during their next clinical visit at least 3 months later. RESULTS: Of the 64 patients, 57 (89%) also had sustained arterial hypertension. Mean office baseline blood pressure (BP) was 147.6/83.8 mmHg and patients used a mean of 3.1 antihypertensive drugs. Five patients did not start using sertraline and three were lost to follow-up. Of the 56 patients who started using sertraline and who came for check up, clinical improvement was observed in 42 (75%) patients - symptoms of paroxysmal hypertension fully subsided in 28 (50%) and were partially reduced in 14 (25%) . Side effects or intolerance leading to discontinuation of treatment occurred in 7 patients (12.5%). Mean office BP in patients using sertraline decreased by 12.8/7.4 mmHg (P<0.001 for both). CONCLUSIONS: Sertraline effectively removed or reduced symptoms of paroxysmal hypertension in the majority of patients who used this treatment.