RESUMEN
Two courses of immunoadsorption with 'Ig Adsopak' were used in the treatment of a patient with dilated cardiomyopathy (DCM) during which all class G and partially class M and A immunoglobulins were removed. Every course consisted of 5 daily procedures and resulted in removal of 98% of immunoglobulins. This was associated with complete removal of autoantibodies to beta1-adrenoreceptor. After the end of a course loss of immunoglobulins was replenished by intravenous infusion of Pentaglobin and Oktagam. Echocardiographic study carried out before, during and after second course of apheresis revealed reduction of left and right ventricular and atrial volumes and dimensions, improvement of contractility of anterior part of interventricular septum and of anterolateral left ventricular wall. As efficacy of drug therapy of dilated cardiomyopathy is low and facilities of cardiac transplantation are limited the method of therapeutic apheresis reveals novel perspectives of the treatment of dilated cardiomyopathies.
Asunto(s)
Eliminación de Componentes Sanguíneos/métodos , Cardiomiopatía Dilatada/terapia , Inmunoglobulinas/metabolismo , Humanos , Persona de Mediana Edad , Índice de Severidad de la EnfermedadRESUMEN
The efficacy of drug (inderal, corinfar) treatment in combination with manual therapy (the course was 4-7 sessions) was examined in hypertensives with cervical osteochondrosis. The latter was evidenced by X-ray studies. Clinically, cervical osteochondrosis appeared as vertebrobasilar insufficiency. The vertebral artery bed displayed circulatory disorders documented by rheoencephalography, electroencephalography, ultrasound Doppler echography of the head and neck vessels. Treating the patients with drugs in combination with manual therapy resulted in improved circulation in the vertebral artery bed, lower clinical signs of vertebrobasilar insufficiency. There was a more persistent and more pronounced decrease in blood pressure with small-dose antihypertensive agents.
Asunto(s)
Presión Sanguínea , Vértebras Cervicales , Hipertensión/terapia , Manipulación Ortopédica , Osteocondritis/complicaciones , Adulto , Anciano , Terapia Combinada , Femenino , Humanos , Hipertensión/complicaciones , Masculino , Persona de Mediana Edad , Osteocondritis/terapiaAsunto(s)
Presión Sanguínea/fisiología , Electrocardiografía Ambulatoria/instrumentación , Hipertensión/diagnóstico , Adulto , Anciano , Determinación de la Presión Sanguínea/instrumentación , Determinación de la Presión Sanguínea/métodos , Ritmo Circadiano , Electrocardiografía Ambulatoria/métodos , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Valores de ReferenciaAsunto(s)
Neumonía/tratamiento farmacológico , Enfermedad Aguda , Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/etiología , Farmacorresistencia Microbiana , Quimioterapia Combinada , Humanos , Neumonía/etiologíaAsunto(s)
Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Enfermedades Pulmonares/tratamiento farmacológico , Antifúngicos/uso terapéutico , Antivirales/uso terapéutico , Humanos , Enfermedades Pulmonares Fúngicas/tratamiento farmacológico , Neumonía/tratamiento farmacológico , Virosis/tratamiento farmacológicoRESUMEN
Computed spirography, He/O test and capnography evaluation of external respiration has been carried out for 52 subjects. Of these 27 were nonsmokers, 25 smoked but had no history of respiratory diseases. The integral criteria of external respiration obstruction (MOCmax, MOC50, MOC75) proved inadequate diagnostic tool for early detection of ventilatory alterations in smokers who are at risk to develop chronic nonspecific pulmonary diseases. Pharmacological tests, He/O investigation and capnography did reveal defects in small bronchi permeability in all the smokers. Problems of pathogenesis of obstructive affections of distal regions of the bronchial tree are under consideration.
Asunto(s)
Respiración , Fumar/fisiopatología , Humanos , Enfermedades Pulmonares Obstructivas/etiología , Pruebas de Función Respiratoria , Factores de RiesgoRESUMEN
A total of 52 subjects (27 normal persons not abusing tobacco-smoking and 25 tobacco-smokers without respiratory disorders) were examined for external respiration function. A study was also made of the capnography data. It has been demonstrated that the classical criteria of the functional disorders of ventilation (FVC, RFV1, RFV1/FVC, MPV) do not enable one to make an early diagnosis of the ventilatory alterations in subjects with a risk of the development of CNPD (in tobacco-smokers). Analysis of the last third of the forced expiration curve flow-volume appeared to be of great informative value. There was a marked correlation between the capnogram characteristics and external respiration function characterizing patency of the small bronchi. It is concluded that capnography can be used as a method for assessing bronchial patency. The most informative criteria of the capnogram are provided.
Asunto(s)
Pruebas de Función Respiratoria , Enfermedades Respiratorias/diagnóstico , Albuterol/farmacología , Humanos , Fumar/efectos adversos , Factores de TiempoAsunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Bronquitis/tratamiento farmacológico , Adulto , Anciano , Bronquitis/inmunología , Bronquitis/fisiopatología , Enfermedad Crónica , Evaluación de Medicamentos , Humanos , Recuento de Leucocitos/efectos de los fármacos , Persona de Mediana Edad , Péptidos/uso terapéutico , Respiración/efectos de los fármacos , Linfocitos T Colaboradores-Inductores/efectos de los fármacos , Linfocitos T Colaboradores-Inductores/inmunología , Linfocitos T Reguladores/efectos de los fármacos , Linfocitos T Reguladores/inmunología , Extractos del Timo/uso terapéutico , Relación Ventilacion-Perfusión/efectos de los fármacosAsunto(s)
Bronquitis/tratamiento farmacológico , Bloqueadores de los Canales de Calcio/administración & dosificación , Hemodinámica/efectos de los fármacos , Hipertensión Pulmonar/tratamiento farmacológico , Nitratos/administración & dosificación , Respiración/efectos de los fármacos , Vasodilatadores/administración & dosificación , Quimioterapia Combinada , Humanos , Dinitrato de Isosorbide/administración & dosificación , Nifedipino/administración & dosificación , Nitroglicerina/administración & dosificación , Enfermedad Cardiopulmonar/prevención & control , Verapamilo/administración & dosificaciónRESUMEN
Problems of early diagnosis, prophylaxis and therapy of chronic cor pulmonale (CCP) were discussed. It was pointed out that the right ventricular hypertrophy could not be regarded as the main diagnostic sign of CCP as it was recognized at late stages of diseases when therapy was of low efficacy. The authors proposed to specify CCP clinico-functional definition with 4 functional classes with relation to the expression of disturbances of ventilation function of the lungs and hemodynamics. The results of isoket and corinfar therapy of 250 patients with obstructive bronchitis of various gravity of ventilation and hemodynamic disturbances were presented. They showed that the use of prolonged nitrates was found appropriate in the patients of the 3rd-4th functional classes with signs of developed CCP. The use of prolonged nitrates in the patients of the 1st-2nd functional classes resulted in an increase of pulmonary functional shunting of the blood. Calcium antagonists made a balanced effect on the bronchial permeability and pulmonary hemodynamics. Their use was indicated at early stages of the process when functional mechanisms played the leading role in the pathogenesis of disturbances.
Asunto(s)
Enfermedad Cardiopulmonar/diagnóstico , Bloqueadores de los Canales de Calcio/uso terapéutico , Enfermedad Crónica , Hemodinámica/efectos de los fármacos , Humanos , Nitroglicerina/uso terapéutico , Circulación Pulmonar/efectos de los fármacos , Enfermedad Cardiopulmonar/tratamiento farmacológico , Enfermedad Cardiopulmonar/prevención & control , Insuficiencia Respiratoria/diagnóstico , Insuficiencia Respiratoria/etiologíaRESUMEN
Thirty-three patients with infectious allergic bronchial asthma and chronic obstructive bronchitis and 47 normal subjects were examined with the aid of a complex of bloodless research methods for the pulmonary circulation and central hemodynamics under graded physical exercise of minor power. Investigation at rest did not disclose any hemodynamic disorders in the greater and pulmonary circulation. Application of bicycle ergometry to patients with chronic obstructive bronchitis and bronchial asthma in a stage of remission made it possible to reveal latent hemodynamic disorders of the pulmonary circulation that manifested by long-term elevation of the pressure in the pulmonary artery and pulmonary vascular resistance, restitution of the central hemodynamics according to the hyperkinetic type. The use of the generally accepted formulas for calculating the proper magnitudes of the ejection period and mechanical systole with the heart rate exceeding 90 per minute resulted in overdiagnosis of the overload of the right ventricle. The authors offer the regression equations for calculating these parameters during tachycardia.