The application of whole-body vibration in physiotherapy - A narrative review.

Whole-body vibration (WBV) training is a very popular kind of practice in sport, fitness and physiotherapy. This work reviews the current knowledge regarding the use and effectiveness of WBV in the physiotherapy. The discrepancies between different authors' results are probably due to divergence in WBV training protocols. The paperwork clearly showed that despite its ultimate effects, exercises on a vibration platform are safe, feasible, and well tolerated by patients with different disorders. This narrative review should help physiotherapists verify therapy programs regarding patients' exposure to WBV.

[P-wave ekg averaging technique--a new method of selecting patients with paroxysmal atrial fibrillation]. / Technika usredniania zalamka P ekg--nowa metoda wyodrebniania chorych z napadowym migotaniem przedsionków.

The aim of study was to assess the value of signal averaged ecg for detection of patients (pts) at risk for paroxysmal atrial fibrillation (paf). We examined three groups of pts: group I-41 pts with nonvalvular paf, group II-20 pts with hypertension and/or ischemic heart disease without paf and group 3-26 health persons, without organic heart disease. In all pts the signal-averaged electrocardiogram triggered by P waves was recorded. Seven parameters of the spatial magnitude of filtered P wave were measured. Significant difference between group I and group II or III was found in most parameters. Using the method of multidimensional variance analysis we constructed "the diagnostic vector" in multidimensional parameters space, which was used to determine patients belonging to group. Total percent of right decision was 85%. These findings suggest that pts at risk for paf could be detected while in sinus rhythm by using the P wave-triggered signal-averaged ecg.

Elevated plasma atrial natriuretic peptide concentrations in hypertensive patients with acute myocardial infarction.

BACKGROUND: Atrial natriuretic peptide (ANP) has been extensively studied in cardiovascular disorders in recent years. Particular attention has been paid to the role of ANP in the pathogenesis of hypertension and congestive heart failure and in the neurohormonal response to myocardial infarction. However, no published data are available on the significance of ANP in hypertensive patients with acute myocardial infarction. METHODS: We studied the relationship between plasma ANP concentration and systolic blood pressure, diastolic blood pressure, left atrial dimension, left ventricular diastolic dimension and left ventricular mass index in patients with essential hypertension in the acute phase of myocardial infarction. Plasma ANP concentrations were determined at 0, 4, 8, 16, 24, 48 and 72 h after admission in 40 patients with a first myocardial infarction (18 hypertensive patients, group 1; 22 normotensive patients, group 2). Left atrial dimension and left ventricular diastolic dimension were assessed echocardiographically within the first 48 h of acute myocardial infarction. RESULTS: Maximum and mean plasma ANP values at 0, 4, 8, 16, 24, 48, and 72 h as well as mean ANP concentrations within the 72 h period were higher in group 1 than in group 2 (P < 0.001). Plasma ANP concentration, left atrial dimension (r = 0.59) and left ventricular diastolic dimension (r = 0.56) were positively correlated in both groups. CONCLUSION: Acute myocardial infarction is characterized by a more pronounced rise in plasma ANP concentration in hypertensive patients than in those without a history of hypertension. Plasma ANP concentration correlates with left heart chamber sizes.

[Prognostic value of an early peak CK-MB in plasma of patients treated with streptokinase for acute myocardial infarction]. / Wartosc prognostyczna wczesnego szczytu aktywnosci CK-MB w surowicy u chorych leczonych streptokinaza w ostrym zawale serca.

111 patients below 70 years old, with the first acute myocardial infarctions, 6 hours since the pain occurred--have been treated with streptokinase i.v. In 102 patients we obtained full curve of CK-MB activity. Early peak of CK-MB activity < 15 hours after onset of symptoms we have observed in 59 patients, and late peak of CK-MB activity > 15 hours in 43 patients. There was not any significant statistics differences between early and late groups in frequency of: early ventricular fibrillation (< 48 hours), complex ventricular arrhythmia (in 21 day), heart failure and in-hospital mortality. 1 patient died in hospital in early group and in late group also died 1 patient. The follow-up period was from 10 to 48 months (av. 26 +/- 13). 100 patients left the hospital and the full informations we have obtained in 97 cases. No one died in that time. In the group with early peak CK-MB activity we observed more often the unstable angina and the new myocardial infarction (21%) than in the group with late peak of CK-MB activity (15%), but these differences were nonsignificant. In conclusion our results don't confirm that the early peak of CK-MB activity is the positive risk factor of unstable angina and the new myocardial infarction.

[A method of averaged ECG signal does not identify patients with ventricular tachycardia in disorders of intraventricular conduction]. / Technika usredniania sygnalu EKG nie pozwala na wyodrebnienie chorych z czestoskurczem komorowym przy zaburzeniach przewodnictwa sródkomorowego.

Conduction defect are known to delay and fragment the ecg signal and may be expected to cause changes on the signal-averaged ecg that mimic ventricular late potentials. The aim of our study was to asses whether signal-averaged ECG (SAE) identify patients (pts) with sustained ventricular tachycardia (VT) after myocardial infarction (MI) who display right or left bundle branch block (RBBB or LBBB). We studied 23 pts with RBBB and 25 pts with LBBB. SEA was recorded with bidirectional filters at 25-250 HZ and 40-250 Hz using Simson method. The total filtered QRS duration (QRSd), root mean square voltage in the terminal 40ms of the QRS (RMS40) and low amplitude signal duration less than 40uV (LAS40)) were measured. Signal-averaged parameters with a filter at 25-250 Hz were: [table: see text] Signal-averaged parameters with a filter at 40-259 Hz were: [table: see text] In conclusion SAE parameters do not allow separation of pts with sustained VT from pts with RBBB or LBBB after MI. These data indicate that conduction defects have effects on signal-averaged ecg parameters and may result in masking of ventricular late potentials.

Value of the atrial signal-averaged electrocardiogram in identifying patients with paroxysmal atrial fibrillation.

Atrial signal-averaged electrocardiogram was compared between 25 patients with paroxysmal atrial fibrillation and 20 healthy persons without atrial arrhythmias (control). The duration time of the high frequency (50-250 Hz) P wave was significantly (P less than 0.01) prolonged in the groups of patients with paroxysmal atrial fibrillation compared with the control group (116 +/- 16.4 versus 92 +/- 8.1 msec). The diagnostic value of the duration of the high frequency P wave for identifying patients with paroxysmal atrial fibrillation was 104 msec. Using this criterion, a sensitivity of 76% and a specificity of 90% were achieved. Our observation has shown that the atrial signal-averaged electrocardiogram is a useful technique for identifying patients with paroxysmal atrial fibrillation.

[A case of ventricular free wall rupture in acute myocardial infarction treated conservatively with success]. / Przypadek pekniecia wolnej sciany lewej komory w przebiegu swiezego zawalu serca skutecznie leczony zachowawczo.

A sixty year old man developed clinical signs of pericardial tamponade on fifth day of acute myocardial infarction. An echocardiogram showed a pericardial effusion and rupture of left ventricular free wall. After pericardial puncture and four days pericardial drainage, the fissure of rupture was closed by formation of thrombus and pseudoaneurysm. After six weeks patient was discharged in good condition.

[Late ventricular potentials--a new risk factor for cardiac arrhythmias in recent myocardial infarction]. / Pózne potencjaly komorowe--nowy wskaznik zagrozenia niebezpiecznymi zaburzeniami rytmu w swiezym zawale serca.

The study involved 150 patients with recent myocardial infarction. Ventricular lat potentials were registered in these patients during the first 48 hours and repeated in the third week. Ventricular late potentials were found in 31 patients (21%) in the first 48 hours, and in 27 out of 134 patients (20%) before the release from the hospital. Comparing potentials registration in the acute and late phase of the myocardial infarction it was found that ventricular late potentials occurred in 6 and disappeared in 4 patients. Stable ventricular tachycardia was significantly more frequent (p less than 0.001) within the first 48 hours in patients with ventricular late potentials than those without them (19% vs 3%). Ventricular late tachycardia (over 48 hours) was more frequent (p less than less than 0.001) in patients with ventricular late potentials (21% vs 1%). Premature ventricular excitations of Lown class 2-5 were also more frequent (p less than 0.001) in the group of patients with ventricular late potentials than those without these potential (81% vs 24%) when registered with a 24-hour Holter ECG in the third week following myocardial infarction. Antiarrhythmic drugs did not produce the regression of ventricular late potentials. Non-invasive registration of ventricular late potentials helps to select patients with life-threatening ventricular arrhythmias following the acute myocardial infarction.

[Value of recording late ventricular potentials in patients with a history of myocardial infarction]. / Znaczenie rejestracji póznych potencjalów komorowych u chorych z przebytym zawalem serca.

The aim of the work was to determine the values of the registration of late ventricular potentials (PPK) in order to identify patients with paroxysmal ventricular tachycardia following myocardial infarction. PPK was found in 26 out of 30 patients (87%) with episodes of ventricular tachycardia and only in 6 out of 50 (12%) patients without such rhythm disorders following myocardial infarction (p less than 0.001). No PPK were found in any of 25 healthy persons of the control group. No significant difference was found in the frequency of complex ventricular extrasystolic beats (III-V cl. according to Lown) in 24-hour ambulatory electrocardiogram between patients with paroxysmal ventricular tachycardia (47%) and patients without such episodes in anamnesis (30%). The recording of PPK in chest surface leads makes it possible to identify patients with paroxysmal ventricular tachycardia following cardiac infarct.

[Disturbances of upper airway patency and their sequelae]. / Zaburzenia droznosci górnych dróg oddechowych i ich nastepstwa.

The authors present their investigations of the effects of upper airway compromise from hypertrophy of lymphoid tissue, nasal polyps, deviated nasal septum and hypertrophy of the nasal conchae. All the patients were under the age of 18 years. Methods of assessing children with airway compromise include 6-hour polysomnography (PSG). Special attention was paid to the heart function, as well as to pO2 and pCO2 saturation. Computer analysis of PSG studies revealed disturbances in circulatory system function, unnoticed in routine physical examination. The results may serve as one more voice in a debate about the advisability of surgical treatment of airway compromise performed in childhood.

[Nasal obstruction in patients with sleep apnea]. / Niedroznosc nosa u chorych z zaburzeniami oddychania podczas snu (sleep apnea).

The authors described the clinical signs and consequences of suffocations during sleep apnea. They presented the results of the surgical intervention of nasal obstruction in patients with sleep apnea. The during-all-night examinations of these patients proved the possibility of positive effects of surgical intervention of nasal obstruction in patients with sleep apnea.

Prognostic significance of late potentials after myocardial infarction.

Signal-averaged electrocardiograms (ECGs) were registered before hospital discharge in 120 consecutive patients (pts) with first acute myocardial infarction (MI). 26 pts (22%) had abnormal signal-averaged ECGs - late potentials (LP). Pts with LP had a more serious clinical course than pts without LP: sustained ventricular tachycardia (VT) (27% vs. 2%; p less than 0.01), left ventricular aneurysm (35% vs. 11%; p much less than 0.05) and greater infarct size (62 +/- 35 vs. 43 +/- 22 CK-MB gEq; p less than 0.01). Complex ventricular ectopic activity was more often in pts with LP than in those without LP (54% vs. 28%; p less than 0.05). During an up to 18-month follow-up (mean 13) 6 pts presented sustained VT and 2 died suddenly. 5 pts with sustained VT and 2 pts who died suddenly had LP. The sensitivity of the signal-averaged ECG as a predictor of arrhythmic events was 86%, with a specificity of 82%. Signal-averaged ECGs provide prognostic information in identifying arrhythmic events after MI.

Significance of anterior precordial ST-segment depression in acute inferior myocardial infarction.

In 70 consecutive patients (pts) with acute transmural inferior infarction, 58 had significant precordial ST depression (group A) and the remaining 12 had no ECG changes in precordial leads (group B) on admission. At the time of hospital discharge, the persistence of anterior ST depression was observed in 13 pts (group A1), normalization in 45 (group A2). Infarct size was significantly greater (p less than 0.05) in group A than in group B (37.6 vs. 23.8 CK-MB gEq). The largest infarct (51.5 CK-MB gEq) and the most serious clinical course was observed in group A1. No significant differences were noticed in the frequency of reinfarction and episodes of acute coronary insufficiency during hospitalization and one-year follow-up between groups. Persistent precordial ST depression is a simple ECG marker of extensive infarction, left ventricular dysfunction and a worse clinical course.