RESUMO
An altered stress response can contribute to the transition from preclinical psychotic symptoms to the clinical manifestation of schizophrenia and other psychotic disorders. The present study was aimed at testing the hypotheses that (i) the autonomic and neuroendocrine responses under psychosocial stress are dysregulated in individuals with high psychosis proneness (schizotypy); (ii) the magnitude of post-stress autonomic activation and cortisol release predicts alterations in semantic memory retrieval. The study was performed in 73 healthy individuals of both sexes with either high or low schizotypal traits preselected out of 609 individuals using the Schizotypal Personality Questionnaire. A psychosocial stress procedure based on public speech was used as a stress model. We found that individuals with high schizotypy engaged in less adaptive emotional stress-coping strategies than low schizotypy individuals. Yet, the neuroendocrine, immune, and sympathetic activation in response to the stress test was not different between the groups. Irrespective of the exposure to the stressor, individuals with high schizotypy were less fluent when retrieving associations from semantic memory. In addition, we demonstrated that acute psychosocial stress reduced the flexibility of semantic memory retrieval. The post-stress mental inflexibility was reliably predicted by the concomitant elevation of cortisol concentrations in saliva. The present study thus brings novel evidence indicating that the acute psychosocial challenge impairs retrieval flexibility in the semantic domain, which may be due to neuroendocrine activation.
Assuntos
Transtornos Psicóticos , Transtorno da Personalidade Esquizotípica , Masculino , Feminino , Humanos , Transtorno da Personalidade Esquizotípica/diagnóstico , Hidrocortisona , Semântica , Transtornos Psicóticos/psicologia , Estresse PsicológicoRESUMO
AIMS: Coronary artery disease in young adults is important task of contemporary cardiology. Presented our results experience and opinion were obtained by our long term investigation of myocardial infarction in young patients under 40 years. METHODS: Two sets of patients were examined - 78 patients (74 men, 4 women) hospitalised in pretrombolytic era in prospective 8 years follow up (1984-1992) and 39 patients (35 men, 4 women) admitted during period 2000-2010 analysed retrospective. RESULTS: Myocardial infarction in young age belongs roughly to two different groups with considerable overlap in pathogenetic mechanisms: 1. angiographycally normal coronary arteries or unilocular nonsignificant atherosclerotic stenosis (less 50%) in 25-30% with thrombotic occlusion of one infarct related artery probably with substantial vasospastic component. Patients were younger (average 31.7 ± 3.7 years), dominant risk factors smoking, hyperlipidemia, excessive physical and emotional stress. Disease course and prognosis are favourable. 2. premature accelerated atherosclerosis with significant (more 50%) in 70-75 % often multivessel affection. Pts were significantly older (average 35.8 ± 2.6 years; < 0.001) bad risk factors profile, worse clinical course and poor long-term prognosis. CONCLUSIONS: Study of myocardial infarction in young adults indicates: great role of risk factors, mainly smoking, hyperlipidemia, family history and type A behaviour, hostility with participation of low education level and social inequality (unemployment). Noticeable are hypercoagulable states and trauma. Dominancy of men (90-95%). Prognosis depends on age, extend of coronary atherosclerosis and residual cardiac function. Disease picture has not been changed during last 30 years. Aggressive control over risk factors is unavoidable. Current requirement is to evaluate impact of modern treatment strategy on long-term survival. Key words: coronary artery disease - myocardial infarction at young age.
Assuntos
Doença da Artéria Coronariana/diagnóstico , Infarto do Miocárdio/diagnóstico , Adulto , Fatores Etários , Angiografia Coronária , Doença da Artéria Coronariana/complicações , Feminino , Seguimentos , Humanos , Masculino , Infarto do Miocárdio/complicações , Prognóstico , Fatores de RiscoRESUMO
The relationship between hormone release and non-verbal communication under stress conditions is still not sufficiently explored. The aim of the present study was to test the hypothesis that salivary testosterone concentrations and testosterone/cortisol (T/C) ratios correlate positively with assertive behavior representing a non-aggressive form of dominance during an acute stress situation. As a stress model, a socially evaluated cold pressor test was investigated in healthy men. The non-verbal behavior was analyzed according to the ethological coding system for interviews described by Troisi (1999). Salivary testosterone concentrations did not change throughout the stress test. The T/C ratios decreased significantly over time only in subjects showing high stress perception. The duration of affiliative and the frequency of flight behavior was higher in subjects with high stress perception compared to those with low stress perception. A significant positive correlation between the duration of prosocial behavior and values of T/C ratios was found in the whole sample. The area under the curve values of testosterone positively correlated with the duration of assertive behavior in the group with high stress perception and negatively in the other group. Our findings allow suggesting that the changes in non-verbal behavior during acute psychosocial stress situations may be more pronounced in subjects showing high stress perception. Obtained results motivate further research on a better understanding of the consequences of the lack of sense of full facial expressions, such as wearing face masks, on the balance between hormones and non-verbal behavior under stress conditions.
Assuntos
Hidrocortisona , Testosterona , Humanos , Hidrocortisona/metabolismo , Masculino , Saliva/metabolismo , Testosterona/metabolismoRESUMO
The neurotransmitter serotonin has been critically implicated in the pathogenesis of several mental disorders. The serotonin transporter (5-HTT) is a key regulator of serotonergic neurotransmission and its genetic variability is associated with increased risk of psychopathology. One well known polymorphic locus in the 5-HTT gene affecting its expression is a tandem repeat in the promoter region (5-HTTLPR). It has been reported that 5-HTT is functionally coupled with the neuronal nitric oxide synthase (NOS1 or nNOS), an enzyme catalyzing the production of nitric oxide (NO). We have previously demonstrated that a tandem repeat polymorphism in the promoter of NOS1 exon 1f (Ex1f-VNTR) is associated with sensorimotor gating, a marker of inhibitory processing and a well established endophenotype of several neuropsychiatric disorders. Here we investigated the combined genetic effects of NOS1 Ex1f-VNTR and 5-HTTLPR on sensorimotor gating, measured by prepulse inhibition (PPI) of the acoustic startle reflex, in 164 healthy adults. We found no evidence for the interaction between NOS1 Ex1f-VNTR and 5-HTTLPR on PPI. PPI was associated with NOS1 Ex1f-VNTR, but not 5-HTTLPR. Our data suggest that while NOS1 plays a role in sensorimotor gating, the nitrergic pathway of gating regulation does not involve the action of 5-HTT.
Assuntos
Óxido Nítrico Sintase Tipo I/genética , Polimorfismo de Nucleotídeo Único , Inibição Pré-Pulso/genética , Reflexo de Sobressalto/genética , Córtex Sensório-Motor/fisiologia , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Adulto , Éxons , Feminino , Genótipo , Humanos , Masculino , Repetições Minissatélites , Fenótipo , Regiões Promotoras Genéticas , Adulto JovemRESUMO
While opioid addiction has reached pandemic proportions, we still lack a good understanding of how the administration of opioids interacts with cognitive functions. Error processing - the ability to detect erroneous actions and correct one's behaviour afterwards - is one such cognitive function that might be susceptible to opioidergic influences. Errors are hypothesised to induce aversive negative arousal, while opioids have been suggested to reduce aversive arousal induced by unpleasant and stressful stimuli. Thus, this study investigated whether the acute administration of an opioid would affect error processing. In a double-blind between-subject study, 42 male volunteers were recruited and received either 0.2 mg buprenorphine (a partial µ-opioid receptor agonist and κ-opioid receptor antagonist) or a placebo pill before they performed a stimulus-response task provoking errors. Electroencephalograms (EEG) were recorded while participants performed the task. We observed no group differences in terms of reaction times, error rates, and affective state ratings during the task between buprenorphine and control participants. Additional measures of adaptive control, however, showed interfering effects of buprenorphine administration. On the neural level, decreased Pe (Error Positivity) amplitudes were found in buprenorphine compared to control participants following error commission. Further, frontal delta oscillations were decreased in the buprenorphine group after all responses. Our neural results jointly demonstrate a general reduction in error processing in those participants who received an opioid before task completion, thereby suggesting that opioids might have indeed the potential to dampen motivational error signals. Importantly, the effects of the opioid were evident in more elaborate error processing stages, thereby impacting on processes of conscious error appraisal and evidence accumulation.
Assuntos
Analgésicos Opioides/farmacologia , Buprenorfina/administração & dosagem , Buprenorfina/farmacologia , Motivação/efeitos dos fármacos , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Buprenorfina/efeitos adversos , Ritmo Delta/efeitos dos fármacos , Eletroencefalografia , Humanos , Masculino , Antagonistas de Entorpecentes/administração & dosagem , Antagonistas de Entorpecentes/farmacologia , Adulto JovemRESUMO
Isoflavones are a subgroup of phytoestrogens, natural plant substances with structure similar to 17-beta-estradiol and capable of binding to estrogen receptors (ERs). Isoflavones possess higher affinity to ERbeta than to ERalpha and may have a potency to activate both genomic and non-genomic estrogen signaling pathways. In addition, isoflavones interact with the metabolism of steroid hormones. Therefore, the actions of isoflavones are rather complex and may be related to large number of factors, which are not satisfactorily identified yet. Recently, isoflavones have come into focus of interest due to several reports about their positive effect on human health, in particular prevention of hormone-dependent cancers, cardiovascular diseases, osteoporosis, adverse menopausal manifestations and age-related cognitive decline. Isoflavones may bring new insights into the mechanisms of physiological regulations and increase the possibilities of medical interventions.
Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Isoflavonas/uso terapêutico , Neoplasias/tratamento farmacológico , Osteoporose Pós-Menopausa/tratamento farmacológico , Fitoestrógenos/uso terapêutico , Feminino , Humanos , Isoflavonas/química , Fitoestrógenos/química , Transdução de Sinais/efeitos dos fármacosRESUMO
INTRODUCTION: The aim of this research was to, in patients with severe (tight) aortic stenosis (AoS), evaluate a) an association between clinical and some haemodynamic characteristics and natriuretic peptides (ANP, BNP) concentrations and b) usefulness of these hormones in the decision making on the next therapeutic steps. METHODS: Echocardiography and 6-minut exertion walking test were performed in 23 consecutive patients (12 men, 11 women; age 67 +/- 7 years) and 20 controls together with ANP and BNP measurements from three plasma samples before, immediately after and 20 minutes after the exertion test. RESULTS: There was high inter-individual variability in the ANP and BNP concentrations in patients with AoS. All ANP and BNP were significantly higher than in the controls (ANP 1, 2, 3, p < 0.001; BNP 1, 2, 3, p < 0.001). Only the ANP levels increased significantly after the exercise (ANP 1 vs. ANP 2 = 0.011; ANP 2 vs. ANP 3 p = 0.037). We identified significant correlations between aortic peak gradient and BNP 1, 2 (r = 0.821, p < 0.001) and ANP 1, with BNP correlations being stronger. We did not find any correlations with aortic valve area and the left ventricle mass. The hormone levels were non-significantly increased depending on NYHA classification. Exercise did not improve validity ofANP and BNP measurement. Their values had high sensitivity but low specificity in detecting critical AoS. CONCLUSION: ANP and mainly BNP helped to exclude severe AoS but they were not useful in detecting lower, orderline gradients. We did not prove ANP and BNP to be significant factors in decision making about the timing of AoS surgery.
Assuntos
Estenose da Valva Aórtica/diagnóstico , Peptídeos Natriuréticos/sangue , Estenose da Valva Aórtica/fisiopatologia , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Post-weaning social isolation has been shown to be a relevant animal model for studying the mechanisms underlying psychopathological states induced by early-life stressful experiences. Besides extensively studied brain-derived neurotrophic factor (BDNF) and tyrosine receptor kinase B (TrkB) receptor, increasing attention is being given to a neuropeptide precursor VGF (non-acronymic). Several lines of evidence indicate an interplay between the neurotrophins and nitric oxide signaling. This study investigated the long-term consequences of post-weaning social isolation on behavior, VGF/BDNF/TrkB pathway and two isoforms of nitric oxide synthase (NOS) in the hippocampus and examined whether these effects were sex-specific. Male and female Sprague-Dawley rats were reared either in social isolation or social groups from postnatal day 21 for 9 weeks (nâ¯=â¯12-15/group and sex). Post-weaning social isolation induced impairments in sensorimotor gating and increased anxiety-like behavior in rats of both sexes. These behavioral alterations were accompanied by attenuated gene expression of VGF and TrkB receptor in the hippocampus. Isolation-induced reduction in VGF gene expression was more evident in male isolates. Similar changes were found in neuronal NOS (nNOS) gene expression with reduced mRNA levels in male isolates. Gene expression of BDNF and inducible NOS was not influenced by isolation rearing or sex. In addition, sex-specific patterns of VGF and nNOS gene expression in the hippocampus with higher mRNA levels in males than in females were revealed. The present study demonstrates a relationship between nNOS, VGF, BDNF, and TrkB confirming a link between nitric oxide and neurotrophins signaling pathways. Our findings indicate that long-term post-weaning social isolation alters signaling via VGF/BDNF/TrkB and nNOS that could interfere with neurodevelopmental processes which may contribute to pathological behavioral symptoms in adulthood. Future studies are needed to support this suggestion since the direct mechanistic link has not been approached in this study.
Assuntos
Comportamento Animal/efeitos dos fármacos , Hipocampo/metabolismo , Receptor trkB/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Animais , Ansiedade/tratamento farmacológico , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Fator Neurotrófico Derivado do Encéfalo/farmacologia , Neuropeptídeos/metabolismo , Neuropeptídeos/farmacologia , Ratos Sprague-Dawley , Receptor trkB/metabolismo , Isolamento Social , DesmameRESUMO
Accumulating evidence suggests that empathy for pain recruits similar neural processes as the first-hand experience of pain. The pain-related P2, an event-related potential component, has been suggested as a reliable indicator of neural processes associated with first-hand pain. Recent evidence indicates that placebo analgesia modulates this component for both first-hand pain and empathy for pain. Moreover, a psychopharmacological study showed that administration of an opioid antagonist blocked the effects of placebo analgesia on self-report of both first-hand pain and empathy for pain. Together, these findings suggest that the opioid system plays a similar role during first-hand pain and empathy for pain. However, such a conclusion requires evidence showing that neural activity during both experiences is similarly affected by psychopharmacological blockage of opioid receptors. Here, we measured pain-related P2 amplitudes and self-report in a group of participants who first underwent a placebo analgesia induction procedure. Then, they received an opioid receptor antagonist known to block the previously induced analgesic effects. Self-report showed that blocking opioid receptors after the induction of placebo analgesia increased both first-hand pain and empathy for pain, replicating previous findings. Importantly, P2 amplitudes were also increased during both experiences. Thus, the present findings extend models proposing that empathy for pain is partially grounded in first-hand pain by suggesting that this also applies to the underlying opioidergic neurochemical processes.
Assuntos
Encéfalo/fisiopatologia , Empatia/fisiologia , Potenciais Evocados/fisiologia , Dor/fisiopatologia , Dor/psicologia , Adulto , Análise de Variância , Estimulação Elétrica/efeitos adversos , Eletroencefalografia , Potenciais Evocados/efeitos dos fármacos , Feminino , Mãos/inervação , Humanos , Masculino , Naltrexona/farmacologia , Antagonistas de Entorpecentes/farmacologia , Dor/etiologia , Medição da Dor , Limiar da Dor/efeitos dos fármacos , Limiar da Dor/fisiologia , Efeito Placebo , Psicofísica , Tempo de Reação/efeitos dos fármacos , Inquéritos e QuestionáriosRESUMO
The saccadic eye movement related potentials (SEMRPs) enable to study brain mechanisms of the sensorimotor integration. SEMRPs provide insight into various cognitive mechanisms related to planning, programming, generation and execution of the saccadic eye movements. SEMRPs can be used to investigate pathophysiological mechanisms of several disorders of the central nervous system. Here we shortly summarize basic findings concerning the significance of SEMRP components, their relationship to the functional brain asymmetry and visual attention level as well as changes related to certain neuropsychological disorders.
Assuntos
Potenciais Evocados/fisiologia , Movimentos Sacádicos/fisiologia , Animais , Atenção/fisiologia , Encéfalo/fisiopatologia , Encefalopatias/fisiopatologia , Eletroencefalografia , HumanosRESUMO
Cardiovascular diseases associated with molecular variants of individual components of renin-angiotensin system are reported to constitute inherited predisposition in humans. Molecular variant frequencies are race- and population-dependent. We examined frequencies of the M235T variant of angiotensinogen gene and I/D polymorphism of gene for angiotensin-converting enzyme in Slovak population: in hypertensive patients, coronary heart disease (CHD), dilated cardiomyopathy (DCM) and myocardial infarction (MI) patients compared to healthy subjects. Frequency of M235T was significantly increased in hypertensive, CHD and DCM patients compared to controls (0.48 and 0.50 vs. 0.40, p < 0.001). Significant increase in D allele frequency compared to controls was observed in the group of patients after MI (0.58 vs. 0.50, p < 0.001), CHD (0.59 vs. 0.50, p < 0.001) and DCM (0.60 vs. 0.50, p < 0.001). These results correlate with other Caucasian populations. In Slovak population, M235T is associated with increased blood pressure and D allele of ACE gene is associated with MI, chronic CHD and DCM, rather than with hypertension. Our results suggest that in Slovak population, D alelle and M235T variant represent a risk factor for several cardiovascular diseases and these polymorphisms might have a cumulative effect on development of cardiovascular diseases.
Assuntos
Angiotensinogênio/genética , Doenças Cardiovasculares/genética , Variação Genética , Sistema Renina-Angiotensina/genética , Idoso , Alelos , Angiotensinogênio/metabolismo , Sequência de Bases , Pressão Sanguínea/genética , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/epidemiologia , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo Genético , Grupos Populacionais , Renina/genética , Renina/metabolismo , Sistema Renina-Angiotensina/fisiologia , Fatores de Risco , EslováquiaRESUMO
Chaotic transitions likely emerge in a wide variety of cognitive phenomena and may be linked to specific changes during the development of mental disorders. They represent relatively short periods in the behavior of a system, which are extremely sensitive to very small changes. This increased sensitivity has been suggested to occur also during retrieval of stressful emotional experiences because of their fragmentary, temporally and spatially disorganized character. To test this hypothesis we recorded EEG during retrieval of fearful memories related to panic attack in 7 patients and retrieval of anxiety-related memories in 11 healthy controls. Nonlinear data analysis of EEG records showed a statistically significant increase in degree of chaotic dynamics after retrieval of stressful memories in majority of patients as well as in control subjects. This change correlated with subjective intensity of anxiety induced during the memory retrieval. The data suggest a role of nonlinear changes of neural dynamics in the processing of stressful anxiety-related memories, which may play an important role in the pathophysiology of panic disorder.
Assuntos
Eletroencefalografia , Rememoração Mental/fisiologia , Transtorno de Pânico/fisiopatologia , Estresse Psicológico/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Transtorno de Pânico/psicologiaRESUMO
Pulmonary hypertension (PH) is the most serious and potentially devastating chronic disorder of the pulmonary circulation with diverse etiologies and pathogenesis characterized by abnormal increased vasoconstriction and vascular remodelling. Current specific therapy of PH is based on an understanding of its pathogenesis and is acting through pathogenic pathways and therefore changes therapeutic strategy, effectively improves clinical course and prolongs life. The authors discuss the actual classification, pathogenesis in short and particularly actual treatment modalities and the impact on the natural history of this disorder. In chronic thromboembolic pulmonary hypertension is pulmonary endarterectomy if correct indicated the curable method, warranted substantial improvement of life quality and survival. These novel therapies of PH were absent in Slovakia until recently. The authors present initial experiences, results of PH management up to date on the basis of cooperation with PH centres in Austria and Czech Republic (Tab. 1, Fig. 6, Ref. 32).
Assuntos
Hipertensão Pulmonar/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Motivation in performance is often measured via competitions. Winning a competition has been found to increase the motivation to perform in subsequent competitions. One potential neurobiological mechanism that regulates the motivation to compete involves sex hormones, such as the steroids testosterone and estradiol. A wealth of studies in both nonhuman animals and humans have shown that a rise in testosterone levels before and after winning a competition enhances the motivation to compete. There is strong evidence for acute behavioral effects in response to steroid hormones. Intriguingly, a substantial testosterone surge following a win also appears to improve an individual's performance in later contests resulting in a higher probability of winning again. These effects may occur via androgen and estrogen pathways modulating dopaminergic regions, thereby behavior on longer timescales. Hormones thus not only regulate and control social behavior but are also key to adult neurobehavioral plasticity. Here, we present literature showing hormone-driven behavioral effects that persist for extended periods of time beyond acute effects of the hormone, highlighting a fundamental role of sex steroid hormones in adult neuroplasticity. We provide an overview of the relationship between testosterone, motivation measured from objective effort, and their influence in enhancing subsequent effort in competitions. Implications for an important role of testosterone in enabling neuroplasticity to improve performance will be discussed.
Assuntos
Comportamento Competitivo/efeitos dos fármacos , Motivação/efeitos dos fármacos , Plasticidade Neuronal/efeitos dos fármacos , Testosterona/metabolismo , Testosterona/farmacologia , Adulto , Animais , Comportamento Competitivo/fisiologia , Dopamina/metabolismo , Feminino , Humanos , Masculino , Motivação/fisiologia , Testosterona/químicaRESUMO
In eighteen consecutive patients (14 male, 4 females, in the age 37-52 years, mean = 43 years) with dilated cardiomyopathy in NYHA functional classification groups III-IV, the efficacy of ambulatory long-term (mean = 6 years) vasodilator therapy by means mechanocardiography (systolic and diastolic time intervals) and echocardiography (1-D, 2-D) in half-year intervals was evaluated. A combination of slow-release nitroglycerin (Nitro-Mack retard) as venodilator in the dosage of 20 mg/day and Dihydralazin SPOFA as arteriodilator in dosage of 100-200 mg/day under continuing cardiotonic and diuretic treatment were used. Vasodilator therapy had a favourable effect on systolic and diastolic function of the left ventricle with the mostly marked effect at the beginning of treatment. Amidst noninvasive parameters, the diastolic amplitude time index measured by apexcardiography and left ventricular hypertrophy-dilation index obtained by echocardiography had the greatest prognostic value regarding the treatment efficacy and survival of patients. This objective evidence of the efficacy of vasodilator therapy in patients with severe congestive heart failure coincided with the improvement of clinical status (subjective relief, moderation of decompensation, shift to the lower NYHA functional classes) and thus with improvement of life quality and prognosis.
Assuntos
Cardiomiopatia Dilatada/complicações , Insuficiência Cardíaca/tratamento farmacológico , Vasodilatadores/administração & dosagem , Adolescente , Adulto , Anti-Hipertensivos/administração & dosagem , Cardiomiopatia Dilatada/fisiopatologia , Preparações de Ação Retardada , Diástole , Di-Hidralazina/administração & dosagem , Quimioterapia Combinada , Ecocardiografia , Feminino , Seguimentos , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/mortalidade , Humanos , Cinetocardiografia , Masculino , Pessoa de Meia-Idade , Nitroglicerina/administração & dosagem , Sístole , Fatores de TempoRESUMO
The study has been carried out in 73 patients (63 men and 10 women), aged between 22 and 59 years, suffering from angina pectoris. The localization in space of the extremities of the initial QRS vectors (10 and 20 ms) is an indicator which is relatively very sensitive to the disturbance in the myocardial irrigation in the regions around the septum and the adjacent ventricular wall. A good relationship has been found namely with the data obtained with thallium scintigraphy after effort. The sensitivity of the vectocardiographic method, like that of dipolar chronotopocardiography, was clearly superior to that of scalar graphs.
Assuntos
Angina Pectoris/fisiopatologia , Eletrocardiografia/métodos , Septos Cardíacos/fisiopatologia , Vetorcardiografia/métodos , Adulto , Angina Pectoris/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , CintilografiaRESUMO
The level of present-day echocardiography in the CSFR is comparable to that found in other countries. Similarly as abroad, over here too, echocardiography has become the most useful and the most widely spread noninvasive method, which gradually keeps narrowing down the indication range for catheterization of the heart and vessels. One- and two-dimensional imaging is being used routinely in all relevant departments. Contrast and exercise echocardiography are frequently used. Doppler echocardiographic techniques are gradually introduced into current practice. Experience keeps accumulating on the application of transesophageal echocardiography, including its use in circulatory emergencies and cardiosurgical procedures. Adequate economic, conceptual and educational conditions will have to be established to promote further development of echocardiography in the CSFR.
Assuntos
Ecocardiografia , Tchecoslováquia , Ecocardiografia/estatística & dados numéricos , HumanosRESUMO
The coronary disease of the heart (CDH) will be the most frequent cause of mortality and inability to work in the 21st century not only in industrially advanced countries but also in the developing countries. This unfavourable, assumedly paradoxical tendency persevering despite the significant progress in diagnosis and therapy is caused by two circumstances: ageing of population (prolonged mean life expectancy) and the increase in the number of individuals afflicted with (CDH) and living up to high age. In result of this development, the rapid increase in the prevalence of heart failure, especially in the aged, becomes the main cause of mortality, morbidity and hospitalisation.
Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Previsões , Saúde Global , HumanosRESUMO
Pulmonary manifestations of cardiac diseases are reviewed and the contribution of pulmonary function assessment in diagnosis, management and prognosis of these diseases is being emphasized. Inborn and acquired diseases of the heart exert pathological effects on pulmonary hemodynamics and later on also on lung structure, clinically manifested by pulmonary symptomatology and abnormalities in pulmonary function. The basic mechanisms of pulmonary function derangement include pulmonary congestion and hyperreactivity of the airways as a consequence of increased blood pressure or flow in the pulmovascular network (postcapillary or hyperkinetic pulmonary hypertension). The severity of the given cardiac disease determines also the condition of pulmonary function. Thus examinations of pulmonary function substantially contribute to the classification of the functional state and to optimal choices in therapeutic strategy. Appropriate surgical or medical therapeutic procedures can improve the hemodynamic conditions in the pulmonary vascular network. This, in turn, leads to partial regression of morphological changes in the pulmonary parenchyma and thus to gradual improvement of pulmonary function. (Tab. 4, Fig. 4, Ref. 62.)
Assuntos
Cardiopatias/fisiopatologia , Circulação Pulmonar , Mecânica Respiratória , HumanosRESUMO
The establishment of the Slovak Medical Society (SMS) in Bratislava on 13th June 1920 (until 1939, the society was included into the Czechoslovak Medical Society) represents one of the most important milestones in the modern history of Slovak medicine. It was founded in direct consequence of the establishment of the first faculty of the Comenius University, namely the Medical Faculty. SMS began to issue its own journal Bratislavské lekárske listy (Bratislava Medical Journal) which was the first medical journal published in Slovakia after the origin of the Czechoslovak Republic. Eighty years of the existence of SMS which by its 2500 members forms the largest medical association, prove that the share of this society and its contribution to the development of Slovak medicine are essential. For many years, the society has been the only forum for Slovak physicians and scientific workers of the Medical Faculty where they could meet and increase their expertise. The society has witnessed also the significant material and moral support and co-operation between Czech and Slovak physicians during the period of the first Czechoslovak Republic.