M Orolín

Univerzitná Nemocnica Louisa Pasteura

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Martina Hančová

University of Pavol Jozef Šafárik

Peter Jarčuška

University of Pavol Jozef Šafárik

Slavomír Perečinský

University of Pavol Jozef Šafárik

Jaroslav Legáth

University of Veterinary Medicine in Košice

Marek Varga

University of Pavol Jozef Šafárik

Ružena Tkáčová

University of Pavol Jozef Šafárik

Pavol Joppa

University of Pavol Jozef Šafárik

Eduard Veselíny

University of Pavol Jozef Šafárik

A Kovácová

Deutsche Telekom (Slovakia)

Viktória Takácová

Cooperative Institutions

University of Pavol Jozef Šafárik

Univerzitná Nemocnica Louisa Pasteura

Technical University of Košice

Slovak Academy of Sciences

Institute of Experimental Physics of the Slovak Academy of Sciences

University of Veterinary Medicine in Košice

Charles University

Constantine the Philosopher University in Nitra

University of Constantine 3

Institute of Molecular Physics

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Latent Airway Hyperresponsiveness: A Phenomenon Bordering Bronchial Asthma Definition

Advances in experimental medicine and biology (2012)

Jaroslav Legáth Slavomír Perečinský Marek Varga M Orolín Z Tomori

Bronchodilation

Bronchial hyperresponsiveness

Airway hyperresponsiveness

Bronchial Spasm

10.1007/978-94-007-4546-9_13

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Citations (6)

Blood pressure and heart rate variability response to noninvasive ventilation in patients with exacerbations of chronic obstructive pulmonary disease

Physiological Research (2007)

P. Skyba Pavol Joppa M Orolín Ružena Tkáčová

Sympathetic activation and parasympathetic withdrawal are commonly observed during acute exacerbations of chronic obstructive pulmonary disease (COPD). We have demonstrated previously that noninvasive positive-pressure ventilation (NPPV) improves parasympathetic neural control of heart rate in patients with obstructive sleep apnea. We hypothesized that NPPV may exert such beneficial effects in COPD as well. Therefore, we assessed the acute effects of NPPV on systemic blood pressure and indexes of heart rate variability (HRV) in 23 patients with acute exacerbations of COPD. The measurements of HRV in the frequency domain were computed by an autoregressive spectral technique. The use of NPPV resulted in significant increases of oxygen saturation (from 89.2+/-1.0 to 92.4+/-0.9 %, p<0.001) in association with reductions in systolic and diastolic blood pressures and heart rate (from 147+/-3 to 138+/-3 mm Hg, from 86+/-2 to 81+/-2 mm Hg, from 85+/-3 to 75+/-2 bpm, p<0.001 for all variables), and increases in ln-transformed high frequency band of HRV (from 6.4+/-0.5 to 7.4+/-0.6 ms(2)/Hz, p<0.01). Reductions in heart rate and increases in ln-transformed HF band persisted after NPPV withdrawal. In conclusion, these findings suggest that NPPV may cause improvements in the neural control of heart rate in patients with acute exacerbations of COPD.

Oxygen Saturation

10.33549/physiolres.931045

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Citations (23)

Prognostic importance of the monitoring of selected parameters in liver cirrhosis.

PubMed (2003)

Peter Jarčuška M Orolín A Kovácová Martina Hančová

To evaluate the prognostic importance of hepatic encefalopathy and monitoring of transaminase, total and conjugated bilirubine, synthetic liver functions in hospitalized patients with liver cirrhosis.At the Intensive Metabolic Care Unit of 1st Department of Internal Medicine, we evaluated 150 patients (87 males, 63 females) with liver cirrhosis at average age: 52.51 +/- 7.99 years, Child-Pugh score: 11.34 +/- 2.99. 47 patients had died during hospitalization, 103 patients have improved. Student t-test was used for statistical analysis.The patients who expired had significantly higher serum levels of transaminase, total and conjugated bilirubin during the treatment and higher grade of hepatic encefalopathy. Synthetic liver functions were significantly decreased in the group of the expired patients. In patients who died during hospitalization was observed the tendency to increasing of total and conjugated bilirubine and to decreasing of synthehic liver functions.Mortality rate of the hospitalized patients with liver cirrhosis depends on the degree of impairment of the liver functions and its potential improvement during hospitalization. (Tab. 8, Ref. 24.).

Transaminase

Aspartate transaminase

Liver function

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Citations (4)

Monitoring of selected "non-hepatic" laboratory parameters in hospitalized cirrhotic patients and their influence on prognosis.

PubMed (2004)

Peter Jarčuška M Orolín A Kovácová Martina Hančová

To evaluate the prognostic importance of the analysis of leucocytes, prothrombin time and selected serum biochemical parameters in hospitalized patients with liver cirrhosis.At the Intensive Metabolic Care Unit of 1st Department of Internal Medicine we evaluated 150 patients (87 males, 63 females) with liver cirrhosis at average age: 52.51 +/- 7.99 years, Child-Pugh score: 11.34 +/- 2.99. 47 patients have died during hospitalization, 103 patients have improved. Student t-test was used for statistical analysis.Patients who expired had higher serum leucocyte levels and lower prothrombin time and natriuresis when compared with survivors. Low serum sodium levels, hyperkalemia, decompensated metabolic acidosis, spontaneous hypoglycemia, DIC and renal failure occured more often in the patients with liver cirrhosis who died during hospitalisation.Hematological abnmormalities and acid base disturbance are associated with higher hospital mortality rate in patients with liver cirrhosis. (Tab. 6, Ref. 20.)

Prothrombin time

Hepatic Encephalopathy

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Citations (1)

[Spontaneous bacterial peritonitis in the patients with liver cirrhosis].

PubMed (2004)

Peter Jarčuška Eduard Veselíny M Orolín Viktória Takácová Martina Hančová

To assess objective incidence of spontaneous bacterial peritonitis (SBP), laboratory findings, effectivity of the treatment and mortality of cirrhotics with ascites and SBP.From June 1994 to June 1999 we performed 692 abdominal paracenteses in 169 cirrhotic patients (mean age 52,63 +/- 8,02 years, mean Child-Pugh score 10,41 +/- 3,02). Culture of ascitic fluid, total leucocyte and granulocyte count in ascites and total protein, albumin and cholesterol levels in ascites and serum were examinated. Diagnosis of SBP was established by criteria of Wilcox and Dismukes.SBP was found in 27 patients by 1st paracentesis (16,0 %), in the other 13 patients by repeated paracentesis (7,7 %). 51 episodes of SBP (7,4 % of all paracenteses) were found in 40 patients. 48 episodes of SBP (94,7 %) were succesfully treated by ATB therapy, 8 patients with SBP died during hospitalization (15,7 %). Patients with SBP had significant lower total protein, albumin and cholesterol levels in serum and ascites compared to patients without ascites infection (all paramethers p <0,01).SBP is a common complication in patients with advanced liver cirrhosis and ascites. Despite of effectivity of ATB therapy the hospital mortality of patients with SBP is high.liver cirrhosis, ascites, spontaneous bacterial peritonitis, mortality.

Spontaneous bacterial peritonitis

Paracentesis

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Citations (1)

[Infectious complications in patients with liver cirrhosis].

PubMed (2004)

Peter Jarčuška Eduard Veselíny M Orolín Takácová Martina Hančová

To assess the objective incidence of infectious complications in liver cirrhosis, to find out correlation among stage of liver cirrhosis, number of infectious complications and mortality in cirrhotic patients.93 patients with liver cirrhosis were hospitalized from June 1996 to November 1998 (age: 53,44 I 8,03 years, Child-Pugh score: 11,58 I 2,12). 6 patients were in class B, 87 in class C of Child-Pugh classification. Ascites was found in 81 patients, pleural effusion was found in 14 patients. Chest X-ray, examination of ascites and pleural efussion an urine culture were performed by admission, the other infections were actively screened after clinical signs.Spontaneous bacterial peritonitis was found in 17 patients (18,28 %), secondary bacterial peritonitis in 5 patients (5,38 %), spontaneous bacteremia in 3 patients (3,23 %), spontaneous bacterial pleuritis in 3 patients (3,23 %), bronchopneumonia and infections of respiratory tract in 22 patients (23,66 %), uro-infection in 69 patients (74,19 %) and the other kinds of infection in 14 patients (15,05 %). Mortality of patients correlates with stage of liver cirrhosis and number of infectious complications.Infections are common complications in hospitalized cirrhotics. Infectious complications are the most common cause of mortality of cirrhosis, patients with bronchopneumonia, secondary bacterial peritonitis or spontaneous bacterial pleuritis had bad prognosis. Early antibiotic treatment at the base of culture and sensitivity is an optimal therapeutic approach in cirrhotics with infections.

Spontaneous bacterial peritonitis

Bacteremia

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Citations (2)

Area under the maximum expiratory flow-volume curve a sensitive parameter in the evaluation of airway obstruction

European Respiratory Journal (2011)

Jaroslav Legáth Marek Varga Slavomír Perečinský M Orolín

Introduction: The most frequently used parameters for assessing bronchoconstriction and bronchodilation are forced expiratory volume in 1 s (FEV 1) and peak expiratory flow (PEF). Objectives: To assess the sensitivity of other parameters after induced bronchoconstriction and bronchodilation. Methods: Forced vital capacity, FEV 1, PEF, maximum expiratory flows (MEF) at 25, 50 and 75% of vital capacity and the area under the maximal expiratory flow- volumeMEFV curve (Area ex) were measured in two groups of asthmatic patients after induced bronchoconstriction and bronchodilation. Results: In 158 asthmatics without airway obstruction, bronchoconstriction was induced by inhalation of 1% histamine aerosol. The 20% fall in Area ex compared to baseline was found in all asthmatics, while the 20 and 15% falls in FEV 1 were noted in 31 and 69% of the patients, respectively. Other parameters were less sensitive. Another 102 asthmatics with mild-moderate airway obstruction were treated with various bronchodilators. The 20% increase in Area ex was observed in all asthmatics, while the 20% increase in FEV 1 was found in only 28% of the patients and the 15% increase in FEV 1 in 56%. Conclusion: In evaluation of correlation between dynamic functional parameters the most accurate parameter is Areaex – value defining surface under the expiratory part of “flow – volume” curve. Area ex was a sensitive parameter in the evaluation of airway patency in comparison withf MEF25, MEF50, MEF75, FEV 1 and other parameters measured from the MEFV curve in our study patients.

Bronchodilation

Airway obstruction

Bronchodilatation

Vital capacity

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Citations (0)

Can reversibility of nasal obstruction predict the grade of bronchial hyperreactivity?

Bratislavské lekárske listy/Bratislava medical journal (2012)

Slavomír Perečinský Jaroslav Legáth M Orolín

Aim of the study was to reveal the connection between significance of nasal obstruction and bronchial hyperreactivity.Allergic rhinitis is the most common IgE-mediated disease with progressively increasing prevalence in population. Chronic inflammation and remodelation of mucosa of the upper airways can be a part of generalized affection of respiratory system including lower airways. Severe inflammatory damage of nasal mucosa is connected with irreversibility of nasal obstruction, which is possible to verify by nasal decongestion test.Bronchoprovocation test and rhinomanometry examination with decongestion test were performed in 57 patients. We analysed the grade of bronchial hyperreactivity and response of nasal mucosa to decongestion agent. Number of positive and negative decongestion tests were compared in a group of patients with mild bronchial hyperreactivity with the group of moderate and severe hyperreactivity.Comparing the results of decongestion tests there has been a significant difference found between the group with mild hyperreactivity and the group with moderate and severe hyperreactivity.The study points out to narrow relationship between bronchial asthma and allergic rhinitis, where patients with negative decongestion test showed significantly increased grade of bronchial hyperreactivity. Due to this patients with insufficient response of nasal mucosa to decongestive agent probably require more intensive antiinflammatory therapy compared to patients with positive response. Nasal decongestion tests can be used for examination of the effect of allergic inflammation of nasal mucosa on the lower airways and vice versa (Tab. 4, Ref. 27).

Bronchial hyperreactivity

Rhinomanometry

Allergic Inflammation

10.4149/bll_2013_006

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Citations (2)

Postoperative hypercapnic respiratory failure in patients with obstructive sleep apnoea: treatment with non-invasive ventilation

Scottish Medical Journal (2008)

Zuzana Dorková Andrej Somos M Orolín José Francisco de Mattos Farah Pavol Joppa

Acute hypercapnic respiratory failure is a rare but life-threatening complication in grossly obese patients with severe obstructive sleep apnoea (OSA). Facial trauma or upper airway surgery, respiratory tract infections, bronchospasm, use of pain medication and concomitant obstructive or restrictive pulmonary impairment predispose to the development of respiratory failure in such patients. We present a case of a morbidly obese male patient in whom moderately severe OSA (the apnoea-hypoponea index, AHI of 37/hour) was treated with uvulapalatopharyngoplasty (UPPP) because he declined treatment with non-invasive ventilation. The early postoperative period was complicated by severe hypercapnic respiratory failure in association with worsening of OSA: arterial PO 2 was 4.14 kPa, PCO 2 9.7 kPa, AHI increased to 93.8/hour, minimal nocturnal arterial oxygen saturation was 46%. Therapy with non-invasive ventilation using bi-level positive airway pressure (BiPAP) was initiated immediately, and resulted in marked improvements in the patient's clinical condition, in association with the improvements in arterial blood gases. Before the discharge, nocturnal continuous positive airway pressure (CPAP) therapy to treat OSA on the long-term basis was initiated. Two months after the release, the patient's blood gases were within the normal range, and he reported marked improvements in his clinical condition including alleviation of daytime sleepiness and increased physical endurance. Our case demonstrates that in the presence of severe OSA, life-threatening hypoxaemia and hypercapnia were successfully alleviated using BiPAP in the postoperative period after UPPP.

Positive airway pressure

Arterial blood

Oxygen Saturation

10.1258/rsmsmj.53.2.65a

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