The development of selected cardiovascular parameters in patients with type 2 diabetes mellitus during a spa treatment.

Diabetes mellitus is not just a simple metabolic disorder, however, it is considered to be a cardiovascular disease of a metabolic origin. This is apparent especially when speaking about type 2 diabetes (DM II). The objective of our study was to determine whether a comprehensive spa treatment (procedures and drinking cure) may affect the level of the sympathetic tone of patients suffering from DM II. As an indicator of the sympathetic tone, selected electrocardiographic parameters derived from the heart rate variability and microwave alternans were chosen. There were 96 patients enrolled in our study: 38 patients with poorly controlled DM II and two control groups: 9 patients with compensated DM II and 49 patients, average age without diabetes or other disorders of the glucose metabolism. All received an identical spa treatment and continued their medical therapy. The electrophysiological examination of patients was performed before and after a three-week spa treatment using the KARDiVAR system. Parameters derived from the analysis of heart rate variability (HRV), microvolt T-wave alternans, and microvolt R-wave alternans were analyzed in order to evaluate the tones of the autonomic nervous system (ANS). The control group showed a slight increase of parameter the index of activity of regulatory systems (IRSA) (4.4+/-1.3 vs. 3.8+/-1.4; p=0.006) after the spa treatment, while increased heart rate (80.9+/-11.0 vs. 74.6+/-9.6; p=0.028), reduced index of centralization (IC) (1.3+/-0.6 vs. 2.9+/-1.4; p=0.027) and reduced index of myocardium (IM) (9.9+/-7.4 vs. 18.0+/-6.3; p=0.041) were found in patients with a compensated DM II. Patients with a poorly compensated DM II showed a decreased IM (10.9+/-8.6 vs. 16.9+/-5.2; p=0.001) and also a reduced IRSA (4.1+/-3.5 vs. 6.3+/-1.9; p=0.001). The results proved favorable changes in ANS cardiovascular control of patients with DM II after a spa treatment, especially in terms of reducing the sympathoadrenal system activity (decreased IRSA), improving electrical stability of the myocardium and increasing centrally controlled heart rate variability without overloading the cardiovascular system (drop of IM).

QT dispersion and electrocardiographic changes in women with gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) represents additional risks to both mother and infant. Moreover it increases a woman's risk of cardiovascular disease in the postpartum. The aim of our study was therefore to detect changes of both the QT dispersion and the electrical heart field that could be typical for GDM. Body surface potential maps were obtained using the Cardiac 112.2 device from 26 young women with GDM and 54 young healthy pregnant women in the 36th week of pregnancy. The same recordings were obtained from 18 healthy women in the same age (19-36 years). The average QT dispersion (±SD) in women suffering from GDM was significantly higher (107 ± 25 ms) both than in those with physiological pregnancy (73 ± 18 ms) and than in the normal subjects (34 ± 12 ms) (P<0.001). Moreover we have found in GDM patients shorter QRS complex 82.0 ± 6.8 ms vs. 89.5 ± 8.2 ms in healthy pregnant women and 90.8 ± 7.9 ms in the control group (p=0.011), more horizontal electrical heart axis [16.4 ± 20.1° vs. 42.4 ± 28.7° and 74.6 ± 39.2° respectively (P<0.05)] and lower some depolarization and repolarization amplitudes on isopotential and isointegral maps. According to these results we suppose that described electrocardiographic changes reflect a deterioration of the complete process of ventricular depolarization and repolarization in GDM.

[Diagnosis and therapy of sternostomiasis in canaries]. / Diagnostika, klinika a terapie sternostomiázy kanáru.

Fifteen canaries were tested for the possibility of objective intravital diagnostics by smears from the trachea, by transparent tracheoscopy, X-ray examination, and coprological examination. All the results were negative. A positive outcome of the tests is the method of the fixing of the birds for X-ray examination, also applicable for other purposes. Thirty canaries were used for testing the results of therapy by a preparation based on DTHP-Hypocide. Twelve of them were killed before therapy for post-mortal diagnosis, twelve were killed two days, and six were killed nine days from the termination of the therapy. The post-mortem examination of the treated birds demonstrated the effectiveness of the therapy; however, the dosage, application intervals and application sites were found to be unsuitable.

Changes in integrated vagal afferent activity induced by model lung diseases in rats.

An attempt has been made in the present report to evaluate quantitatively the sensory activity in both vagal nerves of control rats and rats with experimental lung inflammation, by employing the integration technique. We evaluated background vagal nerve activity, resting respiration and activity during inflation at constant pressures of 5 to 20 cm of water. It was found that integrated vagal respiratory activity cannot be assessed in absolute units under our experimental conditions, because of the large scatter of data. However, when the integrated values were related, for example, to resting respiration (in percentage), it was possible to compare some respiratory parameters in control, healthy rats of the Wistar strain and rats with lung inflammation. While background activity in control rats represents 75.9% of resting respiration, this parameter is significantly higher both in rats with 2-day carrageenin lung inflammation and those intoxicated with paraquat. Lung inflation at pressures 5, 10, 15, 20 cm H2O increased vagal activity linearly both in control and the two experimental groups with the degree of lung inflation. However, values in experimental animals corresponding to those of the control group were not reached until higher inflation pressures. From the functional aspect, experimental rats had characteristic tachypnoea which returns to control values after bilateral vagotomy. Since it was found that lung compliance was significantly decreased in both carrageenin and paraquat lung processes, it is being suggested that the diminished activity from lung receptors during inflation is due to mechanical properties of the lung tissue, namely lowered lung compliance.

Inflation reflex in the rat.

The Breuer-Hering inflation reflex [BHIR] was elicited in conscious and anaesthetized rats by inflating the lungs with constant pressures of 5--20 cm H2O. The reflex was elicited well in conscious animals, but even with the maximum stimulus [inflation of 20 cm H2O, corresponding to about 4.5-fold the tidal volume] the duration of apnoea did not exceed 4 control respiration cycles. In anaesthetized animals, the same stimulus let to apnoea lasting 180--400 control respiration cycles on the average, according to the type and depth of general anaesthesia. The duration of apnoea in occlusion of the air passages in the expiratory position increased with the depth of anaesthesia, while in occlusion of the air passages at the peak of inspiration it was shortened. Stimulation of chemoreceptors [inhalation of a mixture 4% CO2 in O2 or of 8% O2 in N2] did not influence the elicitability or duration of the BHIR, nor did cooling the rats to 28 degrees C or heating them to 38 degrees C. The mean respiration frequency was 98 c/min in unanaesthetized rats, 96 c/min in urethane anaesthesis and 79--48 c/min in halothane anaesthesia, according to the depth of anaesthesia. Bilateral cervical vagotomy reduced mean respiration frequency to 35.6 c/min in conscious rats and to 31 c/min in urethane-anaesthetized animals. The results indicate the existence of species-related differences between basic regulatory mechanisms in the rat and certain other mammals.

Participation of the Breuer-Hering inflation reflex in regulation of respiration frequency in anaesthetized rats.

The respiration frequency and Breuer-Hering inflation reflex (BHIR) values were compared in anaesthetized rats after unilateral vagotomy. Nos significant differences were found in the decrease in respiration frequency after transection of the right of left vagus and there were no differences in BHIR values in correlation to conduction by the right or left vagus. With unilateral vagotomy and an inflation pressure of 20 cm H20 the BHIR values fell to about one fourth of the control values. Progressive cooling of the contralateral vagus led at 8-10 degrees C to a non-significant decrease in respiration frequency to 87% of the initial value; in this state the BHIR could not be elicited. Further cooling of the vagus to 0 degrees C reduced respiration frequency to the same values as in bilateral vagotomy. The discrepancy between the mild decrease in respiration frequency and simultaneous disappearance of the BHIR shows that changes in respiration frequency in anaesthetized rats are not directly correlated to the presence of the BHIR.