[Indices of left heart ventricle relaxation after 5-months of hypotensive therapy with guanfacine]. / Wskazniki rozkurczu lewej komory serca po 5 miesiacach terapii hipotensyjnej guanfacyna.

The subject of the work is to assess the clinical parameters and diastolic function in patients with mild or moderate essential hypertension after 5-month treatment with guanfacine 0.5-3 mg/day, mean 1.7 mg. In the group there were 8 women and 8 men, mean age 53.7 +/- 7.6. The diastolic function of the left ventricle was assessed from the echocardiographic M-mode paper sweep of the left ventricle by the method of Gibson and Brown. In clinical parameters systolic, diastolic and mean blood pressure was found to decrease significantly, the heart rate was unchanged. Essential improvement of the markers of relaxation was received while amelioration of filling was not significant. The before treatment data were compared with the similar ones of the 60 persons of the control group. The significant differences were found in values of blood pressure, markers of relaxation and indices Iv and Ip.

[Effect of 5-month guanfacine treatment on the renin-angiotensin-aldosterone system and some metabolic factors in patients with diabetes mellitus type II and hypertension]. / Wplyw 5-miesiecznego leczenia guanfacyna na reninemie spoczynkowa, aldosteronemie i aldosteronurie oraz wybrane wskazniki metaboliczne u chorych na cukrzyce typu II i nadcisnienie tetnicze.

The group of the investigated included 25 individuals (11 F, 14 M), aged 55 +/- 1.5 years, with diabetes type II and hypertension. Known diabetes duration was 4.9 +/- 0.8 years and known hypertension duration--7.4 +/- 1.4 years. Two weeks after administering placebo in place of hypertension drugs applied so far, guanfacine was included as the only hypertensive drug. The dosage was increased from 0.5 mg up to 3 mg daily until a good control of blood pressure was achieved. The diabetic treatment, diet and the smoking habit were unchanged. The resting activity of the renin-angiotension-aldosterone system (RAA), cholesterol, triglycerides, HDL and LDL, serum glucose levels and HbA1c were assayed after a 5-month guanfacine period. After treatment a significant decrease in blood pressure both systolic and diastolic (p < 0.001), heart rate (p < 0.005) and plasma renin activity (p < 0.02) were observed. Preliminary measurements of RAA activity and its changes during treatment were not helpful in predicting guanfacine hypotensive effect. The level of lipids, lipoproteins, atherogenic factors, glucose and HbA1c did not change significantly during the study.

[Hyperglycemic hyperosmolar nonketotic coma]. / Nieketonowa, hiperosmolarna spiaczka cukrzycowa.

Ten patients with the syndrome of non-ketotic hyperosmolar coma are described. The mean age of the patients was 62.3 +/- 17.12 years. One patient was 16 years old. In 9 cases the patients had type II diabetes, one had type I diabetes. In 7 cases the coma was the first sign of diabetes. The factor predisposing in most cases was infection. In the treatment-acting insulin and hypotonic solutions were given. In 2 cases clinical signs of the DIS syndrome were observed manifesting themselves with local changes, including mental disturbances. Heparin was given with good effect. Three patients (30%) died in hospital. The cause of death was serious disease associated with this coma: pancreatitis and myocarditis, purulent bronchopneumonia, myocardial infarction.

[Analysis of the cause of death in diabetic ketoacidosis based on 5 years of personal observation]. / Analiza przyczyn smiertelnosci w przebiegu kwasicy cukrzycowej na podstawie wlasnych 5-letnich obserwacji.

The authors observed 53 cases of diabetic ketoacidosis treated with low doses of insulin. Mean age of the patients was 41 +/- 17 years, duration of diabetes mellitus 7.5 +/- 6.4 years. Ketoacidosis was due to: infections in 36%, other diseases in 7%, and cessation of insulin therapy in 25% of cases. Ketoacidosis was a first sign of diabetes mellitus in 19% of cases while causative factor was not detected in 13% of cases. At the admission to hospital mean blood pH was 7.02 +/- 0.15, mean bicarbonate concentration 6.17 +/- 3.45 mM/l, and glycaemia 40.6 +/- 16.8 mM/l. Therapy of ketoacidosis was complicated by hypopotassemia in 1 patient and transient hypoglycaemia in another patient. Five patients (9.6%) died. Infections, myocardial infarction, acute pancreatitis, pulmonary edema, and disseminated intravascular coagulation were the causes of deaths.