[Electrocardiographic changes after heart transplantation]. / Elektrokardiografické zmeny po transplantaci srdce.

Electrocardiographic (ECG) changes are described after heart transplantation in almost 75% patients. During the early postoperative period the usual finding are conduction disorders which in 3-5% call for implantation of a pacemaker. The most frequent persisting disorder is bundle branch block which is of clinical importance only when it has a progressive character. The incidence of postoperative atrial fibrillation or flutter is lower as compared with other cardiosurgical operations and their sudden development may be associated with acute rejection. Ventricular arrhythmias develop as a rule as a complication of advanced coronary disease of the graft and are frequently the cause of sudden death. Before the introduction of cyclosporin A a relatively reliable sign of acute rejection was a reduction of the QRS complex voltage. During contemporary treatment ECG changes develop only in severe forms of rejection, incipient changes can be recorded only by an intracardial electrogram.

[Infectious complications in patients after heart transplantation]. / Infekcní komplikace nemocných po transplantaci srdce.

The incidence of infectious complications was monitored in a group of the first 100 patients undergoing orthotopic heart transplantation at the Institute for Clinical and Experimental Medicine from January 1984 through May 1993. The definition of an infectious complication was a clinically manifest infection requiring treatment. Cytomegalovirus infection and Epstein-Barr virus infection were evaluated by the development of antibody against IgM. A total of 168 infectious complications were detected in 80 patients. The infectious complications were fatal in 11 patients; hence, infections were implicated in 26% of all deaths following heart transplantation. The spectrum of infections markedly varies depending on the interval since the procedure. The most frequent infections within the 30 postoperative days are bacterial (often nosocomial) infections. In the later period (30 days onward), viral infections account for 72% of cases. Of the rarer types of infections, the pulmonary form of aspergillosis was identified in 3 cases, nocardiosis and legionellosis in one case each. Infectious complications were the main cause of deaths in the period of 1 to 4 months post-transplantation, and the spectrum and rate of complications were not different from data reported by other centres.

[Bacterial contamination of arthropods in a health facility]. / Bakteriální kontaminace clenovcu ve zdravotnickém zarízení.

At 55 sites of a health institution in July and September 1990 a total of 161 specimens of arthropods were detected, 30 outdoors and 131 on the premises of the health institution. On their bodies 116 bacterial strains were isolated, mostly Gram-negative rods (more than 85%), in particular spp. Enterobacter, Acinetobacter, Klebsiella, Citrobacter and Pseudomonas. Gram-positive cocci accounted for cca 12%, in particular strains of S. haemolyticus and S. hominis. The greatest number of strains was detected on bodies of cockroaches, flies, Chironomus and Tenebrio. In about one third of strains the diffuse disk test revealed resistance to more than three antibiotics. The investigation was supplemented by microbiological examination of strains from a hospital environment (45 smears) and strains from biological material (82 specimens), from patients with nosocomial infections.