[The role of home pressure monitoring in the treatment hypertension in the practice of general medicine].

J Widimský, I Balazovjech, V Lánská

Vnitr Lek 1999, 45(10):569-577

AIM OF THE STUDY: The aim of the study was to evaluate home blood pressure (BP) measurement using an OMRON HEM 706 device (including printout values) for the treatment of essential hypertension by a greater number of general practitioners and to establish the incidence of "white coat hypertension".METHODS: We compared home BP values, taken by the portable digital Omron HEM 706 device with casual BP values, measured during the course of a 6-month treatment of essential hypertension by the ACE inhibitor perindopril or a combination of perindopril and a diuretic (most frequently a low dose of hydrochlorothiazide) in 503 patients with mild to moderate...

[The level of diabetic compensation and endogenous secretion of insulin in newly diagnosed diabetics. Prospective study: Part 1].

J Perusicová

Vnitr Lek 1999, 45(10):578-582

In a prospective study of newly detected diabetic patients in 1989-1991 the authors focused their attention on the evaluation of blood sugar levels and HbA1c during manifestation of DM and the amount of insulin secretion in relation to diabetes type 1 and 2 in adult patients. Part 1 of the paper reveals great differences in the fasting blood sugar level during manifestation of DM (26% of the group had a blood sugar level lower than 8.5 mmol/l and 14% above 15 mmol/l) even after 1-4 months treatment (3.8-17.2 mmol/l). Similar differences were found in HbA1c values (4.5-12.9%). High C-peptide levels revealed an incorrectly assessed diagnosis of type...

[Relation of the soluble cytoadhesion molecules VCAM-1 and ICAM-1 to selected clinical and laboratory indicators in multiple myeloma].

V Scudla, M Budíková, J Bacovský, M Ordeltová, D Opíchalová, V Heincová

Vnitr Lek 1999, 45(10):583-590

Hitherto conducted studies concerned with the problem of cytoadhesive molecules (CAM) dealt only in a very limited way with the problem of multiple myeloma (MM). The subject of the submitted paper was evaluation of the relationship of soluble forms of "vascular cell adhesive molecule-1" (sVCAM-1) and "intercellular cell adhesion molecule-1" (sICAM-1) in serum from the peripheral bloodstream (PBS) and serum from a bone marrow aspirate (BMA) with selected clinical and laboratory indicators of MM (beta 2-microglobulin, thymidine kinase, immunochemical type of MM, S-creatinine, S-monoclonal immunoglobulin, S-albumin, Hb, percentage ratio of plasmocytes...

[The effect of ambulatory nutritional intervention using defined enteral nutrition on the nutritional status of selected adult patients with cystic fibrosis].

M Kvapil, J Charvát, H Rozehnalová, J Musil

Vnitr Lek 1999, 45(10):591-593

The prevalence of mild and serious nutritional disorders in patients with cystic fibrosis is high. One of the possible ways how to supplement the necessary nutrients is the administration of defined supplementary enteral nutrition. The objective of the presented work is to evaluate the effect of supplementary domiciliary enteral nutrition in adult patients with cystic fibrosis. To eight patients with cystic fibrosis, mean body weight 51.77 +/- 10.63 kg, mean age 24.7 +/- 1.9 years for a period of 6 +/- 1 months enteral nutrition was administered (containing 40 and 55.1% energy as fat) with a caloric density of 10 kcal/kg as supplementary domiciliary...

[Silent forms of hereditary spherocytosis].

V Brabec, J Cermák, P Jarolím

Vnitr Lek 1999, 45(10):594-597

We report 7 cases of "silent" form of hereditary spherocytosis observed among members of 4 different families. Silent form of hereditary spherocytosis occurred in 5.4% of all patients with hereditary spherocytosis treated in our institute. The patients with silent form featured normal Hb level and red blood cell count, normal or slightly elevated reticulocyte count and bilirubin level. Osmotic resistance of red blood cells was decreased and autohemolysis was increased, nevertheless, the differences from normal range were less prominent than in patients with manifest form of the disease. Analysis of red cell membrane revealed deficiency of band 3 protein...

[Serum neopterin in IgA deficiency and common variable immunodeficiency].

J Tomandl, J Litzman, Z Pikulová, J Tallová, J Lokaj

Vnitr Lek 1999, 45(10):598-601

Serum neopterin levels were determined in 31 children and 18 adults with the selective IgA deficiency and in 17 adult patients with a common variable immunodeficiency. The results were compared with serum neopterin levels of 41 children and 26 adult controls. All sera were obtained in an infection-free period. We observed significantly increased serum neopterin levels in common variable immunodeficiency patients; this increase was observed namely in patients with a severe course of the disease. No increase in serum neopterin levels was observed neither in IgA deficient patients prone to respiratory tract infections nor in IgA deficient persons examined...

[Paget's disease of bone--treatment with alendronate, calcium and calcitriol].

J Wendlová, S Galbavý, J Paukovic

Vnitr Lek 1999, 45(10):602-605

In the submitted case-history the authors describe the clinical picture, diagnosis and treatment of the non-complicated form of Paget's disease in a 68-year-old patient with typical X-ray findings on the vertebrae, pelvis and left tibia. The laboratory findings revealed liminal alkaline phosphatase (ALP) values, 2.5 times raised values of the aminoterminal telopeptide of collagen I in the organic bone matrix (NTx) in the 24-hour diuresis and slightly elevated osteocalcin (OSCA) levels. The finding of whole-body skeletal scintigraphy was atypical and thus was no diagnostic asset. Aimed transiliacal bone biopsy according to Bordier taken from the pathological...

[Diagnosis and treatment of pancreatic islet cell tumors producing vasoactive intestinal polypeptide (VIPoma)].

J Kábrt, M Dvorák, J Skrha, G Sindelka

Vnitr Lek 1999, 45(10):606-609

The incidence of VIPoma is approximately one per 10 million population. Thus in the Czech Republic this rare disease should be diagnosed once per year. The authors present their experience with the diagnosis and treatment of patient born in 1956, who suffered since 1990 from diarrhoea, at first episodically. In 1992-1994 the diarrhoea was profuse, caused dehydration, hypokalaemia and severe metabolic acidosis without an increase of the anion gap. As a result of dehydration the patient developed acute renal insufficiency. Due to hypokalaemia he developed paroxysmal atrial fibrillation. The diagnosis was based on the clinical finding and later confirmed...

[Sexual activity and the cardiovascular system in health and disease. Use of sildenafil in heart patients].

J Kovác, J Mensa

Vnitr Lek 1999, 45(10):610-613

Sexual intercourse involves mild to medium severe physical exertion of the cardiovascular system. The risk of sudden death associated with sexual activity is very low, and so is the risk of developing infarction. In patients with pre-existing ischaemic heart disease sexual activity is safe in case of controlled angina with tolerance of a medium-grade load on examination on a treadmill. After acute myocardial infarction with a non-complicated course sexual activity can be resumed in a familiar environment with a familiar partner after about 10 days. In stabilized anginous patients sildenafil administration is safe assuming that the patient does not...

[The paradox of insulin resistance].

K Kubát

Vnitr Lek 1999, 45(10):614-617

Insulin resistance (IR) is a phenomenon which associates several serious "diseases of civilization" within the framework of Reaven's metabolic syndrome. In the submitted paper the authors describe the so-called "paradox of insulin resistance"--a paradoxical finding of inadequate insulin action under laboratory induced conditions while under "common" conditions the finding is reversed. Diabetes mellitus type 2 (with obesity) is characterized by excessive filling of cells by energetically rich substances. A low energy output, inadequate physical activity in these subjects leads to the development of regulatory mechanisms, which restrict further nutrient...

[What will internal medicine look like in the next century in the Czech Republic].

R Kubát

Vnitr Lek 1999, 45(10):618

[The more specialists, the worse the results? Comment on the article by Dr. P. Widimský "What will internal medicine look like in developed countries in the 21st century?".

S Alusík

Vnitr Lek 1999, 45(10):619-620

[The concept of internal medicine as a profession].

S Alusík

Vnitr Lek 1999, 45(10):621-622