[Importance of determination of serum beta-2-microglobulin levels in patients with Hodgkin's lymphoma].

L Raida, T Papajík, A Hlusí, E Faber, R Urbanová, M Heczko, M Jancíková, J Zapletalová, S Komenda, K Indrák

Vnitr Lek 2002, 48(2):91-95

The authors evaluated retrospectively in a group of 69 adult patients with Hodgkin's lymphoma the relationship between the beta-2-microglobulin serum level, basic demographic parameters (age, sex) and factors characterizing the extent (stage III and IV, "bulk" or mediastinal mass, number of affected areas of lymph nodes) and activity of the tumour (presence of B-symptoms, red cell sedimentation rate, haemoglobin, albumin and lactate dehydrogenase level, number of leucocytes and lymphocytes). They analyzed also the possible prognostic impact of beta-2-microglobulin on the therapeutic response risk of relapse and patient's survival. Methods of univariant...

[Prolactin levels before and after stimulation with thyroliberin in primary hypothyroidism].

D Trejbal, D Petrásová, A Macejová, I Lazúrová, H Wágnerová, L Trejbalová

Vnitr Lek 2002, 48(2):96-99

The authors examined the concentration of thyrotropic hormone (TSH) and prolactin (PRL) before and after stimulation with synthetic thyroliberine (0.2 mg TRH i.v.) in a group of 72 women with primary hypothyroidism (mean age 45 years, range 17-69 years) and 12 controls (mean age 35 years, range 17-49 years). According to the total thyroxin concentrations (TT4) and TSH they divided the group into three smaller subgroups: developed primary hypothyroidism (n = 8, mean age 50 years, TT4 < 65 nmol/l, basal TSH concentration > 15.0 mIU/l nmol/l), subclinical hypothyroidism, severe grade (n = 23, mean age 36 years, TT4 > 65 nmol/l, basal TSH concentration...

[Spontaneous bacterial peritonitis in the Czech Republic].

J Lata, T Fejfar, T Krechler, T Musil, L Husová, M Senkyrík, A Sevcíková

Vnitr Lek 2002, 48(2):100-104

The objective of the study was to assess the prevalence and more detailed data pertaining to the incidence of spontaneous bacterial peritonitis (SBP) in the Czech Republic. The authors examined 99 patients with cirrhosis of the liver and ascites. SBP was diagnosed in a high percentage--35 patients, i.e. 35.4%. It was found more frequently in patients with an alcoholic etiology of cirrhosis who had a history of subfebrile and febrile temperatures and increasing trend of ascites. For the diagnosis the increase of leucocytes in serum and C reactive protein levels may prove useful. Lower values of total protein and albumin in ascites predispose to the...

[Serum ferritin, LDL oxidation and risk factors for atherogenesis in healthy offspring of hypertensive patients].

Z Vlasáková, T Pelikánová, L Kazdová, V Lánská

Vnitr Lek 2002, 48(2):105-111

Iron is an important factor in the process of oxidation stress and atherogenesis which is as a rule potentiated in subjects with the insulin resistance syndrome. Hypertension is one of the main components of this syndrome. Ferritin due to its relationship with impaired insulin sensitivity becomes a candidate for a new indicator of insulin resistance. The subject of the present study was to assess whether we shall find in young healthy offspring of hypertensive parents changes in the ferritin level, oxidizability of LDL and whether these are related to parameters of glucose tolerance, insulin secretion and sensitivity. Twelve young (27 +/- 3.6 years)...

[Early diagnosis and reasons for not administering thrombolytic therapy in acute myocardial infarct].

S Cagán, O Jurkovicová, Z Moťovská, S Wimmerová, I Besedová, T Trnovec

Vnitr Lek 2002, 48(2):112-119

In Slovakia we are lacking data on early (before examination of serum markers of myocardial necrosis) pertaining to thrombolytic treatment (TLL) which is inevitable in case of acute myocardial infarction (AIM) as well as data on the reasons why TLL is not implemented. This why the authors analyze the results of completed comprehensive project Audit concerned with diagnostic and therapeutic procedures in patients with acute coronary syndromes during the pre-hospital and hospital stage (AUDIT). The investigation was a perspective multi-centre study. Data were collected from 3123 patients with AIM in 66 departments (in 64 health institutions) during Sept....

[Detection of cytomegalovirus infection with the polymerase chain reaction and antigenemia after allogenic bone marrow transplantation].

P Simková, P Jindra, V Koza, K Cerná

Vnitr Lek 2002, 48(2):120-124

UNLABELLED: The objective of the work was to evaluate the frequency and time of incidence of cytomegaloviral (CMV) infection and disease in patients after allogeneic bone marrow transplantation (BMT). One hundred patients were followed up (70 with a related and 30 with an unrelated donor), who had transplantations during the period between XI/1996-XI/2000.METHODS USED: nested-PCR (MIE-gene) and antigenaemia (antigen pp65). Active CMV infection was proved in antigenaemia > or = 5 positive cells or in two consecutive positive PCR. The CMV syndrome was assessed in confirmed CMV infection and otherwise inexplicable febrile conditions and/or a drop...

[Diagnosis and therapy of gestational diabetes mellitus].

D Bartásková, M Kvapil, J Charvát, D Smetanová, E Kulovaný

Vnitr Lek 2002, 48(2):125-128

In 1999-2000 at the Medical Clinic Motol Faculty Hospital in collaboration with the Gynaecological Clinic of the Hospital a group of 55 pregnant women with the diagnosis of gestational diabetes (GDM) were followed up. The objective of the investigation was to find out how in the investigated area (detachment area of the Gynaecological and Obstetric Clinic Motol Faculty Hospital) GDM is diagnosed at present, how it is treated and what is the percentage of perinatal morbidity in the investigated group. The mean age of the investigated women was 32.3 +/- 4.5 years. The presence of risk factors for the development of GDM was found in 59.8% of the examined...

[Echocardiography after orthotopic heart transplantation].

J Toman, J Meluzín, L Spinarová, J Seménka

Vnitr Lek 2002, 48(2):129-136

UNLABELLED: One of the most serious complications after orthotopic transplantation of the heart (OTH) is graft rejection. Its early detection can help successful control. The diagnostic gold standard is myocardial biopsy, it is however not always supreme. We tried to find out whether some modern echocardiographic methods can provide further valuable information. At the same time we were concerned with the follow up of basic variables of the circulation and echocardiographic indicators of left ventricular function.MATERIAL AND METHODS: The authors examined repeatedly 22 patients where in 1998-2000 OTH was performed, who did not have an acute severe...

[Thyrotoxic heart disease. Part II--aspects of treatment of thyrotoxicosis with cardiac involvement].

J Hrnciar

Vnitr Lek 2002, 48(2):137-141

In the treatment of the thyrotoxic heart a radical, early thyroeliminating procedure should have preference. As the method of first choice a single administration of a whole calculated dose of I131 is recommended without previous medicamentous preparation up to 25-30 mCie which can be administered also in the out-patient department, with subsequent immediate treatment with thyrostatics and beta-blockers till remission of thyrotoxicosis is achieved (6-12 weeks). Total strumectomy after medicamentous preparation in remission of thyrotoxicosis is preferred in large multinodular, iodinated patients and in solitary toxic adenoma where however also partial...

[Non-specific immune responses in patients with chronic diabetic foot syndrome and chronic bacterial infection].

A Jirkovská, V Fejfarová, J Hosová, J Kalanin, I Stríz, J Skibová

Vnitr Lek 2002, 48(2):142-146

Chronic bacterial ulcers infection is a frequent cause of non-healing diabetic foot. The major factors of a non-specific immune response are phagocytic cells including polymporphonuclear (PMN) leukocytes, and humoral systems (complement). PMN leukocytes remove microorganisms by phagocytosis a part of it is intracellular killing and degradation in a process requiring energy and associated with "respiratory burst". The aim of our study was to assess non-specific immune response in patients with diabetic foot syndrome and chronic bacterial infection. 30 patients treated over one month with antibiotics for an infected diabetic foot in our foot clinic had...

[Disorders of the pulmonary lymphatic system].

M Riedel

Vnitr Lek 2002, 48(2):147-150

The pulmonary lymphatic system plays an important role in lung perfusion homeostasis. Congenital errors of lymphatic vessel development lead to primary pulmonary lymphatic disorders (lymphangiomas, lymphangiectasis, lymphatic dysplasia syndromes). Acquired disorders of the pulmonary lymphatic system occur in a variety of clinical settings (ranging from trauma to cancer) and may lead to serious pulmonary disease. Because of their scarcity and confusing and inconsistent use of terminology, these conditions are often misdiagnosed. Their management is difficult.

[Sudden cardiac death (part 1].

M Pleskot, J Kajzr, P Parízek, M Měsťan

Vnitr Lek 2002, 48(2):151-156

Sudden cardiac death is a sudden unexpected non-violent death for cardiac reasons which according to the majority of authors occurs within one hour after the development of symptoms of acute impairment of health. This syndrome is a major problem of contemporary medicine with a very adverse prognosis. The authors analyze the epidemiology, causes, influence of the external environment, basic arrhythmogenic mechanisms and prognosis of sudden death. Examination methods of this clinical condition are evaluated from the aspect of their application in the risk stratification of patients.

[Late recurrence of Hodgkin's disease 20 years after initial diagnosis. Personal observation of two cases and a literature review].

J Marková, J Maaloufová, J Stríteský, D Feltl, T Kozák

Vnitr Lek 2002, 48(2):157-160

Most patients with Hodgkin's disease (especially early stage disease) are successfully treated using modern treatment modalities. Disease relapse usually occurs within the first three years after initial therapy. Late relapses of Hodgkin's disease, occurring after 10 years or even later, are rare (0.6% of cases only). Their biological behaviour is different from that of early relapses, resembling primary disease. The question whether very late relapses represent a second primary disease in patients with a genetic predisposition to Hodgkin's disease rather than a relapse of the original disease remains the subject of much discussion. We report here...

[History of the treatment of essential hypertension--part II].

J Widimský

Vnitr Lek 2002, 48(2):161-170