Vnitřní lékařství, 1991 (roč. 37), číslo 2
[Radionuclide venography in occlusions of the inferior vena cava].
A Fikrle, D Slípková, J Záhlava, M Suchý
Vnitr Lek 1991, 37(2):105-115
Based on 1234 examinations made by radionuclide venography the authors evaluated a group of 11 patients, where an occlusion of the vena cava was proved. In five instances ascension of thrombosis from the area of the pelvic veins was involved. in three instances compression by a tumour, twice the cause of occlusion was surgical ligature of the vena cava inferior. In one instance suppurative thrombosis developed as a result of spread of the infection from an intraabdominal abscess. Radionuclide venography provided evidence of a collateral circulation, as a rule a combination of several collateral routes was involved. Most frequently parietal collaterals...
[Pseudophlebothromobsis].
M Emmerová, M Heidenreichová, J Steinigerová, Z Chudácek
Vnitr Lek 1991, 37(2):116-121
Rational antithrombotic treatment in vascular occlusions is a marked advance in the therapeutic results, incl. reduced mortality. The prerequisite of success is early adequate thrombolytic or anticoagulant treatment taking into account absolute and relative contraindications. Despite this it is necessary to foresee the risk of haemorrhagic complications and orientate diagnosis with the aspect in mind. As an example three case-histories are presented, their common sign being haemorrhage into the lower extremities during antithrombotic treatment. Attention is drawn to the difficulty of differential diagnosis of venous thrombosis and haemorrhage into...
[The importance of blood gas analysis and acid-base equilibrium in pulmonary embolism].
H Brůhová, R Barcal, H Rusnáková
Vnitr Lek 1991, 37(2):122-127
The authors examined in 60 patients with acute pulmonary embolism values of blood gases and acid-base equilibrium, incl. 30 from arterialized capillary blood, in another 30 subjects from arterial blood. On analysis of capillary blood hypoxaemia was present in all subjects, on analysis of arterial blood only in 63%. Respiratory alkalosis was found on capillary examination in 37%, on arterial examination in 23% of the patients. Hypoxaemia and hypocapnia thus are not specific phenomena in acute pulmonary embolism, in particular when accurate blood collection for analysis is respected, and normal values of paO2 and paCO2 do not rule out the presence of...
[Beta-blockers in the treatment of hypertension in elderly patients].
K Lefflerová, J Widimský, Z Lupínek
Vnitr Lek 1991, 37(2):128-134
The authors investigated the effectiveness of treatment of hypertension by monotherapy with beta-blockers--bopindolol (a beta-blocker with a slightly expressed ISA) and metoprolol (cardioselective beta-blocker) in 86 subjects with mild and medium severe hypertension. The purpose of the work was to analyze the effectiveness of control of hypertension in relation to age and to compare groups of subjects under 40 years with patients above 60 years of age. Both investigated beta-blockers proved effective in 80% of subjects above 60 years in the control of hypertension; no serious side-effects were recorded.
[Ranitidine VUFB in the treatment of peptic ulcer].
J Steinigerová, J Kratochvíl
Vnitr Lek 1991, 37(2):135-140
The authors tested in an open clinical investigation in a group of 30 patients the therapeutic effectiveness and tolerance of the newly developed preparation Ranitidine VUFB in the treatment of peptic gastroduodenal ulcers. The preparation was administered to patients with an endoscopically confirmed diagnosis, 300 mg/day by the oral route, for a period of 4 weeks. A positive and rapid effect on regression of subjective complaints was observed and a very favourable effect on healing of the ulcer. After four weeks complete healing of gastroduodenal ulcers was recorded in 73% of the patients, in another 10% marked diminution of the ulcer occurred with...
[Termination of atrial flutter using esophageal stimulation].
J Vainer, A Mádle, J Smíd, J Brunát, I Topinka
Vnitr Lek 1991, 37(2):141-144
The risk of possible complications in atrial flutter leads to attempts to use all available therapeutic possibilities to eliminate this disorder of the cardiac rhythm. By oesophageal stimulation the sinus rhythm was restored in 40% and a change to atrial fibrillation was achieved in 50% of the patients. The advantages of this method include above all speed and the minimal risk of complications; the disadvantage of the method is the unpleasant sensation when the electrode is inserted and the painful perception of the stimuli. Oesophageal stimulation can be recommended as the method of choice in treatment of atrial flutter.
[Cardiac function and adrenergic regulation in incipient hypothyroidism].
V Vavrejnová, J Nedvídková, P Husek, S Vána, V Zamrazil
Vnitr Lek 1991, 37(2):145-150
In patients with thyroid carcinoma who after thyroid elimination took thyroxine and triiodothyronine both hormones were discontinued and after 7 days a complex of peripheral and laboratory parameters was evaluated. Discontinuation of thyroid hormones led to a drop of their serum level and concurrent rise of the TSH level and serum cholesterol. The duration of the pre-ejection period of the systole, the Q-Kd interval and Achilles tendon reflex was protracted. The value of the index of the preejection time increased and that of the index of the expulsion time declined. The heart rate and systolic pressure declined and the body eight increased. Seven-day...
[Cardiotoxicity of anthracycline cytostatic agents--a proposal for routine monitoring and supportive therapy].
M Svojgrová, J Slechtová, J Hůla
Vnitr Lek 1991, 37(2):151-159
The authors investigated a group of 57 patients with acute leukaemia and 30 patients with malignant lymphomas, who were treated by combinations of cytostatics containing the anthracycline antibiotics daunorubicin and adriamycin. Using examination methods which are widely available they tried to find indicators which detect early manifestations of cardiac damage during this treatment. The most valuable indicators of incipient anthracycline cardiomyopathy were the heart rate at rest and the QTc interval on the ECG tracing. The validity of polygraphy and echocardiography could not be assessed in the present work. The authors suggest a procedure of routine...
[Development of therapy of acute myeloid leukemia at the First Internal Medicine Clinic in Plzen].
V Koza, M Svojgrová, J Slechtová, H Pittrová
Vnitr Lek 1991, 37(2):160-165
The authors summarize the development of diagnosis and treatment of acute myeloid leukaemias (AML) at the First Medical Clinic in Plzen in a (group) of 102 patients treated during 1966-1990. On their own results they demonstrate the importance of intensive post-remission treatment with large doses of cytosine arabinoside (ara-c) which makes possible long survival or complete recovery of some patients, and at the same time the necessity and pretentious character of comprehensive supportive treatment is emphasized.
[Erythrocyte kinetics in myelodysplastic syndromes].
M Mistrík
Vnitr Lek 1991, 37(2):166-171
The authors made radioisotope examinations of the erythrokinetics in 21 patients with primary myelodysplastic syndrome: refractory anaemia and sideroblastic anaemia. He investigated the importance of changes of several conventional erythrokinetic parameters as well as the turnover of transferrin molecules which is an indicator of erythropoietic activity independent on sideraemia. The author presents ferrokinetic and erythrokinetic findings associated with myelodysplastic syndrome, as described in the literature. Sideroblastic anaemia produces a typical picture during examination of the erythrokinetics, quite different from other sub-types of the disease...
[Congenital dyserythropoietic anemia].
J Kallo
Vnitr Lek 1991, 37(2):172-177
The author submits the history and classification criteria of congenital dyserythropoietic anaemia and presents at the same time an observation of one of his female patients who was originally dispensarized as hereditary spherocytosis. Failure of splenectomy led to revision of the finding in bone marrow and a change of diagnosis to congenital dyserythropoietic anaemia type II. The patient died at the age of 27 years from hepatic failure as a result of haemosiderosis.
[Sclerotization as a proven method of treatment for varices].
M Horáková-Nedvídková
Vnitr Lek 1991, 37(2):178-185
The author evaluates the importance, technique, mechanism of action, complications and relapses of varicosities treated by sclerotherapy. With improving technique complications are diminishing. Their incidence is minimal and not higher than after surgical operations. In the investigated group of 2250 treated patients within ten years 80.7% major varicosities and 40.5% perforating veins relapsed. The incidence of relapses, in particular of perforating veins depends on the accurate diagnosis. From a group of 7500 patients who attended our out-patient department the most serious complications were two cases of embolism of the lungs and one anaphylactic...
[Use of nonparametric methods in medicine. VII. Kendall's coefficient of concordance in several sequences].
A Gerylovová, J Holcík
Vnitr Lek 1991, 37(2):186-191
The authors describe the procedure, suggested by Kendall for evaluation of the concordance of several sequences. Kendall's coefficient, called also coefficient of concordance, can be used when it is possible to assess the sequence of investigated variables. The calculation procedure and interpretation of the coefficient is explained on a simple example. For evaluation of significance tables of critical values are presented for 1% and 5% levels of significance.