Vnitřní lékařství, 1994 (roč. 40), číslo 1
[Factors affecting the vulnerability of the left atrium during rapid transesophageal atrial stimulation].
B Stancák, S Misíková, Z Schroner, J Pella
Vnitr Lek 1994, 40(1):3-8
Atrial fibrillation (AF) is associated with a higher morbidity and mortality because of the risk of systemic or pulmonary embolism as well as the negative impact on cardiac function. The authors investigate in the submitted paper factors influencing the vulnerability of atria during transoesophageal atrial stimulation (TESP). The group comprised 68 patients with a sinus rhythm, mean age 56.9 +/- 17.9 years. Depending on the response to rapid atrial stimulation, the patients were divided into three groups. In group I (small disposition to AF) they revealed a significantly lower age, the relative thickness of the left ventricular wall assessed by echocardiography...
[Dysfunction of valvular prostheses].
J Fabián, M Pavlovic, V Fischer
Vnitr Lek 1994, 40(1):9-13
Implantation of artificial mechanic valvular prostheses significantly improves and prolong the life of patients with valvular defects with a haemodynamic impact. This therapeutic method does not cure the patients and operation switches the problem of a natural dysfunctional valve to that of a functional artificial valve with improvement of the quality of life and its prolongation. The long-term effect and thus the general prognosis--the patient's "fate" depends above all on complications such as infections and haemocoagulation which are the main cause of dysfunction of artificial prostheses. The authors describe in the submitted paper basic principles...
[Acebutolol in the therapy of mild and moderate hypertension].
J Widimský
Vnitr Lek 1994, 40(1):14-16
Acebutolol (sectral) is one of the new types of cardioselective beta-blockers which has at the same time also qualities of ISA. The author made a 6-month clinical study comprising 20 patients, focused on the antihypertensive effectiveness and tolerance of the drug. Administration of acebutolol led already after two weeks to a significant effect on the systolic and diastolic blood pressure and during the period of 1-6-month administration the maximal antihypertensive effect was achieved (-29 mm Hg systolic BP, -19 mm Hg diastolic BP). 24-hour monitoring of the BP proved antihypertensive effectiveness of acebutolol regardless whether the drug was administered...
[Factors affecting serum lipid levels in patients with type 2 diabetes mellitus].
I Tkác, R Tkácová, A Molcányiová, T Mudríková, M Takác
Vnitr Lek 1994, 40(1):17-20
Serum lipid concentrations were assessed in 147 type 2 diabetics. The patients were divided into different sub-groups in order to follow up different factors which could have an impact on serum lipids. The mean total cholesterol concentrations were significantly higher in diabetic women as compared with men. The authors did not reveal significant differences in lipid concentrations between obese and non-obese diabetics. Hypertensive diabetics had higher mean total cholesterol levels and LDL-cholesterol levels, as compared with diabetic patients without hypertension. Patients using oral antidiabetics had significantly higher mean triglyceride levels...
[Prevalence of bronchial asthma, chronic bronchitis and allergic rhinitis in a South Moravian District].
V Vondra, M Reisová, P Petrík, Z Skulová, M Malý
Vnitr Lek 1994, 40(1):21-25
In a random sample of 648 adults (18-70 years), representing 95,836 people by age and sex, the prevalence of the above mentioned diseases was assessed. The chi 2-test revealed that the sample of examined subjects did not differ significantly from the distribution of the population as regards age and sex. The prevalence of bronchial asthma was 2.0%, of chronic bronchitis 16.3%, pollen rhinitis 4.5% and non-seasonal rhinitis 4.9%. In asthma the immunological type of the disease predominated markedly. Bronchial hyperreactivity after inhaled histamine was almost five time higher in asthma than in bronchitis (100% and 22.5%).
[Comparison of basic somatometric characteristics in randomly selected populations from Prague and Vsetín].
Z Pôbisová, V Zamrazil, A Simecková, J Cerovská, O Hníková, Z Novák, P Vlcek, M Voborská, J Vrbíková
Vnitr Lek 1994, 40(1):26-31
In 1991-1992 in the Czech Republic an epidemiological survey was conducted focused on prevention of iodine deficiency and the incidence of some thyropathies. The authors examined samples of the Prague and Vsetín population selected at random. The clinical examination comprised also somatometric assessment. In a group of 1,100 subjects from Prague and Vsetín anthropometry of basic somatometric characteristics was performed (height, body weight, BMI and four skinfolds). From comparison of the two groups ensues that the Vsetín population is shorter, as compared with the Prague population, the BMI values are significantly higher and so is the percentage...
[A fatal hemorrhagic condition after rodenticide ingestion].
P Dulícek, L Chrobák, K Podzimek, J Voglová
Vnitr Lek 1994, 40(1):32-35
The authors describe a fatal haemorrhagic condition in a 53-year-old man which developed after assumed ingestion of so-called "superwarfarins". Symptoms of intoxication with substances of the warfarin type include the sudden development of haemorrhagic diathesis, marked prolongation of INR and APTT with persisting pathological values of these tests after the usual substitution doses of vitamin K1. The fluctuation of INR and APTT values during repeated examinations is also striking. In the event of such a coagulation finding it is important to consider possible superwarfarin intoxication, even if it is difficult to provide direct evidence, as it is...
[Treatment of macroscopic hematuria complicating renal biopsy by embolization of a branch of the renal artery].
L Golán, J Horejs, V Knotková, K Němecek
Vnitr Lek 1994, 40(1):36-39
The authors describe a case of recurrent macroscopic haematuria which developed after renal biopsy in a young patient with IgA dominant focal and segmental mesangioproliferative glomerulonephritis. As conservative treatment was not successful, renal angiography was performed which revealed a false aneurysm of the segmental branch of the renal artery at the site of the assumed puncture. After selective embolization with gelaspon granules macroscopic haematuria receded quickly.
[Thyrotoxic crisis].
J Hrnciar
Vnitr Lek 1994, 40(1):40-43
A thyrotoxic Crisis is an acute or subacute metabolic explosion caused by uncontrolled release of tyronines from the thyroid gland (more frequently a diffuse thyroid gland) following its injury: strumectomy, administration of a therapeutic dose of I131, inflammations, or excessive stimulation (massive release of TSIg by stress lympholysis, low iodine doses). Concurrently a massive conversion of T4 to T3 in tissues must occur which is enhanced by discontinuation of beta-blockers, thyrostatics, synthetic glucocorticoids and administration of drugs replacing T4 from the bond to plasma carries (salicylates, sodantone, furosemide, barbiturates etc.) during...
[Quantitative determination of left ventricular size using echocardiography].
J Hůla
Vnitr Lek 1994, 40(1):44-47
Echocardiography makes it possible to examine the mass of the left ventricle both by a two-dimensional and one-dimensional approach. The method of one-dimensional echocardiography is simpler and more accurate than two-dimensional echocardiography. There are two most frequently used conventions for assessment of the thickness of the wall and the diameters of its cavity: 1. the method of the American echocardiographic society, 2. the Penn-convention. The latter correlates better with left ventricular mass assessed on autopsy. The prerequisite for use of one-dimensional echocardiography is that the mass of the left ventricle is evenly distributed along...
[The antiphospholipid syndrome].
C Dostál
Vnitr Lek 1994, 40(1):48-52
The author summarized contemporary findings on anti-phospholipid autoantibodies, their different types and probable site of action. This autoimmune phenomenon produces some typical clinical symptoms which made it necessary to describe them as the so-called anti-phospholipid syndrome. If concurrently some autoimmune disease is present, in particular lupus erythematosus , this syndrome is considered "secondary". If this is not the case, it is assumed that the "primary form" is involved. The author suggests diagnostic criteria and in large groups of patients suffering from SLE the true prevalence of different symptoms of this syndrome is tested with participation...
[Ultrasound in the diagnosis of thromboembolism].
P Vahala, P Poliacik, J Daniska, K Plevová, P Pleva
Vnitr Lek 1994, 40(1):53-55
The authors review the importance of echocardiography and duplex examination of the blood vessels of the lower extremities for early diagnosis of thromboembolic attacks. Echocardiographic examination rules out other causes of the patient's complaints such as myocardial infarction, heart defects, ischaemic heart disease and others. The main role of echocardiography is, however, detection of symptoms of an acute rise of the blood pressure in the right heart or symptoms of its failure. The most valuable symptom is dilatation of the right branch of the pulmonary artery and dilatation of the right ventricle found in as many as 75% patients. It is also useful...
[Mechanisms of the antitumor effects interferons].
Z Adam
Vnitr Lek 1994, 40(1):56-58
Interferons alpha, beta and gamma form an interferon system, which is part of the non-specific immune defense of the organism. They participate in the defense against virus infections and have a marked immunoregulating effect. By interfering with the transmission of genetic information in the cells they exert an antiproliferative action on sound as well as tumour cells (they inhibit oncogenes). Alpha interferon exerts the most marked antiproliferative action. All mentioned mechanisms participate in the anti-tumourous action of interferons. The most widely used interferon in oncological treatment is interferon alpha.
[Present status of treatment of opportunistic mycotic infections with systemic antimycotics].
J Háber, E Kolesková, J Straub, P Klener
Vnitr Lek 1994, 40(1):59-64
The authors present a brief review of systemic antimycotics available at present, incl. indications and treatment. In a table these preparations are compared as regards pharmacokinetic properties and undesirable effects.
[Diagnosis of systemic mycotic infections].
J Háber, E Kolesková, J Straub, A Palecek, I Másová, P Klener
Vnitr Lek 1994, 40(1):65-68
The diagnosis of mycotic infections still remains a serious problem. The clinical picture lacks specific manifestations, usually it does not differ substantially from bacterial infections. Routine laboratory examinations are only of subsidiary importance and even more specific methods (assessment of antibodies, and in particular detection of mycotic antigens) do not meet expectations so far. To establish the diagnosis of systemic mycosis it is thus most important to consider the possibility and to support clinical suspicion by an aimed examination.