Vnitřní lékařství, 1994 (roč. 40), číslo 9
[The importance of studying the renin-angiotensin-aldosterone system in essential arterial hypertension in clinical practice. Activity of the renin-angiotensin-aldosterone system during treatment of hypertension with ACE-inhibitors and beta blockers].
J Hrnciar, M Hrnciarová, J Lepej, D Okálová, A Kreze, M Chamulová
Vnitr Lek 1994, 40(9):557-562
The authors assessed in 20 subjects with mild or medium severe arterial hypertension basal and stimulated values of plasma renin activity (PRA) and aldosterone before onset of treatment and after 6-week therapy with enalapril (ENAP KRKA) or metoprolol (Vasocardin Slovakofarma). PRA and aldosterone secretion was stimulated by a vertical position and by administration of 40 mg furosemide by the i.v. This test proved suitable for assessment of secondary arterial hypertension in different forms of primary hyperaldosteronism and for expressing suspicion of renovascular hypertension and hypertension with affection of the renal arteries resp. Based on PRA...
[Ultrasonic indicators of left ventricular function and elasticity of large vessels in newly diagnosed hypertensive patients].
B Stancák, K Belesová, S Misíková, J Pella
Vnitr Lek 1994, 40(9):563-568
The authors investigate the degree of alteration of large vessels in newly detected not treated hypertension, using a series of non-invasive indicators of vascular function and their association with selected parameters of systolic and diastolic left ventricular function in a group of 23 hypertonic patients and 23 subjects with normal blood pressure. The mean age of the examined subjects was 51.1 +/- 16.6 years. In the echocardiographic indicators a significant difference was found between the groups as regards the weight of the LV and in the ratios of amplitudes and time integrals of waves E and A of the Doppler record of transmitral flow. Comparison...
[Infectious endocarditis--new aspects of a well-known disease].
M Belicová, S Funiak, J Květenský, I Markuljak, J Dvorský, V Licko, L Vladár
Vnitr Lek 1994, 40(9):569-572
The authors discuss the incidence, etiology and pathogenesis of infectious endocarditis. They mention the incidence and therapeutic results in patients with infectious endocarditis hospitalized at the First Medical Clinic in Martin in 1988-1993. In the conclusion they present general principles of the treatment of infectious endocarditis.
[Dynamic scintigraphy of the esophagus in young persons with functional algesic-dyspeptic disorders of the upper digestive tract].
Z Antos, O Bělohlávek, B Suchý, V Michal, M Vodák, V Foltýnová
Vnitr Lek 1994, 40(9):573-576
The authors examined a group of 30 young people aged 19-23 years who suffered from chronic algic dyspeptic complaints of the upper type persisting for 3-36 months. The prerequisite for inclusion into the group were normal results of endoscopy, the physical finding and standard biochemical examinations. In all these patients dynamic scintigraphy of the oesophagus was made. A quite normal finding was recorded only in three patients (10%). In the remaining 27 (90%) major or minor abnormalities were recorded. This is in marked contrast with the results of dynamic scintigraphy of the oesophagus in 19 healthy volunteers of the same age. In the latter a normal...
[Cytogenetic findings in patients with primary myelodysplastic syndrome and their prognostic significance. (Analysis of results in 65 patients)].
K Indrák, M Jarosová, I Sulovská, V Scudla, J Hubácek, I Sousková, K Běhal, M Svobodová
Vnitr Lek 1994, 40(9):577-585
Cytogenetic examination of 65 patients with primary MDS revealed cytogenetic changes in 39 (60%) of the patients. The most frequently affected chromosomes were chromosomes 5, 7, 11, 17 and 20. Deletion of 5q only found in 9 (23%) of the patients with chromosomal changes occurred similarly as simple chromosomal changes most frequently in the prognostically more favourable group MDS-RA. Prognostically adverse monosomy of chromosome 7 was found in 3 patients in group RAEB and RAEB-t but only as part of complex chromosomal changes. The latter were encountered most frequently in patients of groups RAEB and RAEB-t, similarly as trisomy of chromosome 8. Patients...
[Treatment of iron overload states with oral administration of the chelator agent, L1 (Deferiprone)].
J Cermák, V Brabec
Vnitr Lek 1994, 40(9):586-590
Nine iron overloaded patients were treated with L1--Deferiprone (1,2-dimethyl-3-hydroxypyrid-4-one) in daily dose 3 g (40-50 mg/kg) for 12 weeks. In 7 patients the efficiency of L 1 treatment was compared to the therapeutic effect of the same dose of desferrioxamine (Desferal). A significant increase in urinary iron excretion was observed after administration of both chelating agents. Iron excretion after L 1 treatment was approximately 65% of that obtained with Desferal. The amount of excreted iron correlated with the amount of iron stores before chelation. A significant decrease in transferrin saturation, serum and red cell ferritin was observed...
[Pulmonary infection with Pneumocystis carinii in patients with malignant hematologic diseases].
J Mayer, J Skricková, J Vorlícek, V Kubálek, R Bucek
Vnitr Lek 1994, 40(9):591-594
The authors describe their experience with the diagnosis of pulmonary infection with Pneumocystis carinii in patients with malignant diseases. In the course of three years they recorded a total of 16 such cases. All cases were diagnosed by bronchoalveolar lavage. The authors analyze in detail the clinical symptoms and radiological picture. Attention is drawn to the fact that no finding is specific for the disease. The infection of Pneumocystis carinii was combined in 13 cases with another infection. Treatment was successful in 75% of the patients.
[Difficulties in the therapy of primary amyloidosis].
Z Adam, L Elbl, J Vorlícek, E Králová, H Novotná, R Hájek, N Hejlová
Vnitr Lek 1994, 40(9):595-599
The therapy of primary amyloidosis is still unsatisfactory. The response rate after the cytostatics, dimethylsulphoxide, colchicin and vitamin E is usually low. None of these treatment modalities prolongs significantly the survival in majority of treated patients. The success of interferon alpha in the maintenance therapy of follicular non-Hodgkin's lymphoma and in the remission of multiple myeloma, as well as successful treatment of primary cryoglobulinaemia, brought us to the idea to test interferon alpha in the therapy of primary amyloidosis. Interferon alpha-2b was administered to the patient with three years history of primary amyloidosis. Interferon...
[Pulmonary infection with Pneumocystis carinii].
J Mayer
Vnitr Lek 1994, 40(9):600-604
The author present extensive review on pulmonary infection with Pneumocystis carinii. He deals with the following aspects: history, pathophysiology, clinical picture and diagnosis. Diagnostic methods used at present are described in great detail. Therapy and prevention are not discussed.
[Current possibilities in the therapy of iron overload].
J Cermák
Vnitr Lek 1994, 40(9):605-608
Tissue damage, cardiac and hepatic failure are the most frequent consequences of chronic iron accumulation within the body. A long term administration of chelating agents may prevent organ damage by surplus of iron as well as improve cardiac and liver function in iron overloaded patients. Desferrioxamine (Desferal) is the only one chelating agent for routine clinical use. To produce a therapeutic effect parenteral administration of the drug in prolonged infusions is needed and therefore many investigators try to search for orally active chelator with effect comparable to desferrioxamine. Hydroxypyridones, especially 1,2-dimethyl-3-hydroxypyrid-4-one...
[New parameters of oxygen metabolism in clinical practice].
M Dastych, I Cundrle
Vnitr Lek 1994, 40(9):609-613
The authors discuss parameters characterizing the oxygen metabolism and their clinical impact: Partial oxygen pressure in arterial and mixed venous blood, lactate and new parameters derived from direct assessment of haemoglobin saturation with oxygen in arterial blood. Oxygen extraction tension (px): partial oxygen pressure in mixed venous blood at which 2.3 mmol oxygen are released from one litre of blood. Extractable oxygen (cx): the amount of oxygen released from on litre of blood when the partial oxygen pressure drops to 5.0 kPa. Oxygen compensation factor (Qx): it is the factor that cardiac output should increase to maintain a normal mixed venous...
[Sepsis. 2].
J Mayer
Vnitr Lek 1994, 40(9):614-618
In part 2 author pays attention to new findings on treatment of sepsis and septic shock. He emphasizes facts which are of immediate importance for clinical practice and therapy. Possibilities of immunomodulating therapy (monoclonal antibodies, immunoglobulins) are described in detail.