[The effect of long-term treatment of arterial hypertension with Ca antagonists on the renin-angiotensin-aldosterone system in diabetics. Hyporeninemic hypoaldosteronism].

J Hrnciar, K Jakubíková, M Hrnciarová, A Kreze, M Chamulová

Vnitr Lek 1995, 41(10):661-666

During long-term treatment of arterial hypertension with calcium antagonists of the dihydropyridine type activation of the sympathetic nervous system and subsequently also of the renin-angiotensin-aldosterone system persists, while the haemodynamic reaction to vasodilatation, manifested by an elevated pulse rate and minute volume from the initial stage of therapy, recedes. In type II diabetics the basal and stimulated response of the renin-angiotensin-aldosterone system is reduced. The administration of calcium antagonists of the dihydropyridine type does not stimulate significantly the renin-angiotensin-aldosterone system as the starting function...

[Neurohumoral activity in liver cirrhosis].

I Lazúrová, I Rosochová, B Lichardus, D Trejbal, T Hildebrand, I Tkác, Y Machánová, J Murár

Vnitr Lek 1995, 41(10):667-671

The authors assessed in 40 patients with cirrhosis of the liver and in 33 controls the plasma renin activity (PRA), aldosterone (PA), the atrial natriuretic factor (ANF) and the digoxin like activity (DLA) in plasma under basal conditions. In patients with cirrhosis of the liver they found significantly lower levels of PRA, PA and DLA, as compared with the control group, the ANF levels were not significantly altered. In the group with cirrhosis the highest neuroendocrine activity was recorded, in particular of PRA and PA in decompensated cirrhotics receiving diuretic treatment. Therefore it is useful to combine diuretics with preparations or measures...

[Safety of hormone replacement therapy in menopause and its favorable effect on the lipid spectrum].

J Murín, M Borovský, J Payer, Z Killinger, L Stecová

Vnitr Lek 1995, 41(10):672-676

The authors pay attention to changes of the serum lipid spectrum and blood sugar level during hormonal substitution treatment of menopausal women. The observation pertains to 70 women (mean age 50 years, 36 women after hysterectomy, mean duration of the menopause 4.5-5.0 years). The lipid spectrum and blood sugar level were assessed by enzyme methods from venous blood collected in the morning on fasting before administration of treatment (a combination of oestrogen and gestagen), on average after 8 months on these drugs. With regard to total cholesterol and HDL-cholesterol before treatment the women were, consistent with recommendations of the European...

[Etofylline clofibrate in the treatment of diabetic dyslipidemia: results of a 6-month period of therapy].

E Rajecová, I Klimes, E Seböková, E Rychnavská, L Pleváková, A Linke-Cvrkalová, H Langrová

Vnitr Lek 1995, 41(10):677-681

The objective was to investigate the tolerance of ethophylline clofibrate (EPC) and its effectiveness on changes of dyslipidaemia and compensation of diabetes in type II diabetics during six-month administration of the preparation Duolip forte (Merckle). Twenty diabetics with dyslipoproteinaemia IIb and IV according to Frederickson's classification, compensated by diet alone or combined with oral antidiabetics (Glucobene, Merckle) were included in the study consecutively according to uniform basal criteria. The selected hypolipidaemic agent was administered to patients according to the following pattern: the first four weeks 1,000 mg (2 tablets in...

[Treatment of chronic myeloid leukemia with bone marrow transplantation at the Institute of Hematology and Blood Transfusion in Prague].

J Hrabánek, M Lukásová, A Vítek, J Sajdová, J Jelínek, J Vanásek, V Chudomel, P Korínková, K Michalová, C Haskovec

Vnitr Lek 1995, 41(10):682-687

The outcomes of bone marrow transplantation (BMT) performed at the Institute of Haematology and Blood Transfusion from April 1988 to December 1994 in 31 patients with chronic myelogenous leukemia are presented. Age of the patients range from 18 to 49 years, median 34 years. Male:female ratio was 1.58:1. The conditioning regimen consisted of Cyclophosphamide and total body irradiation (TBI) or Busulfan and Cyclophosphamide. The results are evaluated as of January 1, 1995. Nineteen patients (61.3%) are alive, 12 patients (38.7%) died. The causes of death are discussed. The median time of follow up all patients is 10.4 months, range 0.3-81.5. The median...

[Successful prevention of Pneumocystis carinii infection with 1,920 mg of trimethoprim-sulfamethoxazole daily in patients with malignant hematopoietic diseases].

P Lemez, P Rysková, V Votava, M Suchmová, A Jirásek, I Rubík

Vnitr Lek 1995, 41(10):688-691

During 1991-94 we treated 51 patients with acute myeloid leukaemias and 3 patients with a myelodysplastic syndrome of refractory anaemia with excess of blasts in transformation. The patients received trimethoprim-sulphamethoxazole (TMP-SMX) 1,920 mg daily as a prophylaxis of Pneumocystis carinii infections and selective decontamination of gastrointestinal tract. The majority of patients received TMP-SMX in their first course of chemotherapy with daunorubicin and cytosine arabinoside. Only one of the 18 patients without TMP-SMX prophylaxis during the first course of chemotherapy developed Pneumocystis carinii pneumonia. That pneumonia was successfully...

[G-CSF (Neupogen Roche) in the treatment of patients with chronic aplastic anemia with severe neutropenia].

J Novotný, M Zvarová, L Prazáková, M Jandlová, L Konvicková

Vnitr Lek 1995, 41(10):692-695

Aplastic anaemia (AA) of the chronic type with severe cytopenia is very frequently a difficult therapeutic problem. Patients with granulocyte values below 0.5 G/l are threatened by infections, incl. sepsis possibly with a fatal outcome. If the pool of stem cells for granulocytes is not completely exhausted and can respond to growth factors, these patients can be treated either chronically and/or in risk situations (e.g. injury, surgery) with preparations of the type of a recombinant, granulocyte colony stimulating factor (rhG-CSF), or granulocyte and monocyte colony stimulating factor (rhGM-CSF). The authors present a review of diagnostic and therapeutic...

[Cortisol and diseases of the gastrointestinal tract].

J Payer, M Huorka, I Duris, H Kratochvíľová, P Ondrejka

Vnitr Lek 1995, 41(10):696-698

Cortisol is the hormone reacting to endogenous and exogenous stress. An important role is ascribed to stress in the genesis and development of malignant and inflammatory diseases of the GIT. The authors examined in their investigation the 24-hour secretion of cortisol in patients with gastric affections, polyps of the large bowel and compared them mutually and with groups of patients with ulcerative colitis and healthy probands. In all investigated groups a 24-hour rhythm of cortisol secretion was confirmed. The only significant difference between the investigated groups was a lower 24-hour amplitude in patients with ulcerative colitis, as compared...

[Determination of differential renal function using dynamic scintigraphy].

O Kraft, J Kuba, V Ullmann

Vnitr Lek 1995, 41(10):699-703

By examination of 71 patients, using static and dynamic scintigraphy of the kidneys, the authors tested whether dynamic scintigraphy provides correct results of the separate renal function in case of a symmetrical localization of the kidneys. In case of slight asymmetry the error of calculation is feasible. In case of major differences in the position of the kidneys the results cannot be used for clinical purposes. In these patients static scintigraphy must be used with correction for different absorption layers.

[Congenital dyserythropoietic type II anemia complicated by extramedullary hematopoiesis in the posterior mediastinum].

K Indrák, M Herman, J Dusek, M Dusková, J Gumulec, P Slezák, J Hubácek, E Faber, B Wiedermann

Vnitr Lek 1995, 41(10):704-709

In a 48-year-old woman investigated on account of congenital dyserythropoietic anaemia type II (HEMPAS) on the X-ray of the chest a polycystic sharply defined shadow in the posterior mediastinum was detected and extramedullary haematopoiesis was suspected. The diagnosis was confirmed cytologically. According to the authors' knowledge this is the second case of this rare complication in CDA-II in the world and the second case of EMH in the mediastinum in this country. In the discussion the authors summarize the diagnostics of congenital dyserythropoietic anaemias. They discuss also the pathogenesis of extramedullary haematopoiesis, diagnosis and differential...

[Coronary heart disease with a marked vasospastic component associated with the menstrual cycle and its treatment].

M Lomícek, V Proks, J Presl

Vnitr Lek 1995, 41(10):710-712

The authors describe the case of a 46-year-old patient with serious manifestations of ischaemic heart disease-repeated myocardial infarctions, malignant arrhythmias, the algic form of angina pectoris, whose complaints were markedly linked to the menstrual cycle. The authors mention also the individual solution, i.e. elimination of ovarian activity by actinotherapy.

[Biological effects of allogenic leukocytes and leukocyte-depleted blood cell products].

I Vásová, J Mayer

Vnitr Lek 1995, 41(10):713-718

The use of leukodepleted cellular blood components may reduce some adverse effect of transfusion in certain indications. This review presents the adverse effects of contaminating donor leukocytes in blood components: alloimmunisation, febrile nonhemolytic transfusion reactions, refractoriness to platelet transfusions, graft versus host disease, transmission of leukotropic infections and immunomodulation. The value of leukodepletion in preventing some of these complications, methods of leukodepletion and the current indications of use of leukodepleted components in clinical practice are discussed.

[Endogenous digitalis-like substance. II. Relation to pathologic states and diseases].

E Martinka

Vnitr Lek 1995, 41(10):719-723

Endogenous digitalis-like substances (EDLS) may play an active but differential role in numerous physiological and pathophysiological mechanisms. Reviewed are diseases, in which EDLS could be considered to play a causative role in their pathogenesis. Relations of EDLS were described mainly to cardiovascular, endocrine and metabolic diseases. Existence of EDLS, however, may have also another clinical implications which include possibility of influencing of digoxin monitoring as well as effects of digoxin therapy. Finally, methods of detection of EDLS are reviewed.

[Extracorporeal elimination of LDL-cholesterol in the treatment of hypercholesterolemia: indications and methods].

V Bláha, E Havel, Z Zadák, V Pidrman, M Bláha, M Kalinová

Vnitr Lek 1995, 41(10):724-729

Extracorporeal elimination of LDL-cholesterol is at present an important part of comprehensive treatment of patients with very high cholesterol levels. An absolute indication for their use are patients with the homozygous form of familial hypercholesterolaemia. Treatment is, after individual consideration, indicated also patient with severe heterozygous familial hypercholesterolaemia, with a positive family history of IHD, if it is not possible to reduce LDL-cholesterol by diet and hypolipidaemic agents below 5.2 mmol/l; also patients with severe IHD and severe hypercholesterolaemia, included in secondary prevention where it is not possible to reduce...

[Assuring care of diabetics in the Czech Republic. Recommendations of the Czech Diabetes Society].

J Skrha

Vnitr Lek 1995, 41(10):731-735