[Physical training in patients with chornic heart failure: haemodynamics, effects].

L Spinarová, J Toman, T Kára, M Soucek, B Zatloukal, M Tomandlová, M Stejfa

Vnitr Lek 2001, 47(2):67-73

UNLABELLED: The objective of the investigation is to assess the safety and contribution of physical training in patients with chronic heart failure and to assess the effect of training on central haemodynamics, left ventricular function evaluated by echocardiography and humoral substances.PATIENTS AND METHODS: Patients with cardiac failure NYHA II and III incl. 17 on t he background of IHD and 21 on the background of dilatation cardiomyopathy. All patients had the ejection fraction below 40% and pVO2 below 20 ml/kg/min. They were divided into groups enagaged in training (T) and controls (K). Before training and after its termination the patients...

[Physical training in patients with chronic heart failure: functional fitness and the role of the periphery].

J Toman, L Spinarová, T Kára, M Soucek, B Zatloukal, Z Lukás

Vnitr Lek 2001, 47(2):74-80

UNLABELLED: In recent years evidence is increasing on the usefulness of physical loads and controlled physical training in patients with chronic heart failure (CHSS). In the presented work the authors assessed changes of the functional capacity and muscular strength after training on a bicycle ergometer. The group comprised 38 patients with CHSS due to IHD or dilatation cardiomyopathy NYHA II-III, EF lower than 40%, with a peak oxygen consumption (pVO2) lower than 20 ml/kg/min. The group was subdivided in a random fashion to subjects participating in training (T) and the control group (K). The patients were subjected to clinical examination, examination...

[Short-term and long-term effect of metformin in type 1 diabetics].

S Lacigová, Z Rusavý, P Kyselová, Z Jankovec, R Kárová, D Cechurová

Vnitr Lek 2001, 47(2):81-86

UNLABELLED: The objective of the investigation was to evaluate the effect of metformin added to the usual insulin treatment on insulin resistance, on the dose of substituted insulin and on the compensation of type 1 diabetes.METHOD: The first part of the study lasted 3 months, it was an open prospective study. The group was formed by 22 type 1 diabetics, average age 38.9 +/- 8.93 (min. 21, max. 55), with duration of diabetes of 13.8 +/- 6.43 years (min. 4, max. 29). Insulin resistance was assessed by means of a hyperinsular euglycaemic clamp (insulinaemia 100 mlU/l) at the onset of the study (B), after three months of metformin treatment which...

[Effect of physical training on the magnitude of left ventricular ischaemic dysfunction in patients with chronic ischaemic heart disease].

J Meluzín, J Jancík, J Siegelová, R Panovský, J Homolka, J Podrábská, J Müllerová

Vnitr Lek 2001, 47(2):87-91

Twenty-two patients with chronic ischaemic heart disease (IHD) and reversible myocardial ischaemia after a load as recorded by single photon emission computed tomography (SPECT) participated in an eight-week rehabilitation programme. Before exercise their efficiency was tested by spiroergometric examinatin and the patients were randomized into two groups. Group A (10 patients) took exercise at the level of the anaerobic threshold (high intensity training), group B (12 patients) trained at the level of the 60 % anaerobic threshold (low intensity training). The exercise unit including the warming up and relaxation stage lasted 50 minutes and was repeated...

[High-dosage chemotherapy with support of autologous haematopoietic cells in the treatment of multiple myeloma--review of contemporary possibilities].

Z Rácil, Z Adam, R Hájek, M Tomíska, M Krejcí, A Krivanová, J Höklová, M Doubek, J Mayer, J Vorlícek

Vnitr Lek 2001, 47(2):92-98

High-dosage chemotherapy with autologous transplantation of haematopietic stem cells prolonged the survival of patients with multiple myeloma as compared with results of standard chemotherapy, on average by 1.5 years. Nowadays this method is the standard treatment for suitable patients. Findings assembled recently are discussed by the authors.

[Advantages of active vitamin D metabolites in the treatment of osteoporosis as compared with calciferol].

I Zofková

Vnitr Lek 2001, 47(2):99-100

Vitamin D is one of the most important regulating agents in the development of bone mass. Therefore administration of calciferol along with calcium in patients with nutritional vitamin D deficiency leads to improvement of bone density. In patients with osteoporosis who do not respond to vitamin D, insensitivity of osseous tissue to the active metabolite of vitamin D--1,25(OH)2 D3--is involved or inadequate synthesis of active metabolites in the liver or kidneys. Administration of 1alpha-OH vitamin D3 and in particular 1,25(OH) 2D3 improves the general calcium balance in the organism and increases by direct osteoforming action the value of bone mass...

[Nitric oxide and the kidneys].

R Dzúrik, V Spustová

Vnitr Lek 2001, 47(2):101-105

Nitrogen oxide (NO) is one of the crucial modulators of the vascular tonus. Apart from its effect on the cardiovascular system it exerts an effect also on other types of cells and ensures their functions.Specially comprehensive is its synthesis and action in the kidneys: NO is formed in the endothelial cells due to the activity of constitutional endothelial synthase (eNOS), in mesangial cells of inductive synthase (iNOS), in smooth muscle cells (vsmNOS), in tubular cells neuronal NOS (nNOS) and iNOS and in the macula densa nNOS. By modulation of the v.afferens it influences the blood flow through the glomeruli and filtration pressure in the glomeruli....

[New interventional gerontology in the geriatrization era of medicine].

P Weber

Vnitr Lek 2001, 47(2):106-110

The author analyzes contemporary demographic structures of the Czech population and outlines the prognosis of its future development. He draws attention to the marked ageing in the European context, analyzes its causes and deduces from this fact conclusions for clinical practice. The author draws attention to the actual needs not only of medical but also social services for senior citizens in general. With the prolongation of the mean life span and the increasing number of senior citizens (incl. those with multimorbidity) the necessity of knowledge of physicians--incl. non-geriatricians looking after senior citizens will increase. New geriatrics must...

[Reversible long-term tachycardia and hypertension as a symptom of autonomic neuropathy in combination with sensorimotor polyneuropathy in a patient with newly discovered type 1 diabetic mellitus].

J Charvát, M Kvapil, H Kubátová, J Vecer

Vnitr Lek 2001, 47(2):111-114

The case of 22 years old woman admitted with ketoacidotic coma and newly diagnosed insulin dependent diabetes mellitus is described. The signs of mixed sensoromotoric polyneuropathia in this patient have been discovered. After the correction of ketoacidotic hyperglycemic coma the significant tachycardia and hypertension with the abnormalities of diurnal rhythm with necessity of the intensive treatment persisted for the period of the several monthes. These changes we attributed to the significant dysfunction of the autonomic system. In the course of 1 year of good diabetes compensation the above mentionned hemodynamic changes subsided completely. In...

[Thrombosis of the upper extremity in a female patient with protein C deficiency].

J Chlumský

Vnitr Lek 2001, 47(2):115-116

The case-record describes a 23-year-old female patient hospitalized on account of phlebothrombosis of the right upper extremity, associated with protein C deficiency and the use of hormonal contraception. The patient was treated with heparin and subsequently warfarin treatment. During the check-up examination by duplex sonography one month after discharge the thrombus was fully recanalized. The authors discuss the causes, diagnosis and treatment of thromboses of the upper extremities.

[Internal medicine 50 years ago].

J Ulrich

Vnitr Lek 2001, 47(2):117-118