Vnitřní lékařství, 1989 (vol. 35), issue 6
[Infarct size and left ventricular function in patients after thrombolytic therapy of acute myocardial infarct].
J Sochman, I Málek, R Ouhrabková, M Englis, J Fabián
Vnitr Lek 1989, 35(6):521-529
The authors give an account of factors which influence left ventricular function after thrombolytic treatment of an occluded coronary artery. They found that improvement of left ventricular function following a three-week interval after recanalization of the artery the occlusion of which led to myocardial infarction, depends on the size of the necrotic focus. Improvement of global left ventricular function and above all of the regional function of the infarction segment can be expected if the size of the focus is such that less than 40 gram-equivalent of total creatine kinase are liberated from it.
[Cardiac tamponade as a complication of acute myocardial infarct. (Clinical and pathologico-anatomic analysis of patients with acute myocardial infarct and cardiac tamponade)].
J Bastecký, E Rehulová, J Kvasnicka, E Simáková, V Wasylivová, E Ettlerová, K Zaydlar
Vnitr Lek 1989, 35(6):530-537
Cardiac tamponade is a frequent cause of death in acute myocardial infarction--in as many 23%. It is encountered in particular in the 7th and 8th decade, in patients with a first infarction which is frequently situated in the anterior wall of the left ventricle. 93% of the patients have obvious ECG manifestations of Q infarction. The diagnosis of cardiac tamponade is easy when during an acute terminal attack slow activity on the ECG tracing is found without a haemodynamic response and the pulse on the great arteries is not palpable even after external cardiac massage. In 80% the onset of cardiac tamponade is very sudden. The presence of shock or cardiac...
[Evaluation of patients after heart surgery in the 20-year period of the 2d rehabilitation phase (1967-1986) in Sliac].
M Drahosová
Vnitr Lek 1989, 35(6):538-545
In the 1967-1986 in the Czechoslovak State spa Sliac 961 (48.15%) men and 1035 (51.85%) women after surgical operations on the heart were followed up during the second rehabilitation stage. The operations were made because of the following indications: acquired rheumatic valvular defects 1208 (60.52%), congenital heart disease 461 (23.10%), ischaemic heart disease 260 (13.03%), myxomas and thrombi of the left atrium 31 (1.55%), pericardiectomy was performed in 36 (1.80%). As to surgical operations, commissurotomy and commissurolysis were performed in 724 (36.27%) an artificial prosthesis was implanted in 330 (16.53%), homotransplants in 151 (7.57%)...
[Cardio-pulmo-cerebral resuscitation in myocardial infarct in the emergency medical service].
J Dostál, K Dvorák
Vnitr Lek 1989, 35(6):546-550
Of 1234 patients with confirmed myocardial infarction who were treated at the emergency medical service station in Ostrava in 95 (8%) circulatory arrest developed and cardiopulmocerebral resuscitation was applied. In 60 (63%) it was not possible to restore spontaneous circulation and they were subjected to necropsy after resuscitation efforts. A total of 35 (37%) of the resuscitated patients were taken to hospital. Resuscitation was permanently successful in 19 (20%) of patients with myocardial infarction. The authors discuss the most frequent shortcomings of urgent resuscitation as well as other possible ways how to improve the final results.
[Importance of type I hypersensitivity to molds in autumnal respiratory allergies].
K Mayer, D Makesová, J Mayer, Z Pospísil
Vnitr Lek 1989, 35(6):551-557
The authors examined by means of skin tests for moulds 108 patients with the diagnosis of pollen rhinitis and/or pollen bronchial asthma. All had maximum complaints at the end of summer and in autumn and were formerly hyposensitized only by pollen allergens. Sensitization to fungi and its polyvalent character was significantly greater in subjects unsuccessfully treated by pollen hyposensitization, as moulds acted obviously as an important allergen. The authors found a low sensitivity and specificity of USOL screening preparations "Outdoor moulds" (76% and 81%) and "Indoor moulds" (74% and 93%).
[Gastroesophageal reflux and respiratory diseases].
M Puchala, M Hudák
Vnitr Lek 1989, 35(6):558-566
Respiratory manifestations of gastrooesophageal reflux are not very well known and therefore frequently not recognized. The multifactorial character of these relations is confirmed by the fact that only 10% of the patients with gastrooesophageal reflux suffer from respiratory diseases. As these relationships are causal, successful treatment depends on their objectivization. Respiratory manifestations of gastrooesophageal reflux may be a serious and frequently the only symptom of reflux disease. When these causal relationships are not recognized, respiratory symptoms are not adequately treated and they develop gradually into chronic or frequently relapsing...
[Serum ferritin levels in elderly patients].
E Masárová, P Cernák, B Kompauerová, I Novotný
Vnitr Lek 1989, 35(6):567-573
The authors examined, using the enzyme immunometric method, the serum ferritin concentration in 144 patients aged 60 to 93 years and in 26 healthy volunteers aged 22 to 30 years. They divided the group into four sub-groups: A control group of old people, B control group of young people, C patients with malignities and D patients with various diseases affecting the serum ferritin level. The authors confirmed the significant difference in the serum ferritin concentration between the two control groups (higher concentration in old people). A significant difference in the ferritinaemia in relation to sex (lower in females) was found only in the group of...
[Evaluation of glycosuria in normal glucose tolerance].
H Polácková, H Platilová, Z Svoboda, P Stolba
Vnitr Lek 1989, 35(6):574-581
In 52 subjects where after 10.6 +/- 7 years after detection of glycosuria on fasting normal glucose tolerance persists some risk factors and early biochemical changes indicating possible later development of diabetes were evaluated. 73% of the subjects had a positive family-history of diabetes and 61% were obese. In 42% of the subjects during the present examination glucose in urine was detected only after a glucose load. In 35% of the subjects pathological serum values of glycoproteins were found and their mean fasting blood sugar levels and levels 60 minutes after a glucose load were significantly higher, although in the range of normal oGTT, as...
[Diabetic osteopathies. 1. Etiologic factors and theoretical prerequisites for the development of bone demineralization in diabetics].
J Kocián, J Brunová
Vnitr Lek 1989, 35(6):582-586
The causes of impaired calcium, phosphorus and vitamin D metabolism in diabetic patients which in the long run lead to demineralization of bone can be summarized into several main groups. Above all disorders of calcium absorption from the small intestine are involved, associated with impaired absorption of vitamin D and its reduced conversion into active metabolites in the liver and kidneys. An increased elimination of calcium from the organism may also play a part (hypercalciuria, excretion in the faeces and sweat), hormonal changes (secondary hyperparathyroidism) and finally changes in the metabolism of the organic bone constituent--osteoid. Subsequent...
[Diabetic autonomic neuropathy].
P Boucek
Vnitr Lek 1989, 35(6):587-594
Affection of the vegetative nervous system is a relatively frequent and often serious complication of diabetes. The aetiopathogenesis of diabetic autonomous neuropathy has not been reliably explained so far, most probably metabolic changes are involved resulting from prolonged hyperglycaemia. A part played by other e.g. congenital factors cannot be ruled out. Autonomous neuropathy can influence the function of the cardiovascular, digestive, urogenital and other systems and cause difficult diagnostic and therapeutic problems. Examinations should comprise also simple tests of cardiovascular reflexes. Preventive effects can be expected also from long-term...
[Valvular defects in advanced age].
L Plachá, I Riecanský
Vnitr Lek 1989, 35(6):595-602
Based on many years experience with the diagnosis and treatment of valvular defects in advanced age the authors present a review of the problem with emphasis on non-rheumatic degenerative damage of the cardiac valves and valvular apparatus. They draw attention to the reliability of non-invasive examination methods and prefer their routine use in cardiological geriatric practice. As regards therapeutic procedures, they draw attention to more progressive methods of treatment of valvular defects in old age such as percutaneous, transluminal balloon valvuloplasty of the aortic valve, open valvuloplasty of the mitral valve and replacement of damaged valves...
[Treatment of autoimmune thrombocytopenia using intravenous immunoglobulins].
M Bandová, A Stachý
Vnitr Lek 1989, 35(6):603-608
Long-term clinical research of the i.v. administration of immunoglobulins extended therapeutic possibilities of autoimmune thrombocytopenia. The administration of large doses of i.v. immunoglobulins is an effective and safe method of treatment in particular in patients refractory to steroid treatment or where steroids are contraindicated, in patients where treatment by splenectomy was ineffective and in pregnant women and young children. By more extensive verification of the above therapeutic method it will be possible to obtain more insight into the aetiology and pathogenesis of this disease.