[Is our cardiovascular program effective?].

J Hrnciar

Vnitr Lek 1990, 36(3):209-218

The author analyzes the causes why the cardiovascular programme of the Ministry of Health of the SSR and the regional programme of the control of arterial hypertension were not as effective as similar programmes abroad. In his opinion the reason is the low and late detection rate of cardiovascular diseases, shortcomings of dispensary care, pharmacotherapy and differential diagnosis, and the low interest taken by society. Acute cardiovascular and cerebrovascular attacks increased in 1960-1980 annually by 8% and 6% resp. This rise was arrested in 1980-1982 which could be the first signs of the effect of the cardiovascular programme in selected model...

[The critical level of renal function in patients with chronic renal failure from the aspect of maintaining normal levels of potassium in the blood].

O Schück, J Erben, V Reitschlägerová

Vnitr Lek 1990, 36(3):219-225

In 29 subjects with chronic renal failure (Pkr = 826 +/- 69 mumol/, Ckr 0.128 +/- +0.039 ml/s) treated by conservative therapy the urinary excretion and residual renal potassium clearance (CK) was investigated. In 17% of these patients the plasma potassium level (PK) was higher than 5 mmol/l. The PK levels were not significantly related to the value of the residual diuresis, to the daily urinary potassium excretion nor the value of residual creatinine clearance. A significant relationship was found between values PK and CK. The critical CK value where PK rises above 5 mmol/l (under conditions of reduced protein intake 0.5 g/kd/day and a potassium intake...

[Transcranial Doppler measurement of hemodynamics in the major cerebral arteries].

M Nevrtal, R Kubák, A Zouhar, M Pellar

Vnitr Lek 1990, 36(3):226-237

Using a pulsed Doppler velocity meter, the authors assessed by a transcranial approach, in order to obtain an idea on the normal haemodynamics of the basal cerebral arteries, the maximal systolic blood flow (Vmax., m.s-1) in these arteries in a group of 25 healthy young men and in 20 healthy children. In different arteries of the two groups the following mean values of Vmax. were recorded: middle cerebral artery 0.73 +/- 0.11 parallel 0.80 +/- 0.17 m.s-1; anterior cerebral artery 0.55 +/- 0.06 parallel 0.51 +/- 0.09 m.s-1 and posterior cerebral artery 0.44 +/- 0.04 parallel 0.40 +/- 0.02 m.s-1. The assessed values of Vmax. are in agreement with data...

[Follow-up of newly diagnosed patients with diabetes in the Prague population. I. Incidence of diabetes and disorders of glucose tolerance, methods of detection, complications].

J Perusicová, V Jiroutková, V Nováková, A Vsetecková, A Bernovská, I Vojtěchovská, V Cacáková, J Kalivoda, K Neuwirt

Vnitr Lek 1990, 36(3):238-245

The authors followed up the incidence of new cases of diabetes in nine Prague diabetological clinics, the way of manifestation of diabetes and its detection, age dependence, seasonal character and incidence of complications. The incidence of type 2 diabetes was 269, of type 1 2.3 and impaired glucose tolerance 27 per 100,000 population. In 76% diabetes was detected accidentally, most frequently by the health community doctor or factory medical officer; 65% of the diabetes were older than 60 years. 51% suffered from hypertension and in 0.9% of type 2 diabetics retinopathy was found.

[Paraneoplastic syndromes in internal medicine].

M Zuffa, I Rusnák, J Kubancok, A Horváth, D Devecka, J Kycina, B Jedlicka

Vnitr Lek 1990, 36(3):246-253

Paraneoplastic syndromes supplement the complex clinical picture of malignomas. Their knowledge improves early diagnosis. The development, course and regression of paraneoplastic syndromes indicates that they have a multifactorial origin and their manifestation depends on the biochemical, metabolic and immunological situation of the organism. The pathogenesis involves many obscure points and the clinical picture is often a surprise, an unexpected variant with regard to theoretical expectations. Sometimes paraneoplastic syndromes prove fatal in patients with a tretable tumour. There does not exist any paraneoplastic syndrome specific for a certain malignoma....

[Practical use of infusion pumps].

J Spinar, J Vítovec, M Stejfa, R Zezulková

Vnitr Lek 1990, 36(3):254-260

The authors present a brief characteristic of infusion pumps on the drop principle and factors which influence the size of the drop. They also pay attention to the knowledge of drop size for nutritional needs and accurate dosage of drugs.

[Legislative control of AIDS in Czechoslovakia].

A Nett

Vnitr Lek 1990, 36(3):261-265

The author discusses problems of the legal regulation of the fight against AIDS in the CSSR. Valid legislation does not create the necessary prerequisites for the solution of problems associated with the responsibility of HIV carriers and patients suffering from AIDS. The foreseen amendement of the penal code and the code on transgressions reacts to a certain degree to these facts. It is, however, necessary to use as a basis the function of responsibility in the sphere of criminal law and administrative law and not overestimate the possibility to influence the actions of people by threatening with sanctions or their application. The author reaches...

[Severe antihistamine poisoning complicated by ventricular tachycardia].

J Bastecký, J Kvasnicka, J Vortel, M Tauchman, V Wasylivová

Vnitr Lek 1990, 36(3):266-269

A 26-year-old female clerk without previous heart disease ingested with suicidal intensions antihistaminic drugs--H1 blockers, astemizole (a total of 700 mg) and terfenadine (a total of 900-1200 mg). The main sign of intoxication was repeated polymorphous ventricular tachycardia type torsade de pointes, which at the onset of hospitalization changed into ventricular fibrillation. Therapeutically the impaired rhythm was controlled by electric cardioversion and atrial stimulation with a frequency of 120/min. On the third day it was possible to discontinue atrial stimulation and later the patient was discharged without any permanent sequelae.

[Double myxoma].

A Janoutová

Vnitr Lek 1990, 36(3):270-274

The author describes a multiple cardiac myxoma in the left atrium and efflux tract of the right ventricle. The diagnosis was established after two years systematic follow up for extracardiac symptoms of a tumour. The author emphasizes the importance of early establishment of the diagnosis by means of echocardiography.

[Solid masses in the pericardial cavity during the acute phase of myocardial infarct--an echocardiographic sign of hemopericardium].

J Benacka

Vnitr Lek 1990, 36(3):275-278

The author describes a case of a patient with haemopericardium during the acute stage of myocardial infarction. In the echocardiographic tracing since the development of the tamponade a thrombus was seen in the pericardial cavity, its organization and gradual complete absorption in the course of a one-year follow up. The finding of echogenic masses in the pericardial cavity containing fluid is highly specific for hemopericardium.

[Evaluation and recording of long-term ambulatory Holter electrocardiographic monitoring].

L Scheidová, A Dukát, V Mongiellová, Z Mikes

Vnitr Lek 1990, 36(3):279-286

[Principles of determining reference values in hematology].

J Berger

Vnitr Lek 1990, 36(3):287-291

A short explanation of fundamental terminology concerning reference values is presented. Criteria for formation of a reference group are discussed and the significance of standardization of blood collection and laboratory procedures is emphasized. Interpretation of reference values is founded on the probability theory and attention is directed to non-parametric statistics.