Vnitřní lékařství, 1990 (vol. 36), issue 5
[A low-energy protein diet--its effect on lipid and protein metabolism].
M Kunesová, V Hainer, V Stich, A Zák, P Hrabák, V Kozich, J Krupicka
Vnitr Lek 1990, 36(5):417-425
The Czechoslovak low-energy protein diet contains 1559 kj per day, incl. 33.0 g protein, 50 g carbohydrate, 4.0 g fat, 6.0 g fibre and recommended vitamin and mineral allowances. The diet was administered to 75 subjects with a mean age of 39.88 +/- 1.21 years and a body weight of 112.57 +/- 2.89 kg, and a body weight index (BMI) of 39.44 +/- 0.94, for 28 days. During treatment the body weight declined by 9.67 +/- 0.41 kg and the BMI by 3.74 +/- 0.20. At the same time there was a significant decline of the total cholesterol (p less than 0.001), LDL cholesterol (p less than 0.001), HDL cholesterol (p less than 0.01) and triacylglycerols (p less than...
[Intravenous systemic thrombolysis using streptokinase in the treatment of developing cardiogenic shock in myocardial infarct].
K Dvorák
Vnitr Lek 1990, 36(5):426-434
The author evaluated retrospectively the therapeutic effect of intravenous systemic thrombolysis by streptokinase in 24 patients with developing cardiogenic shock associated with myocardial infarction. Fourteen patients died while in hospital (58%) and 10 (42%) survived and were discharged after a suitable time in hospital. Serious arrhythmias were frequent already before thrombolysis (ventricular fibrillation 2X, AV block grade II and III 5X, atrial fibrillation 4X). After streptokinase administration in two patients ventricular tachycardia was recorded, twice significant ventricular extrasystoles and once AV block grade II. In none of the patients...
[Inadvertently detected coronary shunts].
J Kerný, J Fabián
Vnitr Lek 1990, 36(5):435-445
The authors analyzed in the form of a retrospective study the clinical picture of coronary arteriovenous fistulae diagnosed by coronarographic examination. A coronary fistula is a rare condition, it was found only in 16 patients, 10 adult men and 6 women, from a total of 5500 coronarographic examinations of adults made in the Institute of Clinical and Experimental Medicine, which corresponds to a 2.9 pro mille incidence. In 6 patients the fistulae were isolated, in 10 they were in a combined form, most frequently with coronary disease. Most frequently the fistulae led into the pulmonary artery and were congenital. The disease was manifested only in...
[Are there abnormalities of parathormone, calcium and phosphorus metabolism in hypertrophic cardiomyopathy?].
P Gregor, M Zichová, P Preucil, P Widimský, V Cervenka, V Vísek
Vnitr Lek 1990, 36(5):446-452
The importance of calcium and phosphorus metabolism for the development of hypertrophic cardiomyopathies is still obscure. Therefore 52 patients with hypertrophic cardiomyopathy were subjected to detailed cardiological and laboratory examinations. Twenty-five age matched healthy subjects served as controls. The following indicators were assessed: calcium and its ionized fraction, phosphorus, chlorides and magnesium in serum and 24 h urine, as well as AST, ALT, ALP, ACP, urea, creatinine, protein electrophoresis (to check calcium values with regard to serum albumins), endogenous creatinine clearance, Palmer's chloride phosphate index and Nordin's index....
[Use of a computer for obtaining optimal serum sodium values at the end of hemodialysis].
M Mydlík, K Derzsiová, J Svec, P Mizla, J Klimcík
Vnitr Lek 1990, 36(5):453-459
The authors made 41 haemodialyses in 21 patients in the course of a long-term dialyzation programme, using a dialyzation monitor connected with a computer. The aim of the investigation was to achieve at the end of the six-hour haemodialysis the optimal serum sodium value of 142 mmol/l, using different ultrafiltrations (1000, 2000 and 3000 ml/6 hours). It was revealed that to obtain the optimal serum sodium level it was necessary to use in the dialyzation solution a sodium concentration of 144.9 +/- 0.2 mmol/l. The water transport from the intracellular to the extracellular fluid was typical for the distribution of total body water, regardless of the...
[Diabetic osteopathy. 4. Laboratory findings].
J Kocián, J Brunová
Vnitr Lek 1990, 36(5):460-466
The authors investigated in a group of 38 subjects with type I diabetes and 222 subjects with type II diabetes laboratory values indicating the level of bone metabolism: calcium, phosphorus, alkaline phosphatase activity in serum, urinary calcium excretion, and they compared the values mutually and with the level of bone mineralization. The authors found significantly lower serum calcium values in all investigated groups, the lowest ones in women with type II diabetes. To these values corresponded always reduced values of bone mineralization which were also lowest in women with type II diabetes. The very lowest bone mineralization was found in groups...
[Follow-up of newly diagnosed patients with diabetes in the Prague population. II. Changes in the group of new diabetics after a 2-year follow-up].
J Perusicová, V Jiroutková, V Nováková, V Krpatová, A Richtrová, V Cacáková, J Kalivoda, J Cerný
Vnitr Lek 1990, 36(5):467-472
From the total number of 1551 new diabetics and patients with PGT 85 subjects died in the course of two years. Treatment was changed 118 times, failure of PAD treatment was recorded in 11 type 2 diabetics. Three patients originally classified as type 1 were later included in type 2. In three diabetics (of 14) who had sings of diabetic retinopathy already during manifestation of DM marked deterioration of the finding on the fundus occurred. The incidence of macroangiopathic complications did not change.
[Monitoring the course of non-A, non-B viral hepatitis in patients with chronic renal insufficiency].
P Chalupa, I Kolácný, Z Horák, P Jezek
Vnitr Lek 1990, 36(5):473-478
A group of 35 patients with viral hepatitis non-A, non-B included in a chronic dialyzation programme was compared with a comparable group of 40 patients with viral hepatitis non-A, non-B. The mean period since the chronic dialyzation programme was started after the development of viral hepatitis non-A, non-B was 10 months. The mean period of hospitalization in the investigated group was 21 days and was practically identical (22 days) as in the control group. 45.7% of the patients in the chronic dialyzation programme were at the time when the diagnosis was established or in its course quite free from complaints. In 54.3% there were mild complaints....
[Single dose administration of netilmicin in the treatment of urinary tract infections].
S Krcméry, J Hromec
Vnitr Lek 1990, 36(5):479-482
The authors submit the results of treatment of non-complicated urinary tract infections by a single dose of netilmicin. They treated 23 patients to whom they administered a single dose of 200 mg netilmicin by the i.m. route. A positive short-term effect was recorded in 82.8%. Cases of failure of this treatment indicate the necessity of careful indication of a single dose of netilmicin only to patients with non-complicated infections of the urinary pathways.
[Treatment of myelodysplastic syndrome using continual subcutaneous infusion of low doses of cytosine arabinoside].
V Vozobulová, V Koza, V Cepelák, R Neuwirtová, Z Masek
Vnitr Lek 1990, 36(5):483-488
The authors summarize their experience with the administration of small doses of cytosine arabinoside continuously by subcutaneous infusion in 13 patients with myelodysplastic syndrome. Alcysten Spofa was administered in doses of 20 mg/sq.m per day for 5-17 days in one cycle. A total of 26 therapeutic cycles were administered. Favourable responses were obtained in four patients, partial results were achieved in two patients; in seven instances treatment produced no response. The authors compare also the results obtained in this group with a previous group of 11 patients treated with small doses of cytosine arabinoside, which was administered intermittently,...
[Significance of angiographic studies in the diagnosis of non-typical epigastric disorders].
A Mersten, E Lakata, E Merstenová
Vnitr Lek 1990, 36(5):489-494
The authors analyze the possibilities and importance of angiographic examinations in the clinical differential diagnosis of patients with atypical epigastric complaints. They demonstrate that in congenital anomalies of the arteries tripus Halleri the examinations do not make it possible to assess hypoperfusion of the epigastric organs. Based on data in the literature they point out that there is often disagreement between clinical symptoms and pressure gradients of intravasally angiographically stenoses of the trunk of the coeliac vein found on operation. From hitherto assembled results it may be, however, expected that two-dimensional Doppler ultrasonic...
[Pure red cell aplasia in chronic lymphatic leukemia. Successful treatment using immunosuppression].
M Svojgrová, J Slechtová, V Koza, P Panzner, V Cepelák
Vnitr Lek 1990, 36(5):495-502
The authors describe two cases of chronic lympocytic leukaemia complicated by pure red cell aplasia of autoimmune origin. The first patient achieved complete recovery of erythropoiesis after short-term immunosuppression by means of cyclophosphamide and prednisone. The second patient did not respond to the same combination of immunosuppressive drugs and remission was achieved by administration of antithymocyte globulin. In the discussion the authors deal with contemporary knowledge of the pathogenesis of autoimmune erythroblastopenia and mechanismus of action of antithymocyte globulin.
[The relation between acute embolism and thromboembolic pulmonary hypertension].
J Widimský
Vnitr Lek 1990, 36(5):503-507
The author analyzes the natural course of acute pulmonary embolism and its progression. Treated acute pulmonary embolism has a favourable long-term prognosis which is negatively influenced only by further diseases. While acute pulmonary embolism is the third most frequent cardiovascular disease--the incidence of chronic thromboembolic pulmonary hypertension is very rare and accounts only for 0.38% in necroptic material.