[Does early echocardiography contribute to the prediction of complications in acute myocardial infarct?].

J Murín, J Kasper, J Bulas, R Uhliar, P Ondrejka

Vnitr Lek 1990, 36(9):833-839

The authors give an account of their experience with early echocardiography (two-dimensional examination, division of left ventricle into 20 segments) during stratification of patients with acute myocardial infarction (a group of patients with a first infarction). They evaluated the presence or absence of serious asynergy (akinesia or dyskinesia) of the left ventricle and its relationship to the incidence of complications (serious dysrhythmia, decompensation, cardiogenic shock and death). The relations between asynergy and different complications were tested by means of multidimensional contingency tables. A statistically significant partial correlation...

[The significance of spontaneous variability in ventricular extrasystole in the evaluation of the effectiveness of therapy of ventricular extrasystole].

P Daxner, M Snincák, S Kepic, V Puskár, M Prokop

Vnitr Lek 1990, 36(9):840-846

In a mixed population of 104 ambulatory patients the authors assessed, based on 24-hour Holter monitoring, the spontaneous variability of ventricular extrasystoles within one-, two-, three-, four-, six-, eight- and twelve-hour intervals. As significant they evaluated a decline of the frequency of ventricular extrasystoles by more than 90% during the subsequent period of time. The magnitude of variability is influenced substantially more by the frequency of extrasystoles than by the period of monitoring. This fact is not generally accepted so far, although it was already described in 1978. It is probable that this fact participates in a significant...

[Paroxysmal atrioventricular block].

J Pella, B Stancák, J Bodnár

Vnitr Lek 1990, 36(9):847-852

The authors analyzed paroxysmal atrioventricular blocks which were not frequency-dependent. It was a clinical, electrocardiographic and electrophysiological evaluation. The authors draw attention to the pitfalls of diagnosis and emphasize that the problem of interpretation of atrioventricular (intraventricular) conductivity is unequivocally associated with the problem of indication of permanent cardiac pacing. Based on their own experience, the authors describe the procedure used for establishment of the diagnosis of paroxysms of atrioventricular blocks. What are the main conclusions? 1. In the first place it is necessary to pay attention to the history...

[Plasma renin activity and aldosterone in patients with essential hypertension].

I Suchmanová, M Pjescák, I Kron, R Tkácová, B Grejtovská, Y Machánová

Vnitr Lek 1990, 36(9):853-859

The authors examined the plasma renin activity (PRA) in 80 patients and plasma aldosterone (PA) in 27 patients with essential hypertension (EH). They confirmed the significant drop of stimulated PRA with age. The PA levels of hypertonic patients did not change with age and did not change significantly in relation to PRA. In obese hypertonic patients a satisfactory response of PRA to stimulation was lacking, while PA reacted adequately. The PA levels are thus in older age groups as well as in obese subjects much higher, as compared with relatively low PRA levels. In relation to the stage of EH the authors did not find any significant differences of...

[Cholecystolithiasis in type II diabetics].

M Suranová, V Růzek, T Vaněcek, V Zamrazil

Vnitr Lek 1990, 36(9):860-866

In a group of 166 type II diabetics hospitalized in a medical department the authors made clinical and ultrasonographic examinations focused on the presence of cholecystolithiasis. The control group was formed by 67 subjects with normal glucose tolerance. None of the patients were hospitalized on account of biliary disease. The purpose of the work was to 1. evaluate the difference in the incidence of cholecystolithiasis in diabetic patients and controls with regard to age and sex, 2. to assess differences in the incidence of obesity, impaired lipid metabolism and a positive biliary family--history in diabetics and controls with lithiasis, 3. to evaluate...

[Weight reduction in obese patients in the early period after myocardial infarct].

J Urban, R Rath

Vnitr Lek 1990, 36(9):867-872

During the early rehabilitation stage to 27 obese subjects after a non-complicated myocardial infarction a low energy diet was administered (2 and 5 MJ resp.--19 patients) or diet no. 7 or 9 (9 and 6 MJ--8 patients). The regime was started on average 8.4 days (at least 5 days) after the acute attack, its tolerance was satisfactory, there were no complications. In the group with a markedly low energy diet the cholesterol and total lipid levels declined. The body weight declined in both groups. It was revealed that early body weight reduction in obese subjects with non-complicated myocardial infarction involves no risk and the hospitalization period...

[The HLA crossmatching test before thrombocyte transfusion. Comparison of 3 methods].

A Májský, J Prazák

Vnitr Lek 1990, 36(9):873-878

Weak accessory HLA antibodies in HLA sera were assessed by three test--the microlymphocytotoxic, antiglobulin cytotoxic and fluorescent cytotoxic test. Most frequently they were detected by the antiglobulin cytotoxic test (69.64%), followed by the fluorescent cytotoxic test (55.73%) and least frequently by the microlymphocytotoxic test (45.77%). From the results ensues that the antiglobulin cytotoxic test is a suitable method of crossmatch before thrombocyte transfusions to patients who developed reactions after transfusions or where therapy failed although the crossmatch was performed by the microlymphocytotoxic test between the donor's lymphocytes...

[Ebstein's anomaly of the tricuspid valve in adulthood].

M Puchala

Vnitr Lek 1990, 36(9):879-883

Ebstein's anomaly is a rare congenital malformation of the heart, the basic feature of which is dislocation of the tricuspid valve into the right ventricular cavity. The frequently present dysplasia of the tricuspid valve is considered as integral part of this anomaly. Although affected subjects may reach adult age, it is no exception that the diagnosis of this anomaly in clinical practice is problematical, as apparent from the presented case-history. The authors emphasize the importance of two-dimensional echocardiography which provides very valuable morphological information needed not only for establishment of the diagnosis of this malformation...

[Thrombotic thrombocytopenic purpura. Report of 2 cases].

E Rímanová, F Fakan, V Machácek

Vnitr Lek 1990, 36(9):884-889

The authors present a report on thrombotic thrombocytopenic purpura in a 63-year-old woman and a 23-year-old man. In both the disease was diagnosed in vivo. In the first case the patient died in the fulminant stage, in the second case, treated for three weeks, death occurred after an infectious complication. In the first case necropsy confirmed the florid stage of the disease, in the second case only late non-specific changes were detected. The varied and prolonged history of the second case can be explained by repeated attacks of the disease, the last one being fatal.

[Long-term pain therapy in malignancies using epidural administration of opiates].

S Haninec, V Dobiás, M Májek

Vnitr Lek 1990, 36(9):890-893

The authors explain basic anatomical and pharmacological principles of epidural opiate analgesia. As to clinical aspects, the authors mention briefly the technique of epidural analgesia. They summarize, based on their own experience and data in the literature, the period of insertion of an epidural catheter, opiate dosage in morphine equivalents, the need of adjuvant treatment and complications. They mention briefly various techniques which can be used in epidural opiate analgesia with an outline on perspectives of this method.

[New quinolines for the treatment of urinary tract infections].

V Krcméry, J Goljer, M Kettner

Vnitr Lek 1990, 36(9):894-902

The submitted review draws attention to the role of new quinolones in anti-infectious chemotherapy of the urinary pathways. It gives an account of published results of treatment and prophylaxis of infections of the urinary pathways and the prostate, as compared with hitherto used chemotherapeutic drugs and antibiotics.

[Reactive oxygen metabolites, antioxidant activity, antioxidants and aging].

J Macejka, V Baláz

Vnitr Lek 1990, 36(9):903-910

The authors refer to literary data on the much discussed issues of reactive oxygen metabolites, presumably involved in a variety of physiological and pathophysiological processes as well as in ageing. The other part of the paper deals with intra- and extracellular antioxidant mechanisms and the feasibility of using different antioxidants to constrain the deleterious effects produced by reactive oxygen products in pathological processes which accelerate ageing. The authors' own observations are also presented.

[Myths and superstitions in the treatment of pain].

V Dobiás, J Macková

Vnitr Lek 1990, 36(9):911-914

Based on recent pharmacological and pathophysiological findings, the authors confront still persisting unsubstantiated views with modern ones regarding the duration of action of analgetics, equianalgesic doses, abstention symptoms, development of dependence, tolerance and the use of co-analgetics. An important place in the potentiation of the effect of analgetics is held by the application of suitable procedures and methods in the sphere of nursing care.

[Compulsory medical confidentiality in association with AIDS].

A Nett

Vnitr Lek 1990, 36(9):915-920

The author deals with the problem of medical secrecy in conjunction with AIDS. He draws attention to some problems pertaining to the relationship of legal authorities and health facilities in conjunction with the provision of data from the medical documentation. He presents brief information on the discussion about compulsory medical secrecy in some western countries in conjunction with AIDS. The author reaches the conclusion that it will be necessary to create prerequisite conditions for the objective evaluation of the problem, while accepting the justified protection of rights of HIV carriers and patients with AIDS, as well as the interests of preserving...

[Use of nonparametric methods in medicine. IV. Comparison of levels in more than 2 samples].

A Gerylovová, J Holcík

Vnitr Lek 1990, 36(9):921-927

The authors mention two tests for comparison of the level of random variables in more than two random samples. It is thus a question of generalization of methods presented in parts II and III. Friedman's test resolves the position for dependent samples when data assembled during different experimental situations in the same group are to be evaluated. This test calls for a complete series of measurements from every statistical unit, in mathematical terminology this means that the samples are equally extensive. In case of large samples Friedman's test is based on chi 2 distribution; for a small number of samples special tables of critical values are...

[Treatment of hyperglycemic coma states in diabetics].

V Rosival

Vnitr Lek 1990, 36(9):935