Vnitřní lékařství, 1991 (vol. 37), issue 5
[How should ventricular arrhythmia be treated?].
J Widimský, J Bytesník
Vnitr Lek 1991, 37(5):419-424
Antiarrhythmic therapy of ventricular arrhythmias in patients after myocardial infarction, even if it reduces the incidence of arrhythmias, does not influence the mortality, as demonstrated in the American CAST study where the most effective antiarrhythmic drugs class Ic, encainide and flecainide, were used. As a result of proarrhythmogenic action therapy may even enhance the risk. The authors present a classification of ventricular arrhythmias and recommend therapeutic strategies. They draw attention to the fact that the proarrhythmogenic action may develop in the early as well as in the late stage of treatment. Beta-blockers still remain the only...
[Arrhythmic syncope and invasive electrophysiologic heart function tests].
M Pleskot, V Pidrman, P Tilser, M Pilc, M Pospísil, A Strasová
Vnitr Lek 1991, 37(5):425-434
The authors submitted to electrophysiological examination a total of 100 patients (66 men and 34 women) with brief disorders of consciousness where they ruled out extracardiac causes of unconsciousness, impaired blood flow through the heart and the syndrome of s-a node dysfunction. Forty-three subjects had severe arrhythmias during ECG monitoring in bed or by Holter's system (20 subjects paroxysms of ventricular tachycardia, 14 subjects ventricular extrasystoles according to Lown class 3-5, six subjects had transient high-grade a-v blocks, three subjects had symptomatic paroxysms of supraventricular tachycardia). In 57 patients ECG monitoring did not...
[The spectrum of cardiovascular diseases at the cardiology section of the internal medicine department in Prostĕjov].
J Lukl, P Heinc, M Rezácová, A Navrátil
Vnitr Lek 1991, 37(5):435-440
In 1981-1989 in the cardiological part of the medical department in Prostĕjov 6255 patients (mean age 62.8 years) were admitted on account of cardiovascular diseases. The most frequent cause for admission was acute coronary syndrome (57%). The hospital lethality differs markedly in new myocardial infarctions (19.5%) and unstable angina, where no death was recorded. The second most frequent disease are cardiac arrhythmias (20.5%) with a low lethality of 0.7%. These are followed by cardiac insufficiencies (incidence 9.2%, lethality 12.8%), pulmonary embolism incidence 5%, lethality 9.9%) and inflammatory heart diseases (pericarditis, myocarditis,...
[Comparison of the effects of nifedipine and diltiazem in patients with stable angina pectoris of various severity and pathomorphology of the coronary arteries].
J Meluzín, M Novák, H Koukalová
Vnitr Lek 1991, 37(5):441-448
In a double blind 7-week randomized study the authors compared in 29 patients with stable angina the action of placebo, nifedipine and diltiazem. Nifedipine was administered in amounts of 60 mg/day for three weeks, diltiazem 270 mg/day also for three weeks. Nifedipine and diltiazem exerted a significant antianginous action in patients with occluded but collateralized coronary arteries (group A), as well as in patients without collaterals (group B). In both these groups diltiazem improved the load tolerance significantly more than nifedipine. Nifedipine and diltiazem were useful also in patients with mild (group E), medium (group D) and severe (group...
[The role of the exercise test in patients with ischemic heart disease in estimating the risk of sudden death].
K Barták, V Pidrman, J Kvasnicka, A Hlava, P Podrabský, L Vokrouhlický, L Cihulová, J Jandík, E Ettlerová
Vnitr Lek 1991, 37(5):449-456
The authors evaluated after 4-year interval the results of coronarographic and spiroergometric examination after a work load on a bicycle ergometer up to the limiting work syndrome in 51 all patients with the aim to reveal "risk factors" of sudden death in CHD patients. The following parameters were recorded: age, duration of treatment number of cigarettes smoked, systolic blood pressure at rest and the daily dose of the most frequently used drugs. After the work load the limiting values of pulse rate, systolic blood pressure, oxygen consumption, blood lactate level and the work ECG were evaluated. In the group of 7 sudden deaths of CHD patients the...
[Risk factors for ischemic heart disease in healthy persons with hyperinsulinemia and normal glucose tolerance].
J Málková, I Kimlová, Z Fenclová
Vnitr Lek 1991, 37(5):457-462
The authors investigated the relationship of plasma insulin to some risk factors of ischaemic heart disease (IHD). They examined 79 healthy men--drivers of international truck transport with a normal glucose tolerance. The group comprised 21 men with hyperinsulinaemia. This group was compared with 21 men from the same group with normal insulin levels. The two groups were comparable (matched pairs) for age, occupation, cigarette and alcohol consumption and education. Significantly higher values of the body mass index (BMI), systolic and diastolic blood pressure were found in the group with hyperinsulinaemia. The latter group had a significantly more...
[Personal experience with lovastatin, a HMG-CoA reductase inhibitor (Mevacor, MSD) in the treatment of hypercholesterolemia].
H Vaverková, N Skottová, L Pudilová, V Horcicka, J Jezdinský, M Trtková
Vnitr Lek 1991, 37(5):463-469
The authors administered lovastatin (Mevacor, MSD) to 18 patients with primary hyperlipoproteinaemia (familial and non-familial) with a lipoprotein pattern type IIa and IIb. During treatment a marked reduction of atherogenic indicators of the lipid metabolism occurred, i.e. a decline of total cholesterol (-28.6%), LDL-cholesterol -39%), apolipoprotein B (-18.6%), the index of total cholesterol/HDL-cholesterol (-44.6%) and the index LDL-cholesterol/HDL-cholesterol (-48.2%). At the same time a favourable effect on indicators of the lipid metabolism to which a protective action is ascribed was recorded: a rise of HDL-cholesterol (+13.6%) and apolipoprotein...
[Is Etolip suitable for treatment of various types of hyperlipoproteinemias?].
J Kollár, V Rozdobuďková, J Koprovicová, E Rajnová, J Seiler
Vnitr Lek 1991, 37(5):470-478
Etolip is the first Czechoslovak hypolipidaemic preparation produced in the Pharmaceutical Research Institute in Modra. As to the chemical structure it is ethophylline clofibrate. It was administered to 39 manual workers with hyperlipoproteinaemia type IIa, IIb, III, IV and V-500 mg/day, i.e. 2-0-2 capsules. The mean age of the patients varied round 43 +/- 6.1 years. They were subdivided into study possible, comparing Lipanthyl and Etolip. Despite the fact that the subjects did not adhere to a strict diet and occasionally consumed 50-100 g alcohol, Etolip (E) reduced the triacylglycerol concentration (TG) in serum for a period of one month after administration...
[Serum beta 2-microglobulin in multiple myeloma. II. Its significance in monitoring the disease].
V Scudla, M Budíková, E Fischerová, I Raska, V Vavrdová
Vnitr Lek 1991, 37(5):479-487
In a group of 71 patients with multiple myeloma the importance of beta 2-microglobulin (S-B2M) serum levels was evaluated with regard to their importance for monitoring of the disease. No significant relationship was found between B2M levels and monoclonal serum immunoglobulin, only in one third of the patients parallel changes of the two proteins were observed. One third of the patients had permanently normal S-B2M values and thus could not be evaluated with regard to the therapeutic results, 9% of the patients had very low S-B2M values throughout the disease regardless of the high activity of the latter and the marked increase of myeloma mass (stage...
[Diagnostic use of neutrophil segments negative for peroxidase, chloroacetate esterase and sudanophilia in peripheral blood in leukemia].
P Skopek, V Koza
Vnitr Lek 1991, 37(5):488-492
The paper contains the results of three cytochemical reactions used for detection of myeloid differentiation (peroxidase, sudanophilia, chloroacetate esterase) in neutrophil segments of the peripheral blood stream in 107 patients with acute myeloid or lymphatic leukaemia. Enzymatically deficient segments were detected in 23 (34.8%) patients with acute myeloid leukaemia. They were not found in any patients lymphatic leukaemia not in healthy subjects. The concurrent deficit of all three reactions was found in 69% of the cases with defective neutrophil segments. However, also isolated affection of any of these reactions was found. In acute leukaemias,...
[Heart tumors in adulthood and advanced age].
M Hirt, J Hrncír
Vnitr Lek 1991, 37(5):493-495
The investigation is focused on the frequency and clinical symptomatology of primary heart tumours. The authors describe their own observation of four cases of these tumours in adult and advanced age: The first one--a myxoma surviving after accurate diagnosis and surgical treatment, and at present free from any cardiac complaints and three others (two fibromas, one mesothelioma) where the diagnosis was not established in time and which proved fatal.
[Thrombosis of the superior vena cava as a complication of permanent cardiac pacing].
V Chytil, J Svejda
Vnitr Lek 1991, 37(5):496-500
The authors present an account of thrombosis of the superior vena cava which developed in two patients with permanent cardiac pacing and led to the development of superior vena cava syndrome. The cause was loosening of the impaired stimulating electrode from fixation and its penetration into the superior vena cava with subsequent formation of a thrombus on the bare surface of the spiral. Contemporary therapeutic procedures are reviewed.
[The autonomic nervous system and disorders of heart rhythm. II].
O Jurkovicová, Cagán
Vnitr Lek 1991, 37(5):501-506
The authors present in their review recent findings on the importance of the autonomous nervous system in disorders of the cardiac rhythm. They emphasize its modulating action in the development, maintenance and termination of many arrhythmias. Vegetative nervous influences may play a part in people without organic heart disease but are manifested more markedly above all at sites of previous damage. Mechanisms by which the autonomous nervous system influences the development and course of arrhythmias are very complicated and so far not completely elucidated. In addition to a generalized tonus of the sympathetic nerve and the parasympathetic nerve and...
[Computers in hematology].
J Berger
Vnitr Lek 1991, 37(5):507-513
Computerization of haematology comprises three areas: 1. hospital information system, 2. specific applications in haematology, 3. a support of scientific work and laboratory administration. IBM AT compatible computers seem to be the most widespread. The brains of recent computers are in software and, therefore, the price of large programmes can exceed that of a computer. Comprehensive clinical computer expert programmes are the aim of research work. However, specific not comprehensive programmes are used in haematological practice. Computer support of a haematological laboratory, including many numeric and other data, can be very effective. Computers...
[Disseminated intravascular coagulation and sepsis].
P Sevcík, M Matýsková, M Penka, D Táborská
Vnitr Lek 1991, 37(5):514-517
The authors give an account on the relations between disseminated intravascular coagulation, sepsis and multiorgan failure. Disseminated intravascular coagulation is defined as an acquired disorder of blood clotting with an increased turnover of thrombocytes, fibrinogen and coagulation factors. The authors discuss aetiopathogenetic aspects, possibilities of laboratory diagnosis, anticoagulation and substitution therapy and prophylaxis of disseminated intravascular coagulation in septicaemia. They emphasize comprehensive treatment of septicaemias where haematological monitoring and therapy must form an integral part. In an extensive series of septic...