Vnitřní lékařství, 1991 (vol. 37), issue 7-8
[Isosorbide dinitrate tolerance in the treatment of patients with angina pectoris and the effect of addition of captopril on therapeutic results].
P Rotrekl, Z Lupínek, J Meluzín, M Novák
Vnitr Lek 1991, 37(7-8):625-632
The authors investigated in patients with stable angina the influence of a single dose and of long-term administration of isosorbide dinitrate alone and combined with captopril. Administration of 40 mg Iso-Mack ret. every 8 hours for four weeks did not lead to the development of tolerance. However, captopril added to isosorbide dinitrate tends to improve the investigated indicators after a single dose as well as after long-term treatment. It is probable that concurrent administration of the two drugs causes addition of their vasodilatating action and thus the vascular resistance declines, as well as the cardiac pre-load and after-load and the oxygen...
[Focal segmental glomerulosclerosis].
K Matousovic, P Rossmann, V Prát
Vnitr Lek 1991, 37(7-8):633-638
Focal and segmental glomerulosclerosis accounted for 4.1% of all primary glomerulopathies. Typical signs of focal and segmental glomerulosclerosis were striking arteriolosclerosis on histological examination, the urinary syndrome of high proteinuria with mild haematuria and frequent nephrotic syndrome. The ten-year cumulative percentage of remissions was 30%. Patients with remission had at the time of biopsy a normal serum creatinine level and no or minimal regressive tubulointerstitial changes. The ten-year cumulative percentage of renal failure was 40%. Presence of nephrotic syndrome, extracapillary proliferation and advanced tubulointerstitial changes,...
[Changes in hemostasis in ischemic heart disease in advanced age].
E Tóthová, D Petrásová, B Mudronová
Vnitr Lek 1991, 37(7-8):639-644
In a group of 178 patients with different forms of ischaemic heart disease and in a group of 40 healthy controls the authors made complete examinations of haemostasis to provide laboratory evidence of a state of hypercoagulation. They assessed the relationship of different coagulation factors between patient groups and healthy controls formed by a group of blood donors. They draw attention to the significant age dependence of the majority of coagulation factors. As apparent from the results, the highest incidence of hypercoagulation was recorded in patients with myocardial infarction.
[Use of hemoperfusion and cholinesterase in acute poisoning with organophosphate cholinesterase inhibitors--clinical analysis of 50 patients].
M Mydlík, P Mizla, J Klimcík, K Derzsiová, S Palko
Vnitr Lek 1991, 37(7-8):645-651
The authors present a retrospective analysis of 50 patients with acute intoxication with various organophosphate cholinesterase inhibitors who were treated in the course of 8 years by comprehensive conservative and extracorporeal elimination treatment. The mean age of the patients was 38 years. During therapy conservative treatment was used (gastric lavage, repeated lavage of the large intestine, forced diuresis, TMB-4 fusion through activated carbon, amberlite XAD-2 and XAD-4, haemodialysis). A total of 63 haemoperfusions and 15 simultaneous haemoperfusions with haemodialysis were performed. Treatment was successful in 92%. The results of treatment...
[Evaluation of heart disease in rheumatoid arthritis using echocardiography].
J Hůla, M Kucera, H Brabcová
Vnitr Lek 1991, 37(7-8):652-657
The authors examined, using one- and two-dimensional echocardiography, 95 patients with rheumatoid arthritis and 11 patients with lupus erythematodes generalisatus. They revealed acute and chronic changes on the pericardium, impaired left ventricular function and valvular changes in percentages which are not negligible. Although the problem of the aetiopathogenesis of these pathological changes is frequently speculative, their detection is of considerable importance for further treatment and the life-style of these patients. Echocardiography is a suitable method for the comprehensive examination of patients with rheumatoid arthritis, in particular...
[The nephrotic syndrome in renal biopsies].
I Slugen, J Bucek, M Pavlovic, K Furková, A Kovác, P Fiala, M Pauer
Vnitr Lek 1991, 37(7-8):658-664
Among 1,499 representative renal biopsies in 278 cases nephrotic syndrome was diagnosed. In the latter only in 201 glomerulonephritis was confirmed by biopsy and in 77 (more than one quarter) the bioptic finding was different. The authors attempt to analyze the essential feature of nephrotic syndrome focused on the glomerular basal membrane and surrounding structures.
[Comparison of the diagnostic contribution of rheography and ultrasound in diabetic macroangiopathy of the lower extremities].
A Lacko, A Kreze, E Hanzen
Vnitr Lek 1991, 37(7-8):665-670
In a group of 140 patients with diabetes mellitus ultrasonographic Doppler examination revealed a 30% incidence, rheographic examination a 34% incidence (p greater than 0.05) of macroangiopathies of the lower extremities. The asset of rheography was the ability to differentiate between pathological functional (21% incidence) and organic changes (13% incidence). The contribution of sonographic examination was the localization of the portion most severely affected by the macroangiopathy. The most frequent variant was general affection of the distal portion of extremities, followed by predominating affection of the posterior tibial artery and affection...
[Arteriosclerosis risk factors in the offspring and siblings of type 2 diabetics].
A Jirkovská, V Válek, J Skibová, R Poledne, R Petrásek
Vnitr Lek 1991, 37(7-8):671-677
Risk factors of atherosclerosis were examined in 63 offspring and 30 siblings of type 2 diabetics and in 22 controls. Clinical complications of atherosclerosis were not found very frequently in direct relatives of diabetic patients. Diabetes was detected in 17% siblings, an impaired glucose tolerance in 11% of the offspring and in 33% siblings. The offspring of diabetics had higher blood sugar values and serum insulin levels on fasting and after stimulation, as compared with controls; as to other metabolic parameters lipids and apolipoproteins, body mass indexes, uricaemia, glycated proteins, C-peptide), the two groups did not differ significantly....
[The effect of age and educational level on the risk profile of men and women in industrial occupations].
H Rosolová, L Krejsová, J Emmer, J Kudová, L Záková, M Haas
Vnitr Lek 1991, 37(7-8):678-685
The authors investigated a population group of 660 men and 440 women aged 35-60 years selected in the Skoda works and examined as part of the integrated programme of prevention of chronic non-infectious diseases. The risk profile of subjects associated with the life-style of the population was evaluated with regard to sex, age and education. It was revealed that the blood pressure rises with age and body weight in men and women. With rising body weight rises also the triglyceride and uric acid level and in women also the total cholesterol level. The authors confirmed the relationship between smoking and the thiocyanate blood level. The magnesium level...
[Echocardiographic detection of wedged emboli in the right heart in patients with pulmonary embolisms].
R Jirmár, R Kramár, J Simek, P Widimský, V Vísek
Vnitr Lek 1991, 37(7-8):686-689
The authors describe two case-histories of patients with the clinical picture of pulmonary embolism where on echocardiography a mobile formation in the right atrium was detected. In both patients the embolus of peripheral origin wedged in the right atrium was removed by surgery.
[Sudden death in rheumatoid arthritis with cervical myelopathy].
J Kyzeková, L Kyzek
Vnitr Lek 1991, 37(7-8):690-694
The authors describe an uncommon case of sudden death in a 53-year-old female patient with cervical myelopathy associated with rheumatoid arthritis stage IV/C. The patient died six hours after a drop of the blood pressure to undetectable values was found. Malignant hypotension of central origin which could not be influenced by pharmacological treatment was involved. It was due to compression of the upper cervical spine by a partly dislocated dens of the epistropheus and subsequent afferent spinal oedema which affected the vasomotor centre in the brain stem. The clinically suspect cause of death was confirmed by autopsy: Myelogenic shock.
[Antibiotics and antimycotics in oncology].
V Krcméry
Vnitr Lek 1991, 37(7-8):695-702
The submitted review gives an account of therapeutic and prophylactic indications in oncology, in aimed, not aimed (empirical) treatment of febrile neutropenic patients, prophylaxis of infection during neutropenic episodes and selective decontamination before and during transplantation of bone marrow, focused on new antimicrobial and antimycotic agents.
[Echocardiographic findings in cerebrovascular accidents].
K Linhartová, P Frídl
Vnitr Lek 1991, 37(7-8):703-709
The authors present a review on the frequency and causes of cardiogenic systemic embolism and on the influence of damage of the central nervous system on the heart muscle. 10-20% of ischaemic cerebrovascular attacks are of cardioembolic origin. In patients with chronic atrial fibrillation the risk of a cerebrovascular attack is six times higher than in the corresponding population with a sinus rhythm. Views on the preventive administration of anticoagulants differ so far. In extensive myocardial infarctions of the anterior wall thrombi in the left ventricle are present in 30-40%. Thrombolytic treatment affects their formation; so far it is not clear...
[Preoperative examination and preparation of patients with ischemic heart disease from the viewpoint of the internist].
I Tokárcik, A Tokárciková
Vnitr Lek 1991, 37(7-8):710-717
In the presented review the authors discuss briefly the effect of anaesthetizing substances on the heart muscle. Examinations to which the patient with IHD should be subjected before a cardiac operation and the surgical risk are discussed in the part on preoperative examination of the patient with IHD. The paper deals in detail with the preoperative preparation and contemporary views on the subject with specific views on different drugs. In the conclusion the authors present the results of the work of the consultant out-patients department of the First Medical Clinic of the Faculty Hospital and policlinic in Kosice which are a practical evaluation...
[How to avoid failure and complications in guided punctures].
J Benacka
Vnitr Lek 1991, 37(7-8):718-723
The author discusses some actual procedures associated with diagnostic and therapeutic interventions using ultrasonography. Based on his own experience from practice, documented in tables with brief comments (attached to the paper) and with regard to data in the literature, he draws attention to some facts (technique of puncture, selection of instruments, local anaesthesia, method of drainage) which may to a varying extent influence the results of aimed puncture or cause possible complications.