Vnitřní lékařství, 1992 (vol. 38), issue 10
[Self-care in the prevention of sudden cardiac death].
Z Fejfar, J Vrána
Vnitr Lek 1992, 38(10):937-944
In acute myocardial infarction a third up to half of death registered within the first month occur in the first hour of the onset of attack most frequently because of ventricular fibrillation. Immediate self administration of drugs stabilizing electrically the heart may prevent it. On the basis of experiments in dogs and in rats flunitrazepam (Rohypnol tabl. 1 mg), tramadol (Tramal caps. 50 mg) and the beta blocker metipranolol (Trimepranol tabl. 10 mg) were selected for clinical trial on high risk patients. As the chosen combinations of drugs were not yet tested in view of possible interactions, we studied their effect on circulation and cardiovascular...
[Prevalence of bone decalcification in the treatment of Crohn's disease].
J Kociánová, K Axmann
Vnitr Lek 1992, 38(10):945-951
In clinically active Crohn's disease the bone mineralization is impaired due to calcium malabsorption by the inflamed intestinal wall which is potentiated by diarrhoea and the thus accelerated transit time. To this we must add the shortening of the gut after operations, the inadequate dietary calcium supply or possibly calcium elimination in case of concurrent lactose intolerance. Corticoid treatment leads also to deterioration of bone mineralization. This is the reason why the authors assessed in 98 patients with Crohn's disease the bone mineralization, using the method of clavicular bone index (NIBA). Then treatment was started: a high protein diet,...
[Alcohol block of the celiac plexus in severe visceral pain].
J Horák, Z Antos, J Dutka, B Suchý, M Vasícek
Vnitr Lek 1992, 38(10):952-958
The authors present their own experience with percutaneous alcohol block of the coeliac plexus. Between April 1988 and December 1991 they used it in 22 patients. Except one patient the others suffered from severe pain of abdominal organs associated with carcinoma of the pancreas. The first four operations were made using angiography, the remainder under CT control. During evaluation of results two weeks after the intervention complete regression of pain was recorded in six patients. A partial effect was achieved in 11 patients, and the intervention failed in five patients. The intervention was repeated in four patients. The authors emphasize that the...
[The effect of education on metabolic compensation in diabetics].
B Podrouzková, L Klabusay, J Bělobrádková, M Koukalová, J Andrásková, S Audyová
Vnitr Lek 1992, 38(10):959-962
The authors evaluate the effect of two years intense individual education on the metabolic compensation of diabetics. They evaluate it in 611 patients with regard to the blood concentration of glycosylated haemoglobin (HbA1c). The improved compensation was most marked in diabetics treated by a combination of insulin and oral antidiabetics (by 2.3%); in the remaining groups treated with insulin alone, with diet alone and derivatives of sulphonyl urea by 1.0-1.4%. Individual education of diabetics, of sufficiently intense, contributes substantially to compensation and should be the basic working method in all diabetological surgeries. The prerequisite...
[Combined therapy with insulin/gliquidone (Glurenorm) in type 2 diabetes after treatment failure using oral antidiabetic agents].
B Podrouzková, D Krusová
Vnitr Lek 1992, 38(10):963-967
The authors evaluate treatment by a combination of insulin and gliquidone (Glurenorm) in 29 type 2 diabetics where long-term treatment with oral antidiabetics alone had failed. Within four months all patients were completely compensated from the metabolic aspect. HbA1c declined from 10.8 to 6.5, C peptide, on the other hand, increased from the original value of 1.2 ng/ml to 1.8 ng/ml. The authors did not observe any undesirable effects or hypoglycaemic states. Gliquidone is suitable for combined treatment because of its short-term effect; stimulation of endogenous secretion has a pulsed character and imitates an intensified regime. The prerequisite...
[Indapamide in the treatment of hypertension in diabetes].
B Podrouzková, L Klabusay, J Olsovský
Vnitr Lek 1992, 38(10):968-970
The authors treated 20 diabetics (14 men and 6 women) in an open clinical trial with indapamide (Arifon, Zorka Co.) for a period of three months, using a morning dose of 2.5 mg. In 10 patients with hypertension stage I in all normalization of the systolic pressure below 18.6 kPa and diastolic pressure below 12 kPa was achieved. Treatment of patients with hypertension stage II was not adequate in 6 patients. In the course of treatment metabolic compensation of diabetes (type 1 or type 2) did not deteriorate. No changes in the blood lipid spectrum and mineral metabolism were recorded. Indapamide is an antihypertensive drug suitable for treatment of mild...
[Long-term treatment with an insulin pump. 3 years' experience].
B Podrouzková
Vnitr Lek 1992, 38(10):971-975
The author treated since 1985 on a long-term basis (for more than one year) 228 diabetic patients with an insulin pump. She gives an account for her experience of three years' treatment of 32 diabetics type 1 and 2, incl. 5 treated already for a period of 5 years. Eight type 1 diabetics treated on account of a great lability of the disease are free from specific complications. In 10 type 1 diabetics treated on account of developing nephropathy and neuropathy the condition has stabilized and does not develop further. In 14 type 2 diabetics progression of complications which led to the indication of pump treatment did not occur. Treatment had the most...
[The significance of circulating endothelial cells in type 2 diabetes].
B Podrouzková, L Klabusay, L Drápelová, B Vyoralová
Vnitr Lek 1992, 38(10):976-979
The authors examined in 134 type 2 diabetics under the age of 60 years (mean age 54.5 years) the number of circulating endothelia. The results were compared with the number of circulating endothelia in 12 type 1 diabetics who were in a compensated state. The number of circulating endothelial increased with the degree of metabolic decompensation, the limital value of glycosylated haemoglobin (HbA1c) was 12%. In patients with a lower HbA1c value the number of circulating endothelia was still at the upper range of normal values. The highest values were recorded in diabetics with ketosis. The elevated number of circulating endothelia does not depend on...
[The effect of a single dose of Bisoprolol on changes in blood pressure and hemodynamic indicators in patients with mild hypertension].
I Oral, I Vareka, D Marek
Vnitr Lek 1992, 38(10):980-985
The authors administered to 10 patients with mild hypertension a single dose of 10 mg bisoprolol (Concor-Merck) during bioimpedance control of changes of the cardiac index and peripheral vascular resistance after an interval of 3 and 24 hours following administration of the drug. In all patients administration of the drug led to a statistically significant drop of the blood pressure. In patients with a high cardiac output (group A, n = 6) the decline of blood pressure was due to a blocked increment of the cardiac output and a slight block of the peripheral vascular resistance. In the group with a low cardiac output and high peripheral vascular resistance...
[The effect of a single dose of Bisoprolol on changes in blood pressure and hemodymic indicators in patients with mild hypertension during loading].
I Oral, I Vareka, D Marek
Vnitr Lek 1992, 38(10):986-991
The authors administered to 10 patients with mild hypertension a single dose of 10 mg bisoprolol (CONCOR-Merck) during bioimpedance control of changes of the cardiac index and peripheral vascular resistance during an isometric load after an interval of 3 and 24 hours following administration of the drug. In all patients administration of the drug led during the third hour to a statistically significant drop of the blood pressure after a load. Twenty-four hours after administration the drop was no longer statistically significant. In patients with a high cardiac index (group A, n = 6) the decline of blood pressure was due to a blocked increment of the...
[Determination of galactose eliminating capacity after intravenous administration--a liver function test].
V Kupcová, L Turecký, E Brixová
Vnitr Lek 1992, 38(10):992-999
The authors discuss a simple method for assessment of the galactose elimination capacity after intravenous administration of a 20% solution, total dose 0.5 g galactose/kg body weight. In six blood venous samples after termination of an infusion (after 25, 30, 35, 40, 45 and 50 minutes) from an inserted venous catheter after assessment of the enzymatic estimation of the galactose concentration in individual samples the elimination line of galactose is assessed as well as its point of intersection (t) with the time axis. By means of these data along with the data on the amount of injected galactose and the amount of galactose excreted in the urine the...
[Asymptomatic HBs antigenemia in pregnant women].
J Ehrmann, H Zupková, A Záková, I Krc
Vnitr Lek 1992, 38(10):1000-1004
The authors have dispensarized for more than ten years HBsAg carriers at the Second Medical Clinic of the Olomouc Faculty Hospital when antigenaemia was detected during blood donorship. Since 1990 the authors dispensarize also women where HBs antigenaemia was revealed during pregnancy. In the presented paper the authors analyze this group of women. In 1990-1991 the authors examined blood samples for HBsAg from 12,042 symptom-free pregnant women. HBsAg positivity was proved in 34 women (0.28%). Eleven women (32.3%) are regularly followed up since delivery. The authors know nothing about the fate of 10 women (29.4%), as they did not respond to repeated...
[Late ventricular potentials in patients with recurrent ventricular tachycardia after myocardial infarct].
P Vojtísek, J Kvasnicka, Z Tusl
Vnitr Lek 1992, 38(10):1005-1010
In 26 patients who had at least two documented attacks of persisting ventricular tachycardia for 48 hours or longer after a myocardial infarction and whose standard QRS complex during sinus rhythm was < or = 120 ms, the authors examined late ventricular potentials using an Arrhythmia Research Technology apparatus EPX 1200. Positive finding were obtained in 19 (73%) of the patients. The finding is comparable with data in the literature on the prevalence of late ventricular potentials in patients with recurrent persisting ventricular tachycardia after myocardial infarction.
[Dual-cavity pacing for maximal work capacity in patients with a chronic high-grade atrioventricular block].
J Lukl, V Doupal, P Heinc, M Berková
Vnitr Lek 1992, 38(10):1011-1017
Twenty-eight patients with a grade 2 and 3 atrioventricular block and an implanted DDD pacemaker were repeatedly subjected to a bicycle ergometric test with a maximum load of the AV block (VV30), ventricular stimulation (VVI70) and DDD stimulation. The maximum work capacity and maximum heart rate achieved on VVI30 were 92 + xi 38 W and 61 +/- 27/min. The maximum work capacity increased on DDD by 49% while on VVI70 only by 22% (p < 0.00001) and the maximum heart rate increased on DDD by 185%, while on VVI70 only by 41% (p < 0.00001). The authors found a significant correlation between the increment of the maximum work capacity on DDD, as compared...
[Are dietetic and non-immunologic therapies becoming deciding factors in the treatment of autoimmune diseases?].
M Sasinka, J Filka, L Podracká, R Roland, E Gayová, V Vargová
Vnitr Lek 1992, 38(10):1018-1027
Authors call attention to non-immunological therapy and its determining role for fate and final prognosis in patients with autoimmune diseases. A stress importance of the timely and rigorous antihypertensive and antiinfectious treatment. From the dietary measures is best known favourable effect of the low protein diet and pharmacological limitation of the phosphorus supply. A new therapeutical aspect is the influence of the lipids on the autoimmune diseases activity and efficiency of the omega-3 unsaturated fatty acids. Non-immunological methods of the treatment are particularly valuable for the general practitioners and pediatricians, because enable...
[On the 30th anniversary of the first hemodialysis in Slovakia].
A Kovác
Vnitr Lek 1992, 38(10):1028-1032
The author reminds of the first attempts of therapeutic dialysis in Slovakia as well as the first instrumental haemodialysis implemented on August 15 1962 by doctors I. Ahlers, N. Scheid and T. Szabo in the Military Hospital in Kosice. Then he analyzes the development of dialyzation treatment in the Slovak Republic and compares the contemporary state with that in Europe.