Vnitřní lékařství, 1992 (vol. 38), issue 12
[Pathogenesis of myocardial ischemia and acute coronary syndromes].
S Cagán, J Dúbrava, H Spitzerová, J Filová
Vnitr Lek 1992, 38(12):1145-1153
Since the seventies, and in particular the eighties of this century, findings on pathogenetic mechanisms of ischaemic heart disease are expanding markedly and are becoming more accurate. This makes it possible to know and understand better factors which influence the genesis and development of myocardial ischaemia including the most serious clinical forms (unstable angina pectoris, acute myocardial infarction and sudden cardiac death). Diminution of the cardiac flow and/or increased oxygen demands of the heart muscle are not the only determinants of myocardial ischaemia which is influenced markedly also by neurohumoral, metabolic, prothrombotic (proaggregation...
[Present views on unstable forms of ischemic coronary disease].
J Vojácek
Vnitr Lek 1992, 38(12):1154-1164
The term unstable angina pectoris covers several forms of ischemic heart disease with heterogeneous pathophysiology, different clinical presentation and non-uniform prognosis. Recent results of angiographic, angioscopic and autoptic observations on the nature of unstable coronary plaque rendered possible a better understanding of clinical symptoms of the unstable myocardial ischemia. Holter ECG monitoring of patients with unstable angina pectoris showed, that myocardial ischemia may persist despite the medical control of angina pectoris. It seems therefore more appropriate to use the terms unstable myocardial ischemia or unstable coronary syndromes...
[Modern cardiac pacing. I. Dual-chamber pacemakers: 10 years' experience].
M Novák, M Psenicka, M Smola, V Vondrácek, M Kucera, J Tosovský
Vnitr Lek 1992, 38(12):1165-1171
Dual chamber cardiac pacemakers restoring an impaired atrioventricular synchrony meet a demand of contemporary so-called physiologic cardiac pacing. 39 dual chamber (DDD) pacers were implanted in 1982-1991 in our center. They improved both well-being and hemodynamic values (doppler echocardiography) more distinctly than common ventricular demand devices did. P-wave driven ventricular pacing in normal sinus node function (in 40 per cent of our DDD patients) made a frequency response in physical exercise possible. A short atrioventricular delay in DDD pacing proved to be helpful in the treatment for reentry tachycardias refractory to antiarrhythmic drug...
[Modern cardiac pacing. II. Rate responsive pacemakers: clinical experience].
M Novák, M Psenicka, M Smola, J Bultas, S Cermák
Vnitr Lek 1992, 38(12):1172-1180
Rate responsive cardiac pacemakers adapting their pacing frequency according to physical effort are able to solve not only a bradycardia, but a chronotropic incompetence too. 23 rate responsive pulse generators, implanted in 1987-1991 in our center, simulated the physiological conditions and in this way they significantly improved both working capacity in bicycle stress test (p < 0.0001) and well-being in comparison with ordinary demand pacers. The incidence of complications did not exceed that in simple common pacemakers, but the rate adaptive ones were expensive and their programming was time consuming. In all three rate adaptive principles used...
[Relation between creatinine clearance and glomerular filtration in various stages of chronic renal disease].
O Schück, V Teplan, H Nádvorńíková, J Skibová
Vnitr Lek 1992, 38(12):1181-1186
The relationship between creatinine clearance (Ccr) and inulin (C(in)) was investigated in 20 healthy subjects (group A) and 54 subjects with chronic renal disease (C(in): 10-80 ml/min/1.73 m2) treated conservatively (group B) and in 10 subjects with regular dialyzation treatment and a preserved residual diuresis (more than 1000 ml/24 h) (group C). In subjects from group B the Ccr/C(in) values were significantly higher than in healthy subjects (p < 0.01). In subjects of group C the values of Ccr/C(in) before dialysis did not differ significantly from values recorded in healthy subjects. Twelve hours after dialysis a marked increase of C(in)/Ccr...
[The effect of erythropoietin therapy on biocompatibility in hemodialysis].
K Opatrný, S Opatrná, L Vít, K Opatrný, A Vilimovskij, S Sulková, J Bláha
Vnitr Lek 1992, 38(12):1187-1194
In order to evaluate the treatment with erythropoietin (EPO) on selected indicators of biocompatibility the authors examined 8 patients dialyzed for prolonged periods before treatment (HTK = 0.23, median), during EPO treatment (Recormon, administered by the s.c. route, HTK = 0.28) in the course of 4-hour haemodialysis on dialyzers with a Cuprophan membrane. The examination before and during treatment was made under equal conditions. Heparinization was also equal despite the fact that during EPO in four patients the residual blood volume in the dialyzer was increased. Comparison of the results before treatment and during EPO treatment did not reveal...
[Increased levels of noradrenaline in hypothyroidism and its association with cardiovascular system function].
V Vavrejnová, J Nedvídková, P Husek, V Zamrazil, J Němec
Vnitr Lek 1992, 38(12):1195-1200
In a group of 10 athyroid subjects treated with thyroxine and triiodothyronine discontinuation of both hormones induced hypothyroidism. During its development on the 7th, 14th, 21st and 28th day systolic time intervals, the heart rate, blood pressure and noradrenaline and adrenaline plasma level were assessed. On the 7th day of hypothyroidism an increased index of the preejection time was recorded, and its value continued to rise throughout the investigation period. A reduction of the index value of the ejection time was also observed on the 7th day and during the subsequent period the value did not change any more. A decline of the heart rate was...
[Significance of laboratory examinations in the diagnosis of iron-deficiency anemia in older persons].
E Goncalvesová, A Vahancík, P Cernák
Vnitr Lek 1992, 38(12):1201-1207
In order to assess the effectiveness of selected laboratory examinations in the differential diagnosis of anaemias in elderly patients the authors examined 170 patients aged 65-93 years. Depending on the cause of anaemia, they divided the group into five sub-groups. Analysis revealed that for the diagnosis of iron-deficiency anaemia the mean corpuscular volume and red cell haemoglobin level have a relatively low sensitivity (63 and 65.6%) and specificity (76.7 and 72.4%), serum iron has a very low specificity (37%) and the total iron binding capacity has a low sensitivity (31.3%). Serum ferritin (sF) has at the lower borderline of the reference interval...
[Smoking habits of male and female physicians in the Czech Republic].
J Widimský, J Skibová, Z Skodová, Z Valenta
Vnitr Lek 1992, 38(12):1208-1214
The results of questionnaires given to 673 male and female physicians, pertaining to smoking habits, were compared with the Czech population with a similar age distribution according to results of the MONICA study. Male doctors smoke less frequently than men of the Czech population (24.2% vs. 44.9%). Female doctors smoke more frequently than male doctors, and what is worse, more frequently than women in the Czech population (27.4% vs. 26.6%). Specialists in internal medicine smoke least frequently (17.4%), surgeons smoke most frequently (32.3%). Partners of male and female smokers smoke more frequently than partners of non-smokers. Husbands more frequently...
[Treatment of congestive heart failure using angiotensin I convertase inhibitors].
J Kyzeková, L Kyzek
Vnitr Lek 1992, 38(12):1215-1220
The authors describe the case of a 70-year-old female patient with ischaemic heart disease with an implanted pacemaker on account of sick-sinus syndrome, who after classical treatment with diuretics and cardiotonics suffered from frequent relapses of global decompensation of the circulation. After administration of the ACE inhibitor--Tensiomin--within a very short time (days) normalization of all indicators of previously severe congestion was found. During the subsequent follow up no relapse of decompensation occurred. The patient was shifted from stage IV to stage II in the functional classification of ischaemic heart disease according to NYHA.
[Adult-onset Still's disease--the effect of methylprednisolone pulse therapy].
J Skoupý, S Alusík
Vnitr Lek 1992, 38(12):1221-1224
The authors describe in a 40-year-old woman Still's disease with an adult onset. The activity of the disease was not controlled by large Prednisone doses and therefore pulsed treatment with methylprednisolone with very favourable results was used. The authors discuss the use of pulsed treatment with methylprednisolone in this disease.