Vnitřní lékařství, 1992 (vol. 38), issue 8
[How should we implement the basic principles of treatment of type 2 diabetes mellitus from the aspect of the hormono-metabolic syndrome X (5H)?].
J Hrnciar, K Jakubíková, J Okapcová
Vnitr Lek 1992, 38(8):729-737
The authors summarize the principles of the therapeutic approach to the 5H syndrome [1. hyperinsulinism, 2. hyperglycaemia (NIDDM), 3. hyperlipoproteinaemia (obesity), 4. hypertension, 5. hirsutism], in particular its two components, i.e. NIDDM and arterial hypertension. The authors found that early treatment of hyperinsulinism, e.g. already in the stage of impaired glucose tolerance or NIDDM with oral antidiabetics, their disproportionate increase with regard to the blood sugar level and glycosylated haemoglobin without making "hygienic" provisions (radical weight reduction; increased physical activity to the maximum possible individual level; energy...
[Abdominal ultrasonography].
I Hrazdira
Vnitr Lek 1992, 38(8):738-744
The author characterizes ultrasonography as a modern diagnostic imaging method. The main attention is drawn to abdominal ultrasonography, especially to its indications and differential diagnostics. The author evaluates critically the present state and further foreseen development of this method. Finally he makes a statement on the question of safety.
[Emergency states in internal medicine--diagnostic contribution of emergency abdominal ultrasonography].
V Růzek, T Vaněcek
Vnitr Lek 1992, 38(8):745-750
The authors analyzed the activities of the sonographic laboratory during four consecutive months. During this period 896 patients were examined by ultrasonography and 119 of them (13.3%) for urgently indicated ultrasonography. The authors present a detailed evaluation of results in these 119 examined patients, in particular from the aspect of yield and asset of the method, affection of different organs, agreement of clinical and sonographic diagnoses and comparison with some other examination methods. Urgent ultrasonography is recommended as a very useful method, in particular as regards diagnostic yield which makes it possible to establish the diagnosis...
[Monitoring immunosuppression after kidney transplantation. I. Study of cellular reactions to antigenic stimulus in a skin abrasion].
P Jansa, J Bystron, K Konecný
Vnitr Lek 1992, 38(8):751-753
In 20 patients the authors performed in the course of 6-8 weeks following renal transplantation a total of 74 examinations of the cellular reaction to an antigenic stimulus. In 68 instances (91.9%) agreement with the clinical picture was recorded, while in 6 patients (8.1%) the interpretation of the cytological impression did not correspond to the clinical course. In four instances activation of lymphocytes was found, i.e. possible risk of rejection which however was not confirmed. In two instances however incipient rejection was not detected.
[Monitoring immunosuppression after kidney transplantation. II. Evaluation of simultaneous monitoring of CD4+ lymphocytes and the cytological reaction to standard antigenic stimulation].
J Bystron, P Jansa, K Konecný, P Vrublovský, J Zadrazil, T Grosmanová, M Petrek
Vnitr Lek 1992, 38(8):754-758
Monitoring of patients after renal transplantations by the concurrent follow up of absolute values of CD4+ lymphocytes and the cytological reaction to an antigenic stimulation in a skin abrasion reflects the actual immune state of patients and is an asset in the comprehensive diagnosis of rejection activity against the transplant in the early period (6-8 weeks) after transplantation. It can contribute also to the signalling of developing rejection activity against the graft, before the onset of the fully developed clinical picture of rejection, when it is possible by early anti-rejection therapy to prevent the functional impairment of the renal graft.
[Disorders of lipid metabolism in type 2 diabetics].
G Ivancová, R Tkácová, I Ivanco
Vnitr Lek 1992, 38(8):759-763
The authors investigated the incidence of different disorders of the lipid metabolism and their age dependence in a group of 67 patients with type 2 diabetes hospitalized at the First Medical Clinic in Kosice. Some disorder of the lipid metabolism was recorded in 67% of the patients. The most frequently encountered disorder was hypertriglyceridaemia (21%). Hypercholesterolaemia was recorded in 16%, combined hyperlipidaemia in 18% and hypoalphalipoproteinaemia in 12% of the patients. Patients with diabetic nephropathy had significantly elevated mean triglyceride levels and reduced HDL-cholesterol levels, as compared with patients without nephropathy....
The effect of Hylak drops on symptomatology in persons with irritable bowel syndrome.
V Zboril, L Prokopová, V Geislerová, A Pokorný, P Dítě, Z Mihula
Vnitr Lek 1992, 38(8):764-768
The authors present an account on the therapeutic effect of Hylak drops of Merckle Co. in patients with irritable bowel syndrome. They assume that in the pathophysiological mechanism of the disease an important part is played by intestinal dysmicrobia. After two weeks' administration Hylak, 3 x 40 drops, they recorded in 20 patients with the exception of one female patient (where ex post lactose intolerance was revealed which is a contraindication of this treatment), partial or complete regression of subjective complaints in particular as regards intestinal discomfort and the number of imperative bowel movements. As to objective indicators, they proved...
[Immunologic indicators in ascites].
L Vladár, M Mokán, J Květenský, I Markuljak, I Kocan, P Galajda, M Horáková
Vnitr Lek 1992, 38(8):769-774
The authors investigated specific and non-specific immunological parameters in malignant, cirrhotic, cardial and nephrogenic ascites. At the same time bacteriological and cytological examinations of ascites were made. In the submitted paper the authors compare, using statistical methods, immunological parameters of ascites in different patient groups and pay attention to their relationship with positive bacteriological and cytological findings in ascites. The authors recorded the largest number of positive bacteriological cultivation in cirrhotic and malignant ascites which correlates with lower values of some non-specific immunological parameters...
[Secondary osteopenia. Iatrogenic causes of osteopenia].
J Kocián
Vnitr Lek 1992, 38(8):775-780
The author investigated during the past 17 years 595 patients with iatrogenic damage of bone mineralization, incl. 302 patients where the disorder developed after drugs and 293 where osteopenia developed after surgery. In demineralizations after the use of drugs in the first place corticoids participate, to a smaller extent non-thiazide diuretics and antiepileptic drugs. The largest ratio of operations causing demineralization is formed by ovariectomies, in particular if performed before the menopause, followed by gastric surgery, operations of the gallbladder, small intestine and strumectomy. Finally the author emphasizes the necessity to know iatrogenic...
[Bronchial asthma. Pathogenesis and clinical aspects].
S Daum
Vnitr Lek 1992, 38(8):785-794
Asthma bronchiale (a.b.) is defined as paroxysmal or permanent, partly or completely reversible dyspnoea due to a bronchospasm resulting from pathological hyperreactivity of the bronchial system. In the pathogenesis participate allergic, immuno-infiltrative and genetic factors, irritating substances (environment) and infectious. The allergic constituent acts via sensitization and allergization of the mast cell, to its degranulation with release of mediators (histamine, serotonin, leukotrienes, thromboxane, PAF) with subsequent bronchoconstriction and production of viscous mucus. As to adrenergic factors, a block of beta-adrenergic receptors and reduced...
[Self-treatment and self-monitoring in patients with bronchial asthma].
J Stiksa, V Vondra
Vnitr Lek 1992, 38(8):795-801
Regular assessment of the peak expiratory flow (PEF), which after proper instruction, the patient can do himself is important for evaluation of the activity of bronchial asthma. It is, however, essential to assess the optimal PEF values of every individual. For control of self-treatment it is important to know the daily variations of PEF and the degree of reversibility of bronchospasm after inhalation of a beta 2-adrenergic substance. Inadequate reversibility of bronchial obstruction despite repeated inhalation of a beta 2-adrenergic substance is usually caused by inflammation. Depending on the clinical status and changes of PEF the patient can, if...
[Climate therapy, rehabilitation and psychotherapy in bronchial asthma].
V Hlinka, J Labus
Vnitr Lek 1992, 38(8):802-807
The authors explain the principle of effectiveness as regards treatment of bronchial asthma (AB) in the climate of the Tatra mountains. The most important place is held by elimination of noxious substances from the patient's environment which is comparable with the eliminations test. The second place is held by factors of a medium stimulating climate which calls for adaptation of the organism. This happens during the three-week acclimatization stage which acts as non-specific therapy. The result of climatotherapy is an increased immunological resistance, hardening, reduced bronchial hyperreactivity and improved life of asthmatic patients. Supplementary...
[Correct inhalation technique--an integral part of rational treatment of bronchial asthma].
J Kandus
Vnitr Lek 1992, 38(8):808-813
In the rational treatment of asthma bronchiale in recent years a marked increase can be observed as regards prescription of beta-2-agonists and glucocorticoids. They are administered almost exclusively from metered dose inhalers (MDI) with an adjustable valve. Almost half the users do not know the correct inhalation technique. Unless that is used, the effect of drugs is markedly reduced. The author deals therefore in his review in detail with all aspects of a correct inhalation technique; above all he emphasizes slow inhalation with subsequent breath retention which is the only way how to achieve maximum penetration of particles to the final branches...
[Fructose metabolism disorders and infusions].
V Palyza, M Bocková
Vnitr Lek 1992, 38(8):814-821
The authors give an account of views regarding the use of non-glucose energy sources in parenteral nutrition during the immediate post-load period/serious operations, severe injuries). Attention is devoted to the metabolic pathway of fructose and its disorders. In hereditary fructose intolerance an infusion of D-fructose or D-glucitol (= sorbitol) can induce life threatening hypoglycaemia (unless glucose is administered concurrently). According to some views, in subjects with this intolerance the organism is threatened also by hepatic and renal failure; their development may be independent on hypoglycaemia. Fructose and D-glucitol (sorbitol) therefore...
[Synergic joint diagnostics].
M Lindusková
Vnitr Lek 1992, 38(8):822-824
The author emphasizes the necessity to use all clinical and paraclinical examination methods in rheumatology to assess an early and correct diagnosis of rheumatic diseases. She emphasizes the importance of examination of the articular punctate and importance of the synoviogram in differential diagnostic considerations. The author reflects also on the importance of the frequently omitted unpretentious examination method--needle biopsy of the joints.