[A letter from the Czech Internal Medicine Society to all the members of the CIS].

K Horký

Vnitr Lek 1993, 39(6):524-526

[Response to the article by Fixa, Komárková, Nozicka: H. pylori in the etiology of ulcer disease and gastritis].

O Urban

Vnitr Lek 1993, 39(6):526

[ACE inhibitors in the treatment of patients after myocardial infarct].

J Widimský

Vnitr Lek 1993, 39(6):527-535

ACE inhibitors are becoming an important part of treatment in patients after acute myocardial infarction if they suffer from asymptomatic dysfunction of the left ventricle (ejection fraction of the left ventricle evaluated by echocardiography or isotope ventriculography 40% or less). It prevents the development of cardiac dilatation, it retards progression of the disease and the development of cardiac failure and reduces the necessity of hospitalization in patients with chronic cardiac failure (stage NYHA II-IV). ACE inhibitors are the drug of choice as they reduce significantly the general mortality of these patients. Treatment should not be initiated...

[Atrial-triggered and ventricular-inhibited ventricular VDD pacing with atrial and ventricular single catheter electrodes--the Phymos MPS pacemaker].

P Kamarýt, J Nicovský, P Mach, M Novák, M Richter, J Julínek

Vnitr Lek 1993, 39(6):536-540

Optimal treatment from the haemodynamic aspect in complete atrioventricular block is dual-chamber DDD pacing. It makes possible atrioventricular sequence and adaptability of the frequency of ventricular pacing to the load under the control of the sinoatrial node. DDD pacing calls, however, for an atrial and ventricular electrode on two leads. Italian authors developed in 1984 a pacemaker (PM) PHYMOS (MEDICO ITALIA) which makes possible atrial triggered ventricular VDD pacing by means of a single pass lead with a tripolar electrode. As the first ones in the post-communist countries the authors implanted to six patients a PM PHYMOS MPS. They confirmed...

[Atenolol and bisoprolol in the treatment of mild and moderately severe hypertension].

M Soucek, J Prásek, L Spinarová

Vnitr Lek 1993, 39(6):541-548

Atenolol and bisoprolol, two beta-1-selective blockers, were compared in patients with mild and medium severe hypertension. Forty patients with a diastolic blood pressure of 95-115 mm Hg were two weeks after discontinuation of treatment divided at random into two groups treated with 50 mg atenolol and 5 mg bisoprolol. If the blood pressure was not affected by this dosage, the dose was raised to 100 mg atenolol and 10 mg bisoprolol. The blood pressure readings, heart rate, side effects of the drugs, laboratory and echocardiographic values were followed up for a period of three months. The authors recorded a marked decline of pressure and heart rate...

[Tiracizine in the treatment of ventricular arrhythmia (preliminary study)].

M Stejfa, K Zeman, L Groch, J Bytesník, R Krausová

Vnitr Lek 1993, 39(6):549-553

Tiracizine a new antiarrhythmic drug class Ia was tested in a open crossover study in a group of 46 patients with more than 2500 ventricular extrasystoles per 24 hours or with ventricular arrhythmias III or a higher Lown class. The authors revealed a statistically significant drop of ventricular extrasystoles and a significant reduction of arrhythmias class IV of Lown's classification with a general shift of arrhythmias to lower classes. Improvement by at least one class occurred in 63%, deterioration without clinical impact in 11%. The drug does not have a clinical effect on haemodynamics. Side-effects of an anticholinergic type were recorded in 13%...

[Significance of the stress score in patients with coronary artery disease].

A Polívková, J Simon, Z Kratochvíl, O Topolcan

Vnitr Lek 1993, 39(6):554-558

The authors tested the importance of the load score for assessment of the prognosis of patients after myocardial infarction and for assessment of the severity of the atherosclerotic affection of the coronary arteries. The score is a numerical value calculated from data assembled during evaluation of bicycle ergometry according to the following formula: total duration of the load-(5X deviation of ST)-(4X anginous index). The value of the load score was retrospectively tested in a group of 31 patients after myocardial infarction (mean age 58.1 years), who died during the subsequent five years, and in 64 subjects, mean age 50.1 years, who were subjected...

[Immunoglobulin E and acute myocardial infarct].

D Petrásová, J Kollár, V Lacková, E Hijová

Vnitr Lek 1993, 39(6):559-563

The authors examined repeatedly the immunoglobulin E (IgE) and immunoglobulin G (IgG) level in patients hospitalized on account of acute myocardial infarction (AMI). In a group of 33 patients aged 40-59 years (25 men, and 8 women) the authors investigated the case-history for hay fever, allergic rhinitis, eczema, allergy to grass, sensitizing household dust or domestic animals. The authors assessed also the presence of asthma and eczema in parents or relatives. Furthermore the authors investigated the relationship of different components of the immunological profile in relation to IgE and AMI. They found that in AMI the IgE serum level rises or is...

[Long-term study of glucose tolerance in individuals with a suspected diagnosis of diabetes].

J Kmoch, A Kabrhelová, J Kmoch, J Hradec

Vnitr Lek 1993, 39(6):564-568

The authors evaluated the results of the long-term monitoring of the glucose tolerance in 90 subjects, 40 men and 50 women, who were referred to a diabetological clinic as suspect diabetics. The mean age during the initial examination was 55.7 years (mean 55.7 +/- 12.5), a diabetic family--history was recorded in 60% of the patients, obesity in 61%. The monitoring proceeded on average for 8.5 years (mean 8.5 +/- 6.8). During the baseline examination diabetes was detected only in three subjects (3.3%), in 41 (45.6%) impaired glucose tolerance was revealed which in the course of 18 years developed in 28 into diabetes. In 32 examined subjects (35.6%)...

[Free oxygen radicals in patients with diabetes mellitus].

V Soska, D Krusová, B Podrouzková, A Lojek, A Zechmeister

Vnitr Lek 1993, 39(6):569-574

Free oxygen radicals (FOR) are one of the factors which participate via lipoperoxides in the development of atherosclerosis. Atherosclerosis complications affect a large part of diabetic patients. The objective of the present work was to test whether in diabetic patients there is, as compared with healthy subjects, a difference in the FOR activity and in the lipoperoxide blood level. A total of 30 patients with insulin non-dependent diabetes and a control group of 31 healthy subjects were examined. The FOR formation in blood, the concentration of malondialdehyde (MDA) as a marker of lipid paroxidation and serum lipid concentrations were assessed. In...

[Experience with sulodexide (Vessel Due F) in diabetics with ischemic disease of the lower extremities].

J Utratová, J Mayer, L Elbl, J Vorlícek, J Prásek

Vnitr Lek 1993, 39(6):575-580

A total of nine patients with diabetes type I and II and with claudications due to macro- and microangiopathies of the lower extremities took sulodexide (Vessel Due F) by the i.m. route for a period of 20 days and then as capsules for 90 days. In all a favourable therapeutic effect was recorded, in particular as regards delay of claudications. The authors recorded lower blood sugar values, lower levels of cholesterol, triglycerides, fibrinogen and plasma viscosity. In the authors' view sulodexide is an important advance in the treatment of diabetics with claudications.

[Helicobacter pylori in patients with diabetes mellitus].

V Kojecký, J Roubalík, N Bartoníková

Vnitr Lek 1993, 39(6):581-584

The authors assessed the frequency of Helicobacter pylori in diabetic patients with gastroduodenal ulceration and non-ulcerative dyspepsia. They evaluated a group of 91 hospitalized type II diabetics which non-ulcerative dyspepsia, endoscopically confirmed ulceration of the duodenal bulbus and gastric ulceration. The control group was formed by 98 hospitalized non-diabetic subjects. Between the two groups there was no difference in the frequency of Helicobacter pylori in non-ulcerative dyspepsia (61.1% as compared with 56.0% in non-diabetics) and gastric ulceration (75.0% as compared with 77.7% in non-diabetics). There is a significantly (p > 0.005)...

[Atrophy of the gastric mucosa and Helicobacter pylori].

M Sorf, V Krislo, M Gogora

Vnitr Lek 1993, 39(6):585-590

The authors investigated the prevalence of Helicobacter pylori (H. p.) in atrophic gastritis in the antrum and/or in the corpus of the stomach (groups I-IV), as compared with mucosae without atrophy. Criteria for elimination were age under 50 years, a case-history of the use of antibiotics during the last 6 months and chronic ingestion of alcoholic beverages. Group IV was formed by probands with pernicious anaemia who were divided into sub-group IVa with atrophy of the corpus and sub-group IVb with atrophy of the corpus and antrum. It was revealed that in probands with pernicious anaemia the presence of H. p. is significantly reduced (p < 0.01)...

[Primary pulmonary hypertension].

I Rihácek, M Soucek, J Toman

Vnitr Lek 1993, 39(6):591-596

The authors describe a case of primary pulmonary hypertension from the onset of subjective complaints to terminal dextrolateral cardiac failure. They give an account of an unsuccessful attempt to influence the haemodynamics in this female patient by calcium channel blockers. In the discussion they deal briefly with contemporary knowledge and treatment of primary pulmonary hypertension.

[New examining technics and approaches in ultrasonography].

J Hromec

Vnitr Lek 1993, 39(6):597-603

The new examination technique and methods are causing a fundamental development in ultrasonic diagnostics. The author describes the characteristic features of new technique and methods, e.g. endosonography, peroperative sonography, computer processing of ultrasonographic images of the liver, coloured picturing of abdominal vessels by the 2-D-Doppler method in real-time, 3-D ultrasonic diagnostic and application of contrast agents in ultrasonography. All said methods require adequate erudition of the examiners and high standard instrumental equipment. They indicate wide prospects of development in ultrasonographic diagnostics in the nineties.

[Mechanisms of erythrocyte sedimentation. Do we know more today than Robin Fahraeus?].

J Mayer, Z Pospísil

Vnitr Lek 1993, 39(6):604-612

The authors analyze in detail all substantial factors which influence the red cell sedimentation. They express this one a function of time, hematocrit, hemoglobin concentration, concentration of some plasma proteins, citrate density and viscosity. These values serve to describe the plasma and red cell density, plasma viscosity, red cell aggregation and to express the influence of the hematocrit on the red cell sedimentation. The authors try to quantify all influences in order to differentiate important factors from less important ones. Finally they demonstrate on several case-histories the necessity of a rational analytical attitude to values of the...

[The Saint Vincent Declaration--a call to increase care of diabetics. IV. Diabetic retinopathy].

J Rybka

Vnitr Lek 1993, 39(6):613-617