[The effect of diuretics on the magnitude of the effect of isosorbide dinitrate given as a single dose and after long-term administration. Ergometric study in patients with stable angina pectoris].

P Rotrekl, J Vlasínová, J Manousek, O Bocek, Y Vlasicová, S Janousek, B Semrád

Vnitr Lek 1994, 40(11):693-697

The authors assessed in 24 men with stable angina pectoris, using means of ergometry, the antiischaemic and antianginose effects of a combination of the nitrate Iso-Mack retard and the diuretic Moduretic. The effects were compared with the effects of Iso-Mack retard administered alone and with the effects of placebo. The examination was made after a single dose of the drugs and after three-week administration. The authors revealed that a single dose of the diuretic significantly enhanced the effects of nitrate. During long-term administration the diuretic did not prevent a significant diminution of the nitrate effects. Finally the authors discuss possible...

[Transesophageal atrial stimulation in routine clinical practice].

R Rybár, D Pella, D Trejbal, M Pjescák, D Soroková

Vnitr Lek 1994, 40(11):698-701

The authors examined 90 patients by the method of transoesophageal atrial stimulation with different indications. They consider transoesophageal atrial stimulation a suitable method for basic examination of an impaired functional status of the sinoatrial node and atrioventricular conductivity. It is suitable for assessment of predisposition to supraventricular disorders of the rhythm and for testing the effectiveness of treatment of impaired supraventricular rhythm. The authors use it also for a modified loading test in patients with coronary heart disease. They evaluate transoesophagel al atrial stimulation as a simple, safe, non-invasive method,...

[Adenosine triphosphate and supraventricular tachycardia].

J Pella

Vnitr Lek 1994, 40(11):702-706

UNLABELLED: Intravenously administered adenosine triphosphate (ATP) converts some supraventricular tachycardias to a sinus rhythm. Temporary atrioventricular block can help with the differentiation of different forms of supraventricular tachycardia.METHOD: Twenty-one patients with different forms of supraventricular tachycardia were subjected to electrophysiological examination for diagnostic or therapeutic (ablation) purposes. During tachycardia (after 5 minutes duration) ATP Spofa was administered by the i.v. route within 3 s into the cubital vein--0.3 mg per 1 kg body weight.RESULTS: One patient had two forms of supraventricular tachycardia....

[A system for monitoring hemodynamic data and treatment of arterial hypertension (Part I. Evaluation of long-term results of classical therapy)].

J A Tichý, V Cervenka, M Hojerová

Vnitr Lek 1994, 40(11):707-711

In 383 hypertonic patients treated for prolonged periods in the classical way (stopped-care-approach) for an average of 12.5 years, all with more than three drugs, the authors used during comprehensive evaluation thoracic electric bioimpedance. In group (0) are 15.9% normotensive subjects, while 84.1% (189 men and 133 women) are divided into groups (III and IV) with 15.4% where treatment failed, into group (II) with controversial therapeutic effect, 32.4%, and group (I) 36.3% where a certain therapeutic effect was achieved. With regard to the reduction of systemic pressure (groups 0 and I), the success of classical treatment could be expressed as 52.2%....

[A system of monitoring hemodynamic data and treatment of arterial hypertension. (Part II: Evaluation of short-term results of directed therapy)].

J A Tichý, V Cervenka, M Hojerová

Vnitr Lek 1994, 40(11):712-714

Short-term results of aimed treatment (4-6 weeks) in 100 consecutive controls (65 men and 35 women) comprise reduction of systemic hypertension in 80% (as compared with 52.5% in those treated by the classical approach). Normodynamic normotension was achieved in 35% (as compared with 10.5%). Aimed treatment uses available antihypertensive drugs of the main classes, based on clinical examination supplemented by analysis of haemodynamic parameters in the CDDP system.

[Blind insertion of a peritoneal catheter in continuous peritoneal dialysis therapy].

A Orban, K Maris

Vnitr Lek 1994, 40(11):715-717

Insertion of the peritoneal catheter is most important for peritoneal continual dialysis. Various techniques described in the literature do not indicate an unequivocal preference of methods and the blind method used by the authors makes it possible to perform the procedure safely by a team of experienced well trained nephrologists and specialists in internal medicine.

[Cytologic picture of medullary carcinoma of the thyroid gland].

E Merstenová, M Stopeková, A Böör, A Mersten, E Lakata, M Tajtáková, J Valjó, J Zimácek, J Zapatická

Vnitr Lek 1994, 40(11):718-725

The authors present cytological and clinical features of six cases of medullary carcinoma of the thyroid. They are quoting a review of the literature about the cytological picture of medullary carcinoma of the thyroid and they draw attention to the advances of immunocytology.

[Increased bone density in patients with multiple myeloma treated with clodronate].

Z Adam, B Prokes, D Hájek, J Vorlícek, M Tomíska, J Hájek, M Penka, J Mayer, N Hejlová

Vnitr Lek 1994, 40(11):726-729

The indication of bisphosphonates in hypercalcemia is fully accepted, the long term therapy with bisphosphonates is still controversial. The aim of our study was to evaluate the influence of clodronate on the bone density of myeloma patients. Twenty patients were included in the study. Clodronate is administered in the total dose of 3,000 mg, which is delivered in 4-6 hour infusions, 600 mg/day, once in tree 3 months. The effect of clodronate on bone density is evaluated by CT-densitometry in a period of 6 months. At the beginning of May 1994, 15 patients had completed at least two estimations of bone density. The amount of hydroxyapatite in these...

[Hemostasis in patients with acute leukemia treated with high doses of cytosine-arabinoside: the effect of chemotherapy and infectious complications on hemostasis].

P Cetkovský, V Koza, V Cepelák, L Vít

Vnitr Lek 1994, 40(11):730-734

Haemostatic parameters were studied in 12 adult patients with acute myeloid leukaemia and acute lymphoblastic leukaemia in complete remission using high-dose cytosine arabinoside regiments together with with other drugs. Increased tissue plasminogen activator (t-PA:Ag) antigen 4 hours after AraC application (p < 0.05) as well as increased levels of plasminogen activator inhibitor activity (PAI) (p < 0.05) and fibrinopeptide A (FPA) antigen (p < 0.05) were observed on day 2. All patients during bone marrow aplasia suffered from infectious complications (7 from sepsis and 5 from fever of undetermined origin). During that period of infection...

[Prognostic significance of ascites in patients with liver cirrhosis].

M Brodanová

Vnitr Lek 1994, 40(11):735-738

The author evaluates the prognostic importance of ascites in 100 patients with cirrhosis of the liver. The patients were followed up on a log-term basis in a hepatology clinic and the diagnosis was confirmed morphologically. Ascites developed at a time when marked objective and laboratory signs of chronic liver disease were present. Ascites was diagnosed by physical examination and verified by ultrasonography. It was treated by contemporary procedures. Survival of cirrhotic patients with ascites was unfavorable--50% survived one year, 38% two years, 17% three years, 15% four years and only 9% five years. Ascites is thus still a very adverse prognostic...

[Modern therapy of ascites in liver cirrhosis].

M Brodanová, P Klener

Vnitr Lek 1994, 40(11):739-744

Ascites is a common sign of decompensated cirrhosis of the liver. In order to improve the patient's quality of life, it is essential to treat him systematically. The authors present an algorithm of therapeutic procedures. The basis is major rest, restricted water and sodium intake. First choice diuretics are aldosterone blockers. The basic diuretic is furosemide. The authors mention also the most important complications of treatment with diuretics. They evaluate contemporary views on paracentesis and therapy by return of ascites into the circulation. Ascites refractory to treatment is an indication for transplantation of the liver.

[The present, something from the past and the future of therapy of type II diabetes (NIDDM). II].

J Rybka

Vnitr Lek 1994, 40(11):745-749

Insulin resistance which is the typical sign of NIDDM and the metabolic "X" syndrome is the basic problem of successful treatment of NIDDM. The author discusses therapeutic possibilities--biguanides, some new perspective pharmaceutical preparations and possibilities of combined treatment with PAD and insulin. Although it is not quite clear so far which treatment is the best, prevention of late diabetic complications, intensive NIDDM treatment must be focused on perfect control of the blood sugar level as well as on correction of associated metabolic abnormalities, as much as possible.

[Contribution to the discussion on the future relations between cardiology and internal medicine].

S Daum

Vnitr Lek 1994, 40(11):754