Vnitřní lékařství, 1995 (vol. 41), issue 5
[Prognostic importance of invasive electrophysiologic findings in the heart].
M Pleskot, V Pidrman, P Tilser, P Parízek, E Ettlerová
Vnitr Lek 1995, 41(5):291-297
The objective of the work was the long-term perspective follow-up of subjects with a normal and pathologically delayed intra-, infra-His conduction in the heart based on the electrogram of the bundle of His and subjects with a normal or pathological finding during programmed stimulation of the ventricles, to assess the impact of these findings for the patients' prognosis. The authors included in the group, after elimination of subjects with the syndrome of ventricular preexcitation, 340 patients (243 men, 97 women, 16-81 years, mean age 49 +/- 16) where they made an invasive electrophysiological examination of the heart (electrogram of the bundle of...
[The effect of dipyridamole on pulmonary venous flow in patients with ischemic heart disease].
J Spác, H Nĕmcová, M Blaha, O Hlinomaz, I Dvorák
Vnitr Lek 1995, 41(5):298-301
In 56 patients with ischaemic heart disease the authors evaluated the blood flow in the pulmonary veins, using transoesophageal echocardiography by the pulsed Doppler technique in the left upper pulmonary vein. They assessed the peak systolic velocity (pVS), the systolic integral time-velocity (S-VTI), the peak diastolic velocity (pVD) and the integral time velocity in the diastolic part of the flow (D-VTI). They found a statistically significant correlation between the ratio pVS/pVD and the LVEDP assessed by the invasive method (r = 0.812). In 36 patients the authors evaluated the flow rate and time-velocity integral at rest and after administration...
[Diagnosis of beta-thalassemia on the basis of HbA2 determination].
H Fortová, V Slavíková, F Musil, J Suttnar, V Brabec
Vnitr Lek 1995, 41(5):302-306
The increased level of HbA2 is a reliable marker of heterozygous beta-thalassaemia. The levels of HbA2 measured by three different methods were compared and the ranges for the normal and for the heterozygous beta-thalassaemia were assessed. The levels of HbA2 2.76 +/- 0.47% for normal (30 blood donors) and 4.62 +/- 0.77% for beta-thalassaemia (50 patients) were obtained by the chromatographic method 2.61 +/- 0.42% HbA2 for normal (30 blood donors) and 5.82 +/- 0.89% HbA2 for beta-thalassaemia (46 patients) were assessed by electrophoresis on hydragel (Sebia) and 2.8 +/- 0.62% HbA2 for normal (30 blood donors) and 6.04 +/- 0.96% HbA2 (47 patients) were...
[The significance of mediastinal involvement and other risk factors for survival in patients with Hodgkin's disease].
L Melínova, Z Hermanská, J Halíková, Z Dienstbier, B Vacková, J Zámecník, E Skala
Vnitr Lek 1995, 41(5):307-312
The impact of prognostic factors for survival was analyzed in a group of 337 patients with Hodgkin's disease. The analysis of survival of patients comprised a total of 13 indicators: histological types LP, NS, MC, LD, clinical stages I, II, III, IV, E lesions, symptomatology A, B, size of the mediastinal tumour (index), age at onset of disease and sex. Cumulative survival of 5, 10, and 20 years in the whole group is 83%, 80% and 72% resp. A first complete remission was achieved by 284 patients, cumulative survival without the disease is 79% after 5 and 73% after 10 years since completion of primary treatment. A significantly adverse effect on the prognosis...
[Pulmonary complications and their prevention in the treatment of Hodgkin's disease].
L Melínová, Z Hermanská, J Halíková, Z Dienstbier, B Vacková, E Skala, J Zámecník
Vnitr Lek 1995, 41(5):313-319
Pulmonary ventilation was monitored in a group of 102 patients with Hodgkin's disease. In the initial finding a tendency of a restrictive disorder is apparent (43% of the patients) with the increasing size of the mediastinal tumour (79% mediastinal patients with a bulky finding in 40%), without statistical significance. After treatment a restrictive disorder was recorded in 35% of the patients with a normal initial finding and conversely normalization of results occurred in 12% patients with a pathological result of the spirometric examination. After a one-year interval the finding deteriorated in 12 % of the patients without post-treatment disorders...
[Lactate acidosis: a rare or common disease?].
K Kubát
Vnitr Lek 1995, 41(5):320-324
The authors present a survey of 50 documented cases of metabolic lactic acidosis (MLAC) recorded in the course of 5 years. To this study cases of severe hyperlactataemia (determined minimum lactate level of concentration 4 mmol/l) have been included. The sample consists of patients hospitalized at the Department of Internal Medicine Litomĕrice (hinterland of about 110,000 inhabitants). Liver involvement in 5 cases, cardiogenous shock in 6 cases, sepsis in 2 cases were the cause of lactic acidosis. The administration of biguanids (Adebit, Silubin R, Diformin) seems to be the probable cause in 21 cases, other cases were triggered by rarer causes....
[Restenosis after coronary angioplasty: status in 1994].
J Vojácek
Vnitr Lek 1995, 41(5):325-331
Percutaneous transluminal coronary angioplasty became well established mode of treatment of coronary artery disease. Restenosis remains, however, so far unresolved problem. Studies based on quantitative coronary angiography showed that restenosis is a time related phenomenon which may lead to a new significant coronary lesion after coronary angioplasty in 20 through 60% of patients. As the process of plaque growth is linear, the vessels with smaller luminal diameter or with suboptimal results after dilatation are more prone to the development of a new significant stenosis. The magnitude of restenotic plaque growth depends on the extent of initial vessel...
[Ambulatory parenteral antibiotic therapy].
Y Pospísilová
Vnitr Lek 1995, 41(5):332-335
The paper sums up the current knowledge on the outpatient parenteral antibiotic therapy, the information is based on the experience with this type of treatment in the USA. The introduction gives the reasons for outpatient as opposed to inpatient therapy. The first part of the paper discusses the indications and the contraindications of outpatient parenteral antibiotic therapy, the choice of the adequate antibiotic, the organisation of this treatment and the cooperation between the doctors, nurses and patients. The second part of the paper deals with specific diseases and the possibility of their treatment by means of outpatient parenteral antibiotic therapy.
[Captopril and other angiotensin converting enzyme inhibitors in the treatment of hypertension].
J Hradec
Vnitr Lek 1995, 41(5):336-339
Captopril was the first oral inhibitor of the angiotension converting enzyme (ACE). Its introduction into clinical practice in 1981 was a great advance in the treatment of essential hypertension. In subsequent years a number of other ACE inhibitors was developed. They are nowadays, due to their favourable effects and good tolerance, basic antihypertensive drugs. They are indicated either as monotherapy or part of combined treatment, in particular in moderate to severe hypertension or when other antihypertensive drugs are ineffective, poorly tolerated or contraindicated. They are suitable also for hypertensive patients with left ventricular hypertrophy,...
[Hyperlipoproteinemia as a risk factor for ischemic heart disease. Epidemiologic and interventional studies].
H Vaverková
Vnitr Lek 1995, 41(5):340-343
The author reviews the main epidemiological studies which identified a number of risk factors of ischaemic heart disease and became the basis for widely accepted ranges of lipids where dietary or medicamentous intervention should be used. She emphasizes in particular the evaluation of the total risk not only from the aspect of various lipid indicators but also non-lipid risk factors. The author reviews the main hypolipidaemic intervention studies and their meta-analyses. She emphasizes the importance of hitherto not widely accepted hypolipidaemic treatment in secondary prevention of ischaemic heart disease, which reduced not only cardiovascular but...
[The present status of conservative therapy in critical lower limb ischemia].
J Linhart, K Roztocil
Vnitr Lek 1995, 41(5):344-347
1. Conservative therapy of critical limb ischaemia either supports the effect of revascularisation procedures (thrombolysis, PTA, surgical reconstruction) or is employed in cases where instrumental intervention is no more possible. As a longterm control programme, the conservative approach reduces the number of local and general vascular complications. 2. The main physiological principles of conservative treatment are as follows: improvement of driving pressure (limb dependency, slow walking, mild temporary hypertension induced by isometric contraction of forearm muscles), decrease of vascular resistance (exercise, reflex dilatation by body heating,...
[New findings in diet therapy and nutritional pharmacology].
J Kábrt
Vnitr Lek 1995, 41(5):348-351
The author gives an account on the effect of a number of nutrients prepared by the pharmaceutical industry and their use in enteral and parenteral nutrition. They are natural substances which promote the action of other pharmaceutical preparations. Their main importance is in prevention: they prevent a number of complications, have no side-effects and there is no risk of overdosage.
[Methods of enteral nutritional intervention in the home].
J Manák, L Sobotka, Z Zadák
Vnitr Lek 1995, 41(5):352-354
The authors review indications and principles for providing home enteral nutrition. It is a method of nutritional support in ambulatory patients, which is effective, easy to administer and financially feasible.