Vnitřní lékařství, 1995 (vol. 41), issue 7
[24-hour effectiveness and tolerance of perindopril (Prestarium), an ACE inhibitor, in the treatment of mild to moderate hypertension. A 1-year Czech and Slovak study].
J Widimský, V Fedelesová, O Uhlír
Vnitr Lek 1995, 41(7):441-444
This one-year open study conducted in two centres investigated the 24-hour effectiveness of the ACE inhibitor perindopril in the treatment of 31 patients with mild or moderate hypertension. The investigation evaluated the so-called "through" effect, i.e. the effect of the drug at the end of the 24-hour dosage period. Monotherapy with perindopril (4 mg or 8 mg administered once a day) led to normalization of the diastolic pressure to values lower than 90 mmHg in 48% of the patients, and a combination of perindopril with hydrochlorothiazide produced this effect in another 38% of patients. Treatment thus was able to normalize the diastolic blood pressure...
[Morphologic findings in liver tissue in chronic active hepatitis B after seroconversion from HBeAg to anti-HBe].
A Chlumská, J Stránský, P Taimr, L Baumruk, M Nevaril
Vnitr Lek 1995, 41(7):445-448
Replication of the virus is in the majority of patients with chronic hepatitis B associated with permanent activity and progression of the inflammatory process. The change of the virus to the latent stage expressed by seroconversion of HBeAg to anti-HBe leads to a significant repression of inflammatory changes and has a favourable impact on the course of the disease. The morphological changes in the hepatic tissue after spontaneous seroconversion or after interferon treatment were investigated in specimens of needle biopsy in 18 patients with active chronic hepatitis B. In 10 of them the diagnosis of chronic hepatitis was confirmed by biopsy in the...
[Levels of endogenous plasma cortisol in patients with rheumatoid arthritis and other diffuse connective tissue diseases].
M Kucera, O Topolcan, J Racek, P Panzner
Vnitr Lek 1995, 41(7):449-453
The authors tried to obtain information on levels of endogenous plasma cortisol in patients with rheumatoid arthritis and other diffuse connective tissue diseases, in particular systemic lupus erythematosus. Endogenous cortisol was assessed by radioimmunoanalysis at 8 a.m. and 4 p.m. If the sum of the morning and afternoon values reached the level of 280 nmol/l (sum of the lowest still normal values), they considered the daily cortisol secretion still normal. In a group of 30 patients who did not have glucocorticoid therapy the authors found only in one patient a lower daily endogenous cortisol secretion. In 117 patients with a relatively severe course...
[Cytomegalovirus antibodies: review of results of repeated examinations in 208 hemodialyzed patients].
L Korcáková
Vnitr Lek 1995, 41(7):454-457
Within the framework of prevention of cytomegalovirus (CMV) transmission from infected kidney donors to non-infected recipients the author investigates as a matter of routine latent CMV infection by assessing the presence of serum IgG against pp150 CMV. Antibodies against this phosphoprotein of the viral matrix are found in more than 80% of haemodialyzed patients, i.e. potential recipients of kidneys (in our group 168 of 208 patients). During repeated examinations of 168 patients, positive as regards IgG against pp150 CMV, the author observed in 18 (11%) a temporary change to negativity. At the time of absence of serum IgG against pp150 CMV, however,...
[Changes in platelet function in patients with arterial hypertension].
J Malý, M Pecka, E Pintérová, V Pidrman, M Bláha, O Siroký, L Jebavý
Vnitr Lek 1995, 41(7):458-461
The authors examined some indicators of platelet activity in patients with hypertension stage II (according to WHO). They revealed an increased platelet activity which was manifested by an increased concentration of platelet factor 4 (50.2 +/- 28.2 ng/ml) and thromboxane B2 (49.9 +/- 20.1 pg/ml) in plasma. The increase of indicators of platelet activation associated with hypertension is a molecular marker of activation of haemostasis and according to data in the literature it is an indicator of vascular complications in hypertension. It is not clear whether the increased platelet functions in hypertension is primary or an induced change.
[Dissecting aortic aneurysm combined with hepatorenal syndrome].
J Procházka, L Kameník, F Kölbel, K Hlavácek, V Růzek, M Langmayerová
Vnitr Lek 1995, 41(7):462-466
The authors present a case of a dissecting aneurysm of the aorta type A which affected also the insertions of visceral and renal arteries, and in addition to renal ischaemia and impaired renal function caused also ischaemia of the liver parenchyma with a rise of transaminases and bilirubin. This led to temporary hospitalization at the infectious department where the patient was referred to rule out hepatitis. In the discussion the authors draw attention to the pathogenesis, differential diagnosis and contemporary therapeutic methods of the disease.
[Pleural effusion in plasmacytic leukemia].
M Matýsková, E Krahulcová, A Buliková, H Novotná
Vnitr Lek 1995, 41(7):467-469
Multiple myeloma affects predominantly osseous spaces and the close vicinity of bones. A plasmacellular exudate is rare. The authors describe the course of plasmacellular leukaemia in a 68-year-old female patient where the first symptom of the disease was anaemia and a dextrolateral pleural exudate with a cytological finding of plasma cells. The exudate disappeared after the first cycle of chemotherapy and intrapleural administration of cytostatic. After the third cycle of chemotherapy remission of the disease was recorded which was, however, short. After three months' remission (six months after establishment of the diagnosis) the disease exacerbated...
[Successful treatment of agranulocytosis caused by carbimazole using recombinant granulocyte-macrophage colony stimulating factor].
A Kreze, A Kuviková, L Laca, S Kompis, M Dobáková, P Babusík, L Matecek, E Pekárová
Vnitr Lek 1995, 41(7):470-472
The authors describe a patient with hyperthyroidism who developed after three weeks' treatment with carbimazole agranulocytosis and the condition was complicated by septic shock. The authors used for treatment in addition to antibiotics and corticoids, for the first time in their practice, human recombinant granulocyte macrophage colonies stimulating factor (rHuGM-CSF) which produced a very favourable effect. In the meantime the patient was prepared for goitrectomy, operated and discharged in a satisfactory condition to have ambulatory treatment.
[Treatment of esophageal motility disorders with acupuncture of the ear (preliminary report)].
A Hep, J Prásek, J Dolina, L Ondrousek, P Dítě
Vnitr Lek 1995, 41(7):473-475
Impaired motility of the oesophagus is relatively frequent in patients with functional blocks of the cervical spine. The patient does not always realize oesophageal dysmotility. Auricular acupuncture focused on reflex relations seems to be a useful therapeutic procedure.
[Ventricular tachycardia in non-ischemic heart disease].
J Murín, S Cagán
Vnitr Lek 1995, 41(7):476-479
Ventricular tachycardia (VT) is found usually in patients with structural heart disease. Its symptomatology depends on haemodynamic manifestations. ECG criteria for the diagnosis of VT are known. For the classification of VT we use morphological criteria (monomorphous and polymorphous), duration of arrhythmia (non-and sustained VT) and the pathomechanism of VT (re-entry, increased automation and triggered activity). The clinical impact of VT and the therapeutic approach depend to a great extent on the basic disease. The therapeutic results and prognostic estimates assembled in ischaemic heart disease cannot be mechanically applied in non-ischaemic...
[Pathophysiology and clinical aspects of dissecting aortic aneurysms].
E Szabóová-Tomoriová, J Gonsorcík
Vnitr Lek 1995, 41(7):480-484
Dissecting aneurysms of the aorta are among the most dangerous acute conditions in medicine. Their incidence is rising in recent years. The pathogenesis of vascular aneurysms is not completely clear. In the submitted paper the authors discuss the most important factors (atherosclerosis, hereditary, metabolic, mechanical, haemodynamic, nutritional) responsible for the development and growth of an aneurysm as well as for the progressing dissection. The authors compare the most important diagnostic methods from the aspect of sensitivity and specificity. In the conclusion they give a brief account of dissecting aneurysms at the IVth Medical Clinic University...
[Cardiomyopathies and myocarditis].
J Gvozdják, A Gvozdjáková, J Kucharská, V Bada
Vnitr Lek 1995, 41(7):485-487
The authors discuss recent findings regarding cardiomyopathies, assembled recently due to the association of clinical and experimental cardiology. The main attention is paid to the pathogenesis of cardiomyopathies from the aspect of metabolic disorders of the heart muscle at the cellular and subcellular level. The differential diagnosis in relation to myocarditis is still a serious problem in cardiology: acute myocarditis is not a myocardiopathy, there exists, however, a close relationship between viral myocarditis and the development of dilatation cardiomyopathies. Echocardiography is one of the most important diagnostic examinations.
[Treatment with nonsteroidal anti-inflammatory agents in the aged].
S Krajcík, H Salamonová, L Cápová
Vnitr Lek 1995, 41(7):488-492
Some 13--33,7% old people use non-steroid antiphlogistics. The authors mention undesirable effects, their incidence being higher in advanced age, as well as differences between effects of different non-steroid antiphlogistics.
[Malnutrition in chronic obstructive bronchopulmonary diseases].
J Horácek, B Král, J Bures, V Pidrman
Vnitr Lek 1995, 41(7):493-497
Malnutrition occurs in 23-70% of patients with chronic obstructive pulmonary disease and appears to be an independent factor connected with poor prognosis. Malnutrition stems from a long-term negative balance of energy and nutrients. That is caused by hypermetabolism, with possible role of an increased thermic effect of food, and probably by (at least intermittently) a limited intake of food. The adverse effect of malnutrition may be mediated by a decreased respiratory muscle strength but also by other mechanisms (electrolyte disorders, disturbed respiratory control, immunosuppression). In these patients, realimentation may be difficult to achieve,...
[New findings on the classification, diagnosis and therapy of primary gastrointestinal lymphomas].
I Krc, J Macák, O Jurysek
Vnitr Lek 1995, 41(7):498-503
Based on available recent data from the literature the authors review recent findings pertaining to the etiopathogenesis, immunology, clinical manifestations and treatment of primary gastrointestinal lymphomas. From the pathogenetic aspect in particular the close association with infections and immune disorders in various portions of the gastrointestinal tract is important. In their review the authors draw attention to new aspects of the histological and immunological classification of these tumors, in particular as far as definition of lymphomas of the MALT-system is concerned. They evaluate also data from their own group of 83 patients with regard...