[Changes in internal medicine over the past nine decades].

J Syllaba

Vnitr Lek 1995, 41(9):577-580

[Importance of programmed ventricular stimulation in the evaluation of proarrhythmic effects of orally administered anti-arrhythmia agents].

M Pleskot, V Pidrman, P Tilser, P Parízek

Vnitr Lek 1995, 41(9):581-585

The objective of the submitted work was to assess, using programmed stimulation of the cardiac ventricles during antiarrhythmic treatment (amiodarone and propafenon administered orally), the presence of indicators suggesting imminent ventricular ectopic proarrhythmia. The authors included in the group, after elimination of subjects with ECG (Holter monitoring) signs of proarrhythmias 50 patients (43 men, 7 women, 23-78 years, mean age 54.0 +/- 14.2 years), where they used initial programmed stimulation of the ventricles, not sooner than three months after acute cardiac disease. On account of electric instability of the ventricles the authors administered...

[Programmed esophageal stimulation of the atrium and the long-term effects of anti-arrhythmia therapy of atrial fibrillation and flutter].

E Novotný, V Uhrová, J Suda

Vnitr Lek 1995, 41(9):586-589

The authors investigated the long-term effect of antiarrhythmic treatment on the maintenance of the sinus rhythm in a group of 32 patients with paroxysmal atrial fibrillation and flutter where the antiarrhythmic drug was selected because of negative results of tests by programmed atrial stimulation, using the method of oesophageal stimulation. After a one-year follow up 56% of the patients had permanently a sinus rhythm without paroxysms of supraventricular arrhythmia. Comparison with results of work evaluating the effectiveness of different antiarrhythmic drugs as regards maintenance of the sinus rhythm without testing suggests that selection of an...

[Safety of maximal ergometric loading in a population of 37,250 individuals at risk (1969-1994)].

J Simícek, A Kána, D Michalík, E Miklová, J Sajnar, Z Tesar

Vnitr Lek 1995, 41(9):590-592

No fatal complications occurred in 37,250 exercise tests (98.7% symptom limited) including 683 predischarge maximal tests in patients soon after myocardial infarction. Acute myocardial infarction was observed in 4 patients, ventricular fibrillation in 1 patient was successfully resolved by defibrillation. Extension of infarct area was recorded in 1 patient soon after myocardial infarction. Complication rates decreased from 1:3,400 in years 1969-1984 to 11,700 in years 1985-1994. Maximal exercise testing soon after myocardial infarction appears to be safe too. It cannot be replaced by submaximal testing. It appears to define high-risk patients suitable...

[Serum interleukin-6 in multiple myeloma: I. Relation to selected laboratory indicators of disease].

V Scudla, J Bacovský, M Budíková, D Klímová, L Faltýnek

Vnitr Lek 1995, 41(9):593-598

In a group of 111 patients with multiple myeloma (MM) comprising a group of 34 patients examined when the diagnosis was established and a group of 77 patients evaluated in different stages of the disease, the author examined the relationship between the interleukin-6 serum level (IL-6), assessed by the method of enzyme immunoanalysis and selected laboratory indicators of the disease. Elevated IL-6 values were recorded in 38% of the patients. In neither of the groups significant relations were found between IL-6 and calcium, urea, creatinine levels, the amount and type of monoclonal immunoglobulin, lacticode dehydrogenase, beta 2-microglobulin, ferritin,...

[Serum interleukin-6 in multiple myeloma. II. Relation to activity and stage of disease].

V Scudla, J Bacovský, M Budíková, K Srovnalík, D Kubalová

Vnitr Lek 1995, 41(9):599-604

In a group of 111 subjects with multiple myeloma (MM) comprising a group of 34 patients examined when the diagnosis was established and a group of 77 patients examined in different stages of development of MM the authors evaluated the relationship between interleukin-6 (IL-6) serum levels and the clinical activity and the stage of the disease. In both groups a significant relationship was found between IL-6 and the clinical activity of MM; "stable" and "active" stages of the disease differed by the frequency of elevated values and the level of IL-6. In both groups the authors recorded rising levels and a rising rate of subjects with elevated IL-6 levels...

[Betaxolol hydrochloride in the treatment of mild and medium hypertension--long-term effects].

M Soucek, J Julínek, I Rihácek, M Stejfa

Vnitr Lek 1995, 41(9):605-608

All available beta-blockers are effective in the treatment of high blood pressure. Differences in the pharmacokinetics are important as they can have an impact on their clinical use. Betaxolol, a beta-1-selective blocker has a long biological half-life which can control the blood pressure and pulse rate for 24 hours. The authors investigated 20 patients with mild and medium severe hypertension by out-patient monitoring of the blood pressure. Treatment was focused on influencing the morning rise of blood pressure and pulse rate. The results confirm the effectiveness of betaxolol (Lokren) in the administered dose of 10-20 mg once per day. A favourable...

[Non-steroidal antirheumatic ointments in the treatment of primary periarticular and intramuscular fibrositis].

J Vachtenheim

Vnitr Lek 1995, 41(9):609-612

The author presents his experience assembled in a short-term (two-week) therapeutic trial with Mobilisin ointment, which contains flufenamic acid, in 50 patients with primary localized periarticular and muscular fibrositis. The preparation was used locally three times per day-2-3 cm of ointment pressed from a tube. The patients were given a form in which they recorded every night the effect classified in four grades from the best to zero effect. In 49 the tolerance of the ointment was very good. In 45 patients a therapeutic effect was achieved (90%), comprising 21 (42%) where the effect was excellent, in 24 it was good or satisfactory (48%) and only...

[Cardiac impairment detected by echocardiography in patients with ankylosing spondylitis].

J Benacka, F Mális, D Zlnay

Vnitr Lek 1995, 41(9):613-617

The authors subjected to complete echocardiographic examination 40 patients with ankylosing spondylitis (AS) in order to assess pathological changes of the heart (changes of the structure and function of valves, myocardial function of the left ventricle and the pericardium) and compare their incidence with clinical characteristics of the patients (age, duration, stage, form and activity of the disease) as well as with the presence of ECG changes. Based on the results and their statistical analysis they revealed that structural changes of the aorta and its valves associated with dilatation of the root of the aorta, its mild insufficiency and the possible...

[Lipoprotein (a): a genetic risk factor with atherogenic and thrombogenic properties].

H Vaverková, D Novotný

Vnitr Lek 1995, 41(9):618-623

Lipoprotein (a) is a relatively new independent risk factor of early atherosclerosis with atherogenic and thrombogenic properties. From the structural aspect it resembles LDL-lipoprotein and differs from the latter by the presence of another glycoprotein-apolipoprotein (a). Due to the great similarity of apolipoprotein (a) and plasminogen, lipoprotein (a) is bound to plasminogen receptors on the fibrin surface (fibrinogen) and thus prevents the cumulation and activation of local fibrinolysis. Its levels are under strict genetic control and are very little influenced by external factors and available hypolipidaemic treatment. There is a great interindividual...

[Factors with insulin-like effects: IGF-I and GLP-1].

J Páv

Vnitr Lek 1995, 41(9):624-628

In the submitted review the author discusses two substances secreted into the circulation which can similarly as insulin lower the blood sugar level. These substances are IGF-I (insulin-like growth factor I) and GLP (glucagon-like peptide). While in case of the former it is not certain whether it participates in the glucose homeostasis, this is beyond doubt in the latter. IGF-I prepared by the recombinant technique can be used therapeutically in cases of insulin resistance caused by a receptor or postreceptor disorder, because it may act via its own receptor. Side-effects after larger doses are a problem. GLP-1, the use of which would be useful in...

[Electrocardiographic Holter monitoring in patients with ventricular pre-excitation: possibilities of its uses and pitfalls].

O Jurkovicová, J Hluchý, S Cagán

Vnitr Lek 1995, 41(9):629-636

Holter monitoring (HM) of the electrocardiogram (ECG) is used currently for the management of patients with ventricular preexcitation (PE). It makes it possible to detect inconstant PE which is considered a marker of a favourable clinical development. HM of ECG is not suitable for the detection of paroxysmal supraventricular tachycardias (PSVT) in patients with PE, as their presence is detected only exceptionally during HM. It can be used for the detection of other disorders of the cardiac rhythm than PSVT, in particular in supraventricular and ventricular extrasystoles (SVES and VES). Frequent SVES and VES detected during HM can as potential triggers...

[Endogenous digitalis-like substance. I. Basic characteristics].

E Martinka

Vnitr Lek 1995, 41(9):637-643

Endogenous digitalis-like substances (EDLS) present endogenous products which structurally belong to cardiac glycosides (CG). According contemporary views these substances potentially present a newly discovered hormonal group produced by adrenal cortex. EDLS, similarly exogenous CG, bind to specific CG- receptor of Na(+)-K(+)-ATPase and inhibit activity of this enzyme. At the cellular level, EDLS lead to increase in intracellular calcium storing and such may play an important role in modulation of calcium-dependent processes and their response to characteristic stimuli (e.g. contractility of vascular smooth muscle cells, hormonal secretion etc.). First...

[Lyme carditis].

P Bartůněk, J Zapletalová, J Němec, K Gorican, J Veselka, V Mrázek

Vnitr Lek 1995, 41(9):644-646

The authors present in the submitted paper the basic characteristics of Lyme carditis as one of the forms of Lyme borreliosis. They mention briefly the clinical symptoms, diagnostic possibilities and causal and symptomatic therapeutic procedures. In the second part they present conclusions which they obtained by comparison of data in the literature and their own experience with dispensary care of 50 patients during several years. In the conclusion they emphasize the great interindividual variability of the clinical picture not only in the acute stage of the disease but also for years after treatment.

[On the integrity of internal medicine (particularly in type II hospitals)].

J Svejda

Vnitr Lek 1995, 41(9):657-658