[How biochemistry, immunology and molecular biology contribute to the diagnosis, prevention and therapy of viral hepatitis].

J Horejsí

Vnitr Lek 1996, 42(10):661-664

[Urinary excretion of neopterin and plasma levels of interferon gamma in patients with multiple myeloma].

I Spicka, Z Tomsová, Z Masek, B Procházka, R Zounar, P Klener

Vnitr Lek 1996, 42(10):665-668

Neopterin, a pteridine derivate, is produced and released by lymphocytes and monocytes/macrophages after stimulation by T-cell derived interferon (IFN) gamma. The urinary excretion of neopterin and plasma IFN-gamma levels were measured in 35 patients with multiple myeloma (MM) and 21 patients with other monoclonal gammapathies (MG). Significantly higher excretion of neopterin was found in patients with MM in the time of diagnosis and/or progressive phase of disease (median 963,7 mumol/mol creatinine, range 183,9-2 376,3) comparing the patients in stable phase of MM (median 407,4, range 184,3-826,4), monoclonal gammapathy of undetermined significance...

[Nutritional status in patients with stroke. Diagnosis, therapy and its monitoring].

J Vavrousková, D Stejakal, J Bartek

Vnitr Lek 1996, 42(10):669-675

Stroke (Ischemic) initiates numerous pathophysiological processes and each of them can be dangerous. When evaluating patient's state and choosing therapeutical strategy, a complexity of the followed-up parameters should be taken into account as well as a complexity of a given therapeutical approach. On the basis of literary data and acquired clinical experience, we developed our own algorithm for diagnosis of the nutritional state and it was implemented into a semi-expert computing system SOFT. Using SOFT program, the group of 23 patients with ischemic CMP was examined within 40 hrs after its origin. These patients were found to show a slight protein...

[Hemostasis in patients with diabetes mellitus. I. Markers of endothelial dysfunction].

P Galajda, E Martinka, P Kubisz, J Ivanková, E Galajdová, J Polko, M Mokán

Vnitr Lek 1996, 42(10):676-679

In the submitted pilot study the authors examined 47 diabetic patients without vascular complications and 15 healthy blood donors. In an aged-matched sub-group the authors confirmed significantly elevated levels of Willebrand factor (vWF) in patients with non-insulin dependent diabetes mellitus (NIDDM), as compared with healthy blood donors, while the thrombomodulin (TM) levels did not differ significantly. The mutual correlation of parameters with calcium-dependent release (vWF, platelet factor PF4 and C-peptide) was confirmed in the group of patients with NIDDM with normal TM values and in the group of blood donors. These findings could be explained...

[Serum and urinary concentrations of magnesium in patients with chronic heart failure].

V Spisák

Vnitr Lek 1996, 42(10):680-683

Patients with chronic heart failure suffer more frequently, due to cumulation of factors leading to impaired magnesium (Mg) metabolism, from disorders of its concentration in serum and urine. Hypomagnesaemia has a marked (statistically significant) negative impact on the one-the two-year survival of patients. The author examined 57 patients with chronic heart failure. He did not detect hypomagnesaemia in any of them (Mg levels below 0.7 mmol/l). In two instances he found reduced urinary levels of Mg (less than 1 mmol/24 hours). Surprising is the more frequent occurrence of hypermagnesaemia (Mg above 1.0 mmol/l) which has also an adverse (statistically...

[Long-term electrocardiographic monitoring of patients after acute myocardial infarct].

J Murín, K Kozlíková, I Hulín, J Bulas

Vnitr Lek 1996, 42(10):684-692

The authors present an account on detailed electrocardiographic follow-up of a patient for 12 months after an inferior myocardial infarction. The patient died 14 months after the IM due to arrhythmia after previous remodelling of the left ventricle. The results assembled by means of superstandard methods of signal averaging electrocardiography (method of cumulative amplitudes, RMS signal and frequency analysis) and electrocardiographie body surface mapping (isointegral maps) are confronted with detailed clinical examinations and repeated echocardiographic investigations. The assembled results indicate that the applied superstandard methods make it...

[Interferon in the treatment of Loeffler's endocarditis].

J Pella, R Rybár, D Pella, D Trejbal

Vnitr Lek 1996, 42(10):693-695

The authors describe their own experience with the administration of recombinant alpha 2c interferon in the treatment of Loefller's endocarditis. Based on their analysis (as well as in keeping with the spares data in the literature-as a rare disease is involved), the authors consider this procedure as a qualitative advance of treatment. They consider their account as preliminary because of the short period of time, and therefore in future strict dispensary care of the patient is essential.

[Portal hypertension--introduction to the problem].

M Brodanová

Vnitr Lek 1996, 42(10):696-699

Portal hypertension is a condition with a permanently raised pressure in the portal area. The most frequent cause is restricted blood flow through some part of the circulation. Depending on the site of obstruction, we classify portal hypertension into prohepatic, hepatic and posthepatic. In adult age the most frequent form is the hepatic one associated with cirrhosis of the liver, in childhood prehepatic hypertension associated with thrombosis of the porta. The significance of portal hypertension is due in particular to its sequelaes. Among the most serious ones is the development of a collateral circulation with subsequent gastroesophageal varicosities....

[Pharmacologic treatment of portal hypertension].

E Drazná

Vnitr Lek 1996, 42(10):700-704

The objective of pharmacotherapy of portal hypertension is to reduce the portal pressure and the subsequent reduction of pressure and blood flow in the oesophageal varicosities in patients with portal hypertension. Pharmacological treatment is used in acute bleeding from oesophageal varices where it is a very useful first step for arresting haemorrhage and it does not require any special training or complicated equipment. Pharmacotherapy holds its place also in primary and secondary prophylaxis of oesophageal variceal bleeding. In particular a combination of pharmacotherapy with sclerotherapy is useful to reduce the occurrence of early recurrent bleeding....

[Heparin-induced thrombocytopenia].

P Dulícek, L Chrobák

Vnitr Lek 1996, 42(10):705-709

Heparin induced thrombocytopenia (HIT) is the result of platelet activation and it is either nonimmunologically (type I) or immunologically mediated (type II). HIT is the most frequent drug induced immune thrombocytopenia. It is completely different from all other forms of immune thrombocytopenia, because it can be accompanied by serious thromboembolic complication because of its serious clinical consequences must be prompt and very intensive.

[Myeloproliferative diseases].

Z Adam, J Vorlícek, M Matýsková

Vnitr Lek 1996, 42(10):710-716

Myeloproliferative diseases include primary polycythemia, primary thrombocytosis, primary myelofibrosis and chronic myeloid leukaemia. The average survival of patients with the former two diagnoses is more than 10 years, in the subsequent two it is only 5 years. Standard treatment of polycythemia still remains phlebotomy, only in patients with associated thrombocythemia and complications caused by it cytoreduction treatment is recommended (hydroxyurea, busulphan or interferon alpha). Patients with primary thrombocythemia due to hypofunctional thrombocytes suffer frequently from haemorrhagic and thrombotic complications. The objective of treatment is...

[Fundamentals of hospital treatment in exacerbations of chronic obstructive lung disease].

J Musil, V Vondra

Vnitr Lek 1996, 42(10):717-723

Treatment of Acute Exacerbations of Chronic Obstructive Lung Disease Involves Administration of O2, beta 2 adrenergic, anticholinergic drugs, corticoids, theophylline, antibiotics, mucolytics and supported ventilation. The objective of oxygen treatment is to increase the oxygen saturation to a minimum of 90%, PaO2 = 8 kPa, without an increase of PaCO2 by more than 1.33 kPa or a reduction of the pH below 7.25. Beta 2 adrenergic substances are the most potent bronchodilatating agents. Inhalation of the preparation in solution is optimal. Neither the interval of administration nor the dosage are uniform. In Europe most frequently the following solutions...