[Evaluation of diastolic filling of the left ventricle using Doppler echocardiography in patients with chronic ischemic heart disease and with normal left ventricular function].

J Meluzín, L Groch, I Hornácek, J Sitar

Vnitr Lek 1997, 43(1):3-6

Twenty-five patients with chronic ischaemic heart disease and intact left ventricular systolic function who had no other cardiovascular, systemic or metabolic diseases were examined by two-dimensional and Doppler echocardiography. At rest and during an isometric load Doppler parameters of left ventricular diastolic filling were obtained such as: peak transmitral flow velocity in early diastole - E, peak transmitral flow velocity in atrial contraction - A, their ratio E/A and deceleration time of early filling. Based on the coronarographic finding, the patients were divided in two ways: 1. group A - 15 patients with critical narrowing of some major...

[The process of ventricular remodeling after acute myocardial infarct associated with left ventricular aneurysm and ventricular septum rupture treated with radical surgery].

J Hůla

Vnitr Lek 1997, 43(1):7-12

Even after a successful operation of mechanical complications on account of acute myocardial infarction gradually developing adverse remodelling of the left ventricle has to be envisaged. In a six-year clinical study by means of echocardiography the authors followed up systematically some cardiac dimensions and volumes and functional systolic and diastolic left ventricular parameters. The changes pertained in particular to the endsystolic and enddiastolic volume, the ejection fraction, the peak maximum rate, early and late diastolic filling and their ratio as well as to indirect values of the mean pressure in the pulmonary artery. These changes, which...

[Interferon-alpha in the treatment of patients with chronic myeloid leukemia].

E Faber, M Jarosová, V Divoký, M Luhový, S Komenda, I Sulovská, J Hubácek, P Slezák, T Papajik, L Raida, M Heczko, K Indrák

Vnitr Lek 1997, 43(1):13-17

A retrospective analysis of the treatment with Interferon alpha in 18 patients with Ph positive chronic myeloid leukaemia is presented and compared with the results of peroral chemotherapy with Hydroxyurea or Busulphan in 20 patients. Patients treated with Interferon were significantly younger than the control group (median age 40.5 versus 55.5) (p = 0.01) and were followed-up for shorter period of time (median 10.5 months versus 36.5 months) ( p = 0.002), but did not differ in other parameters. Despite the shorter period of observation and treatment, significantly more complete haematological remissions were achieved with Interferon (86%) than with...

[The effect of chemotherapy on energy and nitrogen balance in patients with hematologic neoplasms].

M Tomíska, M Dastych, J Dolezalová, J Vorlícek

Vnitr Lek 1997, 43(1):18-24

Energy balance and nitrogen balance were evaluated within the opening week of standard induction chemotherapy in 26 haematooncological patients. The patients were uncomplicated in good nutritional status and nutritional requirements were covered by oral diet under the daily assistance of specially trained dietary nurse. Resting energy expenditure (REE) measured by indirect calorimetry under standard circumstances was elevated to 113.1% of predicted value by Harris-Benedict equation. We found a significant decrease in REE to 106.1% of predicted value (p < 0.01) on day 7 after the beginning of induction chemotherapy. Total energy requirements calculated...

[Fludarabine monophosphate in the treatment of patients with advanced stages of chronic B-cell lymphatic leukemia resistant to conventional chemotherapy].

T Papajík, E Faber, J Hubácek, P Slezák, L Raida, M Heczko, I Sulovská, M Jarosová, Z Pikalová, K Indrák

Vnitr Lek 1997, 43(1):25-28

The authors evaluated retrospectively a group of 12 patients with B-chronic lymphatic leukaemia to whom fludarabine was administered. All patients had been treated in the past by combined chemotherapy (1-4 regimes, median 3). Fludarabine was administered in amounts of 30 mg/m2/day for 5 days to 4 patients and for 3 days to patients. The median of the number of administered cycles was 3. Only two patients achieved partial remission of the disease, the reminder did not respond to therapy. All patients had complications which very probably were associated with the administered treatment. A total of 21 episodes were recorded in the course of 36 cycles,...

[The most rapid detection of ischemic strokes].

P Kalvach

Vnitr Lek 1997, 43(1):29-33

[Special features of strokes in diabetics].

V Baros, J Rybka

Vnitr Lek 1997, 43(1):34-36

Diabetes mellitus is a potent risk factor of cerebrovascular episodes. All statistics reveal a markedly higher prevalence in diabetic patients, as compared with non-diabetics, a poorer prognosis, more frequent recurrence and higher mortality. These facts are particularly relevant with regard to the increasing rate of diabetes in this country and in the world and also with regard to data on the rising incidence of cerebrovascular episodes in diabetic subjects, at least as recorded e.g. in the USA. Prevention is the concern of diabetologists, specialists in internal medicine and all doctors who are in contact with diabetic patients. Essentially it is...

[Treatment of acute cerebrovascular ischemia].

Z Kalita

Vnitr Lek 1997, 43(1):37-40

The author presents contemporary views on the main pathophysiological mechanisms of focal cerebral ischaemia and gives an account of possibilities of pharmacological treatment. Consistent with the concept of so-called pharmacological window he divides treatment of acute cerebrovascular ischaemia into treatment of the acute stage (within eight hours after the development of the attack) and treatment of the subacute and chronic stage. He emphasizes the basic importance of early hospital admission to special intensive care units (stroke units) to improve the resulting therapeutic effect and to reduce mortality. He draws attention to the debt of the Czech...

[Treatment of chronic viral hepatitis B and C].

J Stránský

Vnitr Lek 1997, 43(1):41-44

[A new purine analog in the treatment of hematologic malignancy. I. Fludarabine].

I Vásová, M Penka, R Hájek, J Mayer, E Krahulcová

Vnitr Lek 1997, 43(1):45-50

New purine analogues, fludarabine, 2-chlorodeoxyadenosine and 2-deoxycoformycin are remarkably active in generally incurable malignant lymphoproliferative disorders. The first part of the review summarises pharmacological properties, the mechanism of action, toxicity and clinical use of fludarabine. Major clinical experience with fludarabine has been obtained in patients with chronic lymphocytic leukaemia (CLL). In the studies in pretreated patients with CLL, the overall response rate was over 50%. In previously untreated patients with CLL response rate of 75-80% was recorded with a high ratio of complete responses. Fludarabine was found to be active...

[Peritoneal catheters in the treatment of continuous peritoneal dialysis (CAPD)].

P Makovník, B Kozová

Vnitr Lek 1997, 43(1):51-54

Continual ambulatory dialysis (CAPD) is used during the last five years with increasing frequency in the treatment of patients with chronic renal failure. In some countries already a very high proportion of patients is treated by this method, e.g. in Great Britain about 50%. A decisive influence in the design of peritoneal catheters (PC) and improvement of the exchange system of bags with the dialyzatin fluid. The most important step in the development of the peritoneal catheter was the introduction of a dacron cuff in the intramural portion of the catheter by Tenckhoff. The cuff is a strong barrier against penetration of infection into the abdominal...