Vnitřní lékařství, 1997 (vol. 43), issue 4
[Use of drug therapy in hyperlipidemia in patients after myocardial infarct in the Czech Republic].
J Widimský, V Lánská, F Jurán, J Leisser, P Vaněk, A Spírek, Z Koval
Vnitr Lek 1997, 43(4):191-194
The use of hypolipidemic drugs has been analyzed in 1,113 patients after myocardial infarction using a questionnaire with data entered from the medical records by spa physicians. 80.1% of patients had total cholesterol values > 5.2 mmol/l; mean value being 6.16 +/- 1.08 mmol/l. Mean values of LDL-cholesterol were 4.05 +/- 0.1 mmol/l, of triglycerides 2.01 +/- 1.14 and of HDL-cholesterol 1.26 +/- 0.61 mmol/l. Hypolipidemic drugs were used only in 16.5% patients with total cholesterol values above 7.0 mmol/l, in 14.4% patients with total cholesterol values 6.2-7.0 mmol/l and in 11.4% of patients with cholesterol values 5.2-6.2 mmol/l. Even some patients...
[Relation between serum amino acids and insulin sensitivity (results of a clamp study in offspring of hypertensive patients].
Z Vlasáková, J Válek, T Pelikánová, J Růzicková
Vnitr Lek 1997, 43(4):195-200
Hypertension which is part of the metabolic syndrome has frequently a family background. The authors investigated therefore indicators of insulin sensitivity by the method of a hyperinsulinaemic euglycaemic clamp in the offspring of hypertensive probands. In conjunction with the increased interest in the role of muscles in influencing insulin sensitivity the authors were also interested in serum amino acid levels. They examined a group of 15 healthy offspring of hypertonic subjects (PHT) and compared them with a group of 18 healthy volunteers without a family-history of hypertension. PHT had as compared with controls a higher systolic pressure (117...
[Nutritional status in patients with chronic obstructive pulmonary disease].
J Musil, S Musilová, M Kvapil
Vnitr Lek 1997, 43(4):201-203
The authors examined the nutritional status of 50 patients admitted on account of exacerbation of chronic obstructive lung disease. The mean height of patients was 168 +/- 8.8 cm, the body weight 72.2 +/- 16.2 kg, BMI 25.5 +/- 5.5 kg/m2. The mean albumin concentration was 33.1 +/- 4.6 g/l, transferrin 2.3 +/- 0.6 g/l, the skinfold thickness 17.3 +/- 9.9 mm, arm circumference 28.6 +/- 7.2 cm. The mean energy expenditure at rest (REE) was 122.1 +/- 12.3%. The total number of undernourished patients was 7 (14%), there were 27 obese patients (54%). The authors did not find a relationship between respiratory parameters and values of blood gases on the one...
[Percutaneous endoscopic gastrostomy in nutritional therapy--personal experience].
A Záková, H Münzová, M Kunovská, V Zboril
Vnitr Lek 1997, 43(4):204-207
The authors have described the indications, contraindications of percutaneous endoscopic gastrostomy (PEG) and its consecutive nutritional possibilities. They have described their own experience with 11 patients. Most common indications for the placement of a gastrostomy tube were neurological, and only in one case, esophageal diverticle. The average duration of PEG was 102 days (2-732). Besides PEG, not only polymeric diet, such as Nutrison standard sol, Fresubin, Salvimulsin, was administered, but also home-made diet, for example, mixed soup, mashed potatoes, yoghurt, juice and cocoa. The diet prepared at home was tolerated well, except for subjective...
[Famotidine in the treatment of gastropathy induced by non-steroidal antirheumatic agents].
I Rybár, J Rovenský, R Hyrdel
Vnitr Lek 1997, 43(4):208-210
In an open clinical endoscopically controlled study in 30 consecutive patients with rheumatic diseases complicated by the ulcerative and erosive form of gastroduodenopathy induced by non-steroidal antiinflammatory drugs and oesophagitis, after four weeks treatment with oral famotidine (one dose of 40 mg/day) confirmed a significant improvement of the mean oesophageal (0.67 +/- 1.06 vs. 0.03 +/- 0.18, p rrr 0.01) gastric 2.10 +/- 1.49 vs. 0.63 +/- 0.85, p rrr 0.001) and duodenal mucosal score (1.80 +/- 1.52 vs. 0.43 +/- 0.82, p rrr 0.001). After four weeks treatment 71% lesions (5/7) in the oesophagus were cured, 77% gastric lesions (10/13) and 75%...
[Esophageal echocardiography in patients with cerebrovascular stroke and atrial fibrillation].
J Chlumský, M Bojar, P Sváb, D Holá
Vnitr Lek 1997, 43(4):211-213
Atrial fibrillation is an important risk factor of embolization into the CNS. Thus affected patients should receive permanent anticoagulant therapy. Oesophageal echocardiography (TEE) can help our decision in patients with relative contraindications of anticoagulant therapy. TEE was performed in 52 patients with atrial fibrillation and cerebrovascular attack (CMP) with an ischaemic aetiology. Transthoracic echocardiography did not reveal the source of embolization. In 10% patients a thrombus was found in the appendage of the left atrium, in another 9% patients a spontaneous echocontrast was found in the left atrium (prethrombotic condition) and in...
[Bone changes in ulcerative colitis].
M Huorka, J Payer, I Duris, Z Killinger, H Kratochvíµová, P Ondrejka
Vnitr Lek 1997, 43(4):214-216
One of the complications of ulcerative colitis with frequent relapses is mineral deficiency (potassium, calcium, magnesium and phosphorus). The objective of the present work is to examine the bone density and laboratory parameters of bone metabolism in 25 patients with a medium severe and severe form of ulcerative colitis. In patients with ulcerative colitis a significantly reduced bone density was found in the era of neck of the femur (p < 0.05), a a non-significantly reduction of the bone density in the era of the lumbar vertebrae and an elevated level of osteocalcin (p < 0.05). These findings indicate a higher prevalence of bone changes in...
[Is quinidine an outmoded drug?].
R Goldmann, S Folwarczny, A Skrízalová, V Pieniazková
Vnitr Lek 1997, 43(4):217-220
In a group of 273 patients with a recently developed atrial fibrillation the authors compared the success of cardioversion in a group of 141 patients using quinidine and a group of 132 patients where for cardioversion different preparations were used. The results of the investigation confirmed the advantages of quinidine as an antiarrhythmic drug used for pharmacological cardioversion of atrial fibrillation.
[Clinical aspects of use of beta-blockers in the treatment of arterial hypertension].
J Widimský
Vnitr Lek 1997, 43(4):221-225
The author presents a brief account on the mechanisms of action of beta-blockers in arterial hypertension. He mentions mainly clinical aspects of treatment with beta-blockers. A basic classification is presented with an account on different substances. Indications of beta-blockers are discussed as well as their combinations with other hypotensive drugs not only in the treatment of arterial hypertension but also in concomitant diseases such as ischaemic heart disease and other pathological conditions. In the conclusion the author mentions the most frequent side-effects of beta-blockers and their contraindications.
[Principles of monitoring patients with exacerbation of chronic obstructive pulmonary disease].
J Musil, V Hirsch
Vnitr Lek 1997, 43(4):226-229
In patient treated on account of exacerbations of chronic obstructive pulmonary disease the authors monitor the peak expiration frequency (PEF) or spirometry, blood gases, pulse and respiration rate, grade of dyspnoea, ECG, blood count, blood sugar level, serum lactate concentration theophyllinaemia. It is necessary also to make an X-ray examination of the chest and bacteriological examination of sputum. The authors describe the method of different examinations and the relationship of the monitored parameters to the pathophysiology of the disease.
[Mushroom poisoning--classification, symptoms and therapy].
R Kohn, Z Mo»ovská
Vnitr Lek 1997, 43(4):230-233
The most serious poisonings are the hepatotoxic ones which are caused above all by Amanita phalloides, virosa, verna, Lepiota helveola, Galerina marginata, Gyromitra esculenta, Hypholoma fasciculare, and nephroptoxic intoxications which are caused above all by Cortinarius orrelanus and Paxillus involutus. Neurotoxic and psychotropic intoxications develop after ingestion of Inocybe, Clitocybe, Amanita-panterina, muscaria and Psilocybe. Most frequently the gastroenteric type of mushroom poisoning is encountered which is caused by many species e.g. Boletus satanas, Entoloma sinuatum and others. In the diagnosis anamnestic data are used, the clinical picture,...
[Bisphosphonates, their mechanism of action and properties useful in the therapy of metabolic bone diseases].
Z Fojtík, M Kandusová
Vnitr Lek 1997, 43(4):234-237
Bisphosphonates are a group of chemical substances which have been used in medicine for thirty years in the treatment of skeletal diseases and disorders of calcium metabolism. Bisphosphonates are derived from pyrophosphate by substitution of an O atom for a C atom. This structure makes possible a number of variants by changing the side-chains of the C atom. The basic P-C-P bond is very thermostabile and completely resistant to enzymatic hydrolysis. The basic biological property of bisphosphonates is inhibition of bone resorption but has not been completely elucidated so far. The prerequisite is the inhibitory action of bisphosphonates on osteoclast...
[Pancreatic diabetes].
V Bartos
Vnitr Lek 1997, 43(4):238-242
A review of recent data from the literature on the pathophysiology and clinical aspects of pancreatogenic diabetes, carcinoma of the pancreas and conditions after pancreatectomy. It deals with the secretion of insular hormones, insulin sensitivity and contraregulatory mechanisms. On these findings, not always complete, adequate treatment should be based.
[Combined disorders of the acid-base equilibrium. Clinical comments].
K Kubát
Vnitr Lek 1997, 43(4):243-249
The submitted paper contains comments on the evaluation of combined disorders of the acid-base balance. Some different definitions of the acid-base balance are given as well as their importance for the evaluation of combined conditions. The author discusses parallel and opposite deviations which develop inside and outside the cell, disorders associated with the mere accumulation of some ions and disorders associated with an impaired energy balance. On several examples clinical manifestations of impaired acid-base balance are illustrated where the laboratory finding may be atypical.
[Current views on use of megestrol acetate in oncology practice].
R Vyzula
Vnitr Lek 1997, 43(4):250-255
Anorexia of tumourous origin associated with cachexia is a frequent clinical problem which has a substantial impact on the therapeutic results and patient survival. It is encountered in as many as 90% patients in the stage of palliative care. Tumourous cachexia is thus a difficult problem in oncological practice. Hormonal therapy of malignant breast disease is an integral part of adjuvant as well as palliative treatment in postmenopausal as well as premenopausal patients. Both oncological problems, tumourous cachexia and hormonal therapy interfere by their consequences with the quality of life of oncological patients, i.e. a situation which is becoming...