[A Czech and Slovak interventional study of spirapril (the CASSIS study). A randomized, double-blind, multicenter, placebo-controlled study in chronic heart failure].

P Jerie, H J Kremer, O Uhlír, J Widimský

Vnitr Lek 1997, 43(6):351-358

Spirapril, an ACE-inhibitor without the SH group was tested in a randomized double-blind multicentric study in patients with chronic symptomatic heart failure (NYHA II-IV). After a 1-4-week initial stage with placebo the patients were randomized into five groups: the first was given placebo, the second one spirapril 1.5 mg, the third one spirapril 3 mg, the fourth one spirapril 6 mg and the fifth one 5 and later 10 mg for a period of 12 weeks. The number of patients in different groups was in the following order: 48, 48, 53, 51 and 48. The condition for admission into the study was chronic heart failure not responding adequately to treatment with digoxin...

[Therapy of heart failure with spirapril--the open phase of the CASSIS study. Analysis of the 2nd year extension of the CASSIS study].

J Widimský, P Jerie, H J Kremer, O Uhlír, L Nikodýmová

Vnitr Lek 1997, 43(6):359-362

The CASSIS study was a double-blind multicentric controlled Czech and Slovak study focused on treatment of chronic heart failure with the ACE inhibitor spirapril; it was conducted for 12 weeks. The present work analyzes the second year of the extended open part of the study when all patients (n = 168) were treated with 3 mg or 6 mg spirapril. A small proportion of the patients was treated with 12 mg spirapril. The objective of the study was to test the long-term effectiveness and tolerance of spirapril. The general mortality was analyzed throughout the whole two-year period. The results revealed an unchanging total mortality, analyzed after three-month...

[An invasive approach in patients with non-Q myocardial infarct. Yes or no?].

P Cervinka, V Pidrman, J Gregor, J Sťásek, V Rozsíval

Vnitr Lek 1997, 43(6):363-365

The objective of the presented retrospective work was to evaluate the expedience of general indication of an invasive procedure in patients with non-Q myocardial infarction (non-Q IM). The group is formed by 40 patients with non-Q IM, after a first coronary attack. The authors investigated the premorbid condition, the clinical course, early and late mortality, they evaluated the coronarographic findings of those who were subjected to angiographic examination and compared conservatively treated patients with those who had a revascularization operation. The results are in favour of an invasive procedure in all patients with a non-transmural IM, in particular...

[Cardiogenic shock in acute myocardial infarct].

J Malík, J Murín, J Kasper, F Mikla

Vnitr Lek 1997, 43(6):366-368

Based on clinical records (three years) the authors assessed the characteristics of patients with cardiogenic shock during myocardial infarction (48 of 270 patients with infarctions, i.e. 18%). The mortality of these patients was 77%. The incidence of cardiogenic shock evidently rose with age in both sexes and amounted to as much as 35% in the most advanced age groups. Other "risk factors" for the development of shock were arterial hypertension and diabetes. By dividing patients with myocardial infarction and cardiogenic shock into first infarctions (55%) and re-infarctions (45%) it was found that other risk factors for the development of cardiogenic...

[The role of D-dimer determination in clinical evaluation with pulmonary perfusion scintigraphy].

P Kasalický, J Pivonka, V Tolman

Vnitr Lek 1997, 43(6):369-372

The diagnosis of pulmonary embolism is even in contemporary clinical practice problematical. Pulmonary angiography is used in our departments very little due to its invasive character. The method of choice for diagnosis remains therefore perfusion scintigraphy of the lungs, in this country frequently without ventilation scintigraphy as it is not available in the majority of our departments of nuclear medicine. In recent years in the diagnostic algorithms also assessment of D-dimers was started, i.e. assessment of products of fibrinolysis assessed by monoclonal antibodies. The authors tried to find out how many patients admitted to the medical department...

[The insulin resistance syndrome and fibrinolysis disorders].

J Okapcová, J Hrnciar

Vnitr Lek 1997, 43(6):373-378

The high atherogenic potential of the insulin resistance syndrome can be only partly explained by the association of "classical" risk factors of atherosclerosis which are considered part of it, i.e. impaired carbohydrate tolerance/diabetes mellitus type II, dyslipidaemia, hypertension and obesity. Impaired fibrinolysis due to excessive production of the plasminogen activator inhibitor-1 (PAI-1) are further risk factors which participate in the process of atherogenesis from the beginning of formation of the atheromatous plaque to the thrombotic occlusion of the vascular lumen. The authors present a group of 25 patients with different grades of glucose...

[Kinetic analysis in the evaluation of glucose tolerance disorders. Evaluation and use of a new method in the diagnosis of glucose tolerance in clinical practice].

D Stejskal, P Mohapl, R Pastorková, J Bártek, R Chlup, M Hrbková

Vnitr Lek 1997, 43(6):379-387

A kinetic model of oGTT has been used. This model is characterized by 7 glycaemia collections (0, 30, 45, 60, 120, 180 min). In some cases this is supplemented by determination of C-peptide and insulin values (0, 60, 120 min). This method is very simple and highly useful in clinical practice because it gives information about physiological stimulation by enterohormones, the first glucose passage through liver and next glucose utilization. The first part of the study deals with random error of the kinetic model of oGTT found by repeated calculations (> 10,000 repeatings) of identical initial glycaemias in individual groups (DM, PGT, N). Random error...

[The effect of antioxidant therapy on indicators of activity of free radicals in workers exposed to risks of styrene].

O Kaderábková, J Racek, J Kohout, V Holecek, V Senft, I Krejcová

Vnitr Lek 1997, 43(6):388-391

To 30 workers exposed to the risk of styrene for a period of 30 days a mixture of antioxidants was administered: vitamin C 200 mg, vitamin E 300 mg, selenium 20 mg, troxerutin 600 mg and beta-carotene 6 mg. Before the onset of supplementation and immediately afterwards laboratory indicators of antioxidant protection and lipid peroxidation were investigated. Before treatment workers exposed to the risk of styrene had a significantly higher malondialdehyde concentration (p < 0.01) and antioxidant capacity (p < 0.01) as compared with the control group. Due to the established positive correlation between these parameters (r = 0.42, p < 0.05) the...

[A rheumatologic syndrome (paraneoplastic?) in benign tumors].

M Zuffa, I Rusnák, B Ujcová, M Filková

Vnitr Lek 1997, 43(6):392-394

The authors discuss the possible development of rheumatoid paraneoplastic syndrome in patients with benign tumours. They present three observations they made (cardiac myxoma, subpleural lipoma and pulmonary fibrosclerotic pseudotumour). Paraneoplasias in these cases are interesting from the pathogenetic aspect as regards their development, possibly malignant transformation of benign intrathoracic tumours.

[Disappearance of the sleep apnea syndrome in a female patient after surgery of a hypophyseal adenoma with acromegaly].

V Weiss, M Pretl, K Sonka

Vnitr Lek 1997, 43(6):395-397

The association of the syndrome of sleep apnoea and acromegaly was described in the literature. However, so far no satisfactory explanation was given of the more frequent concomitant incidence of these diseases. The authors describe the disappearance of the sleep apnoea syndrome in a female patient after removal of an intrasellar microadenoma of the pituitary with overproduction of growth hormone.

[Standards of diagnosis and therapy in arterial hypertension].

K Horký, J Widimský, R Cífková

Vnitr Lek 1997, 43(6):398-403

[Oncopterin in clinical diagnosis].

J Tomandl

Vnitr Lek 1997, 43(6):404-406

In the submitted review the author presents hitherto published data on the new tumour marker oncopterin which was assessed in urine of patients with different types of tumours. Oncopterin is a derivative of endogenous pterins and trimethylene amine needed for the synthesis of polyamines which are synthetized specially in proliferating cells. Urinary oncopterin excretion can be assessed by high resolution liquid chromatography (HPLC). As test for the presence of malignant growth it seems to have a relatively high specificity.