[Control of hypertension in the Czech part of the Pardubice-Augsburg Study].

J Matějka, M Bobák, P Vojtísek, P Franc

Vnitr Lek 1998, 44(11):633-636

Objective of the work is to evaluate the prevalence of arterial hypertension, awareness of it, its treatment and control in the Czech part of the Pardubice-Augsburg Study. A random sample of 191 men aged 45-64 years was invited for examination. Arterial hypertension according to the present definition of WHO/International Society of Hypertension (blood pressure > or = 140/90 mm Hg = 18.8/12kPa) was recorded in 113 subjects, its prevalence being 59% .55% hypertensive patients were aware of their diagnosis. 40% of the hypertensive patients were on pharmacological treatment. Hypertension control was achieved in 9% of the treated and in 4% of all hypertensive...

[Late ventricular potentials in patients with arterial hypertension].

P Franc, P Vojtísek, H Buresová, M Sychra

Vnitr Lek 1998, 44(11):637-641

Arterial hypertension is a risk factor of left ventricular hypertrophy, ventricular arrhythmias and sudden cardiac death. Late ventricular potentials are the electric manifestation of an arrhythmogenic substrate. They identify patients threatened with ventricular tachycardia and sudden cardiac death. The objective of the work was to assess the prevalence of late ventricular potentials in patients with essential arterial hypertension and to assess the relationship of their occurrence with the presence of left ventricular hypertrophy and complex ventricular arrhythmias. Late ventricular potentials were detected in 8% patients with arterial hypertension,...

[Frequency of newly detected hypothyroidism in lipid clinics].

M Szabó, Z Málek

Vnitr Lek 1998, 44(11):642-645

Impaired thyroid function-hypothyroidism, is associated with changes in the spectrum of serum lipids. Thyroid hormones increase the number and activity of LDL receptors in the liver and peripheral tissues and have also a direct impact on the triacylglycerol synthesis in the liver. If their amount in the organism is inadequate, the metabolic turnover of LDL-cholesterol and triacylglycerols is reduced and subsequently a rise of the LDL-cholesterol and triacylglycerol plasma concentration occurs. The patients are then frequently referred with the diagnosis of hyperlipoproteinaemia to a lipid clinic for treatment, the hypothyroidism remaining undetected....

[Esophageal reflux disease--role of 24-hour pH measurement].

J Dolina, A Hep, V Kotrc, J Prásek, P Dítě, Z Němecek

Vnitr Lek 1998, 44(11):646-648

24-hour ph-metry of the oesophagus is a standard examination method in patients with reflux complaints. For objective evaluation of the record the following points are most important: 1. calibration of the instrument, 2. precise placement of the pH-probe, preferably under manometric control, 3. elimination of medication (inhibitors of proton pump, H-2 blockers, antacids, prokinetic preparations), 4. cooperation of the patient. A 24-hour record makes it possible to analyze in detail the type of reflux, and when using available software, also its quantity.

[Osteoporosis in multiple myeloma].

A Sakalová, Z Herrmann, S Gazová, I Chabronová, L Dedík, M Mistrík, M Hrubisko

Vnitr Lek 1998, 44(11):649-653

The problem of osteoporosis is world-wide in people above 50 years of age. As this period is also a risk period for the development of multiple myeloma or other malignant processes, comprehensive differential diagnosis of malignant and benign osteoporosis is essential. By retrospective analysis of a 12-year group of 270 patients treated by chemotherapy on account of multiple myeloma the authors selected a group of 151 patients treated in addition to chemotherapy and immunomodulating drugs (mixture of proteolytic enzymes-Wobe Mugos) for 2-3 years, also with biphosphonates. At the time ofdiagnosis osteoporosis was in 24.5% patients the only finding on...

[Poisoning in patients treated during 4 years at the Metabolic Unit of the Second Internal Medicine Clinic of the Charles University Medical School in Prague].

D Rath, J Vecer

Vnitr Lek 1998, 44(11):654-657

The authors summarize their experience with intoxicated patients who were treated between 1994 and 1997 at the metabolic unit of the Medical Clinic, Second Medical Faculty Charles University, Prague. The group of intoxicated patients comprises 165 subjects, incl. 76 men and 89 women. 107 intoxications were committed with suicidal intentions, in another 27 cases intoxication was accidental, in 14 toxicomania was involved and 17 patients were chronic alcohol addicts. From the total number 57 patients suffered from serious psychiatric disease of the type of psychosis, but only 22 patients had a psychiatric case-history. In 46 instances suicide was a demonstrative...

[Treatment of insulin-dependent diabetics during delivery].

A Adamíková, Z Adamík

Vnitr Lek 1998, 44(11):658-660

The authors discuss the care of an insulin-dependent diabetic woman during delivery. Due to the introduction of modern procedures in diabetology, obstetrics and neonatology the perinatal mortality in diabetic pregnancies is close to that in healthy women. In the Zlín region there was in 1997 a total of 2301 deliveries, incl. 8 IDDM patients (0.34%) and 32 patients with gestational diabetes (0.72%). The perinatal mortality in diabetic pregnancies was 0 pro mille and in non-diabetic ones 5.14 pro mille.

[Tissue plasminogen activator and diabetes mellitus].

P Galajda, E Martinka, P Kubisz, M Mokán

Vnitr Lek 1998, 44(11):661-664

tPA has been the independent risk factor of the thrombosis associated with atherosclerosis. There are increased tPA levels in type 1 diabetic patients with vascular complications and tPA is endothelial injury marker in this case. In type 2 diabetes mellitus elevated tPA antigen levels in early disease stage are caused by increased production of complexes with inhibitor (PAI-1) and tPA or fibrinolytic activity has been decreased.

[Indications for immunosuppressive therapy in hepatology].

P Husa, P Chalupa

Vnitr Lek 1998, 44(11):665-670

Immunosuppressive, and in particular corticosteroid therapy, has held its firm place in hepatology for many years. With the development of knowledge on the etiology of liver diseases however the spectrum of diseases where this treatment is administered changes. The authors pay attention in particular to autoimmune hepatitis where the indication for immunosuppressive treatment is beyond doubt. They deal also with viral hepatitis, alcoholic hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis where views on the administration of corticosteroids or immunosuppressive drugs are not uniform. In viral hepatitis administration of corticosteroids...

[A new model of hemostasis].

P Galajda, D Baláz, M Mokán, P Kubisz

Vnitr Lek 1998, 44(11):671-674

Haemostasis is a complexly controlled process which takes place in two stages. The first initial stage leads to the formation of a small amount of thrombin. The crucial step of initiation is the bond between the activated factor VIIa and the tissue factor. It is regulated by interaction between factors promoting and inhibiting the process of thrombogenesis. The initiation of haemostasis must be associated with the formation of the thrombus and for effective fibrinogenesis the second stage, amplification of haemostasis, is necessary. A new two-stage model of coagulation imitates the process of haemostasis in vivo as the classical MacFarlan cascade model...

[Personal experience with long-term peroral corticosteroid therapy in patients with bronchial asthma].

Z Susa, A Ouredník

Vnitr Lek 1998, 44(11):679-681