Vnitřní lékařství, 1998 (vol. 44), issue 4
[Correlation of SPECT myocardial stress scintigraphy with coronary angiography].
M Kamínek, M Myslivecek, M Skvarilová, V Husák, O Lang
Vnitr Lek 1998, 44(4):187-191
The sensitivity and specificity of a myocardial perfusion single-photon emission tomography (SPECT) for the detection of the coronary artery disease (CAD) was investigated. As a gold standard the coronary angiography was used--the stenosis of the artery by 50% and more was considered as significant for CAD. After performing SPECT studies patients were examined by coronary angiography according to the attending physician's judgement. In the retrospectively created group of 123 subjects (94 males and 29 females, mean age 53 years, range 30-69 years) 55 patients underwent myocardial infarction (MI). The stress was performed using a bicycle ergometer or,...
[Tissue amino acids in patients with colorectal carcinoma].
J Vecer, M Kvapil, L Sprongl, H Kubátová, J Hoch, Z Jech, J Charvát
Vnitr Lek 1998, 44(4):192-194
Different catabolic conditions have their special characteristics of intracellular biochemical changes. The objective of the presented work is to assess the concentration of free amino acids in muscles of patients with colorectal carcinoma. In a group of 17 patients the free amino acid level was assessed in tissues and plasma. Material was collected on operation by biopsy of the rectus abdominis muscle, the concentration of different amino acids was assessed by the HPLCV method with fluorescent detection. For statistical evaluation the T-test was used. From the results ensues that in patients with colorectal cancer in plasma statistically significantly...
[The Groningen Activity Restriction Scale (GARS) in the evaluation of severity of rheumatoid arthritis].
A Szilasiová, Z Macejová, M Kovárová, I Nagyová, D Trejbal, I Pramuk, A Beresová
Vnitr Lek 1998, 44(4):195-200
BACKGROUND: The functional ability of the patient in chronic diseases reflects the severity of the pathological process and the success of treatment.OBJECTIVE: Evaluation of the functional ability of patients with RA and assessment of the influence of the pathological process on the performance of simple everyday tasks.METHODS: Physical capacity and functional ability were examined using the Groningen activity restriction scale (GARS) and Health Assessment Quesionnaire (HAQ).RESULTS: The authors examined 160 patients with RA (135 women and 25 men), mean age 48.3 +/- 12.13 years and a duration of the disease of 21.32 +/- 15.61 months. The...
[Structure and dynamics of electrocardiographic changes in patients with Lyme carditis (pilot study)].
P Bartůněk, V Mrázek, P Varejka, K Gorican
Vnitr Lek 1998, 44(4):201-205
A maximum of 10% of the patients suffering from Lyme borreliosis suffer from cardiac damage. This affection is usually the source of diagnostic doubts, mainly because of the significant variability of clinical manifestations, the objectivization of which is difficult. Great variability is pathognomic also for electrocardiograms. For a three-month period 7 patients aged 43 years (29-53) were followed up under conditions of ambulatory ECG monitoring, i.e. using Holter s dynamic electrocardiography (HM) and ECG transmission by telephone (TTM). The focus of interest and objective of this pilot study was evaluation of the structure and dynamics of ECG changes,...
[Transjugular biopsy of the liver].
L Skladaný, S Okapec, P Hudec, J Svác, S Cársky
Vnitr Lek 1998, 44(4):206-208
Transjugular liver biopsy is an alternative of percutaneous biopsy in collection of hepatic tissue for histological examination. It is used when percutaneous biopsy is contraindicated, or involves great risk, i.e. in particular in patients with severe ascites and severely impaired blood coagulation. According to worldwide statistics it occurs in about one third of hepatological patients. The authors present a group of 16 patients who had transjugular biopsy and report on the high yield and low risk of the method. A representative histological sample was obtained in 100%, there were no complications in the investigated group. The authors give an account...
[Realimentation in patients with anorexia nervosa and critical malnutrition--personal experience].
H Kubátová, J Vecer, M Kvapil, J Charvát
Vnitr Lek 1998, 44(4):209-211
The objective of the work is to find a suitable realimentation procedure for patients with anorexia nervosa and critical malnutrition, whose mortality is round 6%. In a group of 10 patients aged 22.3 +/- 2.33 years during hospitalization for 10.0 +/- 6.11 days a weight increment of 5.0 +/- 1.16 kg was achieved. According to hitherto assembled experience and consistent with data in the literature it is best to start immediately after admission complete parenteral nutrition with a hyperalimentation regime regardless of the amount of food ingested by the patient. Thus within the shortest time maximum weight increments are achieved and the patients can...
[Changes in pharmacotherapy of hypertension 1989-1996 in patients with diabetes mellitus].
R Vlha, J Hellerová, V Vlhová
Vnitr Lek 1998, 44(4):212-216
The authors investigated in a retrospective study in a group of diabetics changes in the pharmacotherapy of hypertension. In 1989-1996 2308 diabetics had spa treatment in the Military Balneological Institute in Karlovy Vary and 1058 of these patients had hypertension (45.8%). The patients were from all parts of the Czech Republic and before 1993 from the whole Czechoslovak Federal Republic. The authors investigated the pharmacotherapy of hypertension and focused attention on four basic groups of antihypertensive drugs (beta-blockers, diuretics, Ca channel blockers and ACE inhibitors). They recorded a marked drop of the number of patients taking diuretics...
[Personal experience with the treatment of organic hyperinsulinism].
J Skrha, G Sindelka, L Krusina, J Hilgertová, J Páv
Vnitr Lek 1998, 44(4):217-221
In 1981-1997 at the Third Medical Clinic 52 patients with confirmed organic hyperinsulinism were treated. Forty-three were operated and the remaining nine were treated conservatively. An insulinoma was removed surgically in 35 patients, in one female microadenomatosis was detected. The operation was successful in 84%, while topographic preoperative examination aroused suspicion of a focus (i.e. insulinoma) only in 49% of the operated patients. A total of 11 patients (four after surgery and seven not operated) were treated successfully with diazoxide, in nine patients this treatment is still administered. According to the response to diazoxide it is...
[Occurrence of diabetes, hyperinsulinism and other risk factors for atherosclerosis in patients with pernicious anemia].
P Kessler, J Veberová, I Bradácková
Vnitr Lek 1998, 44(4):222-226
In 18 patients with pernicious anaemia (PA) the authors assessed the blood glucose level, C-peptide level and immunoreactive insulin (IRI) during the oral glucose tolerance test (o-GTT). They calculated the body mass index (BMI), assessed the level of the thyroid-stimulating hormone (s-TSH), free thyroxine (fT4), triiodothyronine (T3) and took repeatedly blood pressure readings. In one female patient they confirmed the diagnosis of insulin dependent diabetes mellitus (IDDM), in another six subjects they detected non-insulin dependent diabetes mellitus (NIDDM), incl. two persons where it was detected newly. In four patients impaired glucose tolerance...
[Importance of short-term administration of low doses of somatostatin analog in the development and remission of type 1 diabetes mellitus in adult patients].
H Dvoráková, K Vondra, M Voborská, B Bendlová, M Kvapil, V Zamrazil
Vnitr Lek 1998, 44(4):227-231
The objective of the presented work was to evaluate the short-term administration of octreotide on the development, onset and persistence of remission in recent insulin-dependent diabetics. The importance of remission means for the patient a clinically favourable condition with satisfactory metabolic compensation and a greater metabolic stability during the subsequent course of the disease. The period of remission is important from the aspect of prevention of late organ complications. Two-week treatment with octreotide, 150 micrograms/day, administered during the first month after establishment of the diagnosis was not associated with serious undesirable...
[Type 1 diabetes mellitus in the aged].
M Anděl, P Kucera, L Treslová, J Perusicová, V Karlová, A Richterová, J Potocková
Vnitr Lek 1998, 44(4):232-236
Diabetes mellitus type I was till recently considered a disease affecting children and young adults. Research in the past several years provided evidence that this type of diabetes is found in all age groups and that the majority develops after the age of 35 years. Diagnostic possibilities of type I diabetes were markedly extended due to the introduction of radioimmunoassay of antibodies against glutamate decarboxylase. This examination has a 82% sensitivity and 100% specificity in diabetes. Diabetes mellitus in advanced age is manifested much less dramatically than in child age. It is found in non-obese subjects and usually its clinical manifestation...
[Controlling the progression of diabetic nephropathy].
V Bartos
Vnitr Lek 1998, 44(4):237-239
Diabetic nephropathy is a serious microangiopathic complication of diabetes type I and II, which accounts for a marked proportion of the high morbidity and invalidity of diabetics. Although when the disease is fully developed, progression is inevitable, ther are ways how to prevent its development and retard its course. Because reliable prediction of diabetic nephropathy is not possible, primary prevention is essential in all diabetics. It involves, as soon as the diagnosis of diabetes is established, systematic checks of the blood sugar level and permanent satisfactory compensation of diabetes (HbA1c less than 6.5%) which is the main principle during...
[Clinical significance of glucose-dependent insulinotropic polypeptide (GIP)].
V Bartos
Vnitr Lek 1998, 44(4):240-244
Findings on the effects of GIP indicate that its incretory effect on stimulation of insulin secretion under conditions of hyperglycaemia is more important than the formerly known effect of enterogastrone. Numerous experimental trials provide evidence that GIP can participate in the regulation of the postprandial glucose and lipid metabolism and circulation in the splancnic area. The physiological action of GIP has however still obscure consequences in pathological conditions. Because GIP secretion by the mucosa of the small intestine is conditioned by nutrient absorption and its incretory effect on the functional capacity of the B-cells of the pancreas,...
[Infection of the diabetic foot--appropriate antibiotics and therapeutic strategies].
T Mudríková, I Tkác
Vnitr Lek 1998, 44(4):245-248
The authors give a review of the appropriate antibiotics used in the treatment of diabetic foot infection as well as the therapeutic strategies with regard for the severity of the infection and the expected pathogen. They also analyze some specific problems of antibiotic treatment in this group of patients.