Vnitřní lékařství, 1998 (vol. 44), issue 7
[Changes in thrombocyte aggregation in primary hypothyroidism].
I Lazúrová, J Lazúr, M Mosanská, D Trejbal, L Trejbalová, E Zemberová
Vnitr Lek 1998, 44(7):383-386
The authors examined the thrombocyte aggregation in 10 controls and 17 patients with the diagnosis of primary hypothyroidism before and after 2 months substitution treatment with levothyroxine. They recorded a significantly reduced intensity of the aggregation response in untreated patients as compared with controls after adrenaline (p < 0.01), ADP (p < 0.01) but not after ristocetin. Impaired thrombocyte aggregation was observed in 11 of 17 patients, i.e. in 65%. After treatment the thrombocytopathy improved in 7 of 11 patients (63%), in four it persisted. Except one female patient the thrombocytopathy improved in all patients with manifest...
[Treatment of endocrine orbital disease by elimination of the thyroid gland. The effect of unsuccessful elimination, severe pretibial myxedema and persistence of hypothyroidism after removal in long-term results].
S Vána, J Němec, P Rezek, Z Novák
Vnitr Lek 1998, 44(7):387-390
The reason why soon after elimination of the thyroid gland protrusion of the bulbi does not recede and adequate regression of soft orbital tissue infiltration does not occur is at first the short time which has elapsed after elimination. The result usually is recorded only later. The long-term cause of minor improvement is the impossibility to combine surgery of the thyroid gland and radioiodine with corticoids, as well as incomplete thyroid elimination and presence of residues and finally pretibial myxoedema associated with a persisting high level of antibodies against the receptor for TSH. Hypothyroidism after the eliminating dose must not be left...
[Determination of cardiac troponin-I in prediction of thrombolysis].
D Stejskal, D Horalík, J Bartek
Vnitr Lek 1998, 44(7):391-395
Acute myocardial infarction (AMI) is a disease with high morbidity and mortality. Diagnosis of AMI using common methods (classical biochemistry, ECG) fails even in the fifth part of patients so that other noninvasive diagnostic methods are preferred. Recently, the biochemical analysis has been restored in the case of AMI diagnostics and also in prediction of coronary reperfusion after administration of a fibrinolytic agent. A suitable markers of AMI diagnostics is a combination of myoglobin and cardial troponin-I which is reported as a marker with high specificity and sensitivity. To determine coronary reperfusion, the examination of cardial troponin-T...
[Levels of vitamins A, E and C in serum and gastric juice in relation to gastric mucosa and occurrence of Helicobacter pylori].
A Hep, J Pospísilová, J Dolina, J Prásek, P Dítě
Vnitr Lek 1998, 44(7):396-399
Colonization of the gastric mucosa with Helicobacter pylori H.p. reduces the vitamin C concentration of gastric juice. Eradication of H.p. within four weeks after completed treatment does not exert a significant effect on changes in the concentration of vitamins A, E and C in gastric juice or serum. Despite this after eradication a rising trend of vitamin E in gastric juice was recorded. Substitution of vitamin C and E in gastritis associated with colonization with H.p. has a favourable effect and may reduce the risk of malignization.
[Treatment of multiple myeloma with high-dose chemotherapy and transplantation of autologous hematopoietic stem cells and subsequent maintenance therapy with interferon alfa-2b or interferon alfa 2b and dexamethasone. Report of the ongoing study of the "4W" Czech Myeloma Group].
Z Adam, M Krejcí, J Bacovský, N Hejlová, B Kuca, M Svojgrová, H Franková, J Gumulec, J Janca, K Veprek, B Januska, F Lehanka, Z Rezek, P Praskac, S Cahová, M Vránová, T Papajík, E Králová, J Novotná, V Scudla, V Koza, J Drbal, E Faber, I Mareschová, R Hájek
Vnitr Lek 1998, 44(7):400-408
We report our results with high-dose chemotherapy in previously untreated multiple myeloma patients (4 courses of VAD chemotherapy, collection of PBSC after priming with cyclophosphamide, 5 g/m2, high-dose chemotherapy with melphalan, 200 mg/m2). Second transplantation was indicated only for patients who did not achieve remission after the first high-dose therapy (paraprotein lower than 25% of the pretreatment value). For the second transplantation melphalan (200 mg/m2) with methylprednisolone (1.5 g for 5 days) were used as conditioning regimen. After high-dose therapy all patients were randomized into two arms of maintenance therapy: interferon alpha-2b...
[The short-acting insulin analog Lispro (Humalog) in the treatment of diabetes--comparison of preprandial and postprandial administration and comparison with treatment using Humulin R].
J Perusicová, J M Svehelka
Vnitr Lek 1998, 44(7):409-414
The results of a clinical trial comprising 162 type 1 and 2 diabetics who took for 12 weeks Humalog in cartridges revealed that administration of this insulin before or 20 minutes after a meal does not affect the blood sugar level in a major way. None of the patients developed after Humalog administration local or general allergic manifestations. Hypoglycaemic episodes grade I and II were not more frequent during treatment with human insulins. The mean compensation of diabetes (HbA1c) remained unchanged. 80% of the diabetics are statistically significantly satisfied with Humalog treatment as compared with Humulinem R administration.
[What dosage is sufficient in combined inhalation therapy (fenoterol + ipratropium bromide) in patients with exacerbation of chronic obstructive lung disease?].
J Musil, V Hirsch, V Vondra, M Reisová
Vnitr Lek 1998, 44(7):415-417
The authors compared in a prospective study the bronchodilatating and undesirable effects of combined inhalation treatment (phenoterol + ipratropium bromide) in the treatment of patients with exacerbation of chronic obstructive pulmonary disease, using different dosages. The patients were divided at random into two groups--group one inhaled berodual sol 3.5 ml/day (i.e. 1.75 mg phenoteroli + 0.875 mg ipratropii bromidium), the second group had a dose of double size. During the trial the authors monitored the peak expiration rate, the heart and respiration rate, blood gases and the subjective state of dyspnoea, using a 10 cm line. By comparison of bronchodilatating...
[Needle-like inclusions in liver cells are specific diagnostic signs of porphyria cutanea tarda].
F Fakan, A Chlumská, L Malina
Vnitr Lek 1998, 44(7):418-422
Needle-shaped cytoplasmic liver cell inclusions are considered to represent a feature typical of porphyria cutanea tarda (PCT). Histological sections of 849 liver biopsies were stained with ferricyanide reduction reaction for demonstration of the inclusions. They were detected in 18 cases, and in all of them the diagnosis PCT was clinically and/or biochemically confirmed. In our group of patients, PCT was associated with alcoholic liver disease in three cases, with chronic hepatitis C in three cases and with hepatocellular carcinoma in two cases. In the liver with hepatocellular carcinoma, the inclusions were present only in non-neoplastic liver tissue,...
[Schnitzler's syndrome].
A Oborilová, Z Adam
Vnitr Lek 1998, 44(7):423-427
The authors describe the development of disease in a patient with monoclonal immunoglobulin IgM, urticarial morphoeae and intensive pain in the region of the pelvic bones due to osteolysis and osteosclerosis. The combination of these symptoms corresponds with the so-called Schnitzler syndrome which is analyzed in detail in the discussion. The urticarial manifestations diminish only temporarily during corticoid treatment, other drugs have no effect. 2-chlorodeoxyadenosine, the most effective drug in treatment of m. Waldenström, suppressed the skin manifestations temporarily. However, the concentration of monoclonal IgM did not decline even after two...
[Controlling the progression of diabetic nephropathy].
V Bartos
Vnitr Lek 1998, 44(7):428-430
Diabetic nephropathy is a serious microangiopathic complication of type 1 and 2 diabetes and accounts in a major way for the high morbidity and invalidity of diabetics. Although progression is inevitable when the disease is advanced, there are ways how to prevent its development and retard its progress. Because reliable prediction of diabetic nephropathy is impossible, primary prevention is essential in all diabetic patients. As soon as the diagnosis of diabetes is established, the blood sugar level should be checked systematically and permanent satisfactory compensation of diabetes should be ensured (HbA1c less than 6.5%) which is the main principle...
[Treatment of urinary infections in chronic renal insufficiency].
M Merta
Vnitr Lek 1998, 44(7):431-434
The author describes some differences in the course of treatment of urinary pathway infections in prolonged reduced renal function. He emphasizes changes from the aspect of the clinical course of urinary infections and changes in the pharmacokinetics and pharmacodynamics of antibiotics and principles for selection of therapy are outlined.
[ATP-sensitive potassium channels and substances affecting them].
Y Pospísilová
Vnitr Lek 1998, 44(7):435-438
ATP-sensitive potassium channels are the site of action of the sulphonylurea derivatives that are used to treat non-insulin-dependent diabetes mellitus. These ATP-sensitive potassium channels are also found in myocardial cells and in vascular smooth muscle cells. The sulphonylurea derivatives have been reported to cancel the cardioprotective effects by blocking the opening of these channels in myocardium and vascular smooth muscles. A new sulphonylurea derivative, glimepiride, has been shown to be devoid of vascular ATP-sensitive potassium channel binding properties. The so called potassium-channel-openers, on the other hand, are expected to be used...
[Clinical use of glycoprotein IIb/IIIa receptor blockers in invasive cardiology].
P Cervinka
Vnitr Lek 1998, 44(7):439-443
Acute coronary syndromes (unstable angina pectoris, acute myocardial infarction) are still the main cause of mortality and morbidity not only in economically advanced countries. Although coronary angioplasty has become modern treatment of stable angina as well as of acute coronaries, acute occlusion of the vessel is still a serious problem. The prognosis of patients undergoing coronary angioplasty can be substantially improved by accurate evaluation of the risk of possible complications during or shortly after the procedure and by development of more effective anticoagulants. Research provided evidence that platelets play a decisive role in the formation...