[Significance of left ventricular hypertrophy in hypertension].

W M Ghanem, J Murín, J Bulas

Vnitr Lek 1998, 44(9):513-517

Left ventricular hypertrophy (LVH) is supposed to be a useful marker of cardiovascular (CV) complications during the course of hypertension (HT). To evaluate it, authors compared the clinical findings in hypertensive patients (pts) with and without LVH defined by echocardiography (echo). Hospital records of hypertensives treated in the 1st Medical Department during the year 1995 were analysed. LVH was defined by echo (Penn convention) as left ventricular mass index (LVMI) > 125 g/m2 in men and > 115 g/m2 in women. Presence of LVH was found in 72 pts (mean age 66 y), absence of LVH in 38 pts (mean age 56 y). There were statistically significant...

[Haplotypes of the beta-globulin locus in Czechs and Slovaks with beta-thalassemia and structurally variant hemoglobins].

E Kynclová, L Kovaríková, P Fajkosová, R Melichárková, J Indráková, V Brabec, J Cermák, K Jindrák, K Indrák

Vnitr Lek 1998, 44(9):518-523

In 29 Czech and Slovak families with the most frequent and newly identified beta-thalassaemic alleles and with some structural haemoglobin variants (Hb E, Hb Haná, Hb Santa Ana) haplotypes of the beta-globin locus of alleles with these mutations were identified. In most instances haplotypes I and V were involved which were found in 57% of the patients. The bond of the most common beta-thalassaemic mutation: IVS-I-1, IVS-I-110, CD 39 (C-T), IVS-II-745, IVS-I-6 with alleles with the same haplotypes as in the mediterranean region suggests a mediterranean origin of these mutations. In Hb Santa Ana a hitherto not described haplotype was identified (-(+)-(-)-(+3),...

[Effect of octreotide on the clinical course of acute pancreatitis and levels of free oxygen radicals and antioxidants].

J Lata, P Dítě, K Julínková, M Precechtělová, J Prásek

Vnitr Lek 1998, 44(9):524-527

Twenty-one patients with a medium severe form of acute pancreatitis were divided into two groups. Eleven were treated with octreotide, 200 micrograms s.c. every 8 hours, combined with standard conservative treatment, 10 patients had the same treatment but without octreotide. In the octreotide-treated group the level of free oxygen radicals and important antioxidants--vitamins A, E and C--was assessed. In the octreotide-treated group the authors found after five days normal levels of originally elevated free oxygen radicals and a significant increase of the vitamin C level. As compared with the control group, in the octreotide group the period of hospitalization...

[Primary hepatosplenic (gamma delta) T-cell lymphoma: clinico-pathologic analysis of 3 cases].

L Plank, M Fricová, N Stecová, E Tóthová, B Mudronová, P Fuschsberger, K Mociková, H Genserková, O Kreze, H Mociková

Vnitr Lek 1998, 44(9):528-534

The authors analyze three cases of hepatosplenic (gamma-delta) T-cell lymphoma which is a newly defined unit in the spectrum of primary splenic lymphomas. The first two were diagnosed in sequential biopsies of bone marrow, splenectomic material and the liver of female patients aged 38 and 67 years. In the clinical picture dominated symptoms of progressing splenomegaly, hepatomegaly, haemolytic anaemia and different manifestations of leuco- and thrombocytopenia with expulsion of tumour cells into the peripheral blood. The first patient died after complete remission with signs of heart failure, the second one is surviving for 11 months in partial remission....

[Hepatitis B immunization in hemodialysis patients].

L Skladaný, J Svác, P Javorský, M Kmeť

Vnitr Lek 1998, 44(9):535-537

Infection with the virus of hepatitis B is found in haemodialyzed patients many times more frequently than in the normal population and it participates in their morbidity and mortality. It is also an important issue in patients after transplantation of the kidney. With regard to the alarmingly high prevalence of this infection in their haemodialyzation centre the authors analyzed retrospectively the effectiveness of the most successful preventive measure--active immunization--in 84 patients immunized with Engerix B according to the protocol recommended for haemodialyses. They found that: i) active immunization started after the onset of haemodialyzation...

[Adrenal incidentalomas. Clinical experience].

Z Frysák, F Záťura, L Benýsek, J Lukes, Y Hrcková

Vnitr Lek 1998, 44(9):538-540

In the course of two years the authors treated 27 patients with incidentally detected adrenal tumours. Detailed morphological and laboratory examination revealed four cases of non-classical late type adrenogenital syndrome (AGS) and two pheochromocytomas. From the submitted paper ensues that it is essential to provide interdisciplinary comprehensive treatment in departments which have sufficient experience with this problem.

[Assessment of the need for and length of hospitalization at the internal medicine department].

P Hrobon, J Chlumský, V Jirásek, M Kvapil

Vnitr Lek 1998, 44(9):541-546

We used the Appropriateness Evaluation Protocol (AEP) to evaluate appropriateness of admission and continuing hospitalization (daily till discharge of maximally till 15th day of hospitalization) of 260 patients admitted consecutively to department of internal medicine of a teaching hospital. Reasons of inappropriate admissions and delayed discharges were classified and analyzed. Results of the valuation of some patients were subject to control by a committee of fully specialized hospital physicians. 63 (24%) of 260 admissions and 1005 (54%) of 1869 evaluated days of stay failed the AEP criteria. These patients could be well served by lower treatment...

[Successful treatment of hemothorax with recombinant factor VIIa in a hemophilic child with inhibitor].

M Hulíková, P Galajda, P Kubisz

Vnitr Lek 1998, 44(9):547-550

rFVIIa is at present the most progressive treatment in different haemorrhages and operations in patients with haemophilia A and a high titre of inhibitor. As apparent from the presented case of a 4-year-old boy with haemorrhage into the pleural cavity, rFVIIa is sufficiently effective to induce haemostasis, while it is safe and has no side-effects. It does not induce systemic activation of haemostasis. Its application requires, due to the high price, that all criteria should be met which were elaborated for the Slovak Republic in the National centre of haemostasis and thrombosis.

[Whipple's disease, early diagnosis, early therapy].

J Vykouril, Z Lukás, V Balák, A Pavlousková

Vnitr Lek 1998, 44(9):551-554

The authors describe a case of Whipple's disease diagnosed early during gastroduodenofibroscopy from a bioptioc specimen of the prepyloric gastric mucosa, and treated in time. The disease was complicated by superinfection with Salmonella enteritidis. In the clinical picture digestive symptoms predominated, loose stools, malabsorption, loss of body weight, anaemia, skin pigmentation. After antibiotic and later chemotherapeutic treatment clinical symptoms receded and the histological finding in bioptic specimens from the stomach was normal.

[Determination of cystatin C in serum and its use in prediction of glomerular filtration].

D Stejskal, V Růzicka, J Bartek, M Franková, D Horalík

Vnitr Lek 1998, 44(9):555-557

[Beta blockers in the treatment of chronic cardiac failure].

L Spinarová, J Spinar

Vnitr Lek 1998, 44(9):558-562

The authors present contemporary findings on the treatment with beta-blockers in patients with chronic heart failure. It is important to differentiate acute and chronic administration. The authors discuss theoretical prerequisites for the administration of beta-blockers in chronic heart failure. They give an account of indications, contraindications and mode of treatment. The dosage pattern for different preparations is given. The authors summarize the results of major studies with beta-blockers: MDC, CIBIS, ANZ, US Carvedilol Trials and they outline the trends of future research and indications for treatment with beta-blockers.

[Prevention and treatment of unstable atherosclerotic lesions in atherosclerosis].

P Gavorník

Vnitr Lek 1998, 44(9):563-570

Primary, secondary and tertiary prevention and treatment of atherosclerosis and unstable atherosclerotic lesions as well as of their sequelae must be comprehensively angioprotective (comprehensively antiatherogenic), above all antilipidogenic (antihyperlipidaemic), antithrombogenic (antithrombotic) and endotheloprotective (cytoprotective). It is important to use an individual approach, differentiated with regard to actual results of basic and functional physical, instrumental and laboratory angiological examination which must be made at frequent, regular intervals. Prevention and treatment must not be alternatives substituting each other.