[Role of physiopathology in medical aspects of large clinical studies].

F Simko, I Hulín

Vnitr Lek 1999, 45(4):199-201

[Serum leptin levels in female patients with protein-calorie malnutrition and its relation to biochemical indicators of nutritional status].

M Haluzík, J Kábrt, J Nedvídková, J Svobodová, E Kotrlíková

Vnitr Lek 1999, 45(4):202-205

Leptin is a protein hormone produced by adipocytes. Its serum concentrations in the most of cases positively correlate with total body fat content. Serum leptin levels are increased in obese in comparison with lean subjects. Leptin levels in females are two or three times higher than in body mass index and age-matched males. The aim of our study was to investigate the serum leptin concentrations in females with protein-caloric malnutrition of various aetiology, the relationship between leptin levels and biochemical nutritional parameters and to compare the values with those of age-matched control group. Totally 12 patients with malnutrition of various...

[Leptinemia in individuals with hypertension (pilot study)].

D Stejskal, V Růzicka, D Horalík, L Jedelský, J Bartek, I Oral

Vnitr Lek 1999, 45(4):206-209

UNLABELLED: During the last decade several papers were published where obesity in included among the building stones of the so-called metabolic cardiovascular syndrome (along with hypertension, dyslipidaemia, impaired glucose tolerance and hyperinsulinaemia). Several months ago it was also revealed that some patients with the metabolic syndrome suffer from hyperleptinaemia. Leptinaemia is considered by some authors as independent indicator of the risk of accelerated atherosclerosis. The cause of these hypothesis were (in addition to the known conclusions on the occurrence frequent incidence of leptin resistance and insulin resistance) in particular...

[Long-term treatment of combined hyperlipidemia with a combination of fluvastatin and fenofibrate].

J Widimský, V Hulínský, I Balazovjech, V Lánská

Vnitr Lek 1999, 45(4):210-216

The long-term efficacy and safety of fluvastatin monotherapy was compared with that of the combination of fluvastatin and fenofibrate in 104 patients with coronary heart disease and combined hyperlipidemia in an open, randomised, parallel group, clinical study of 78 weeks duration. Combined hyperlipidemia was defined as LDL-cholesterol 4.1 mmol/l and higher and triglycerides between 2.5 and 4.5 mmol/l after 8 weeks of dietary intervention. The patients were treated with either fluvastatin 40 mg daily or with the combination of fluvastatin (20 mg daily) and micronized fenofibrate 200 mg daily. Mean values of total and LDL-cholesterol decreased by 19.3%...

[Serum levels of zinc, copper and selenium in patients with Wilson's disease treated with zinc].

M Dastych

Vnitr Lek 1999, 45(4):217-219

Zinc administered on a long-term basis in excess to patients with Wilson a disease blocks in a significant way copper absorption from the gut, prevents its accumulation and toxic action in the organism. The authors investigated the effect of its long-term administration on the plasma concentration of copper, zinc, and selenium, on the superoxide dismutase activity in red blood cells and glutathione peroxidase activity in whole blood. In seven patients with Wilson a disease treated with zinc sulphate, 136 mg of elemental zinc for 1.5 years (18 months), the authors assessed the plasma concentration of zinc, copper, selenium and ceruloplasmin, the activity...

[Pregnancy in patients with hereditary spherocytosis].

V Brabec, J Cermák, K Petrtýlová, P Jarolím

Vnitr Lek 1999, 45(4):220-223

The influence of pregnancy on the course of hereditary spherocytosis was investigated in 21 women during their 44 pregnancies. Fourteen pregnancies were followed up directly, 30 were evaluated from anamnestic data. In the majority of investigated women with hereditary spherocytosis pregnancy caused no problems. When complications developed, they were not serious as a rule. Only about one third of pregnancies in non-splenectomized women developed anaemia or anaemia deteriorated. In the latter enhanced haemolysis participated. In splenectomized patients the incidence of complaints was minimal.

[Pregnancy after kidney transplantation].

M Horcicková, I Reneltová, M Símová, J Jirka, J Lácha, V Lánská, B Budínská, M Dvorák

Vnitr Lek 1999, 45(4):224-227

In the period 1966-1997 renal allografting was performed in 1746 recipients, 244 of whom were women in fertile age. In 32 of them 45 pregnancies were registered. 29 of them (64%) resulted in abortion, which was spontaneous in 4 and medically advised in 25. There were 16 labours, 4 of them free of any complications; of the latter, hypertension was the most frequent one (8). Of the former, 13 were solved by caesarean section and 3 were vaginal deliveries. Of 15 live babies 7 were immature (one died 1.5 year later of renal failure due to microcystic kidneys). No unfavourable effect of pregnancy on prognosis and on long-term graft function was found.

[Conn's syndrome and severe arrhythmias].

J Pella, I Lazúrová, B Javorská, D Trejbal

Vnitr Lek 1999, 45(4):228-231

In the submitted case-history the authors describe Conn's syndrome. A solitary cortical adenoma was involved manifested at first by so-called "lone" atrial fibrillation (idiopathic without organic causes). The trigger factor of the life threatening ventricular tachycardia were variable values of serum potassium and treatment of atrial fibrillation by anti-arrhythmic drugs.

[Endothelial dysfunction and arterial hypertension].

Z Marecková, S Heller, K Horký

Vnitr Lek 1999, 45(4):232-237

The endothelium lines all blood vessels in the human body, it is the basic structure which ensures the action of substances circulating in the blood stream on the vascular wall. It is an organ the sound state of which is essential for the physiological function of the vascular system. Its impaired function is a basic factor in the genesis and development of vascular disease. Under physiological conditions the endothelium has antiadhesive and antithrombotic properties, it produces vasoactive substances, prevents the penetration of circulating substances and formed elements across the vascular wall, and via adhesion molecules it participates in the interaction...

[New cytokines and their role in supportive care].

P Klener, M Trněný

Vnitr Lek 1999, 45(4):238-242

Several cytokines stimulating hematopoiesis, mainly lineage restricted, are already widely used in supportive care to correct myelosuppression or anaemia (GM-CSF, G-CSF, EPO). The new growth factor are tested in preclinical or clinical studies to abrogate other anti-cancer therapy side-effects (thrombocytopenia, mucositis etc.). IL-3 has been shown to have only limited effect on neutrophils and platelets production respectively. IL-6 and IL-11 have been tested to improve thrombocytopenia and mucositis (IL-11). Thrombopoetin (TPO, c-mpl) is tested in clinical trials and shows very strong effect on platelet counts. Stem cell factor (SCF) has shown to...

[Drug therapy of esophageal varices hemorrhage in portal hypertension].

J Lata

Vnitr Lek 1999, 45(4):243-247

The author discusses the etiopathogenesis of portal hypertension and possibilities how to influence it during treatment of acute haemorrhage from varicosities and how to implement primary and secondary prevention. In treatment of acute haemorrhage the author recommends terlipresin, 1 mg every 4 hours. In primary and in particular in secondary prevention he emphasizes the necessity of early administration of beta-blockers.

[Renaissance of fluorides and calcium in the treatment of osteoporosis].

J Kocián

Vnitr Lek 1999, 45(4):248-250

After the initial enthusiasm for fluorides in the treatment of osteoporosis there was a regression after some time and a "campaign" against fluorides. Recently in particular after the introduction of monofluorophosphate instead of NaF there is a revival of the use of fluorides in the treatment of osteoporosis, along with Ca, vitamin D and exercise as the classical combination of four. This can be supplemented by HRT in women, thyrocalcitonin, alendronate and other drugs with individual consideration of the optimal combination of these drugs. Also in future fluorides remain the foremost representative of the group of agents stimulating new formation of bone.

[The concept of internal medicine and its subspecialties at the end of the 2nd millennium. An open letter to members of the Czech Internal Medicine Society].

K Horký

Vnitr Lek 1999, 45(4):251-252

The making of an internist: an European view.

R A Streuli

Vnitr Lek 1999, 45(4):253-257

[What will internal medicine look like in developed countries in the 21st century?].

P Widimský

Vnitr Lek 1999, 45(4):258-259