Vnitřní lékařství, 1999 (vol. 45), issue 7
[Changes in left ventricular function during chemotherapy with doxorubicin].
L Elbl, V Chaloupka, I Vásová, I Kiss, J Jancík, J Vorlícek, M Navrátil
Vnitr Lek 1999, 45(7):395-402
The authors investigated by echocardiography changes of left ventricular function in 79 patients with non-Hodgkin lymphoma or Hodgkin's disease who were treated by chemotherapy containing doxorubicin. In 22% patients they diagnosed during treatment a significant gradual decline of the left ventricular ejection fraction (change > 10% or a drop of EF below 50%) after a cumulative dose of 185 +/- 52 mg/m2 doxorubicin (median 200 mg/m2). Changes of the ejection fraction were at the expense of an increasing endsystolic left ventricular volume. These changes correlated closely with the increase of endsystolic stress of the left ventricular wall (r = -0.87)....
[The Ewing test for autonomic neuropathy and spectral analysis of heartrate variability aid in the diagnosis of Charcot's osteoarthropathy].
A Jirkovská, P Boucek, J Pumprla, J Hosová, J Skibová, V Wosková
Vnitr Lek 1999, 45(7):403-408
UNLABELLED: The objective of the work was to evaluate the contribution of examining autonomic neuropathy in diabetic patients to early diagnosis of Charcot's osteoarthropathy by classical Ewing's tests, as well as the more recent method--spectral analysis of heart rate variability. The authors examined 18 diabetic patients in the early stage of Charcot's osteoarthropathy and the results were compared with a group of 30 subjects matched for age and sex. The results of examination by Ewing's test (heart rate variability during deep breathing, in orthostasis and during Valsalva's manoeuvre and blood pressure changes during orthostasis) revealed autonomic...
[Treatment with interferon and autoimmunity].
A Gaja, H Franková, I Kocák, J Slapnicková, N Hejlová
Vnitr Lek 1999, 45(7):409-413
Interferons are commonly used, frequently already as a standard drug, in a relatively wide spectrum of indications in tumourous and non-tumourous diseases. The numerous undesirable therapeutic effects include also relatively frequent induction of autoimmune processes which, however, only rarely is associated with marked clinical manifestations. The author presents an account on two patients from their own clinical practice treated with interferon alpha who developed complications which in the author's opinion may be associated with autoimmunity (a patient with thrombocytopenia responding well to immunosuppressive treatment, originally treated on a...
[A patient with Madelung's disease at the internal medicine department].
M Doubek, M Tomíska
Vnitr Lek 1999, 45(7):414-417
Madelung disease, benign symmetrical lipomatosis, is a rare disorder of unknown etiology. It is characterized by the accumulation of fat deposits around the neck and upper body. It is often associated with glucose intolerance, liver disease, and malignant tumors of the lungs. This disease normally affects middle-aged males with a history of alcohol abuse. Surgical removal of the lipomatose mass is the treatment of choice. A case of Madelung disease in a 53-year old man with hepatopathy and respiratory failure is presented.
[Fulminant liver failure as a sequelae of acute dystrophy of the right hepatic lobe].
Z Frysák, Y Hrcková, I Sisola, P Navrátil, J Lukl
Vnitr Lek 1999, 45(7):418-420
A 38-year-old female patient developed signs of fulminant hepatic failure, caused by extensive, spontaneous, devastating ischaemia of the right liver lobe. The patient survived the acute attack. During the subsequent eight years hypertrophy of the intact left liver lobe occurred which eventually completely replaced the loss of the dominant right lobe.
[Hypertrophy of the left ventricle--etiopathogenesis, clinical consequences and prognosis].
M A Ghanem Wisam, J Murín, J Bulas
Vnitr Lek 1999, 45(7):421-428
The left ventricular hypertrophy is a risk marker of the cardiovascular morbidity and mortality in hypertensive patients--it contributes to sudden death, myocardial infarction, myocardial ischemia, heart failure, arrhythmias, left ventricular diastolic dysfunction, stroke and renal failure. The mechanisms by which the heart hypertrophy increases the risk of cardiovascular morbidity and mortality, however, is not completely clear yet. Pressure overload (resulting in the concentric hypertrophy) and volume overload (resulting in the eccentric hypertrophy) of the left ventricle play a significant role in the development of the hypertrophy of the left ventricle....
[Non-invasive detection of failure of thrombolysis in acute myocardial infarct].
J Kovác
Vnitr Lek 1999, 45(7):429-432
Despite advances in thrombolytic treatment of acute infarction in a major proportion of patients occasionally despite its administration reperfusion of the heart muscle does not occur which implies a negative impact on the long-term prognosis of these patients. With regard to the fact that invasive diagnostic methods are not available in the field, the basis of non-invasive diagnosis and stratification of patients for further reperfusion treatment is assessment of the symptomatology (chest pain) and frequent controls of 12-lead ECG, although controlled trials evaluating their validity for decisions in acute situations are not quite unequivocal. With...
[Vasoneuroses].
J Pi»ha, I Oliva
Vnitr Lek 1999, 45(7):433-437
The term vasoneuroses comprises functional disorders of peripheral vessels, in particular arterioles, manifested by vasospasms on the periphery of the upper and lower extremities, more rarely the nose and ears. The main representant of these diseases is a disorder manifested by episodic attacks of ischaemia of the fingers, in particular of the upper extremities--Raynaud's phenomenon (RP) which has two forms: primary RP (Raynaud's disease) where no other basic disease is diagnoses during a two-year period. secondary RP (Raynaud's phenomenon) as an associated symptom of other, in particular systemic diseases. The etiology and pathology of Raynaud's phenomenon...
[Present status of fibrates in the treatment of hyperlipoproteinemias].
V Soska
Vnitr Lek 1999, 45(7):438-440
Fibrates are hypolipaemic agents with a broad spectrum of action and long-term safety. They reduce the cardiovascular mortality and morbidity and can induce also regression of coronary atherosclerosis. They lower the plasma concentration of total and LDL-cholesterol, triacylglycerols, and produce a rise of HDL-cholesterol. Moreover they can reduce the level of fibrinogen, lipoprotein/a/, PAI-1, uric acid and the concentration of highly atherogenic small dense LDL3. Their effect is mediated by activation of "peroxisome proliferator-activated receptors" (PPARs) in the cell nucleus. At present we find on the market second generation fibrates as well as...
[Micronized fenofibrate and LDL-cholesterol subfractions].
V Soska
Vnitr Lek 1999, 45(7):441-443
LDL-cholesterol subfractions have a different atherogenity; the most atherogenic are small LDL3 called small dense LDL. A clear relationship was proved between their concentration and early manifestation of ischaemic heart disease. In some instances they were found to act as an independent risk factor of cardiovascular disease. Their concentration depends to a great extent on the triacyglycerol concentration. They are found most frequently in patients with combined hyperlipidaemia, in associated metabolic syndrome and in patients with type 2 diabetes mellitus. Their plasma concentration can be reduced by non-pharmacological methods (restriction of...