[Role of determination of QT dispersal intervals in anti-arrhythmia therapy].

P Konecná, R Dvorák, B Semrád

Vnitr Lek 1999, 45(8):453-456

In recent years attempts intensified to identify and treat patients with an increased risk of sudden cardiac death caused by malignant ventricular arrhythmias. An elevated dispersion value of the QT interval of surface ECG suggests non-homogeneous repolarization and thus the presence of an arrhythmogenic substrate. In patients with ischaemic heart disease and confirmed malignant arrhythmias after onset of antiarrhythmic therapy changes in the dispersion of the QT interval occur, depending on the antiarrhythmic agent used and the effectiveness of treatment. In the authors group of 40 patients the value of dispersion of the QT interval declined significantly...

[Sonographic measurement of intimal thickness of the common carotid artery in diabetics].

P Kraml, J Potocková, M Anděl, J Zvárová, M Stefek

Vnitr Lek 1999, 45(8):457-462

Incidence of atherosclerotic cardiovascular diseases in diabetics is known to be 2-4 times higher than in nondiabetic subjects. Intima-media-thickness of common carotid artery (IMT ACC) measured by B-mode sonography positively correlates with the severity of atherosclerotic changes in coronary arteries. This study compares sonographically assessed IMT ACC in patients with type 2 diabetes mellitus (27 patients, mean age 66.57 +/- 6.06 years) vs. 66 nondiabetic subjects (mean age 63.58 +/- 9.09 years). Intima-media thickness in diabetics was significantly higher when compared with the control group (0.826 +/- 0.29 mm vs. 0.647 +/- 0.26 mm). In the whole...

[Monitoring markers of bone turnover in multiple myeloma].

I Spicka, P Spacek, H Hulejová, B Procházka, P Cieslar, M Chrz, V Válková, P Klener

Vnitr Lek 1999, 45(8):463-467

PURPOSE: To assess the efficacy of bone turnover markers monitoring for prediction of overall survival and event-free survival in patients with multiple myeloma. To determine the value of initial measurement for differential diagnosis and evaluation of myeloma stage and activity.METHODS AND RESULTS: We evaluated 79 consecutive, previously untreated patients with myeloma and 24 with monoclonal gammopathy of undetermined significance. Urine excretion rates of pyridinoline (PYR) and deoxypyridinoline (DPYR) as markers of bone resorption and serum osteocalcin (OC) as marker of bone formation were measured at diagnosis and further repeatedly during...

[Clinical importance of determining levels of circulating transferrin receptors in blood].

J Cermák, V Brabec

Vnitr Lek 1999, 45(8):468-472

Circulating serum transferrin receptor level was measured using mouse monoclonal antibody against transferrin receptor (Orion Diagnostica, Finland) in 126 patients with various disorders of erythropoiesis and the results were compared to those obtained form control group consisted of 30 healthy volunteers with normal iron stores. Serum transferrin receptor level was significantly elevated in patients with iron deficiency and in all patients with hyperplastic erythropoiesis (hereditary spherocytosis, immune hemolytic anemia, beta thalassemia, myelodysplasia). Measurement of circulating serum transferrin receptor level was a sensitive indicator of iron...

[Vitamin D deficiency in hospitalized patients].

Z Killinger, J Payer, K Sládeková, M Kratochvíľová, P Ondrejka

Vnitr Lek 1999, 45(8):473-475

Vitamin D deficiency is one of the important risk factors for the development of osteoporosis and fractures. The high prevalence of hypovitaminosis in elderly people in old age pnesioners homes was proved in several investigations, similarly as the favourable effect of vitamin D (800 IU/day) and calcium supplementation on a decline of fracture risk. Risk factors of hypovitaminosis such as an inadequately varied diet; low exposure to sunlight, chronic liver and kidney disease and treatment affecting the metabolism and clearance of vitamin D are very frequent in elderly patients hospitalized in medical departments. In the submitted trial the authors...

[Salmon calcitonin in the treatment of osteoporosis].

J Payer, Z Killinger, P Ondrejka

Vnitr Lek 1999, 45(8):476-479

Salmon calcitonin is frequently used in the treatment of osteoporosis. Via specific receptors on osteoclasts it reduces bone absorption and has also an osteogenic effect. Treatment with calcitonin leads to an increase in bone density, drop of markers of bone turnover and reduction of risk fractures. In the submitted trial the authors investigated the influence of nasal calcitonin administered in amounts of 100 IU in three-month intervals, on bone density. The group comprised 59 patients, mean age 64 years. The mean period of treatment was 2.5 years. Treatment led to a significant increase of bone density in the region of the lumbar spine and neck of...

[Why evaluate the quality of life in patients with bronchial obstruction?].

F Salajka

Vnitr Lek 1999, 45(8):480-483

Quality of life, more precisely health related quality of life, is gaining basic importance in evaluating of patient's health status and results of medical interventions. On the example of patients with bronchial obstruction is demonstrated that quality of life evaluation, although not usually used in clinical practice yet, is in significant correlation with some of usual clinical measures; moreover, it brings otherwise inaccessible information about patient's subjective assessment of his disease and his health situation.

[The little known Fay syndrome (benign carotidynia)].

M Zuffa, I Rusnák, A Schóber, O Zuffová, M Oravec

Vnitr Lek 1999, 45(8):484-486

The authors describe the little known Fay syndrome (benign carotidynia, extracranial vascular cephalea). They emphasize the importance of a careful case-history (in particular sore throat--usually unilateral), with careful physical examination (palpation sensitivity of the carotid artery beneath the bifurcation). The authors assume that the syndrome is not as rare but that it is rarely correctly diagnosed. The drug of choice are non-steroid antirheumatic drugs. The authors describe in an epicritical manner eight of their own observations made during the last three years.

[Leukemic transformation of polycythemia vera after treatment with hydroxyurea and chromosome 17 abnormalities].

E Tóthová, E Nebesnáková, A Kafková, N Stecová, M Fricová

Vnitr Lek 1999, 45(8):487-489

The authors present two patients with polycythemia vera where they recorded after several years' treatment with hydroxyurea development of acute myeloblastic leukaemia. In both instances they found, associated with leukaemia, abnormalities of chromosome no.17, in one case meeting criteria of the so-called 17p-syndrome. Progression of polycythemia vera into acute leukaemia is explained by the possible association with the long-term use of the drug and loss of chromosomal material (short arm of chromosome 17), the part where genes important in the process of leukaemogenesis are located. The authors draw attention to contemplated long-term administration...

[Drug interactions in coumarin anticoagulation].

P Kessler

Vnitr Lek 1999, 45(8):490-495

The clinically most important negative properties of coumarin anticoagulants are their numerous interactions with other drugs. Data in the literature on these interactions are frequently controversial. The causes of this phenomenon are a) the complicated path from ingestion of anticoagulants to their clinical effect and laboratory results, b) interindividual differences in enzyme activity participating in vitamin K metabolism, in the synthesis of hemocoagulation factors and in the biotransformation of coumarin derivatives, c) the different clinical state of the patient on the one hand and the healthy volunteer on the other, d) differences in the biotransformation...

[Population screening for colorectal carcinoma by examining feces for occult hemorrhage].

D Musil

Vnitr Lek 1999, 45(8):496-499

Colorectal carcinoma is in the western world one of the most frequent deaths from malignant disease. A reliable way how to reduce the mortality from this disease is early diagnosis by screening in the population, the most suitable method being examination of the faeces for occult bleeding. During the last five years in the world literature results of several long-term and well elaborated studies were published focused on screening of colorectal carcinoma by detection of occult haemorrhage in the faeces. There were three American and four European papers from which ensued: 1. In the examined population in the mentioned investigations a reduction of...

[Assessment of risk for the development of manifest atherosclerosis and indications for hypolipidemic therapy (global risk assessment)].

D Stejskal, R Pastorková, D Horalík, I Oral

Vnitr Lek 1999, 45(8):500-502

The estimated risk of development of complications of atherosclerosis (coronary or cerebral ischaemia) is one of the activities every physician should include in the diagnostic and therapeutic algorithm. Treatment with hypolipidaemic agents is indicated according to the European consensus if the danger of a coronary or cerebral event is 20%/10 years. The objective of preventive provisions should be reduction of this risk to < 5%/10 years in younger subjects (< 45 years in men and < 50 years in women) and < 10%/10 years in elderly subjects. These recommendations obviously do not apply to secondary prevention (in case of complications of...

[The first 100 liver transplantations in Brno].

J Cerný, P Nĕmec, J Nicovský, J Ondrásek, J Benedík, P Studeník, J Hökl, M Kuman, M Simková, R Wagner, M Haslingerová, P Pavlík, O Janícková, V Korístek

Vnitr Lek 1999, 45(8):503-505

[Is the existence of integrated internists necessary and why?].

J Hrnciar

Vnitr Lek 1999, 45(8):506-508