[The concept of internal medicine as a profession].

K Horký, L Kotík, S Alusík

Vnitr Lek 2000, 46(3):139-147

[Dual endopeptidase inhibitors--a new direction in the development of hypertensive agents].

K Horký

Vnitr Lek 2000, 46(3):148-151

Endogenous peptidases participate in a major way in the formation of peptide pressor substances such as angiotensin II (A II) and endothelin (ET) as well as in the degradation of depressor substances, e.g. atrial natriuretic peptide (ANP) or bradykinin. They include on the one hand the angiotensin converting enzyme (ACE) and endothelin converting enzyme (ECE), on the other hand kinase II for bradykinin and neutral endopeptidase 24.11 (NEP) for ANP. Inhibition of these enzymatic reactions leads to a decline of vasopressors A II and ET and conversely delays the break-down of vasodilatating bradykinin and ANP. The main haemodynamic consequence of this...

[The new atherogenic plasma index reflects the triglyceride and HDL-cholesterol ratio, the lipoprotein particle size and the cholesterol esterification rate: changes during lipanor therapy].

M Dobiásová, J Frohlich

Vnitr Lek 2000, 46(3):152-156

The new atherogenic plasma index (AIP) is a logarithmic transformation of the ratio of the molar triglyceride (TG) concentration and high density lipoprotein cholesterol (HDL-C). AIP correlates closely with the size of LDL particles (r = 0.8) and esterification rate of plasma cholesterol devoid of apo B lipoproteins (FERHDL), r = 0.9 which are considered at present the most sensitive indicators of the atherogenic plasma profile. AIP was recommended by the authors, based on analysis of results of 11 previous studies (1156 subjects) where FERHDL and plasma lipid parameters were investigated in different groups of people who differed as to the atherogenic...

[Ciprofibrate in the treatment of combined hyperlipoproteinemia. Results in more than 600 patients from 23 centers in the Czech Republic].

R Ceska, T Kvasnicka, T Haas, V Soska, H Vaverková

Vnitr Lek 2000, 46(3):157-160

A total of 633 patients with combined hyperlipoproteinaemia from 23 centres in the Czech Republic met the criteria for assessment of the effectiveness of 3-month administration of 100 mg ciprofibrate (Lipanor) per day. The cholesterol concentration declined from the original values of 6.94 mmol/l by 13%. The drop of triglycerides was even more significant from 3.03 mmol/l by more than 41%. The relatively low HDL cholesterol at the beginning, 1.14 mmol/l, increased by 15%, while LDL-cholesterol dropped significantly by almost 12%. The classical atherogenic index expressed by the ratio of total/HDL cholesterol declined by 25%. Treatment was very well...

[Beta-blockers in the treatment of chronic heart failure. How should results of clinical studies be introduced into clinical practice].

J Vítovec, J Spinar

Vnitr Lek 2000, 46(3):161-165

The long-term action of elevated catecholamine concentrations on the heart muscle causes a number of adverse effects from apoptosis to malignant arrhythmia or terminal failure of the cardiac pump. Recently completed mortality studies with beta-blockers (BB) in chronic heart failure CIBIS II and MERIT HF confirmed the conclusions of pilot studies with carvedilol that in stabilized chronic heart failure BB reduces the mortality rate as well as the need of hospital admission on account of deteriorating heart failure. Proper selection of patients for administration of BB is necessary, assessment of absolute and relative contraindications. It is also necessary...

[Angiotensin I converting enzyme: what results from new findings] .

Y Pospísilová, Y Brychtová

Vnitr Lek 2000, 46(3):166-169

Angiotensin I converting enzyme (ACE) participates not only in the regulation of the extracellular fluid volume and blood pressure but also in the control of proliferating processes in the human organism. The favourable effect of ACE inhibitors in the treatment of essential hypertension may be caused also by their antiproliferative effect. The development of essential hypertension is probably of polygenic origin. The gene for ACE, and its alleles encountered commonly in the population is involved in the pathophysiology of systemic hypertension by acting on the dynamic properties of processes in the organism which regulate changes of the extracellular...

[IgG subclasses and autoantibodies in adult patients with selective IgA deficiency].

J Litzman, D Bartonková, Z Pikulová, A Pazdírková, I Sevcíková, J Lokaj

Vnitr Lek 2000, 46(3):170-173

Selective IgA deficiency is the most common primary immunodeficiency disease, but the etiopathogenesis is unknown. In a portion of patients disturbed IgA production is accompanied by various immunological abnormalities. Serological laboratory results of 30 female and 22 male adult patients with selective IgA deficiency were compared with sex- and age-matched healthy controls. Hypergammaglobulinemia IgG was observed in 31 patients and only in 2 control persons. Serum IgG1 was increased in 12 and/or IgG3 in 18 patients, the increase in IgG2 was less common (6 persons). The number of persons with increased IgE did not differ from the control group. The...

[Chronic heart failure in the aged].

J Bruthans

Vnitr Lek 2000, 46(3):174-177

Ageing of the population, advances in the treatment of cardiovascular diseases and in the treatment of chronic heart failure cause a rapid increase of the prevalence of chronic heart failure in the population and of the number of hospital admissions on account of this diagnosis. The majority of patients with chronic heart failure are over 65 years and their ratio is increasing. The diagnosis clinical course and treatment of old patients with chronic hearth failure has specific features which become more marked with advancing age. As a role other associated diseases are present as well as factor which cause deterioration of chronic hearth failure, complicate...

[Cardiotoxicity of antineoplastic therapy].

L Elbl, I Vásová, I Kiss, V Chaloupka, H Kubesová, J Vorlícek

Vnitr Lek 2000, 46(3):178-183

Cardiotoxicity is a serious complication of anti-tumorous treatment. Cytostatics can cause a number of undesirable side-effects such as arrhythmias, angina pectoris, acute myocardial infarction, sudden death, cardiac failure. The probably most serious cardiotoxicity is chronic cardiac failure after treatment with anthracyclines. Interest in the diagnosis, monitoring and treatment of cardiotoxicity revealed new findings of cardiac complications after various cytostatics, high-dosage chemotherapy and transplantation of haematopoietic cells. Prospective paediatric studies provided evidence of the serious character of late cardiotoxicity of anthracyclines....

[Principles of conservative treatment in chronic pancreatitis].

P Dítě, M Precechtělová, I Novotný, V Zboril, J Lata

Vnitr Lek 2000, 46(3):184-186

The authors summarize the principles of conservative treatment of chronic pancreatitis with special attention to treatment of exocrine pancreatic insufficiency and pancreatic pain. They emphasize the principles of the rational administration of drugs with pancreatin, the position of analgesics, and other possible procedures, if medicamentous treatment fails. An outline of dietetic treatment is also given.

[Geriatrization of internal medicine].

S Alusík

Vnitr Lek 2000, 46(3):187-188

The author draws attention to the need of more profound knowledge of geriatrics in the training of specialists in internal medicine. He draws attention to the ageing population, trends in advanced countries and planned enlistment of general specialists in internal medicine into primary care.