[Stem cell transplantation for paroxysmal nocturnal hemoglobinuria].

J Cermák, A Vítek, I Marinov, M Písacka, V Brabec

Vnitr Lek 2000, 46(6):319-322

Paroxysmal nocturnal hemoglobinuria (PNH) represents a rare clonal disorder of hematopoiesis clinically characterized by acquired hemolytic anemia, intravascular hemolysis, hemoglobinuria and frequent occurrence of venous thrombosis. Stem cell transplantation is indicated in patients with severe bone marrow aplasia, repeated massive hemolysis or recurrent life threatening thrombotic complications. Almost 90 transplanted patients with PNH have been published. We report a case of successful allogeneic peripheral blood stem cell transplantation performed in a 24 years old woman with a severe form of PNH with frequent episodes of massive intravascular...

[Dual-photon bone densitometry in dialyzed patients].

A Jaros, M Budíková, J Bartek, J Zadrazil, K Konecný, K Krejcí, P Vrublovský, J Zahálková, Z Kosatíková

Vnitr Lek 2000, 46(6):323-327

In non-invasive diagnosis of renal osteodystrophy the levels of bone minerals and the extent of bone turnover are evaluated. The contents of bone minerals are assessed quantitatively by different modalities of bone densitometry, among which the most accurate one is double-energy bone densitometry. So far no standard examination method was defined nor the most suitable portion of the skeleton for densitometric examination. In order to find such an area and also to assess the prevalence of bone demineralization, its severity and regional differences the authors made a cross-sectional study of bone density in dialyzed patients. The group comprised 45...

[Long-term monitoring of patients with a syncope of obscure etiology with an implantable monitoring device].

J Kovác, J D Skehan

Vnitr Lek 2000, 46(6):328-331

INTRODUCTION: Generally available methods for the diagnosis of syncopal conditions such as Holter monitoring, the tilt test and invasive electrophysiological examinations, lead to the assessment of the cause of sporadic syncopes only in some patients. The implantable monitoring device REVEAL protracts significantly the monitoring period.METHODS, RESULTS: The authors implanted the implantable monitoring device REVEAL in the course of 14 months to 19 patients with syncopes of obscure origin. During this period it was possible to prove the cause of the syncope in a total of 10 patients (53%), in 8 patients the cause was arrhythmia, in another two...

[Abdominal obesity and cardiovascular risk in type 2 diabetics].

J Válek, O Stiebler, M Stieblerová, E Vorlová, M Pípalová, V Skoda, R Cernín, M Kaftanová, H Jerábková, M Pavlousková, L Válková

Vnitr Lek 2000, 46(6):332-336

A group of 247 middle-aged men and women with diabetes lasting mostly for less than 5 years, treated by diet alone and oral antidiabetics resp. is followed up in the surgeries of nine general practitioners, with special attention to early detection and prevention of macroangiopathies. In the submitted paper the authors focus their attention on the body build of patients and the importance of assessment of abdominal adipose tissue by available anthropometric methods. The patients were obese, mostly with abdominal accumulation of adipose tissue. As to indicators of abdominal obesity in particular the waist circumference and waist/hip ratio proved useful...

[Irbesartan in the treatment of arterial hypertension].

J Widimský, J Zizka, T Haas

Vnitr Lek 2000, 46(6):337-340

Irbesartan (Aprovel) belongs into the new group drugs for the cardiovascular system which exert an antagonistic effect at the level of angiotensin II, but experimental pilot studies as well as clinical studies draw also attention to the possible therapeutic potential of AT1 receptor blockers in the treatment of chronic heart failure. Irbesartan has a marked antihypertensive effect as is apparent from a recent clinical study in 139 patients with mild and moderate hypertension--implemented in the Czech Republic. Twelve-week treatment with Irbesartan led to a marked drop of the systolic and diastolic blood pressure (159.2 +/- 14 vs. 137 +/- 13 mmHg/99.2...

[Possibilities in the diagnosis of Helicobacter pylori].

M Kopácová, J Bures, V Vorísek

Vnitr Lek 2000, 46(6):341-346

The authors present an overview of current possibilities of the diagnostics of Helicobacter pylori (HP) focused on non-invasive methods. The overview is based on author's own experience and studying of applicable literature. Non-invasive methods (endoscopy is not needed) include serology (blood tests) and breath tests. Both methods are compared one with the other (and with invasive methods as well) not only from the point of view of sensitivity and specificity, but especially from the point of view of their practical use and correct indication of their use. 13C urea breath tests are non-invasive global tests with 100% reproducibility, high sensitivity...

[An unusual case of primary hyperparathyroidism in a woman with Gorlin-Goltz syndrome].

I Zofková, M Kuklík, Z Novák, J Betka, V Dorazilová

Vnitr Lek 2000, 46(6):347-349

Nevoid basal cell carcinoma syndrome (NBCCS) has been known to coincide with different forms of other neoplasias; however, parathyroid adenoma in this syndrome has not previously been described. The authors report a case of such association in a 50-year old white woman. The adenoma was verified before operation by biochemical, isotopic and cytologic methods and later, after the excision of adenoma, histologically.

[Percutaneous rescue transluminal coronary angioplasty].

A Herman, I Varvarovský, V Rozsíval, J Sťásek, P Cervinka, M Brtko, D Cernohorský

Vnitr Lek 2000, 46(6):350-353

Rescue angioplasty is an operation performed in the acute stage of myocardial infarction where systemic thrombolysis did not lead to opening of the artery. Investigations made in recent years indicate the benefit of rescue angioplasty only in those patients where the infarcted artery is patent several hours after evidence that thrombolysis failed. At the same time they provide evidence of the increasing safety and technical success of the operation. The authors present a brief review of the literature pertaining to the development of views, and emphasize the need of early and correct indication.

[Effect of free radicals and antioxidant on the vascular wall].

E Ginter

Vnitr Lek 2000, 46(6):354-359

Free radicals pay an important role in the pathogenesis of atherosclerosis by their direct toxic action on the vascular endothelium as well as by antioxidant of low density lipoproteins (LDL) which subsequently increase their atherogenic potential. Natural antioxidants interrupt the chain-like increase of radicals and thus also the risk of oxidation stress. The majority of epidemiological data indicate that an increased intake of fruit, vegetables and other foods of plant origin reduces the risk of cardiovascular disease. On the other hand, several so far not completed long-term intervention studies with some antioxidant vitamins (e. g. vitamin E,...

[Non-steroidal antiinflamatory drugs in the elderly].

S Krajcík, I Bartosovic

Vnitr Lek 2000, 46(6):360-364

Significance of non-steroidal antiinflammatory drugs treatment becomes more pronounced due to population ageing because these drugs are used by the elderly very frequently. The causes of the increased adverse effects of non-steroidal antiinflammatory drugs in old age (e.g decreased production and effectivness of prostaglandins, decreased nitrogen oxide production and decreased pain sensation) are analysed. New explanation of the the action are discussed too. Some new potential indications (e.g. Alzheimer disease, tumor prevention and modification of cellular immunity impairment caused by ageing) are reviewed.

[Treatment osteoporosis 1999].

J Kocián

Vnitr Lek 2000, 46(6):365-367