[The impact factor].

P Svacina

Vnitr Lek 2002, 48(8):693-694

[Acetylsalicylic acid and ACE inhibitors in heart disease--a phenomenon in dogs and cats?].

J Bělohlávek, M Aschermann

Vnitr Lek 2002, 48(8):695-697

[Acetylsalicylic acid--is everything clear? Probably not].

M Penka

Vnitr Lek 2002, 48(8):698-700

[Treatment of hypertension in diabetics with trandolapril, an angiotensin converting enzyme inhibitor--a multicenter study].

H Rosolová, F Cech, F Sefrna

Vnitr Lek 2002, 48(8):701-706

Subjects with diabetes mellitus (DM) are high-risk patients because of the cardiovascular morbidity and mortality. A one-year open clinical prospective study took place in 7 centres in the Czech and Slovak Republic in 1996-1997. Aim of the study was treatment of hypertension in patients with DM of both types by the ACE inhibitor trandolapril in dose of 2-4 mg, possibly in combination with the calcium channel blocker verapamil--240 mg. The investigation was completed by 79 patients (60 patients with DM type 2 and 19 with DM type 1). All patients achieved the target blood pressure which in 1997 was also for patients with DM less than 140/90 mm Hg. As...

[Therapeutic results and changes in prognosis in patients with multiple myeloma in central and northern Moravia over the past 40 years].

V Scudla, J Bacovský, K Indrák, V Koďousková, M Vytrasová, E Faber, T Papajík, V Vavrdová, Z Adam, R Hájek, V Farbiaková, K Srovnalík, L Novosadová, M Vránová, M Micaníková, E Sumná, B Kuca, J Slezar, V Heincová, J Gumulec, J Zivná, P Schlemmer, E Lautnerová, Z Lasota, M Kubecková, I Krajsová, M Růzicka, K Cíhal, A Martínek, B Cernosek, J Doubravský, J Papajík, P Prodělal

Vnitr Lek 2002, 48(8):707-717

OBJECTIVE: The objective of the investigation is evaluation of therapeutic results and the development of the prognosis of patients with multiple myeloma (MM) as a result of consecutive changes of therapeutic procedures in patients of central and northern Moravia in the course of the last 40 years.METHODS AND RESULTS: The analyzed group of 562 patients with MM was concentrated at the Ist and IIIrd Medical Clinic of the Faculty Hospital Olomouc in 1959 - 2000, median age 63 (28-91) male/female ratio 1.1: 1.0. From analysis of Kaplan-Meier survival curves and the results of statistical analysis (log rank test p = 0.0000) ensued that during the...

[Is mild essential hypertension without obvious organ complications and risk factors associated with increased levels of circulating markers of endothelial dysfunction? Effect of ACE inhibitor therapy].

Z Hlubocká, V Umnerová, S Heller, J Peleska, A Jindra, M Jáchymová, J Kvasnicka, M Aschermann, K Horký

Vnitr Lek 2002, 48(8):718-723

The objective of the investigation was to assess whether circulating adhesion molecules, von Willebrand factor (vWf) and endothelin-1 are elevated in patients with mild uncomplicated essential hypertension without further risk factors of atherosclerosis and whether they could serve as indicators of endothelial dysfunction in this form of hypertension. Furthermore the authors investigated the effect of ACE inhibitor treatment (ACEI), quinapril, on the level of these markers of endothelial dysfunction. The level of adhesion molecules [intercellular cytoadhesion molecule-1 (ICAM-1), E-selectin, P-selectin], von Willebrand s factor (vWf) and endothelin-1...

[Efficacy and tolerance of rilmenidine in patients with mild to moderate hypertension. Results of a Czech and Slovak 6-month multicenter study].

J Widimský

Vnitr Lek 2002, 48(8):724-729

AIM OF THE STUDY: To evaluate the efficacy and tolerability of rilmenidine (Tenaxum) in the dose of 1-2 mg in patients with mild to moderate hypertension.GROUP OF PATIENTS AND METHODS: 243 patients (53% men, 47% women, mean age 52 +/- 11 years with mild to moderate essential hypertension were included into the study. Several cardiovascular risk factors for CAD were reported in the investigated group of patients: dyslipidaemia in 54%, obesity in 29%, diabetes mellitus in 14% and smoking in 17% of subjects. 87% of patients were subjects with newly diagnosed untreated or shortly (< 3 months) treated hypertension. In remaining hypertensives the...

[Implantation of coronary stents in reperfusion therapy in acute myocardial infarct].

P Kala, M Poloczek, O Bocek, P Jerábek, P Neugebauer, J Kosová

Vnitr Lek 2002, 48(8):730-735

BACKGROUND: Primary coronary angioplasty was accepted as a method of choice in the reperfusion treating strategy of the ST elevation acute myocardial infarction. Since 1995, when the very good results of the stent implantation in patients with acute myocardial infarction were published, there has been a general trend to more stenting also in the Czech Republic.AIM: The analysis of the effectivety and safety of the coronary stent implantation in acute myocardial infarction.METHODS: Prospective analysis of the patients with ST elevation acute myocardial infarction treated with primary coronary angioplasty with one coronary stent implantation...

[Glycoprotein IIb/IIIa platelet blockers in acute myocardial infarct treated with primary coronary angioplasty].

P Kala, M Poloczek, O Bocek, P Jerábek, P Neugebauer, J Kosová, B Semrád

Vnitr Lek 2002, 48(8):736-741

BACKGROUND: Primary coronary angioplasty is at present accepted as the most effective reperfusion treatment strategy of the ST elevation acute myocardial infarction. The optimum approach appears to be combination of the interventional technique (mechanical reperfusion) with aggressive pharmacological treatment aimed at the platelets. Intravenous blockers of the glycoprotein receptors IIb/IIIa together with acetylsalicylic acid have the additive antiaggregant effect and are used more frequently as adjunctive therapy by coronary interventions in patients with acute coronary syndromes and the acute myocardial infarction.AIM: The assessment of safety...

[Use of a health insurance company database for study of theoretical exposure to hypolipidemic agents].

J Vlcek, M Kocová, Z Kucera, K Macek, Z Vitásek, D Ulmanová

Vnitr Lek 2002, 48(8):742-748

OBJECTIVE: The objective of the investigation was to analyze theoretical exposures to hypolipidaemics in patients treated chronically with these drugs, using the database of the health insurance company.INVESTIGATED GROUP: From the database (with information on age, sex of the insured person, the number of packages and the type of hypolipidemic and year of issue of the prescription) of subjects insured at the Employees Health Insurance Skoda Mladá Boleslav comprising some 100,000 insured subjects in 1994-2000. Patients with long-term (more than one year) hypolipidaemic treatment were selected in years from 1995 to 1999. The group increased every...

[Relation of polymorphism of genes controlling endothelial function and blood pressure and the occurrence of vascular complications in type 2 diabetes].

D Mosorjáková, L Kyslanová, M Kozárová, I Tkác

Vnitr Lek 2002, 48(8):749-754

Genetic polymorphisms of factors regulating the function of endothelium and blood pressure are recently intensively studied also in type 2 diabetes because endothelial dysfunction and arterial hypertension are risk factors of atherosclerosis. The following review deals with relations of polymorphisms in the renin-angiotensin-aldosterone (RAAS) system, polymorphisms of NO-synthase (NOS) as well as the gene for atrial natriuretic peptide (hANP). So far most information was assembled on the influence of polymorphisms of RAAS genes, in particular the gene coding the angiotensin converting enzyme (ACE), on complications of type 2 diabetes. A relationship...

[Role of cytokines in the development of local and systemic inflammation and septic shock].

M Bucová

Vnitr Lek 2002, 48(8):755-762

A central position in the development of systemic inflammation is played by activation of the vascular endothelium and monocyte- macrophage system. Both are associated with the formation of inflammatory cytokines, the primary mission of which is mobilization of the organism to cope with the infection. The so-called acute stage response develops with typical clinical manifestations and laboratory values. When it is impossible to stop the inflammation the syndrome of systemic inflammatory response develops with excessive activity of inflammatory cytokines and immune mechanisms. This apparently favourable system can be highly toxic for the organism and...

[The SEN virus--will there be another letter in the alphabet of viral hepatitis?] ].

P Husa, P Chalupa, L Husová

Vnitr Lek 2002, 48(8):763-766

The SEN virus (SENV) is a small nonenveloped single-stranded DNA virus which is probably a circovirus. By phylogenetic analysis it is possible to differentiate genotypes SENV A-H. The pathway of transmission of infection is not known so far but the infection by this virus is frequent in recipients of blood transfusions and liver grafts and in intravenous drug addicts. This suggests possible parenteral transmission of infection. Other routes of transmission of the infection are also possible as the virus can be detected also in a significant proportion of young subjects without the risk of parenteral infection in the case-history. Whether SENV causes...

[The significance of aldosterone in chronic heart failure: the RALES study].

F Simko, V Bada, M Simková, J Simko, L Kovács, I Hulín

Vnitr Lek 2002, 48(8):767-772

Reduction of excessive neurohumoral activation in chronic heart failure (CHF) improves the prognoses. In addition to reduction of angiotensin production or angiotensin II action and the influence of the sympathoadrenal system also blocking of aldosterone effects becomes part of the therapeutic procedure in patients with CHF. Excessive systemic and probably also local aldosterone production promotes undesirable fluid retention, hypokalaemia and hypomagnesaemia, induction of hypertrophy and fibrosis of the heart muscle and blood vessels and the development of endothelial dysfunction, peripheral vasoconstriction and depression of the baroreflex. In addition...

[Diagnosis and therapy of idiopathic thrombocytopenic purpura (ITP) in adults].

L Chrobák

Vnitr Lek 2002, 48(8):773-780

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder resulting from the binding of antibodies directed toward platelet surface glycoproteins GP IIb/IIIa and GP Ib/IX leading to their clearance by reticuloendothelial system. The diagnosis of ITP is made clinically by exclusion of other causes of thrombocytopenia. The treatment of chronic ITP is palliative, not curative and is directed toward inactivation and removal of a major site of platelet destruction and antibody production represented by the spleen. Spontaneous remission of ITP in adults are very rare. The goal of treatment for ITP is to prevent serious bleeding. About 30% of the...

[Acetylsalicylic acid (ASA)--is everything clear?].

J Spinar, J Vítovec

Vnitr Lek 2002, 48(8):781-790

The authors summarize results of trials with acetysalicyl acid (ASA) in patients with ischaemic heart disease and in particular with chronic cardiac failure. They draw attention to the relatively frequent use this drug in common practice, although so far not a single trial was completed which would prove the effect of acetylsalicyl acid on long-term mortality. The authors discuss also possible interactions of acetylsalicyl acid and ACE inhibitors which in retrospective analyses indicate possible veakening of the ACE-I when administered concurrently with ASA in cardiac failure. The authors mention also other antiaggregation drugs, which similarly as...

[Repeat thrombolysis in acute myocardial infarction].

M Sychra

Vnitr Lek 2002, 48(8):791-793

The author describes a case-history of streptokinase intolerance during treatment of acute myocardial infarction (IM) where it was impossible to ensure rescue percutaneous coronary angioplasty (PTCA) and to resolve this condition by subsequent alteplase treatment. The author discusses whether it is justified and indicated to use this procedure rarely mentioned in the literature.

[The life achievements of Jaroslav Pojer, professor of internal medicine].

Vĕra Linhartová

Vnitr Lek 2002, 48(8):794-797

[History and development of research in cardiorespiratory and pulmonary circulation in the Czech Republic].

Severin Daum

Vnitr Lek 2002, 48(8):799-802