[Is adenosine used effectively in clinical practice?].

M Fiala

Vnitr Lek 2003, 49(4):251-252

[Biorhythms].

J Siegelová

Vnitr Lek 2003, 49(4):253

[von Willebrand disease type 2N (Normandy)].

D Habart

Vnitr Lek 2003, 49(4):253-255

[High or low dose, that is the question?].

J Spinar, J Vítovec

Vnitr Lek 2003, 49(4):255-257

[Bacterial infections in patients with acute hemorrhage due to portal hypertension--personal experience].

L Husová, J Lata, M Senkyrík, J Juránková, P Husa

Vnitr Lek 2003, 49(4):258-262

Acute haemorrhage from the upper gastrointestinal tract is a frequent and serious complication which affects 20-60% patients with cirrhosis of the liver and portal hypertension. It is assumed that bacterial infections can be the direct cause of haemorrhage but accurate data on the influence of infection on the development and course of haemorrhage are lacking. Acute haemorrhage as a result of portal hypertension has a very high mortality, 30-50%, and an early relapse of haemorrhage occurs in as many as 40% of these patients. Most recent meta-analyses indicate that bacterial infection is an independent prognostic factor in failure of haemostasis and...

[Ambulatory monitoring of blood pressure in regular dialysis therapy].

J Erben, V Panácek, J Procházka

Vnitr Lek 2003, 49(4):263-266

Ambulatory monitoring of the blood pressure (AMBP) makes it possible to diagnose in hypertensive patients the so-called dipper phenomenon, i.e. a drop of the BP during the night provided that the patient is asleep. The absence of this phenomenon implies as a rule serious damage of the cardiovascular apparatus, brain or kidneys. By means of an apparatus ABP monitoring type 90207 of Space Labs. Inc. a group of 16 patients in regular dialysis treatment (RDT) was examined and the blood pressures were evaluated before and after dialysis. Patients with the dipper profile reacted more adequately during dialysis i.e. by a drop of the blood pressure due to...

[Effectiveness and safety of adenosine in the therapy and diagnosis of arrhythmias].

J Dúbrava, O Jurkovicová

Vnitr Lek 2003, 49(4):267-272

Adenosine is a drug with unique clinical and electrophysiological properties. Despite this, its use in Slovakia is rare. The decisive reason, besides its price, is the physicians fear of potential adverse effects and their limited knowledge regarding its clinical use. This study was aimed at analysis of the contribution of adenosine to the treatment and diagnostics of arrhythmias and evaluation of its safety. We studied the effect of adenosine in 62 patients. Adenosine terminated paroxysmal supraventricular tachycardia (PSVT) in 16 of 44 patients (36.4%) and in another 21 patients (47.7%) we revealed the type of unclear PSVT. We observed contribution...

[Dynamic stress echocardiography in asymptomatic patients treated for malignant diseases in childhood].

L Elbl, H Hrstková, V Chaloupka, J Novotný

Vnitr Lek 2003, 49(4):273-279

INTRODUCTION: The authors used echocardiography at rest and dynamic stress echocardiography to assess left ventricular function in asymptomatic patients treated during childhood or adolescence by chemotherapy containing anthracyclines.MATERIAL AND METHODS: 137 patients were examined (81 men, 56 women) aged 16.6 +/- 4.8 years (median 17 years) where at the age of 9.1 +/- 4.8 years (median 9 years) malignant disease was detected and treatment with a cumulative dose of anthracyclines 242 +/- 110 mg/m2 (median 240 mg/m2) was administered. The control group was formed by 30 subjects (14 men, 16 women) aged 19.5 +/- 5.2 years (median 20 years). The echocardiographic...

[Combined training in patients with systolic left ventricular dysfunction].

J Jancík, H Svacinová, P Dobsák, J Siegelová, Z Placheta, J Meluzín, R Panovský

Vnitr Lek 2003, 49(4):280-284

The objective of the work was to evaluate the effect of eight-week combined training on the performance, aerobic capacity and basic haemodynamic parameters in patients with systolic dysfunction of the left ventricle and to assess its safety. The investigation comprised 26 patients, men mean age (x +/- SD) 61.8 +/- 11.1 years with coronarographically verified chronic ischaemic heart disease and with a left ventricular ejection fraction lower than 40% (EF 35 +/- 4%). Before the beginning and after completion of the rehabilitation programme (eight weeks) a spiroergometric examination was made, up to the symptom-limited maximum. Fitness elements were included...

[Long-term treatment with statins in patients with ischemic heart disease after coronary angioplasty].

R Skulec, A Linhart, T Hnátek, H Spundová, V Mrázek, J Bělohlávek, F Holm, M Aschermann

Vnitr Lek 2003, 49(4):285-290

UNLABELLED: Long-term statin therapy is the corner-stone in management of patients with coronary artery disease.PURPOSE OF STUDY: The aim of our study was to analyze the state of the statin therapy at patients undergoing percutaneous coronary intervention (PCI) and to determine predictors of long-term statin treatment.METHODS: We performed a retrospective study in 520 patients who underwent percutaneous coronary angioplasty in 2nd Dept. of Internal Medicine, 1st School of Medicine, Charles University, Prague during the year 2000. Data were collected from hospital records and from a mailed questionnaire.RESULTS: The response rate was...

[NO (nitric oxide) and its significance in regulation of vascular homeostasis].

T Kvasnicka

Vnitr Lek 2003, 49(4):291-296

The endothelium is the largest autocrine and endocrine organ of the human organism. It participates in the regulation of the blood flow and tonus of the vascular wall, activation of thrombocytes, adhesion of monocytes to the vascular wall, thrombogenesis, lipid metabolism and growth of vessels. Endothelial cells may produce some 25 different biologically active substances. The most important one among them is probably NO. Under physiological conditions endothelial cells release permanently a small amount of NO or EDRF (endothelium-derived relaxing factor) and participate thus in the regulation of the tonus of the vascular wall at rest. The presence...

[Circadian rhythms in cardiovascular diseases--arrhythmias].

M Kozák

Vnitr Lek 2003, 49(4):297-301

Circadian patterns have been observed for variety of cardiovascular disorders, including cardiac arrhythmias, sudden cardiac death, cerebrovascular events, episodes of stable angina, unstable angina and acute myocardial infarction. The morning predominance of these events has been well documented in a number of large population studies. This fact provides the stimulus for better understanding our own chronobiology and the periodicity of circadian rhythms which contribute to this predominance of adverse events in the morning hours. We now understand that a number of important physiological parameters such as heart rate, blood pressure, vascular reactivity,...

[Circadian rhythms in cardiovascular diseases--ischemic heart disease].

M Kozák

Vnitr Lek 2003, 49(4):302-307

Several key advances in understanding of pathophysiology now provide the opportunity to develop improved treatment and prevention strategies. First, the importance o mechanism of plaque rupture and thrombosis in onset of myocardial infarction. Second, there has been demonstrated, that plaques that lead to acute occlusion often have only a mild degree of stenosis. A third advance that has stimulated the field has been the recognition that time of onset of cardiac events is not random but instead shows a circadian pattern of onset. In the decade since the 1985 observation by Muller a spol. that the frequency of onset of myocardial infarction peaks at...

[Use of chronobiology findings in therapy of cardiovascular diseases].

M Kozák

Vnitr Lek 2003, 49(4):308-313

The concept of homeostasis in biology postulates that there is constancy of the intern milieu. Thus is assumed the risk and exacerbation of disease are invariable and independent of the time of day, day of month, and month of year as are the responses of patients to diagnostic tests and medications. Findings from the field of chronobiology, the study of biological rhythms, challenge the concept of homeostasis and the many assumptions and procedures of clinical medicine based on it. It is now recognized that human functions have daily, weekly, monthly and yearly biological rhythms. Plants, animals, and insects also have chronobiological rhythms. Circadian...

[Standards for diagnosis and therapy of diabetic retinopathy and its complications. Recommendations of the Czech Diabetology Society and the Czech Ophthalmology Society].

B Kalvodová, T Sosna, J Rehák, T Pelikánová

Vnitr Lek 2003, 49(4):314-318

[Von Willebrand disease--type 2N (case report)].

M Zarnovicanová, S Pelikánová

Vnitr Lek 2003, 49(4):319-321

Isolated reduced coagulation activity of FVIII may be a manifestation of haemophilia A, carriership of haemophilia A, haemophilia A in a woman, acquired haemophilia A and type 2N of von Willebrand's disease. The authors were concerned with the cause of isolated reduction of the coagulation activity of factor VIII (19 IU/dl) in a 40-year-old woman with a history of excessive haemorrhage of the type of mild haemophilia A with a negative family history. The personal history, family history and laboratory examination suggested type (variant) 2N of von Willebrand's disease. For indirect evidence the authors used a therapeutic study where they investigated...

[Administration of maximal or median doses of drugs in cardiovascular diseases?].

J Spácil

Vnitr Lek 2003, 49(4):322-5;

In recent years some specialists recommend to treat patients with cardiovascular diseases with maximal doses of drugs and refer to the results of extensive clinical studies. On critical evaluation of some it seems that the results are not interpreted accurately and that the highest doses of drugs (or combined treatment) do not produce better results than the use of smaller doses. This applies e.g. to the study HOT with felodipine in hypertensive patients and patients with cardiac insufficiency in the ATLAS study with lisinopril and the MERIT-HF study with metoprolol. It applies also the HOPE study with ramipril in secondary prevention in subjects with...

[History of nephrology and extracorporeal drug removal at the L. Pasteur Hospital in Kosice].

M Mydlík, K Derzsiová

Vnitr Lek 2003, 49(4):329-333

The authors describe the development of clinical nephrology from 1948 to 2002 at the Medical Faculty of the P. J. Safarík University and L. Pasteur Faculty Hospital from the aspect of therapeutic and preventive care, teaching and research activities. The dialysis centre which was established in 1966 at the Medical Clinic of the Faculty Hospital in Kosice continued in the activities as the Nephrological laboratory which was founded in 1954. This laboratory still operates under the conditions of the Nephrological Clinic. In 1964 at the Medical Clinic the first percutaneous renal biopsy was implemented. In 1966 the first peritoneal dialysis was implemented...

[Pathophysiology solves key questions in the therapy of type 2 diabetes mellitus].

J Skrha

Vnitr Lek 2003, 49(4):334-338

Pathophysiological mechanisms accompanying Type 2 diabetes mellitus are the basement for the rational therapy of this disease. The finding of the relationship between impaired insulin secretion and its action including the regulatory mechanisms is of importance for successful treatment. In a review article there are included the most important pathways influencing therapeutical considerations in clinical practice.

[Drug therapy of portal hypertension].

J Lata

Vnitr Lek 2003, 49(4):339-342

The author presents a list of preparations used to influence portal hypertension resulting from cirrhosis of the liver, in particular in treatment or prevention of haemorrhage from oesophageal varices or gastropathy. The author describes the mechanism of action of drugs administered in acute haemorrhage (vasopressin, terlipressin, somatostatin, octreotide)) and preparations used in primary or secondary prevention of this haemorrhage (beta-blockers, nitrates, newly tested preparations or combinations). In the conclusion are recommendations for practical procedures according to principles of evidence-based medicine.

[Management of dementia and cognitive functions in patients after cerebrovascular stroke: new results from the PROGRESS study].

J Widimský

Vnitr Lek 2003, 49(4):343-349