[Unstable angina pectoris--therapeutic strategy].

M Kozák

Vnitr Lek 2003, 49(8):585-586

[Nutrition and acute cerebrovascular stroke].

Z Kalita

Vnitr Lek 2003, 49(8):587

[Comment on the article by E. Zemanova et al: "Clostridium difficile infection associated with pseudomembranous colitis in district hospitals].

V Zboril

Vnitr Lek 2003, 49(8):588-589

[Growth hormone replacement in adults: improvement in quality of life or life span?].

J Cáp

Vnitr Lek 2003, 49(8):589-591

[Comparison of utilization of cardiovascular drugs in the Czech Republic and in Wales].

K Górecká, J Vlcek, R Walker

Vnitr Lek 2003, 49(8):592-597

AIM: To compare and describe the trends in the consumption of selected groups of cardiovascular drugs in several districts of the Czech Republic and counties of Wales in the period of 1997-2000.METHODS: A retrospective analysis of prescription data from General Medical Insurance Company (three districts in the Czech Republic) and data from the Health Solutions Wales (3 counties of Wales). The data were analyzed during seven half-year intervals from January 1997 till June 2000. The authors investigated the consumption of antihypertensives, diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, hypolipidemic drugs, digoxin and acetylsalicylic...

[D-dimers in the diagnosis of deep venous thrombosis].

O Mayer, Z Poklopová, T Mádr, I Martínková

Vnitr Lek 2003, 49(8):598-602

D-dimers (D-d) are degeneration products of fibrin. According to some recommendations (Lee et al., Ann Rev Med, 2002; 53: 15-33) the vein thromboembolism may be excluded by the determination of D-dimers level especially when the probability of diagnosis of deep vein thrombosis is less strong. The determination of D-dimers with made possible was the development of monoclonal antibodies and their detection is based on the determination using the principle of ELISA or agglutination techniques. An increased D-d level is not completely specific for venous thrombo-embolism; it may be enhanced during tumorous diseases, infections, kidney failure etc. In contrast,...

[Patients with unstable angina pectoris--what were the real facts in Czech and Moravian hospitals in the year 2000?].

J Spác, J Parenica, M Partisová, S Habrovcová, M Hamplová

Vnitr Lek 2003, 49(8):603-609

The authors evaluated the occurrence of risk factors, mode of therapy and in-patient mortality in 726 patients admitted to 38 Czech and Moravian hospitals for unstable angina pectoris with ECG finding of ischaemia without ST segment elevation, who were indicated to application of anticoagulant treatment with low molecular weight heparin. The duration of the before-hospital phase represented a significant risk factor for the progression of disease up to Q myocardial infarction. The relapse of stenocardia occurred in 19.8% of patients during the hospitalization and myocardical infarction Q occurred in 7.5% patients, while 2.89% patients died during hospitalization....

[Anatomic and hemodynamic changes in the venous vascular bed in the lower extremities with chronic venous insufficiency].

D Musil, J Herman

Vnitr Lek 2003, 49(8):610-617

The authors paid attention to revealing as precisely as possible anatomical and haemodynamic conditions in venous vascular bed in the course of ultrasonographic examination of 309 lower extremities with clinical manifestations of chronic venous insufficiency (CVI). A combined reflux in the superficial and deep venous system (53.7%) or isolated reflux in superficial veins (25.9%) proved to be the most frequent pathogenic bases of CVI. Pathophysiology of varices was mostly based on the venous reflux and the primary idiopathic CVI was mostly present (98.1%). The post-thrombotic partial obstruction of the deep venous system (post-thrombotic venous changes...

[Nutritional intervention in patients with cerebrovascular stroke].

S Kozáková, J Charvát, L Hrdlicka, M Soucek, M Kvapil

Vnitr Lek 2003, 49(8):618-622

The patients with acute cerebral stroke suffer from stress situation which may induce the catabolic state. The aim of our study was to evaluate the influence of the nutrition intervention and follow-up of the nutrition parameters in the patients with acute ischemic cerebral stroke. We have examined 30 patients with acute ischemic cerebral stroke, the average age 71.4 +/- 8.6 years. In all the patients we have measured some antropometric, biochemic and immunologic parameters of the nutrition status on admission. At the same time we have evaluated the size of the neurological deficit with NIH stroke scale and Barthel index. Every day we have monitored...

[Endothelial dysfunction in a family with familial combined hyperlipidemia].

D Karásek, H Vaverková, M Hutyra, M Halenka, D Novotnyý, M Budíková, L Slavík

Vnitr Lek 2003, 49(8):623-629

Familial Combined Hyperlipidemia is the most frequent familial hyperlipidemia with a high risk a early manifestation of arteriosclerosis. Endothelial dysfunction is the first step in the development of arteriosclerosis. The aim of our investigation was to examine selected markers of endothelial dysfunction in hyperlipidemic members of families with familial combined hyperlipidemia and their normolipidemia first-line relatives and to compare them with healthy individuals. The study includes non-smoking members of the affected families (probands and first-line relatives), who have not suffered from clinical manifestations of arteriosclerosis and/or hypertension...

[Puncture aspiration using ultrasound guidance in the treatment of abscesses and other purulent foci in the liver, pancreas and kidneys].

A Martínek, V Hrabovský, P Klvana

Vnitr Lek 2003, 49(8):630-636

The authors deal with the problem of application of a therapeutic fine needle aspiration puncture in abscesses and other purulent foci in organs of abdominal cavity and retroperitoneum. The treatment using this method under continuing antibiotic therapy has been used in 60 patients (40 men, 20 women), 25 of them suffering from liver abscesses, 28 other from purulent foci of pancreas and seven patients from purulent foci of the kidney. In most patients there were solitary foci (43 persons). The total volume of the evacuated pus was higher than 20 ml in most patients (52), being even more than 100 ml in 2 patients. No relation ship was found among the...

[Disorders of laminins in diseases of myocardial and skeletal muscles].

L Spinarová, J Toman, P Hude, S Vohánka, M Vytopil, Z Lukás, M Novák, J Vítovec

Vnitr Lek 2003, 49(8):637-641

UNLABELLED: The Emery-Dreifuss muscular dystrophy is caused by muscular lesions and disorders of cardial rhythm and/or by cardiomyopathy. An autosomal dominant form is related to mutations of genes, which are coding for lamins A/C.GROUP AND METHODS: In the group A the authors examined 37 patients with the diagnosis of dilatation cardiomyopathy (DKMP) and the mean ejection fraction 28.4; 8.8%. In the group B of 13 patients a cardiac stimulator was implanted for a rhythm disorder. Both groups were subjected to cardiological, neurological, clinical and electromyographic (EMG) examinations. A muscle biopsy from m. vastus lateralis was made and the...

[Liver biopsy in Slovakia].

L Skladaný, P Jarcuska, S Hrusovský, M Oltman, M Brix, J Glomba, M Hlista, M Hôrka, R Hyrdel, V Kupcová, J Pastvová, I Schréter

Vnitr Lek 2003, 49(8):642-644

INTRODUCTION: Liver biopsy is the most specific diagnostic modality in hepatology, but information about its application in Slovakia is rather obscure.METHODS: The authors performed a correspondence study with the aim to find out how many biopsy examinations has been done in Slovakia in 2001, for which indications, what kind of techniques have been applied and which small or great complications were encountered.RESULTS: It was established that in the year 2001, 400 biopsies for diffuse liver diseases were performed. There were 296 percutaneous biopsies, 82 laparoscopic biopsies and 22 trans-jugular biopsies forming the survey. Acute viral hepatitis...

[Clostridium difficile infection associated with pseudomembranous colitis in district hospitals].

E Zemanová, O Urban, J Chalupa, V Mrózek, V Taubová

Vnitr Lek 2003, 49(8):645-649

At a regional hospital serving 150,000 inhabitants, the authors were tracking the occurrence of antibiotic-associated diarrhea caused by a nosocomial infection of the Clostridium difficile, especially its most serious form--pseudomembranous colitis. Six cases of the disease were found in a retrospective study in 2001, another 20 cases were diagnosed while actively searching for the disease from January till September of 2002. The patients suffered from many complications, were of an average age of 69.24 years, their hospitalization averaged 34 days and 15 (52%) of them underwent surgery during their hospitalization. It could be demonstrably proved...

[Total body composition in adult patients with growth hormone deficiency before and after its administration].

V Weiss, M Krsek, J Marek, J Stěpán, J Malík

Vnitr Lek 2003, 49(8):650-655

Effect of growth hormone (GH) on the growth and development of children is generally known. Effects of GH in adults are favorable, though. The aim of the work was to verify effects of GH administration on body composition in adult patients with GH deficit (GHD). The authors examined 15 adult patients with GHD originated in 13 of them in adulthood and in two of them in childhood. Their mean age was 43.9 +/- 11.3 years, the mean body mass was 80.0 +/- 15.2 kg. The GH deficit was verified by the stimulation insulin tolerance test. For the period of 12 months, they were subcutaneously administered recombinant human GH in a substitution dose of 0.5 to 1.5...

[Effect of hypercortisolism on development of atherosclerotic changes in blood vessels].

J Jezková, J Marek, M Prázný, M Krsek, K Malícková, M Rosická, Z Jarkovská, L Pecen

Vnitr Lek 2003, 49(8):656-667

UNLABELLED: Hypercortisolism is associated with a high risk of sickness rate and death rate particularly in view of facilitated arteriosclerotic processes. It is most frequently induced by drug therapy, but endogenous hypercortisolism (Cushing's syndrome) may serve as a suitable model of the effect of hypercortisolism on vascular wall. Our cohort included the following groups of patients and control individuals: 1. a group of patients with florid so far untreated Cushing's syndrome--14 patients, 2. a control group to these patients--16 individuals, 3. a group recently operated on and healed-up patients with Cushing's syndrome--8 patients, 4. a group...

[Rhabdomyolysis--development, causes, sequelae and therapy].

A Krouzecký, M Matĕjovic, R Rokyta, I Novák

Vnitr Lek 2003, 49(8):668-672

Rhabdomyolysis is a syndrome characterized by striated muscle necrosis and the release of intracellular muscle constituents into the circulation. The severity of illness ranges from asymptomatic elevations of muscle enzymes in the serum to life-threatening cases associated with extreme enzyme elevations, electrolyte imbalances, and acute renal failure. This chapter reviews recent knowledge of pathophysiologic mechanisms leading to myocytes injury, diseases its causes, consequences and treatment options. Particular attention is focused on rhabdomyolysis in critically ill patients.

[Cytoprotective effects of amifostine in the treatment of tumors].

P Burkon, P Petýrek, V Spurný

Vnitr Lek 2003, 49(8):673-678

An efficient therapy of patients with tumorous diseases should include maximum killing of malignant cells with minimal damage to cells in healthy tissues. Radiotherapy and chemotherapy are frequently associated with a series of undesirable effects. Side effects related to the therapy may unfavorably influence quality of life for a short or long period of time, may cause the need to decrease the dosage or shorten the overall period of treatment or survival of the patient. Therefore, particular attention has recently been paid to compounds, which mitigate or eliminate the undesirable effects of the therapy. A way to decrease toxicity is the administration...

[Percutaneous biopsy of the liver].

L Skladaný, P Jarcuska, M Oltman, S Hrusovský

Vnitr Lek 2003, 49(8):679-683

Percutaneous liver biopsy represents the most specific examination of the nature and severity of liver diseases. P. Ehrlich was the first physician in history having done the intervention in 1880. The new history begins with the Menghini's publication on s.c. one-second biopsy in 1957. The present paper deals exclusively with diffuse diseases of the liver including the most frequent ones--virus hepatitis, alcohol and non-alcohol steatohepatitis. The contraindications include mainly coagulation disorders and non-cooperative patients. The percutaneous biopsy is mostly executed after ultrasonographic examination or under the control of various image-forming...

[Cholestatic icterus during parenteral nutrition and the therapeutic effect of enteral feeding--case report].

E Havel, L Sobotka, J Bedrna, P Hladík, J Manák, V Bláha, P Adámek, P Vyroubal, Z Zadák

Vnitr Lek 2003, 49(8):684-688

An acute operation was made on a 56-year woman for inflammatory perforation of colon. A series of repeated operations followed due to relapsing iatrogenic intestinal fistula and peritonitis. From the day 70 the patient was treated at the Intensive Metabolic Care Unit of the Gerontological and Metabolic Clinic of Faculty Hospital in Hradec Králové. Having cured the septic shock the authors prepared the patient to a reconstruction operation on alimentary tract by administering parenteral nutrition, treating the wounds and by motion rehabilitation. From day 150 on the patient was treated with low doses of enteral nutrition into the segment of intestine...

[Cholestasis].

M Brodanová

Vnitr Lek 2003, 49(8):689-695

Cholestasis is a condition, where the bile flow into the intestine is defective. The causes may be extrahepatic (in large biliary ducts) or intrahepatic (at the level of hepatocytes or minor biliary ducts). The lack of bile in the intestine results in serious consequences, mainly malabsorption, malnutrition and skeletal changes. The compounds, which are normally excreted in the bile, accumulate and liver biliary cirrhosis ensues. Cholestatis is characterized by a typical laboratory picture, outlined in publications, which serves for differentiation of individual forms of cholestasis. There are various causes of cholestasis, listed in the survey. Extrahepatic...