[Comment on: Myocardial infarct and malignant diseases].

Helena Coupková

Vnitr Lek 2004, 50(10):731-732

[Viral hepatitis as a job-related illness among Czech health care workers].

J Beran, S Plísek

Vnitr Lek 2004, 50(10):732-733

[First experience with the cobalt binding capacity (ACB) test in the diagnosis of acute coronary syndrome (a pilot study)].

D Stejskal, B Lacnák, R Juráková, S Adamovská, J Prosková, R Ochmanová, G Ozanová

Vnitr Lek 2004, 50(10):734-739

INTRODUCTION: Commonly used laboratory markers of coronary damage in individuals with acute coronary syndrome (ACS) are not specific for myocardial ischemia and prove only irreversible myocardial damage. There have been concerns recently of a laboratory test able to distinguish sufficiently an individual with myocardial ischemia and typical IHD symptoms from patients without IHD. Since 1994 several works about cobalt binding capacity of albumin (ACB) have been published in which a unique diagnostic sensitivity and specificity of this test for estimations of the presence of myocardial ischemia has been described. In February 2003 this test was approved...

[ST-segment resolution as a simple tool for the assessment of successful primary coronary intervention at a microvascular level].

M Poloczek, P Kala, P Neugebauer, T Brychta, O Bocek, P Jerábek, J Parenica, M Vytiska, B Semrád

Vnitr Lek 2004, 50(10):740-745

BACKGROUND: The primary success of the coronary artery reperfusion by primary coronary intervention (PCI) is almost angiographically assessed by TIMI flow score. The perfusion at a microvascular level can be inadequate despite the restoring of normal flow in the epicardial coronary artery. One of the options of successful reperfusion at a microvascular level is the measurement of ST-segment resolution (STR) after primary PCI.AIM: The assessment of ST-segment resolution in patients indicated for primary PCI and the comparison with clinical data.METHODS: The authors studied 149 patients (68.5 % men) with ST elevation acute myocardial infarction...

[Can the position of a patient influence the result of an ultrasound examination of venous valve insufficiency?].

D Musil

Vnitr Lek 2004, 50(10):746-750

The goal of our work was to test sensitivity of the duplex ultrasound examination in making a sapheno-femoral junction diagnosis in lying patients. For this reason we tried to find out whether in ultrasound examination of lumen diameter of the great saphenous vein (B-mode) the speed of blood flow and reflux detection (CFM, pulse Doppler detection) are influenced by the position of a patient when lying and when standing. We examined 70 lower limbs of 70 different patients (47 women and 23 men) in whom the sapheno-femoral junction was not diagnosed when examined in the lying position. The difference in the lumen diameter of the great saphenous vein measured...

[The occurrence of occult malignancy in patients less than 50 years of age with venous thromboembolism: which diagnostic screening methods to use?].

R Malý, L Vodicková

Vnitr Lek 2004, 50(10):751-755

Trousseau was the first who describe an association of venous thromboembolism (VTE) with malignancy. The prevalence of occult cancer in patients with secondary VTE is comparable with the prevalence of cancer in general population (2-3%), while the prevalence of occult cancer in patients with idiopathic VTE is 4-10%. It has been demonstrated that the frequency of malignancy is higher in the first 6 to 12 months after diagnosis of VTE. 113 consecutive patients (50 males, 63 females) with first or recurrent VTE before the age 50, mean age (mean age 34.1 at time of VTE diagnosis) were followed retrospectively. Patients with known cancer were excluded for...

[Molecular pathophysiology of late complications diabetes mellitus--hyperglycemia-induced changes].

K Kanková

Vnitr Lek 2004, 50(10):756-767

Late diabetic complications due to vascular and extravascular impairments develop as a consequence of chronic diabetes mellitus. Extent of affection reflects disease duration and therapeutic compensation; however, other modulating factors are involved. Due to growing incidence and permanent shift to younger age diabetes represents serious health problem. T2DM develops in consequence of "dysadaptation" of human genome to rapidly changing environment and life style. Primary prevention of diabetes is rather limited at present, secondary prevention or minimalization of late consequences is practically achievable. Full understanding of pathogenesis and...

[Myocardial infarction and malignant diseases].

M Zuffa

Vnitr Lek 2004, 50(10):768-70;

Not much known relations between acute myocardial infarction and malignant diseases have been pointed out recently. Melanomas, often hidden by various paraneoplastic effects (in changed coagulation status, especially thrombotic) can facilitate ischemic processes in myocardium.

[What risk is a health care worker infected with hepatitis B or C virus for his patients?].

P Husa, L Husová

Vnitr Lek 2004, 50(10):771-776

Presently, there are no legislative standards in the Czech Republic banning health care workers with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection to do activities with a risk of the transmission of these viral infections to patients (surgeries and other invasive interventions). In a range of developed countries in the world individuals with chronic HBV infection, HBeAg positive individuals, have a restricted access to the risk interventions. A quantitative assessment of viremia is important in the health care workers infected with HBeAg-minus mutant of the virus. There are particular critical viremia values set up (serum HBV...

[Quality of therapeutic control of hyperlipidemias in secondary prevention of coronary heart disease in the light of current recommendations].

O Mayer, O Mayer

Vnitr Lek 2004, 50(10):777-780

Definite evidence has been established, that coronary patients benefit from appropriate therapeutic control of risk profile, as recommended by several Guidelines. However, the impact of these Guidelines on coronary morbidity and mortality is limited by level of its implementation into broad clinical practice and possibility to reach the defined secondary preventive targets with currently available therapeutic resources. We reviewed 6 studies, realized between 1995 and 2000, which was aimed to establish, how many patients with clinical coronary heart disease achieved recommended targets for lipid-lowering treatment. From 10850 cardiac patients examined...

[Spontaneous necrosis of parathyroid adenoma].

T Vasátko, J Cáp, A Ryska, A Kohout

Vnitr Lek 2004, 50(10):781-785

The authors describe a female patient with large parathyroid gland adenoma presenting with clinical symptoms of primary hyperparathyroidism and severe hypercalcaemia. Before planned surgical treatment the patient spontaneously developed clinical symptoms of tetany. Hypocalcaemia was confirmed by laboratory test. The reason turned out to be spontaneous necrosis of the parathyroid adenoma, resulting in remission of hyperparathyroidism. After stabilization of calcium levels, the necrotic adenoma was removed and histopathological examination revealed necrotic adenoma with only occasional vital adenoma cells. During the next follow-up the patient was without...

[Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis). Case study and a literature review].

M Olejárová, V Campr, K Pavelka

Vnitr Lek 2004, 50(10):786-792

Kikuchi-Fujimoto disease is a rare feverish disease characterised by lymphadenopathy, the most frequently cervical, exanthem, arthralgias and arthritis. It affects especially young women. Patients have high erythrocyte sedimentation rate (ES) and leucopenia, antibodies are missing. Course of the disease is usually very benign and can subside spontaneously. However, clinical picture is usually very dramatic and can suggest infectious, autoimmune or malign systemic disease; also association with some of autoimmune diseases was described. Its occurrence is sporadic in all the world, the most of cases were seen in Asia, in the Czech Republic it has not...

[Pulmonary embolism, prolonged diagnosis in young man].

M Belicová, M Knazeje, M Lojdlová, M Mokán

Vnitr Lek 2004, 50(10):793-798

Despite progress in early detection and treatment, the rates of mortality and recurrences of pulmonary embolism remain high. Cardiovascular specialists must keep pulmonary embolism in mind when they evaluate patients with unexplained substernal or pleuritic chest pain, dyspnea and syncope because these symptoms constitute the cardinal clinical presentation of pulmonary embolism. Authors are presenting a case report of a patient with repeating pleuritic chest pain with pleural effusion. The patient was treated as suspected tuberculous pleuritis. Authors diagnosed pulmonary embolism as a cause of pleural effusion by elevated plasmatic D-dimer and perfusion...