[Hormones, aging and old age, myths and reality].

V Pacovský

Vnitr Lek 1991, 37(1):1-5

[Angina pectoris revisited].

M Stejfa

Vnitr Lek 1991, 37(1):6-12

Based on data in the literature and his own experience, the author presents modern views on angina pectoris. He discusses anamnestic signs of typical and atypical angina and non-anginous chest pain. He mentions the pathogenesis and clinical picture of stable angina (secondary and mixed angina, syndrome X), unstable angina (mixed and primary angina) and silent ischaemia. As to examinations, he emphasizes in addition to the case-history the importance of the objective finding and stress tests. On the latter indications for invasive examinations are based. The author recapitulates treatment, prognosis an assessment.

[Disorders of fibrinolysis and thrombophilic states, risk factors and possibilities of dietary effects].

V Cepelák, J Dvorák, L Vít, H Cepeláková, V Beránek

Vnitr Lek 1991, 37(1):13-20

An inadequate efficiency of the fibrinolytic system was revealed in 50-60% of subjects suffering young age from venous thrombosis or myocardial infarction. In a group of 27 patients with the history of deep venous thrombosis of the idiopathic type the authors revealed a significant relationship between the elevated body weight and inadequate fibrinolysis manifested by a reduced fibrinolytic capacity and excess inhibitor of plasminogen activator and its inadequate decline after desmopressin infusion (DDAVP). In a group of 29 patients, who had suffered a myocardial infarction when young, the authors revealed a significant association between reduced...

[Intravenous streptokinase in the treatment of acute myocardial infarct].

Z Lupínek, S Janousek, Z Lupínková, J Meluzín, M Novák, M Soucek, F Rysavý

Vnitr Lek 1991, 37(1):21-28

In 314 patients with a first myocardial infarction, admitted within four hours after development of symptoms, the authors used in addition to standard therapy heparin treatment in 205 and streptokinase treatment (1.5 mil. u. i.v. with subsequent i.v. heparin administration) in 109 patients. Thrombolytic treatment was more effective, it reduced the lethality by 55.7% and was associated with a lower incidence of complications during the first 30 days. The reduced lethality, however, did not reach statistical significance because of the small number of patients and the low mortality rate in both groups. The left ventricular ejection fraction was practically...

[Changes in plasma lipids, lipoproteins and utilization of energy substrates during continuous enteral nutrition with 50% medium chain triacylglycerols (Preciten MCT 50)].

Z Zadák, L Sobotka, J Horácek, B Cervenka

Vnitr Lek 1991, 37(1):29-36

Enteral nutrition (EN) containing part of the energy substrates in the form of triacylglycerols with medium chain fatty acids (MCT) has a number of advantages in particular in patients with an impaired utilization of energy and impaired nutrient absorption from the small intestine. The increased MCT supply reduces the risk of the development of shock lung, consumption coagulopathy and has a very favourable effect in patients with severe catabolism associated with Crohn's disease. On the other hand EN containing MCT may produce also some undesirable effects such as deterioration of glucose utilization in the liver, changes, on the composition of plasma...

[Essential fatty acids in carcinoma].

J Skorepa, E Sindelková, Z Zadák

Vnitr Lek 1991, 37(1):37-40

Carcinomatous tissue consumes intensely polyenic fatty acids which are the building elements of growing biomembranes. The authors compared plasma levels of essential fatty acids (EFA) in three groups of subjects: 1. patients with carcinoma, 2. control group, 3. groups with sub-nutrition. The profile in these three groups differs significantly. In patients with carcinoma the level of derived EFA is reduced (20:4w6, 20:5w3, 22:6w3), while primary EFA (linoleic acid 18:2w6) is unaltered. The results suggest that in patients with carcinoma there is a specific reduction of EFA essential for the formation of cellular biomembranes. The reduction is probably...

[Treatment of hypertension and cardiovascular complications].

J Widimský

Vnitr Lek 1991, 37(1):41-47

The aim in treatment of hypertension is normalization of blood pressure. The impact of treatment of hypertension on the development of IHD depends not only on the treatment of hypertension but also on influencing other basic risk factors, i.e. hyperlipoproteinaemia and smoking. Treatment of hypertension can be and should be individual and depends on a) age, b) the level of hypertension, c) complications of hypertension and d) the presence of other diseases, in particular hyperlipoproteinaemia and diabetes mellitus. The treatment of choice in hyperlipoproteinaemia are calcium antagonists, prazosin, ACE inhibitors and beta-blockers with ISA. There is...

[Incidence of arterial hypertension during and after acute glomerulonephritis].

V Monhart, M Jaros

Vnitr Lek 1991, 37(1):48-52

The authors investigated the incidence of arterial hypertension during acute glomerulonephritis in adults and during the period after glomerulonephritis. Hypertension was recorded in 34% of 126 patients treated on account of acute glomerulonephritis (mean age 23 +/- 6 years). Only in six patients the diastolic pressure was higher than 15.3 kPa. At the end of hospitalization hypertension persisted in four subjects. After a three-year interval following glomerulonephritis hypertension was recorded in 15% of 119 examined subjects. In 7 subjects it was isolated, in another 11 associated with a pathological finding in urine. Four to twenty years after acute...

[Primary prevention of ischemic heart disease in a homogeneous young military population group].

J Květenský, D Bestvina

Vnitr Lek 1991, 37(1):53-62

The authors submit a report on the implementation of primary preventive provisions against ischaemic heart disease in a homogeneous group of young soldiers. The investigation was pursued for five years. After screening of risk factors the implementation of principles of primary prevention was started: a rational diet, control of smoking and control of obesity: Aimed comprehensive psychological and educational provisions were made in the whole group. Physical activity was increased to improve their physical fitness. The following other parameters were monitored: laboratory values, ECG tracing, somatic examination, etc. The results obtained in the intervention...

[Long-term study of diffuse connective tissue disease after methylprednisolone pulsed therapy].

Z Hrncír, P Bradna, H Nozicková, M Tichý

Vnitr Lek 1991, 37(1):63-72

Pulsed i.v. treatment with methylprednisolone (MP) infusions à 1 g 3-5 times on alternate days was administered in 22 diffuse connective tissue diseases: 13X systemic lupus erythematosus (SLE), 1X Sharp's syndrome and 8X polymyositis/dermatomyositis (PM/DM). In all instances active disease was involved with serious organ manifestations; 17 patients had no aimed treatment so far, in 5 previous treatment had failed. A total of 101 pulsed MP was administered. Initial MP treatment was always successful. The patients were then followed up during oral maintenance treatment for 3-60 months (mean 27 months) in a stage of persistent, inconstant or partial...

[Preparation of thrombocyte concentrates in the Travenol CS-3000 separator (factors affecting the thrombocyte yield and presence of leukocytes)].

M Bláha, I Varvarovský, M Pecka, J Malý, L Jebavý, O Siroký

Vnitr Lek 1991, 37(1):73-79

The authors made 184 thrombocytaphereses for the preparation of thrombocyte concentrates on a Travenol CS-3000 separator. They evaluate indicators on which the thrombocyte yield depends: it was found that the yield is higher in donors with a higher number of platelets and that it increases with the period of separation. The mean thrombocyte yield was 2.91 +/- 0.84 x 10(11). It corresponded to the average lower platelet number of donors--182 x 10(9)/L. In those donors where the number of platelets was higher than 180 x 10(9)/L, the yield was 3.21 x 10(9)/L. The undesirable presence of leucocytes (in 98% lymphocytes) increases in relation to the number...

[Plasmapheresis in the treatment of Crohn's disease].

B Fixa, O Komárková, J Krejsek, J Bures

Vnitr Lek 1991, 37(1):80-84

Crohn's disease is a disease with unknown etiology of which immunological mechanisms participate. As standard treatment is sometimes ineffective, in 15 patients therapeutic plasmapheresis was used. Before plasmapheresis and immediately after it some immunological parameters were assessed. In the serum a significant drop of all immunoglobulins of the basic classes was recorded: (P less than 0.05) and of circulating immunocomplexes (P less than 0.02). Marked clinical improvement was observed in three patients, which as compared with data in the literature, is somewhat less. The cause is in the author's opinion in the selection of patients (plasmapheresis...

[Predictive value of indicators of oxygen supply to tissues in patients with chronic obstructive lung disease].

B Král, A Hamet, D Cernohorský, J Sťásek, P Tilser, M Pospísil, J Eliás, K Zaydlar, V Koudelka

Vnitr Lek 1991, 37(1):85-91

The authors investigated in a group of 83 patients with chronic obstructive pulmonary disease the prognostic impact of some indicators of pulmonary function, haemodynamics and oxygen transport. They demonstrated that the prognosis is less favourable in patients with a lower one-second vital capacity with a higher median pressure in the pulmonary artery, with a lower oxygen tension in the arterial blood and higher haemoglobin concentration. They did not reveal significant differences between those who died and those who survived for more than five years, after the examination, as regards oxygen supply of tissues, oxygen consumption, coefficient of oxygen...