Vnitřní lékařství, 1993 (roč. 39), číslo 9
[The hypertensive metabolic syndrome].
K Horký
Vnitr Lek 1993, 39(9):836-843
Systemic arterial hypertension is not merely a simple haemodynamic abnormality. It is as frequently as in 80% associated with metabolic deviations such as impaired glucose tolerance or NIDDM, obesity, hyperuricaemia, hyperlipoproteinaemia, rapid development of atherosclerosis. This cluster of different symptoms with higher BP readings is too frequent to be incidental. We speak therefore of hypertensive metabolic syndrome which is close to or identical with Reaven's syndrome X or familial dyslipidaemic hypertension. The common pathogenetic basis of the listed metabolic deviations and hypertension is probably genetic or acquired reduction of tissue sensitivity,...
[Non-invasive programmed transthoracic ventricular stimulation].
F Prochaczek, J Galecka, R Stípal, T Minarík
Vnitr Lek 1993, 39(9):844-848
In 10 healthy volunteers programmed transthoracic stimulation of the ventricles was performed using two commercially available non-invasive pacemakers. The connection of the oesophageal stimulator SP-5 with the transthoracic ventricular stimulator NP-4D made it possible to obtain a two-lead ECG tracing without artefacts. The quality of the obtained tracings (surface tracing and oesophageal tracing) made it possible to assess accurately the ventriculo-atrial conduction. The examinations performed indicate the practical use of combined oesophageal and transthoracic stimulation during non-invasive diagnosis.
[Evaluation of physical rehabilitation in myocardial revascularization using echocardiography].
J Spác, M Blaha, H Nĕmcová, J Cerný, I Dvorák
Vnitr Lek 1993, 39(9):849-855
The authors investigated 155 patients, mean age 50.6 years, after revascularization of the myocardium. The group was divided at random into a group with a high intensity of physical rehabilitation (A) and a medium and low rehabilitation group (B). The rehabilitation programme comprised physical exercise at least three times per week for at least 30 mins. with a dynamic load up to 80% of the maximum heart rate in group A and up to 40% in group B. The mean initial haemodynamic indicators in both groups were equal (LVEDP 17.5 mm Hg and 16.5 resp. and EF 52.3% and 50.5% resp. in group A and B). Six months after revascularization the mean values of work...
[Comparison of the effects of molsidomine retard and isosorbide dinitrate retard in patients with stable angina pectoris using an ergometry test].
P Rotrekl, J Vlasínová, J Manousek, B Semrád, F Rysavý, Z Lupínek, J Meluzín, I Vlasicová, I Pirochtová, O Bocek
Vnitr Lek 1993, 39(9):856-864
In 24 men with angina after exertion the authors assessed, using ergometry, the action of molsidomine retard and isosorbide dinitrate retard after a single dose and after tree-week administration of the drug. The authors found that 8 mg of molsidomine retard in a single dose had a somewhat more potent effect than 40 mg isosorbide dinitrate retard. After prolonged administration the effect of both drugs on haemodynamics diminished and in molsidomine a significant decline of action was observed before development of a reduced S-T segment on the ECG. After three weeks' administration the effects of both drugs were comparable. After neither drug clinically...
[Bisoprolol in the treatment of hypertension].
J Spinar, J Zicha, J Vítovec
Vnitr Lek 1993, 39(9):865-870
Bisoprolol is an effective antihypertensive drug which reduces significantly the systolic, and diastolic blood pressure, the pulse rate in a recumbent, sitting and standing position. Recommended dosage is 10-15 mg once a day. Bisoprolol is suitable for use in hypertensive patients with associated diseases, in particular angina pectoris and impaired rhythm.
[The significance of plasminogen activator inhibitor 2 in patients with hematologic malignancies].
P Cetkovský, V Koza, V Cepelák, L Vít
Vnitr Lek 1993, 39(9):871-875
The authors investigated the incidence of the plasminogen activator inhibitor-2 (PAI-2) in 88 patients with haematological tumours. In four patients (4.5%) an elevated PAI-2 level was found: in patient (no. 1) with non-differentiated leukaemia which developed as a result of transformation of myelodysplastic syndrome, in a female patient (no. 2) with non-differentiated blastic crisis of chronic myeloid leukaemia, in a female patient (no. 3) with acute monocytic leukaemia (M5) and in a pregnant female (patient no. 4) with a malignant lymphogranuloma. In none of the other patients with another type of acute myeloid leukaemia or other haematological tumours...
[Leukocyte growth factors in patients with neoplasms].
Z Adam, D Syslová, J Vorlícek
Vnitr Lek 1993, 39(9):876-881
In a group of 10 patients (six with acute lymphatic leukaemia, one patient with Ewing's sarcoma, one patient with lung cancer, one patient with a myeloma and one patient with Hodgkin's lymphogranuloma) treatment with leucocytic growth factors (Neupogen Hoffman La Roche) was started only after the onset of leukopenia. Even after this mode of administration of leucocytic growth factors septic conditions in leukopenic patients were more easily controlled and it was thus possible to complete chemotherapy with planned doses in the planned time interval. In five patients with acute lymphatic leukaemia the leucocytic growth factors participated in the achievement...
[Do we have a sufficient supply of anti-HLA serum? Review of sera produced by the transfusion service 1974-1992].
A Májský
Vnitr Lek 1993, 39(9):883-886
In 1974-1992 in the HLA reference laboratory of the Institute of Haematology and Blood Transfusion in Prague 15,731 sera sent by transfusion departments were examined; 4368 sera met the standard required for HLA typing, detecting 9 HLA-A, 18 HLA-B and 3 HLA-C antigens. Against these antigens with the exception of HLA-B41 and public antigens HLA-Bw4 and HLA-Bw6 monospecific sera were found: against 15 HLA antigens in a large number and against 12 HLA antigens--2 to 21 for the given antigen. Sera against subtypes of HLA antigens were sought only in rare instances, as in common practice it is sufficient (and sometimes essential) to type only basic HLA antigens.
[Is undirected liver biopsy a safe procedure?].
L Oliva, M Hirt
Vnitr Lek 1993, 39(9):887-890
In the authors' group of 976 umaimed liver biopsies (ULB) 10 complications were recorded. The authors described them and compared them with reports from the world literature. Two patients from the group died after ULB. One as a result of biopsy from haemoperitoneum, the other patient died with delirium tremens after surgery called for by persisting peritoneal syndrome. In eight patients mild complications were involved. In five patients complications receded spontaneously, in three after administration of an analgetic. From the submitted paper ensues that ULB is not quite safe, even when used by an experienced physician and when all contraindications...
[Protective special shoes for diabetics. Personal experience with a group of high risk diabetics during a 2 and 1/2 year period].
E Záhumenský, A Adamíková
Vnitr Lek 1993, 39(9):891-895
A group of 60 type II diabetics with the risk of development of ulceration of the feet was provided with protective specialized footwear. In the course of 2.5 years in 45 patients who could be evaluated the frequency of relapses of previous ulcerations, the development of first ulcerations and the effect on indicators of immediate high risk of a defect (formation of decubital ulcers, blisters) was investigated, as well as the general biomechanical comfort. In 10 patients with relapsing defects relapses developed twice (20%), no primary ulceration developed. As compared with common footwear, the protective footwear had a favourable effect on the formation...
[Lymph node enlargement in hairy cell leukemia and problems with significant abdominal lymphadenopathy].
P Zák, L Chrobák, E Simáková, A Michl, J Voglová, S Mirová, K Podzimek
Vnitr Lek 1993, 39(9):896-901
Enlargement of nodes in leukaemia with hairy cells (LVB) during the initial examination is rarely encountered. In the final stage of the disease it was found in six of our ten patients. A special situation is marked enlargement of retroperitoneal nodes observed in two patients. In one of them the nodes diminished after irradiation, in the second patient irradiation was not possible because of severe pancytopenia. Treatment with alpha-interferon failed previously in this patient. The question remains whether marked enlargement of the abdominal nodes is part of the picture of the disease or whether it is the manifestation of transformation of the disease...
[To what extent is it possible to noninvasively determine left ventricular diastolic function in patients with ischemic heart disease using doppler echocardiography?].
J Meluzín
Vnitr Lek 1993, 39(9):902-908
The author discusses possibilities of non-invasive assessment of left ventricular diastolic function in patients with ischaemic heart disease, using Doppler echocardiography with visualization of left ventricular diastolic filling. Attention is drawn to the fact that left ventricular filling is a very complicated process which depends not only on the diastolic function of the left ventricle but also on the given haemodynamic state of the patient and on other factors; this must be taken into account when interpreting Doppler filling curves. The author concludes that during gradual development of left ventricular dysfunction non-linear changes occur...
[Diuretics in the treatment of hypertension].
R Dzúrik, V Fedelesová, V Dzúriková, V Spustová
Vnitr Lek 1993, 39(9):909-915
Diuretics are one of the basic groups of antihypertensive drugs. They have also certain limitations and undesirable effects which are better defined than in other more recently developed antihypertensives. Undesirable effects can be prevented by early combination of saluretics with K+ sparing diuretics or other antihypertensive drugs and by prevention of metabolic disorders (in particular insulin resistance and dyslipoproteinaemia) and by prescription of small doses. Only prospective intervention studies will show whether the advantages of other groups of antihypertensives, as compared with diuretics, will influence the prognosis of patients with essential...