Vnitřní lékařství, 1994 (roč. 40), číslo 6
[Gastrointestinal motility and possibilities of influencing it].
I Duris, J Payer, M Huorka, V Randus, P Ondrejka
Vnitr Lek 1994, 40(6):341-344
The authors discuss factors which influence the motility of the smooth muscles in the pancreatobiliary region. They investigated some clinical and laboratory parameters after administration of the selective antagonist of calcium influx-Pineverium bromide-Dicetel. The drug influenced significantly in a positive way nausea, flatulence, pain and chronically elevated amylases. The authors mention a cycle of possible neurohumoral changes with which specific calcium channel antagonists could interfere.
[Present possibilities of treatment of primary chronic glomerulonephritis].
V Knotková, K Němecek
Vnitr Lek 1994, 40(6):345-348
The authors evaluate in a retrospective study the effect of prednisone, cyclophosphamide, small doses of acetylsalicylic acid, conventional antihypertensive drugs and ACE inhibitors on the course of primary chronic proliferative types of glomerulonephritis. The group comprised 44 patients, incl. 16 with normal blood pressure and 28 with hypertension. All were at first given prednisone and cyclophosphamide--for an average of 18 months--and the patients with systemic hypertension conventional antihypertensive drugs. At the termination of treatment proteinuria in the whole group was significantly lower, while glomerular filtration was unaltered, i.e....
[Tumor markers in the diagnosis of tumors in the subhepatic area].
V Dufek, J Petrtýl, P Klener, J Chmel
Vnitr Lek 1994, 40(6):350-353
Concentrations of CA 19-9, CA 50, CA 195 and DUPAN-2 were followed in serum, bile and pancreatic juice of 65 patients with malignant or benign lesions of CBD and/or pancrease. In sera, significant differences between neoplasias and benign lesions were seen only in patients with tumors in stages III. and IV. In the bile, however, the significant increase of DUPAN-2 and CA 195 were present in all stages of cholangiocarcinoma when compared with benign CBD lesions. In the pancreatic juice, the significant increase on of CA 19-9, CA 50 and DUPAN-2 in patients with pancreatic cancer (stages I-IV) could also be evidenced.
[Changes in hemocoagulation during thrombolytic therapy of acute myocardial infarct in relation to risks of thrombotic complications].
P Kessler, M Kubícková
Vnitr Lek 1994, 40(6):354-358
In 38 patients with acute myocardial infarction treated with 1.5 million u. of streptokinase hemocoagulation parameters were assessed before and after treatment and after another 12, 24 and 48 hours. The authors revealed three risk indicators of thrombotic complications: 1. a shortened aPTT before treatment and at the same time a less than double prolongation of aPTT, as compared with control plasma after treatment (P < 0.01, sensitivity 0.67, specificity 0.81). 2. A non-detectable fibrinogen level (less than 1.1 milligrams) 24 hours after termination of treatment (P < 0.05, sensitivity 0.59, specificity 0.71). 3. The third risk factor 3 is a...
[The incidence of anemia in the Slovak population].
V Krislo, P Kubisz, I Piacková, T Prekopp, M Sorf
Vnitr Lek 1994, 40(6):359-361
The authors examined in two diagnostic preventive systems a total of 26,620 asymptomatic people in the district. The total number comprised 15,511 women (58.3%) and 12,109 men (41.7%) above 15 years of age. In the group of women anaemia was recorded in 4.1% and in men only in 0.19%. The highest incidence was in women and men in the age bracket from 15 to 19 years and above 70 years (girls 11.5% and boys 1.27%). Sideropenic anaemias accounted for 91.9% in women and 60.8% in men. Macroerythrocytic anaemia in men (13.1%) is associated with chronic alcohol intake.
[The role of iron deficiency on the development of anemia in patients on regular dialysis therapy].
J Zadrazil, T Papajík, P Bachleda, M Budíková, D Novotný, V Scudla
Vnitr Lek 1994, 40(6):362-366
In the course of regular dialyzation treatment very frequently iron deficiency develops. The objective of the work was to evaluate the participation of sideropenia in the development of the hypoproliferative component of anaemia and to evaluate the effectiveness of oral iron administration in a group of 24 dialyzed patients whose serum ferritin concentration was lower than 100 micrograms/l. Administration of 105 mg elemental iron per day (1 tablet of Ferronat retard, Spofa) for a period of 6 months led in 17 patients (71%) to a statistically significant increase of erythrocytes, serum ferritin, the iron plasma level and transferrin saturation. In these...
[Recurrent spontaneous pneumomediastinum as a cause of recurrent diabetic ketoacidosis?].
V Kojecký
Vnitr Lek 1994, 40(6):367-369
The author describes the case of a female patient with repeated ketoacidoses associated with the presence of spontaneous pneumomediastinum. In the discussion the author summarizes briefly contemporary knowledge on the incidence, symptoms and course of spontaneous pneumomediastinum. The possible interrelation of relapses of pneumomediastinum and diabetic ketoacidoses is discussed.
[The past, present and future of treatment of type II diabetes mellitus].
J Rybka
Vnitr Lek 1994, 40(6):370-375
Diabetes mellitus type II-NIDDM--is characterized by insulin insufficiency and insulin resistance. The main therapeutic aim is to mitigate symptoms, achieve and maintain desirable body weight, achieve a normal blood sugar level and treat complications. The main principle of NIDDM therapy remains an adequate dietary programme with reduction of the total energy intake. The greatest problem of successful therapy remains dietary non-compliance of the patient. Oral antidiabetics--in particular sulphonyl urea, have been the basis of therapy for more than 30 years. But even on this point there are some controversial views. The author discusses some problems...
[The present status of treatment of unstable angina pectoris].
M Takác, J Vancík, I Tkác, E Tomoriová
Vnitr Lek 1994, 40(6):376-381
UAP is a frequent manifestation of ischaemic heart disease; it is intermediary between stable angina and myocardial infarction and sudden death resp. The hospitalization mortality is 5%, approximately 15% of the patients with UAP develop myocardial infarction. The aim of UAP treatment is: 1. prevention of ischaemic episodes, 2. prevention of infarction and 3. control or elimination of risk factors, to improve the long-term prognosis in these patients. As antianginal drugs in UAP as a routine calcium antagonists, beta-blockers and nitrates are used. A very important part in the treatment of UAP is played by antithrombotic and thrombolytic treatment...
[Stenosis of the papilla of Vater--clinical picture and possibilities of therapy].
V Dufek
Vnitr Lek 1994, 40(6):382-385
Stenosis of the ampulla of Vater is encountered in as many as 10% of patients with biliary diseases. In general it is classified as tumourous, inflammatory of functional stenosis. In the clinical picture biliary dyspepsia associated with cholestasis predominates. The cause of functional stenosis of the ampulla of Vater is not known. In the development of inflammatory stenosis most frequently iatrogenic damage of the ampulla during revision of the biliary pathways participates or repeated passage of concrements in cholecystolithiasis. Treatment of tumours of the ampulla of Vater is surgical, treatment of inflammatory stenosis is endoscopic by endoscopic...
[New trends in antineoplastic chemotherapy].
P Klener
Vnitr Lek 1994, 40(6):386-390
The author present some possible ways how to enhance the effectiveness of chemotherapy. In addition to modification of the tactics of chemotherapy it is above all a reduction of the effects of cytostatics and overcoming the resistance to chemotherapy, while the introduction of new drugs is rather rare during the last decade. As to non-traditional ways, a part can be played by more effective prophylaxis of secondaries, induction of cell differentiation, a combination of chemotherapy with biological response modifiers (interferons and cytokines) or treatment with cytokines alone (interleukin-2, tumour necrosis factor).
[Cardiotonic therapy in advanced age].
S Krajcík
Vnitr Lek 1994, 40(6):391-393
Cardiotonic drugs are taken by as many as 13.1% of old people living at home. Their effect in old age is markedly influenced by changes of old age, polymorbidity and the administration of other drugs. Therefore as much as 80% of undesirable effects of cardiotonics are recorded in old people. The author deals also with chronic administration of cardiotonics. Factors influencing cardiotonic treatment in old age are discussed.
[Diagnostic validity of tests--binary tables or multidimensional statistical methods?].
R Gasko, E Klímová
Vnitr Lek 1994, 40(6):394-397
The authors criticize the use of concepts of sensitivity and specificity calculated by means of a binary table in differential diagnostic reflections pertaining to more than one disease or several, i.e. more than one diagnostic test. On examples they present possibilities of different ways for calculating these concepts with different not correlating results. They indicate the justification of using multidimensional statistical methods in those instances and their better diagnostic yield.