Vnitřní lékařství, 1995 (roč. 41), číslo 12
[Quo vadis internal medicine?].
I Duris
Vnitr Lek 1995, 41(12):807-809
General internal medicine is continuously atomized. With respect to the patient, however, particularly concerning indications for medication and surgical treatment of polymorbid patients, as well as in solving the problems of the aged, general medicine is necessary. To fulfill the tasks expected of a specialist in internal medicine he has to build up a bank of diagnostic and therapeutic data of high and up to date quality and master many procedural skills.
[Perception of dyspnea in asthmatics--long-term study].
B Král, Z Paráková, P Tilser
Vnitr Lek 1995, 41(12):810-815
The authors investigated the relationship between perception of dyspnoea and some respiratory parameters (vital capacity - FVC, one-second vital capacity - FEV 1) in 43 patients with bronchial asthma. They followed up the changes of this relationship during repeated examinations within 3 - 60 months following the first examination. They were also interested to find out whether the patients perceive a reduction of the bronchial obstruction after Berotec. The authors provided evidence that: 1. a small proportion of the patients (18.4%) do not report subjective dyspnoea even in case of major obstruction of the respiratory pathways. 2. Another part of...
[Relapse in Hodgkin's disease. Incidence of relapse in a group of 374 patients from 1 June 1968 to 31 March 1995].
Z Dienstbier, Z Hermanská, J Zámecník, L Melínová, B Vacková, E Skala, D Srbová
Vnitr Lek 1995, 41(12):816-821
From a group of 366 patients with complete data complete remission was achieved by 290. Fifty-five patients relapsed, 39 men and 16 women, mostly with an initial finding of advanced disease (KS III + IV 64%), with affection of the mediastinum (73%) aged under 40 years. 42% of the relapses were detected within one year after termination of primary treatment and 33% during the subsequent 2 years, the longest interval before a relapse being 20 years. During primary treatment in 63% of the patients chemotherapy was reduced to 75-25% of the total dose of cytostatics with protraction of the interval between cycles in 58% and radiotherapy in another 34% of...
[Density of adhesive proteins after oral administration of proteolytic enzymes in multiple myeloma].
A Sakalová, R Kunze, D Holománová, J Hapalová, B Chorváth, M Mistrík, J Sedlák
Vnitr Lek 1995, 41(12):822-826
The authors present information on the presence of adhesive proteins on membranes of myeloma and precursor cells isolated from bone marrow and blood from a group of 33 patients examined by fluorescent flow cytometry. They also compare the density of integrins (CD29, CD49e, CD41, CD51 and CD61) and adhesive proteins from the group of "homing" receptors (CD44) and IgG "superfamily" (LFA-1, LFA-3, ICAM-1, N-CAM) and their changes after a single oral dose of a mixture of proteolytic enzymes (Wobe Mugos, Wobenzym, MUCOS Pharma, FRG). The authors observed a significant drop of CD29, CD54 (ICAM-1), CD58 (LFA-3) after Wobe Mugos, CD49, CD51, CD58 after Wobenzyme....
[Fever of unknown origin].
S Alusík
Vnitr Lek 1995, 41(12):827-831
From a total of 4,123 hospitalized patients the criteria of fever of unknown origin were met by 81 (2%) who were divided with regard to the evoking cause into five groups: infection, tumors, rheumatic diseases, other diseases, diagnosis not established. The most frequent cause of fever was infection (29 patients, i. e. 35.8%), rheumatic diseases (16 patients, i. e. 19.7%), and the group of other diseases (14 patients, i. e. 17.3%). Tumors as the cause of fever held the fourth place (12 patients, i. e. 14.8%). In a small group of patients (10, i.e. 12.3%) the diagnosis was not established.
[Ventricular fibrillation after administration of adenosine].
J Pella, B Stancák, E Komanová, R Novotný
Vnitr Lek 1995, 41(12):832-835
In the submitted case-history the authors describe a hitherto unknown proarrhythmic effect of adenosine. Adenosine was administered on account of supraventricular tachycardia and the undesirable proarrhythmic effect was so-called "sine wave-like tachycardia" and ventricular fibrillation. Proarrhythmia was resistant to electric cardioversion and resuscitation was successful probably only after the breakdown of adenosine. The very short half-life of breakdown of this antiarrhythmic is thus useful not only for antiarrhythmic strategy but, because of the possible occurrence of rare proarrhythmias, adenosine holds a preferential position among other antiarrhythmic...
[Evaluation of a standard electrocardiogram in acute myocardial infarct and therapy with thrombolysis].
L Kuchárová, S Cagán
Vnitr Lek 1995, 41(12):836-841
Electrocardiography the cheapest, quickest and most readily available supportive examination method in patients with acute coronary events is irreplaceable also in the era of thrombolysis. The authors present a review of data from the literature on evaluation of the success of thrombolysis based on the electrocardiogram. They emphasize in the first place the importance of a rapid drop or normalization of the ST segment and/or the presence of so-called reperfusion arrhythmias (in particular an early, frequent, repetitive accelerated idioventricular rhythm). The authors mention also changes of the QRS complex, the T wave and Q-T interval during thrombolytic...
[Principals of clinical examinations of mitral stenosis prior to invasive treatment].
J Hůla
Vnitr Lek 1995, 41(12):842-845
Mitral stenosis, being a progressive disease, remains even at present an important specialized diagnostic field of cardiology which deserves special attention. Although a substantial regression of rheumatic disease was recorded in our country, we have to take into account that there are patients after surgery of mitral stenosis made in the past, that restenosis may develop and that there is also a certain number of non-rheumatic forms of mitral stenosis. Clinical cardiological examination still remains the basis for evaluation of mitral stenosis. A central position in the diagnosis of mitral stenosis for assessment of structural morphological changes...
[Neural syncope--a current therapeutic problem].
R Dvorák, M Kozák, B Semrád, M Sisáková, L Krivan
Vnitr Lek 1995, 41(12):846-850
Syncope, a state performed by transient loss of consciousness connected with postural tone decrease present still an important therapeutical problem. It can vary from a benign physiological body reaction to a life-limiting situation. The authors of the article present HUT-testing to be a simple, useful and safe method for discovering vasovagal mechanism of the syncope. They notice the experiences with treatment according to the HUT results. The most frequent types of therapy are the pharmacological and the pacing ones, when the former is appropriate for I and III class of VVS the latter then for the II. class. There are some big studies in progress...
[Osteoporosis. 2].
Z Fojtík, J Mayer
Vnitr Lek 1995, 41(12):851-857
Drug used to treatment osteoporosis can be grouped in two main categories: those that decrease bone resorption and those that increase bone formation. Long-term estrogen therapy as antiresorptive drugs are most effective when bone turnover is increased at time of menopause. Further antiresorptive drugs include oral calcium, calcitonin, bisphosphonates. Drugs that act by increasing bone formation produce an increase in bone mass, these agents are good candidates for the treatment of osteoporosis. Intermittent slow-release sodium fluoride administered for osteoporotic patients inhibits new vertebral fractures, increases the mean spinal bone mass and...