[Prevention of polymorphous ventricular tachycardia in patients with congenital long QT interval syndrome].

G Kaliská, P Kmec, I Nedělová, M Szentivanyi, J Skamla

Vnitr Lek 1996, 42(3):147-149

Patients with the Romano-Ward long QT interval syndrome run a high risk of sudden cardiac death. Beta-blockers of the sympathetic nerve are effective treatment. Some patients die suddenly despite this treatment. The treatment of choice is a combination of beta-blockers of the sympathetic nerve and cardiostimulation. The authors describe a group of their own five patients from three families with the Romano-Ward syndrome. The course was favourable. The stimulation rate needed for normalization of the QT interval and a favourable clinical development was 78 +/- 6 imp./min. Based on data in the literature and their own experience the authors recommended...

[Is antibiotic prophylaxis necessary in patients on chronic dialysis and with recurrent endocarditis?].

V Kopal, J Svejda, Svobodová

Vnitr Lek 1996, 42(3):150-152

The authors present a group of 77 patients with chronic dialysis treatment during the period from 1/92 to 4/95 with regard to the prevalence of infectious endocarditis. This disease was detected in 8 instances in 6 patients whereby one patient had three relapses. In 75% staphylococci were the infectious agent. The main risks of the disease are according to the authors impaired immunity, repeated cannulation, degenerative valvular changes. In the conclusion the authors state that the risk of developing infectious endocarditis and relapses of the disease can be reduced by careful diagnosis and antibiotic therapy. The authors do not consider lifelong...

[Personal clinical experience in the treatment of arterial hypertension using amlodipine].

J Zicha

Vnitr Lek 1996, 42(3):153-156

In 15 centres of the Czech Republic the antihypertensive effect of Amlodipine-Norvasc of Pfizer Co. was tested in 155 patients with mild or medium severe hypertension. The patients were treated by monotherapy, using doses of 5 mg (92%) and 10 mg (8%) per day. In all investigated hypertensive subjects a statistically significant decline of the systolic and diastolic blood pressure occurred in the course of the 12-week investigation (P smaller than 0.01) without affecting the heart rate. The rate of undesirable effects of treatment was very low: only three patients (1.9%) discontinued treatment on account of undesirable effects. The most frequent ones...

[A protein-restricted diet combined with ACE inhibitors does not improve insulin sensitivity in renal hypertension].

V Spustová, K Stefiková, A Oksa, R Dzúrik

Vnitr Lek 1996, 42(3):157-161

Hypertension is one of the most important accelerating factors for progression of nephropathies. Its prevalence is about 35% in patients with nephropathies, even in minor or medium severe functional impairment. This is evidence that it is essential to select an optimal therapeutic regimen as soon as possible. A group of 38 patients (14 hypertensive patients) with a minor or medium severe functional impairment were included in a controlled trial. The patients were served a low-protein diet--0.6-0.7 g/kg/day and 2-10mg enalapril/day divided into two doses. The amount of enalapril depended on the blood pressure and enalapril was given also to normotensive...

[The clinical picture of latent hypothyroidism in women].

D Trejbal, V Gonsorcíková, I Lazúrová, J Vajó, E Pálová, L Trejbalová, L Sokol, J Zimácek

Vnitr Lek 1996, 42(3):162-165

The authors investigated the most frequent clinical symptoms in a group of 132 women with latent hypothyroidism (mean age 40.2 years, incl. 102 women younger than 45 years). They assessed the diagnosis on the basis of an excessive TSH response after administration of 0.2 mg thyreoliberin by the i.v. route (TRH test), while the thyroxine values were normal (TSH 0 min.: 4.93 +/- 3.55, TSH after 20 min. following TRH: 39.27 +/- 18.28 mIU/ml, T4: 102.0 +/- 25.02 nmol/l). Forty-one patients (31%) had goitrectomy in the case-history. USG examination of 70 patients revealed goitre in 13 (18.6%) reduced echogenity of the thyroid gland in 20 (28.6%) and microcysts...

[Treatment of autonomous thyroid gland nodules using percutaneous injections of ethanol under ultrasonography control--initial experience].

V Gonsorcíková, D Trejbal, M Tajtáková, J Gonsorcík, J Klimcík, S Koval, Y Machánová, V Niznanská

Vnitr Lek 1996, 42(3):166-170

The authors treated nine women with autonomous adenomas of the thyroid gland by repeated ethanol injections under ultrasonographic control. In all patients clinical and laboratory characteristics of hyperthyroidism were present. After treatment is seven patients euthyroidism was induced, in two patients subclinical hypothyroidism which persisted also during the 6-month follow-up period. In all patients ultrasonographic changes in the nodes were recorded: a reduced echogenity the development of "halo"--hypoechogenic outlines--a change of the shape and on average a 37% reduction of the volume. Treatment was feasible also under out-patient conditions:...

[Cystic fibrosis--a serious disease affecting the nutritional status and energy requirements in adult patients].

S Musilová, J Musil, M Kvapil

Vnitr Lek 1996, 42(3):171-174

At the Department for TB and Respiratory Diseases of the Faculty Hospital in Prague Motol at present half the patients with cystic fibrosis who in the Czech Republic reached adult age are being followed-up. The objective of the present work was to evaluate the nutritional profile of these adult patients with cystic fibrosis. The authors examined 15 patients, mean age 22.9 +/- 3.2 years. The examination included assessment of height, body weight, skinfold thickness above the triceps, brachii, the energy output transferrin, blood gases. Functional examination of the lungs was made by the method of the flow-volume curve. The body mass index (BMI) was...

[Treatment of inoperable non-small cell bronchogenic carcinoma with a combination of cisplatin and vinorelbine--preliminary evaluation].

Z Adam, H Coupková, V Kolek, M Kucera, L Loffelman, A Martinez, L Nováková, P Průsa, P Reiterer, P Rozánek, B Skalová, J Skricková, S Spelda, V Sturza, J Vorlícek, F Wurst

Vnitr Lek 1996, 42(3):175-180

The optimal therapeutic approach to patients with inoperable non-small-cell carcinoma is still a matter of discussion. The reason is that chemotherapy improves the quality of life only in some patients. It prolongs their life only by several weeks. In recent years in this indication a new cytostatic is tested--vinorelbine which when used in monotherapy achieves a therapeutic response in 16--30%. In clinical trials of phase 2 a combination of vinorelbine and cisplatinum was most effective and therefore it was selected for the third phase of clinical trials. In the Czech Republic a clinical investigation was made with the objective to verify published...

[Basic indicators characterizing the acid-base equilibrium and its disorders].

K Kubát

Vnitr Lek 1996, 42(3):181-187

The author describes and evaluates basic parameters used for evaluation of the acid-base balance: pH, pCO2, BE, BBS, (Na + K)/Cl, (AG) and RA. He compares the theories of two basic schools, the Copenhagen and Boston school and synthesizes the different views of various authors. A combination of modern theories permits to evaluate simple and combined disorders of the acid-base balance, disorders which can potentiate each other but also mask their effect. The author mentions also the importance of oxygen parameters and of other substances essential for obtaining energy, the importance of assessment of the patient's clinical condition, the necessity of...

[Use of molecular genetics in the early diagnosis of familial adenomatous polyposis].

J Simko, V Zajac

Vnitr Lek 1996, 42(3):188-190

Familial adenomatous polyposis (FAP) is an autosomal dominant hereditary precancerous condition manifested by hundreds to thousands of polyps in the colon and rectum. Practically, with a 100% certainty, patients with FAP develop carcinoma of the colon or rectum. FAP is this the most dangerous sign of a precancerous condition. So far the only possibility of early diagnosis of this disease was rectoscopy or colonoscopy of risk subjects after annual intervals up to advanced age, After localization of the gene responsible for the development of FAP and discovery of its internal structure, possibilities for revealing FAP, decades before the first clinical...

[Lipid risk factors and their role in the pathogenesis of atherosclerosis].

H Vaverková

Vnitr Lek 1996, 42(3):191-196

The author presents an account on the main lipid risk factors of ischaemic heart disease. She emphasizes the causal role of cholesterol and low density lipoproteins (LDL), incl. the VLDL subclass and oxidized LDL in the pathogenesis of atherosclerosis. The atherogenic action of elevated concentrations of triacylglycerols is discussed (the importance of heterogenity of lipoproteins rich in triacyglycerols, postprandial hypertriacylglycerolaemia, combination with low concentrations of high density lipoproteins (HDL) and prothrombogenic changes). The protective role of HDL is mediated not only by their participation in the reverse cholesterol transport...

[Erythropoietin in the treatment of anemias].

I Spicka, P Klener, J Lachmanová, J Háber

Vnitr Lek 1996, 42(3):197-199

Recombinant erythropoietin (r-HuEPO) was the first growth factor introduced into clinical practice. The main indication for its therapeutic use remains treatment of anaemias during chronic renal failure. In Czech Republic it is at present administered to 55% of patients included in a regular haemodialyzation program and in the pre-dialyzation stage of the disease, consistent with European practice. In addition to a marked improvement of the quality of life, during r-HuEPO treatment also the prevalence of some cardiovascular complications is reduced and immune functions improve. The list of diseases where r-HuEPO therapy is indicated has been, however,...

[Insulin resistance and pathogenesis of non-insulin-dependent diabetes mellitus (part II)].

E Martinka, P Galajda, M Mokán

Vnitr Lek 1996, 42(3):200-204

A review of the existing views is given, focused on the role of insulin resistance (IR), impaired insulin secretion and reduced suppression of hepatic glucose output and in the pathogenesis of noninsulin dependent diabetes mellitus (NIDDM). Currently, there are two basic theories on the sequence of these defects. Most of the authors suggest that NIDDM is caused primarily by insulin resistance (IR) (which is also considered an earliest detectable defect) with subsequent inability of the pancreas sufficiently compensate for IR. However, some authors suggest that NIDDM results from the abnormal pancreatic beta-cell function (disturbed pulsatility and...

[The beginnings of extracorporeal hemodialysis at the 2nd Internal Medicine Clinic of the Charles University Medical School in Prague].

S Daum

Vnitr Lek 1996, 42(3):205-208

[Ludwig Hirszfeld (1884-1954), a Polish physician and scientist].

Z Churý

Vnitr Lek 1996, 42(3):209-210