Vnitřní lékařství, 2000 (roč. 46), číslo 2
[The prehospital phase in patients with acute myocardial infarct in Slovakia. A challenge].
S Cagán, M Pavlovic, R Stefanovic, J Murín, S Wimmerová, I Besedová, T Trnovec
Vnitr Lek 2000, 46(2):67-79
Better management of patients with acute myocardial infarction during the prehospital phase is at present a challenge not only for health workers but for society as a whole. The authors pay attention to knowledge of the complex problem of the prehospital phase in patients with acute myocardial infarction which is a prerequisite for finding possible solutions for a favourable effect on their management. The authors analyzed 3,040 patients who were admitted to hospital alive within 96 hours after the development of complaints with suspicion of a first or repeated acute myocardial infarction. They focused attention in particular on prehospital time delay....
[Ventricular fibrillation in chronic heart disease].
M Pleskot, P Parízek, M Hodac, L Haman, J Stásek, P Cervinka, M Tauchman
Vnitr Lek 2000, 46(2):80-86
The objective of the work was to describe in subjects with spontaneous ventricular fibrillation, after elimination of acute cardiac disease, the strategy of antiarrhythmic treatment and to evaluate, based on prospective follow-up, the effectiveness of this treatment. The authors included in the group 36 patients (30 men and 6 women) within the range from 34 to 78 years (mean age 58 +/- 11 years) with spontaneous ventricular fibrillation. They divided the group into a subgroup (15 subjects) without revascularization of the heart muscle, into a subgroup (17 subjects) with revascularization of the myocardium (coronary angioplasty and bypasses) and a subgroup...
[Effect of bisoprolol on heart rate variability in patients with hyperthyroidism].
T Mudríková, V Jurcová, A Tokarcíková, V Gonsorcíková, J Gonsorcík, M Gregorová, I Tkác
Vnitr Lek 2000, 46(2):87-91
OBJECTIVE: The objective of the submitted work was to assess by the method of spectral analysis of the heart rate how the use of bisoprolol will affect the autonomous modulation of the heart rate in hyperthyroid patients and what are the time relations of this effect.MATERIAL AND METHODS: In the investigation 10 female patients with thyreotoxicosis caused by Graves-Basedow's disease were included. Their average age was 38 years and along with a thyrostatic drug bisoprolol was administered. Spectral analysis of the heart rate was made before the onset of treatment, after a week and after six weeks with the patients in an upright and recumbent position....
[Radiofrequency catheter ablation of left-sided atrioventricular accessory pathways. Immediate and long-term results using the trans-aortic approach].
M Fiala, P Heinc, J Lukl
Vnitr Lek 2000, 46(2):92-95
UNLABELLED: Catheter mapping and ablation of left accessory pathways may be difficult if the pathway fibre orientation is oblique across the mitral annulus. This is particularly true in case of concealed accessory pathway that conducts only in ventriculoatrial direction. The purpose of the study was to compare catheter ablation safety, efficacy, procedure and fluoroscopy times and number of radiofrequency energy deliveries for manifest and concealed left accessory pathways using retrograde transaortic approach. 56 patients (26 females) aged 41.6 +/- 15.1 years underwent 59 ablation procedures for 59 left accessory pathways. 25 (44.6%) patients with...
[Adult patients after surgery of ostium primum type of atrial septal defects in childhood: echocardiography study].
J Veselka, M Mates, T Honěk, T Tláskal, J Skovránek
Vnitr Lek 2000, 46(2):96-101
The authors examined, using transthoracic and transoesophageal echocardiography, 36 adult patients (15 men) aged 22 +/- 3.1 years (18-29 years) who were operated 12.2 +/- 3.7 years previously on account of a defect of the atrial septum type ostium primum. In these patients no other congenital cardiac defect was present. In addition to closure of the defect in the patients complete suture of the "cleft" of the anterior cusp of the mitral valve was performed, in 7 partial suture of the "cleft" of the anterior cusp of the mitral valve and in 4 commissuroplasty. In one instance later reoperation with replacement of the mitral valve by a mechanical prosthesis...
[Evaluation of kidney function in patients before and after orthotopic liver transplantation].
H Hrncárková, O Schück, J Malý, P Trunecka, J Spicák
Vnitr Lek 2000, 46(2):102-106
Subjects before and after orthotopic transplantation of the liver develop frequently renal disorders. Evaluation of the renal function based on the serum creatinine concentration or its clearance is difficult in these cases because the concurrent hyperbilirubinaemia usually interferes with the method used for creatinine assessment (based on Jaffé's positive chromogen) and gives incorrect lower values. In the submitted work the authors investigated the development of the serum creatinine concentration and serum bilirubin concentration in 50 subjects before and one year after transplantation of the liver. The findings suggest that although under conditions...
[Latent membrane protein LMP-1 in Hodgkin's lymphoma].
J Macák, L Plank, B Habanec, P Fabian
Vnitr Lek 2000, 46(2):107-110
The authors examined using the antibody against latent membrane protein (LMP-1) a group of 169 patients with Hodgkin's lymphoma (age 2 to 82 years). From the total number of 169 patients 48 (28%) patients were positive when tested with this antibody. In the whole group the following histological types were represented most frequently: type II (nodular sclerosis) 83 (49%) patients, and type III (mixed cellularity) 70 (41%) patients. Type I (lymphocytic predominance) was not represented. In type IV (lymphocyte depletion) there were three cases (1.7%). Type V (lymphocyte rich) was represented by 13 patients (7.6%). The frequency of positive cases was...
[Plasma pH and anticoagulant solutions used in the plasmapheresis method of blood collection from donors].
J Pták, L Novácková, M Stachelová, D Slabík, S Králová
Vnitr Lek 2000, 46(2):111-113
The resulting pH of fresh frozen plasma for clinical use, collected by plasmapheresis from blood donors is influenced by the type of anticoagulant solution and its ratio with the donor's blood. The authors describe the use of three anticoagulant solutions with a different sodium citrate concentration and different ratios of donor blood. As compared with the physiological range of pH of the blood, the resulting pH value of the collected plasma, when using ACD-A and AB-16 solutions, varies within the range classified as acidosis, i.e. less than 7.36. When using a 4% sodium citrate solution the plasma pH value is in the area evaluated as alkalosis. The...
[Postural trauma and rhabdomyolosis causing acute renal failure].
J Vecer, H Kubátová, M Soucek, J Charvát, M Kvapil, K Matousovic, V Martínek
Vnitr Lek 2000, 46(2):114-115
Rhabdomyolysis (damage of the muscles of various origin) leads to the efflux of the intracellular fluids in the circulation. The common complication of this status is the renal failure. The early diagnosis and the proper treatment makes the fall of renal function reversible. That is why the possibility of the rhabdomyolysis must be consider. The case report describes the development of renal failure in young, previously healthy men, followed by trauma mechanism after drug and alcohol abuse.
[Thrombotic thrombocytopenic purpura--still a therapeutic problem. Case report of a patient on long-term therapy].
J Pták, M Kubecková
Vnitr Lek 2000, 46(2):116-118
Thrombotic thromboctopenic purpura is a rare multisystemic life threatening disease the treatment of which is still a serious problem. The most successful therapy is plasmapheresis where the whole plasma volume of the patient is replaced by fresh frozen plasma or cryosupernatant. The authors describe a 34-year-old patient with the chronic relapsing form of the disease and repeated cerebrovascular attacks with an ischaemic genesis with developed organic psychosyndrome. The only effective treatment of the patient are exchange plasmaphereses replacing plasma by cryosupernatant after the patient became refractory to fresh frozen plasma. The authors describe...
[Pacemaker dysfunction during use of a mobile telephone].
J Vlasínová, T Novotný
Vnitr Lek 2000, 46(2):119-121
Ubiquitious electronic equipment increases the number of potential sources of electromagnetic interference with sufficient energy to influence a pacemaker function. Besides others the mobile phone play important role. A 76 year-old female patient with pacemaker was hospitalized because of bilateral congestive heart failure. During ECG telemetry a short episode of pacemaker dysfunction was recorded. In a period of 15 seconds at first a pulse output inhibition occurred, then an undersensing was present. In all the 24-hour recording no other similar episode was observed. Such an utterly atypical picture lead to a direct question on mobile telephone calling....
[Imidazole receptor agonists--a new advance in the treatment of hypertension?].
J Spinar, J Vítovec
Vnitr Lek 2000, 46(2):122-125
Agonists of I1 imidazolin receptors are a new drug groups which was registered for the treatment of hypertension. Their antihypertensive action is comparable with current antihypertensives (hydrochlorothiazide, enalapril, atenolol, nifedipine retard) and causes a drop of the systolic BP by cca 15-20 mm Hg and a drop of the diastolic BP by 10-15 mm Hg with a probable normalization of the blood pressure in cca 60% patients with mild to moderate hypertension. Agonists of I1 imidazoline receptors are suitable in particular for the treatment of hypertension associated with metabolic syndrome. Their effect in patients with ischaemic heart disease or after...
[Diagnostic approaches in pleural effusion].
G Engel
Vnitr Lek 2000, 46(2):126-129
It is not easy to discover the underlying cause for pleural effusion. Over a quarter of the pleural effusions remain unexplained by indirect methods of examination such as chemical, cytological or bacterial tests. Thoracoscopy however, shows impressive results and can be conducted under simple conditions. Different statistical collections allow for the assumption that pleural effusions due to cardiac disease and malignant conditions occur equally often. They are followed in frequency by infection diseases and the often misjudged effusion with pulmonary embolism.
[High resolution electrocardiography of P-wave signals in clinical cardiology].
R Kucinský, J Gonsorcík, J Franko, A Rajnic, P Olexa
Vnitr Lek 2000, 46(2):130-135
Signal-averaged electrocardiography of the QRS complex detects presence of late potentials which represent significant arrhythmogenic marker responsible for increased risk of life-threatening ventricular arrhythmias especially in post myocardial infarction patients. The P wave signal-averaged electrocardiography has been designed to predict development of atrial fibrillation in different populations of patients. Many P wave signal-averaging methodological procedures have been developed. However their common disadvantages remain lack of standardization, relatively low specificity and sensitivity, low positive predictive value as well as limited number...