[Serum gastrin and somatostatin in diseases of the stomach].

J Payer, M Huorka, I Duris, V Randus, P Ondrejka, H Kratochvíľová

Vnitr Lek 1995, 41(6):367-370

Gastrin and somatostatin are enterohormones which influence several physiological processes in the gastrointestinal tract. Gastrin has a pro-malignant and pro-ulcerogenic effect, while somatostatin deficiency has a similar effect. The authors examined in their investigation the 24-hour secretion of both hormones in patients with gastric ulcer and atypical gastric conditions. They revealed a significant difference in the 24-hour somatostatin level which was higher in patients with atypical gastric conditions (p < 0.05). The finding may suggest a more intense reaction of somatostatin to malignant than to non-malignant disease. In the other compared...

[Kinetics of phosphorus in individuals on regular dialysis therapy].

O Schück, J Kaslíková

Vnitr Lek 1995, 41(6):371-376

In eight subjects with hyperphosphataemia included in regular dialyzation treatment repeatedly phosphorus kinetics (iP) were assessed based on changes in serum concentrations and the amount of iP removed from the organism during every dialysis (D). The serum concentration of iP before dialysis (HD) was on average 3.06 (+/- 0.81) mmol/l and D was on average 55.6 (+/- 10.0) mmol. The value of D calculated per body weight (D/BW) was on average 0.76 (+/- 0.15) mmol/kg. As the differences of predialysis serum concentrations of iP after consecutive HD sessions did not exceed the range of error of analytical assessment of iP, the D values were considered...

[Epstein-Barr virus antibodies: review of results from repeated examinations in 208 hemodialyzed patients].

L Korcáková

Vnitr Lek 1995, 41(6):377-379

Latent infection with the Epstein-Bar virus (EBV) is diagnosed as a matter of routine in haemodialyzed patients on the waiting list for renal transplantation by assessment of serum immunoglobulin G (IgG) against the nuclear antigen-1 (EBNA-1). Antibodies against EBNA-1 were detected in 163 of 208 patients (78.27%). Of these 158 entered the investigation already IgG positive against EBNA-1 and five converted later to positivity. Thirty-five of 50 patients who were IgG negative at the onset of the investigation, however, were IgG positive against the capsid antigen (VCA) EBV. Antibodies against EBNA-1 or against VCA were not detected during repeated...

[Modern diagnosis and therapy of ischemic heart disease and its acute forms in a region without a cardiac care center in 1992].

J Kovác, J Lukl

Vnitr Lek 1995, 41(6):380-384

The authors assembled and analyzed in the submitted study data on the extension of treatment of acute myocardial infarction by thrombolysis as well as data on the extension of invasive diagnostic methods and non-pharmacological treatment of ischaemic heart disease in a Central Moravian region without a cardiocentre. The conclusions were compared with a similar investigation made in 1989. As compared with the previous investigation, a marked increase in the number of patients with acute myocardial infarction treated by thrombolysis from the total number of patients admitted with this diagnosis was recorded. Thrombolytic treatment is now used by 100%...

[Endomyocardial biopsy in cardiopathy of unknown origin].

J Fabián, I Slugen, S Mizera, D Danis, R Kohn, J Pacák, Z Schreinerová, E Schrameková, M Pavlovic

Vnitr Lek 1995, 41(6):385-389

The authors described their experiences with endomyocardial biopsy (EMB) in 21 adult patients aged from 18 to 59 years with the preliminary diagnosis of cardiopathy of uncertain origin (CPUO). Their definition of CPUO is as symptoms and/or findings of cardiac disease, which cannot be exactly identify using even complex clinical and noninvasive cardiological diagnostic procedures. Diagnostic value of EMB was substantial in two of their patients (in one hypereosinophilia of myocardium, and in another amyloidosis), non specific results were found in 18 patients, and 1 patient had normal pattern of the biopsy. EMB is useful and safe clinical diagnostic...

[Indirect calorimetry and pulmonary function in chronic pulmonary disease].

J Horácek, B Král, J Bures, P Tilser, V Pidrman

Vnitr Lek 1995, 41(6):390-394

Data derived from indirect calorimetry in patients with stable chronic pneumopathies were evaluated together with their pulmonary function data (spirometry, diffusing capacity, blood gases). Their basal metabolic rate was significantly higher (116.1% of the predicted value), this increase being more expressed in the patients with hypoxemia and with more severe obstructive disorder. In chronic obstructive pulmonary disease, the increased energy expenditure in hypoxemia was accompanied with increased lipid oxidation. There also was a correlation between the patients' nutritional status (evaluated by their body mass index) and their pulmonary function....

[Successful completion of pregnancy in a dialyzed patient].

J Fialová, M Havrda, K Němecek, V Umnerová, L Golán, E Kulovaný, J Rezácová, E Sucharová, J Tocík

Vnitr Lek 1995, 41(6):395-399

The authors describe the first case of a successful pregnancy in the Czech Republic in a patient treated by continuous ambulatory peritoneal dialysis. The 22-year-old patient became pregnant ten months after the onset of treatment by peritoneal dialysis. During pregnancy deterioration of arterial hypertension occurred, deterioration of anaemia and from the 29th week onwards cholestasis gravidarum developed. The development of the foetus was within normal limits. Because of suspected preeclampsia the pregnancy was terminated during the 35th week by Caesarean section. The patient was delivered of a healthy eutrophic boy without any congenital abnormalities.

[The Crow-Fukase (POEMS) syndrome].

J Krízová, V Mazárová, J Válek, J Charvát, M Englis

Vnitr Lek 1995, 41(6):400-402

[Manifestations in cardiovascular organs of essential hypertension-- possibilities of directed therapy and prevention].

J Widimský

Vnitr Lek 1995, 41(6):403-410

Effective treatment of hypertension with permanent achievement of normal blood pressure readings is the most effective prevention of organ manifestations of hypertension. Treatment must, however, affect also other risk factors, in particular hyperlipoproteinaemia, smoking and diabetes. Treatment of hypertension is individually adjusted and depends on: a) age, b) the presence of complications of hypertension and c) the presence of associated diseases. In elderly hypertensive patients small doses of diuretics and beta-blockers are the drugs of choice. The most frequent complication of hypertension is hypertrophy of the heart and IHD. The drug of choice...

[Mutants of the hepatitis virus].

P Chalupa, P Jezek, P Husa

Vnitr Lek 1995, 41(6):411-414

The variability of genomes of the hepatitis viruses leads to the development of viral mutants which are of great importance not only for epidemiology and therapy but also for the prevention of infections they cause. Contemporary knowledge indicates that investigation of mutants of hepatitis viruses is not only necessary for the understanding of the epidemiology, spread, elucidation of the severity of the disease and sequelae after acute infection but also for our therapeutic possibilities in different forms of viral hepatitis (VH). The submitted paper reviews the most important mutants of different types of VH (HA, HB, HC, HD, and HE).

[Venous thrombosis in relation to central venous catheters: pathogenesis, diagnosis, therapy, possibilities of prophylaxis].

R Hájek, M Matýsková

Vnitr Lek 1995, 41(6):415-420

Thrombosis represents one of the most frequent and severe complication of central venous catheterization. The incidence of catheter-related venous thrombosis is not well established. This complication was found in 3.3% patients in the analysis of 23 studies with central venous access devices-ports. We have found it in 3% of our patients with implanted port. The types of catheter related thrombosis are following: mural thrombosis, fibrin sheath, thrombosis on the catheter tip. Venography has been shown to be highly reliable in identification of upper-extremity deep venous thrombosis. The up-to-date possibility of treatment and prophylaxis of venous...

[Infections in patients with central venous systems for long-term venous access: pathogenesis, classification, diagnosis and therapy].

R Hájek, D Burgetová, I Vásová, M Tomíska

Vnitr Lek 1995, 41(6):421-426

Central venous access devices are a major source of nosocomial infection. The skin and catheter hub are the two major sources for the introduction of the colonizing organisms. Staphylococci are the leading causative agents. The authors reviews classification of catheter-related infection complications, diagnostic problems of catheter sepsis and up-to-date trends in their treatment. Diagnosis of catheter-related sepsis remains still difficult, if device is not removed. Candida catheter related is associated with higher morbidity and mortality than infections with other organisms and the device should be removed if possible. Prophylactic measures include...

[Present possibilities of prevention of infectious complications associated with central venous catheter systems].

R Hájek, J Mayer, M Tomíska

Vnitr Lek 1995, 41(6):427-431

Central venous access devices are a major source of nosocomial infection. The skin and catheter hub are the two major sources for the introduction of the colonizing organisms. Authors reviewed up-to-date prophylactic possibilities in this paper. Prophylactic measures include a skilled team, topical disinfectants, topical antibiotics, new types of devices such as coating catheter with antiseptic agent and catheter with silver impregnated cuffs, maximal barrier precautions during insertion, systemic vancomycin therapy of high risk patients. Exchanging central venous catheters over a guidewire might be useful diagnostically but have not been used to be...