Casopís lékar̆ů c̆eských
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Casopís lékar̆ů c̆eských · Sep 2002
Case Reports[Hemophagocytic lymphohistiocytosis as a manifestation of visceral leishmaniasis].
A 7-year-old previously healthy Czech boy was admitted due to fever, hepatosplenomegaly and pancytopenia. Aspiration of bone marrow revealed no signs of hemoblastosis (nor hemophagocytosis). He was treated with antibiotics and virostatics without effect. ⋯ In control bone marrow aspirate performed three months later, the parasites were not detected. Ten months after the event, the patient is in complete remission of HLH with normal immunologic parameters. Most probably, he contracted visceral leishmaniasis during a visit of a Neapol area in Italy 3 months before the onset of the disease.
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Casopís lékar̆ů c̆eských · Sep 2002
Historical Article[Tobacco and the global epidemic of lung cancer].
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Casopís lékar̆ů c̆eských · Aug 2002
Review[Fluid resuscitation in conditions with disorders of capillary permeability].
Fluid resuscitation remains a cornerstone in the treatment of various types of circulatory failure. Alterations in microvascular permeability are a hallmark of a number of inflammatory conditions including sepsis, septic shock, burns and the acute respiratory distress syndrome. As a result, the loss of plasma fluid into the interstitial space leads to hypovolaemia and tissue hypoperfusion. ⋯ This strategy, however, involves the risk of interstitial edema formation, which in turn may further impair tissue oxygen distribution. The presented paper briefly reviews the principles of transvascular fluid exchange and the pathophysiology of capillary permeability. It discusses the ongoing controversy on the optimal way and the end points of volume replacement as well as the choice of fluid in conditions associated with capillary leakage.
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Sudden onset of tachyarrhythmias in an operating theatre or an intensive care unit can be a frustrating experience for an attending physician and sometimes even for his patient, not only because of severity of patient's clinical state, but also for the mental stress loaded on him by collaborating surgeons. From that reason, a diagnosis and treatment of such condition should be intensive, simple, effective and safe for the patient. ⋯ In this review article, the author highlights a basic electrophysiology and molecular pathophysiology of heart rhythm disturbances, and on the background of recent clinical studies he tries to propose a simplified therapeutic algorithm for treatment of these difficult states. Beta-blockers and group III, antiarrhythmics of Vaughan-Williams classification (amidarone) are recommended as the optimal remedies for the treatment of tachyarrhythmias in the perioperative period.
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Casopís lékar̆ů c̆eských · May 2002
[Nitric oxide in the treatment of acute respiratory distress syndrome].
Nitric oxide (NO) is a selective pulmonary vasodilator effective in the treatment of pulmonary hypertension and hypoxemic respiratory failure. Reports in the Czech literature on the results of its therapeutic use are still scarce. ⋯ Despite the transient increase in oxygenation after NO administration, mortality of patients with ARDS remained high. NO administration could not be considered the standard method of treatment of patients with ARDS in intensive care.