Vnitr̆ní lékar̆ství
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Pancreatic diseases are often accompanied by pleuropulmonal complications. Acute pancreatitis may induce a number of various pathological findings in respiratory tract including hypoxemia, decrease of transfer-factor (DLCO), decrease of transfer-coefficient (DLCO/VO), decrease in forced expiratory flow 25%- 75% of forced vital capacity (FEF25-75%), elevated and/or immobile diaphragm, basal atelectasis, unilateral or bilateral pulmonary infiltrations, mediastinal pseudocyst and pleural effusion. ⋯ Pancreaticopleural fistula (PPF) is the most common cause of this type of pleural effusion. We describe a study group of 3 patients with PPF and pleural effusion, their clinical symptoms, diagnostics and management.
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Vnitr̆ní lékar̆ství · Dec 2006
[Allogeneic hematopoietic stem cell transplantation in patients with chronic myeloid leukemia in the Czech Republic--a retrospective analysis of results in years 1988-2005].
Analyses of hematopoietic stem cell transplantation (SCT) results are of high importance for decision-making on treatment strategy for patients with SCT as a possible therapeutic alternative. In this paper the Czech National Registry of SCT and Transplantation Centre in Pilsen present their joint retrospective analysis of the results of allogeneic SCT in patients with chronic myeloid leukemia (CML) performed in the Czech Republic from 1988 to spring 2005. 295 patients (179 men and 116 women) ranging in age from 6.9 to 59.5 years (median 37.3) underwent transplants. In most cases the donor was an HLA-identical sibling (164; 55.6%) or a voluntary unrelated donor from the register (110; 37.3%), in a minority of cases another relative of the patient (21; 7.1%). ⋯ In Cox multivariate analysis the EBMT risk score and the interval from the diagnosis to SCT were identified as independent factors in patient survival. An "ideal" patient, aged under 30, undergoing transplant in the chronic phase of CML within one year since the diagnosis after 2000 had a survival probability of 88% for three years after SCT. It can be concluded that results of allogeneic SCT in CML in the Czech Republic reflect current global trends, are comparable with results achieved in other countries and show significant improvements.
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Positron emission tomography (PET) is a non-invasive diagnostic method which shows the bio-distribution of positron emitter labelled radiopharmaceuticals in the body. Due to the fact that not only timorous, but in certain conditions also some inflammatory cells may exhibit increased accumulation of 18F-FDG, 18F-FDG PET can be used in the diagnosis of both tumours and certain types of inflammations. ⋯ Positron emission tomography using 18F-FDG can be used to detect active large vessel vasculitis in patients examined for symptoms of fever of uncertain origin. Apparently, PET can detect cases of large vessel vasculitis where other imaging methods have failed and can be also used to follow the development of vasculitis activity during therapy.
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Vnitr̆ní lékar̆ství · Sep 2006
Review[Diuretics in therapy of "diuretic resistance" by patients with congestive heart failure].
Loop diuretics are integral part of overall therapy of severe congestive heart failure. Approximately 10-20 % of patients with congestive heart failure (NYHA class III-IV) do not respond satisfactorily to diuretic treatment. Despite its frequency, the term "diuretic resistance" remains inadequately defined. ⋯ The combination of diuretics, particularly of loop diuretic with thiazide agents, is recommended for prevention as well as treatment of this complication. Effective management is also continuous infusion of loop diuretic. If it is impossible to achieve adequate response by combination of diuretics, increasing of its dosage or/and frequency or continuous infusion, then dialysis methods may be employed (however it is not intended to discuss this option in this article).
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Vnitr̆ní lékar̆ství · Sep 2006
Comparative Study[Monitoring of glucose concentration in critical patients, comparing arterial blood glucose concentrations and interstitial glucose concentration measured by microdialysis technique].
Recent studies have shown that normalization of blood glucose in critically ill patients by intensive insulin therapy significantly decreases their mortality and morbidity. The aim of our study was to compare interstitial glucose concentrations in subcutaneous adipose tissue (measured by microdialysis technique) and arterial blood glucose concentrations to test the suitability of subcutaneous adipose tissue for long-term placement of biosensors for glucose measurement in critically ill patients. ⋯ Our study demonstrated good correlation between interstitial glucose concentrations in subcutaneous adipose tissue and arterial blood glucose concentrations in post-cardiac surgery patients. Further studies are needed to evaluate this relationship in patients with more severely disturbed perfusion of subcutaneous adipose tissue.