Vnitr̆ní lékar̆ství
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Vulpian in France and Hoff and Ludwing in Germany first studied atrial fibrillation in experimental animals. In clinical medicine, de Senac and others, first observed irregular and fast pulse. Hering in 1903 described "pulsus irregularis perpetuus" as a distinct arrhythmia. ⋯ Mackenzie was another British author who played an important role in the clarification of atrial fibrillation, particularly after Cushny convinced him, that the so-called nodal rhythm was atrial fibrillation. Einthoven reported the first ECG of atrial fibrillation without recognizing its true nature. Finally in 1909 and 1910 Lewis in London and, Rothberger and Winterberg in Vienna established atrial fibrillation as a clinical entity.
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Vnitr̆ní lékar̆ství · Dec 2002
[Importance of the ECG for evaluation of severity of pulmonary embolisms].
To evaluate whether it is possible on the basis of ECG examination to judge the haemodynamic impact of pulmonary embolism. ⋯ The absence of ECG changes does not rule out serious pulmonary embolism. The finding of typical ECG changes is very frequently associated with pulmonary hypertension, right ventricular dilatation and a serious haemodynamic finding.
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Vnitr̆ní lékar̆ství · Nov 2002
Randomized Controlled Trial Clinical Trial[Parenteral glutamine does not improve the nutritional status in patients during high-dose chemotherapy and autologous peripheral stem cell transplantation].
High-dose chemotherapy is aggressive treatment modality adversely affecting both energy/protein demands and oral intake/resorption of nutrients. Aminoacid glutamine is known for its' proteoanabolic effect and as an energy source for enterocytes and immune system. Nutritional parameters have been studied in a controlled, randomised, double-blinded trial of parenteral glutamine supplementation of autologous stem cell transplant patients. ⋯ High-dose chemotherapy with autologous stem cell transplantation causes proteocatabolism of medium severity. Nutritional status of patients cannot be improved by the mode and dosage of parenteral glutamine used in our study. Optimal nutritional monitoring and treatment for this group of patients is suggested.
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Vnitr̆ní lékar̆ství · Nov 2002
[Diagnosis and therapy of ethylene glycol poisoning--analysis of 20 patients].
The paper presents a retrospective analysis of 20 patients with acute ethylene glycol intoxication who were treated from 1972 to 2001 in the Dialysis Centre of the IVth Medical Clinic and from 1997 at the L. Pasteur Nephrological Clinic of the Faculty Hospital and Safarík Medical Faculty in Kosice. The ethylene glycol intoxication was manifested by neurological symptoms, extreme metabolic acidosis, acute toxic hepatitis and acute renal failure. ⋯ Concomitant application of haemoperfusion over active charcoal during the first haemodialysis in four patients led to a potentiated effect on the uraemic syndrome. Conservative and extracorporeal elimination treatment of ethylene glycol intoxication succeeded in 16 patients (80%). According to the authors' experience early and fractionated application of bicarbonate haemodialysis with 100 mg% concentration of ethylalcohol in the dialysis solution is the method of choice in the treatment of ethylene glycol intoxication.
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Vnitr̆ní lékar̆ství · Aug 2002
Multicenter Study Clinical Trial[Treatment of hypertension in diabetics with trandolapril, an angiotensin converting enzyme inhibitor--a multicenter study].
Subjects with diabetes mellitus (DM) are high-risk patients because of the cardiovascular morbidity and mortality. A one-year open clinical prospective study took place in 7 centres in the Czech and Slovak Republic in 1996-1997. Aim of the study was treatment of hypertension in patients with DM of both types by the ACE inhibitor trandolapril in dose of 2-4 mg, possibly in combination with the calcium channel blocker verapamil--240 mg. ⋯ On comparison of other risk factors in groups of patients with a BP below 130/85 mm Hg and higher than this borderlimit line it was revealed that one-year treatment of hypertension with trandolapril--4 mg alone or combined with verapamil 240 mg led to a greater reduction of the pulse rate, fasting insulin level, hematicrit and triglycerides and to an increase of HDL-cholesterol. This study revealed that systematic treatment of hypertension by the above mentioned drugs in patients with DM is effective and well tolerated. In addition to reduction of the blood pressure the activity of the sympathetic nervous system was reduced and some metabolic parameters improved.