Vnitr̆ní lékar̆ství
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Vnitr̆ní lékar̆ství · Aug 2002
Review[Role of cytokines in the development of local and systemic inflammation and septic shock].
A central position in the development of systemic inflammation is played by activation of the vascular endothelium and monocyte- macrophage system. Both are associated with the formation of inflammatory cytokines, the primary mission of which is mobilization of the organism to cope with the infection. The so-called acute stage response develops with typical clinical manifestations and laboratory values. ⋯ The compensatory antagonistic mechanism which develops due to the formation of anti-inflammatory cytokines leads sometimes to the development of a balanced state of immunity which is most favourable from the prognostic aspect. In case of their excess however immunodepression develops which is equally dangerous for the patient as excessive cytokine activity. From what has been said ensues the need of regular monitoring of patients with sepsis and thus also detailed investigation of their immune system.
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Vnitr̆ní lékar̆ství · May 2002
[Occurrence of autoimmune complications in patients with chronic myelocytic leukemia during treatment with interferon alfa].
Several prospective randomized studies have shown that the treatment of chronic myeloid leukemia with interferon alfa (IFN alpha) prolongs the survival by comparison with conventional chemotherapy. However, long-term treatment with Interferon alfa (IFN alpha) can produce or exacerbate immune-mediated complications (IMC). The purpose of this study was to analyze the experience with IMC in patients with chronic myelogenous leukemia (CML) undergoing IFN alpha treatment. ⋯ The frequency of IMC of clinical relevance with interferon alfa therapy in CML increased (long-term therapy). The patients treated with interferon alfa should be monitored for sign and symptoms of autoimmunity.
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Vnitr̆ní lékar̆ství · Apr 2002
[Relation between pulmonary ventilation parameters, exercise tolerance and quality of life in patients with chronic obstructive lung disease].
Patients with chronic obstructive pulmonary disease (COPD) do usually have decreased tolerance of exercise capacity and impaired quality of life. Several studies have shown that exercise capacity is related relatively weakly to lung functions in this group of patients. The aim of the present study was to find parameter which could better reflect or predict maximal exercise capacity. 19 patients with the diagnosis COPD with mean value of forced expiratory volume in one second (FEV1) 46% predicted (range 21-79%) entering pulmonary rehabilitation program were included into the study. ⋯ Total score of SGRQ correlated significantly to maximal exercise capacity. Pulmonary function tests and respiratory muscle function have important impact on exercise tolerance in patients with COPD. Tolerance of exercise capacity is significantly reflected by total score of quality of life in this group of patients.
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Vnitr̆ní lékar̆ství · Jan 2002
[Reliability and validition of the Slovak modified version of the Stanford Health Assessment Questionnaire using the functional disability index in patients with rheumatoid arthritis].
Functional disability is one of the most important consequences of RA in the patient's daily life. The HAQ has been widely used in its self administered form for the assessment of disability. A sensitive and valid instrument is needed for a Slovak population with RA. ⋯ The results of the current investigation provide support for reliability and construct validity of the Slovak version of the HAQ in patients with RA. The HAQ has sufficient discriminant ability. The index disability can be used as an criterion of severity of RA, as a criterion of effectiveness in therapeutical trials for patient stratification of the Slovak population with RA.