Vnitr̆ní lékar̆ství
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Vnitr̆ní lékar̆ství · Sep 2001
[Relation between clinical severity of bronchial asthma and degree of airway inflammation assessed by the eosinophilic leukocyte count in induced sputum].
Airways inflammation, involving infiltration of bronchial wall with activated eosinophils, mast cells and T lymphocytes, is an established feature of asthma. Clinical assessment of disease severity is based upon pulmonary function tests, their variability and symptom score. The relationship between the degree of airway inflammation and disease control is probably not significant. ⋯ Specificity of clinical markers ranged from 0.43 to 0.94, diurnal variability of PEF having the highest specificity. Despite of good correlation of clinical markers of asthma severity with sputum eosinophils, pulmonary function test, diurnal variability of PEF and rescue salbutamol can hardly predict the degree of airway inflammation or the efficacy of antiinflammatory treatment in a particular patient. Percentage of sputum eosinophils seems to be a useful and promising marker for measuring the degree of airway inflammation in patients with bronchial asthma, especially in more severe cases.
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Vnitr̆ní lékar̆ství · Dec 2000
[Catheter therapy in patients with stable angina pectoris. Results of 662 coronary angioplasties].
Coronary angioplasty supplemented by implantation of a stent has become a standard therapeutic method in patients with stable angina pectoris. The authors analyzed the spectrum of patients indicated for this treatment, its successfulness and complications of catheterizations. In the course of a two-year period the authors implemented 662 catheterizations in 602 patients with stable angina. 58% patients indicated for coronary angioplasty on account of stable angina had a history of myocardial Q infarction, 93% had angina grade II or III according to CCS. ⋯ In 57% of the treated lesions a coronary stent was implanted. Serious clinical complications developed in 1% of the interventions, none of the patients died. Catheterization treatment of stable angina is very successful and safe.
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Vnitr̆ní lékar̆ství · Jul 2000
Case Reports[Severe sepsis with organ failure in necrotizing fasciitis of the right leg caused by infection with Vibrio vulnificus].
Vibrio vulnificus is a human pathogen which can cause the septicemia and necrosis of the soft tissue, especially fasciitis. The occurrence is most common in the summer, the source of infection can be sea water or the sand on the beaches, however the infection after eating seafood was described as well. The patient with predominant liver dysfunction are more often affected. ⋯ The mortality more than 60% is reported. This case report describes the course of disease in 64 year old patient, who has spent his vacation in Bulgaria. After return he was admitted with severe sepsis with multiorgan failure and despite the intensive therapy and high amputation of the limb which was performed, the patient died.
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Vnitr̆ní lékar̆ství · Feb 2000
[The prehospital phase in patients with acute myocardial infarct in Slovakia. A challenge].
Better management of patients with acute myocardial infarction during the prehospital phase is at present a challenge not only for health workers but for society as a whole. The authors pay attention to knowledge of the complex problem of the prehospital phase in patients with acute myocardial infarction which is a prerequisite for finding possible solutions for a favourable effect on their management. The authors analyzed 3,040 patients who were admitted to hospital alive within 96 hours after the development of complaints with suspicion of a first or repeated acute myocardial infarction. ⋯ Comprehensive implementation of the survival chain (24), the most comprehensive implementation of recommendations of the European Society of Cardiology and the European Resuscitation Council for in the management of patients with acute heart attacks during the prehospital phase (21) and early effective treatment which begins already in the prehospital phase has a favourable impact on the condition of patients with acute myocardial infarction and on their prognosis. Along with early and effective treatment of patients with acute myocardial infarction in hospital and their stratification these are the most important approaches to the development and control of sudden cardiac death. Knowledge of the complex problem of the prehospital phase in patients with acute myocardial infarction is the prerequisite for the elaboration of high standard prehospital management of patients with acute myocardial infarction.
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Vnitr̆ní lékar̆ství · Dec 1999
Case Reports[An attack of malignant hyperthermia caused by a combination of the effects of succinylcholine, increased physical exertion and alcohol abuse].
The authors submit the case-history of a 29-year-old man, followed up on account of liver steatosis with a toxic-nutritional etiology who developed, after previous increased physical exertion and alcohol abuse, fever associated with major muscular weakness. Gradually he developed an amental delirious state which was evaluated as suspect delirium tremens. Fever of 40-41 degrees C continued, the patient developed muscular rigidity, tremor and hypotension. ⋯ Gradually the acidosis improved, the blood pressure became stabilized and artificial ventilation was no longer used. The patient was discharged after 34 days in hospital in a state of cardiopulmonary compensation with mild polyuria but without signs of retention of nitrogenous substances with sideropenic anaemia and marginal creatine kinase and lactate dehydrogenase values. Within one month after discharge the laboratory values reached normal levels and only slight muscular weakness and greater fatiguability persisted.