[Anticoagulation therapy and bone metabolism]. / Antikoagulacná liecba a kostný metabolizmus.

The effect of anticoagulation treatment with coumarin and heparin on bone metabolism is in recent years frequently discussed in professional journals. Its ever expanding use in the treatment of patients deserves therefore attention in particular in patients having prolonged anticoagulation treatment. In the submitted paper the authors investigated the effect of Warfarin on some indicators of bone metabolism in a group of 17 patients. In the investigated parameters such as estimation of parathormone, serum calcium, phosphatemia, isoenzyme of alkaline phosphatase they did not reveal any statistically significant changes during coumarin treatment.

[Hemophilic arthropathy as a multidisciplinary problem]. / Hemofilické artropatie ako multidisciplinárny medicínsky problém.

The authors have at present on their records in Slovakia 422 patients with haemophilia type A, i.e. 7.9 per 100,000 population, 76 cases of haemophilia type B, i.e. an incidence of 1.4, 189 patients with von Willebrand's disease with an incidence of 3.6 and 215 patients with hypoconvertinaemia with an incidence of 3.98 per 100,000 population. The authors present an account on the most frequent complications of haemophilia with special attention to haemorrhage into the joints and the development of serious haemophilic arthropathies. They emphasize the great contribution of team work of different medical specialists who participate in the diagnosis and treatment of these diseases.

[The incidence of anemia in the Slovak population]. / K problematike výskytu anémií v nasej populácii.

The authors examined in two diagnostic preventive systems a total of 26,620 asymptomatic people in the district. The total number comprised 15,511 women (58.3%) and 12,109 men (41.7%) above 15 years of age. In the group of women anaemia was recorded in 4.1% and in men only in 0.19%. The highest incidence was in women and men in the age bracket from 15 to 19 years and above 70 years (girls 11.5% and boys 1.27%). Sideropenic anaemias accounted for 91.9% in women and 60.8% in men. Macroerythrocytic anaemia in men (13.1%) is associated with chronic alcohol intake.

[Atrophy of the gastric mucosa and Helicobacter pylori]. / Atrofia sliznice zalúdka a Helicobacter pylori.

The authors investigated the prevalence of Helicobacter pylori (H. p.) in atrophic gastritis in the antrum and/or in the corpus of the stomach (groups I-IV), as compared with mucosae without atrophy. Criteria for elimination were age under 50 years, a case-history of the use of antibiotics during the last 6 months and chronic ingestion of alcoholic beverages. Group IV was formed by probands with pernicious anaemia who were divided into sub-group IVa with atrophy of the corpus and sub-group IVb with atrophy of the corpus and antrum. It was revealed that in probands with pernicious anaemia the presence of H. p. is significantly reduced (p < 0.01) when atrophy was present not only in the corpus but also in the antrum. The authors concluded that atrophic changes in the corpus only do not have a significant effect on the presence of H. p. in the antrum. The presence of H. p. is significantly influenced in a negative sense only when atrophic changes, in particular total atrophy, affect the antral mucosa.

[von Hippel-Lindau disease]. / Nekolik poznámek k von Hippelove-Lindauove nemoci.

The available diagnostic and therapeutic possibilities allow to treat successfully all manifestations of von Hippel-Lindau disease. Adenocarcinomas of the kidneys, however, still present a serious therapeutic problem due to their mostly bilateral and multifocal occurrence. Evidence that patients after bilateral nephrectomy with subsequent dialysis or transplantation would have a longer survival time than patients whose kidneys had not been removed has not been provided as yet. Partial resection or enucleation of tumors may postpone the development of metastases but does not prevent tumor formation in the remaining parts of the kidneys. Considering the late appearance of metastases, though evidence only in one of our patients, we preferred not to remove the kidney and to introduce dialysis. The availability of sonography has put the kidney into the focus od attention in this disease. Not only does sonography allow to monitor regularly members of the affected families but also to screen for the disease at routine sonographic examination of the abdomen. (Fig. 7, Ref. 15.)

[Ambulatory therapy of internal hemorrhoids using infrared photocoagulation and elastic ligature]. / Ambulantná liecba vnútorných hemoroidov infracervenou fotokoaguláciou a jej kombináciou s elastickou ligatúrou.

The authors present their experience with infrared photocoagulation and its combination with suction ligature by means of elastic rings in the treatment of internal haemorrhoids. They used infrared photocoagulation in 15 patients with grade I haemorrhoids, the procedure was painless in 80% and 20% of the patients reported mild pain. As to side-effects, 13.3% reported mild discomfort during defaecation. After one month 66.6% were symptom-free, 26.7% improved and 6.7% did not report improvement. The authors used the combination of suction ligation and infrared photocoagulation in 27 patients with internal haemorrhoids grade II. The procedure was painless in 70.4%, slight pain was reported by 25.9% and in one patient the procedure was associated with severe pain (3.7%). No side-effects were reported by 44.4% of the patients, mild discomfort during defaecation in 48.2% and more marked discomfort in 7.4%. None of the methods were associated with haemorrhage. After one month 74.1% of the patients were asymptomatic, 18.5% reported improvement and two probands (7.4%) did not report improvement. These methods can be used, due to the simple procedure, slight discomfort caused to the patients and low incidence of side-effects in out-patients departments. The short time taken by the procedure and the low cost are not negligible either.

[Angiodysplasia--a cause of severe hemorrhage in the gastrointestinal tract]. / Angiodysplázia--prícina zavazného krvcania v gastrointestinálnom trakte.

The authors describe a case of relapsing severe haemorrhage from angiodysplasias localized in the small intestine in an eighty-year-old female patient diagnosed only after probatory laparotomy. They discuss the diagnostic possibilities in angiodysplasia of the gastrointestinal tract and how it can be influenced by therapy. Even after resection of the affected portion of the intestine the formation of new angiodysplasias must be foreseen in previously intact areas and those can be the source of further severe haemorrhage.

[Chronic active surface-positive Campylobacter antrum gastritis-- morphological changes 1 year after treatment with bismuth]. / Chronická povrchová aktívna Campylobacter pozitívna antrumgastritída--morfologické zmeny v odstupe roka po liecbe bizmutom.

The works is based on a previous investigation published in the journal Vnitrní Lékarství, 36, 1990, 8, pp. 759-762. The authors investigated morphological changes of the gastric mucosa and the presence of Campylobacter pylori (CP) in probands with chronic active surface CP positive antrum gastritis one year after treatment with a bismuth preparation (Bismuth citrate 120 mg per capsule made on prescription) for a one-month period 4 capsules per day. This concerned probands with functional dyspepsia without a history of alcohol intake. After a one-year interval eradication of CP persisted in 8 probands (53.3%); in 7 patients (46.7%) there was a relapse of CP positivity. The authors confirmed that CP and active chronic gastritis are associated. Chronic non-specific inflammatory cellulitis persisted after one year with the same intensity in 17 probands (74%), in 6 it increased by one grade (26%). Improvement or complete recovery of the histological finding was not recorded in any of the patients. In the corpus of the stomach the unaltered finding persisted. Morphological changes were always directly proportional to the presence of CP. Its eradication appears to be causal treatment of chronic active surface CP positive antrum gastritis, one of the groups in the wide spectrum of chronic gastritis.

[Morphologic changes in chronic active superficial Campylobacter pylori-positive antrum gastritis after treatment with bismuth]. / Morfologické zmeny chronickej aktívnej povrchovej Campylobacter pylori pozitívnej antrumgastritídy po liecbe bizmutom.

The authors investigated the effect of one month bismuth treatment (Bismuthi citrici 120 mg per capsule), 4 x 120 mg/day, on morphological changes of the gastric mucosa along with the effect on Campylobacter pylori (CP) in a group of 23 probands with histologically verified active superficial CP positive antrum gastritis. The probands suffered only from functional dyspepsia, to eliminate the action of other disease of the digestive tract on chronic gastritis. Complete eradication of CP occurred in 65.2% and disappearance of granulocytic infiltration as a manifestation of activity in 73.9%. The disappearance of activity correlated with the eradication of CP in 88.2. The authors evaluated also the degree of circular nuclear cellulization (grade 1-3). After one-month treatment it was reduced by 1 grade in 56.5% in the antrum, while in the corpus it remained unaltered in the majority. Complete histological normalization of the mucosa was not recorded.

[Crohn's disease of the stomach]. / Crohnova choroba zalúdka.

The authors describe the incidence of Crohn's disease at an uncommon site the stomach--in a 40-year-old man. With regard to the steadily increasing incidence of the disease, it is important to consider its presence also in uncommon sites in the gastrointestinal tract. The establishment of the diagnosis must be comprehensive, as even histological examination of endobioptic specimens or resected portions need not be unequivocal from the diagnostic aspect.

[Ischemic colitis as a localized manifestation of ergotism?]. / Ischemická kolitída ako lokálny prejav ergotizmu?

The authors discuss a case of the development of ischaemic colitis in a 69-year-old female patient with superficial thrombophlebitis of the lower extremity treated by a combination of dehydrated ergot alkaloid Secatoxin forte drops with smaller doses of Heparin inj. After ruling out other causes of the development of ischaemia, the authors consider ischaemic colitis a local manifestation of ergotism.

[Incidence of chronic gastritis in young patients with functional dyspepsia]. / Výskyt chronickej gastritídy v mladom veku chorých s funkcnou dyspepsiou.

The authors made during a 16-month period in 226 patients the diagnosis of functional gastric dyspepsia (144 women and 82 men aged 20 to 50 years). The differentiating criterion was a pathological organic finding in the upper part of the digestive tract, a pathological finding on the liver, gallbladder and pancreas as well as a pathological laboratory finding. The probands were divided by age into two groups and compared with a control group with similar differentiating criteria; however, the latter had no dyspeptic complaints. The differences in the incidence of chronic gastritis were not significant. From the investigation the following conclusions ensue: 1. Chronic gastritis is not the prerequisite factor of dyspepsia. 2. With advancing age the incidence of chronic gastritis increases. In group of men with functional dyspepsia and without it at the age of 35 years a normal antral mucosa is found only in 1/4 and a normal mucosa of the corpus in 1/2, whereby the corresponding figures at the age of 50 are 1/10 and 1/3. In the group of women with functional dyspepsia and without it at the age of 35 years a normal mucosa of the antrum is found in 1/3 and in the corpus in 2/3, the corresponding figures at the age of 50 years are 1/5 and 1/2. Under the age of 50 the authors recorded a higher incidence of chronic gastritis in the male population (antrum 96.1%, corpus 66.7%), as compared with women (antrum 76.9%, corpus 54.8%).(ABSTRACT TRUNCATED AT 250 WORDS)

[Residual urine and phagocytic activity of polymorphonuclear cells in diabetes]. / Mocové reziduum a fagocytárna aktívita polymorfonukleárov pri cukrovke.

The authors examined by ultrasonography the residual urine in 105 diabetics after passing urine (55 men--53.3% and 49 women--46.7%) aged 20 to 50 years and compared the results with a control group of 103 non-diabetics selected at random (55 men--48.7% and 58 women--51.3%), also aged 20-50 years. Patients with organic diseases affecting the residual urine were not included in the group. In all patients the phagocytic ratio was examined, the urine was analyzed chemically and the sediment was examined, in selected cases also cultivation examinations were 105 diabetics residual urine was found in 34 cases (34.4% and in the control group of 113 non-diabetics in 3 cases (2.7%). The difference is highly significant (p less than 0.001). In the group of diabetic men and women residual urine was found more frequently in type I diabetics with diabetes existing for prolonged periods and the amount of residual urine was larger as compared with type II diabetes. Comparison of the phagocytic ratio in the diabetics and controls of both sexes revealed significant changes at the level of p less than 0.05. In the group of diabetics with residual urine was a significantly higher incidence of pathological findings in urine as compared with diabetics without residual urine which is of pathognomic importance for the development and persistence of urinary infections.

[Cystic changes in the liver in our 5-year ultrasonographic study]. / Cystické zmeny pecene v nasom pätrocnom ultrasonografickom materiáli.

The authors examined during 1983-1987 by ultrasonography the liver in a group of 13,672 patients with an average age of 54.8 +/- 4.1 years. The group comprised 7830 women (57.27%) and 5842 men (42.73%). Cystic changes were detected in 39 patients (0.28%). During subsequent examinations they revealed that in four patients metastases of tumours were involved. The correctness of the ultrasonographic diagnosis was confirmed in 35 patients (89.7%). Non-inflammatory and non-parasitic cysts were present in 31 patients (0.23%), incl. 20 women (0.26%) and 11 men (0.19%) with a sex ratio of 1.4:1. Concurrent cystic changes on the kidneys were found in 22.6% and on the pancreas in 12.9%. The spleen was not affected by cystic changes in any of the patients. The diagnosis of cysts was supplemented by laboratory, laparoscopic, scintigraphic, computed tomographic peroperative and aimed bioptic examinations, depending on the character of changes. An inflammatory cyst (tuberculous cavity) as well as three cases of echinococcal cysts were treated by operation. In the conclusion the authors discuss contemporary diagnostic and therapeutic methods in cystic liver diseases.

[Non-cystic diseases of the liver in a 5-year ultrasonographic study]. / Necystické ochorenia pecene v pätrocnom ultrasonografickom materiáli.

The authors evaluate five-year ultrasonographic material (13,672 examinations) focused on non-cystic liver disease. 8212 examinations (60.1%) were made as part of examinations of the gallbladder, 4919 (36%) as part of examination of the right sub-costal area or other organs and only 541 examinations (3.96%) were focused in the first place on the liver. The total number of examined patients included 7830 women (57.3%) and 5842 men (42.7%). Most frequently the ultrasonographic picture of steatosis was found--in 747 patients (5.46%), cirrhosis of the liver in 45 patients (0.33%), primary carcinoma of the liver was present in 7 patients (0.05%) and tumour metastases in 63 patients (0.46%). The group of women with steatosis comprised 42 diabetic women (32.06%), 78 overweight women (59.5%) and 18 with excessive alcohol intake for several years (13.7%). In the group of men with steatosis there were 48 diabetics (7.79%), 92 overweight (14.9%) and 479 with excessive alcohol intake extending over several years (77.7%). In the group of 34 men with cirrhosis excessive alcohol intake for years was found in 31 (91.2%), in the group of eight women with cirrhosis in five instances (62.5%). In abdominal ultrasonography liver disease must be actively searched for, in particular in patients with long-term alcohol intake, overweight, diabetes and long-term use of various hepatotropic drugs.

[Initial experience with thin-needle biopsy under ultrasonic control in diffuse liver diseases]. / Nase prvé skúsenosti s biopsiou tenkou ihlou pod ultrasonografickou kontrolou pri difúznych ochoreniach pecene.

The authors used thin-needle biopsy (Westcott needle) under ultrasonographic control for the morphological determination of ultrasonographic pictures of steatosis in 37 patients. In the case history they reported alcohol consumption of more than 5 years above 60 g of absolute alcohol per day; mostly abuse of beer was involved (32.4%) and beer with liquor (43.3%). A sufficient amount of material for histological examination was taken in all 37 patients, incl. 8 during the second insertion. Histological examination revealed mainly large-droplet steatosis of the mild and medium grade (40.5%) and severe grade (21.6%). Of 37 ultrasonographic pictures of steatosis the latter was confirmed by histological examination in 34 patients (91.2%). The biopsies were made without algic reactions of the patients and no complications were observed. With regard to the non-pretentious, simple and safe character and the high yield of the procedure the authors consider thin-needle biopsy under ultrasonographic control a foremost operation which makes morphological assessment even of diffuse liver diseases possible.

[Results of treatment of peptic ulcers using Gastrozepine and antacids in the endoscopic picture]. / Výsledky liecby peptického vredu gastrozepinom a antacidami v endoskopickom obraze.

The authors investigated the therapeutic results in gastroduodenal ulcers in 96 patients treated with Gastrozepin (Slovakofarma), using daily doses of 75 mg combined with antacids. The examinations were made by means of a videogastroscope of Welch-Allyn Co. with subsequent control after four weeks, and if the ulcer was not healed, after two-week intervals. During the first examination they recorded the size of the ulcer and during check-up examinations the stage of healing. In a group of 51 men with a mean age of 44.4 years the incidence of duodenal ulcers was 29 cases (59.6%) and gastric ulcers 22 cases (43.1%). In a group of 45 women with a mean age of 51.4 years duodenal ulcers were detected in 24 (53.3%) and gastric ulcers in 21 (46.7%). After one-month treatment of 53 duodenal ulcers 44 (83%) healed by a scars. Healing of small and medium sized defects was excellent, they healed in 93.6%, while large defects only in 33.3%. Of 43 gastric ulcers after one month treatment 31 healed (72.1%) by a scar. Small and medium-sized defects healed in 80.5% and large ones only in 28.6%. With the exception of one case all were in an advanced stage of healing with a tendency of complete healing with scare formation.