Electronic Library of Scientific Literature
Electronic Library of Scientific Literature
Volume X / 1996, Number 2
INFLUENCE OF BIOMIN H ON BIOCHEMICAL MARKERS OF BONE METABOLISM IN POSTMENOPAUSAL WOMEN WITH OSTEOPOROSIS
M. STANCIKOVA, P. MASARYK, A. LETKOVSKA, J. ROVENSKY, J. WENDLOVA, E. ORVISKY
Vyskumny ustav reumatickych chorob, Piestany
Riaditel: prof. MUDr. J. Rovensky, DrSc.
Suhrn
Pozadie problemu: Biomin-H je povodnym liekom na liecbu osteoporozy
vyvinutym na Slovensku. Je vyrobeny z vajecnych skrupin zdravotne nezavadnych
konzumnych vajec. Jeden gram Biominu-H v prasku obsahuje priblizne 370
mg vapnika, male mnozstvo fosforu a stopove prvky zinok, stroncium, horcik,
med, selen a ine. V sucasnosti prebiehaju klinicke studie tohto preparatu
u zien s postmenopauzalnou osteoporozou, ktorych sucastou je aj predlozena
praca.
Ciel: V praci sme sledovali vplyv polrocnej terapie Biominom-H
na serovu hladinu vapnika a fosforu, kalciuriu a na vybrane biochemicke
markery kostneho metabolizmu (osteokalcin, pyridinolin, deoxypyridinolin)
u postmenopauzalnych zien s osteoporozou (21 osob). Liecena skupina dostavala
denne 1 vrecko Biominu-H, priblizne 1,1 g vapnika. Hodnoty biochemickych
ukazovatelov u postmenopauzalnych zien s osteoporozou sme porovnavali s
hodnotami vybranej skupiny preme-nopauzalnych zien (15 osob).
Vysledky: Hodnoty kalcia v sere a v moci u premenopauzalnych
a postmenopauzalnych zien sa vyrazne nelisili. Po polrocnej terapii Biominom-H
sa hodnoty kalcia v sere zmenili len malo, koncentracia fosforu sa znizila.
Kalciuria v 24 h moci sa signifikantne zvysila, hornu hranicu normy vsak
prevysila len u troch zien. Koncentracie osteokalcinu v sere, pyridinolinu
a deoxypyridinolinu v moci u pacientok s osteoporozou boli vyznamne vyssie
v porovnani s premenopauzalnymi zenami. Po polrocnej liecbe Biominom-H
osteokalcin signifikantne klesol. Koncentracia pyridinolinu v prepocte
na kreatinin sa signifikantne znizila priblizne na polovicu pociatocnej
hodnoty. Vyznamny pokles sme zaznamenali aj v koncentracii deoxypyridinolinu.
Zavery: Mozeme konstatovat, ze nase laboratorne vysledky svedcia
o signifikantnom inhibicnom ucinku Biominu-H na kostnu resorpciu u postmenopauzalnych
zien. Jeho ucinok na kalciuriu je porovnatelny s inymi vapnikovymi preparatmi
pouzivanymi v liecbe osteoporozy.
Klucove slova: Biomin-H, postmenopauzalne zeny, osteokalcin,
pyridinolin, deoxypyridinolin.
Summary
Background of the problem: Biomin H is an original drug for
therapy of osteoporosis developed in Slovakia. It is produced from egg
shells of healthy consumer eggs. One gram of Biomin H in powder contains
approximalety 370 mg of calcium, a small amount of phosphorus and trace
elements zinc, strontium, magnesium, copper, selenium and other. At present
clinical trials of this drug in women with postmenopausal osteoporosis
are in progress, of which a part is also the presented study.
Aim: In the study the influence of half a year therapy with
Biomin H was studied on serum calcium and phosphorus levels, calciuria,
and on selected biochemic markers of bone metabolism (osteocalcin, pyridinoline,
deoxypyridinoline) in postmenopausal women with osteoporosis (21 persons).
The treated group received daily 1 sachet of Biomin H, i.e. 1.1 g of calcium.
The values of biochemic markers in postmenopausal women with osteoporosis
were compared with the values of a group of selected premenopausal women
(15 persons).
Results: The serum and urine calcium values in premenopausal
and postmenopausal women did not markedly differ. After half a year of
Biomin H therapy the serum calcium values changed only a little, phosphorus
concentration decreased. Calciuria in 24-h urine significantly increased,
the upper limit of the norm was surpassed, however, only in three women.
Serum osteocalcin concentrations, urine pyridinoline and deoxypyridinoline
in patients with osteoporosis were significantly higher in comparison with
premenopausal women. After half a year of Biomin H therapy osteocalcin
significantly decreased. Pyridinoline concentration converted to creatinine
significantly decreased, approximately to a half of the original value.
A significant decrease was recorded also in the deoxypyridinoline concentration.
Conclusions: It can be concluded that our laboratory results
demonstrate a significant inhibitory effect of Biomin H on bone resorption
in postmenopausal women. Its effect on calciuria is comparable with other
calcium drugs used in the treatment of osteoporosis.
Key words: Biomin H, postmenopausal women, osteocalcin, pyridinoline,
deoxypyridinoline.
pp. 61 – 65
THE DRUG DICLOREUM (DICLOFENAC SODIUM) IN THE TREATMENT OF ANKYLOSING SPONDYLITIS
D. ZLNAY, D. MICEKOVA, J. ROVENSKY, P. MASARYK
Vyskumny ustav reumatickych chorob, Piestany
Riaditel: prof. MUDr. J. Rovensky, DrSc.
Suhrn
Pozadie problemu: V poslednom case sa na nasom trhu rozsirila
paleta diklofenakovych pripravkov o novy preparat Dicloreum (diclofenac
sodium) talianskej firmy Alfa Schiapparelli Wassermann. Ide o nesteroidne
antireumatikum s vyraznymi analgetickymi, antiflogistickymi a antipyretickymi
vlastnostami.
Ciel a vychodiska: Autori v otvorenej studii vyhodnotili ucinnost
a toleranciu preparatu Dicloreum ako monoterapiu u chorych s ankylozujucou
spondylitidou.
Metody: U 30 chorych (26 muzov a 4 zeny) s istou diagnozou ankylozujucej
spondylitidy, prevazne so strednou a vyssou aktivitou ochorenia, sa podaval
Dicloreum inj. 6 dni 1 amp. 75 mg s naslednou mesacnou peroralnou liecbou
50 mg enterosolventnymi tabletami v dennej davke 150 mg. Vyhodnocoval sa
vplyv preparatu na bolest, pocit zdravia, trvanie rannej stuhnutosti, ulava
od bolesti hodnotena pacientom, sledoval sa vplyv na pohyblivost chrbtice.
Verbalne sa hodnotila tolerancia a ucinnost osobitne lekarom a pacientom.
Sucasne sa sledovali neziaduce ucinky preparatu klinicky a laboratorne.
Hlavne vysledky: Autori zistili, ze preparat Dicloreum dobre
ovplyvnuje pokojovu a pohybovu bolest ako v injekcnej, tak aj v tabletovej
forme. Pri korelacii s aktivitou ochorenia vyznamnejsie posobi pri strednej
a nizsej aktivite. Dobra a kompletna ulava od bolesti sa zistila u viac
ako 70 % chorych. Statisticky vyznamne doslo k zlepseniu hybnosti chrbtice
do dlhsom podavani preparatu vo forme tabliet. U 90 % chorych bola vyborna
a velmi dobra tolerancia, pricom podobne velmi dobre a dobre hodnotil ucinnost
pacient a lekar. Len u jedneho choreho bola liecba prerusena pre alergicku
koznu reakciu, u ostatnych chorych sa nevyskytli zavaznejsie klinicke a
laboratorne komplikacie liecby.
Zavery: Preparat Dicloreum je pomerne bezpecne antireumatikum
s dobrou ucinnostou a toleranciou, ktore rozsiruje paletu medikamentoznej
liecby ankylozujucej spondylitidy.
Klucove slova: ankylozujuca spondylitida, liecba nesteroidnymi
antireumatikami, Diclofenac, tolerancia, ucinnost.
Summary
Background of the problem: In the recent time the offer of diclofenac
drugs on our market has been enriched by a new drug Dicloreum (diclofenac
sodium) of the Italian firm Alfa Schiapparelli Wassermann. It is a non-steroidal
antirheumatic drug with marked analgesic, antiphlogistic and antipyretic
properties.
The aim and the starting points: The authors in an open trial
evaluated the efficacy and tolerance of Dicloreum as a monotherapy in patients
with ankylosing spondylitis.
Methods: In 30 patients (26 men and 4 women) with certain diagnosis
of ankylosing spondylitis, predominantly with middle and high activity
of the disease, Dicloreum inj. were administered 6 days in the dosage 1
amp. of 75 mg, with a subsequent one month peroral treatment with 50 mg
enterosolvent tablets in the daily dosage of 150 mg. We have evaluated
the influence of the drug on pain, feeling of well-bein, duration of morning
stiffness, relief from pain evaluated by patients, and the influence on
spine mobility. Verbally, the tolerance and efficacy was evaluated by physician
and the patient separately. At the same time the undesirable effects of
the drug were studied clinically and by laboratory examinations.
Main results: The authors found out that Dicloreum influences
favourably the pain at rest and in motion in both injection and tablets
form. In correlation with activity of the disease, it has a more significant
effect in the middle and low activity. A good and complete relief from
pain was found in more than 70 % of patients. There was a statistically
significant improvement of spine mobility after a longer administration
of the drug in tablets. In 90 % of patients, there was a good and/or very
good tolerance and good and very good evaluation of its efficacy by both
the physician and the patient. In a single case the treatment was discontinued
due to an alergic reaction, in the remaining patients there were no more
severe clinical or laboratory complications of the treatment.
Conclusions: Dicloreum is a relatively safe antirheumatic drug
with a good efficacy and tolerance, widening the scale of drug therapy
of ankylosing spondylitis.
Key words: ankylosing spondylitis, therapy with non-steroidal
antirheumatic drugs, Diclofenac, tolerance, efficacy.
pp. 67 –73
CHRONOBIOLOGY OF ACUTE GOUT ARTHRITIS II.
MOON AND SOLAR ROTATION CYCLES
M. MIKULECKY, A. VALACHOVA, J. ROVENSKY, K. BOSMANSKY, F. MALIS
Ustav preventivnej a klinickej mediciny, Bratislava
Riaditel: prof. MUDr. T. Trnovec, DrSc.
I. interna klinika LFUK a FN, Bratislava
Prednosta: prof. MUDr. I. Duris, DrSc.
Vyskumny ustav reumatickych chorob, Piestany
Riaditel: prof. MUDr. J. Rovensky, DrSc.
Suhrn
Casove udaje o 126 zachvatoch dny registrovanych v priebehu viac ako
22 rokov vo Vyskumnom ustave reumatickych chorob v Piestanoch sa posudili
z hladiska ich pripadnej zavislosti od faz solarne rotacneho, tropickeho
lunarneho, anomalistickeho lunarneho a synodickeho lunarneho cyklu. Na
testovanie prislusnych hypotez sa pouzila periodogramova a kosinorova analyza
s hladinou vyznamnosti alpha=0,05. Statisticky vyznamna periodicita s dlzkou
celeho cyklu sa nasla pre vsetky styri cykly, s polovicnou dlzkou cyklu
pri anomalistickom, s tretinovou pri vsetkych lunarnych, so stvrtinovou
a patinovou pri vsetkych okrem anomalistickeho a so sestinovou pri solarnom
a synodickom cykle. Najtesnejsia zavislost (s 97 % celkoveho rozptylu vysvetleneho
pouzitou regresiou) sa ukazala pri synodickom, najmenej tesna (78 %) pri
solarne rotacnom cykle. Najnapadnejsie je nakopenie pripadov (s rozdielmi
az o viac ako o 100 %) okolo splnu a novu v synodickom a okolo perigea
v anomalistickom mesacnom cykle. Podla toho by mechanizmus vplyvu mesacnych
faz, aspon v pripade dny, mohol spocivat v zmenach lunisolarnej gravitacie.
Vo vsetkych plexogramoch okrem anomalistickeho mesacneho je zrejmy priblizne
tyzdnovy rytmus. To potvrdzuje predstavu o kozmickom prapovode cirkaseptanov
— rytmov s priblizne tyzdnovou periodou, a teda aj socialneho tyzdna kodifikovaneho
v mnohych kulturach ludskej spolocnosti. Zmeny v priebehu synodickeho cyklu
a scasti aj inych mesacnych cyklov sa porovnavaju s podobnymi zmenami pozorovanymi
pri urgentnych stavoch v kardiologii, infektologii, psychiatrii, neurologii,
gastroenterologii. Vysledky bude pravdepodobne mozne zuzitkovat nielen
pri patogenetickych uvahach, ale aj pri prevencii.
Klucove slova: zachvaty dny, chronobiologia, solarne rotacny
cyklus, tropicky lunarny cyklus, anomalisticky lunarny cyklus, synodicky
lunarny cyklus, analyza casovych radov.
Summary
The data defined in time concerning 126 attacks of gout, registered
during more than 22 years in The Research Institute of Rheumatic Diseases
in Piestany were analyzed from the point of view of their possible dependence
upon the phases of the solar rotation, tropical lunar, anomalistic lunar
and synodic lunar cycles. To test the corresponding hypothe-ses, the periodogram
and cosinor analysis has been applied with the significance level of alpha=0.05.
A statistically significant periodicity with the length of the whole cycle
was found for all four cycles, with half length in the anomalistic, with
one third length in all lunar, with one fourth and one fifth in all excluding
the anomalistic, and with one sixth in the solar and synodic cycles. The
most pronounced dependence (with 97 % of the total variance explained by
the regression applied) appeared for the synodic, a least pronounced (78
%) for the solar rotation cycle. The most conspicuous phenomenon is an
accumulation of cases (with differences by more than by 100 %) around the
full and new moon within the synodic, and around the perigee in the anomalistic
lunar cycle. Accordingly, the mechanism of the influence of moon phases
could be explained, at least for the case of gout, by changes in the lunisolar
gravitation. In all plexograms, excluding the anomalistic lunar one, an
approximately weekly rhythm is apparent. This confirms the idea about a
cosmic ancient origin of circaseptans — rhythms with roughly weekly period,
and therefore also about that of social week, codified in many cultures
of human society. The changes during synodic, and partly other lunar cycles
are compared with similar ones, observed earlier for urgent situations
in cardiology, infectology, psychiatry, neurology, gastroenterology and
other fields. The results can probably be used for pathogenetic considerations,
for organization of work and for prevention.
Key words: gout attacks, chronobiology, solar rotation cycle,
tropic lunar cycle, anomalistic lunar cycle, synodic lunar cycle, time
series analysis.
pp. 75 – 82
RHEUMATOID ARTHRITIS AND EUROPEAN RESEARCH ON INCAPACITATING DISEASES AND SOCIAL SUPPORT
A. SZILASIOVA, M. KOVAROVA, Z. MACEJOVA, D. ZAHORSKA, D. TREJBAL, A. BERESOVA, K. KOHLER, K. GOMBOSOVA, A. SCHLOSEROVA
II. interna klinika FNsP, Kosice
Prednosta: doc. MUDr. D. Trejbal, CSc.
Ustav socialnej mediciny LF UPJS, Kosice
Prednosta: MUDr. M. Kovarova, CSc.
Suhrn
Pozadie problemu: Projekt Europsky vyskum invalidizujucich chorob
a socialna podpora — EURIDISS, ktory vznikol roku 1990, je zame-rany na
dlhodobe sledovanie chorych s reumatoidnou artritidou. Lekarska fakulta
UPJS v Kosiciach bola zaradena od 1.10.1994 do tohto projektu, ktory potrva
4 roky.
Ciel: Zhodnotit prvu cast suboru chorych z hladiska osobnych
a demografickych udajov, zistit ich socialno-ekonomicke postavenie a zdravotno-funkcny
stav.
Material a metody: Autori vysetrili 62 chorych s priemernym
vekom 47 rokov trvanim choroby od 4 do 48 mesiacov od 1.10.1994 do 31.12.1994.
Pouzili niektore metody z projetku EURIDISS ako Groningensku skalu na hodnotenie
obmedzenia aktivity, hodnotenie zdravia indexom neschopnosti, Karnofskeho
skalu na hodnotenie vykonnostneho stavu choreho, hodnotenie vlastnej osoby,
vlastnu definiciu reumatickej choroby a dotaznik na zistenie stavu socialnej
podpory pri dennych cinnostiach.
Vysledky: Autori zistili, ze 54,8 % chorych je stale ekonomicky
aktivnych, pricom iba 34 % chorych z celeho suboru ma plnu schopnost pre
beznu dennu aktivitu s malymi alebo so ziadnymi znamkami ochorenia. Stav
funkcnej schopnosti chorych vyznamne koreluje s aktivitou ochorenia. Prevazna
cast pacientov si doveruje a ma pozitivny vztah k svojej osobe. 92 % chorych
povazuje reumatizmus za zavazne ochorenie. Napriek znacnemu prisposobeniu
sa tejto chorobe 82 % chorych vyzaduje pomoc blizkeho okolia a spolocnosti.
Zaver: Socialna podpora a pomoc u vacsiny pacientov je nedostatocna
v oblasti citovej, ako aj v oblasti technickej pomoci.
Klucove slova: reumatoidna artritida, Europsky vyskum invalidizujucich
chorob a socialna podpora (EURIDISS projekt).
Summary
Objectives: The objective of the follow-up European Research
on Incapacitating Diseases and Social Support project is to study patients
suffering from rheumatoid arthritis. Faculty of Medicine and the University
Hospital of P.J. Safarik University in Kosice joined this international
project since the 1st of October 1994.
Aim: The aim of this paper is to introduce the preliminary results
evaluated in a pilot sample of patients with regard to demographic and
personal data, social and economic background and medical-functional status.
Material and methods: In the time span since 1 October 1994
to 31 December 1994 the authors followed a sample of 62 patients with the
mean age of 47 years. The duration of the rheumatoid arthritis ranged since
4 to 48 months. The following selected measures of the project were administered
and assessed: The Groningen Activity Restriction Scale, Health Assessment
Questionnaire, Self Esteem, Subjective Definition of the Rheumatoid Condition,
The Karnofsky Perfomance Status Scale, Social Support Questionnaire for
Transactions for assessment of received and needed amount of interactions
to support patients in their daily activities.
Results: The authors found 54.8 % patients still being economically
active. 34 % patients have preserved full capacity for common daily activities
showing moderate sings or no signs of the disease. The patient s functional
status strongly correlates with the disease activity level. The majority
of the patients reports selfconfidency and development of positive attitude
toward his/her own person. Rheumatism is considered to be a serious disease
in 92 % of the study samples. Though our patients showed a great extent
of the adaptation to the restrictions caused by the disease, at least 82
% of them require a social help and support of their close relatives or
wider society.
Conclusions: Patients showed dissatisfaction with social support
and network, especially in terms of lack in emotional and technical type
of support.
Key words: rheumatoid arthrithis, European research on incapacitating
disease and social support (EURIDISS project).
pp. 83 – 87
LUMBAR TRACTION IN COMPREHENSIVE TREATMENT OF ANKYLOSING SPONDYLITIS
V. DRLICKOVA, D. ZLNAY, P. MASARYK, P. SCHULTZ
Vyskumny ustav reumatickych chorob, Piestany
Riaditel: prof. MUDr. J. Rovensky, DrSc.
Suhrn
Trakcia chrbtice sa doteraz odporucala najcastejsie pri lumboischialgickom
syndrome. Pri jej posobeni sa dosiahla relaxacia paravertebralneho svalstva,
zvacsenie medzistavcoveho priestoru a distrakcia intervertebralnych klbov.
Takyto ucinok sme chceli vyuzit aj u chorych s ankylozujucou spondylitidou.
Nasou ulohou bolo sledovanie vplyvu lumbalnej trakcie na pohyblivost
a bolestivost chrbtice v oblasti L[_5]—S[_1]. Do suboru sme zaradili chorych
bez osifikacii v sledovanej oblasti.
U 70 hospitalizovanych pacientov (48 muzov a 22 zien) sme hodnotili
ucinok intermitentnej lumbalnej trakcie, pricom sme porovnavali vysledky
u 28 chorych s intermitentnou lumbalnou trakciou a 42 chorych bez trakcie
ako kontrolnej skupiny. Sucasne vsetci pacienti dostavali standardnu balneorehabilitacnu
liecbu. Lumbalna trakcia sa podavala v leziacej polohe, 10 dni pomocou
elektronickej trakcnej aparatury firmy Enraf Nonius. Intermitentny tah
bol standardny, trakcna sila 2/3 hmotnosti tela pacienta posobila periodicky
10 sekund s naslednym poklesom tahu o 50—100 N pocas 6 sekund a s celkovym
trvanim 10 minut. Objektivizacia rozsahu pohybu v LS chrbtici sa vykonavala
pomocou pocitacovej dynamometrie Isostation B-200.
Pri hodnoteni pohyblivosti LS chrbtice sa zistilo statisticky vyznamne
zlepsenie v rotaciach, v ostatnych rovinach bolo zlepsenie len percentualne.
Pri hodnoteni trakcie vo vztahu k aktivite z hladiska bezpecnosti je vyhodnejsia
indikacia u chorych s nizkou, pripadne strednou aktivitou ochorenia, pri
vysokej aktivite je potrebne individualne zvazenie. Z hladiska bolestivosti
nedoslo k statisticky vyznamnemu zmierneniu oproti kontrolnej skupine,
ani v jednom pripade sa vsak nemusela trakcia prerusit.
Intermitentnu lumbalnu trakciu v individualnych pripadoch mozno povazovat
za vhodnu doplnkovu metodu ku komplexnej rehabilitacnej liecbe pre chorych
s ankylozujucou spondylitidou.
Klucove slova: intermitentna lumbalna trakcia, ankylozujuca
spondylitida, rozsah pohyblivosti LS chrbtice, rehabilitacia.
Summary
Traction of the spine has been so far most often recommended in lumboischialgic
syndrome. During its action relaxation of paravertebral muscles is achieved,
as well as an increase of intervertebral space and distraction of intervertebral
joints. The presented study describes its use in patients with ankylosing
spondylitis.
Our aim was to study the influence of the lumbar traction on mobility
and painfulness of the spine in the region of L[_5]—S[_1]. The group were
included the patients without ossifications in the studied region.
In 70 inpatients (48 men and 22 women) the effect of intermittent lumbar
traction was evaluated, comparing the results in 28 patients with intermittent
lumbar traction and 42 patients without traction as a control group. At
the same time, all the patients received standard balneorehabilitation.
Lumbar traction was administered in lying position for 10 days by means
of electronic traction equipment of the firm Enraf Nonius. The intermittent
traction was standard, traction strenght of 2/3 patient’s body weight was
acting periodically 10 seconds with a subsequent decrease of the traction
of 50—100 N for 6 seconds and the total duration 10 minutes. The objectification
of the range of motion in the LS spine was performed by means of computer
dynamometrics Isostation B-200.
The evaluation of the LS spine mobility revealed a statistically signi-ficant
improvement in rotations, in the other planes the improvement was only
percentual. Evaluating the traction from the point of view of its safety
in relation to the disease activity, a more advantageous is the indication
in patients with low and/or middle activity of the disease, in the high
activity an individual consideration is necessary. In painfulness, no statistically
significant improvement was achieved in comparison with the control group,
but there was not a single case when the traction had to be interrupted.
Intermittent lumbar traction can be considered in individual cases
as a suitable complementary method in comprehensive rehabilitation treatment
of patients with ankylosing spondylitis.
Key words: intermittent lumbar traction, ankylosing spondylitis,
range of motion of the LS spine, rehabilitation.
pp. 89 – 93
NEUROHUMORAL REGULATION OF INFLAMMATORY PROCESS
K. TRNAVSKY
Arthrocentrum, Praha
Reditel: prof. MUDr. K. Trnavsky, DrSc.
Souhrn
V prehlednem referatu jsou uvedeny nektere novejsi poznatky o ucasti
periferniho neuronu a neuropeptidu na rozvoji zanetliveho procesu. Jsou
uvedeny moznosti regulace zanetu interakci mezi strukturami centralniho
nervoveho systemu, osou hypofyza—nadledvinka a imunitnimi procesy. Je diskutovana
revmatodini artritida jako onemocneni s poruchou osy hypotalamus—hypofyza—nadledvinka.
Klicova slova: periferni neuron, centralni nervovy system, osa
hypotalamus, hypofyza, nadledvinka.
Summary
In the review some recent findings are presented about the role of
peripheral neuron and neuropeptides in the development of the inflammatory
process. Possibilities of the inflammation regulation by interaction between
the structures of central nervous system, the hypophysis—adrenal gland
axis and immune processes are presented. Rheumatoid arthritis as a disease
with the disorder of the hypothalamus—hypophysis—adrenal gland axis is
discussed.
Key words: inflammation, peripheral neuron, central nervous
system, hypothalamus, hypophysis, adrenal gland axis.
pp. 95 – 97
SUCCESSFUL GRAVIDITY WITH DIFFUSE SYSTEMIC SCLEROSIS AND SCLERODERMA NEFROPATHY PROVEN WITH BIOPSY
Z. DVORAK, L. KUBES, E. PINTEROVA, Z. HRNCIR
II. interni klinika FN, Hradec Kralove
Prednosta: prof. MUDr. V. Pidrman, DrSc.
Ustav patologicke anatomie FN, Hradec Kralove
Prednosta: doc. MUDr. I. Steiner, DrSc.
Souhrn
Popsano 10 let trvajici pozorovani nemocne se systemovou sklerozou
(SS) a biopticky overenou sklerodermickou nefropatii. Nemocna si prala
otehotnet, prestoze jiz mela jedno zdrave dite narozene pred manifestaci
SS a byla poucena o riziku dalsi gravidity. Tymova spoluprace revmatologa,
nefrologa a porodnika zabezpecila fyziologicke druhe tehotenstvi zakoncene
porodem zdraveho chlapce, a to bez nasledku pro nemocnou. Popsany priklad
doklada, ze planovana, soustavna a individualne specifikovana lekarska
pece v nekterych pripadech umoznuje uspesne tehotenstvi bez nasledku pro
matku a dite u zen se SS a sklerodermickou nefropatii.
Klicova slova: systemova skleroza, sklerodermicka nefropatie,
tehotenstvi.
Summary
This case report describes ten years long observation of a women-patient
with systemic sclerosis (SS) and scleroderma nefropathy proven with biopsy.
This women wanted to be pregnant although she already had one healthy child
who was born before the manifestation of SS and she was told about possible
risks of another gravidity. Team cooperation of rheumatologist, nefrologist
and obstetrician secured physiologic second pregnancy that was finished
by delivery of a healthy boy without side effects for the patient and her
child. Shown case suggested, that planned, systematic and individually
designed medical care provides in some cases successful gravidity harmless
for the mother and the child also in women with SS and scleroderma nefropathy.
Key words: systemic sclerosis, scleroderma nefropathy, pregnancy.
pp. 99 – 102
ARTHROPATHY WITH HEMOCHROMATOSIS — SCREENING IN A RHEUMATOLOGICAL CLINIC
P. HNILICA Jr., M.R. PIJAK, J. SIDLO, S. MAHROVA
2. interna klinika LFUK, Bratislava
Prednosta: prof. MUDr. I. Balazovjech, DrSc.
Ustav patologickej anatomie LFUK, Bratislava
Prednosta: prof. MUDr. M. Zaviacic, DrSc.
Farmakologicky ustav LFUK, Bratislava
Prednosta: prof. MUDr. M. Kriska, DrSc.
Suhrn
Na priklade kazuistiky autori poukazuju na reumatologicke prejavy genetickej
(idiopatickej, primarnej) hemochromatozy (GH) a na skriningove diagnosticke
postupy, ktore umoznuju vcasnu diagnostiku GH uz v klinicky asymptomatickom
stadiu.
Klucove slova: hemochromatoza, artropatia, feritin, skrining.
Summary
In the case report of a patient with genetic (idiopathic, primary)
hemochromatosis (GH) the authors concentrate on rheumatological signs of
GH. The authors point out on the screening diagnostic methods for early
establishment of the diagnosis already in the asymptomatic stage of disease.
Key words: hemochromatosis, arthropathy, ferritin, screening.
pp. 103 – 105