The advantages and limitations of impedance aggregometry in detection of heparin-induced thrombocytopenia.

Background: Heparin-induced thrombocytopenia (HIT) represents a serious complication of heparin treatment. IgG antibodies binding platelet factor 4 (PF4) and heparin trigger the clinical manifestations of HIT. However, only a portion of the antibodies have the ability to activate platelets, and these can be identified by a platelet aggregation test (functional testing).

[Dabigatran etexilate in clinical practice for prevention of thromboembolic events in patients with atrial fibrillation].

Dabigatrane is the first new generation antiacoagulant that at a dose of 150 mg twice daily was, in the RE-LY study, more effective in cerebrovascular event and systemic embolisation prevention than well-controlled warfarin and had comparable or better safety profile than well-controlled warfarin. The 110 mg twice daily dose showed comparable efficacy and superior safety against warfarin. Crucial and unique among modern anticoagulants is its ability to significantly reduce ischemic as well as hemorrhagic CVEs at a dose of 150 mg twice daily.

[Basic anthropometric characteristics and their relationship with the metabolism of saccharides in women with PCOS].

Aim Of Study: To determine basic anthropometric characteristics and their relationship with the metabolism of saccharides in women with PCOS in the Olomouc region.

Type Of Study: Retrospective study of the results of 72 women with PCOS examined in the endocrinology clinic.

Material And Method: The study entailed the processing of data gained on the basis of examination of women sent to endocrinology clinic for examination in the years 2008-2010, who corresponded to the diagnostic criteria for PCOS according to the Rotterdam consensus.

[Infective endocarditis--crucial early diagnosis].

A 64-year old female patient with polymorbidity, including diabetes, was admitted to our clinic with a suspicion of silent myocardial infarction. However, no acute coronary lesion was subsequently confirmed. Transthoracal echocardiography performed just after the admission suggested infective endocarditis.

[Idiopathic hypoparathyroidism with celiac disease--diagnostic and therapeutic problem].

A middle-aged woman developed gradually diseases where most probably the common denominator is an autoimmune process. The authors describe the clinical condition persisting for seven years, where hypoparathyroidism was associated with coeliac disease which did not respond to dietary measures. Malabsorption was manifested by a selective block for calcium absorption from the gut.

[Fulminant liver failure as a sequelae of acute dystrophy of the right hepatic lobe].

A 38-year-old female patient developed signs of fulminant hepatic failure, caused by extensive, spontaneous, devastating ischaemia of the right liver lobe. The patient survived the acute attack. During the subsequent eight years hypertrophy of the intact left liver lobe occurred which eventually completely replaced the loss of the dominant right lobe.

[The hepatic form of Wilson's disease in young patients].

Unlabelled: Wilson's disease (WD) is a hereditary disorder of the copper metabolism with very varied clinical and biochemical symptoms. Hepatic and neurological forms are the most frequent manifestations of this rare disease. In schoolchildren and adolescents symptoms of liver damage predominate.

[Adrenal incidentalomas. Clinical experience].

In the course of two years the authors treated 27 patients with incidentally detected adrenal tumours. Detailed morphological and laboratory examination revealed four cases of non-classical late type adrenogenital syndrome (AGS) and two pheochromocytomas. From the submitted paper ensues that it is essential to provide interdisciplinary comprehensive treatment in departments which have sufficient experience with this problem.

[Sarcoidosis of the liver, a granulomatous process with an unclear prognosis].

The authors demonstrate on two patients the pitfalls of the diagnosis and prognostic uncertainty of systemic sarcoidosis. The typical pulmonary finding was in the background due to the very extensive and serious affection of the liver.

[Colchicine in the treatment of liver cirrhosis. 12 years' experience].

The authors evaluate more than 12 years of their own experience with the administration of colchicine to patients with cirrhosis of the liver. Colchicine did not produce any apparent undesirable effects. The authors emphasize the absence of knowledge of prognostic parameters (except the stage of the disease and its activity) which would make it possible to evaluate in advance the effect of many years' treatment.

Effect of physical load on the platelet function and ultrastructure in patients with ischemic heart disease.

The aggregability of the blood platelets and their ultrastructure were examined during the bicycle exercise test in 20 patients with ischemic heart disease and stable angina pectoris. In 8 patients with unequivocally positive exercise test a significant increment of stimulated aggregation from 58.2 (CV7%) to 71.

Bleeding to the adrenal gland as a terminal manifestation of acute leukaemia.

The authors refer about an unusual localization of haemorrhage to the adrenal glands, observed in two patients with acute leukaemia similar to the picture of Waterhouse-Friderichsen's syndrome. This complication causing serious and dramatic effects should be taken into differential diagnostic consideration. Literature data and own results are given in order to review the general characteristics of bleeding in acute leukaemia.

Malignant lymphoma involving the heart.

In a group of 116 patients with different types of malignant lymphoma, the frequency, type and clinical manifestations of heart involvement are evaluated. A case of primary cardiac lymphoma is demonstrated. Along with this, clinical and pathological findings in 15 further subjects with secondary lymphomatous infiltration of the heart are discussed; attention is being paid also to indirect factors causing cardiovascular damage, including radio- and chemotherapy.