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Biomedical subjects

A Kovác

Publications and source records attributed to A Kovác.

At least 19 recordsLinked to original sources
PubMed1999

[Pathology of the spleen in ultrasonographic imaging].

Authors provide review on diffuse and focal splenic lesions, traumatic injuries, contribution of ultrasonography in staging of malignant lymphomas and ultrasound-guided percutaneous biopsy. Special attention is given to the question of normal spleen size and diagnosis of splenomegaly. In 230 patients (98 males) aged 18-72 years (median 34.2) witch underwent complex preventive examination, maximal longitudinal diameter (LDmax) of the spleen were measured. Using linear regression analysis relation of spleen size and body high, weigh and body mass index (BMI) was evaluated. Median LDmax was 10.1 cm, range 7.8-13.5 cm. As a reference limit authors accept 95% confidence interval of median: 7.9-12.3 cm. Statistically significant correlation (p < 0.01, r = 0.31) between LDmax and body high was found out. Ultrasonography because of diagnostic efficiency is suggested the method of choice in diagnosing pathologic involvement of the spleen.

Adolescent↗
PubMed1997

[Controlled clinical study of Consupren versus cyclophosphamide in chronic glomerulonephritis. II. Adverse effects].

BACKGROUND: The second part of the study was designed to assess Consupren side effects. METHODS AND RESULTS: The groups of patients studied were described in Part I. Side affects typical of Cy-A were evaluated only in the CS group. Gastrointestinal intolerance, only mild and temporary, was observed in 31%, neurotoxicity in 44%, hypertrichosis in 37%, nephrotoxicity in 25%, and gingival hypertrophy in 19%. Mean values of systolic and diastolic blood pressure did not change significantly in the course of treatment. When changes in blood pressure were individually investigated in particular patients, they were found in 31% in the CS group and in none in the K group. Mean values of uric acid non-significantly increased in the CS group and, on individual investigation, hyperuricaemia was observed in 31%. Mean values of serum potassium did not alter significantly. Signs of possible hepatotoxicity were found in 37% patients of the CS group. In this group, there was a significant decrease in haemoglobin mean values and a decrease in haemoglobin of more than 25 g/l was observed in 44% of CS group patients. In the K group significant decrease in mean leukocyte count was noted, but no patient developed real leukopenia. CONCLUSIONS: The occurrence of side effects was comparable to data known from the literature.

Chronic Disease↗
PubMed1997

[A controlled clinical trial of Consupren versus cyclophosphamide in chronic glomerulonephritis].

BACKGROUND: Experience gained from recent studies shows, that Cyclosporine-A (Cy-A) may decrease proteinuria (PU) in some forms of chronic glomerulonephritis (GN) with the nephrotic syndrome. The aim of this study was to test the efficacy of Czech-made Cy-A, Consupren. METHODS AND RESULTS: 30 patients with chronic GN, confirmed by biopsy and PU higher than 3 g/d, corticodependent or corticoresistant, were randomized according to the month of birth to either therapy with Consupren at an initial dose of 5 mg/kg/d (CS group, after dropout of 3 patients who did not finish the treatment, n = 16) or Cyclophosphamide at a dose of 1.5 mg/kg/d (K group, n = 11), and prednisone maintained at the original dose in both groups. The treatment was stopped after six months or after achieving remission. The main criterion of efficacy was PU. The decrease in mean values, statistically evaluated by Holm's procedure was highly significant in the CS group and non-significant in the K group. A similar evaluation of PU corrected by glomerular filtration rate was significant in both groups. Partial or complete remission was reached in 50% of CS group patients and in 34% of K group patients (NS). In the CS group a significant increase in the mean values of albumin and gama-globulin, and a decrease in cholesterol levels were observed. In the K group, these changes were non-significant. CONCLUSIONS: In patients with chronic GN and the nephrotic syndrome, the efficacy of Consupren treatment gives comparable, or even better results versus treatment with Cyclophosphamide.

Adult↗
PubMed1997

Adrenal incidentalomas--analysis of 23 cases discovered by ultrasound.

Frequent use of abdominal ultrasonography (USG) increases discovery of incidental adrenal tumors. Our experience and concise review of recent opinions on management of adrenal incidentalomas is presented. In four out of 23 patients with adrenal incidentalomas false positivity of USG was found (all on the left side), 4 cases were identified as pseudoadrenal masses. Hormonal activity was proved in 4 out of 15 true adrenal masses (2 pheochromocytomass, 2 aldosteronomas). Five out of 11 hormonally inactive tumors were benign adenomass, 2 myelolipomas, 2 simple cysts, 1 metastasis of bronchogenic carcinoma and 1 tuberculotic involvement. The smallest tumor was aldosteronoma (2 cm in diameter), the largest was myelolipoma (more than 10 cm). Size of benign adenomas ranged between 2.5-4.8 cm. Three main ultrasonic patterns of adrenal tumors were recognized: (1) anechogenic cysts, (2) complex but predominantly hyperechogenic myelolipomas, (3) hypoechogenic all other masses.

Adenoma↗
PubMed1997

[Fibrillary glomerulopathy].

The authors present an account on contemporary knowledge of the diagnosis and differential diagnosis of fibrillar glomerulopathies. The latter are characterized by extracellular localized microfibrils and microtubules resp. in the glomeruli of the kidneys, their diameter being 8-60 nm. They are divided into amyloid and non-amyloid types. The others are classified according to the immunofluorescent finding into immunoglobulin positive and negative ones. The differential diagnosis is important in particular in immunoglobulin positive ones as they are present in serious diseases such as cryoglobulinaemia, monoclonal gammapathy, systemic lupus erythematosus and immunotactoid glomerulopathy.

Adult↗
PubMed1997

[Thyrotropin-secreting adenomas of the hypophysis].

Thyrotropin secreting pituitary adenomas are scarce. They may cause an extremely rare form of hyperthyroidism. The diagnosis is often delayed because the clinical symptoms are attributed to common types of hyperthyroidism. The diagnosis involves detection of elevated or normal (unsuppressed) thyrotropin levels in hyperthyroid patients and evidence of a pituitary adenoma by computed tomography or magnetic resonance imaging. The thyrotropin response in the thyrotropin-releasing hormone test is either absent or insufficient. When the pituitary microadenoma appears to be undetectable, the familiar syndrome of selective pituitary resistance to thyroid hormones has to be excluded. Treatment involves extirpation of the tumour. If the macroadenoma is not removed completely, external radiotherapy of the pituitary follows. If this conventional treatment does not produce an adequate effect, treatment with long-acting somatostatin analogues is recommended.

Adenoma↗
PubMed1996

Tubular basement membrane thickening in diabetes mellitus.

Authors measured the thickness of the basement membranes of the proximal and distal tubuli in the renal cortex in 20 patients with verified diabetes mellitus. The test group consisted of 20 patients with small abnormalities of glomeruli (or in the range of variable norm), of the same sex and comparable age. Measurements were performed in locations without tubulo-interstitial changes. The average thickness of TBM in patients with diabetes mellitus was 1540 +/- 616 nm, and in the test group 360 +/- 86 nm, which is a statistically significant difference (p < 0.000000). In spite of the small number of cases and possible error in the manual measurement of electron microscopic pictures, a significant thickening of TBM in diabetes mellitus has been found. We consider this to be of diagnostic value.

Basement Membrane↗
PubMed1996

[Chronic renal insufficiency. Present views on pathogenesis, clinical aspects and treatment].

The authors present contemporary views on the pathogenesis, clinical picture and treatment of chronic renal failure. A comprehensive approach to the pathogenesis of renal failure revealed new therapeutic methods such as treatment with erythropoietin, vitamin D etc. The authors emphasize substantial changes in the quality and range of the clinical picture which developed due to the prolonged survival of patients with dialyzation treatment. New problems developed such as e.g. dialyzation amyloidosis, aluminium intoxication, endocrine changes, increased occurrence of malignities etc. These must be foreseen, diagnosed and treated. While during the first half of this century uraemia was a fatal disease, at the end of the nineties patients survive due to the dialyzation and transplantation programme.

Humans↗
PubMed1996

[Chronic renal insufficiency].

The authors submit a review on the etiopathogenesis, clinical picture and treatment of chronic renal insufficiency. They emphasize the fact that based on pathogenetic ideas it proved possible to influence the majority of pathological processes: retention and deficiency of substances as well as impaired regulation. After introduction of treatment, using erythropoietin, calcitriol as well as due to advances in the technique and quality of dialysis treatment, the patients' quality of life improved substantially. The authors draw attention also to the danger of accumulation of some drugs in renal insufficiency and its development.

Humans↗
PubMed1995

[Variations in histologic and ultrastructural findings in renal glomerular biopsies].

On the basis of 506 renal biopsies performed within a six-year period (237 of which were evaluated electron-microscopically) the authors discovered that in 11 cases the diagnosis based on electron microscopic examination had to be corrected or supplemented by the diagnostic statement of membranous glomerulonephritis. These cases included 1 boy (HBsAg positive), 2 men and 8 women were middle aged. 5 women were treated due to polyarthritis. All cases when examined light-microscopically yielded a pattern evaluated as normal, or as minute abnormalities of glomeruli. Half-thick sections were not sufficient for the diagnosis. 3 cases of biopsies yielded a variously developed chronic tubulointerstitial nephritis, two cases were accompanied with polyarthritis. On the basis of the latter the authors consider the electron microscopic examination as indicated: 1. in cases when the diagnosis statement is not achieved by other examinations, 2. findings are in the range of the so-called variable norm, 3. in all cases of minute abnormalities in glomeruli detected without electron microscopy, 4. the impact of any of effective drugs cannot be excluded, 5. the diagnostic conclusion based on renal biopsy and the clinical-laboratory pattern of the disease are inconsistent. The authors assume that especially the fourth and fifth groups are going to be gradually supplemented and made more precise. (Fig. 1, Ref. 5.).

Adult↗
PubMed1992

[On the 30th anniversary of the first hemodialysis in Slovakia].

The author reminds of the first attempts of therapeutic dialysis in Slovakia as well as the first instrumental haemodialysis implemented on August 15 1962 by doctors I. Ahlers, N. Scheid and T. Szabo in the Military Hospital in Kosice. Then he analyzes the development of dialyzation treatment in the Slovak Republic and compares the contemporary state with that in Europe.

Czechoslovakia↗
PubMed1992

[Antibiotic therapy of infections in patients on dialysis].

The results obtained in treating infections in 53 patients involved in a chronic dialysis-transplantation program are reported. Higher susceptibility to infections and reduced immune functions were observed in dialyzed patients. The problem of the occurrence rate of individual infections was analyzed and infections of the respiratory system, particularly bronchopneumonia, were found to be predominant. No patient died of infection; in two patients the prescribed antibiotic of first choice had to be changed; positive clinical and laboratory effect was recorded in 51 of the 53 patients treated, and after change of the antibiotic in all the patients. Particular regimens of individual antibiotics in dialyzed patients are given along with the dialyzability of the drugs. The best results were obtained with ofloxacin and doxycycline of Czecho-Slovak make in monotherapy, in combined treatment gentamycin an amikacin with cefamezin or with cefotaxim proved to be most effective. Of the 45 pathogenic agents isolated, Staphylococcus aureus, Klebsiella spp, and Acinetobacter lwoffi, which have a good sensitivity to antibiotics, had the highest occurrence rates. (Tab. 4, Ref. 6.).

Anti-Bacterial Agents↗
PubMed1991

[Intermittent transcutaneous monitoring of acid-base equilibrium in neonates].

The authors discuss intermittent transcutaneous monitoring of the acid base balance in blood where the feedback model: lungs-milieou intérieur is used as part of a new theory, i.e. the concept of "electronic blood" (Kovác A.) which implies simulation of the internal environment by a computer. Part of the model, evidence of the existing relationship of the external and internal environment are the following parameters: a shift in the Haldane effect and the constant in Haldane's effect. The authors compare the values of the acid-base balance obtained by surgical means and by means of a computer.

Acid-Base Equilibrium↗
PubMed1991

[Diagnosis of diabetes mellitus based on the renal biopsy].

In a total of 1499 representative renal biopsies 30 displayed morphological changes suggesting diabetic nephropathy. Six patients had clinically diagnosed diabetes at the time of biopsy, 20 according to the bioptic finding, and in four patients the examination did not confirm diabetes. The authors describe the morphological vascular changes in particular the cumulation of masses resembling the mesangial matrix and basal membranes, as well as hyaline lesions, their development, site and combinations. In the author's opinion the most reliable sign of early diabetic nephropathy is thickening of the glomerular basal membrane. They draw attention to the non-specific character of the morphological finding and the necessity to diagnose diabetes mellitus by clinical and in particular by laboratory methods.

Biopsy, Needle↗
PubMed1989

[Acute renal insufficiency after the administration of tetracycline and gentamycin].

The clinical course of eight case reports of patients with acute renal failure after administration of nephrotoxic antibiotics--specially of tetracycline and gentamycin--is demonstrated. All patients were suffering on preexisting nephropathy, many of them in stage of chronic renal failure according to various etiopathogenesis. As concomitant factor inducing acute renal failure together with antibiotics are: elderly, hepatopathy, surgical interventions, administration of other nephrotoxic drugs. In 6 patients, where acute renal failure induced by nonreducted doses of antibiotics appeared, the treatment was successful, in five cases due to short term haemodialysis, once conservatively with diuretics and volume diuresis. Two patients died before the therapeutic measures and dialysis could be performed. Algorithms in diagnosis and treatment of chronic renal failure--patients where antibiotic treatment is necessary are discussed.

Acute Kidney Injury↗
PubMed1989

[Ultrasonography of echinococcosis, toxocariasis and cysticercosis of the liver].

The diagnosis of tissue parasitoses has remained complicated until the present time for variability of clinical picture. Their incidence been increasing due to aimed and accidental findings of foci in parenchymal organs employing new methods of visualization such as computer tomography and especially ultrasonography whose advantage is a good detection rate, availability and a possibility to follow the dynamics of parasitosis development. The authors present a survey of ultra-sonographic findings of the liver in cases of tissue parasitoses occurring in Czechoslovakia, while using their own image documentation. If a focal affection in the liver is established the differential diagnosis considerations should also take into account a tissue parasitosis, whose ultrasound picture may be nonspecific.

Cysticercosis↗
PubMed1989

[Diagnosis and classification of tubulointerstitial nephritis].

To make a correct diagnosis of tubulointerstitial nephritis and to make it in time calls for knowledge of its clinical symptomatology (it is usually very marked in acute forms and in chronic forms it is frequently inapparent) and it is essential to know the main causes which produce this type of renal damage. In some instances the already developed disease is diagnosed and not infrequently even renal failure. Recognition of the aetiological and pathogenetic multiplicity of the disease, as made possible by the submitted classification of the WHO expert commission, is one of the prerequisites of the diagnosis and treatment in time or of prevention by effective provisions.

Humans↗