[Glucose tolerance in the elderly--changes in insulin, C-peptide and glucagon secretion]. / Die Glukosetoleranz im Alter--Anderungen der Insulin-, C-Peptid- und Glukagonsekretion.

The OGTT has been carried out by the authors with 25 older individuals (age 82 +/- 5.1) and 14 younger persons (age 28 +/- 9.0) who all showed neither clinical nor laboratory symptoms of apparent diabetes. During the test authors were determining venose glycaemia, insulin, C-peptide, glucagone and they computed some mathematical quantities enabling the estimation of the insulin secretion. The course of the OGTT of the older group showed higher values of glycaemia, insulin and C-peptide since the 60th minute tending to a duration or to a slow decline (up to the 120th minute). A significant difference in the glucagone values was found by the authors only in the case of fasting higher with the older ones (p = 0.01). The estimation of insulin secretion in the early phase of the OGTT was found by the authors significantly higher with the younger ones in both times.

[Clinical problems in non-A, non-B viral hepatitis. I. Diagnosis of non-A, non-B viral hepatitis and its role in the occurrence of acute viral hepatitis in the Czechoslovak population]. / Klinická problematika virových hepatitid non-A, non-B. I. Diagnostika virové hepatitidy non-A, non-B a její podíl na výskytu akutních virových hepatitid v nasí populaci.

Using RIA and ELISA methods the authors examined HBsAg, anti-HBc IgM and anti-HAV IgM antibodies in 830 adult patients and 101 children with acute viral hepatitis from the catchment area of the South Moravian region. In these groups also the most frequent hepatotropic infectious agent as the possible cause of hepatitis was examined. It was revealed that in adults viral hepatitis A accounted for 22%, viral hepatitis B for 48.5%, viral hepatitis non-A, non-B for 28.8% of the group. The percentage distribution of viral hepatitis in children is different: hepatitis A predominates (65%), hepatitis B is less frequent (22%) and viral hepatitis non-A, non-B is least frequent (13%). It was demonstrated that viral hepatitis non-A, non-B is under our conditions a very frequent disease, it accounts for one quarter of all cases of viral hepatitis and if we take into account that non-A, non-B hepatitis has frequently permanent serious sequelae, then proper attention must be paid to this disease. The authors demonstrate that differentiation of types of viral hepatitis by routine methods is possible which leads to a substantially more accurate differentiation of hepatitis.

[Clinical problems in non-A, non-B viral hepatitis. II. Clinical picture of non-A, non-B viral hepatitis in the acute stage]. / Klinická problematika virových hepatitid non-A, non-B. II. Klinický obraz virové hepatitidy non-A, non-B v akutním stádiu.

Comparison of large groups of patients with acute viral hepatitis A (HA), B (HB) and non-A, non-B (HNANB) revealed that the highest percentage of anicteric forms is found in HA (44.8%) followed by HNANB (27.3%) and the lowest percentage in HB (23.6%). Investigation of mean values of biochemical functional liver tests showed that 1. the highest mean values of bilirubinaemia, ALT and AST were recorded in HB. The differences are statistically significantly higher (p less than 0.01) than in the two remaining types. 2. The difference between the cholesterol serum level, GMT and ALP in HB and HNANB on the one hand and HA on the other hand was at the same level of significance. 3. The transaminase activity is only slightly higher in HA than in HNANB, the differences are not significant (p greater than 0.05). 4. The cholestatic features are more marked in HNANB than in HA. The differences are also significant (p less than 0.01). In the clinical picture in acute HNANB symptoms of influenza predominated (53.33%), followed by digestive complaints (47.5%) and the percentage of articular complaints was lowest (24.17%). Analysis of 24 cases of fulminant forms of viral hepatitis revealed that this course was most frequent in HB (50%), followed by HNANB (41.7%) and least frequent in HA (8.3%).

[Clinical problems in non-A, non-B viral hepatitis. III. The course of non-A, non-B viral hepatitis in the chronic stages]. / Klinická problematika virových hepatitid non-A, non-B. III. Prubeh chronického stadia virové hepatitidy non-A, non-B.

Investigation of a group of 231 patients with viral hepatitis non-A, non-B (HNANB) revealed that the majority of cases is of the parenteral type (60.17%) and the remainder was without parenteral procedures. The course of HNANB was icteric in the majority (72.55%). On check-up examination one year after the onset of the acute stage the pathological clinical and laboratory finding, i.e. chronic liver disease still persisted in 31.6%. A follow-up of the patients in the course of six years revealed that the ratio of serious sequelae (chronic active hepatitis and cirrhosis of the liver) is significant and increases with time and thus already after two years these serious diagnoses predominate over the number of patients with chronic persistent hepatitis. The chi2 test revealed that there is no sexual difference as regards the development of the chronic stage of HNANB, that the chronic stage develops in both basic types of HNANB (in the parenteral and the epidemic type) but it is significantly more frequent in the parenteral type. The development of the chronic stage is equally frequent after icteric and anicteric forms. In patients who recovered completely within one year (68.39%) the convalescence was protracted and normalization of the clinical and biochemical finding occurred later than in patients with viral hepatitis A and B, hospitalized during the same period.

[Monitoring the course of non-A, non-B viral hepatitis in patients with chronic renal insufficiency]. / Sledování prubehu virových hepatitid non-A non-B u nemocných s chronickou renální insuficiencí.

A group of 35 patients with viral hepatitis non-A, non-B included in a chronic dialyzation programme was compared with a comparable group of 40 patients with viral hepatitis non-A, non-B. The mean period since the chronic dialyzation programme was started after the development of viral hepatitis non-A, non-B was 10 months. The mean period of hospitalization in the investigated group was 21 days and was practically identical (22 days) as in the control group. 45.7% of the patients in the chronic dialyzation programme were at the time when the diagnosis was established or in its course quite free from complaints. In 54.3% there were mild complaints. In the control group the number of patients with complaints was much higher (80%). In 82.9% patients included in the chronic dialyzation programme the viral non-A, non-B hepatitis was anicteric. In the control group an icteric course was recorded twice as frequently (37.5%). The authors compared also the means of maximal values of biochemical examinations. Attention was drawn to the fact that among patients in the chronic dialyzation programme there was not a single case of viral hepatitis A.