[A commentary to the article by Dvoráková, Poledne: "An ultrasensitive C-reactive protein assay--a new parameter of a cardiovascular risk" sent from the Laboratory for Aterosclerosis Investigation at IKEM Prague].

F Málek

Vnitr Lek 2004, 50(11):807-809

[C-reactive protein--a molecule that changed cardiology].

P Ostádal

Vnitr Lek 2004, 50(11):809-811

[Impact of acute fluid restriction on levels of natriuretic peptides in patients on a chronic dialysis program].

I Oral, D Stejskal, J Loucký, Z Sislák, Z Coufal, J Mistrík, R Náplava

Vnitr Lek 2004, 50(11):812-817

In order to assess an impact of acute changes in blood volume on levels of B-type natriuretic peptides (BNP and NT-proBNP) 30 patients with a heart disease and chronic renal insufficiency on chronic dialysis program were assessed. An acute fluid restriction of 3750 ml on an average lead to decreased filling of the left heart ventricle (echocardiography revealed a reduced size of the left atrium, change in E/A parameters and deceleration time, and decreased end-diastolic volume of the left ventricle). Prior to dialysis normal levels of BNP (2.58 +/- 1.21 pg/ml) and elevated levels of NT-proBNP (193.2 +/- 117.7 pg/ml) had been indicated. Following dialysis...

[Rosiglitazon in treatment of Type II diabetes mellitus--experience of diabetologists in the Czech Republic. Part I: compensation of diabetes, sugar metabolism].

J Perusicová, T Haas

Vnitr Lek 2004, 50(11):818-824

UNLABELLED: Thiazolidindione derivates (glitazones) make a very promising group of peroral antidiabetic drugs. They are represented by rosiglitazon which is available on our market to type II diabetics. As far as sugar metabolism is concerned, rosiglitazon can reduce glycaemia and insulin level both when fasting and postprandially.GOAL: The goal of the authors' work was to gain their own experience with rosiglitazon treatment in type II diabetics in the Czech Republic.SAMPLE: The monitored sample consisted of 388 patients with insufficiently compensated type II diabetes when treated by sulphonylurea compounds or metformine.METHODS: 95 diabetologists...

[Sibutramin in obesity treatment (multicenter, open, prospective 12-month-long study)].

J Payer, V Hainer, P Ondrejka, Z Kajtor

Vnitr Lek 2004, 50(11):825-829

Obesity presents a significant medical and socio-economic problem due its prevalence exceeding 20% of adult population. Body weight reduction significantly decreases both morbidity from numerous complications and total mortality. Nonpharmacological measures are the first step in weight reduction, however an effective pharmacotherapy is also needed in some of the patients. In a 12-month-long study 50 obese female patients were treated with Sibutramin doses of 10 mg or 15 mg. Sibutramin is a drug with a dual effect: it reduces intake of energy by simultaneous bringing on a sense of satiety and inhibiting reduction of the energy release which usually...

[Factors participating in development of bleeding varices in portal hypertension. Part I: bacterial infection and comparison of intravenous and peroral antibiotics effects--a randomised study].

J Lata, J Juránková, L Husová, M Senkyrík, P Dítě, M Dastych, V Príbramská

Vnitr Lek 2004, 50(11):830-835

An acute bleeding from oesophageal varices as a result of portal hypertension is a frequent and at the same time serious complication of cirrhosis of the liver. One of factors influencing this bleeding can be a bacterial infection. Endotoxines can increase portal pressure and so participate in development of bleeding and simultaneously deteriorate a patient's prognosis. An antibiotic treatment is a part of a treatment algorithm, however what antibiotics to administer and in what manner is unclear. A group of 46 patients who were admitted to a hospital for an acute bleeding from varices has been compared in the study to 48 cirrhosis patients hospitalised...

[Assessment of changes in peripheral microcirculation in type I diabetics with laser doppler flowmetry].

I Hofírek, O Sochor, J Olovský

Vnitr Lek 2004, 50(11):836-841

GOAL: To make out a methodology and assessment of peripheral microcirculation with laser Doppler flowmetry (LDF) in patients with type I diabetes mellitus and to compare their results to findings in healthy control people using frequency analyses.METHODOLOGY: A group of 32 patients suffering from type I diabetes on an average for 14 years (group A) has been examined. The patients suffered from a basic angiology disorder in arteries of lower extremities. Peripheral circulation in lower extremities has been examined via laser Doppler flowmetry. The same tests have been done in a group of 40 healthy people (group B).RESULTS: Basic evaluation revealed...

[Primary biliary cirrhosis--specific anti-mitochondrial antibodies].

L Wenchich, T Krechler, J Horak, A Sedivá, J Bartůnková, H Hansiková, P Martásek, J Zeman, T Svestka

Vnitr Lek 2004, 50(11):842-845

UNLABELLED: Primary biliary cirrhosis is a chronic liver disease, characterized by the destruction of the epithelial cells of the sublobular, interlobular and septal bile ducts and with the development of cirrhosis. The presence of anti-mitochondrial antibodies against the subunits of mitochondrial 2-oxoacids dehydrogenases is characteristic for patients with primary biliary cirrhosis. The aim of this work was to study the effect of anti-mitochondrial antibodies upon activity of the isolated mitochondrial pyruvate dehydrogenase complex after the incubation with serum from patients with primary biliary cirrhosis.GROUP OF PATIENTS AND METHODS: The...

[Cardiac manifestation of Fabry's disease: current knowledge].

T Palecek, J-C Lubanda, S Magage, D Karetová, J Bultas, A Linhart

Vnitr Lek 2004, 50(11):846-851

Fabry's disease is a rare lysosomal storage disease caused by the X-linked defect of the enzyme alpha-galactosidase A leading to the intracellular accumulation of glycosphingolipids in various organs and tissues. Cardiac involvement is frequent and, in individuals with some residual enzyme activity, may be the sole manifestation of the disease. Hemizygous men are generally more seriously affected than heterozygous women. The dominant cardiac manifestations include myocardial hypertrophy of the left ventricle, which, in some patients, mimics hypertrophic cardiomypathy. Left ventricular systolic function is usually preserved, on the other hand mild to...

[An ultrasensitive C-reactive protein assay--a new parameter in cardiovascular risk].

A Dvoráková, R Poledne

Vnitr Lek 2004, 50(11):852-857

Elevated C-reactive protein concentration, measured by an ultrasensitive method (hsCRP), has been proved to be a risk factor for atherosclerosis progression and its complications (myocardial infarction and stroke) in otherwise healthy men and women. In patients with already diagnosed atherosclerotic disease elevated concentration of hsCRP predicts prognosis. There are multiple causes of elevated hsCRP concentration: metabolic changes (e.g. as a part of metabolic syndrome), genetic background and chronic infections. Proinflammatory effect of adipose tissue in obese individuals seems to play an important role, hsCRP levels correlate with markers of abdominal...

[The role of anti-ulcerative drugs in treatment and prevention of gastropathies induced by nonsteroidal anti-inflammatory drugs].

P Fialová, J Vlcek

Vnitr Lek 2004, 50(11):858-866

Nonsteroidal anti-inflammatory drugs (NSAIDs) as effective agents for the relief of pain and inflammation are among the most widely prescribed drugs. Unfortunately, their benefits especially for patients with osteoarthritis and other chronic musculoskeletal conditions, are accompanied by well established toxicity. A significant percentage of NSAIDs users experience some type of gastrointestinal adverse events, ranging from manageable dyspepsia to clinically important complications (gastrointestinal bleeding, ulcer perforation, obstruction). In an attempt to reduce the incidence of NSAID-induced gastropathy, the following approaches have been proposed:...

[Diabetic gastroparesis and gastropathy].

V Kojecký

Vnitr Lek 2004, 50(11):867-872

Dysfunction of gastrointestinal tract affects about 30-60 % diabetic patients. The gastroparesis occurs only in part of patients. Dysfunction has different manifestations from quantitative and qualitative changes of motility to alterations of visceral sensitivity. Pathogenesis of the disturbances is multifactorial - autonomic neuropathy, quality of metabolic control, function of enteric nervous system and others. Scintigraphy is a standard for making diagnosis. Due to its multifactorial natural history, therapy is difficult. It encompasses dietary modifications, good control of diabetes, prokinetic drugs. New drugs and treatment techniques are beeing...

[Syncope in ventricular tachycardia as a first clinical sign of patent ductus arteriosus in an adulthood].

R Praus, P Parízek, P Cervinka, L Haman, M Tauchman, J Sťásek, R Pudil, J Gregor, M Hudík, M Hodac

Vnitr Lek 2004, 50(11):873-876

The case-report describes a 48-year-old-female patient with the patent ductus arteriosus with the following structural changes leading to the malignant arrhythmias manifested as a syncope. The patient was treated by Amplatzer occluder and the implantation of the cardioverter-defibrillator. The authors discuss the patent ductus arteriosus, arrhythmias and sudden cardiac death in the patients with the congenital heart disease in an adulthood.

[Explanation of the Stewart-Fencl views on the acid-base equilibrium].

Viktor Rosival

Vnitr Lek 2004, 50(11):877