[Glamour and poverty of oncology].

J Vorlícek

Vnitr Lek 2004, 50(Supplement 1):S9-22

The problematics of oncology is staying at the fore of the health problems in our republic. Every third of us falls ill with malignant tumour and every fourth dies of it. There were 37,000 malignant tumours diagnosed in our republic in 1977, in 1999 it was 59,500 and the amount is expected to increase up to 70,000 in 2004. Our results regarding the relative 5-year survival of the patients with all the oncologic diagnoses from 15 to 44 years are below European average. The most frequent tumour is lung cancer and bronchial cancer in males, breast cancer in females and the most frequent malignant tumour in both sexes is the colorectal cancer, the absolute...

[Heart failure--epidemic of the 21st century].

J Hradec

Vnitr Lek 2004, 50(Supplement 1):S23-S31

Number of patients with chronic heart failure is increasing in all developed countries. The reasons are both, the improving prevention and treatment of deadly cardiovascular diseases, like acute myocardial infarction or stroke, and the increasing life expectancy. The cardiovascular mortality has declined by 30% and the average life expectancy has increased by 4 years also in the Czech Republic during the last 15 years. The prevalence of heart failure is about 1.5% in a general population, which means that there is about 150,000 patients in the Czech Republic. The annual incidence is about 0.4%, which means that there is about 40,000 new patients in...

[Echocardiography--a stethoscope of the 21st century].

J Meluzín

Vnitr Lek 2004, 50(Supplement 1):S32-S35

The goal of this article is to provide a report of a current potential of an ultrasound examination of heart and to outline future development of echocardiography and its use in clinical practice. Since echocardiography appearance in the middle of the 20th century till today, the method has undergone a very dynamic development. From a simple one-dimensional image (M-mode), through two-dimensional image (2D) complemented with Doppler imaging of blood flows, echocardiography developed into currently up to date methods such as contrast echocardiography, tissue Doppler imaging, assessment of myocardial strain and strain rate, methods based on detection...

[New trends in pharmacotherapy of cardiovascular diseases].

J Bultas, D Karetová

Vnitr Lek 2004, 50(Supplement 1):S37-S58

There has not been a year that would not have brought something new, often upheaval in the field of cardiovascular pharmacotherapy during last decades. This overview addresses the perspectives that may be expected in the treatment of cardiovascular diseases in the coming years. As for the field of dyslipidemy treatment there are some new options of blocking cholesterol resorption at the enterocyte level opening up in the field of dyslipidemy treatment (e.g. brush border transport system inhibitors, inhibitors of esterification or bind to apolipoprotein), further big revolution may be foreseen in the field of the stimulation of peroxysomal receptors...

[Drug eluting stents--end of restenosis?].

L Groch

Vnitr Lek 2004, 50(Supplement 1):S59-S62

[Defibrillators--end of sudden cardiac death?].

M Kozák

Vnitr Lek 2004, 50(Supplement 1):S63-S67

The ventricular fibrillation is still the main cause of a sudden cardiac death, even though it was described 155 years ago in experiment (M. Hoffa 1849) and its therapy--defibrillation--has been known since 1947 (C. Beck). In Europe 2500 inhabitants suffer from cardiac arrest daily and 90% is caused by ventricular fibrillation. A key interval for an effective defibrillation seems to be 3-8 minutes from the begining of a cardiac arrest. Automated (automatized) external defibrillators (AED) have been used for last 15 years, especially in USA. However it is still unclear how many devices will be needed and where to place them. We don't know if they improve...

[Preventable diseases: an appeal at the beginning of the 21st century].

M Andel, P Dlouhý, P Kraml

Vnitr Lek 2004, 50(Supplement 1):S68-S70

[Dyslipidemia at the turn of the century: optimism or scepticism?].

V Soska

Vnitr Lek 2004, 50(Supplement 1):S71-S75

Treatment of dyslipidaemia is one of the most important factors that decreases cardiovascular mortality and morbidity. Although we know lipid levels goals, we are not very successful in achiving them. The number of hypolipidemic substances is increasing and we have got guidelines for treatment dyslipidaemic patients. It is very important to implement this guidelines in the clinical practice. Another problem is rather poor patients's compliance both for dyslipidaemia treatment and for lifestyle changes. Pharmacologic treatment of dyslipidaemia may be limited due to its high expense. Pharmacologic treatment thus should be target to the high risk population:...

[New trends in diabetology].

S Svacina

Vnitr Lek 2004, 50(Supplement 1):S76-S80

Number of diabetics increases enormously in the whole world. In last years many new approaches and technologies were developed e.g. strategies of diabetes prevention, new findings in metabolic syndrome pathogenesis, new findings in postprandial state, new antidiabetic and antiobesity drugs, new insulin analogues, new technologies in glucose monitoring and insulin delivery, new approaches were developed also in insulin dosing in intensive care. Many changes will influence diabetology in next years: inhalation and bucal application of insulin, development of drugs functioning in all components of metabolic syndrome, automatisation of insulin dosing (closing...

[Some important news in clinical nephrology in years 2003-2004].

V Tesar

Vnitr Lek 2004, 50(Supplement 1):S81-S87

A new classification of chronic renal diseases enables to stratify risk of complications of chronic renal insufficiency and cardiovascular diseases. Chronic renal diseases are not rare, their incidence increases with age. Main causes of morbidity and mortality of patients with chronic renal diseases are cardiovascular complications. Besides typical risk factors, patients with chronic renal disease are at risk of specific renal diseases (such as anaemia or hyperphosphatemia). A cardiovascular risk of renal patients also increases dislipidemia. Statin treatment is able to decrease not only cardiovascular morbidity and mortality but also to slow down...

[What has changed in knowledge of etiopathogenensis, diagnostics and therapy of gastroesophageal reflux over last 15 years?].

A Hep

Vnitr Lek 2004, 50(Supplement 1):S88-S90

An incidence of gastroesophageal reflux disease (GERD) in population is continuously increasing. A probable etiology, except anatomical changes (such as hiatus hernia, transient lower esophageal sphincter relaxation etc.), can also include a change in life style For diagnostic purposes upper endoscopy and in unclear cases esophageal pH-metry is used. From an etiopathogenetic point of view, besides reflux of acidic content, the alkaline content and night change in production of hydrochloric acid during treatment with proton pump blockers (PPI) are considered to be important too. Attention should be paid to extraesophageal signs of GERD. In treatment...

[Gastric and duodenal ulcers--etiopathogenesis, diagnosis and therapy at the milestone of the 20th century].

J Bures

Vnitr Lek 2004, 50(Supplement 1):S91-S93

Peptic ulcer disease has been still very actual topic as 10% of western population would fell ill during its life. Substantial changes in understanding of etiopathogenesis were achieved within last hundred years. The first milestone means development of gastric physiology (gastric secretion, histamine, gastrin, cyclo-oxygenase, H2-receptors, proton pump). There is no doubt peptic ulcer is a typically human disease with involvement of the cortico-visceral axis and psychosomatic traits. Others factors play their role in the etiopathogenesis (like genetic, ethnic, environmental and socio-economic factors). However, main etiologic factors are Helicobacter...

[Idiopathic intestinal inflammations--contemporary therapeutic approaches].

V Zboril

Vnitr Lek 2004, 50(Supplement 1):S94-S97

Current pharmacotherapy of idiopathic intestinal inflammations can benefit from standard (conventional) therapies based on results of controlled studies, non-standard (unconventional) therapies based on pilot and uncontrolled studies, or can be a subject of clinical experiments. Clinical experimental area is a way to a progress in traditional treatment methods. Currently it includes a group of new drugs (immunosuppressives tacrolimus mycophenolate, thalidomide, biologic therapy, probiotics, neuroinflammation blockers), new treatment techniques (cytaphereses, sequential immunosuppression, immunosuppression with high doses), and finally new indications...

[Chronic pancreatitis--a disease we can treat but cannot cure].

P Dítě

Vnitr Lek 2004, 50(Supplement 1):S98-102

Chronic pancreatitis is one of conditions with a significant impact on quality of life of patients and is an important risk factor for carcinoma emergence. Currently we have a lot of fundamental evidence concerning etiopathogenic mechanisms of chronic pancreatitis genesis. Among conclusive etiology factors belong genetic influence, heredity or autoimmune influence. However, in majority of cases the disease is not diagnosed until diagnosis of manifesting stages is made both clinically and morphologically. In spite of it new very sensitive diagnostic methods appear to give precision to diagnostics, such as new generations of NMR appliances making possible...

[The screening of sporadic colorectal cancer].

M Zavoral

Vnitr Lek 2004, 50(Supplement 1):S103-S106

World Health Organization (WHO) defined the criteria for screening (i.e. the location of asymptomatic individuals) of the diseases seriously endangering the public health condition. The decisive criterion is the decrease of mortality with the disease the screening is made of. The programme based on the testing the asymptomatic individuals for the presence of the fecal occult bleeding (FOBT), which was introduced also in Czech republic, meets the criterion at the screening of colorectal cancer (CR-CA), which has been proved since the year 1993 by the two case-control studies and further particularly by the three prospective, randomized, controlled studies...

[Renal transplantation--effective or useful?].

M Kuman

Vnitr Lek 2004, 50(Supplement 1):S107-S109

In indicated cases the renal transplantations constitute a very effective method of solving the final renal failure. Their medical and economic importance is constantly increasing. They positively influence not only the quality of life, but also a morbidity and mortality of transplanted. It has been a long time since the comparison of annual financial costs per dialysed patient (in average 750,000 CZK) and transplanted one (in average 500,000 CZK in first year after transplantation, consequently 250,000 CZK per year) is known. Annual saving of 250,000 CZK or half a million crowns per patient with a functioning implant is a sufficiently expressive argument...

[The role of liver transplantation in clinical practice].

P Studeník

Vnitr Lek 2004, 50(Supplement 1):S110-S114

The first succesful liver transplantation was made in USA in 1967. These operations had been made only in few centres in the world until the 80-ies of the last century and the results were not so good. However, along with the development of surgical techniques, immunosuppression and postoperational care the results of these operations significantly improved and their amount increased. The liver transplantation was declared the clinical therapy in USA in 1983. In the same year there was made a succesful liver transplantation in Czech republic too. Nowadays there is annually made approximately 10,000 such operations worldwide. During the last decade...

[New horizons in heart transplantation].

L Spinarová

Vnitr Lek 2004, 50(Supplement 1):S115-S121

Since its beginning in 1967 heart transplantations have become in 80s of the 20th century a routine treatment method of an advanced heart failure. In spite of the successes in transplantations a range of possible topics and research goals still has to be disclosed to improve quality of life and survival of patients. New horizons in heart transplantations can be summarised in following points: 1 Search of new more efficient immunosuppressives with less adverse effects. Classically a combination of Cyclosporin, Azathioprin, and corticoids have been used. Mycophenolate mofetil starts to be used in treatment instead of Azathioprin, Tacrolimus has been...

[Proceedings of the 127th Internal Medicine Seminar and 20th Vanysek Seminar held March 19 2004 in Brno].

Vnitr Lek 2004, 50(Supplement 1):S9-121