[The Czech and Slovak Internal Medical Society and the Czech Society of Pneumonology and Phthisiology in cooperation with the Czech Society for Prevention of Chronic Obstructive Pulmonary Disease (COPN) and the Hospital of Ceské Budĕjovice present the 126th Internal Medicine Seminar on Thursday, 27 November 2003 in Ceské Budĕjovice. Chronic obstructive pulmonary disease (COPD) and pulmonary hypertension].

Vnitr Lek 2004, 50(9):653-714

[The importance of chronic obstructive pulmonary disease].

V Vondra

Vnitr Lek 2004, 50(9):654-658

COPD mortality is a world-wide growing problem. COPD is the fifth leading cause of mortality among all diseases now and is projected to be the third one in 2020. In the USA died 119,000 inhabitants in 2001. The Czech republic mortality for COPD in the same year was: men 21.3/100,000 inhabitants, women 11.6/100,000; this represents total number of 1666 deaths for COPD. Prevalence of COPD is from 4.5% to 11% in developed countries of Europe and in the USA; prevalence in the Czech republic is 7.7%. Total economic cost of COPD reaches in the USA nearly the same value as cost of lung cancer. The cost is increasing with severity of the disease and with hospitalization,...

[New and old definitions and COPD terminology].

F Salajka

Vnitr Lek 2004, 50(9):659-662

Terminology of the disease currently known as chronic obstructive pulmonary disease has gone through a long and non-uniform development. Various definitions have been gradually developed and chronic bronchitis was separated from pulmonary emphysema. Various umbrella names have been suggested to unite this group of diseases. At present a classification based on World strategy for diagnosing, treatment and prevention of the chronic obstructive pulmonary disease from 2000 which has been published in our country too is used.

[Pathogenesis of the chronic obstructive pulmonary disease (COPD)].

J Musil

Vnitr Lek 2004, 50(9):663-667

An inflammation in the bronchial wall is usually present already in an early stage of the disease. An inflammatory infiltration cause predominantly mononuclear cells in the mucous membrane and neutrophiles in the phlegm produced by airways. Also eosinophiles can participate in the inflammation. Lymphocytes distribution is different from asthma because there is mainly submucosa infiltrated in COPD. Metaplasia of goblet cells appears. Chronic bronchial obstruction characterizing COPD is induced by conjunction of small airways disease (obstructive bronchiolitis) and a destruction of pulmonary parenchyma (emphysema) which both contribute to an impairment...

[Diagnostics and differential diagnostics of the chronic obstructive pulmonary disease].

S Kos

Vnitr Lek 2004, 50(9):668-669

The author builds upon present definition of chronic obstructive pulmonary disease (COPD) and states that diagnosis of COPD is based on history of risk factors and on presence of bronchial obstruction which is not entirely reversible. The main examination method for diagnosing and confirmation of COPD is spirometry. Differential diagnostics is necessary for identifying other diseases with similar symptoms: bronchial asthma, congestive heart failure, lung carcinoma, bronchiectasia, pulmonary tuberculosis, bronchitis obliterans, interstitial pulmonary processes. The author presents a list of symptoms and findings which help to distinguish these diseases...

[Implication of the lung function tests in chronic obstructive pulmonary disease].

J Satinská

Vnitr Lek 2004, 50(9):670-674

The authors summarize the methods of lung function tests with play important role in diagnosis and monitoring the patients with chronic obstructive pulmonary disease.

[Treatment of stabilized chronic obstructive pulmonary disease].

V Snorek

Vnitr Lek 2004, 50(9):675-676

Treatment of stabilized chronic obstructive pulmonary disease (COPD) is intended to decrease consequences activated by causes, such as inhalation of deleterious particles and gases especially from polluted air and cigarette smoking. From this reason treatment must include an effort to eliminate the cause. Respective treatment includes drug administration, rehabilitation, long term oxygen therapy in home environment, noninvasive positive pressure ventilation (NIPPV), and sometimes surgical procedures. Every treatment should be accompanied with an education of a patient and people in his/her surrounding.

[Treatment principle of the chronic obstructive pulmonary disease (COPD) exacerbation].

J Musil

Vnitr Lek 2004, 50(9):677-681

COPD is often accompanied with acute symptoms exacerbations. Patients in Ist stage: slide grade of COPD and IInd stage: middle grade of COPD suffer exacerbations accompanied with increased dyspnoea often together with increased cough and increased production of sputum. Patients in IIIrd stage (serious) and IVth stage (very serious) experience during exacerbations development of respiration insufficiency or its worsening and thus are usually treated in hospital. The most frequent causes of exacerbations are tracheobronchial tree infections and air pollution. The cause of approximately one third of serious exacerbations is not disclosed. Conditions which...

[Erythrocytapheresis in patients with secondary polyglobulia].

P Kessler

Vnitr Lek 2004, 50(9):682-684

Apheresis is in blood components separators used to remove abundant or pathological blood components or to replace them with healthy ones. Erythrocytapheresis is an up-to-date, efficient and selective alternative of venepuncture. In our country it is used especially for treatment of abundant erythrocytes in polycythemia vera and secondary polyglobulias where its correct use leads both to significant symptomatic relief and erosion of pathogenetic chain and to a reduction of over-production of erythrocytes.

[Pathophysiology and classification of pulmonary hypertension].

H Sládková, P Jansa, Z Susa, M Aschermann

Vnitr Lek 2004, 50(9):685-688

Pulmonary hypertension is present when the mean pulmonary pressure is increased above 25 mm Hg in a rest or above 30 mm Hg during exercise. It is possible to divide it from different point of view. Well known is pathophysiologic classification and Venice classification suggested by WHO symposium 2003. The rise of arterial pulmonary pressure is caused by three essential abnormalities, these are elevated pulmonary vascular resistance, blood flow and pulmonary artery wedge pressure. Vasoconstriction, remodeling of vessels and in situ trombosis are pathogenetic mechanism which contribute to rise of pulmonary hypertension.

[Present ways of diagnosing and treatment of pulmonary hypertension in the Czech Republic].

P Jansa, H Sládková, Z Susa, M Aschermann

Vnitr Lek 2004, 50(9):689-694

Pulmonary hypertension is a condition characterized by elevation of the mean blood pressure in pulmonary artery above 25 mm Hg at rest or above 30 mm Hg during exercise. Pulmonary hypertension signs are not specific. They are frequently camouflaged by signs of a primary disease causing pulmonary hypertension. That causes difficulties with diagnosing and often doesn't lead to recognition of pulmonary hypertension till pressure in pulmonary artery is difficult to manage therapeutically. Treatment of secondary pulmonary hypertension tries to affect primary disease. In patients with pulmonary artery hypertension with preserved vasoreactivity so called...

[Lung transplantation for primary pulmonary hypertension].

R Lischke, J Simonek, A Stolz, J Schützner, P Pafko

Vnitr Lek 2004, 50(9):695-697

Significant advances in the treatment of primary pulmonary hypertension (PPH) have been achieved in the past decade. Continuous intravenous prostacyclin and lung transplantation are complex and effective approaches in the therapy of PPH. Indication, technique, postoperative care and results of lung transplantation for PPH are discussed.

[Recommendations for diagnostics and treatment of pulmonary arterial hypertension in the Czech Republic].

P Jansa, M Aschermann, M Riedel, P Pafko, Z Susa

Vnitr Lek 2004, 50(9):698-708

[Recommendations for diagnostics and treatment of arterial hypertension--version 2004. Recommendations of the Czech Society for Prevention of Hypertension].

R Cífková, K Horký, J Widimský, J Widimský, J Filipovský, M Grundmann, V Monhart, H Rosolová, M Soucek, J Spinar, J Vitovec,

Vnitr Lek 2004, 50(9):709-722