Úvodník

P. Svačina

Vnitr Lek 2005, 51(1):7-10  

Slovo nakladatele

E. Skalková

Vnitr Lek 2005, 51(1):10  

Význam centralizace péče o nemocné s akutním krvácením do horní části trávicího traktu

L. Husová

Vnitr Lek 2005, 51(1):11-12  

Individuální výběr nemocných pro silový trénink po akutním infarktu myokardu se sníženou ejekční frakcí levé komory

K. Martiník

Vnitr Lek 2005, 51(1):13-16  

Myokarditidy

K. Zeman

Vnitr Lek 2005, 51(1):17-19  

Myelodysplastic syndrome in the new millennium. How to classify and treat patients?

J. Čermák, A. Vítek, K. Michalová, J. Březinová, Z. Zemanová

Vnitr Lek 2005, 51(1):20-30  

Aim of the study and methods:A retrospective analysis of the relationship between the initial classification according to either FAB or WHO classification and survival was performed in a group of 197 patients with primary myelodysplastic syndrome (MDS), who were also subdivided into risk groups according to the International Prognostic Scoring System (IPSS). The influence of stem cell transplantation (SCT) or supportive therapy on survival of different subgroups of patients was also studied. Results:A classification of 107 patients on the base of WHO criteria revealed a significant difference in median survival between patients...

Effect and tolerability of combine therapy fludarabine plus cyclophosphamide in patients with B-chronic lymphocytic leukemia

E. Tóthová, A. Kafková, T. Guman, M. Fričová, N. Štecová, E. Švorcová, M. Hlebašková

Vnitr Lek 2005, 51(1):31-35  

Introduction:Combined treatment of fludarabine (FLU) with cyclophosphamide (CY) may increase the complete remission (CR) rate, decreased minimal residual disease (MRD) and, possibly, prolong survival in B-chronic lymphocytic leukemia patients (B-CLL). The aim of study was to evaluate the activity and toxicity of FLU in combination with CY, the FLU-CY schedule, in patients with previously untreated B-CLL. Material and methods:From May 1999 to December 2003, 57 patients with advanced or progressive B-CLL, received treatment with FLU at a dose of 30 mg/m2 for three consecutive days and CY at a dose of 300 mg/m2 for three days....

Our experience with the new organisation of care of patients with acute upper gastrointestinal bleeding

M. Konečný, J. Ehrmann, V. Procházka, L. Válka, I. Vinklerová, I. Tozzi, K. Aiglová

Vnitr Lek 2005, 51(1):36-40  

Acute upper gastrointestinal bleeding is life-threatening condition with substantial incidence and relatively high mortality. The fundamental principle of the care for such patients is not only the hospitalisation with intensive monitoring of life functions, but especially the existence of multispecialty team, which must be the integrated unit in diagnostic and therapeutic procedure. For the sake of improving the quality of care for these patients it is necessary for such service to be centralised and organisationally supported by mandatory guideline in individual health facilities. In this frame the 2nd Internal Clinic of UH Olomouc was authorised...

Power training at the patients after acute myocardial infarction with decreased left ventricular ejection fraction

L. Elbl, V. Chaloupka, I. Tomášková, F. Jedlička, S. Nehyba, P. Kala, J. Schildberger, M. Poloczek, Š. Chaloupková, M. Hudcová

Vnitr Lek 2005, 51(1):41-47  

Intention of the work:Cardiovascular rehabilitation programme is an important and indivisible part of care of the patients after acute myocardial infarction. The basis of the rehabilitation programme in patients at rehabilitation phase II is an anaerobic training recently combined with the training with power moves. The submitted work addresses the evaluation of the training safety in patients with decreased left ventricular ejection fraction (EF). Patients and methods:The authors have involved 109 patients (18 women, 91 men) in the age of 58 ± 9 years (median 58 years) to the ambulantory controlled rehabilitation programme....

Komentář k Doporučení American Heart Association/American College of Cardiology Foundation pro léčbu warfarinem

M. Penka

Vnitr Lek 2005, 51(1):119-122  

Introduction to the metabolic syndrome problematics

M. Souček

Vnitr Lek 2005, 51(1):48-52  

Metabolic syndrome is easily diagnosable but in each individual patient it should be evaluated in all its relationships. Metabolic syndrome is determined according to the presence of hypertension, obesity, dyslipidemia and the presence of type 2 diabetes mellitus. In addition to the combination of basic clinical disorders, we can find some other metabolic abnormalities, indicating the seriousness of pathophysiologic changes caused by the syndrome. In recent years, the syndrome was widened by other metabolic and fibronolysis disorders. The causes of metabolic syndrome remain unclear. Landsberg et al. determined as a primary pathogenetic mechanism...

Metabolic syndrome and sympathetic nervous system: is obstructive sleep apnea a key to understanding?

T. Kára, M. Souček, Š. Kárová, J. Vítovec, V. K. Somers

Vnitr Lek 2005, 51(1):53-61  

Chronically increased sympathetic nervous system activity may contribute to the onset and progression of the metabolic syndrome. However, the primary cause of increased sympathetic activity in patients with this syndrome remains unclear. Obstructive sleep apnea has a high incidence in the general population and may be a significant independent risk factor for some cardiovascular diseases. Despite these considerations, obstructive sleep apnea remains generally underestimated phenomenon in both clinical practice as well as research. Data from clinical and basic research suggest that obstructive sleep apnea is associated with, and may contribute to, a...

Diabetes mellitus and metabolic syndrome

J. Olšovský

Vnitr Lek 2005, 51(1):62-65  

Author deals with the issue of metabolic syndrome in diabetics from the aspect of the occurence, diagnostical possibilities and insulinresistance therapy. He pays attention to the diabetes prevention in patients with metabolic syndrome.

Hypertension as a part of metabolic syndrome

H. Němcová

Vnitr Lek 2005, 51(1):66-70  

Metabolic syndrome is a set of symptoms and diseases the integrating factor of whose is decreased tissue insulin sensitivity. Its consequences are still more important and they are prognostically serious since they relate to the diseases with mass occurence, as obesity, hypertension, diabetes, hyperlipoproteinemy. Increased insulin level as a consequence of insulinresistance leads to the weight, blood pressure and aterogenous lipids increase, significantly accelerating aterosclerosis, which is the main death cause. Therefore early detection of metabolic syndrome before the development of organ complications is necessary as well as introduction of the...

Obesity and metabolic syndrome

D. Zeman

Vnitr Lek 2005, 51(1):72-75  

Obesity is associated with insulinresistance and metabolic syndrome. The correlation of the presence of abdominal or visceral obesity defined by waist circumference with the occurence of metabolic risk factors and metabolic syndrome is more significant than body mass index. Adipocytokine secretion activity of adipose tissue participates in the pathogenesis of metabolic syndrome. External factors can significantly modify the course of metabolic syndrome disease. Weight reduction is an effective therapeutical intervention. Complex therapeutical approach includes the cognitive behavioral intervention techniques, dietotherapy, regimen exercise measures,...

Dyslipidemia and metabolic syndrome

V. Soška

Vnitr Lek 2005, 51(1):77-81  

Dyslipidemia is common part of the metabolic syndrome. The typical lipid disorders are hypertrigylceridemia and low HDL-cholesterol. Elevation of small LDL3 and apolipoprotein B100 are also present in most patients. Weight reduction, diet and regular physical activity are the most effective way how to treat this type of dyslipoproteinemia. Before hypolipidemic drug therapy is started, type of dyslipidemia must be considered. Fibrates are recommended in patients with hypertriglyceridemia and low HDL-cholesterol. When high LDL-cholesterol is present, statin therapy is recommended. In some patients therapy with both fibrate and statin is needed to reach...

Hypertension and hyperuricemy

J. Špinar, J. Vítovec, J. Pařenica

Vnitr Lek 2005, 51(1):82-86  

The authors give an overview of contemporary knowledge of the importance of plasma uricacid level in hypertension. Uric acid level is an independent prognostic factor in hypertension, ischemic heart disease and chronic heart failure. Uric acid level increase is very often accompanied by renal insufficiency. Nowadays it is recommended to influence uric acid level by dietary measures and correct choice of antihypertensive drug. Thiazid diuretics are inappropriate, losartan, ACE inhibitors and calcium channels blockers are recommended. Uricosuric and uricostatic drugs are recommended in overt gout and gouty nephropathy. Their preventive administration...

The role of exercise therapy and physical fitness in prevention and treatment of metabolic syndrome

H. Svačinová

Vnitr Lek 2005, 51(1):87-92  

Regimen measures including increase of physical activity and weight reduction are of crucial importance in the metabolic syndrome treatment since they influence directly its causes. As documented by numerous retrospective epidemiologic studies, physical inactivity and low physical fitness (except abdominal obesity and other factors) leads to the development of metabolic syndrome as a complex of the cardiovascular diseases risk factors. Moreover, physical inactivity seems to be more serious risk than abdominal obesity. The submitted work presents an overview of epidemiologic studies results related to the evaluation of physical activity level and cardiorespiratory...

Acute myocardial infarction in patient with history of infective endocarditis

A. Mažárová, D. Marek, E. Kociánová, T. Mráz, M. Sluka, P. Němec, J. Lukl

Vnitr Lek 2005, 51(1):93-96  

The most significant risk factors of coronary embolic events are valvular heart disease and status after valve replacement surgery, cardiomyopathies, chronic atrial fibrilation, syfilitic or atherosclerotic aortic lesions, intracardial trombi and tumors. In our report we describe a case of young man with embolic myocardial infarction. The origin of the embolus was the bicuspid aortic valve, degeneratively changed after infective endocarditis.

Extramedullary plasmacytoma of the thyroid gland - a rare vause of a solitary struma nodosa and hyperthyroidism

D. Karásek, M. Halenka, L. Kučerová, M. Kamínek, Z. Fryšák, V. Ščudla

Vnitr Lek 2005, 51(1):97-100  

Authors describe an abnormal case of a secondary thyroid gland damage caused by extramedullary plasmacytoma manifesting as a solitary thyroid gland nodule and hyperthyroidism. During chemotherapy treatment a remission of a primary disorder has been reached - multiple myeloma, total disappearance of the nodule, and normal thyroid function. The article proves the importance of an ultrasonic examination of the thyroid gland accompanied by a fine needle aspiration biopsy.

Liver disease at alpha-1-antitrypsin deficiency

L. Husová, M. Dastych jr., E. Kunertová, P. Husa, K. Dvořák, M. Votava

Vnitr Lek 2005, 51(1):101-105  

Alpha-1-antitrypsin deficiency is a hereditary disease. Most often it affects lungs and liver. It can manifest itself as cholestasis in the newborn period or later as chronic hepatitis, liver cirrhosis, and also pulmonary emphysema. In this article a case report of a 21-year-old woman with alpha-1-antitrypsin deficiency determined by liver tests during a viral disease with high fevers treated by antibiotics and paracetamol has been described. Histology proved no changes in liver except PAS positive granules in hepatocytes. Examinations proved alpha-1-antitrypsin deficiency and PiZZ phenotype in the patient. Her medical history revealed asthma bronchiale...

Acute myocarditis manifesting as a transmural myocardial infarction accompanied by acute renal failure

L. Brunerová, I. Rychlík, H. Bartáková, P. Gregor, M. Anděl

Vnitr Lek 2005, 51(1):106-112  

We present a case report of a 70 year-old female patient admitted to our medical department for acute renal failure with ECG evidence of acute Q wave myocardial infarction, positive cardiospecific enzymes, and an echocardiography image of regional hypokinesis imitating acute myocardial infarction, but clinically silent. Acute myocarditis was diagnosed to be a cause of the patient's condition. Renal failure developed due to renal hypoperfusion following hemodynamic changes caused by myocarditis and dehydration. The goal of this case report is to show an unusual manifestation of acute myocarditis imitating acute myocardial infarction.

Jan Lebl, Štěpánka Průhová et al. Abeceda diabetu. Příručka pro děti, mladé dospělé a jejich rodiče

P. Žák

Vnitr Lek 2005, 51(1):128  

Jiří Vítovec, Jindřich Špinar et al. Farmakoterapie kardiovaskulárních onemocnění

M. Aschermann

Vnitr Lek 2005, 51(1):129  

Petr Cetkovský et al. Intenzivní péče v hematologii

L. Chrobák

Vnitr Lek 2005, 51(1):129-130  

Viktor Chrobok, Jaromír Astl, Pavel Komínek et al. Tracheostomie a koniotomie, techniky, komplikace a ošetřovatelská péče

P. Ševčík

Vnitr Lek 2005, 51(1):130  

Anna Jedličková. Antimikrobiální terapie v každodenní praxi

R. Tejkalová

Vnitr Lek 2005, 51(1):131  

David Cibula, Luboslav Stárka, Jana Vrbíková et al. Syndrom polycystických ovarií

V. Olšovská

Vnitr Lek 2005, 51(1):131-132  

Tomáš Skalický, Vladislav Třeška, Jiří Šanjdauf et al. Chirurgie jater

J. Leypold

Vnitr Lek 2005, 51(1):132  

Bioekvivalenční studie s novými antihypertenzivy

T. Doležal, T. Hauser

Vnitr Lek 2005, 51(1):115-118  

Sir William Osler's legacy

L. Chrobák

Vnitr Lek 2005, 51(1):123-127  

William Osler (1849-1919) is generally regarded as one of the greatest and most respected physicians in the history of medicine. As an outstanding clinician and a professor of medicine at four universities in three countries he exerted a profound influence on medical education. His textbook "The Principles and Practice of Medicine" became the most popular treatise on medicine in the world. He emphasized the value of hard work. His compassion and concern for patients, students and colleagues reflected his personality. Osler's humanism, his philosophy and views did not loose their validity even today.

Za profesorem MUDr. Stanislavem Havelkou

Karel Trnavský

Vnitr Lek 2005, 51(1):112  

Otevřený dopis Jiřímu Vorlíčkovi

Petr Svačina

Vnitr Lek 2005, 51(1):113-114  

Zpráva o kurzu Hot topics in internal medicine, Alicante, Španělsko, 16.-22. 10. 2004

M. Haluzík, J. Václavík

Vnitr Lek 2005, 51(1):133