BNP - zdroj informací o funkci srdce a o kardiovaskulárním riziku nemocného - editorial

F. Kölbel

Vnitr Lek 2005, 51(6):640-641  

Vliv předchozí dlouhodobé léčby aspirinem na klinický průběh akutního koronárního syndromu - editorial

J. Murín

Vnitr Lek 2005, 51(6):642-643  

Hrozba světové pandemie obezity - editorial

J. Rybka

Vnitr Lek 2005, 51(6):644-646  

Je třeba pátrat po maskované hypertenzi a jak? - editorial

J. Ceral

Vnitr Lek 2005, 51(6):647  

Sérová koncentrace kreatininu a funkce ledvin - editorial

K. Matoušovic

Vnitr Lek 2005, 51(6):648-649  

Predictive factors for symptoms of thyroid ophthalmopathy development in patients after either radioiodine therapy or thyroidectomy

Z. Novák, P. Hrdá, P. Matucha, I. Šterzl

Vnitr Lek 2005, 51(6):650-657  

The aim of the study was to investigate whether patients with Graves-Basedow thyrotoxicosis developing into endocrine ophthalmopathy of diverse severity after treatment by radioiodine or total thyroidectomy are different in their pre-treatment parameters from Graves-Basedow patients without any signs of ophthalmopathy development. 42 patients were divided into 2 groups: a group of 26 patients treated by radioiodine and a group of 16 patients treated by thyroidectomy. All patients were without symptoms of ophthalmopathy and were examined clinically, on laboratory markers and by ultrasound of the thyroid and of the orbit. The patients were divided according...

B-type natriuretic peptide (BNP) - application in differential diagnosis of dyspnoea

R. Bejšovec, I. Jokl

Vnitr Lek 2005, 51(6):658-663  

Objective:To assess the benefit of determination of B-type natriuretic peptide (NT-pro BNP) in differential diagnosis of dyspnoea (differentiation of dyspnoea associated with myocardial affection from other type of dyspnoea) in settings of our admission internal outpatient clinic of the hospital Na Františku. Patient population:We have enrolled 68 patients (37 women and 31 men) of an average age of 75.2 years complaining of dyspnoea during preliminary examination at the outpatient clinic in the study. Procedures:We have drawn blood samples from patients immediately on admission for an immediate examination (statim)...

Influence of previous long-term treatment with aspirin on clinical progression of an acute coronary syndrome

J. Špác, J. Pařenica

Vnitr Lek 2005, 51(6):664-670  

There is a failure of antiaggregation treatment in a large group of patients with chronic forms of ischaemic disease leading to recurrence of ischaemic events. The objective of this paper is to analyse the influence of previous long-term antiaggregation treatment on clinical progression of an acute coronary syndrome. Method:The importance of previous treatment has been evaluated in 726 patients admitted into 38 hospitals in Czech Republic for acute coronary syndrome (ACS) without ST segment elevations in the year 2000. 396 patients were treated with aspirin (group A) on a long-term basis before admission and 330 patients were without...

Hepatic and renal damage after acute poisonings

M. Mydlík, K. Derzsiová

Vnitr Lek 2005, 51(6):671-675  

In the paper the analysis of concomitant damage of liver and kidneys after acute tetrachloromethane poisoning in 60 patients, after mushroom poisoning (Amanita phalloides) in 81 patients and after ethyleneglycol poisoning in 20 patients from the view of differential diagnosis, conservative and extracorporeal elimination treatment is described. Acute toxic hepatitis with the different degree of severity was present in all patients and even acute renal failure was present in some patients. After acute tetrachloromethane poisoning acute hepatitis developed approximately simultaneously with the development of acute renal failure. After acute Amanita phalloides...

Results of multi-centre monitoring of sibutramine treatment in obese diabetic patients in Czech Republic

A. Šmahelová

Vnitr Lek 2005, 51(6):676-680  

Sibutramine is a very effective antiobesitic drug in the present. It has weight reducing, global metabolic and antidiabetic effects. To verify and to get the experiences with practical use of sibutramin in Type 2 diabetics in the Czech Republic was the purpose of the clinical observation MERIDIOS I. Patients and methods:499 diabetics (average age 52.4 ± 9,5 years) were included, to the statistical evaluation after 3 months of the therapy Wilcoxon rank sum test was used. 308 (61,7%) diabetics took oral antidiabetic agents. 424 (83%) diabetics used antihypertensive drugs, 384 (75%) hypolipidemic agents. 275 (55.1%) diabetics took...

Disorders of iron metabolism I. Regulation of iron homeostasis

J. Novotný

Vnitr Lek 2005, 51(6):681-689  

Iron is an ubiquitously ocurring vital element which can be found in all living cell from bacterias and yeasts to mammals. The cells explore the redox potential of iron, which can be used in many essential and vital biochemical reactions. The iron homeostasis must be very finely tuned beacuse iron overload may lead to the generation of very toxic reactive oxid radicals, which may damage lipids, proteins and nucleic acids with possible severe cellular damage and death. Iron homeostasis is maintained on cellular and whole body levels and details of this fascinating network have been disclosed only very recently. The transferrin receptor (TfR) and ferritin...

Practice guidelines for diagnosis and therapy of essential thrombocytaemia and thrombocytaemia associated with other myeloproliferative diseases

M. Penka, J. Schwarz, R. Pytlík, M. Doubek, Y. Brychtová, P. Dulíček

Vnitr Lek 2005, 51(6):741-751  

Essential thrombocytaemia (ET) is not a frequent disease (incidence rate is about 0.1-1.5 cases per 100,000 persons) but as new approaches and possibilities advancing the standard care but contrariwise requiring responsible and systematic approach occur both in relationship with diagnosis and with treatment, it is necessary to deal appropriately with this problem. There is a variety of aspects, which evoke controversy within the scope of diagnosis and differential diagnosis - the most important thing is whether the histological examination of bone marrow is required or not and how to organise care of patients. All this relates not only to essential...

The REAL/WHO classification of neoplastic disease of the lymphoid tissues: 10 years of common language function from the clinical practice view point

T. Papajík, L. Raida, K. Indrák

Vnitr Lek 2005, 51(6):690-698  

Neoplasms of lymphoid tissues represent relatively great and heterogeneous group of human tumors. The expansion of data on lymphomagenesis could help us to understand similarities and also differences among various subgroups of malignant lymphomas. Hence there has been an increasing need to exactly define, differentiate and classify individual lymphoma entities. Previous classification systems were based on a neoplastic cell and tissue morphology, only a few information about physiology and pathophysiology of immune system were incorporated in them. These lymphoma classifications have been a source of confusion for many years for both clinicians and...

Masked hypertension

J. Widimský, M. Sachová

Vnitr Lek 2005, 51(6):699-703  

The term masked hypertension means the hypertension found in daily ambulatory blood pressure measurements (mean BP ≥ 135 and/or ≥ 85 mm Hg) accompanied by normal values of casual blood pressure (BP < 140 and < 90 mm Hg). Home blood pressure should be measured 2x daily over 7 days in the week, whereas the first day measurements are not taken into account as the blood pressure is usually higher the first day. In the diagnosis of hypertension it is possible to meet following groups of patients: a) real hypertension - hypertension at doctor's office and hypertension at home +; b) real normotension - normal BP at doctor's office and at home...

Esophageal achalasia

E. Veseliny, T. Hildebrand, P. Jarčuška, M. Zakuciová

Vnitr Lek 2005, 51(6):704-713  

Achalasia is a well-recognized primary esophageal motor disorder of unknown etiology. It is characterized by incomplete lower esophageal sphincter (LES) relaxation and aperistalsis of the esophageal body. These abnormalities are thought to result from frequently observed neuropathic changes involving a loss of inhibitory ganglionic cells of myenteric plexus in the LES and in the esophageal body. The pathogenesis of idiopathic achalasia is unknown. Available data suggest hereditary, degenerative, autoimmune, and infectious factors as possible causes for achalasia, the latter two being the most commonly accepted. The diagnosis of achalasia should be...

The role of the ECG in the diagnosis and management of acute coronary syndrome

P. Schweitzer, R. Kučinský

Vnitr Lek 2005, 51(6):714-717  

The classification of acute myocardial ischemic heart disease underwent important evolution. Presently the initial working diagnosis is acute coronary syndrome (ACS), sub classified into ST segment elevation (STE) and non-ST segment elevation (NSTE). Some authors continue to use Q (QMI) and Non Q wave myocardial infarction (NQMI), others consider the differences between them meaningless. Similarly there is no general agreement whether Q and NQMI should be replaced with ST segment elevation (STEMI) and Non-ST elevation segment (NSTEMI) myocardial infarction only as the initial working diagnosis or as the final one. The purpose of this review is to discuss...

The possibilities of atherosclerosis prevention in type 2 diabetes mellitus

I. Tkáč

Vnitr Lek 2005, 51(6):718-724  

The prevention of atherosclerosis in type 2 diabetes should start a long time before the diagnosis of diabetes is done by early screening of the high risk individuals based on their family history or on the presence of obesity, hypertension, dyslipidemia, impaired fasting glucose or microalbuminuria. Early lifestyle and drug interventions in such subjects are able to delay both the development of diabetes and atherosclerosis. After making the diagnosis of diabetes, it is necessary to begin or to continue with multifactorial intervention (reviewed in the table), which will eventually lead to reduction of incidence of macrovascular diseases in diabetes...

Serum creatinine concentration and renal function (new insight into an old problem)

O. Schück, V. Teplan, I. Smrčková, J. Skibová, M. Štollová

Vnitr Lek 2005, 51(6):725-727  

In the brief review current possibilities of assessment of glomerular filtration rate based on single non-adjusted serum creatinine concentrations (S_Kr) are analysed and when so-called adjusted values of S_Kr are necessary to be used. In terms of adjusted value of S_Kr Cockcroft-Gault equation and prediction of GF based on abbreviated MDRD (Modification of Diet in Renal Disease) equation are analysed in more detail.

Antihypertensive treatment in diabetes and diuretics

P. Bouček

Vnitr Lek 2005, 51(6):728-733  

Blood pressure elevation occurs more commonly among diabetic patients than in non-diabetic subjects and represents one of the main reasons for their high cardiovascular risk. Sodium retention is an important pathogenic factor contributing to the genesis of hypertension in diabetes. Effective blood pressure reduction in diabetic patients, for which combination drug therapy is generally needed from the outset, confers an exceptionally high benefit with regard to vascular and renal outcomes. Thiazide diuretics are not recommended as optimal first-line treatment in hypertensive diabetic patients since they may be associated with adverse metabolic effects....

Acute masive pulmonary embolism - indication for surgical thromboembolectomy

A. Mokráček, M. Vambera, M. Šulda, M. Šetina, F. Toušek

Vnitr Lek 2005, 51(6):734-739  

The authors report the case of 63-year-old man with hypertension admitted to heart center with extreme respiratory distress, cyanosis, somnolence and manifestations of acute cor pulmonale. His admission was preceded by one-month history of worsening of dyspnea peaking on day before admission by a presyncopic state. Ultrasound demonstrated a freely rotating thrombus in the right atrium, massive pulmonary embolism with a big thrombus in the right pulmonary artery, foramen ovale patens and severe right ventricular dysfunction. Within 90 minutes of admission, the patient in a critical circulatory state, was connected to extracorporeal circulation. A surgeon...

Aschermann M et al. Kardiologie

Jiří Vítovec

Vnitr Lek 2005, 51(6):761-762  

Lukáš J et al. Tracheostomie v intenzivní péči

Rom Kostřica

Vnitr Lek 2005, 51(6):763  

Tate P. Příručka komunikace pro lékaře. Jak získat důvěru pacienta

Věra Linhartová

Vnitr Lek 2005, 51(6):763-764  

Josef Kořenek. Lékařská etika

Jaroslav Rybka

Vnitr Lek 2005, 51(6):764-765  

Block B. Průvodce sonografií - kapesní atlas

Ivo Hrazdira

Vnitr Lek 2005, 51(6):765-766  

Redakční pošta

Vnitr Lek 2005, 51(6):759-760  

105. birthday anniversary and XI. professor MUDr. František Pór memorial

M. Mydlík, K. Derzsiová

Vnitr Lek 2005, 51(6):752-754  

Professor MUDr. František Pór was one of the most important internists in Czechoslovakia. He founded the 1st Internal Clinic of Medical Faculty and Faculty Hospital of KÚNZ in Košice. Prof. MUDr. F. Pór was the head of the 1st Internal Clinic from the year 1948 to the year 1971. He educated 11 associate professors and 3 full professors during his active life. In the year 1961 prof. MUDr. F. Pór organised East Slovak Medical Days in Nový Smokovec in High Tatras for the first time. From that time the Medical Society in Košice organises these scientific medical days in co-operation with Medical Societies of East Slovak region yearly. Moreover the Medical...

Prof. MUDr. Jaroslav Blahoš, DrSc. pětasedmdesátiletý

Jaroslav Rybka

Vnitr Lek 2005, 51(6):757-758  

XXIV. dny mladých internistů České republiky a Slovenska v Olomouci

P. Horák

Vnitr Lek 2005, 51(6):755-756