Vnitřní lékařství, 2006 (vol. 52), issue 4

Editorial

Význam včasné diagnózy chronických onemocnění ledvin - editorial

S. Dusilová Sulková

Vnitr Lek 2006, 52(4):300-301

Hypertrofická kardiomyopatie - názory na současné léčebné postupy - editorial

J. Vojáček

Vnitr Lek 2006, 52(4):302-303

Postavení torakoskopie v diagnostice onemocnění plic a pleury v současnosti - editorial

I. Čapov

Vnitr Lek 2006, 52(4):304-305

Je kardiotoxicita chemoterapie problémem onkologa nebo také kardiologa? - editorial

R. Pudil, J. M. Horáček

Vnitr Lek 2006, 52(4):306-307

Original articles

Chronic nephropathies and disorders of renal function - is it sufficiently diagnosed in patients hospitalised on department of internal medicine and cardiology?

Z. Michelová, M. Horáčková, J. Pafčugová, M. Hrašková, K. Matoušovic, M. Kvapil, J. Páleníčková

Vnitr Lek 2006, 52(4):308-312

We have found out that nephropathies and renal dysfunctions are diagnosed insufficiently. At the same time, it has been observed that patients are sent to nephrology out-patient clinics too late. The aim of our study was to identify how nephropathy and renal dysfunction are diagnosed and how these diagnoses are recorded in diagnostic summary of hospital discharge report in patients hospitalized in department of internal medicine and cardiology of a big teaching hospital. Also, we studied the incidence of risk diseases (arterial hypertension and diabetes mellitus) and serious cardiovascular complications in individual stages of renal dysfunction. We...

Non-pharmacologic therapy of hypertrophic obstructive cardiomyopathy - results of therapy based on percutaneous transluminal septal myocardial ablation compared with results of dual-chamber cardiac pacing

J. Krejčí, L. Groch, J. Meluzín, T. Vykypěl, J. Halámek, J. Vítovec

Vnitr Lek 2006, 52(4):313-320

Background:Percutaneous transluminal septal myocardial ablation (PTSMA) and pacemaker (PM) therapy with apical preexcitation are therapeutic options for hypertrophic obstructive cardiomyopathy (HOCM) patients with symptoms despite pharmacological therapy. Aim:Evaluation and comparison of treatment results of PTSMA and PM implantation. Patients:22 HOCM patients (NYHA class III and IV) with left ventricle outflow tract gradient (LVOTG) at rest more than 30 mm Hg. In group A were evaluated 11 patients treated by PTSMA. Left ventricle outflow tract gradient (LVOTG) was 90.5 ± 16.0 mm Hg, NYHA class 3.1 ±...

Medical videothoracoscopy in diagnosis and therapy of pleural effusions

P. Pužman, M. Teřl, P. Mukenšnabl

Vnitr Lek 2006, 52(4):321-327

Videothoracoscopy (VTS) has been performed in the Department of Pneumology in Plzen since the year 2001. Up to September 2005 there were realized 75 videothoracoscopies, all under local anaesthesia with analgosedation and during the spontaneous ventilation. The objective of the present work is to demonstrate that the so called "medical" videothoracoscopy is very well tolerated, quick and accurate miniinvasive method of examination of pleural pathological states, which has a high diagnostic effect and minimal complications. During the exploration it is possible to carry out, besides the collection of bioptic samples from parietal as well as visceral...

Late cardiotoxicity in patients with malignant lymphoma treated with doxorubicin chemotherapy

L. Elbl, I. Vášová, M. Navrátil, I. Tomášková, F. Jedlička, V. Chaloupka, J. Vorlíček

Vnitr Lek 2006, 52(4):328-338

Aim of the study:Chronic cardiotoxicity of doxorubicin occurs at least one year after the chemotherapy is finished. As such, it is a serious late complication in patients with malignant lymphomas. The aim of the study was to identify the incidence of late clinical and subclinical doxorubicin cardiotoxicity and cardiopulmonary performance of patients being in remission for five and more years from the initial therapy. Group of patients:We worked with 96 patients (47 men and 49 women) aged 43 ± 15 (median 41, 23-79) years. Average period of monitoring was 6.2 ± 1.5 (median 6.5-10) years. On the basis of therapy...

Primary prevention of ischemic heart disease in middle-aged men living in Prague: Results of twenty-year research

F. Boudík, J. Reissigová, K. Hrach, M. Tomečková, J. Bultas, Z. Anger, M. Aschermann, J. Zvárová

Vnitr Lek 2006, 52(4):339-347

Introduction:Ischemic Heart Disease (IHD) represents the most frequent cause of mortality and morbidity in the Czech Republic. The aim of this study is to analyze long-term mortality of cardiovascular disease (CVD), identify its predictors and verify the validity of Framingham risk function for Czech patients. Design and methods:The twenty-year study (STULONG) of primary prevention of risk factors of atherosclerosis in 1419 men aged 38 to 53 years living in Prague was started in 1975. Results: CVD mortality analysis showed a higher risk of death for heavy smokers vs. non-smokers or light smokers (p < 0.0001), hypertensive...

Polymorphism of gene promotor region for MMP-2 in rheumatoid arthritis

P. Němec, M. Goldbergová, T. Swobodnik, D. Polášková, M. Souček, A. Vašků

Vnitr Lek 2006, 52(4):348-354

Introduction:Matrix metalloproteinase (MMP) belonging to family of zinc-dependent endopeptidases participates in remodelling of extracellular matrix in many physiological and pathological processes including rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic autoimmune inflammatory multi-systemic disease characterized, among others, by degradation of hyaline articular cartilage and escalated angiogenesis. As a matter of fact, these processes may by influenced by MMP. On the other hand, MMP can suppress inflammation by degrading biologically active molecules like cytokines, chemokines or growth factor receptors. Increased levels...

Histiocytosis from Langerhans cell in adults - experience of one department and review of treatment alternatives

Z. Adam, J. Vaníček, P. Šlampa, P. Čoupek, I. Mareschova, J. Neubauer, L. Babičková, Z. Adamová, M. Tomíška, M. Navrátil

Vnitr Lek 2006, 52(4):355-370

Thirteen patients with Langerhans cell histiocytosis (LCH) have been treated in hospital Brno Masaryk University during the last 15 years. In 4 cases of this total amount, the diagnosis was made in childhood and these young adults were referred to our department from Pediatric cancer center. In 9 cases, the diagnosis has been made in people elder than 18 years. The disease recidived in 3 patients with LCH diagnosed in childhood, in one case with neurodegenerative impairment of brain. In 4 patients from the total of 9 with LCH diagnosed in age over 18 years, the disease had aggressive course with several recidives. In one case it was pulmonal and multifocal...

Reviews

Ubiquitins, proteasomes, sumoylation and application today and in future for cancer and other diseases therapy I. Ubiquitin-proteasome system and the transcription factor NF-κB

O. Fuchs, R. Neuwirtová

Vnitr Lek 2006, 52(4):371-378

Proteasome is protein complex with proteolytic activity. Proteasomes are in addition to lysosomes the main proteolytic machinery of the eukaryotic cell. Proteins destined for degradation in proteasomes are marked by ubiquitinylation, which consists in attachment of polyubiquitin to relevant protein. The transport of polyubiquitinylated protein follows to proteasome, where protein is cleaved into small peptides. Besides polyubiquitin attachment to protein, monoubiquitinylation of proteins exists and has an important role in DNA repair, transcription of genes, endocytosis and signal transduction. The function of an important transcription factor NF-κB...

The Prophylaxis against Venous Thromboembolic Complications in Internal Medicine - the Gap between Theory and Practice

J. Hirmerová

Vnitr Lek 2006, 52(4):379-388

Venous thromboembolism is an important cause of morbidity and mortality in internal medicine but antithrombotic prophylaxis is not being sufficiently used in comparison with surgical settings. In medical patients there are usually multiple risk factors, often with cumulative effect and the comprehensive risk assessment is complicated. The most important agents for pharmacological thromboprophylaxis are heparins - unfractionated and low-molecular-weight. The metaanalysis of randomised trials comparing unfractionated or low-molecular-weight heparin against control (placebo or aspirin) in medical patients has confirmed a significant risk reduction for...

Case reports

Problems with interpretation of low levels of thyroidal hormones conditioned by changes in transport proteins

Z. Fryšák, D. Karásek, M. Halenka, J. Skyvová

Vnitr Lek 2006, 52(4):389-391

In clinical practice, we often observe conditions accompanied by secondary drop of binding proteins that bind, more or less specifically, thyroidal hormones. This is usually considered as normal situation that is often not properly interpreted from clinical point of view. In other words, we tolerate such conditions because we build on values of free hormones FT3 and FT4. However, it is very rare to observe significant decrease or even absence of thyroxin binding globulin (TBG) due to inborn error of metabolism. In such situations, the overall level of thyroidal hormones becomes a part of evaluated laboratory profile. Unusual laboratory constellation...

From scholarly literature

P. Kohout et al. Dieta. Celiakie a bezlepková dieta. Praha: Maxdorf 2006. 166 stran. ISBN 80-7345-070-4

Bohuslav Kianička

Vnitr Lek 2006, 52(4):395