Úvodní slovo k přednáškám ze 130. internistického dne Revmatologie v klinické praxi

V. Ščudla

Vnitr Lek 2006, 52(7-8):664  

Česká a Slovenská internistická společnost ČLS JEP, Spolek lékařů Olomouc. 130. internistický den. REVMATOLOGIE V KLINICKÉ PRAXI

Vnitr Lek 2006, 52(7-8):663  

Treatment of early arthritis - recommendations of EULAR

K. Pavelka

Vnitr Lek 2006, 52(7-8):665-672  

Team of fourteen prominent rheumatologists created the "Recommendations for the therapy of early arthritis" based on standard operating procedures. This publication was made on the basis of analysis of previously published double-blind studies (the so-called evidence based procedure) and mutual consensus of the authors.

Gastroduodenal complications associated with non-steroidal anti-inflammatory drugs in Slovak Republic: results of one-year prospective study

I. Rybár, M. Hlísta, P. Masaryk, J. Rovenský, R. Hyrdel, M. Kriška

Vnitr Lek 2006, 52(7-8):673-676  

The aim of the one-year prospective study was to estimate the prevalence of non-steroidal anti-inflammatory drugs using in patients with symptomatic gastroduodenal ulcers, the upper gastrointestinal bleeding and perforation (PUB - perforation, ulcer, bleeding). Among of 326 patients with PUB, prevalence of non-steroidal anti-inflammatory drugs using was 60 %. In the group of 194 patients with non-steroidal antiinflammatory drugs induced PUB, 49 % patients took aspirin, 38 % non-aspirin non-steroidal anti-inflammatory drugs and 13 % their combination. Low dosing aspirin (daily dosis ≤ 200 mg) was associated with PUB in 21 % of patients. Age higher...

Problems of cardiovascular toxicity of coxibs and non-selective NSA

Š. Forejtová

Vnitr Lek 2006, 52(7-8):677-685  

Non-steroidal antirheumatics (NSA) belong to the most often prescribed drugs. Certain observation studies indicate that they are used by 20 to 30% of population of developed countries. The most common NSA's adverse effects are gastrointestinal complications. Coxibs have been developed as an alternative to conventional non-selective NSA; with similar efficacy, they should reduce the risk of development of gastrointestinal complications. In the few last years, possible toxicity of coxibs and other non-steroidal antirheumatics has been widely discussed. The VIGOR study, which was performed 6 years ago, showed five times higher incidence of nonfatal myocardial...

Nonsteroidal antiinflammatory drugs and the kidney

J. Zadražil

Vnitr Lek 2006, 52(7-8):686-690  

Nonsteroidal antiinflammatory drugs (NSAIDs) have potentially important renal adverse effects. With regard to renal adverse effects there is no indication of significant differences between conventional NSAIDs and selective COX-2 inhibitors. Their nephrotoxicity has been well documented. Many of the renal abnormalities that are encountered as a result of NSAIDs use can be attributed to the inhibition of prostaglandins synthesis. The release of prostaglandins is particulary importent in high-risk patients, including patients with severe heart disease, liver disease, preexisting renal disease, elderly and patients with volume depletion. The common complication...

Polymyalgia rheumatica and giant cell arteritis - first results of a year-long study

J. Rovenský, A. Tuchyňová, P. Poprac, S. Blažíčková, V. Bošák, V. Štvrtinová

Vnitr Lek 2006, 52(7-8):691-696  

Introduction:Due to ageing of population, gerontorheumatology becomes more and more important. Both polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) typically develop in later life and they have many other common features. The aim of our study was to explore diagnostic and prognostic markers and, prospectively, establish diagnostic and therapeutic algorithm for patients with PMR and GCA. Sample and methods:We examined 27 patients with suspected PMR or OBA. The diagnosis was verified in 22 patients. Three of them were in a long-term clinical remission. Besides examination for basic clinical and laboratory parameters,...

How can the autoantibody detection help in the diagnostics and evaluation of connective tissue diseases?

J. Vencovský

Vnitr Lek 2006, 52(7-8):697-701  

Autoantibodies are immunoglobulins that are directed against self tissues. Variable structural components of the cells or their products may be the targets. Production of a majority of autoantibodies is a physiological phenomenon, which does not have to lead to the disease. Autoantibodies that are associated with connective tissue diseases are produced in high levels, they are usually of high affinity and IgG isotype. Connective tissue diseases are characterized by a frequent presence of organ non-specific autoantibodies. Some of their properties can be used for clinical evaluation. The presence of the autoantibody may directly diagnose a specific...

Systemic lupus erythematodes

J. Lukáč, J. Rovenský, O. Lukáčová, D. Kozáková

Vnitr Lek 2006, 52(7-8):702-711  

Systemic lupus erythematodes (SLE) is chronic autoimmune disease, characteristic by production of autoantibodies against different autoantigens. Etiopathogenesis in not precise determinated, but genetic, immunologic, hormonal factors or influence of environment are assumed. It manifests by various symptoms and it can affect whichever organ or system in the body. Clinical manifestation are due chronic inflammation in the tissues, which is caused first of all by deposit of immunocomplex and by cytotoxic damage. At the last decades the mortality of patients with SLE is markly lower and their live is prolong. In spite of this diagnostic, to follow up and...

New trends in diagnosis and treatment of systemic sclerosis

R. Bečvář, J. Štork, P. Jansa

Vnitr Lek 2006, 52(7-8):712-717  

Systemic sclerosis (SSc) is a generalised connective tissue disease of unknown origin, which clinically shows by skin thickening and sclerosis of different extent (scleroderma) and by typical involvement of visceral organs. At the same time fibrotic and sclerotic changes occur in the blood vesel walls. SSc usually involves females at young and middle age. Myalgias, arthralgias and arthritis are nonspecific, tendon friction rubs in fingers are more typical for this diagnosis. Gastrointestinal involvement starts early in the oropharyngeal part, esophagus and proceeds into the distal parts. Fibrotic changes lead to slow transit dysmotility and pseudoobstruction...

Antiphospholipid syndrome

Z. Fojtík

Vnitr Lek 2006, 52(7-8):718-725  

Antiphospholipid syndrome (APS), first described and termed in the early 1980's, is defined by its clinical and laboratory signs. If other disorders inducing antibody production are excluded, APS may be considered a primary disease. Or it can be a secondary condition that is usually seen in systemic diseases of connective tissues. The main concept of APS is based on strong association between its clinical and laboratory manifestations and patient's medical history. Clinical signs include recurrent arterial and venous thrombosis or repeated fetal losses; laboratory criteria involve lupus anticoagulant (LA) syndrome or medium and high titres of anticardiolipin...

Early diagnostics of ankylosing spondylitis

K. Pavelka

Vnitr Lek 2006, 52(7-8):726-729  

The present study surveys the problems of diagnostics of early ankylosing spondylitis (AS) and axial spondylarthritis (SpA). Epidemiologic studies repeatedly identified seven- to nine-year delay of diagnosis of AS from its development to its first manifestations. Delayed diagnostics is caused both by unfamiliarity of rheumatologists with the disease and the inappropriateness of New York classification criteria for early stages of AS. In this study, we suggest diagnostic algorithms allowing high probability diagnosis of AS/axial in X-ray silent stage (the so-called pre X-ray stage). Spondylarthritis represents approximately 5 % of a total number of...

Ankylosing spondylitis - the current situation and new therapeutic options

D. Žlnay, M. Žlnay, J. Rovenský

Vnitr Lek 2006, 52(7-8):730-735  

Ankylosing spondylitis (AS) is a chronic, immunologically mediated rheumatic disease whose progression largely depends on the extent of inflammatory activity. In contrast to rheumatoid arthritis (RA), therapeutic control of AS is very limited. Therapy of ankylosing spondylitis should not only control inflammatory processes, but also prevent structural damages and maintain the functions. Until recently, physiotherapy and non-steroidal antiphlogistics (NSA) therapy was a gold standard of AS treatment. NSA therapy alleviates inflammatory pain of spine in 60 to 80% of patients. According to the most recent findings, long-term administration of NSA can...

Pathogenesis, diagnostics and therapy of gout

M. Žurek

Vnitr Lek 2006, 52(7-8):736-741  

Gout refers to heterogeneous group of metabolic diseases characterized by production of deposits of sodium urate crystals in tissues. Gout manifests as acute gouty arthritis with classic clinical picture, or as chronic gouty arthropathy with periarticular and subcutaneous deposits of sodium urate crystals, i.e. tophi. As for kidney, gout is manifested as acute or chronic gouty nephropathy and urolithiasis. These manifestations occur separately or they are combined. Hyperuricemia of primary gout is caused rather by impaired renal secretion than overproduction of uric acid. Secondary hyperuricemia is associated with many pathological conditions; it is...

Musculoskeletal manifestations of diabetes mellitus

T. Philipp, L. Franeková

Vnitr Lek 2006, 52(7-8):742-747  

The article outlines changes of locomotor system in patients with diabetes mellitus. Classification of individual diseases is based on the requirements of clinical practice mainly. The following diseases are described here: diabetic cheiroarthropathy, shoulder impingement syndrome, Charcots joint, diffuse idiopathic skeletal hyperostosis, diabetic osteopathy and other pathologies associated with diabetes.

Present possibilities of diagnostics and therapy of osteoporosis

P. Horák, T. Pika

Vnitr Lek 2006, 52(7-8):749-755  

The occurence of osteoporosis is not so poor in industrial countries, together with advance of socioeconomical level and spreading of human life's lenght, increases the prevalence of osteoporosis, affect about 5-6 % of Europe population and also raises the number of the most consequential results - fractures, complications, dramatically deteriorating health state and limiting social self-realization of the pacients. Osteoporosis belongs to metabolic bone diseases with highly clarified mechanisms of bone tissue decrease and comprehensive diagnostic platform, based on combination of imaging and laboratory methods, enabling early disease detection, before...