Monitorování glykemie u kriticky nemocných pacientů - editorial

J. Rybka

Vnitr Lek 2006, 52(9):765-767  

Ateroskleróza a infekce - editorial

H. Němcová

Vnitr Lek 2006, 52(9):768-770  

MELD score in prediction of early mortality in patients suffering refractory ascites treated by TIPS

T. Fejfar, V. Šafka, P. Hůlek, T. Vaňásek, A. Krajina, V. Jirkovský

Vnitr Lek 2006, 52(9):771-776  

Transjugular Intrahepatic Portosystemic Shunt (TIPS) is now well established in the treatment of complications of symptomatic portal hypertension such as acute or recurrent variceal bleeding, refractory ascites and Budd-Chiari syndrome. In some patients with refractory ascites who belong to group C according to Child-Pugh classification (score around 12), the indication of the procedure could be very questionable and early mortality is quite high. However, in some cases, the subgroup of such risky patients can profit from TIPS. Child-Pugh classification is used for the stratification of the patients routinely. During the last decade other scoring systems...

Monitoring of glucose concentration in critical patients, comparing arterial blood glucose concentrations and interstitial glucose concentration measured by microdialysis technique

J. Křemen, J. Bláha, M. Matias, K. Anderlová, M. Ellmerer, J. Plank, T. Pieber, Š. Svačina, M. Haluzík

Vnitr Lek 2006, 52(9):777-781  

Introduction:Recent studies have shown that normalization of blood glucose in critically ill patients by intensive insulin therapy significantly decreases their mortality and morbidity. The aim of our study was to compare interstitial glucose concentrations in subcutaneous adipose tissue (measured by microdialysis technique) and arterial blood glucose concentrations to test the suitability of subcutaneous adipose tissue for long-term placement of biosensors for glucose measurement in critically ill patients. Patients and methods:20 patients (16 men and 4 women) after cardiac surgery hospitalized at postoperative intensive...

Diuretics in therapy of "diuretic resistance" by patients with congestive heart failure

P. Tůma, P. Hrdý

Vnitr Lek 2006, 52(9):782-789  

Loop diuretics are integral part of overall therapy of severe congestive heart failure. Approximately 10-20 % of patients with congestive heart failure (NYHA class III-IV) do not respond satisfactorily to diuretic treatment. Despite its frequency, the term "diuretic resistance" remains inadequately defined. In general, failure to decrease the extracellular fluid volume despite liberal use of diuretics is often termed "diuretic resistance". The combination of diuretics, particularly of loop diuretic with thiazide agents, is recommended for prevention as well as treatment of this complication. Effective management is also continuous infusion of loop...

Prevention of type 2 diabetes mellitus due to antihypertensive treatment affecting renin-angiotensin system

P. Bouček

Vnitr Lek 2006, 52(9):791-796  

Hypertension is often associated with an impairment of glucose tolerance and is a risk factor for the development of type 2 diabetes mellitus. The occurrence of diabetes may be also influenced by the selection of the type of antihypertensive treatment. While it has been shown that the use of older type antihypertensives - diuretics and beta-blockers - may precipitate diabetes, newer drugs which inhibit the renin-angiotensin system have a positive effect on glucose tolerance. Several recent clinical trials of ACE-inhibitors and AT₁-blockers have demonstrated a decreased risk of the occurrence of diabetes in comparison with placebo or conventional...

Tumor angiogenesis

Š. Lukešová, O. Kopecký, J. Dvořák, D. Hlávková, V. Vroblová

Vnitr Lek 2006, 52(9):797-800  

Angiogenesis have shown a major role in tumor growth and metastasis formation. For tumor growth beyond the size 1-2 mm³, angiogenesis must be started to form vascular supply of tumor cells. Angiogenesis is a complex process, involving degradation of the basement membrane of preexisting vessel, proliferation of endothelial cells towards the angiogenetic stimulus, maturation of endothelial cells with formation of luminized capillary, and finally formation of a functional vessel, surrounded by basement membrane and pericytes. Angiogenesis is regulated by numerous angiogenic and anti-angiogenic factors. Hypoxia is a significant stimulus for...

Chronic autoimmune thyroiditis and connective tissue system diseases

Ž. Macejová, K. Benhatchi, I. Lazúrová

Vnitr Lek 2006, 52(9):801-804  

Autoimmune thyroiditis is often related to non-specific autoimmune organ diseases such as Rheumatoid Arthritis, Sjögren's syndrome, systemic sclerosis, Systemic Lupus Erythematosus or polymyalgia rheumatica. Etiology of autoimmune diseases has not been clearly discovered yet. In many aspects, mechanisms leading to organ-specific autoimmune diseases are identic with mechanisms causing organ-nonspecific autoimmune disease. In many cases genetic disposal combined with specific antigens can be seen. Another possible factor in terms of endogenesis is genus. External factors are important too, such as undergoing infection, stress situations, exposion to...

Contrast medium indicated nephropathy

D. Krusová, K. Ševela

Vnitr Lek 2006, 52(9):805-811  

Contrast medium indicated nephropathy (CMIN) is a iatrogenic disorder by which patients become inflicted due to contrast medium exposure. Prevalence of this disorder might increase as more and more diagnostic and intervence radiology has been used. The article is focused on known pathofysiological mechanisms that are responsible for CMIN incidence. There are many risk factors guided by more frequent development of this complication, in particular diabetes mellitus, preexisting renal disease, hypertensis. Plus, the risk of CMIN is much higher in patients with risky medication. Measures to prevent contrast nephropathy coincidence are mentioned; however,...

Pulmonary trombendarterectomy in the patient with the symptoms of massive pulmonary embolism

P. Němec, M. Kaláb, M. Gwozdziewicz, R. Hájek

Vnitr Lek 2006, 52(9):812-814  

The case-report of a 57-year-old patient with the symptoms of massive pulmonary embolism is presented. The patient was admitted to the hospital in the cardiogenic shock, ventilated and with high dose of inotropic support. It was impossible to find out the exact data from personal history. The patient was operated on urgently. The chronic occlusion of the right pulmonary artery due to the chronic tromboembolic disease was found out. Thromboendarterectomy of the pulmonary artery was successfully performed. Three month after operation the patient is in excellent clinical condition almost without any functional limitation. Some atypical features of this...

Traumatic tricuspid regurgitation: case report

J. Bizoň, R. Brát

Vnitr Lek 2006, 52(9):815-818  

Traumatic tricuspid regurgitation is a rare disease owing to penetrating or nonpenetrating thoracic trauma. In the last 40 years, since motorism is increasing, this disease can be seen more frequently. In most cases, rupture of chordae tendinae on the tricuspid valve, damage of the front papillary muscle and rupture of the tricuspid valve leaflets. On an acute stage, the damage of the valve can remain undiagnosed. Later on, the patient might have no symptoms; however, symtoms of right heart failure indicating an operation appear. This case-study is concerned with a patient with traumatic tricuspid regurgitation.

Combination of imatinib and anagrelide in treatment of chronic myeloid leukemia in blastic phase

J. Voglová, V. Maisnar, M. Beránek, L. Chrobák

Vnitr Lek 2006, 52(9):819-822  

Chronic myeloid leukemia in blast phase (BP) is resistant to chemotherapy and majority of patients die within 6 months. Inhibitor Bcr-Abl tyrosine kinase imatinib mesylate dramatically improved outcome of patients in chronic phase (CP) and is also effective in BP of CML. The prognosis of patients treated with imatinib in BP is worse than in CP. High platelet counts are often observed at diagnosis or in the subsequent course of the CML in about 25 % of patients. Thrombohemorrhagic complications associated with the thrombocythemia may be serious. Anagrelide selectively reduces circulating platelets and is used in treatment of thrombocythemia in chronic...

Z odborné literatury

Vnitr Lek 2006, 52(9):838-845  

Eliška Přemyslovna a pivo

Z. Susa

Vnitr Lek 2006, 52(9):834-835  

Za primárom MUDr. Bohuslavom Finďom

Milan Pavlovič

Vnitr Lek 2006, 52(9):836-837  

Generalista a špecialista v internej medicíne dneška

Ľ. Mokrá, J. Murín

Vnitr Lek 2006, 52(9):830-833  

Atherosclerosis and infection?

K. Zeman

Vnitr Lek 2006, 52(9):823-826  

Atherosclerosis is guided by chronicle inflammation process. In the last decades of the 20th century, studies considering infection another possible risk factor of atherosclerosis development were written. Helicobacter pylori, Porphyromas gingivalis, some viruses but most frequently Chlamydia pneumonie are infection agens mentioned in these studies. Some of them emphasize also combined infections caused by more pathogenic factors having influence on vascular inflammation. Serological, epidemiological, histological and imunological studies show the pathogenic influence of acute or chronic infections. Many studies selected makrolid...

Britové odsoudili užití beta-blokátorů u hypertenze

J. Špinar, J. Vítovec

Vnitr Lek 2006, 52(9):827-829