XI. kongres o ateroskleróze

Vnitr Lek 2007, 53(12):1341-1382  

Vztah mezi osteoporózou a celiakií - editorial

J. Blahoš

Vnitr Lek 2007, 53(12):1241-1242  

Celiakie a osteoporóza - je vazba natolik těsná, že vyžaduje akci? - editorial

V. Palička

Vnitr Lek 2007, 53(12):1243-1244  

Srovnání zátěžové echokardiografie a SPECT myokardiální perfuze - editorial

M. Kamínek

Vnitr Lek 2007, 53(12):1245-1247  

Recurrent arrhythmias after catheter ablation of originally paroxysmal atrial fibrillation and results of repeat ablation

M. Fiala, J. Chovančík, R. Moravec, D. Wojnarová, H. Szymeczek, R. Neuwirth, R. Nevřalová, O. Jiravský, J. Januška, L. Škňouřil, M. Dorda, J. Indrák, J. Černý, I. Nykl, M. Branny

Vnitr Lek 2007, 53(12):1248-1254  

Aims:The aim is a description of the recurrent arrhythmias after previous ablation of paroxysmal atrial fibrillation (AF), and the results of a repeat catheter ablation. Methods:A repeat ablation was performed in 76 patients (18 females, 54 ± 11 years) in 96 procedures, which was 21 % out of 362 patients, who had undergone the first ablation for a paroxysmal AF. The endpoints of the repeat ablation were re-isolation of the pulmonary veins (PV) and termination of a spontaneous or induced arrhythmia and restoration of a stable sinus rhythm (SR), and possibly achievement of noninducibility of any arrhythmia. Results:Clinical...

Bacterial infection and its relation to the genesis and course of varicose hemorrhage

L. Husová, J. Juránková, J. Lata, M. Šenkyřík, V. Příbramská, M. Dastych jr, R. Kroupa, D. Králová

Vnitr Lek 2007, 53(12):1255-1264  

Acute hemorrhage from esophageal varices due to portal hypertension is a frequent and serious complication of liver cirrhosis. Bacterial infection may be one of the factors influencing such hemorrhage. Endotoxins may increase portal tension and at the same time result in primary hemostasis disorder, thus becoming one of the causes of hemorrhage. The authors of the paper compared the incidence of bacterial infection in 53 patients with varicose hemorrhage due to portal hypertension with 62 patients with liver cirrhosis and portal hypertension without varicose hemorrhage. At least one pathogen was found in considerable 61.1 % of the total of patients...

Prolactine response to stress in patients with systemic lupus erythematodes (SLE), rheumatoid arthritis (RA) and in healthy controls

C. Dostál, M. Fojtíková, Z. Lacinová, M. Černá, L. Moszkorzová, J. Zvárová, J. Marek

Vnitr Lek 2007, 53(12):1265-1268  

Prolactin is a one of the stress hormones, like the growth hormone, ACTH, cortisol and catecholamins. Among its wide range of functions is the important role of controlling the immune response which is, unlike in the case of cortisol, of stimulatory nature. For this activity, it is monitored as a factor influencing the progress and course of autoimmune diseases. The authors of the paper monitored prolactin response to stress in a normal stress situation, i.e. blood collection. A significant difference was detected between the levels of prolactin in 3 successive blood collections in 30 minute intervals (P < 0.001). Prolactin responded by a prompt...

The treatment of hyperglycaemia in critically ill patients: comparison of standard protocol and computer algorithm

J. Křemen, J. Bláha, P. Kopecký, L. Bošanská, E. Kotrlíková, T. Roubíček, K. Anderlová, Š. Svačina, M. Matias, J. Rulíšek, R. Hovorka, M. Haluzík

Vnitr Lek 2007, 53(12):1269-1273  

Introduction:Hyperglycemia is commonly observed in patients hospitalized on intensive care units. It is has been demonstrated that normalization of blood glucose level using intensive insulin therapy significantly improves prognosis of these patients. The aim of our study was comparison of standard protocol of intensive insulin therapy used on cardiac surgery ICU in General University Hospital in Prague and computer algorithm MPC (Model Predictive Control). Patients and methods:20 patients with glycaemia higher than 6.7 mmol/l at the time of admission to ICU were included into the study, 10 subjects were randomized for standard...

The etiology of upper gastrointestinal bleeding in patients with liver cirrhosis

P. Svoboda, J. Ehrmann, P. Klvaňa, E. Machytka, M. Rydlo, V. Hrabovský

Vnitr Lek 2007, 53(12):1274-1277  

108 patients suffering from the cirrhosis of the liver and acute bleeding into the upper digestive tract underwent a prospective endoscopic examination with diagnostic and therapeutic objectives. The most frequent causes of acute bleeding included oesophagus varices (57.4 %) followed by peptic gastric ulcer (13.9 %) and peptic ulcer of duodenum (11.1 %), then portal hypertension gastropathy (5.6 %), gastric varices (4.6 %), reflux oesophagitis (2.8 %), Mallory-Weiss syndrom (2.8 %) and erosive gastropathy (0.9 %). The endoscopy of the upper digestive tract in one patient resulted in negative diagnosis. 69 % of examinations showed multiple findings...

Differences in Ulcer Location in Diabetic Foot Syndrome

P. Piťhová, H. Pátková, I. Galandáková, L. Doležalová, M. Kvapil

Vnitr Lek 2007, 53(12):1278-1285  

The foot ulcerations are among the most debilitating complications in diabetic patients. The main risk factors leading to the ulcer development are diabetic neuropathy (sensoric, autonomic), limb ischemia (angiopathy), limited joint mobility and teh plantar pressure; the infection plays a role in difficulty of ulcer healing. The aim of our study was to assess the possible differences in location of diabetic ulcers with regard to their origin. In 502 patients during 5 year interval 835 new diabetic ulcers were diagnosed. Methods:Ulcers were divided into 3 groups according to their origin: neuropathic, neuroischemic and ischemic. Results:In...

Monitoring functional disorders of microcirculation using laser Doppler flowmetry in patients with chronic venous insufficiency class 2 according to CEAP classification before and after varicose veins surgery

S. Šárník, I. Hofírek, R. Panovský

Vnitr Lek 2007, 53(12):1286-1295  

Introduction:Laser Doppler flowmetry is a sensitive modern method for evaluating the function of small veins which allows for the detection and assessment of early pathological changes in microcirculation. The method uses a low power laser beam which is emitted into the tissue where it is reflected and further recollected and analysed. The objective of the study was to compare laser Doppler flowmetry parameters for patients with chronic venous insufficiency (class 2 according to CEAP, primary varices) prior to and 1 month after surgery of varicose veins. Methodology and patient sample:The examination was performed by a Periflux...

Celiac disease - a frequent cause of "idiopathic osteoporosis" in premenopausal and early postmenopausal women

Ľ. Kubincová, J. Payer, Z. Killinger, I. Mačugová, K. Beráková

Vnitr Lek 2007, 53(12):1296-1302  

Introduction:Celiac disease (CD) is an autoimmune disease with a wide variety of clinical symptoms. Osteopathy is its possible manifestation in adulthood. Objective:Verify the assumption, in view of contradictory literary data concerning serological screening for CD in osteoporosis, that the screened group could be women with idiopathic osteoporosis diagnosed in premenopause or within 5 years from its onset. Patient sample and results:We examined 52 patients with idiopathic osteoporosis detected by a DXA test of LS or the femur in premenopause or within the maximum of 5 years after menopause for the presence...

Dobutamin exercise echocardiography versus SPECT in diagnosing ischemic heart disease

G. Valočik, I. Majerčák, P. Mitro, V. Tóthová, I. Marin

Vnitr Lek 2007, 53(12):1303-1309  

The aim of the study was comparison of dobutamine stress echocardiography with SPECT in the assessment of ischemic heart disease. Methods:It is a retrospective study analysing 119 patients (72 women and 47 men, mean age 56.9 ± 10.68 years), who underwent dobutamine stress echocardiography and SPECT. Because of inconclusive findings (LBBB, decreased myocardial perfusion by SPECT depending on the position of the body), 23 patients were excluded. Results:In the whole group of 96 patients the diagnostic validity of dobutamine stress echocardiography was as follows: sensitivity 78 %, specificity 93 %, positive predictive...

Diabetes mellitus and microalbuminuria

D. Krusová

Vnitr Lek 2007, 53(12):1310-1318  

Microalbuminuria is considered as an independent predictor of cardiovascular morbidity and mortality and is a general marker of endothelial dysfunction. Microalbuminuria is the indicator of the incipient phase of diabetic nephropathy in diabetes mellitus, and especially in the type 1 diabetes mellitus patients. Progressive continuously growing albumin secretion into the urine is a generally recognised criterion for determining the degree of diabetic renal affection. The modern definition of diabetic nephropathy therefore includes increased cardiovascular risk which - if not treated - is accompanied by progressive decrease in renal functions related...

Current view on the risks of artificial pulmonary ventilation

R. Kula, P. Sklienka, V. Chýlek, P. Szturz, J. Neiser

Vnitr Lek 2007, 53(12):1319-1324  

There is no doubt that artificial ventilation of lungs seems to be proven as life-saving manoeuvre, whereas a growing amount of evidence is presented and published recently that artificial ventilation cause damage to patient by so far unexplained mechanism - by conversion of mechanical stress to biochemical signals inducing local and systemic inflammatory response, which is wide spreading and causing multiple organ dysfunction syndrome (MODS). Higher mortality of patients with acute lung injury on MODS rather than acute respiratory failure itself can be explained just by these findings. The article is brief summary of recent opinions of mechanism of...

Waldenström macroglobulinemia - clinical manifestations and differential diagnosis and prognosis of the disease

Z. Adam, J. Šmardová, V. Ščudla

Vnitr Lek 2007, 53(12):1325-1337  

Waldenström macroglobulinemia is defined by the presence of IgM type monoclonal immunoglobulin and histological prove of lymphoplasmocytary lymphoma in the bone marrow. Clinical symptoms of the disease depend on the pressure on the bone marrow by the malignant clone with subsequent cytopenia, extramedullary infiltration and toxic manifestations of monoclonal immunoglobulin. 6q deletion and absence of translocation in the sphere of the heavy immunoglobin chain gene, which is otherwise typical for other lymphoproliferative disorders, is the typical cytogenetic abnormality. The text describes the symptoms of the disease and the issues of its differential...

II. interní klinika Lékařské fakulty MU a FN u sv. Anny v Brně oslavuje 60. výročí svého vzniku

M. Souček, P. Svačina

Vnitr Lek 2007, 53(12):1338-1339  

O ztrátách a nálezech s odstupem

P. Bravený

Vnitr Lek 2007, 53(12):1339-1340