Vnitřní lékařství, 2007 (vol. 53), issue 2

Editorial

Pankreatikopleurální píštěle - editorial

J. Skřičková

Vnitr Lek 2007, 53(2):111

Chirurgická ablace fibrilace síní: budoucnost kardiochirurgie? - editorial

J. Kautzner

Vnitr Lek 2007, 53(2):112-115

Original articles

Residual echocardiographic findings and NT-proBNP in asymptomatic adult patients after radical correction of Fallot's tetralogy

T. Zatočil, J. Maňoušek, T. Brychta, A. Nečasová, J. Špinar

Vnitr Lek 2007, 53(2):116-122

Objective:Define the profile of NT-proBNP values in asymptomatic adult patients after radical correction of Tetralogy of Fallot (TOF) and identify links between possible increase in NT-proBNP and residual echocardiographic findings. Methodology:NT-proBNP samples were taken from and a detailed echocardiographic examination was performed in 21 adult stabilised patients after radical correction of TOF in childhood. The results were submitted for statistical analysis. Results:The incidence of low values of the S wave < 11.5 cm/s of tricuspid anulus evaluated by tissue Doppler echocardiography (TDI) (P < 0.05)...

The impact of secondary insertion of ePTFE-coated stent on sustainable TIPS patency

V. Jirkovský, T. Fejfar, V. Šafka, P. Hůlek, V. Chovanec, A. Krajina, J. Raupach, M. Lojík

Vnitr Lek 2007, 53(2):123-128

Objective:Retrospective evaluation of the effect of secondary insertion of ePTFE-coated stent in the treatment of TIPS dysfunction versus other current options (simple angioplasty, insertion of additional non-coated stent). Patient set and methodology:From the beginning of 2000 to the end of 2004, there were 121 interventions for TIPS dysfunction performed in our centre in which a non-coated stent was used to make up the shunt at the time of intervention. Depending on the type of intervention, the patient set was divided in 4 groups: simple angioplasty (52 cases, 43 %), insertion of non-coated stent (35 cases, 28.9 %), insertion...

Low-dose thalidomid in refractory and relapsing multiple myeloma

J. Radocha, V. Maisnar

Vnitr Lek 2007, 53(2):129-134

Introduction:Thalidomide is one of the drugs which are newly used in the therapy of multiple myeloma. Its immunomodulating action and a number of additional effects have been proven in the treatment of advanced and refractory stage of the disease. However, the best dosing scheme has not yet been discovered and is the subject of research in a number of clinical studies today. Patients and methods:On a retrospective basis, we evaluated results for 59 patients with multiple myeloma who were treated with thalidomide in our facility (median dose of 100 mg), in monotherapy or in combination with corticosteroids, between 2000 and...

Pancreaticopleural fistula

P. Jakubec, V. Kolek, V. Procházka, M. Konečný, T. Jakubcová

Vnitr Lek 2007, 53(2):135-142

Pancreatic diseases are often accompanied by pleuropulmonal complications. Acute pancreatitis may induce a number of various pathological findings in respiratory tract including hypoxemia, decrease of transfer-factor (DLCO), decrease of transfer-coefficient (DLCO/VO), decrease in forced expiratory flow 25 % - 75 % of forced vital capacity (FEF25-75 %), elevated and/or immobile diaphragm, basal atelectasis, unilateral or bilateral pulmonary infiltrations, mediastinal pseudocyst and pleural effusion. Acute respiratory distress syndrome (ARDS) is the most dangerous complication of acute pancreatitis. Large, recurrent pleural effusion is sometimes present...

Paradoxical Embolization and Patent Foramen Ovale in scuba divers: screening possibilities

T. Honěk, J. Veselka, A. Tomek, M. Šrámek, J. Januška, L. Šefc, R. Kerekeš, Š. Novotný

Vnitr Lek 2007, 53(2):143-146

Introduction:The cause of decompression sickness (DCS) in scuba-divers is bubble formation in tissues and in venous blood during ascent. Divers with patent foramen ovale (PFO) have an increased risk of paradoxical embolization to the brain or other vital organs. The aim of our study was to assess the incidence of PFO in scuba-divers with DCS, to compare the group with asymptomatic controls, and to evaluate ultrasound contrast methods suitable for screening. Methodology:We examined 28 scuba-divers (more than 100 dives). The right-to-left shunt detection was performed by bubble contrast transthoracic echocardiographic examination...

Clinically manifest gastrointestinal bleeding in patients subject to coronary angiography

V. Kojecký, Z. Coufal

Vnitr Lek 2007, 53(2):147-150

Patient set and methodology:The authors evaluated the incidence of acute bleeding from the upper gastrointestinal tract in 5,955 patients (of which 3,684 men and 2,271 women) during hospitalisation for coronary angiography, and the incidence of potential sources of bleeding from the upper gastrointestinal tract in the patients without bleeding. Results:Bleeding occurred in 9 persons, within 3.4 ± 3.6 days of the coronary angiography (the median of 1.0 day), with a 33 % mortality rate. An ulcer of the duodenal bulbus or bulbitis were detected in four cases (44 %), esophagitis in one case (11 %), esophageal varices in...

Long term effectiveness of surgical cryoMAZE ablation for chronic atrial fibrillation in patients undergoing surgery for severe mitral valve regurgitation

R. Neuwirth, M. Fiala, P. Branny, J. Novosad, M. Urban, O. Jiravský, J. Chovančík, R. Nevřalová, M. Branny

Vnitr Lek 2007, 53(2):151-156

Objective:The objective of the study was to evaluate effectiveness of surgical cryoMAZE ablation for chronic atrial fibrillation (AF) in patients undergoing mitral valve surgical intervention. Methodology:Forty-seven patients (31 females), aged 67.3 ± ± 7.3 years who underwent surgical intervention for severe mitral regurgitation were studied. Mitral valvuloplasty was performed in 21 patients, and mitral valve replacement in 26 patients. Combined procedure was employed in 35 patients; simultaneous aortocoronary bypass was performed in 16 patients, tricuspid valvuloplasty (TVP) in 5 patients, and aortic valve...

Guidelines

Czech Atherosclerosis Society Guidelines for the Diagnosis and Treatment of Dyslipidemias in Adults

H. Vaverková, V. Soška, H. Rosolová, R. Češka, R. Cífková, T. Freiberger, J. Piťha, R. Poledne, T. Štulc, Z. Urbanová, M. Vráblík

Vnitr Lek 2007, 53(2):181-197

The present guidelines are based on the recommendations published in 2005 entitled "Prevention of Cardiovascular Diseases in Adulthood" summarizing the conclusions of nine Czech medical societies and agree with them in the assessment of individual risks of mortality from cardiovascular disease (CVD) according to SCORE tables. They reflect new research data in pathophysiology of dyslipidemias (DLP) and particularly the results of recent clinical trials of lipid-lowering therapy and their meta-analyses. They establish priorities for the screening and management of DLP, present suitable diagnostic methods, additional investigations of potential use in...

Reviews

Dysfunction of transjugular intrahepatic portosystemic shunt (TIPS) and applicable solutions

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

Vnitr Lek 2007, 53(2):157-163

A synoptic article providing a comprehensive view of TIPS dysfunction. The article covers current terminology, definition, etiology, pathogenesis, diagnostics, therapy and prevention of TIPS dysfunction.

Encapsulating peritoneal sclerosis

L. Fantová, R. Šafářová, S. Vaňková

Vnitr Lek 2007, 53(2):164-168

Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis (PD) characterized by extensive peritoneal fibrosis and bowel obstruction. Opinions on its etiopathogenesis diverge. It appears that the performance of peritoneal dialysis itself and the exposition of the peritoneum to non-physiological influences (the incidence increases in proportion to the length of peritoneal dialysis treatment) is an important factor. Yet there is also patients' individual sensitiveness, which apparently depends on individual immunological response. EPS causes severe changes in peritoneal anatomy and functions, resulting both in the loss of...

Fever of unknown origin - etiology and diagnostic algorithm

A. Křivanová, Z. Adam, J. Mayer, P. Husa, Z. Fojtík, J. Skřičková, Z. Řehák, J. Vorlíček

Vnitr Lek 2007, 53(2):169-178

Fever of unknown origin is a frequent and significant diagnostic problem often faced by physicians. The first part of the text is dedicated to its definition and wide-ranging aetiology. On the one hand, fever may be a banal and benign condition, on the other, it can be the symptom of a life threatening disease. The second part presents our suggestions for diagnostic approach to fever of unknown origin. We believe this text may become a useful tool for this extremely complex and interesting differential diagnostic. In view of extension and complexity of the topic, the text of this part is presented in full.

From scholarly literature

Kalita Z et al. Akutní cévní mozkové příhody. Diagnostika, patofyziologie, management

Stanislav Voháňka

Vnitr Lek 2007, 53(2):202

Safar ME, O'Rourke MF (eds). Arterial stiffness in hypertension

Pavel Jerie

Vnitr Lek 2007, 53(2):202-203

Veselka J et al. Hypertrofická kardiomyopatie a příbuzná témata

Jiří Vítovec

Vnitr Lek 2007, 53(2):203-204

Válek V, Kala Z, Kiss I et al. Maligní ložiskové procesy jater. Diagnostika a léčba včetně minimálně invazivních metod

Petr Dítě

Vnitr Lek 2007, 53(2):204

Krajsová I. Melanom. Klasifikace, diagnostika, terapie, prevence

Hana Jedličková